Welcoming The Babies

In Bali, at the birth of each babe, the midwives and all in attendance would begin to sing this song.  As the babe was crowning, it was very important to begin singing.  I fumbled along but never really got the words stuck into my brain like I wanted them to be.  This time around, I want to sing along knowing both the words and their meaning.  The midwife did explain to me something along the lines of, "we are welcoming each babe.  telling them we recognize the god in them."

For me, seeing words spelled out really helps to understand a language.  If I spell your name, when we meet, I am likely to recall it!  So, seeing the song spelled out is helping me to memorize it.  I am so stoked to sing along this time.  Oh, wait!!!  I am tone deaf.  I don't know a beat or a rhythm.   All memebers of my immediate family have asked me to stop singing at one point.  It's true.  This holiday season, as I sang Ezra Jack Keats' version of "The Little Drummer Boy", my Ez asked me to "just read it, mom."  Now, what?  Sing anyway and ruin the otherwise melodic births of these precious babes?  Or just spell it in my head as I hum or mumble along inside pleasantly happy enough to finally KNOW the words.

The babes at Bumi Sehat hear these words being sung over them:

Om Bur Buvah Suvaha
Thath Savithur Varenyam
Bhargo Devasya Dhi-Mahi
Dhiyo Yonaha Prachodayat

What does it mean, you ask?  Well, I asked the same!  It means:

Oh God! Thou art the Giver of Life, Remover of pain and sorrow, The Bestower of happiness, Oh! Creator of the Universe, May we receive thy supreme sin- destroying light, May Thou guide our intellect in the right direction.

And, just for clarity, not every single babe hears these words first.  Why not?  It is tradition for the Muslim dads to whisper The Call to Prayer into their babe's right ear.  We are all quiet to honor this.  Everyone, including the dad, perhaps has been singing up until this point sometimes.  But, if we know the family is Muslim, all gets quiet for the dad to whisper.  I have seen it done with tears streaking down the dad's cheeks as he is so full of joy in welcoming his precious babe just as we, the birth attendants are.

Beautiful Mama of Multiple Babes

Charity by Adolph William Bouguereau

Merry Christmas

 Today will be a fabulous day, one where my family celebrates the birth of a sweet babe.

If you are looking to get crafty today, this looks like a beautiful project to do.

Matchings...Oops

First, let me share with you a blog post that makes me want to be a more consistent blogger and just a truer human mama person.  It's from my long-distance rockin' mama friend.  She even rocks in labor and birth, trust me, I was (HONORED TO BE) there to witness.

One of the bear's favorite books is Sandra Boynton's "Blue Hat, Green Hat" which ends in the word "oops". She reads it to herself on a daily basis now. One of her other favorite things (and e's, too) is to have matchings with her sister. Whether it is clothes, crayons, shoes or food portions, they both really like to have the same.

So, being a mama that really enjoys the visual imagery of Hanna Andersson dresses, I ordered them matching red snowflake dresses.  Now, I did not go to the official website to order them but rather spent time on ebay bidding frugally on matching reds.  The bear's came first and one for e came later.  If you know about Hanna, they are European sizing which my brain doesn't always compute.  So, the dress for e that came was a tad too big.  We laughed for a long time as she tried it on, already knowing it would fit Maggie better than ez.

Huge ole dress.  And, yes, the bear does have her dress on backwards and with a pair of pants that I put in the give away pile a week earlier.  Doesn't get much better.  We are awesome.

Somehow, the dress did get turned around but e never did get one in the right size.  Oops.  She really didn't seem to mind, at least.  Merry Christmas!  

Jumping Beans

In mid-air, she leaps from the ledge to the ground.  Why?  B/c it is just the right height to be jumped from, of course.

Getting sister in on it is the best part.  Even a sister dressed in silly ole boy clothes.  Yes, she is not two years old, yet and already loves wearing her boyfriend's shirt.  What's a mama to do?  Have him over for a slumber party, of course!  If they are going to get hitched one day, I have to start teaching him how to wait on her hand and foot like all good partners do for each other.

Love that they held hands through the whole jump.  Precious.

