Thursday, February 13, 2014

Childbirth Classes in Northampton - Spring 2014

(This class series is already completed. Please click HERE to find the current class schedule.)

These comprehensive childbirth classes cover all aspects of pregnancy, labor and delivery, and postpartum care, including medicated and non-medicated pain management. Breastfeeding and Infant Care classes are also available. Unlike Bradley or Lamaze methods, we tailor our classes to help each individual couple determine what kind of birth they want and what they can do to achieve it. Whether mom wishes for an epidural or a non-medicated birth, to breastfeed or feed with formula, is planning a vaginal birth or scheduled Cesarean birth, we help her plan for her care and build the skills necessary to have the birth she wants.


Spring 2014 Schedule - Northampton, MA

To sign up for a class, click here to contact Mollie at Crafted Birth.


6-Week Series

Dates: Saturdays, March 1 through April 5, 10am--12pm
Cost: $90.00 per couple*
Classes (2 hours each):
  • Saturday March 1: Choosing Care, Anatomy & Physiology
  • Saturday March 8: Labor & Delivery
  • Saturday March 15: Pain Management
  • Saturday March 22: Common Interventions
  • Saturday March 29: Basic Newborn Care & Feeding
  • Saturday April 5: Postpartum Care 


Breastfeeding

Date: Saturday April 12, 10am--12pm
Cost: With 6-Week Series, $15.00 per couple
            Without series, $20.00 per couple
Topics:
  • Anatomy of nursing
  • Latch
  • Breastfeeding Positions
  • Common problems and solutions
  • Pumping and Bottle-Feeding Expressed Milk 


Newborn Care

Date: Saturday April 19, 10am--12pm
Cost: With 6-Week Series, $15.00 per couple
            Without series, $20.00 per couple
Topics:
  • Newborn Anatomy
  • Bathing and Skin Care
  • Diapering
  • Calming and Swaddling
  • Sleep Safety
  • Car-Seats
  • Baby-wearing 


Group Weekend Intensive Class

Dates: Saturday May 3, 1pm--5pm & Saturday May 10, 1pm--5pm
Cost: $120.00 per couple
Topics:
  • Choosing Care, Anatomy & Physiology
  • Labor & Delivery
  • Pain Management
  • Common Interventions
  • Basic Newborn Care & Feeding
  • Postpartum Care 

To sign up for a class, click here to contact Mollie at Crafted Birth.

For information about private sessions and to discuss pricing and scheduling, please contact Mollie

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Follow Crafted Birth on Facebook for updates and birth-related resources.

Jeopardy Review Game

(Cross posted in my crafty blog, Tough Love Knitters)

When I was in high school I had a wonderful Anatomy teacher named Mr. Annand. He was famous for a strict no-swearing rule in his classroom (punishment was 10 push-ups), his Friday Talks (where he lectured us on smart choices like abstinence ("not until you're married and financially stable") and not drinking ("when you're TWENTY-ONE"), and the infamous STD slideshow ("This ... is a penis. This is a penis with herpes. Any questions?"). But more than that, he was an awesome teacher with a wonderful ability to make the material fun. Interpretive dances about Mitosis and Meiosis, 3D models of DNA, and my personal favorite, Jeopardy Review games before big tests (and there was always a Potpourri Trivia category about movies).

During my CBI training, I wrote up a fun activity to review class material and get students to relax and have fun. Thanks to Mr. Annand, I have a very good idea of how to run a Jeopardy class activity.

Of course we need a good title.

Jeopardy Review Gam - Title
"THIS ... IS ... PREGNANCY!"

And some categories. Classes 1 and 2 cover different types of care providers, decision-making, maternal anatomy, fetal positions, stage 1 labor, and stage 2 labor. Before covering stage 3 labor and pain management, I want to make sure students remember he key points of the first two classes.

Jeopardy Review Gam - Board

And questions/clues, of course. Many of them are actually written so they can be answered in the form of a question.

Jeopardy Review Gam - Question


I had so much fun with this. And the internet is oh so helpful with things like this.

