Birth Write

Remembering the Pearls of Mothering Advice

2009-05-12T09:33:00.000-07:00

As a new or expecting mom, it seems you are open to a lot of unwanted and un-asked-for advice. It's easy to feel overwhelmed by it all. It's hard to sift through it and figure out what to listen to and what to toss. Sometimes we even feel resentful when we heed someone's advice and find that it really doesn't work for us. And often, the well-meant tips and suggestions leave us feeling judged and inadequate. But sometimes, we stumble on some great wisdom and we're grateful that someone shared it with us.

Sunday was my 4th Mother’s Day and in that short time (oh but it seemed long, didn't it?) I am amazed how often I've completely changed my mind about parenting specifics. As I look back, I begin to see that my parenting boils down to a few generalities and otherwise, there is a lot of room for improvisation. Always. There isn't a lot of advice that remained constant through it all. Yet, if I had to pinpoint three things that I’m glad someone told me as a new mom they would be:

Sleeping

Whether you co-sleep or use a crib in another room, whether you parent to sleep or teach baby to self soothe, whether you believe in schedules or flexibility, it is helpful to know this:

Little babies can only be up for about two hours before they are tired again. Knowing this can make all the difference in how your days unfold. Knowing this can soften sleep struggles. Take note of when they get up and watch them after about two hours. It’s easier to put a sleepy baby to bed than to fight a baby who is either over-tired or not tired at all.

Eating

If you can, breastfeed. It’s the best choice for mom and baby. There are health benefits for both of you. But more importantly, it’s not just a way of feeding baby. It’s a beautiful relationship. It’s not always easy and there are definitely areas where support could be improved from community, employers, governments and often, families and friends. But it’s worth it. If you are struggling, find help from La Leche League, Dr. Jack Newman, Kellymom, a lactation consultant or public health nurse. You’ll be glad you did.

Parenting

Do What Works. I learned this from my older sister, mother of four. This means do what works for your family. Trust your gut and if something is working for you, keep doing it. Don’t worry about what other people or experts think you should be doing. Just do what works. And be ready to change your methods because what works today might not work tomorrow. What works for this child might not work for the next one. Parenthood is an ever changing evolving practice. It will take lots of rearranging to strike a balance between what works for your kids and what works for you but if you keep at it, you can’t go wrong.

How about you? What pearls of wisdom were you grateful for as a new mother?

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International Day of the Midwife

2009-05-05T14:18:00.000-07:00

Today is International Day of the Midwife. This special occasion is near and dear to my heart. Both of my children were born with the help of midwives and I have spent the last 3 years spreading the word about how wonderful they are.

I exhibited at the 2007 Canadian Association of Midwifery conference in Vancouver. The conference was held in Vancouver that year to also celebrate the 10th anniversary of the legalisation of midwifery in BC. At the conference, I bought a t-shirt that quickly became my favourite (coincidentally, I was even wearing it when I went into labour with my daughter last year) because of the colour, the fabric (organic cotton) and the message - 10 years of Registered Midwives. When I wear this t-shirt I often get asked if I am a midwife (sadly, the answer is no) and I always reply, "No. I just really like midwives!"

Most of my friends have also had the opportunity to experience midwifery care so I occasionally get the mistaken impression that it's more widespread than it is. Ann Douglas recently shared some of the results of the Canadian Maternity Experiences Survey and I was shocked to discover that only 6.1% of births are attended by midwives.

I was well aware that though Vancouver struggles with a shortage of midwives I was lucky to live there because other communities have no midwives at all. I fervently believe that we need more midwives. Even so, I didn't realise the numbers were as low as they are.

The theme for this year's International Day of the Midwife is The World Needs Midwives Now More Than Ever and you can read some info about this from a global perspective at the International Confederation of Midwives website.

What does the picture look like in Canada?

Midwifery is legal and government funded in the Western provinces and Ontario and Quebec. However, the territories and Maritime provinces are still struggling to have midwifery recognized and paid for through the healthcare system.

Province	Regulated	Provincially funded	Practising midwives	Link
British Columbia	yes	yes	120	bcmidwives.com
Alberta	yes	in process*	30	albertamidwives.com
Saskatchewan	yes	yes	5	saskatchewanmidwives.com
Manitoba	yes	yes	40	midwives.mb.ca
Quebec	yes	yes	100	canadianmidwives.org
Ontario	yes	yes	450	aom.on.ca
New Brunswick	in process	no	1	canadianmidwives.org
Nova Scotia	in process*	no	7	canadianmidwives.org
PEI	no	no	1	canadianmidwives.org
Newfoundland and Labrador	no	no	n/a	canadianmidwives.org
Yukon	no	no	1	canadianmidwives.org
Northwest Territories	yes	yes	3	canadianmidwives.org
Nunavut	in process	partial funding	3	canadianmidwives.org

Source: Today's Parent, March 2009

Some good news:
Despite government regulation since 1998, Alberta just agreed to publicly fund midwifery. The deal was finalized in early April of this year.

Nova Scotia has also proclaimed the Act Respecting Midwifery but have limited coverage to only a few districts within the province.

Some bad news:
The shortage of midwives is quite real and according to this recent Maclean's article on the Midwife Crisis, it is just a part of a larger crisis within maternity care in Canada. The article's byline goes so far as to say that "it's a bad time to have a baby in Canada."

And in Ottawa, despite the fact that Ontario is one of the provinces that recognizes and funds midwifery care, there's been a major step backward - the Ottawa Hospital has closed its doors to midwives.

What Can You Do To Support Midwifery in Canada?

Spread the word—tell your friends, family, co-workers about midwifery

Share positive stories about midwives, doulas and birth

Donate to your local midwifery association

Join an advocacy group:
- Midwifery Coalition of Nova Scotia
- BORN PEI
- Yukoners for Funded Midwifery
- Learn more about midwifery in our northern communities - Inuit Midwifery Network
- Association for Safe Alternatives in Childbirth

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Creating Community at Home and in School

2009-03-21T20:09:00.000-07:00

Healthy Families Conference Announcement

Vancouver, BC – On April 18-19, 2009 educators and parents from across the Pacific Northwest will gather to participate in an event designed to inspire, support, and connect the amazing individuals who contribute to building community for our children at home and in school.

