2017 Birthing Instincts Year in Review

 

Well, that went fast. Another year of births, advocating and teaching for the Birthing Instincts team. I want to specifically thank my staff and students, Kati and Catalina along with all the midwives who refer and trust me with their clients. As always, a special thanks to midwives Beth Cannon and Blyss Young who have been with me through it all. It is always interesting to look back so let’s see what adventures, both personal and professional we had in 2017.  As always, I was available to answer questions, emails and calls from midwives and clients pretty much every day, 24/7 365. It didn’t take long to see that the 2017 practice was going to be caring for more and more breech families. As choices diminished with the retirement of Dr. Ronald Wu and the banning of breech and most twin deliveries at multiple hospitals women were left with fewer options. We are happy to note that friend and colleague, Emiliano Chavira, MD helped picked up the baton and gave women the option of a hospital breech birth at St. Francis Hospital in Lynwood, CA. The first week of January saw the waterbirth of our first 2017 twins born 45 minutes apart. The very next day we dropped off my daughter, Madeleine, at LAX on her way for her semester abroad in Barcelona. A month later I traveled to Barcelona to visit and we had a great time. Seeing the sites, sampling the food, the Salvador Dali Museum and catching a match between Barcelona and Real Madrid were all special. Not much better than Father-Daughter camaraderie.

Sadly, in late January, we lost my dad to his battle with father time. He lived a wonderful 96 years and will be missed (Reminder: You can hear some of his wisdom and humor when I had the good fortune to interview him on his 96th birthday at DrStusPodcast.com #100). Later in February I once again traveled with the charitable Cure Cervical Cancer team, this time to Vietnam. We spent just over a week teaching and screening for cervical cancer in the villages around Ha Long Bay. My stepson Max moved back to LA from Brooklyn so now all my kids are in the SoCal area and family gatherings were made that much easier. April saw the arrival of the Annual ACOG Meeting, this year in San Diego. While there was much to see and learn there was an obvious huge gap between the medical birth world and the midwifery one. I was inspired by the lack of acceptance of breech and limitations on VBAC and twins in the lectures to go on and acquire a breech trainer, Sophie and her mum. With the help of so many of you and a GoFundMe account I was able to raise nearly all of the $11,000.00. Thank you all so much. Happy to say the Sophie and her mum now reside in my apartment in downtown Los Angeles and are looking forward towards many journeys in 2018.

 

The month of May saw a well-attended ICAN event in Santa Barbara in support of VBAC. Dr. Emiliano Chavira, Dr. Terry Cole and Jen Kamel of VBAC Facts joined me and some eloquent VBAC mothers for an informative evening. We also had an emergency episode of Dr. Stu’s Podcast in support of our friend and colleague, Dr. Brad Bootstaylor in Atlanta. His local institution was trying to restrict legitimate birthing options. Funny, with more and more literature coming out supporting the importance of the microbiome and the concerning high cesarean rate you would like to think hospitals would be climbing on board instead of going backwards. Big sigh!

 

June saw me travel to NYC for a special night with an old friend and a dinner party in Manhattan. My friend worked for the United Nations and she and I were treated to a warm hug from Swami Amritaswarupananda Puri, the spiritual leader better known as Amma. A very special moment. Another special moment came when a local ENT physician and his wife had a beautiful home waterbirth against the best advice from all his partners and medical colleagues. What do they know, anyway? In July, I was privileged to be invited to the swearing in ceremony to American citizenship of one of my clients along with several thousand new Americans. Another very special and moving moment. Only a month later she gave birth in her bed at home. Welcome Piper!

Congratulations to my long-time associate, Jason Rothbart, and his beautiful bride, Leigh on their August wedding in Spokane. Nature continued to show its wonder with the total eclipse that, for 3 minutes, mesmerized the country. All year long many visitors came to spend time with me, saw clients, attended a few births and pick my brain. I enjoy these interactions and they keep me on my toes. With the onset of Autumn, Nebraska Birth Keeper Angie Hock spent a week with the highlight being a Los Angeles, Kings hockey game, of course! September saw my colleague Rixa Freeze of Stand and Deliver blog fame and me submit a paper for peer reviewed journal publication comparing 60 home breech births with 109 home singleton cephalic births. We hope it will be out very soon. In October, Sophie and her mum held their first seminar with Dr. Stu attended by local midwives in Ventura. We are very excited with the expanding teaching schedule for 2018 and we are hopeful to get CME accreditation so we can attract doctors, residents and medical students to these events. (Check the calendar page on the web site)

