I nursed my babies as they desired for as long as they desired and allowed them to share our bed at night. We loved it! It was easy and having three babies in four years, it helped us all get more sleep!

When my grandkids come over for the night, they have always been welcomed in our bed. We love having little ones snuggled in next to us at night.

I wore my babies. I loved wearing my first but after that it became a necessity to wear  the baby as you may have noticed- I had three babies in four years. I had one walking, one in the stroller and one in the sling. It was the way I could go out and get things done- and I loved it!

One of the thing I miss the most about not having a new grandbaby is not being able to wear that baby when I go out with my daughters. When they get to be big toddlers, since it is not done on a regular basis enough to help my body prepare for it, I can not wear the big toddlers. But I love being at the mall or the park wearing my grand babies!

I taught my children to be peaceful with others… no hitting or biting but using your words instead. I would love to say I never resorted to spanking my kids- but I did rarely. I hated doing it and feel I fell into my old childhood pattern that my parents left me an example of on occasion. But gentle guidance does not mean no discipline. I disciplined my children and they understood what “unacceptable behavior” was without being told they were bad.

I do think it takes a village to raise a child. One of my grandchildren lived with us for a while with his mom. He knew what was acceptable and knew the repercussions from me if he disobeyed. I still step in to share how their behavior effects others and gently guide them if they are in my presence and need guidance.

My neighbor thought it odd that I let my children tell me how they felt. She considered it “back talking.” I allowed them to share whatever they were feeling as long as it was respectful. I feel that is what helps them to not stuff feelings today.

I often ask my grandchildren about their feelings. I think it is important for them to obey but it is also important to understand what they are thinking and feeling if not even more so.

Attachment parenting is not about posing on the front of a magazine with a child in the chair nursing. That child is three. I nursed two of my children into their third year. I see nothing wrong with that at all. I do think this mom and little boy were used for sensationalism. And I do think it has hurt the idea of toddlers or preschoolers nursing.

I do want parents to meet their children’s needs irregardless of what others think. I do think children need to behave in such a way that is respectful of others. I do like children need loving guidance. Attachment parenting to me means doing just that. Being attached at the heart with your children. I am still an attachment parent. I am not afraid to show affection to my grown children. I try my best to nurture them and meet their needs when I am able to do so. I stroke hair, change bandages, shampoo their heads when injuries prohibit them from doing so, allow them to come to my bed and curl in and cry when they need to, and stroke their hair when things are going badly. My oldest had a migraine on Sunday and I rubbed her back and stroked her forearm the way I have always done when she was hurting. It is what a loving parent does.

I encourage- instill courage into my children. I help build their confidence- helping them to know I believe in them. I support them- telling them often how incredible they are and how proud I am of them. But mostly I love them- unconditionally just where they are. And they in turn do all of those things for me. That is what an attachment family looks like.

I have caught one grandchild at their birth, helped each of them nurse effectively, changed tons of diapers, held them and rocked them when they were upset, given loving kisses to them, tussled and wrestled with them, played with them and swung them in the swing, swung with them, jumped on the trampoline with them, stroked their backs as they went to sleep, massaged them after their baths, worn them in slings, talked to them about their feelings, told them what I thought of their behavior and how it effected others and much more.

I look forward to sitting with them as teenagers and listening. I look forward to sharing a beer with them as they sit across a booth as young adults and ask for guidance and my opinion. Attachment parenting does not stop when they go off to college or leave home. It continues for many generations. It has been the foundation of how I raised my children and the way they are raising theirs.

Did you know that each state government sets up the regulations for that state’s birth centers? If you do not like something a birth center can or cannot offer, take it up with the state with whom they are regulated. Every state is different. Let’s see what the State of Georgia has to say about the regulation of our soon to be Atlanta Birth Center. So realizing that these regulations are what dictates certain things at the birth center and not the actual birth center deciding these things will help us in knowing what needs changing- the law of the state. Now special certificates and considerations can be submitted to the state to change the regulations- and I am sure that the Atlanta Birth Center will do all they can do to include as many women as possible. But I wanted to share what the law states now in Georgia. Here is the link- I have only commented on a few of the regulations:

http://rules.sos.state.ga.us/cgi-bin/page.cgi?g=DEPARTMENT_OF_HUMAN_SERVICES%2FPUBLIC_HEALTH%2FBIRTH_CENTERS%2Findex.html&d=1

290-5-41-.01 Definitions.

It must have an administrator:   ”Administrator” means the individual who is responsible for the day to day management of the center.

It is not a hospital:   ”Birth Center”, “Birthing Center” or “Center” means a facility, other than the laboring woman’s legal residence, which admits persons for the purpose of childbearing and which facility has not been classified and licensed by the Department as a hospital.

It has birth rooms:   ”Birth Room” means any room within a center which is provided as an area where births take place.