Then, they found an empty box and jumped into it for a while.

Until it needed to be transformed into a boat for lots more play.  Oh, happy evening.  

The joy on both of our faces and the loving hold.  And most of all, the plastic kids headband (bought for holding pig ears in place at halloween) that gets put on me practically every day when I pick it up off the floor-couch-counter-desk-stairs-table and don't have enough hands to lug it to the bathroom drawer where it "belongs". 

While You Were Sleeping

This must have happened in that marvelous time when I sleep in while Glammi takes care of my girls.  Love it.

They are all so happy just doing this!

Our Winter Garden?

Ez found this cucumber in our garden the other day.  what in the world?

Silly Pictures Part II

Celebrating Advent with my Mom

We go this book last year about Little Bear, which introduces a new character each day who is following the star.  One day, I would love to create my own calender to go along with the story line.

Granny Jenny rode the train down to see us for a few days.  We were grateful to spend time with her and to not have to make a trip up to Richmond right now with all the other travel we have coming up.  And, yes, that is the shrek advent page in the aforementioned book.

We should all be so excited about a toothbrush and some xylitol, eh?

Where we burn off some steam before bath, bed and beyond.

My sister sent a stuffed christmas bear to each of the girls.

Snuggling with her eza girl.

Silly Pictures

a lil tree

The girls and hubby picked out a tree while i was at a midwifery workshop.  It's a precious little one. 

Sometimes the bear is a huge fan of takings pics and other times (like in this pic), not so much.

We've gotten live trees in the past but this year, they chose to get a cut one.  It's decorated with ornaments from each year of our family's life together and quite a few from my childhood.  I have a handful of ornaments from 1985; must have been a good year for me.

 

As embarrassing as this is, the girls are enthralled by Shrek The Halls.  It's a book that I got when E had a huge crush on Shrek from watching all 3 movies in Bali while I was busy having morning sickness and being horizontal on the floor beside her.  She laughed hysterically at the movies.  It's been a while since she saw them and the Bear doesn't really watch movies before getting bored and bouncing around.  But, this book makes them giggle still.

This is usually our nature table.  Not a whole lot of nature perhaps right now.  We light a small candle with each week of advent.

3 bears

EFM Response

Jackie says here:

"It turns out that there are indeed Prospective Randomized Controlled Trials done on EFM that go all the way back to the ’80s. By 1987 there were 8 or so of those “gold standard” trials published in authoritative journals in the US and Europe, including one from ‘86, in the British Medical Journal, comparing EFM with intermittent listening, and all the studies were summarized in the Lancet, December 12, 1987 (the intermittent listening was done with fetascope or Doppler, and differences between those two methods were not distinguished).

This meta-analysis showed unequivocal results, since all the studies came to the SAME CONCLUSION: EFM has only one constant and significant statistical effect: it increases the rate of cesarean section. The studies showed that there was no beneficial effect on fetal health, or on fetal outcomes. NONE. It does not identify more babies at risk than intermittent listening, or identify and save babies from CP, or turn compromised babies into healthy ones or save baby’s lives any more than simple intermittent listening. Therefore, the ratio of benefit-to-risk was negative in that it caused an increase in c-section without any benefit to mother or baby.

Yet today and every day, EFM machines churn away in every L&D, and no laboring mother is ever told that it’s just fine to have someone just listen to her baby’s heart rate every half-hour, or that she can request, and indeed insist, that she have intermittent monitoring. And of course, no one ever tells her that if she stays connected to the monitor, her chances of c-section go up. Even more distressing is the fact that no matter how ACOG re-analyzes and renames and re-categorizes FHR monitoring, as in the new practice bulletin, they will never come out and say.”Don’t use continuous monitoring because it has proven negative consequences”…that pesky increase in the rate of cesareans.