Conference visionary Margo Running, of LifeWays Childcare Society, is launching this new conference in Vancouver because she hears educators and parents asking the same questions: “How do we simplify, slow down in order to give quality time to our children, in our home, in our care and in our school? How do we create a community around our children?” Margo says this two-day conference is packed with presentations, breakout sessions, workshops, discussion groups, and meals that will create a collaborative and participatory setting; each participant will gain a toolkit of resources and contacts.

The Healthy Families Conference is aiming to provide individuals with the skills and strategies they need to nurture strong relationships within their families and create strong ties for children within their community and is the first of its kind in Vancouver.

This conference has attracted some of the biggest names in parenting and early-childhood development. Peggy O'Mara (Editor/Owner of Mothering Magazine - Santa Fe, New Mexico) jumped at the chance to come to Vancouver for the opportunity to connect with this diverse audience of parents and educators; Peggy will be speaking on Finding & Creating Community.

Event Details – Healthy Families Canada is hosting the conference at the UBC Student Union Building (6138 Student Union Boulevard) on April 18-19, 2009. Registration is available online at www.healthyfamiliescanada.org and individuals can register at the early-bird rate of just $200 prior to March 15, 2009 (group discounts are also available). Questions about the conference can be sent to info@healthyfamiliescanada.org.

Media Contact – If you are a member of the media and would like to learn more about emerging stories regarding the Healthy Families Conference or would like to interview Margo Running or Peggy O’Mara please contact Corwin Hiebert by phone at 604-803-2019 or by e-mail at: corwin@redwagonmanagement.com.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Breastfeeding Furor Post Script

2009-03-21T13:39:00.000-07:00

The furor continues after The Atlantic published Hanna Rosin's op. ed. The Case Against Breast-feeding this month.

Some of the latest news:

MSNBC picked up the article to spread it further into the mainstream consciousness. At the end of article there's an option to discuss it on Newsvine. Have a look at the comments. Many thank yous from women who themselves couldn't or didn't want to breastfeed. All these women who did not or could not breastfeed applaud The Case Against Breastfeeding because it makes breastfeeding the villain and assuages their own guilty consciences.

Brings me to the point Dr. Newman makes about guilt and breastfeeding. He says "In order to prevent women feeling guilty about not breastfeeding what is required is not avoiding promotion of breastfeeding, but promotion of breastfeeding coupled with good, knowledgeable and skillful support."

Once again, we have to remember that difficulties breastfeeding are not because breastfeeding is the problem; it is usually because mothers are not getting the support they need from spouse or family, the work place, the community, health care practitioners, the government...the list goes on.

Of course, The Academy of Breastfeeding Medicine issued a statement this week in rebuttal. You can read it here.

Here also is the response from the American Academy of Pediatrics:

In the article, "The Case Against Breast-Feeding" by Hanna Rosin, the author skims the literature and has omitted many recent statements including the 2005 statement of the American Academy of Pediatrics which supports the value of breastfeeding for most infants.

This policy references every statement with scientific evidence from over 200 articles which meet scientific standards for accuracy and rigor. The statement was meticulously reviewed by the Section on Breastfeeding, the Committee on Nutrition and numerous other committees and approved by the Board of Directors of the Academy. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries, a study released by the Agency for Healthcare Research and Quality (the AHRQ Report) strongly supports the evidence of benefits demonstrated in the breastfeeding research.

The evidence for the value of breastfeeding is scientific, it is strong, and it is continually being reaffirmed by new research work.

The American Academy of Pediatrics encourages women to make an informed decision about feeding their infants based on scientifically established information from credible resources.

David T. Tayloe, Jr., MD, FAAP
President, American Academy of Pediatrics

Thank you to Tanya Lieberman at Motherwear's Breastfeeding Blog for posting that. Her response is also well worth a read as she tackles some of the scientific claims.

And here is a joint letter to the editor of The Atlantic from the United States Breastfeeding Commitee.

I'm interested to see a round up of the blog posts and articles that address Rosin's science. I think there should be something forthcoming from Phd In Parenting who also put together a collection of the voices who responded to the feminist issues in the original article. Thank you to Annie for including us in such great company.

And just for fun, Hathor the Cow Goddess's take on it all.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

The Case Against Doing It All

2009-03-17T22:15:00.000-07:00

I don’t consider myself a lactavist. I didn’t call the CBC when I was asked to move into a change room at Superstore while nursing my daughter. I have not been to a nurse-in. I have never smuggled breastmilk onto a plane.

I do think that breastfeeding is a normal natural beautiful act. I breastfeed my daughter anywhere I choose. I don’t let people’s opinions or rude looks stop me. I will breastfeed in a restaurant. At my table. Without a cover. I exclusively breastfed both of my children to 6 months. I continued with my son until he was 2.5 years old and probably will with my daughter as well. I fervently believe that it is the best and in most cases should be the ONLY choice for feeding our children.

Why?

Because I distrust processed food. Because just like I prefer to make my own food from scratch as much as I can, I also prefer to give my babies the food that is specially made for them. I believe that if my body is making it for my baby, it’s obviously the best thing to give her. I trust this million year old evolutionary biological process way more than I trust Nestlé. Because I am amazed that the composition of breastmilk changes depending on the time of day and depending on if my baby is a preemie or a toddler. Because I’ve seen the list of ingredients of breastmilk and I’ve heard that they don’t even know what it’s all for or how to replicate it in formula. Because I believe that there is a purpose for all of those ingredients even if science and medicine hasn’t been able to figure it out yet. Because I don’t doubt that they would find a link between every single one of the components of breastmilk and better human functioning in some area (physical, cognitive, emotional) if it were ethically and humanly possible to do so. Because I believe that the act of breastfeeding is about so much more than food.

So it was with utter dismay that I read Hanna Rosin’s recent article for The Atlantic, The Case Against Breast-feeding. The article is so ridiculous and odious that my husband even suggested that it may be a farce, another attempt by the author to have a little game with us, just like she did on the playground. Farce or not, I couldn’t remain quiet.