November is often remembered as the month of Thanksgiving and this year there was much to be thankful for. Our student, Catalina, discovered some very exciting personal news. More to come on that in 9 months! Dr. Stu gave a talk on breech techniques at the 2017 MANA conference. And while not everyone seemed in the thankful mood this year it was nice to see so many old friends and colleagues. Congratulations to Dr. Stu’s niece and nephew on the unmedicated delivery of his great niece proving once again that good things can happen in the hospital setting. Dr. Stu’s daughter, Madeleine, turned 21 and she celebrated by going skydiving with her friends and drinking legally with her dad. The year ended on a sweet note with a Christmas HBAC in Santa Barbara proving once again that good things can happen in the home setting, too! As always, Dr. Stu and his staff want to express their gratitude to all the mothers and fathers and birth professionals who have supported the Birthing Instincts mission. Your trust and assistance provide the sustenance that keeps us going all hours of the night. Happy new year to you all.

 

2017 Birthing Instincts Statistics

 Total Clients in care: 45

Transfer of care prior to labor (TOC): 6

 

1)     Twins, 37 weeks, SPROM, A is footling breech

2)     VBAC, Macrosomia, Type 1 Diabetes

3)     Twins, VBAC SPROM at 34 weeks

4)     Twins, SPROM at 35 weeks

5)     VBAC, IUGR

6)     Twins, TTTS at 23 weeks treated with Laser therapy

 

 

Laboring Clients: 39

                  Primips: 21 (Includes 1st time mothers and VBAC mothers)

                  Multips: 18

 

Vaginal: 32 (82.1%) (Home Vaginal Delivery Rate is 72%)

                  NSVD:                      15

                  Vacuum:                4

                  Twins:                      2

                  Breech:                   9

                  VBAC:                       2

 

Transports: 11 (Rate 28%)

                  Cesarean:               7 (Rate 17.9%)

                  Vaginal:                                    4

 

Transports in Labor:

1)     Breech, VBAC, Hypertension (VD)

2)     VBA4C, Pain

3)     Breech, Arrest @ 6cm

4)     Br/Vtx Twins, Arrest @ 7cm

5)     Breech, Arrest @ 7cm

6)     Breech, Floating @ 5cm, Footling

7)     42 Weeks, Desired pain relief (VD)

8)     Breech, VBAC, 4+ Meconium at 8cm

9)     Twins, VBAC, Sharp suprapubic pain at 10cm

10)  VBA2C, Hypertension (VD)

11)  Primip, Vertex, Desired pain relief (VD)

 

Summary: 45 clients entered into care with Dr. Stu as the primary caregiver in 2017. Many entered into care late in their pregnancy because of newly discovered breech presentation and midwife care going beyond 42 weeks. Six of these women developed antenatal problems requiring a transfer of care to a hospital based physician. Of the 39 remaining, 32 delivered vaginally (82%). There were 11 transports with 4 of these delivering vaginally in the hospital and the remaining 7 transports having a cesarean section (18%). All 4 vacuums were at the request of midwives to assist with their laboring clients. As our practice has evolved we are seeing more clients with conditions considered high risk in the medical model as choices diminish resulting in higher cesarean section and transport rates than in previous years. Many local midwives are accepting VBAC clients with more confidence and Dr. Stu saw more than 20 of these women in consultation for VBAC “clearance”. While not required by California law, consultation gives reassurance to those midwives and clients who prefer a second opinion. Structural 20-week scans and dating ultrasounds as well as biophysical profiles continue to be offered to midwife clients in a reassuring environment. In addition, Dr. Stu continues to provide the option of repairing significant lacerations in the home setting when requested. We assisted births from San Luis Obispo to San Diego and even had one family relocate from Aspen, Colorado to have their twin birth plan honored.

All of us at Birthing Instincts, Inc are honored to be of assistance and provide these services to the families and practitioners who desire them, wherever they may be. 

 

The Hazmat Birth

On the header of my blog are a few of my favorite historical quotes. I think my favorite has become Albert Camus’, “The Welfare of humanity is always the alibi of tyrants!” Fear is the easiest way to manipulate. And claiming safety is a perfect way to shut down any discussion. It’s good for you. It’s safer for the children. You don’t want to put your baby in danger, do you? We live in a world where ACOG admits that 2/3’s of its guidelines are not based on good scientific evidence. Yet they put them out anyway. In my world, on a daily basis, I am told directly or from print media about manipulation of women through skewed or even overtly false information. When it comes to pregnancy the bowing to the false god of safety has become the standard. Your baby is too big. Your baby is too small. Your pelvis is inadequate. The head is smaller than the shoulders which might get stuck. The fluid is decreasing. The cord is around the neck. You are 3 days overdue and your placenta is getting weak. VBAC is too dangerous. Your breech baby’s head might get stuck. Hospitals are safer. Induction is easy. Cesarean sections are routine.

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