Here’s a really upsetting study published in the American Journal of Obstetrics and Gynecology that the Times will never mention: since obstetricians really couldn’t believe that observing every fetal heartbeat on a strip isn’t helping the health of babies, they thought that more training in interpretation of the monitor tracings would be the answer. So a study was done to find out if special training for obstetricians and perinatologists could reliably identify babies in trouble by using continuous monitoring. Here’s the citation in case you want to check it out: “Intrapartum nonreassuring fetal heart rate tracing and prediction of adverse outcomes: Interobserver variability”. American Journal of Obstetrics and Gynecology, doi 10.1016/j.ajog.2008.06.027[Abstract]. And here’s the conclusion of that study: even special extra training of experienced maternal-fetal medical professionals does not help predict or identify which babies would be compromised. It’s not just that they disagree because training is useless or because experts can disagree…it’s that they disagree because EFM is useless… or, as the researchers state: “intrapartum FHR (EFM) monitoring is not a useful diagnostic test…” If the effect of a procedure is neither neutral nor beneficial, if it has indeed been shown to have risk, i.e., lead to increased, and by implication, unnecessary c-section, how can the use of EFM on every woman every day in this country have any ethical justification.

ACOG says, in Practice Bulletin #76, “Despite its widespread use, there is controversy about the efficacy of EFM. Moreover, there is evidence that the use of EFM increases the rate of cesarean and operative vaginal deliveries. Given that the available data do not clearly support the use of EFM over intermittent ausculation, either option is acceptable in a patient without complications.” (Obstetrics and Gynecology, Intrapartum Fetal Heart-Rate Monitoring 106 (6), 1463-1561.) They can remove what they like from their own prior literature, but Amy is correct in that they cannot erase the studies already out there for years. Is it ethical for ACOG even to call EFM an “acceptable option”? ACOG wants everyone “to be on the same page”? Maybe intermittent listening is the page all should be on!! Let’s not even begin to talk about “defensive” medical practices!"

ACOG Issues New Practice Bulletin on Continuous Electronic Fetal Monitoring

From Our Bodies, Ourselves:
July 9, 2009

ACOG Issues New Practice Bulletin on Continuous Electronic Fetal Monitoring

Posted by Rachel

This is going to be a long one, readers, so sit tight!
The American College of Obstetricians and Gynecologists (ACOG) has issued a new practice bulletin on continuous electronic fetal monitoring in labor. Given how thoroughly this practice has been embraced by obstetricians – it was used in more than 85% of births in 2002, up from 45% in 1980 – some readers may be surprised by the bulletin’s strong statements about potential harms of and lack of evidence supporting its use.
Continuous electronic fetal monitoring (cEFM) was introduced in the early 1970s in the hopes of reducing certain complications such as cerebral palsy or fetal death, which were believed to occur because the fetus wasn’t getting enough oxygen. However, these expected benefits were not demonstrated prior to cEFM becoming nearly ubiquitous in obstetrics. As a New York Times piece on the bulletin points out: “Continuous monitoring became a standard obstetrical procedure before studies could show if the benefits outweighed the risks, and without clear-cut guidelines on how doctors should interpret the findings.”
The authors of the ACOG bulletin explain that – in weighing the evidence now – the efficacy of cEFM should be “judged by its ability to decrease complications, such as neonatal seizures, cerebral palsy, or intrapartum fetal death, while minimizing the need for unnecessary obstetric interventions, such as operative vaginal delivery or cesarean delivery.” [emphasis added]
Because there are no randomized trials comparing cEFM with other monitoring methods, the benefits “are gauged from reports comparing it with intermittent auscultation” [periodic listening via stethoscope].
The report states that cEFM does not reduce the risk of perinatal mortality or of cerebral palsy. It is thought to reduce the risk of neonatal seizures by about 50%; these seizures are estimated to occur in about 1 in 500 neonates, with a good prognosis for most patients. On the risk side,  the authors very clearly note that cEFM increases the risk of c-section, and the risk of vacuum and forceps operative delivery.
Given these findings – though with a caveat that current practices for frequency of monitoring may make it logistically difficult under some current models of labor management and hospital staffing – the bulletin states:

Given that the available data do not show a clear benefit for the use of EFM over intermittent auscultation, either option is acceptable in a patient without complications.