I have to warn you that I won’t even have a chance to tackle Rosin’s research and studies because I have so much to say about her attitude. And to be honest, I don’t give a damn about the studies she quoted. Personally, I think that science has a long way to go in explaining most human functions from breastmilk to the brain. Inconclusive studies about the power of breastmilk are not going to convince me that evolution was flawed when it came up with mammals.

The tone of The Case Against Breast-feeding is sarcastic, resentful and bitter and I can’t help but wonder why Rosin is so unhappy. She writes about how it is “hard not to seethe” as she breastfeeds her new baby while her husband sleeps, about being “unreasonably furious” at her husband as he leaves her “stuck at home breast-feeding.” She writes about what the What to Expect authors can expect her to do “with this damned fork” (Ok, fair enough, I can’t stand the What to Expect books either) and about wanting to “hit {people} with a two-by-four.” Wow. Really? Why are you so angry Hanna?

When I start to dissect her article, it really doesn’t seem that breastfeeding is the issue. To me her article reads like the whiney self-pitying diatribe of a woman who is unhappy in her marriage, has few real friends, is not supported to breastfeed by her mother, dislikes all the women on the playground and resents her children for interrupting her career and her life. Okay, so now I have to take back the whiney and self-pitying part because wow, that really does sound sad and my heart goes out to such a woman. To be fair to Rosin I have experienced episodes of the rage, loneliness, “crying jags” and cursing at husbands that she writes about but I realise that those times don’t sum up my breastfeeding experience. I really don’t understand how breastfeeding became the scapegoat in this story and I struggle to forgive someone who can damage years and years of work in public health trying to raise breastfeeding rates just because she is unhappy with her life.

Acceptance
The whole article begins with the way Rosin felt at the playground. She witnessed firsthand how judgmental her so-called friends and fellow moms on the playground could be. Of course, she is busy judging right back. She tries to be funny as she describes the “urban moms in their tight jeans and oversize sunglasses” and ridicules their “signifiers” (“organic content of snacks, sleekness of stroller and ratio of wooden toys to plastic”) but she comes off just as awful as she tries to portray them. She talks about her “mother friends” in a way that doesn’t sound like they are her friends at all.

Mothering criticism is definitely running rampant these days; Rosin is right to bring it up. Lord knows I’ve felt it. And stooped to it. We all need to work a little harder to accept each other. That’s a post on its own right there. Yes, moms need to cut each other some slack but that doesn’t amount to a case against breastfeeding (even if it is the major point we judge each other on—“the real ticket into the club” as Rosin puts it).

Breastfeeding Rates
Rosin goes on to wonder why every woman she knows “has become a breast-feeding fascist.” Apparently Rosin only associates with a very slim percentage of the population if every woman she knows is a breastfeeding fascist. In the US, only 17 percent of babies are still breastfed at 6 months. Rosin quotes the breastfeeding rates in the States triumphantly: “breast-feeding is on the rise—69 percent of mothers initiate the practice at the hospital, and 17 percent nurse exclusively for at least 6 months”—as if to say “How much higher can they really go?” I personally find these numbers shockingly low, especially when you consider that those women who initiate the practice in the hospital may not even stick it out past a week or two.

Meanwhile, 83 percent of mothers are NOT breastfeeding for 6 months. These are the women that the Department of Health and Human Services are trying to target with the ad campaigns that Rosin hates so much that she would wean her child out of spite. The tv ads may be tacky and the print ads may be extreme but they are up against big bucks formula companies (with marketing dollars and Washington lobbyists). Ms.Rosin, they are also up against people like you who do so much damage by suggesting that breastfeeding is holding women back from all the things they want to be doing. The ads are a desperate bid to squeak that 17 percent just a little higher.

Rosin herself explains that “the numbers are much higher among women who are white, older, and educated.” Exactly. Like the women Rosin describes in her “playground set” with their “Baby Einstein videos, piano lessons and the rest.” I would wager that the other 83 percent of the population who give up on breastfeeding after initiating it includes all the women who are working because they have to, not because they have a feminist axe to grind.

Class Struggles
Rosin explains that formula was demonized in the 70’s because South American and African studies showed that formula fed babies were more likely to die. “The mothers, it turned out, were using contaminated water or rationing formula because it was so expensive. Still, in the US, the whole episode turned breast-feeding advocates and formula makers into Crips and Bloods,” she says. Oh, I see. It wasn’t really the formula’s fault. It was the mothers. For being poor. For using dirty water. And besides, it isn’t relevant because it wasn’t in the US. As long as you can afford it and have access to clean water, formula isn’t a bad thing—is that what Rosin is saying? That sounds a little elitist coming from the same woman who (rightfully) derides breastfeeding campaigns that encourage working mothers to pump at work for being unrealistic for the lower classes (waitresses and bus drivers).

And her point about wanting to hit people who say that breastfeeding is free with a two-by-four because that means a woman’s time is worth nothing? Well, for the working poor, a woman’s time is only worth $6.55 an hour (US federal minimum wage – 28 states have minimum wage that are either the same or less than the federal rate). If she buys the cheapest formula at Walgreen’s, it is $9.99 for 105 fl. oz. and her three month old baby will go through it in 4-6 days. So on top of the time it takes to feed her baby she is spending almost 2 hours every week working just to buy the formula. And that doesn’t even get into the number of hours she has to work to pay for her childcare.

Of course, Rosin who talks about launching Web sites, answering cell phones, the luxury of working part time from home, and even having a husband to curse at over division of labour is coming at the whole article from the perspective of the privileged. As she herself says, she is “too privileged for pity” so how does she know the real cost of formula?

Working Moms
Rosin doesn’t even question whether or not the same mother who can’t pump at her waitressing job can even afford to buy formula. Rosin focuses all her anger on breastfeeding and the people that she feels are pushing it down our throats. She brings up the American Academy of Pediatrics’ 1997 policy recommending that babies be breastfed to 1 year (still only half of what is recommended by the WHO) and explains that the National Organization for Women “complained that this would tax working mothers, but to no avail.” The real question is not what a woman’s time is worth (and whether she should spend it nursing her baby) but rather, why are so many new mothers working?