Question font ... the official font is call ITC Korinna bold
But this one, ScaKorinna, can be found here for free.
http://fonts101.com/fonts/view/Uncategorized/29108/ScaKorinna
White with a black shadow.

The Category font is haettenschweiler, but I couldn't find a porn-free site to download, so I used Impact. Close enough.

This school had a fun PowerPoint template, including the Final Jeopardy music.
http://sctritonscience.com/Wilson/powerpoint_review_game_templates.htm

I ended up making my own, with hyperlinks so I could go back and forth between the clues and the game board while the presentation was in full-screen mode.
(adding hyperlinks within a presentation).
Note: you can change the color of the hyperlinks in the color themes, so they'll be the correct Jeopardy colors and not the default bright blue that doesn't match anything.

This should be fun!!!



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Like what you've read? Pregnant and looking for a class in Western/Central Massachusetts?
Check out our current class schedule here.

Questions? I'm never very far away from my email.

Follow Crafted Birth on Facebook for updates and birth-related resources.

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Tuesday, February 4, 2014

Facebook Rules for Late Pregnancy/Birth Announcements

If I ever have another baby, I'm instituting some strict rules for Facebook Comments.


1) Don't ask me if I've had the baby yet. If you post on my wall or comment on a post asking "Are you still pregnant?" or "Wow! You still haven't had her/her yet?" or "This is taking tooooooo long!" or "Where is this baby you've been promising me?" or "Baby time yet?" ... I will delete it. (Note, this are all real quotes taken from a friend's FB page over the last few weeks .. and she's not even due yet.). Guess what ... it takes a long time to make a baby. "Due Dates" are based on 40 weeks, but did you know that the average first-time pregnancy lasts 41 weeks and 1 day?(http://www.ncbi.nlm.nih.gov/pubmed/2342739) Babies are not "Post Due" until 42 weeks. So people, keep your astonishment that yes, that baby is still inside by body to yourself. Believe me, I'm aware.
While we're on the subject, don't ask me how many more days until I have the baby. Cause I don't know. Baby will come when baby will come. And only about 5% of babies are born on their due dates, so please stop fixating on that day. I won't be. (You'll also notice that I'll stop answering the "When are you due" question after a while, because I don't want to fixate on the date. "Sometime in April or May" is going to have to suffice.)



2) Don't tell me how fat I'm getting, or that I'm not big enough to be full term, or that I must be having twins. Most women do not like comments about their size, and pregnant women are no different. Commenting on the size of my belly is rude, and it makes it sound like you have nothing better to say. Here's are some suggestions: "You look great!" or "How are you feeling?" or "Can I bring you a coffee/dinner/flowers?"


On the same note ...

3) Don't comment on by baby's size. If he's 9 pounds, don't scream that he's huge and I must be "feeling sore" or that you hope they cut me open to get him out. Because if I'm healthy and I still grew a 9 pound baby, then I'll be able to push out my 9 pound baby. Unless I have Gestational Diabetes, there's no reason to think that my body will grow a baby that's too big to get out. All that comment does is perpetuate the fear of "big babies" requiring induction or cesareans.
And if he's tiny, don't say that be probably just "fell out of me", unless you want to diminish all the work I just did. Because even a 5 or 6 pound baby requires labor, and labor is hard.
The tradition of describing the baby by weight came around because it was the easiest way to determine the baby's health -- which is the reason why when we say "10-pound baby" we go "WOW!!!" but when we say "4-pound baby" we say "ooooo, that's not good." It's ingrained in our culture, but it doesn't need to be anymore. How about you ask me "How's he doing?" And since I'm clearly on Facebook already, I'll just tell you "He's doing great".


4) Don't suggest that I'll need pain medication, or tell me that I'm crazy for planning an unmedicated birth. I probably won't be using an epidural, until it's absolutely necessary. I'm not ruling it out, but I'm planning to go med-free, that's just how I roll. It's possible to have babies without pain medication, it happens every day. Again, please keep your astonishment to yourself.