The old practice bulletin has already been withdrawn, so it’s difficult to compare exact changes, but an ACOG press release explains that “One notable update in the guidelines is the three-tier classification system for FHR tracings (print-outs of the fetal heart rate).” The authors defined three categories of tracings with specific clinical criteria for each; they are normal (no action required), indeterminate (further evaluation and surveillance needed), and abnormal (requiring prompt evaluation).
Interestingly, the guideline does not recommend immediate cesarean section for the Category III tracings. Instead, it indicates that initial evaluation and treatment may include discontinuation of labor stimulating drugs, cervical exam to check for things like umbilical cord prolapse, changing the woman’s position, monitoring her blood pressure, and assessment of uterine contractions. They further explain that “If a Category III tracing does not resolve with these measures, delivery should be undertaken.”
The authors also explain that “Our goal with the ACOG guidelines was to define existing terminology and narrow definitions and categories so that everyone is on the same page.” This may be necessary in part because providers may often interpret fetal monitor strips very differently from one another, as evidenced here:

For example, when four obstetricians examined 50 cardiotocograms, they agreed in only 22% of the cases. Two months later, during the second review of the same 50 tracings, the clinicians interpreted 21% of the tracings differently than they did during the first evaluation. In another study, five obstetricians independently interpreted 150 cardiotocograms. The obstetricians interpreted the tracings similarly in 29% of the cases, suggesting poor interobserver reliability.

Continuous fetal monitoring may have become commonly used in part because clinicians hoped to avoid malpractice judgments. If there is little agreement between clinicians looking at these tracings, and little evidence of fetal benefit, however, that rationale may need to be discarded. The NY Times piece points out that “Monitoring results are widely used by lawyers to bolster malpractice cases of spurious merit” – in other words, a technique that clinicians have widely adopted with the hope that it would protect them and their patients may instead have a negative effect on their careers, finances, and (last but not least) patients.
Overall, the practice bulletin agrees pretty well with what advocates (including OBOS) have been saying for some time, by addressing reducing women’s exposure to unnecessary procedures, clearly outlining the risks and lack of many assumed benefits of continuous EFM, suggesting that the high tech option isn’t always better, acknowledging that providers may err and vary, and providing the possibility of initial measures that don’t involve going straight to c-section. It’s too early to tell what the response to this ACOG bulletin might be (and further refinements are expected next year), but we’ll certainly keep an eye out for commentary – please leave yours in the comments.

Cesarean Section Birth

Risks of Cesarean Section

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When a cesarean is done, the risks and benefits of the procedure need to be weighed. This includes looking at the added benefits and risks of doing a cesarean or of birthing the child vaginally. Sometimes the benefits of the cesarean will outweigh the risks, and sometime the vaginal birth benefits will outweigh the risks of the cesarean. People were asking what the additional risk of the cesarean were. I am condensing the following list from the book Mayo Clinic: Complete Book of Pregnancy & Baby's First Year. If you have any questions feel free to write me at: pregnancy.guide@about.com Robin Elise Weiss, ICCE, CD(DONA) http://pregnancy.about.com/ Cesarean birth is major surgery, and, as with other surgical procedures, risks are involved. The estimated risk of a woman dying after a cesarean birth is less than one in 2,500 (the risk of death after a vaginal birth is less than one in 10,000). These are estimated risks for a large population of women. Individual medical conditions such as some heart problems may make the risk of vaginal birth higher than cesarean birth. Other risks for the mother include the following: Infection. The uterus or nearby pelvic organs such as the bladder or kidneys can become infected. Increased blood loss. Blood loss on the average is about twice as much with cesarean birth as with vaginal birth. However, blood transfusions are rarely needed during a cesarean. Decreased bowel function. The bowel sometimes slows down for several days after surgery, resulting in distention, bloating and discomfort. Respiratory complications. General anesthesia can sometimes lead to pneumonia. Longer hospital stay and recovery time. Three to five days in the hospital is the common length of stay, whereas it is less than one to three days for a vaginal birth. Reactions to anesthesia. The mother's health could be endangered by unexpected responses (such as blood pressure that drops quickly) to anesthesia or other medications during the surgery. Risk of additional surgeries. For example, hysterectomy, bladder repair, etc. In cesarean birth, the possible risks to the baby include the following: Premature birth. If the due date was not accurately calculated, the baby could be delivered too early. Breathing problems. Babies born by cesarean are more likely to develop breathing problems such as transient tachypnea (abnormally fast breathing during the first few days after birth). Low Apgar scores. Babies born by cesarean sometimes have low Apgar scores. The low score can be an effect of the anesthesia and cesarean birth, or the baby may have been in distress to begin with. Or perhaps the baby was not stimulated as he or she would have been by vaginal birth. Fetal injury. Although rare, the surgeon can accidentally nick the baby while making the uterine incision. Copyright © 1994 - 1998 by Childbirth.org All rights reserved.

