Viewing entries in
Birth

Comment

Frederick Birth Center

Twenty years ago, Special Beginnings was opened in Arnold, Maryland, and has since been one of the only freestanding birth centers in the state. For families that live too far from Special Beginnings, there are two options: use your local hospital or birth at home. There’s a wide swing to that pendulum in consideration of care providers, cesarean rate, interventions , maternal and infant health, and financial cost. Having options is important, and families should be able to find a birthing place that best fits their family.

 

Fortunately for our Maryland families, there will be another option. Meet Mychal Pilia, CNM and owner of the Frederick Birth Center.

mychal.JPG

 

Mychal holds a bachelors degrees in Nutrition, Nursing and a masters degree in Nurse-Midwifery. She has been serving the home birth community since 2014. Mychal has spent extensive amounts of time in both business research and seeking feedback from the community. You may remember seeing her at Baker park last summer completing surveys, and talking with families.

 

Her vision for the Frederick Birth Center includes a holistic and family centered approach to pregnancy and birth. Evidence based care is the mainstay of the practice, and means that parents are active participants in their prenatal care.

 

What makes a birthing center different?

 

The care at the birthing center is personal and is built on a relationship with Mychal and the midwives at the birth center throughout your pregnancy. You develop personal trusting relationships with your providers, because they spend more time with you.  Your appointments are typically a half hour long with the initial one being an hour. Discussions include everything from nutrition, options for prenatal testing, mental health and emotional health, and how your feeling physically. It’s a whole person approach.

 

Not only do they provide more one on one time and attention, but they also offer classes you can take with mothers due around the same time. These range from early pregnancy topics, sibling preparation, labor and birth, breastfeeding and new parenting classes.

black room.PNG

 

Rather than cycle through all the doctors and midwives at a large practice, your time is spent with your midwife and her nurse. When you come to the center in labor, your midwife is the one meeting you there. She’s the one evaluating your labor and overseeing the safety and comfort for both you and your baby. At a hospital, you are meeting with a group of strangers, wondering who’s on call, and only seeing that doctor for mere moments at a time, and often only at the glorious moment of when baby is crowning to its birth.

 

The birthing center facility is a beautifully designed home like atmosphere, with a real bed, shower, full immersion tubs for labor and birth, equipped with all the medical needs for mom and baby. This isn’t birthing in the hospital where it tries to not resemble a hospital. This is a home away from home.

 

When can you receive care at FBC?

The Frederick Birthing Center is now open and is currently taking patients. You can begin care before you even get pregnant or transfer care almost any time during your pregnancy.  After all this is a “service industry” and your health care providers work for you!

Boho room with creams, pops of color and texture.  

Boho room with creams, pops of color and texture.  

 

 

 

What does care include?

A midwife and nurse are on call if you have emergent or non-emergent needs during your pregnancy. Care includes 10-12 prenatal visits depending on when you begin services, and group classes are available. You will also have access to the lending library if your enjoy to prepare for your birth through reading.

 

You are fully supported during your birth, and families can leave for home as early as four hours after birth (upper limit is twelve).

 

Postpartum checks are completed with a 24-hour phone call, 1-2 day home visit, and a 1-2 week and 6 weeks office visits.

 

Well-woman care is also available at the center including pap smears, full range of family planning options, health screenings (cholesterol, blood sugar, thyroid, and anemia labs to say the least), and mental health counseling and screenings.

This 33" Japanese soaking tub is huge. I'm 5'5", and could easily submerge into this beauty. 

This 33" Japanese soaking tub is huge. I'm 5'5", and could easily submerge into this beauty. 

 

 

Cost of birthing at a Birth Center

Cost is $7,000 and includes the professional care and the facility fee. Check with your insurance provider for full understanding of benefits and what can be covered or reimbursed for your out-of-hospital birth.