Rosin implies that public health officials should have tempered their child health policies to make it easier on working mothers. I would like to suggest that the problem in the United States is actually that the lack of solid maternity leave is taxing breastfeeding mothers. It certainly is difficult to breastfeed your baby to 6 months or a year when your country’s maternity leave would have you back at work when your baby is 12 weeks old (if you can even afford to take those 12 weeks off unpaid).

Support
Of course, a good maternity leave is only one aspect of the broader issue which is the need for support. Rosin herself appears to feel alienated and unsupported in her attempt to breastfeed. “Being stuck at home breast-feeding as he walked out the door for work just made me unreasonably furious, at him and everyone else,” she says. “So I was left feeling trapped,” she says. She likens her life to a prison. Her mother pesters her about whether her breastfed children are getting enough to eat. She is obviously uncomfortable with breastfeeding in public: “There I was, sitting half-naked in public for the tenth time that day, the hundredth time that month, the millionth time in my life.”

Doesn’t she realize that all the books, lactation consultants, support groups, public health campaigns, and legislation that she is tearing down with her sarcastic and mean words all exist to try to help the women who feel alienated and unsupported? All these people are working so hard to try to make the general public understand that breastfeeding moms have a huge job that is hard and often lonely, that breastfeeding in public is acceptable, that no one should have to stay home and breastfeed all the time, that mothers need help with the hours of breastfeeding they put in. They are trying to make these women feel supported. And they don’t expect you to stay away from your mother. They just want her to realise that her comments don’t help.

Feminism
But for Rosin anyway it sounds like the problem isn’t one of lack of support, but rather of feminist discontent. Her angry ranting unfortunately discloses way too much about her own feelings about children and her husband for my comfort level and tells me in no uncertain terms that she resents breastfeeding (and by extension, her children) for the inequalities in her marriage and for her inability to focus on her career.

“But fear not, You,” she says, “The root of the problem is not the sudden realization that your ideal of an equal marriage, with two parents happily taking turns working and raising children, now seem like a farce.” Who is this You she is talking to? It feels like maybe this is her own issue, especially when you see how often it comes up. I already mentioned how she seethed at her husband in the night, how furious she was that he got to go to work. She goes on to say that she “was raised to expect that co-parenting was an attainable goal. But who were we kidding?” Okay, so she resents the fact that her feminist ideals of marriage are perhaps unrealistic? Fair enough.

But listen to the way she talks about raising children:

“after three children and 28 months of breast-feeding (and counting), the insistent cheerleading has begun to grate.”

“This time around, nirvana did not describe my state of mind: I was launching a new Web site and I had two other children to care for, and a husband I would occasionally like to talk to.”

“So I was left feeling trapped, like many women before me, in the middle-class mother’s prison of vague discontent: surly but too privileged for pity, breast-feeding with one hand while answering the cell phone with the other, and barking at my older kids to get their own organic, 100 percent juice”

“With her first child, for instance, a mother may be extra cautious, keeping the neighbor’s germy brats away and slapping the nurse who gives out the free formula sample. By her third child, she may no longer breast-feed…Maybe she is now using day care, exposing the baby to more illnesses. Surely she is not noticing that kid No.2 has the baby’s pacifier in his mouth, or that the cat is sleeping in the crib (trust me on this one). She is also not staring lovingly into the baby’s eyes all day, singing songs, reading book after infant book, because she has to make sure that the other two kids are not drowning each other in the tub.”

She uses words like grate, prison, trapped, germy brats, slapping and barking to describe raising children. She talks about 28 months and counting of breastfeeding. Maybe she should stop counting and try to enjoy it. She says that by her third child, she is not staring lovingly into the baby’s eyes. Maybe she should have stopped at two children then.

Rosin closes her article with a most jarring tribute to breastfeeding after more than 5000 words in her case against it. She says “breast-feeding does not belong in the realm of facts and hard numbers; it is much too intimate and elemental. It contains all of my awe about motherhood” and yet that is the only indication in the whole article of any kind of enjoyment, let alone awe of motherhood. The only positive thing she says about breastfeeding or her children is the last sentence: “But I also know that this is probably my last chance to feel warm baby skin up against mine, and one day I will miss it.”

She spends the rest of her article comparing breastfeeding to the vacuum in keeping women downtrodden, lamenting that there aren’t more women in “positions of serious power,” complaining about pumping at work as a newspaper reporter, and as mentioned above breastfeeding while answering the cell phone and launching a new Web site while caring for two children and a nursing baby. Hmmm. Maybe the problem isn’t breastfeeding but thinking we can have it all? Maybe it’s this unrealistic feminist ideal that is the problem. Maybe Rosin is upset because she is realizing that we can’t have it all, that we do have to make choices and sacrifices.

Rosin’s feminist rhetoric fumes about a woman’s time being worth nothing and yet it is the feminists themselves who decided that the work of mothers was not valuable, the ones who said that we should all want to get out and work with the men.

Personally I think it’s time for a new brand of feminism, a feminism that says that the most amazing work a woman can possibly do is to bear, nurse and raise her babies, a brand of feminism that says that if you want to work outside the home you can but you might have to make some tough choices, a brand of feminism that says a woman’s time IS worth something and a mother’s time is invaluable. I think feminism has done us a major disservice by saying that we should be able to work AND raise kids AND have time for ourselves. The simple biological truth is that child bearing and nursing must fall to women so now with our quest for workplace power we have the pressure to do everything. No wonder we are tired and stressed out and alienated. No wonder Rosin resents breastfeeding. Because the reality is that breastfeeding and motherhood (at least while our children are young) are pretty much a full-time job. It’s hard bloody work and yes, it’s really frustrating to do all that while holding down an outside job too.

Let me be clear here. I am NOT saying that mothers shouldn't work. I am saying that the demands on today's mothers are unfair; the bar has been set too high. My own feeling is that breastfeeding shouldn't really be a choice. That is, as much as possible, with a huge margin for medical difficulties and other issues like lack of support, breastfeeding should be one of those things that is a given for parents - just like providing shelter, food, love and schooling as our children grow. Because pregnancy, birth and breastfeeding fall to the females, there will undoubtedly be times in a woman's life where she has to choose between working and mothering. The first year after the birth of a baby is one of those times. If maternity leaves allowed mothers to stay home and focus on their babies while they need to be breastfed, women might find it easier to balance work life and family life. The problem is not breastfeeding. The problem is the lack of programs and support for women who want to prioritize breastfeeding. The problem is the expectation that no one should have to make those choices, that women should do everything.