EDD

November 25th is the date that will stay in my heart and head forever. There is nothing that could erase it, I hope. When I was pregnant, I thought about that date so many times. Over and over, I would tell people who asked or just dream about her coming in my head. I wasn't even so attached to the date, even. I knew that babes come when they are ready. To some people, I would just say I was due around the end of November. It's just such a precious month, a precious number next to the month. My little E bear decided to come weeks before November 25th, gently into our house, she slid into the hands of our midwife. I do remember pushing (a total of twice!) and lifting her up to my body. What I do not recall were my first words to her. My mother-in-law heard me and later told me that I kept repeating, "I love you, baby. I love you, baby. I love you, baby." And, oh, how I do love that baby.

For months, we've been trying to agree on whether or not she is still a baby. I am thoroughly convinced that she will always be a baby, my baby no matter how much she grows. We laugh bunches during these talks. My heart clenched in my chest as I know she has already grow up so much...she is strong and kind and a really compassionate friend. She lets me know if she gets overwhelmed and she shares joy with me. She tells me how much she loves the snow but really does not like...hmmmnn...to do anything until she is ready to do it. Wow, I had to pause for a while to think of what it is that she really doesn't like. This morning, she didn't like the almonds in her oatmeal for quite a while but she came around to eating a whole bowl full with no prodding from me, really. She surprises me like that. Sometimes she won't budge on a certain food, piece of clothing, sharing her carseat, leaving somewhere, but then other times, she just will decide she's okay with almonds in her oatmeal, striped pants, saying goodbye to a friend or having a talk with her sister about the carseats. It amazes me how flexible she can be and I truly appreciate this aspect of being her mom.

Looking back to her first month of life, I can see that she adapted well to the outside the womb world rather well even then. It couldn't have been easy to be sooo tiny and learn to breathe and eat and all that jazz. But she thrived. She never needed needles or doctors or artificial baby formulas. She became so into reading and so verbal at a young age that it shocked us; it still does shock us daily! And, her heart is just so pure. She's so much like her dad and I in some of our best ways (like the two above details). We will forever celebrate her birth, her life, even her EDD. In my deep heart place, I so hope that she will always share her life with us as it feels ours would be amiss without her right in the middle of it.

$2400 in 24 hours

did you see that i am doing a fundraiser today for the birth center in bali where i volunteer? not sleeping for 24 hours to raise $2400 by midnight. could you help me buy them a doppler?  log onto my facebook page to give, please!  we are only half way there and have 3 hours left!

korea

getting a little bit thoughtful about this place called korea.  we've flown through, have friends from there and i even participated in a name exchange with two korean friends years ago.   the only two phrases that i know how to say are "i love you" and "hello".  we should then, right?

Vist Korea!

Hear Ina May Speak for Free

Ina May's Talks are on youtube available for us to watch and hear or just to listen to as we crochet in our homes.  How kind.

Ina May is Coming to Town

She will be hosting a workshop on Shoulder Dystocia and Breech Birth.