 

Having your baby at a birthing center is a lower cost option, with lower interventions, high level of satisfaction and high safety standards proven with large national studies (check out the National Birth Center Study II to see the birth center difference!). The cesarean rate in Maryland is currently ~36% (higher than the national average (33%), where the rate for birth centers is only 6%. For healthy low-risk pregnancies, out-of-hospital births provide options that protect maternal and infant health, while lowering health care costs, and providing a memorable experience for your family for a lilfetime.

 

For a look at hospital care cost, check out this article here:  http://www.scpr.org/blogs/health/2015/07/22/18049/pricecheck-how-much-does-it-cost-to-have-a-baby-at/

 

Future plans

Plans include two more Maryland freestanding birthing centers, located in Baltimore and Silver Spring.

 

For more information

You can reach Mychal Pilia at the Frederick Birth Center (frederickbirthcenter.com).

 

More about birthing centers:

https://www.mamanatural.com/birth-center/

http://www.birthcenters.org/?page=bce_what_is_a_bc

Comment

Comment

Digging through the literature: Best New Baby Books (and available at your library!)

When I first thought about getting pregnant, I did what my nerd brain naturally gravitated toward: I went to the library and checked out a pile of books on every aspect of the topic.

Your local library can be a wealth of resources for your family. Plus, who doesn't love the smell of a good book?

Your local library can be a wealth of resources for your family. Plus, who doesn't love the smell of a good book?

 

I sifted through the old standby classics like What to Expect When You’re Expecting by Heidi Murkoff, some humorous ones like Belly Laughs by Jenny McCarthy or Girlfriends Guide to Pregnancy. Some I found really informative, others super dry, and a few became favorites.

 

As the years have passed, I was turned on to some great books by my doula while I was preparing for birth. Others I have come across during my training with Birth Arts International. I’m always dissecting birth and pregnancy books.

Is the language accessible and not just medical jargon? Is it up to date with evidence based practices? Which clients or friends will appreciate this particular book?

 

Know better, do better. 

Know better, do better. 

I’ve gathered my top 3 favorite birth and pregnancy books. The bonus: they are available for free at your local library! If it’s not available for some reason, ask your librarian. Often a book title can be requested from another library or they’ll purchase it for you. If you have a favorite birth book, consider donating a copy to your local library. It’s great to have a collection of birth literature available in your community.

1)The Mama Natural Week by Week Guide to Pregnancy and Childbirth by Genevieve Howland

Written by YouTuber and natural parenting blogger,  Genevieve Howland, this comprehensive book covers all aspects of fertility, pregnancy, and birth. It covers all the options with prenatal testing, providers, birthing locations, etc. Having these options laid out is the definition of informed consent, and can help with decision making. It offers great natural options and nutrition options without seeming too far out there. (I can honestly say that on a personal level, I laugh when I see tofu in a pregnancy nutrition book. Not happening. Pass me that giant bowl of pasta please.) 

This is my favorite new pregnancy book. It's modern, it's accessible, and it gives a fresh take on birth. Have your support, know your options, and have the best birth you can that day. 

2) nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood- and Trusting Yourself and Your Body by Erica Chidi Cohen. 

Author Erica Chidi Cohen brings a new voice to the pregnancy and birth literature choir. Writing from the perspective of a birth and postpartum doula, she brings a compassionate conversation to the reader instead of the usual lecture you feel like you're getting (eat right, get your finances and all the things done, be happy, etc.). 

The book takes a deep dive into the emotions surrounding pregnancy and birth, and offers beautifully realistic ways of handling them. She has a strong focus on self care and mindfulness that often gets overlooked. It hits the full spectrum of care that's needed for mamas and families right on the head. 

Best part of this book: more than a third of nurture is dedicated to postpartum care of mom. Postpartum care often gets the short end of the stick. The focus is on labor and newborn care, often not bringing attention to the fact that moms get put through the ringer with birth. Moms need more than just a primer on how to use a peri bottle and nursing. Cohen helps to plan your household, and gives tips for healing and bonding with baby without chaos, but with a lot more grace. 