Rosin needs to look in the mirror and consider if it really is breastfeeding that she is so disenchanted with. The illusion of co-parenting is not shattered by breastfeeding. The illusion crumbles because the expectations on women are unrealistic and unfair. As Rosin’s life became more complex breastfeeding seemed to her an unbearable burden but she never stops to ask why she took on so much. In The Case Against Breast-feeding, breastfeeding became the unfortunate scapegoat in our society’s quest to have it all.

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Technicolor Birth Memories

2009-03-05T10:11:00.000-08:00

I have just started reading Ina May's Guide to Childbirth. The first 1/3 of the book consists of birth stories, mostly from women associated with or at The Farm in Tennessee. The stories are varied, representing women from differing backgrounds but most are extremely positive and uplifting, beautiful.

Birth stories often have a play-by-play quality (first this happened, and then this, and then I said this and then...) as mothers recount every little detail. Other times, they are too short, only giving a general account of what happened. Despite this, I always love to read them.

As I read Ina May's Guide I was struck by some of the women's vivid memories of very small details of the day their children were born:

I looked at the clear blue November sky and the brown oak leaves and basked in the warmth of the sun.
~ James's Birth

I remember the way the wind blew up the stairwell as I walked down with my beautiful son. Then the thunder and lightning began, and it started to pour rain, making everything cool and comfortable.
~ Otis Francisco's Birth

It was quite comforting to curl up next to my man, listening to the sound of the woodstove crackling.
~ Mulci's Birth

These tiny details, usually just a sentence here or there are what brought the stories to life for me. Some of the women talk about how the world was more vivid and clear, crisper than it had ever been before. I had never thought about it in quite that way before but as I remember my children's births, I realise that this is exactly true. The world, or at least certain parts of it, were in sharp focus. I have very vivid memories of a few small moments, sensations that will be with me all my life.

The day my son was born I remember the look of the lake, still and calm, reflecting the Indian Summer sunrise with the promise of a little more warmth before winter.

The day my daughter was born - I remember the rattle and hum of yet another load of towels and sheets in the dryer mingling with the shouts of children floating in the open window. I remember the early evening midsummer light, sun still high at 8:00 pm. I remember baby potatoes with dill from the garden.

I wonder about your experiences. What tiny detail is etched in your consciousness? If everyone shared their one bright moment, what kind of variation will we see? Will there be a difference between home birthers and hospital birthers?

Join the discussion on Facebook or post your comments here.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Review: The No-Cry Nap Solution

2009-02-22T14:55:00.000-08:00

Usually I am wary of sleep books. My three year old son has resisted sleep since he was five months old. We tried everything. We read books. We struggled. Sometimes we just gave in and accepted that he wasn’t a sleeper. Somewhere in there I gave up on all advice about getting children to sleep. I quit reading the books and I followed my older sister’s tried and true parenting adage “Do What Works.” Since then we’ve added a family member (8 month old daughter) and we’ve seen that there are both similarities and differences in our children’s sleep personalities. We’ve attempted to do things a little differently with her and sometimes we’ve been successful and sometimes we haven’t.

Along came Elizabeth Pantley’s new offering, The No-Cry Nap Solution – Guaranteed Gentle Ways to Solve All Your Naptime Problems. Having read The No-Cry Sleep Solution when my son was a baby, I already respected Pantley’s approach and philosophies. She is well recommended by the docs (dad and sons) over at Dr. Sears and I respect her tireless efforts to spread the word about gentle ways to get your child to sleep. I too am fervently opposed to the Cry-It-Out approach so despite giving up on sleep advice, Pantley remained one of my favourite parenting authors.

The newest book in her No-Cry series did not disappoint in the least. Like previous offerings, this book is well-researched, sensitive and practical. She includes in-depth explanations about baby and child sleep patterns and about the science and benefits of naps. These sections were extremely helpful, provided several Aha! moments and paved the way for me to re-evaluate our daily schedule for both our pre-schooler and our baby. It gave me the background information I needed to discover why certain methods were working and others weren’t.

After some general discussion about sleep and naps, the rest of the book is organized around specific challenges and solutions. Each challenge is explained and followed by more than one way to solve it. The bonus here is that a busy mom doesn’t have to sit down and read the book cover to cover. After the first few chapters, it is easy to flip to the section that applies to you and come back whenever your situation changes to try something new. As long as you can get past the distracting references to other pages in every chapter, this small paperback will become a treasured reference book to come back to over and over.

Because the book is written for a general audience, it may feel daunting when the list of possible causes to catnaps includes so many possibilities that you don’t know where to begin. My daughter’s frequent wakings could be caused by teething, impending developmental leap (crawling) or separation anxiety. My son’s inability to settle for a nap could be caused by being over-tired or not tired enough. But Pantley is thorough; rest assured that she has guaranteed gentle suggestions for every possible scenario that you might face. Gentle solutions are not always easy solutions though and The No-Cry Nap Solution is certainly not a quick-fix manual. Some of Pantley’s suggestions have to be done over and over again before they work. It might take five times unlatching your nurse-to-sleep baby before you can sneak away. You might have to try several different methods before finding the one that works for you.

Sometimes a sleep-deprived parent will feel like it’s easier to just do what’s been working. Which brings me to my favourite thing about Elizabeth Pantley and The No-Cry Nap Solution: Pantley accepts that all families are different and she repeatedly asserts to do what works for you. She offers the log sheets and schedules to fill out and then says to go ahead and skip them if they don’t suit your personality. She describes sleep challenges like a baby that will only nap in arms and then explains that not all families will consider that a challenge. Her No-Cry Process for Peaceful Problem Solving was like a page torn from my parenting manifesto:

"Address only those problems that are true problems to you, and don’t create or imagine problems because someone else thinks you have them, no matter if that person is family, friend or expert."

As always, Pantley proves sensitive not only to differing parenting approaches and family situations but also to the child. Her suggestions are always gentle and never designed to cause the child distress and yet she recognizes that parents need practical ways to get their children to sleep so they can re-charge too. Her approaches are balanced and realistic in that the goal is rest for both parent and child.