A Bunch O' Births

Outside of the front office doors, midwives from various countries, nurses and staff pose alongside a group of babies that were born within about 48 hours of each other at Yayasan Bumi Sehat.  Pictured in the center is the birth center's founding midwife, Robin Lim with midwife Katherine Bramhall to her left.  Katherine volunteers her time raising funds and awareness for Bumi between Vermont and Bali.

cord burning

"Recently Robin has begun to teach midwives how to burn the umbilical cord, rather than cutting it, in order to prevent infection in less than sterile environments. This oddly beautiful practice--using a little piece of cardboard and a candle-- is a gift from Chinese medicine. It is both soothing to the baby (who usually falls asleep during the procedure) and completely safe and sterile."

the bali birth center

Have you brought an empty doko?

by Martha Carlough.

The community health staff of United Mission to Nepal’s Okhaldhunga Health Project began new work in four villages last year. These villages were chosen carefully, based on a balance of needs and resources in the communities.

What were we offering?

Over a period of nine months, we spent much time and effort getting to know the communities, using participatory rural appraisal (PRA) methods. Small teams of staff worked in each village: mapping resources, prioritising needs, interviewing informants and building rapport with the community. We gained lots of information. We helped villagers recognise their own strengths. Community members seemed enthused and committed to working with us. Yet as I sat at a closing ceremony where results of the PRA were being shared, a village woman asked me why we had brought an empty doko to her village. Were we, like those who had surveyed in other places, just filling our own baskets and notebooks? Just what were we offering that would make a difference in the village, and why had we not made that clear from the beginning?

What did we want?

Following the basic principles of PRA, our staff had tried very hard not to take over the process of prioritising and planning. We listened to community voices, collected data, and organised ideas. But while doing this, we had not clearly talked about what we were willing to do, and what the future of the partnership between the community health staff and the village could be like. We had brought only an empty doko. Participation is much more than a set of tools, or a democratic process of empowerment. Participation is partnership. We all come with agendas that need to be made clear, discussed, and are open to change as we link hands to work with communities.

Participatory rural appraisal has become a key component of all kinds of development work. It is a stamp of approval that the work is ‘bottom up’, democratic and empowering. But agendas are still often developed outside communities and PRA serves to raise expectations that can’t be met within the limitations of staff and funding in the programmes we work for.

The agenda of Jesus

As Christians in development, we have agendas. We cannot pretend otherwise. Jesus Christ had an agenda in his dealings with people. He met them where their needs were – with physical healing, food and water, words for personal growth – but his ultimate agenda was to direct them towards salvation. Jesus practised PRA as he empowered people to recognise their own needs and gifts and to partner with him. He performed community diagnosis and determined where and when his words would be most effectively utilised – in the marketplace, in the synagogue, by the lakeside. He did not offer an empty doko, and neither should we. It would be wise to follow his example in being open about what we stand for, and what we can offer. Our challenge as Christians involved in health and development, and engaged in participatory work, is to be clear about what we believe and can offer, while at the same time addressing needs, identifying strengths and partnering with communities for sustainable change.

Martha Carlough is the Project Director of the Okhaldhunga Health Project. Her address is United Mission to Nepal, PO Box 126, Kathmandu, Nepal.

Happy 4th Birthday!

Crafty Advice on How to Make This

I would love to make these as favors for E's upcoming 4th Birthday party. They shouldn't be too hard, right? How can I get started? I have some peace fleece roving and embroidery thread. Any offers to come tutor me?

Birth In Nepal

We Know How to Do These Things: Birth In a Newar Village

click here to preview this film

by Barbara Johnson, with support from the Smithsonian Institution Human Studies Film Archives
color, 40 min, 1997

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For these villagers, giving birth is a family affair; while a young girl is in labor, the birth attendant, mother and mother-in-law alternate between lending a hand and story telling. Barbara Johnson studied documentary film and photography with Jerry Liebling and Elaine Mayes at Hampshire College from 1970-1974. She began working for the Smithsonian's newly formed National Anthropological Film Center in 1975. She was sent to Nepal to document early childhood socialization and daily life in a large farming village in the Kathmandu Valley. One of the Film Center's solo research filmmakers, she lived in this village for 15 months in 1978 and 1980. The 50 hours of sync-sound 16mm film which she shot in Nepal are part of the Smithsonian's Human Studies Film Archives. We Know How To Do These Things is made from the last hour of film she shot in Nepal.