5) Don't tell me horror stories. Don't tell me how your mother's aunt's daughter's friend's neighbor died because she had a homebirth. Or that you couldn't breastfeed. Or that you read on Huffpost that my uterus can explode during labor. Just don't. Now, as an educator, I would love to ask you why you feel the need to talk about horrific things related to childbirth, because I think we could uncover a few things. And I'd love to talk about the misperceptions about breastfeeding difficulties. But don't put that into my head when I'm about to have a baby. Only peaceful, positive things here. Need a suggestion? How about the classic, "How are you feeling", or "You're going to do awesome," or "I can't wait to hear all about it" (oh, does no one else like to hear all the details of other people's births? Just me?).



These are just a few I've come up with so far. More will come, I'm sure of it.


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Like what you've read? Pregnant and looking for a class in Western/Central Massachusetts?
Check out our current class schedule here.

Questions? I'm never very far away from my email.

Follow Crafted Birth on Facebook for updates and birth-related resources.

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Monday, February 3, 2014

Circumcision -- Evidence-Based Information for Parents

Circumcision is a controversial topic for many parents, and it is often difficult to find unbiased, evidence-based information about the procedure, benefits, and risks. Parents rely on Facebook pages, message-board threads, and their friends for information. Unfortunately, there is no regulation over what friends and webpages can say, and a community group or a meme is not required to cite their data. Parents must be critical of all the information provided to them and check that it coming from a reliable source. We encourage you to check the data presented here as well! It is your right to have correct, reliable, evidence-based data, and it is your responsibility to make an informed decision for you and your family.

**The information provided below was gathered from peer-reviewed journals and trusted sites. If you have questions about the data presented, please contact CraftedBirth@gmail.com or speak to your pediatrician**

For a printable version of this information, please click HERE.



CIRCUMCISION


What is it?

In infant boys the foreskin is fused to the tip of the penis (like the skin is fused around a fingernail). As an intact penis grows, the foreskin begins to separate from the tip, and can usually be fully retracted by age 10. Circumcision removes the foreskin. It is usually performed within a few days of birth by a pediatric surgeon or a religious figure like a mohel. In 2010, about 58% of newborn boys in the U.S. were circumcised; the rate is about 30% in Canada, and less than 20% in Europe.1 The procedure is very common in the Jewish and Muslim faiths.



How is it done?

The baby is placed on his back and his arms and legs are restrained to prevent movement during the procedure. The baby will either have a topical anesthetic applied to the surface of the penis or have numbing agents injected into the base of the penis. The foreskin is first separated from the tip with forceps and cut with surgical scissors or a scalpel to expose the tip.

Plastibell Method: a clear plastic bulb is placed over the tip and covered with the foreskin. A suture string is tied around the foreskin, squeezing it tightly against the plastibell. The skin above the tie is cut with a scalpel surgical scissors. The ring is left on and will fall off in 3—7 days when the wound heals.

Gomco Clamp: a bulb is placed over the tip and covered with the foreskin. The clamp is placed over the bulb and tightened until the skin is squeezed tightly against the clamp. The foreskin above the clamp is then cut with a scalpel or surgical scissors.

Mogen Clamp: the foreskin is lifted through a clamp and pressed flat. The foreskin above the clamp is cut with a scalpel.2,3,4

 Circumcision - Procedure



What are the potential risks?

The overall complication rate is about 1.5% (conclusive rates for individual complications is not currently available). More complications are seen with non-medical providers, non-hospital-based procedures, “free-hand” methods, premature infants, and older children and adults.5 While death due to circumcision complication is rare, it has been reported (usually due to bleeding, infection, and shock).6,7

Pain: Doctors may use topical numbing cream and/or a numbing injection to help ease the pain, as well as a pacifier dipped in sugar. A review of studies showed that none of these interventions completely eliminated the pain response to circumcision.8 The “Ring Block” injection is the most effective at blocking pain. All interventions run the risk of complications (8-14% show skin redness, swelling, irritation from topic cream; 11% show bruising from injection).9 Circumcision without anesthesia is extremely painful, so make sure your pediatrician, obstetrician, or mohel uses anesthesia and waits at least 30 minutes after application before proceeding with the circumcision.