The book is peppered with quotes and photos from real-life parents. The photos are sweet and sometimes funny. The quotes give a tired, frustrated parent hope, a glimmer of light at the end of a dark sleepless tunnel. Both give the book added credibility. The science and research are wonderful but it’s the fact that Pantley has tested these ideas on real families (209 in 18 different countries) that makes it feel like they might work in my own.

Amazingly, many of Pantley’s solutions did work for us, despite our track record. Some suggestions were new to us and have worked their magic in only a couple of short weeks. Others show promise but are not paying off just yet. Still others were old tricks that we found on our own through trial and error. Imagine my surprise when I read solutions in the book that I had learned to employ in our family while struggling with sleep for three years. It was like a message telling me that I do know what I’m doing. And thankfully for all of us, so does Elizabeth Pantley; this book is one more great reason why she is the trusted resource for all parents looking to help their children sleep better.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

So tell me...

2009-02-13T15:01:00.000-08:00

...Why would a woman want to have an unmedicated birth?

What a great question! And beautifully answered here by fellow blogger at Feminist Childbirth Studies.

Thank you to Sarah at Birth Matters Virginia for sharing.

Why did you want to give birth unmedicated? Leave a comment with your answer or join the discussion on our Facebook Group.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Beautiful Breastfeeding Resources

2009-02-13T14:31:00.000-08:00

Just a quick post to share some wonderful breastfeeding resources I came across today. These were posted on the BC Baby-Friendly Network as resources for World Breastfeeding Week in October 2008. There are all kinds of interesting things including posters for your workplace, clinic or shop, a doorhanger for a new mom that on the front reminds guests that mom and baby are resting and explains on the back how to nurse side-lying and a list of all the ingredients in breastmilk among other things.

I particularly liked this great Motivational Breastfeeding Poster Series:

Support - large or small
Satisfaction - large or small
Protection - large or small
Preferred - large or small
Healing - large or small
Family - large or small
Connection - large or small

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Birth Video Contest

2009-02-10T15:30:00.000-08:00

Do you feel strongly about the need for mother/baby-friendly maternity care? Do you want to win $1000?

Check out this video contest from Birth Matters Virginia. It will be judged by Ricki Lake and Abby Epstein of The Business of Being Born and by author/birth expert Dr. Sarah Buckley. Contest closes on Mother's Day, May 10, 2009. All contest rules and info can be found here. You can also join their Facebook group to learn more.

You don't need to be a filmmaker to enter. Birth Matters is encouraging amateurs to enter as well and the site has suggestions and tips for those who've never made a film before.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

The Birth Survey

2009-02-10T15:01:00.000-08:00

US Mamas:

Some of you may know about this already; it went national in August 2008. It's worth posting here just to continue spreading the word. I have utmost respect for these kinds of initiatives and really wish that we could do this in Canada too.

Non-profit organization the Coalition for Improving Maternity Services (CIMS) has started a project for collecting feedback on maternity care in the United States. You can take the survey to share your experience/information and you can also access data about the caregivers in your area so that you can make informed decisions as you choose your practitioner and your care facility.
From the Birth Survey website:

The Transparency in Maternity Care Project was birthed in February of 2006 by the Grassroots Advocates Committee (GAC) of the Coalition for Improving Maternity Services (CIMS). We are a volunteer group dedicated to ensuring public access to quality of care information specifically related to maternity care providers and institutions. It is our intention to extend the current social trend toward transparency in health care into the virtually overlooked maternity care arena.

The Birth Survey is structured around the Coalition for Improving Maternity Services (CIMS) evidence-based 10 Steps to Mother-Friendly Care and other quality of care indicators. The creation of The Birth Survey has been inspired by Childbirth Connection's Listening to Mothers Survey (Harris Interactive, October 2002) and the A-CAHPS (Ambulatory Consumer Assessment of Healthcare Providers and Systems) program and surveys.

We believe that women of childbearing age must have access to information that will help them choose maternity care providers and institutions that are most compatible with their own philosophies and needs. We hope that the Transparency in Maternity Care Project will provide information that will help women make fully informed maternity care decisions.

We also believe that maternity care practitioners and institutions must have access to feedback from their patients. We hope that doctors, midwives, and hospital administrators will find the information generated through the Transparency in Maternity Care Project useful in quality improvement efforts.

Women need accurate, objective data in order to make fully informed choices about birth settings and providers. Practitioners and hospital administrators also need data to evaluate whether they are delivering quality care. We hope this project will fill a void by providing much needed information that benefits all parties engaged in maternity care.

Take the Survey. View Survey Reports. View Intervention Rates. Spread the word. Or just learn more about the project. The Birth Survey.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Should You Write A Birth Plan?

2009-01-23T14:54:00.000-08:00

I have been working on a re-design and update of our main website Sweet Home lately and that has me fairly busy, especially with the new routine juggling work with two children at home and with the current sleep deprivation issues. I have been doing some research for a new page on Birth Plans and was surprised this past week when I went to get a haircut (gasp!) and read Modern times: Don't be so pushy - Making a "birth plan" is about more than being prepared. It's about being in control. Here's why letting go of all that is way harder – and that much better by Katrina Onstad in Chatelaine at the salon.

I couldn't decide how I felt about the piece. On the one hand, here was a mainstream national magazine that was talking about midwifery in a very off-hand way, as if it is becoming the norm and I do agree with the main message which is that "sometimes the best plan is no plan at all." It's important to not get too caught up in the whole plan part of the birth plan because, well, we really can't plan our births. She is right to say that when it comes to birth we have to expect the unexpected and not get overly attached to our vision of the ideal birth.

But then again, something rubbed me the wrong way. I mean, it was easy for her to say that the best plan is no plan at all when she had lucked out with an unmedicated natural birth which left her feeling like she "had birthed the universe." A beautiful way to put it, but not necessarily how other mothers feel when they end up with a horrifying intervention-filled birth. The author suggests that the reason these mothers feel disappointed is because they have too many expectations going into it. Plan or no plan, aren't these mothers entitled to mourn unnecessary medical interventions? Perhaps Ms. Onstad would be writing a completely different article had she endured a 36 hour labour that ended in a cesarean birth while under general anesthetic. You can bet she'd be researching and making birth plans for her second birth.