3) The Whole 9 Months: A Week-by-Week Pregnancy Nutrition Guide with Recipes for a Healthy Start by Jennifer Lang, MD. 

If you were like me during pregnancy, you spent the first several months trying decide what would stay down, or at least not be brutal if it came back up. It's survival mode. This title tackles the nutrition behind feeling better during those early weeks, and how to eat for wellness for the remainder of your pregnancy. 

Lang breaks down what to look for in a prenatal vitamin, as well as eating to tackle pregnancy issues (hello constipation) and alternatives for crazy pregnancy cravings. 

The best part are the recipes included in the book. They're easy, delicious and healthy, and several can be made while having a screaming toddler at your feet. I love a realistic take on nutrition! 

What was your favorite book when you were preparing for pregnancy and birth? Share with us below! 

Comment

Comment

Jacob's Birth Story: A fast breech vaginal birth

Before I begin my most recent birth story, I need to give some background information about myself. I am a Neonatal Nurse Practitioner and work at the same hospital that I receive my OB care; therefore, I have a close professional relationship with my OB providers. I also have a uterine anomaly called a bicornuate uterus. This means that my uterus is divided into two sections. This was discovered at my 13 week nuchal transluceny ultrasound with my first pregnancy. The complications associated with this anomaly are cervical insufficiency, preterm labor, preterm delivery, growth restriction, and breech presentation. The risk of breech presentation is due to the limited space for the baby to turn. Because of this anomaly, I was followed very closely by the high risk OB and had approximately 13 ultrasounds with my first pregnancy. My son was born by vaginal delivery after spontaneous labor at 37 weeks and 2 days. At every ultrasound he was head down.

With my second pregnancy, my son was in breech presentation at every ultrasound. I really became concerned about this around 26-28 weeks, given the limited uterine space and that my first son was always head down and this time my son was always breech. Everyone (both medical and non-medical) tried to reassure me that “there’s plenty of time for him to flip.” It was at this point that I began my research on getting a baby to turn. I googled, youtubed, and read a lot of articles and blogs. I tried anything and everything to get my baby to turn, with no avail. At 34 weeks I had a discussion with my OB about attempting an external cephalic version (ECV); however, I am not a candidate for this procedure given my uterine anomaly. It finally started to sink in that I was going to have a c-section. My OB decided not to schedule me for a c-section, rather we would wait until I went into labor in order to give me every opportunity for the baby to flip.

Breech presentations include:

  • Frank Breech (Bottom down, feet are up by the head)
  • Footling breech (One or both feet are by down)
  • Complete breech (Bottom is down and legs are crossed. Imagine baby sitting Indian style.)

During a casual conversation one day at work with the high risk OB director, I expressed my concern for having a c-section and how much I did not want to have one. He agreed that I was not a candidate for an ECV and what I thought was jokingly, he said,“Well you could always do a breech vaginal, the only problem is I would have to be at your delivery, and that might be uncomfortable for you.” My response was that I would not have a breech vaginal because of the risks associated with it. That was the extent of our conversation. I did not have any conversation with my primary OB about a breech vaginal delivery.

So what are the risks with breech birth?
- Placenta being compressed
- Head getting stuck
- Some incidence of large limb fractures
Biggest issue currently is finding a provider who is experienced and educated in delivering a breech!

At 37 weeks I went to my routine OB appointment, and again had a discussion with my OB about a C-section, and again expressed my feelings and anxiety about it. She was very empathetic, but tried to reassure me that it wouldn’t be as bad as I thought and also gently brought me to reality that this baby would most likely not flip at this point. I was 1 cm dilated and 50% effaced at this appointment and not having any significant contractions.