Bleeding: Blood loss is often minimal, but in rare cases the frenular artery bleeds and requires sutures. If this occurs at home, blood loss may be substantial and cause shock or death. Undiagnosed blood disorders, such as hemophilia, can also lead to dangerous bleeding and if there is a family history of bleeding illness, circumcision is not recommended. (Note: because infant blood volume is low, even losing 1 oz of blood can cause shock, and losing 2.3 oz of blood can be fatal.)6

Infection: The incision can become infected. The infection rate is higher with the Plastibell method, as the foreign object remains on the penis for several days.7 Infection is also a specific concern with the Orthodox Jewish metzitzah b’peh ritual, where the mohel sucks the blood away from the penis with his mouth (which can also spread other diseases like Herpes).5

Meatal Stenosis: the narrowing of the urethra which can interfere with urination and require surgery to fix.7 

Adhesions: pieces of the foreskin remain stuck to the head and must be removed surgically.

Too much/too little/uneven skin removal: If too much skin is removed, a man may not have enough skin for an erection, and the skin may split. If too little skin is removed, the excess skin can slide back over the tip and scar, causing phimosis (when the foreskin cannot be retracted). If the skin removal is uneven, the penis may curve to one side. This is called Chordee, and may be treated with additional surgery. Note: some penile curvature is natural.7



What are the potential benefits?

HIV/AIDS: African studies have shown a decrease in HIV/AIDS infection when heterosexual men are circumcised. The theory is that the underside of the foreskin is more susceptible to infection (it contains more “target cells” for bacteria and disease).5 Circumcision would remove this susceptible skin. However, these studies are criticized because of the methods used and because the results cannot be duplicated in the United States and other developed countries (discussed below). The American Academy of Pediatrics states that circumcision is most beneficial in populations of very high HIV rates.10

Urinary Tract Infection (UTI): Only for boys with recurrent UTIs, circumcision can reduce the number of infections. The rate of UTI for healthy infants is about 1% for both circumcised and intact boys, and this rate declines as the boy ages.9



Why the controversy?

Disease:
- HIV/AIDS: Many disagree on the reliability of the African HIV studies. The circumcised men were put into different environments than their intact peers, with acess to clean water and soap, and the results have not been duplicated in the United States or other developed countries.11,12 Additionally, many believe that the studies have actually done more harm in Africa, as they may have instilled a false belief that circumcision alone prevents the spread of HIV. An alternate view states that instead of preventing sexually-transmitted diseases with surgery, men and women should be encouraged to use condoms and other safer-sex practices.
- Human Papillomavirus (HPV) & Penile Cancer: Similar to the HIV studies, results show a decrease in HPV infection in circumcised African men, but these results have not been duplicated in the U.S. Again, an alternate view states that condoms and the HPV vaccine is just a good at preventing HPV in men and women, and Penile Cancer in men (which can be caused by HPV).5

Ethics:
- Autonomy: Many parents believe that it is wrong to permanently alter a boy’s body when he cannot consent; however others argue that parents make medical decisions for their children all the time (for example, vaccination or medications).
- Tradition and Culture: Some equate male circumcision with female-genital-mutilation, which is illegal is many countries, including the U.S.; however many people believe circumcision to be a valuable and important part of their religion and culture.
- Elective Surgery: Some liken circumcision to elective cosmetic surgery, something that would never be allowed on an infant.

Official Recommendations: The American Academy of Pediatrics’ statement about circumcision is ambiguous:
“Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns.”12



Thought Starters:

Do you believe the benefits of circumcision outweigh the risks? 

Do you believe it is your job as a parent to make this decision for your son? 

Are there any other positive factors to consider? 

Do those factors outweigh the risks? 

Are there any other negative factors to consider? 

Do those factors outweigh the benefits? 



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Like what you've read? Pregnant and looking for a class in Western/Central Massachusetts?
Check out our current class schedule here.

Questions? I'm never very far away from my email.

Follow Crafted Birth on Facebook for updates and birth-related resources.