Film Festivals, Screenings, Awards
Margaret Mead Film Festival, NYC 1997
Royal Anthropological Institute Basil Wright Prize nominee 1998
Berlin Ethnographic Film Festival, 1999
Women in the Directors Chair Film Festival, 1999

happy birthday, river!

So VERY glad to hear that Staci had her HBAC with little baby River. I got to know Staci, a midwife (who works at The Farm in Tennessee with Ina May) when she led a training for aspiring midwives in the next city over from me. It was an awesome four days of learning. We got to hear how Staci was planning a HBAC with this babe in the womb. So glad to hear that he was born into loving hands at home.

Bali Birth Center

Monday, June 1, 2009

Bumi Sehat

Two and half weeks after our first meeting with Ebu Jane (Fund raising director at Bumi Sehat) we were finally able to see Bumi Sehat in action. Bumi Sehat is a non-profit NGO that provides "Gentle Births for a Peaceful Future." It provides completely free care to all mothers and their children because cheap and good pre and post natal care is hard to come by on the island of Bali.

Two of the focuses on our trip to Indonesia are ecology and health care. Due to the recent change from Balinese red and brown rice to GMO (genetically modified) white rice has caused malnutrition in both mothers and babies. This ultimately led to increaseing maternal mortality and less healthy birth outcomes. This staple food of the people stopped providing pregnant women with all the nutrients necessary to sustain healthy pregnancies.

Unlike the US, Bumi Sehat's patients have a 100% breast feeding rate. Breast feeding provides the baby with all of the essential nutrients at next to no cost. Many doctors in Indonesian (and US) hospitals present formula as an ideal option for mothers, for many formula companies offer incentives. Not only does this place an unneeded cost on the family, but the lack of clean and sterile water in Bali causes even more sickness and mortality for children.

Bumi Sehat practices gentle birthing. They believe that violence at birth leads to a violent life and therefore should be avoided. They allow the women to choose the way in which they birth (50% water births) to decrease pain and drug use. They do not perform any vacuum births, circumcisions, or epidurals. Another thing attached to violent births is the clamping and cutting of the umbilical cord and placenta. Many of the baby's blood is still in the placenta upon birth and an immediate clamp and cut depletes the baby of these needed nutrients. Bumi Sehat practices delayed clamp and cuts as well as lotus births (where the placenta naturally falls off in 3-4 days). This clinic also does not separate the mom from the child like many American and Indonesian hospitals do.

Our group was impressed with the cleanliness and proactive attitudes of the clinic staff. They truly wanted what was best for the mother and child regardless of common practices and western ideals. This kind of clinic is the ideal but hard to come by in the states. Many women are not aware of gentle birthing and the clamp and cut procedures. They see the norm and assume that it is whats best, while Bumi Sehat functions to provide the best care as shown through OB/GYN research. Bali's low socio economic status citizens have a tendency to want to deliver their children at home because they cannot afford a hospital or puskesmas (public health clinic). Bumi Sehat offers completely free care which we could see made a huge impact. Unfortunately because of Bali's health care system, the directors of Bumi Sehat feel that it would not be appropriate to advertise. They see that they cannot change the system so they work around it in order to provide the best care.

from here.

a smancy wedding

the lovebirds.

just a little bear.

a little bear with her dada. they both choose pink.

yes, i could kiss her cheeks and squeeze her arms all day long.

can you tell that we are thrilled? we are! now, smancy are finally united in holy matrimony at our dear outer banks. we've been camping with smancy for about 4 years on the outer banks now. we threw around the idea of them actually getting married there. it was awesome to see it actually come true, all those dreams we had over a fire at the cape hatteras national seashore or on ocracoke. lovely.

they are a light unto my path.

all pictures were taken by my friend, bob witchger who is an amazing photographer and musician and husband and gardener and artist...among other things. feels like yesterday that we were at HIS wedding!

newish dinosaurs @ museum of life and science

mama on tour

hey, when did you learn to play the drums? i thought you liked the keys? lots of love, little mama.