The next morning, at 37 weeks and 1 day, I woke up with some intermittent cramping back pain. It wasn’t very painful, but it was certainly noticeable. Shortly thereafter I began to have some lower abdominal cramping similar to that of a period. I didn’t time the cramping but thought something might be happening given that it was intermittent and not a consistent discomfort. At this point I didn’t want to call my OB, because I knew she would want me to come in right away given the breech presentation and I didn’t want to have my husband come home from work and call my childcare if this wasn’t, “the real thing.” But, I did get my (almost) 2 year old set up with breakfast and hopped in the shower, did my hair and makeup, and got myself all ready “just in case” this was it. I packed the car with our bags before heading out with my son. Throughout the pregnancy I constantly thought about the, “last day” that it would be just, “us.” My son loves ice cream, so I wanted to take him out on an ice cream date. We got to the ice cream parlor a little before noon just to find out they didn’t open until noon. We went next door to the grocery store to kill a little time. By this point the cramping was occurring more frequently, but not necessarily with more intensity. I stopped in the bathroom on our way out and that’s when I had my bloody mucousy show. It finally sunk in at that time that I was in early labor. We got our ice cream and I just sat and enjoyed those last minutes with my son before my attention was going to have to be shared.

Megan the morning of Jacob's birth.

Megan the morning of Jacob's birth.

We got out to the car around 12:15 and I called my OB to report my symptoms. As I expected, she told me to come to the hospital to get evaluated. I called my husband who was working an hour away and my sister who was going to watch my son. By the time my husband got home and we got out the door it was around 1:30. We weren’t in the car more than 5 minutes when the intensity of my contractions increased and I was unable to talk during them. The ride to where we were meeting my sister was about 25 minutes. Just as we pulled up my water broke. I called my OB again to give her an update and that we were about 20 minutes away. By the time we arrived to the hospital I could barely think or talk due to the pain of the contractions which were now about a minute apart.

I was immediately taken into a room (the PACU was full) and my OB checked me and said I was 6 cms. There were so many medical professionals in my room working diligently to get me prepared for my c-section since I had progressed into labor so quickly and was continuing to have very strong contractions every minute. That was when my OB told me that the hospitalist was on service and she has experience with breech vaginal deliveries and asked if that was something I wanted to consider. I could barely focus on her words so she decided to get me my epidural and get me comfortable before we had any further conversation. As soon as I got my epidural she checked me again and I was 9 cms (that was about 30 minutes after the first time she checked me). I had to make my decision very quickly after having a brief but serious conversation with the hospitalist. I knew in my heart that this was the right decision for me. My husband was against it, but said he trusted me and my OB and knew that I was very aware of the risks associated with this type of delivery given my medical background.

So we moved into the OR, which is where I had to deliver in case they had to do an emergency c-section. As was explained to me before making my decision, I labored down for about an hour before I started pushing in order for the baby to optimally move into the birth canal vs pushing him into position. I pushed for 18 minutes until I heard the most beautiful sound in the world which was that of my baby crying. He was placed skin to skin with me and I just cried tears of joy and relief. He weighed exactly the same as my first son, which was 6 lbs 13 oz. I had no tears and felt so wonderful during my recovery. Every day I thought about how different my recovery would have been if I had a c-section.

On the way to the hospital when I was contracting so painfully I thought to myself, “Why did I wait so long to call my OB? I should have called this morning! This pain is so unbearable I could have avoided this if I hadn’t waited!” Afterwards, I was so thankful that I did wait to call, because my delivery experience would have been so different. Everything happened to just fall into place to make this all possible. The OB that I had such extensive conversations with was on service at the hospital so she knew my anxiety about having a c-section, the hospitalist who will do the breech vaginal delivery was on service, I was in spontaneous labor with contractions every minute with very fast cervical dilation, and my baby was tolerating the labor. Had any one of these factors been missing or different, I would have had a c-section. I absolutely love my birth story and I hope you enjoyed reading it!

Jacob meets his big brother.

Jacob meets his big brother.

 

 

Comment