And it has to have CNMs not lay midwives or CPM- certified professional midwives but actual nurse midwives that are registered and licensed by the state and ACNM:   ”Certified Nurse Midwife” means an individual who is a Registered Nurse currently licensed in the State of Georgia and who is also certified by the American College of Nurse Midwives.

They cannot offer anything other than local anesthesia- so no epidurals or general anesthetic can be used:    ”Local Anesthesia” means any drug which, when administered, provides localized temporary loss of sensation, but not accompanied by a state of unconsciousness.

And you must be a low risk patient. So the state then goes on to state what a low risk patient actually is:   ”Low Risk Patient” means an individual who:

1. is in general good health with uncomplicated prenatal course;
2.  is participating in an ongoing prenatal care and education program;
3. has no major medical problems;
4. has no significant signs or symptoms of hypertension, toxemia, hydramnios, abruptio placenta, chorioamnionitis, malformed fetus, multiple gestation, intrauterine growth  retardation, fetal meconium, fetal distress, alcoholism, or drug addiction, Rh or other blood group antigen sensitization;
5.  has no history of fetal wastage or premature delivery;
6.  has no previous significant obstetrical complications likely to recur, nor previous
7. uterine wall surgery or Cesarean section; (you read that right- no VBACs can be done here)
8.  has parity under six unless a justification for a variation is documented by clinical staff;
9.  is not a nullipara of greater than thirty six years of age; (That means if it is your first baby you have to be 36 years old or younger!)
10.  is not less than sixteen years of age at onset of pregnancy;
11.  is appropriate for a setting where anesthesia is limited to local infiltration of the perineum, or a pudendal block, and analgesia is limited;
12.  while in active labor:(i) demonstrates no significant signs, or symptoms, or evidence of anemia, significant hypertension, placenta previa, malpositioned fetus or breech; (so no breech babies can be born here) (ii) is progressing normally; (iii) is without prolonged ruptured membranes; and (iv) is not in premature labor. (so it is up to the midwives I am guessing as to when a labor is no longer progressing normally or what is considered prolonged rupture of membranes)
13.  is not postmature.( again- is this after 42 weeks?)

290-5-41-.07 Transfer and Transport Capability.

So, they must have an agreement with a hospital and lab:   Each birth center shall have a written agreement with a hospital(s) which is licensed to provide obstetrical services, for emergency care. Each physician practicing in the birth center shall have admitting privileges at the back-up hospital.   Each birth center shall have a written agreement with the emergency back-up hospital for acceptance and examination of laboratory specimens to expedite treatment, prior to formal admission procedures.

And they cannot be more than 30 minutes away from that hospital:   The center shall have the capability to transfer and transport the adult and/or newborn patients to the contract hospital within thirty (30) minutes of initiation of transfer procedure to the arrival on the obstetric/newborn service of the hospital. Documentation of each transfer shall be maintained by the center to substantiate to the Department that it has met this requirement.

And they will be contracted with a local ambulance service:   The center shall have a written contract with a licensed ambulance service which will assure timely response.

290-5-41-.06 Organization and Administration

Here’s that administrator’s role again:   The center shall be at all times under the personal and daily supervision and control of the administrator (or a designated representative) whose authority, duties and responsibilities shall be defined in writing. This information shall be available to the Department on request.

OPEN 24/7:  The center shall be available for occupancy 24 hours per day, with professional staff on call at all times.

Low risk women of any diversity will be welcomed:   Criteria for admission to the center shall be clearly identified in the center’s policies. The admission policy shall be submitted with the application for licensure. At a minimum, admission criteria shall include a provision that only low-risk patients will be admitted and that there will be no discrimination according to race.

You must have had prenatal care based on their policies:   Admissions to the center shall be restricted to low-risk patients who have received antepartum care in accordance with the facility’s policies. The center’s policies and procedures regarding management of complications shall be explained by a staff physician or certified nurse midwife.

You must only stay 24 hours:    The mother and newborn shall be discharged within twenty-four (24) hours after delivery, in a condition which will not endanger the well-being of either the mother or newborn, or shall be transferred to a licensed hospital. The mother and newborn will be discharged in the care of another responsible adult who will assist in their transport from the birth center.

The medical director must be an MD or DO- got to be a doctor!:   The center shall have a medical director who is a physician, designated by the governing body, who shall be responsible for the direction and coordination of all professional aspects of the center’s program.

290 5-41-.08 Professional Services.

You care will be a midwife, doctor and other professional staff member: All intrapartal services shall be under the direct supervision of a physician or a certified nurse midwife. At least one other member of the professional staff shall also be present at each delivery.