There is something hypocritical about this romanticization of her own birth when the article's theme clearly seems to be that "the romanticization of the birth moment is not good for women" (as quoted by cesarean mom Judith). This statement erroneously puts the blame for all these disappointed women on the women themselves, for having plans and expectations. Despite mentioning the rising rates and risks of cesarean birth, Onstad neglects to suppose that labor mis-managment and the cascade of interventions could be the culprits for all the disappointment.

Finally, Onstad makes a huge mistake by thinking that creating a birth plan to speak for you regarding your consent to medical procedures equates to an inability to submit to the forces of labour. She says:

I was completely and totally out of control, but that moment of submission – totally without any expectation of anything – held the greatest power I've ever experienced.

Is it not possible to still have that moment of submission while ensuring that your medical rights aren't violated? What if Onstad's birth had left her feeling that all her power had been stripped from her, that her body had been violated, or that she couldn't protect her baby from painful or scary procedures?

The difference in these two situations is that in one case the mother submits to the forces of labour, her birth and nature and in the other the mother must submit to the power of the medical system, which unfortunately isn't omniscient. Having a birth plan is a way of exercising your right to informed consent in your most vulnerable moments, not a way to avoid submitting to the unknowable.

I was divided over whether or not to post the article but I couldn't stop thinking about it, particularly because I loved the dialogue between the article and a blog post I found from one of the commenters.

Phd in Parenting wrote a lovely thoughtful (and a little irate) piece in response to the Chatelaine article. She makes an extremely valid point that when you trust your care provider and are anticipating birthing with a midwife, whose model allows for submission to, not management of, the birth process, you perhaps don't need a birth plan. But for anyone else, especially those birthing within obstetrics, a birth plan is a wise decision.

I wanted to recommend both of these as a great read together. It will really get you thinking about how you feel about birth plans. I have to say that personally, I think that rather than expecting the unexpected, it's wiser to plan for the unexpected. Then you can submit to the birth process, knowing that your care providers will respect your wishes regardless of what happens.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Sneak Peek at Pantley's New Book

2008-11-26T15:31:00.000-08:00

Just wanted to share with you how excited I am that I have been selected to review an advance copy of Elizabeth Pantley's new book The No-Cry Nap Solution. I should be getting my copy in early December and I look forward to reading it and sharing my thoughts with you. It's especially timely for me as I have been struggling with a few nap issues with my children so I really can't wait to get my copy.

From the publisher:

The No-Cry Nap Solution: Guaranteed Gentle Ways to Solve All Your Naptime Problems

Bestselling parenting author brings her solutions to your naptime dilemmas

Will your child only nap in your arms, in a swing, or after elaborate rituals? Does your child take cat naps--or none at all? Let world-renowned, trusted parenting author Elizabeth Pantley help you. She'll guide you with the same sensitive expertise and gentle approach used in her other No-Cry bestsellers.

Research shows that naps improve health, mood, growth, and well-being. Yet children often resist the naps they need. The results are fussy, crying babies and cranky, grouchy kids who also have trouble sleeping at night!

In The No-Cry Nap Solution Pantley explains to parents of children ages newborn to kindergarten the importance of napping to both behavior during the day and sleeping during (and through!) the night. She then shares with you her gentle, loving techniques--tested on families of all sizes and circumstances--and shows you how you can customize her solutions for your own family. Pantley addresses issues such as children who resist naps, dealing with schedule changes, turning short naps into longer ones, helping a child go from needing motion to sleep to "stationery"� sleep, nursing at naptime, solving daycare napping problems, and more.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Vancouver Screening Big Success!

2008-11-26T15:16:00.000-08:00

This isn't exactly NEW news but I'm trying to get caught up on some of the things that have happened in the months surrounding the birth of my daughter.

More than 200 people made it out to the Special Vancouver screening of Ricki Lake's Business of Being Born at the Rio theatre in April. As a result, Sweet Home Birth Boxes and Birth Lounge were able to donate $900 to SMILE (Support for Young Mothers Integrating Love and Education).

Thank you to the ladies of Birth Lounge, Rebecca of Titania Productions and to everyone who came out to the screening for making the event a great success!

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Birth & Breastfeeding News

2008-11-13T14:58:00.001-08:00

Dr. Jack Newman's Clinic Needs Your Help

Dr. Jack Newman is a pediatrician, former consultant to the UNICEF Baby Friendly Initiative, and world renowned breastfeeding advocator. His books, handouts, videos and consulting at the clinic have helped countless mothers achieve long-lasting breastfeeding relationships despite challenges,conflicting advice and unsupportive health practitioners.

As of September 30, 2008, the clinic will no longer be receiving any private funding. (Government funding ceased in 2005). They need immediate donations to keep the clinic open and their website (with all of their educational resources) online. For a charitable tax receipt, please send your donation to www.canadianbreastfeedingfoundation.org. Please direct your donation to NEWMAN BREASTFEEDING CLINIC. You can also call 416-498-0002.

Alberta Midwifery Receives Government Funding

In October, the Alberta government announced that midwifery will finally be funded. Though regulated by the government since 1998, families have had to pay out of pocket for midwifery care. As of April 2009, families will now be able to choose midwifery care and their birth place with the service covered. This is great news for midwifery and home birth. Click here for more information.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

It's been a very long time...

2008-11-13T14:51:00.000-08:00

The reason bloggers often don't blog is because they are too busy. You know, IRL - in real life. I am no exception. Life intervened for a while. At the end of June, we welcomed our daughter Noa in a beautiful, speedy, midwife-assisted home birth. And two weeks later we moved to Vancouver Island. The last few months we've been focusing on our family, on discovering who this newcomer is and on helping our three year old son adjust to the major changes.

But I'm back, at least on light duty, after a long hiatus. There is a lot of news to catch up on.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Dr. Phil Looking for Home Birth Horror Stories for his show.