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Sources:

1.   Wikipedia contributors. "Circumcision." Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 23 Jan. 2014. Web. 26 Jan. 2014, http://en.wikipedia.org/wiki/Circumcision
2.   Morris, B. J. “Circumcision—The Procedure Itself” 2013, http://www.circinfo.net/the_procedure_itself.html
3.   Scheve, Tom.  "How Circumcision Works"  20 January 2009.  HowStuffWorks.com. 26 January 2014,  http://people.howstuffworks.com/circumcision4.htm
4.   Wikipedia contributors. "Circumcision surgical procedure." Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 19 Oct. 2013. Web. 26 Jan. 2014, http://en.wikipedia.org/wiki/Circumcision_surgical_procedure
5.   Meilke, R. T. “Counseling Parents Who are Considering Newborn Male Circumcision” J. Midwifery Womens Health, 2013;58:671-682
6.   Frisbie, D. “Death from Circumcision” The Male Infant Circumcision Information Site, 2010, http://www.circinfosite.com/45.html
7.   Newborn Nursery at Lucile Packard Children's Hospital , “Complications of Circumcision” Stanford School of Medicine, 2014, http://newborns.stanford.edu/CircComplications.html
8.   Brady-Fryer B, Wiebe N, Lander JA. “Pain relief for neonatal circumcision” Cochrane Database of Systematic Reviews 2004, Issue 4,   http://summaries.cochrane.org/CD004217/pain-relief-for-neonatal-circumcision#sthash.t0sibvLf.dpuf
9.   American Academy of Pediatrics Task Force on Circumcision, “Technical Report: Male Circumcision” Pediatrics 2012; 130:3 e756-e785, http://pediatrics.aappublications.org/content/130/3/e756.full
10. Young, M.R, et al. “Factors Associated With Uptake of Infant Male Circumcision for HIV Prevention in Western Kenya.” Pediatrics 2012; 130:1 e175-e182
11. Frisch, M. et al. “Cultural Bias in the AAP’s 2012 Technical Report and Policy Statement on Male Circumcision” Pediatrics 2013; 131:4 796-800, http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2896
12. American Academy of Pediatrics, “Circumcision Policy Statement. Task Force on Circumcision” Pediatrics, 2012; 130:3, 585 -586. http://pediatrics.aappublications.org/content/130/3/585.full

Just show me numbers

The West Wing Two Cathedrals Show me numbers meme
(from one of my favorite episodes of The West Wing, "Two Cathedrals")

I've yelled this a few times in the past few weeks. I've been spending my free time navigating through peer-reviewed journals (as well a few other less-reliable websites) trying to gather evidence about some of the more controversial topics for parents. 

One-sheets about Circumcision, Vaccines, maybe Bed-Sharing/Co-Sleeping will find their way to this blog (and to my classes) eventually (oh, and by One-Sheet, and I mean 2 or 3 pages, because I cannot seem to condense it all onto one page). It's surprisingly difficult to find reliable information about these topics online -- I now have much more sympathy for parents who are debating these decisions and end up relying on Facebook groups, BabyCenter threads, and their friends for information. Unfortunately, there is no regulation on what a Facebook group can post, a BabyCenter mom can share, or where your friends' opinions come from. Even medical research sites like the American Academy of Pediatrics, the Center of Disease Control and Prevention, and the World Health Organization make statements without any citations, so it is incredibly difficult to understand where all the "data" comes from. For example, one site may say "Adverse reactions to this vaccine are extremely rare", while another says "Your child can have a serious adverse reaction to this vaccine"; both statements might be correct, but neither tells you what the adverse reaction is or the likelihood that it may happen. That is what we're going to try to fix.

Over the next few months Crafted Birth will delve into these topics for you, pulling out the best information and giving you NUMBERS to help you make the best decisions for yourselves and your baby. Stay tuned ...



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Like what you've read? Pregnant and looking for a class in Western/Central Massachusetts?
Check out our current class schedule here.

Questions? I'm never very far away from my email.

Follow Crafted Birth on Facebook for updates and birth-related resources.

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