So the PKU, erythromycin, etc will be offered there and these policies will have a pediatrician involved: The center shall have written policies and procedures to ensure (a) metabolic screening of all newborns within one week of age, (b) assessment of newborn status, including Apgar score at one and five minutes, (c) prevention of eye infection, (d) umbilical cord care, and (e) periodic observation and assessment after birth until the infant’s condition is stable. These policies shall be developed in consultation with a pediatrician.

Rhogam will be available: Policies, procedures and facilities shall be provided for proper collection, storage and laboratory testing of cord blood for necessary studies on Rh Negative and O Positive mothers and a supply of Rhogam or other appropriate treatment material shall be readily available for use when needed.

A doctor will examine your baby before you go home: Prior to discharge, each newborn shall be examined by a physician.

290-5-41-.14 Anesthesia.

If you decide you need an epidural then you are transported to a hospital: General or regional anesthesia shall not be utilized in a birth center. Local or pudendal anesthesia is permitted.

I met a young mother of two, pregnant with her third this weekend that discussed her last birth with me. She is considering a different home birth midwife this time. I inquired as to why. Her husband really wants her to, feeling the midwife lives too far away. I asked for more details. Seems her second labor was so different in the lack of intensity from her first that she mistook active labor for really being early labor with her second. She had called the midwife, but had not even taken the time to time contractions yet- feeling it very early in the labor. But when intensity came over her, a call to the midwife was only 30 minutes prior to the birth. The midwife did not make it in time for the actual birth, but arrived a bit later. I did not ask if she was happy with her birth. But it seemed the father had not been happy about the unassisted birth. This time she wants a doula. I suppose she thinks a doula may know when to call the midwife sooner. She also said she would feel better about having the doula come sooner than she would have the midwife come. Although, I am unsure why. But as I pondered this more I thought, the midwife did nothing wrong. Yet the father assigns the negative memory of this birth to this midwife.

I recently attended a mom who after most of a day ended up in the OR for a cesarean birth. She had a supportive husband, midwife and doula. She had taken wonderful classes and had done excellent preparation. Yet the baby was not tolerating labor. Later we found out that the double loop of cord around his neck was perhaps the culprit in allowing him to move down into the pelvis. I thought she would be accepting of the fact she had tried everything. We talked about it after the birth and I thought she felt good about her journey. I saw her husband this week and shared I had left several messages for her but had yet to talk to her. He said she was just not ready to talk about the birth yet. I felt so sad to hear that. It makes me wonder if she holds me somewhat responsible.

Now of course the thought of holding me responsible is not really rational. I could not effect the cord being tightly around her son’s neck. But when bad things happen or things unfold in such a way that we did not plan or want, we want to hold someone responsible. We want to blame someone. It is the way we are wired sometimes. The idea that the universe, God is in control., the idea that some things are outside of our control, the thought that there is a lesson to be learned from our experiences, is too hard to comprehend sometimes. So we grapple at whatever else could be responsible.

I have had moms choose to not return to the same practice for their next birth, not because the midwife or doctor did anything wrong, but because the memory of that experience is tied to that practice. I have had moms choose different doulas than their previous one, not because the doula did anything wrong, but she was present when the outcome of the previous birth was not what they desired, so she is tied to that experience. It is a shame, but again that is how we are sometimes wired.

I had a mom sit in my class and take responsibility for her first cesarean. She had not prepared in such a way that she felt like made her an informed consumer. She shared how initially she blamed the practice, she blamed her husband a bit for being out of town in her early labor, she blamed the hospital staff for making her stay in the bed… but eventually she took responsibility for her part. She chose the practice and the hospital. She chose the method of preparation for her birth.

But I ask why is there a need to assign blame at all? Today I read an article by a hypnobabies instructor who is also a doula. She feels that her students when they fail to select a hypnobaby doula are setting themselves up possibly for failure. Really? What kind of doula does not ask her client what she will need in labor for support and then offer her that? When was the success of a childbirth method working properly up to the doula? She tells me she did not mean the article to portray that thought, but I read it again- and it is what it portrays to me. I think we need to take responsibility for that which we choose- the practice, the location, the childbirth preparation, the support and the mind body connection we either fail to make or make. It is not about blame but responsibility.

Sometimes bad things happen to good people. Sometimes you can do everything right- do everything you know to do, and the outcome is still not perfect. It happens. I understand now returning to the restaurant- I have done that! I understand wanting a fresh, clean slate. A new canvas to paint the next painting on. I get it. I hope this mom will call me soon. I hope she allows me to be there for her in her sadness and disappointment. But if she can not, I understand that for now too. I have been lost in the middle of the labyrinth before and sometimes it just takes time to venture out.

But if women are going to learn to take back their births, they will also need to take responsibility for that which they can control and let go of the things they can not control and forgive. Moving forward means just that- one step in front of the next, not lingering to constantly look back at what could have been or should have been- but moving forward for that they want.