2008-09-19T15:44:00.000-07:00

Dr. Phil has a page on his website asking for people to share their stories of having a home birth and regretting it.
Please click here to add your POSITIVE story. Maybe he'll be flooded with stories of good outcomes and have no material for the story of regret he's looking for.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Home Birth Under Attack in America

2008-08-04T15:42:00.000-07:00

ABC News reports that the American Medical Association is supporting proposed legislation that would effectively ban home births. Resolution 205 supports the American College of Obstetricians and Gynecologists' position that home births are not safe.
Read the story...

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Savvy Mom Baby Shower Gift Guide

2008-04-09T14:25:00.000-07:00

Our Baby Bath Box was chosen as a SavvyMom Pick for the Dream Baby Shower Gift Guide. If you live in the Greater Toronto area you can enter to win all of the items in the guide. And if you live elsewhere, you can pick up one of our Baby Bath Boxes in the SHOP for the next baby shower you have to attend!

The Baby Bath Kit is 100% natural just like your baby. Everything you need to keep your baby clean, sweet smelling and cozy. All products are natural or organic.

Contents:

1 Bamboo hooded towel
5 Bamboo washcloths
1 Angel Baby Shampoo & Body Wash - 160mL
1 Angel Baby massage oil - 30 mL

Why Bamboo? Find out the benefits of bamboo.

Find out why you should choose natural skin care products.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Special Vancouver Benefit Screening of the Business of Being Born

2008-04-01T10:09:00.000-07:00

You are invited to a special benefit screening of:

April 6, 2008 ~ 1 pm
Rio Theatre
1660 East Broadway (at Commercial Drive)
Vancouver, BC

Tickets: $10 at the door

The Birth Lounge and Sweet Home Birth Boxes are pleased to present a special screening of the Abby Epstein/Ricki Lake documentary, The Business of Being Born. The screening will be followed by a question and answer period about the issues the film raises with a panel that includes a family practice physician, a registered midwife and a birth doula. All proceeds of the screening will go to SMILE, a non-profit organization that gives prenatal care to young mothers.

Let all of your friends in Vancouver know about this special event!

If you are on Facebook, you can invite your friends from the event page: http://www.facebook.com/event.php?eid=24457412440.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Until next year...

2008-03-12T14:36:00.000-07:00

We had a great time at Birth Fest this year. There were even more vendors, great music and storytellers for the kids and lots of prizes! It sure is exciting to see how much local talent we have in Vancouver.

Thought I'd share the photos of our display for those who didn't make it.

Click to Enlarge

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Midwives Now

2008-02-26T09:43:00.000-08:00

Some vocal Pomegranate midwifery clients from the Sea-to-Sky Corridor are demanding that midwives become integrated into the maternity care services there. They have put together a website for their cause: www.midwivesnow.com. On the site there is a letter they have written to send to their MLA as well as some prominent members of the Vancouver Coastal Health Authority to expedite the integration of midwives. Please sign this letter in their support.

Pomegranate has been accepting patients from communities such as Squamish and Pemberton since they opened their doors two years ago, and many of these woman have to drive long hours and traverse natural obstacles to get the care that they rightfully deserve to have close to home. There are midwives who are eager to set up their life in the Sea-to-Sky Corridor and offer comprehensive maternity care to women and families.

Please forward the weblink to others who agree that solving the maternity care crisis in BC includes integrating midwives across the province.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

We'll See You at BirthFest!

2008-02-22T16:00:00.000-08:00

We are exhibiting at BirthFest again this year. The second annual celebration of bellies, birth and babies is co-sponsored by Birth Lounge, Britannia Community Centre and Eastside Family Place. This free event is for the whole family – live music, local maternity care services, local vendors and more.

Last year we had so much fun. The gym was packed despite the downpour outside. Kids were dancing, parents were chatting, prizes were won and there were great vendors showcasing their wares. We are really looking forward to being a part of it again this year.

Britannia Community Centre
Gym D
March 8th from 10am – 3pm.

For more information visit www.birthlounge.com

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Voices: What Story is Your Birth Story Really Telling?

2008-02-06T10:57:00.000-08:00

I recently had the opportunity to share the story of my son’s birth with a university class on Child Development during Infancy (conception-3 years). The students are in their early twenties and many had never seen a birth before nor had any prior exposure to the basics of childbirth.

As I wrote out my story, I became increasingly aware that I couldn’t just tell it the way I remembered it. I had to bear in mind that the students would be forming impressions about childbirth from my words. I had an opportunity to cut through the noise of birth as pain and talk about what else it can be, beyond just a physical experience. I realized that to be taken seriously I would need to acknowledge that birth IS painful but I also decided to focus on the experience itself: preparations, perceptions, emotions. I spoke about why I chose to have a homebirth in a rational way so that my words would not be brushed aside as those of someone “brave” or “radical.”

I had to make very calculated decisions about what to say and what not to say and I got to thinking about the stories our birth stories really tell. Is it a story of fear, pain, control, joy, courage, triumph, peace, dignity, sorrow? Do the details we give and the words we use convey what we intend? Are we aware of our audience when we casually explain about the day we gave birth? Do we pay attention to the fact that there might be a young pre-teen girl there who is soaking it up? What do we want listeners to take away from our tales?

In a culture where birth is a medical event, we owe it to future families to tell a positive empowering story if we can. Young women today are bombarded with stories on tv and in the media of childbirth as being so painful and dangerous that the only way they will get through it is by putting their trust in the authorities, giving up the power in their bodies and taking the multitude of drugs offered to manage their birth safely. We can help shape future mothers’ perceptions of birth by carefully choosing our words when we talk about ours. Regardless of the circumstances—whether it was a blissed out waterbirth or a cesarean for breech presentation—we are the ones who tell our stories. We can choose to be positive and inspiring or to instill fear and dread. It’s your story.

If you are interested, you can read my story here.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!

Reflection

2008-02-06T10:52:00.000-08:00

What story does your birth story tell?

Is your birth story always the same?

Do you adjust the details of your story depending on who you are talking to?

Does your story focus on positive emotions?

Could you make your story more inspiring?

Does answering these questions bring up any unresolved feelings that you might need to work through?

Post your comments or send us an email so we can publish excerpts in upcoming newsletters. We would love it if you email us your birth story to be posted on the Sweet Home Community.

Sweet Home Birth Boxes - the supplies you need no matter what your birth plan includes!