The decision of when, how, and why to vaccinate (or not vaccinate) your young child is a hot topic spanning personal health, public health, spirituality, freedom, environment, and parenting forums nationwide.  How can one sort through the loaded arguments, personal anecdotes, reasonable assumptions, hypotheses, and scientific research to come to an fully informed decision that is yours and yours alone?  

One resource to start you off is an interview with Midwife and MD Aviva Romm. She discusses the many options and challenges facing families making these tough decisions in this recorded webinar.  Her approach to medicine is holistic and natural and she also has the research and clinical knowledge to balance the potential pros and cons of the both sides.  Best of all she truly approaches the topic from a unbiased, nonjudgmental perspective, presenting any and all relevant evidence.  More information can be found in her book, Vaccinations: A Thoughtful Parent's Guide.   

Topics include:
- Reasons people choose to not vaccinate or vaccinate their kids
- Benefits and side effects of vaccination
- How spacing vaccinations alters and fails to alter the potential side effects
- The most important vaccinations for children in the US
- Which vaccinations might be needed for international travel
- How to minimize reactions to vaccinations
- Natural methods of supporting the immune system

It's the possibility that most hope they don't have to face, but you never know if you and your baby might need an emergency or planned c-section.  If it does come to that, you can still prepare for the best c-section experience you can have.


Things to consider:
- Requesting skin to skin on your chest
- Request your partner or an accompanying family member or friend do skin to skin if you cannot
- Request to stay with your child while being stitched and moved to recovery
- Request sutures instead of staples, mothers with sutures are less likely to have complications and more likely to be satisfied with the stitches and scar appearance (Ob Gyn News)
- If you are morbidly obese, discuss a vertical incision instead of the typical transverse (Ob Gyn News)
- If a c-section is planned and there are no complications, see if you doctor can accommodate you waiting for you to go into labor instead of scheduling a date

Aviva Romm, family health practioner, herbalist, midwife, and MD, discusses the risks associated with gestation diabetes in this article.  She discusses the need for pregnant mothers and practitoners to asses the mother's risk at developing GD and their nutrition and diet. But she posits that universal glucose testing may not be the best solution.  The best take away here though is this...

The ACOG report released earlier this year clarifying situations in which interventions and c-sections can be avoided.  Knowing and discussing these with your doctor and doula may help you avoid an unnecessary c-section.  

Here is what you and they should know. (Taken from Childbirth Connection's summary of the ACOG report).  

Labor induction 

• Labor induction (using drugs or other methods to try to cause labor to start) before the 41st week of pregnancy should generally be done for medical reasons.
• Before inducing labor, if a woman's cervix is not soft and ready to open, drugs or devices for cervical ripening should be used to help prepare it for labor.
• Cesarean should not be used for unsuccessful labor induction (failed induction) until at least 24 hours of labor have passed without reaching a cervical opening (dilation) of 6 centimeters.
• If membranes are broken, cesarean should not be used for unsuccessful labor induction (failed induction) until synthetic oxytocin (Pitocin, a drug that is used to start labor) has been used for at least 12 to 18 hours.

Labor before the pushing phase 

• Cesarean is not appropriate before the pushing phase of labor if labor is slow but progressing.
• Labor before the cervix is open 6 centimeters is known as latent labor. Cesarean is not appropriate just because latent labor is prolonged (i.e., has gone on for more than 20 hours in first-time mothers or more than 14 hours in experienced mothers).
• Labor after the cervix is open 6 centimeters is known as active labor. Cesarean should only be done for poor progress in active labor if 1) membranes are broken and there have been 4 hours of contractions with no progress or 2) synthetic oxytocin (Pitocin, a drug that is used to strengthen contractions) has been used for 6 hours with no progress.

Labor during the pushing phase 

• There is no fixed upper time limit for the pushing phase of labor.
• Intervention should not be used for lack of progress (arrested labor) until first-time moms have pushed for at least 3 hours and experienced moms for at least 2 hours. More time may be appropriate, e.g., if the woman is using epidural pain relief or the baby is not well-positioned for passing through the pelvis, so long as some progress is being made.
• When the baby is not well-positioned for passing through the pelvis, having a provider use a hand to move the head to a better position (manual rotation) may avoid the need for assisted vaginal birth (with vacuum extractor or forceps) or cesarean birth.
• When intervention is needed during the pushing phase of labor, a providers skilled, experienced use of a vacuum extractor or forceps is a safe alternative to cesarean birth.

Other 

• Continuous labor support, such as labor doula care, reduces risk of cesarean.
• Cesarean is not appropriate even for most babies that are estimated to be large near the end of pregnancy (estimates are often wrong, and many large babies are born vaginally). It may be appropriate if the baby is estimated to be at least 4,500 grams in women with diabetes and at least 5,000 grams in other women (5,000 grams, or 11 pounds, is rare).
• If a baby is breech (buttocks- or feet-first) at about 36 weeks of pregnancy, hands-to-belly movements to turn babies head-first (external cephalic version) should be offered.
• Women with twins and the first twin head-first should be encouraged to plan a vaginal birth.
• Women who have had herpes simplex virus should consider using acyclovir, a medication to prevent a late-pregnancy outbreak, and should plan a vaginal birth if the virus is inactive at labor.
• Women who are counseled about avoiding excess pregnancy weight gain may be able to avoid a cesarean.

Bring Me The Gas!

The return of nitrous oxide to the delivery room.  

"Nitrous does not eliminate pain, as an epidural does; generally women report that nitrous makes them care less about the pain. “I felt the pain but I was able to distance myself from it,” is how Shauna Zurawski, a new adopter who used it during the birth of her son last year, described it to me.Because it doesn’t block pain, nitrous allows women to maintain control during labor. “You can still move around, you can also use it in a tub,” says Fletcher Wilson, obstetrician at Monadnock Community Hospital (MCH) in Peterborough, N.H., which recently started offering the gas to obstetric patients. "