Cascade of intervention

The “cascade of intervention” is widespread in American birthing practice.  Birth has become a medical problem to be treated.  It starts with unrealistic expectations about childbirth, fear of pain, leads to an induction (suggested by the mother and/or doctor and often not medically necessary), makes an easy transition to an epidural, increases the risk for an instrumented or surgical delivery.  I think Prof. Tracy is right on by saying we’re moved away from  the “natural rhythm of women giving birth”.

Well-trained midwives play a huge part in helping mothers avoid the cascade of intervention through education and empowerment.  In fact, as stated in the video below, countries that employ nurse-midwives as first-line care providers for pregnant women have the best outcomes!

The Journal of Midwifery and Women’s Health recently published an excellent handout on how (and why!) to prevent a cesarean delivery.  This is an invaluable resource for women who feel pulled in to the cascade (downward spiral!) of intervention!


(no) Breast self exams

I’m nearing the end of the 3rd quarter of my graduate school program to become a nurse-midwife.  Nearly 1/3 of the way finished!

One of my current classes discusses preventive medicine and screening tests.  We were introduced to a tool for primary care providers developed by the U.S. Preventive Service Task Force identifying preventive services which offer significant health benefits and are backed by evidence. For example, screenings for high blood pressure and sexually transmitted infections or counseling for obesity. The nice thing about this tool (it’s available as a free app!) is that it bases its screening and counseling recommendations on gender, age and predisposing conditions.


For me, the most notable recommendation was AGAINST teaching women to do breast self exams as a screening tool for breast cancer.  The evidence does not indicate that doing monthly breast self exams catches breast cancer earlier or decreases mortality. In fact, the high number of false positives (women who find lumps and bumps that end up being benign) causes more emotional distress for the woman, unnecessary testing and higher cost in the end.

This change in screening recommendation does not mean that women should not take responsibility for their health!  There are many things you can do to decrease your risk and follow screening tests which have been proven effective.  The Susan G Komen for the Cure website has some great guidelines:

Breast cancer screening and awareness

I urge you to take a look for yourself!  FYI:  knowing your personal risks, getting regular recommended screenings (such as yearly mammograms after age 40) and BREASTFEEDING as protection are on the list!

Do you know anyone who discovered their breast cancer using a breast self exam?  Has this been part of your regular preventive health routine?


Baby shoes and such

My baby girl’s first birthday is coming up quick!  I’ve been on the hunt for some adorable, comfortable shoes now that she’s on the verge of walking.  I’ve had these moccasins in mind for her (I have a matching pair! How cute!).  I’ve also eyed the version with the rubber sole considering the inclement fall and winter weather here in Colorado.


Then today  I came across a post by the ever-clever and intelligent Katy of Aligned and Well.  She did a short interview with a podiatrist on kids’ foot health.  The clear recommendation is to allow kids to be bare foot as much as possible, delay shoes until it is necessary and to choose early footwear that is as minimal as possible (flexible, thin sole and soft moveable upper with plenty of room in the toe box).

And then the stars aligned as I caught sight of the most adorable soft sole shoes worn by Emily’s baby via her lovely website! She quickly pointed me to this etsy shop and I’m SOLD.  Teal, soft sole baby shoes with ruffles?  Count me in!

Now to find a matching pair for myself…


Advocacy for women

Last week a prominent politician made a false remark about rape and its consequences.  And then the media world blew up.

I, too, am astounded at this horribly false claim but, most of all, I’m disappointed that it points to a bigger problem: the lack of public knowledge concerning women’s health.  Although this man has made an enormous and public error (and has consequently been publicly corrected), the good to come is the attention it brings to sound medical knowledge and advocacy for women.

Violence towards women should never be tolerated.

I appreciate the ACNM’s response.

he and she

Lately I’ve been thinking of how I manage the passing of time differently with my two children.  I’ve always been told that a mother loves her children equally.  I first felt this the day I introduced my newly born daughter to my nearly 2 year old son.  There’s a miraculous expansion that makes my love enough–enough for my babies regardless of their age, number or location.  These past few days I am realizing the weight of how I love my children differently.

My firstborn has forever been my best-foot-forward announcement to the world that I am a mother.  I have eagerly anticipated each milestone, always cheering him onward.  We take our firsts together and celebrate by keeping our gazes ahead.  I have memorized every last inch of his flesh yet always feel amazed at just how quickly it changes.

My last one, my daughter, shows me how a mother’s body remembers her babies.  Almost as an extension of my own body, I can easily recall their soft folds, intricate fingers, pillowy lips.  But my last one will always trail a sense of longing in my life because there will be no more coming after.  Somehow love full with anticipation and pride is so completely different that love full with surrender and savoring.

Our second and final baby is perpetually held in the balance of receiving my divided attention and inheriting every last moment of savoring imaginable.  He is the baby that moves my love forward and she, always slowing it down.