Hayden Layneís Birth Story
Sunday, April 17th was Haydenís due date, and I had been having contractions all day. The contractions started around seven in the morning and were 3-5 minutes apart, and intense enough to get my attention. The sensations continued for a couple of hours, and then started to become more irregular in timing and varying in intensity. They were at times slowing down and becoming further apart. I spent the day alternating between relaxing and doing things to keep the contractions coming. We went for several walks (it was a beautiful sunny day) and also allowed Liam (our first son) to nurse as often as he wanted (the nipple stimulation helped to strengthen the sensations). Around 8:30 or 9 PM, the contractions started to become stronger again. After about an hour or so, I started to become hot and flushed. I also started to feel nauseated. I decided it was time to call the midwife. We called around 11 PM and I described what I was feeling and she said it sounded as if it was time for us to come to the Birth Place. We left the house at midnight. Upon arrival at the hospital, they checked my cervix which turned out to be 5-6 centimeters dilated. I was four centimeters at my last appointment four days earlier. They began to monitor the contractions, at which time were 2-4 minutes apart. As time passed though, the contractions began to pitter out again. They asked if I wanted them to break my water. I was very hesitant to do that, because it had been my original intention, as stated in my birth plan, not to have artificial rupture of the membranes. They suggested I try to sleep and get some rest. We were able to fall asleep at about three in the morning. At 5:30 AM, Gretchen came into the room. She checked my cervix, and I was only at six centimeters. Again, we talked about whether or not to break the bag of waters. I agreed that it should be done. It seemed that it was between either that, or continuing to labor for another day or so, and not really be able to rest. I was afraid that if I went on to labor for that extended amount of time, I would not have the energy to push when the time came. Gretchen assured me that we would have a baby very soon after she broke the water, although I knew that it would also immediately intensity the contractions. We decided that I would rest for a couple more hours, while Gretchen went home to get her son off to school. We would rupture the membranes when she returned. At 8:15 AM we broke the water. It was suggested that I spend some time in the shower and I did some nipple simulation to get the labor going. It sure worked!!! In the shower, I began to experience some very intense sensations right away. By the time I was out and dried off at around 9AM, I could not talk through them. I could not concentrate on anything else but what my body was feeling. I labored standing, and swaying, leaning against the birth ball and the bed, while Craig rubbed my back. The sensations were getting stronger and stronger, at times I began to doubt myself, almost on the verge of panic. I was starting to tremble a bit and asked Gretchen if I would be nearing transition already. The answer was yes. I began to make some low labor sounds to direct that energy elsewhere. Still looking for an outlet, I turned, and held onto my husband He felt so strong, and it brought such relief to be in his arms. We continued to sway back and forth as I held onto him. I knew I was not alone. After a couple more contractions, Gretchen asked to check my progress. I was close, but had no urge to push yet. I got back off the bed, as it was unbearable to remain still. Only one to two contractions later, I did feel that urge. I felt my body give small grunting pushes at first, during the very peak of a contraction. With each one, though the urge became stronger and stronger. I was not able to breath through them and not push. We got back onto the bed and checked my progress again. I heard Gretchen say that there was still a bit on an anterior lip, but there would be no stopping the baby. I was still on my back, when I felt the urge to push again, and reminded everyone that I did not want to be on my back for the birth. We raised the head of the bed, and I turned and got on my knees. I pushed while on my knees, leaning over the back of the bed. At times, I also sat back on my heels in a half squat. I started to feel Haydenís head getting lower and lower and it felt as he was almost crowning. A few more moments of self doubt as the pain was even more intense. My perineum began to burn and stretch. I was afraid to push, but with each wave that overcame my body, I was not able to hold back. I had to surrender. I had to feel this experience down to the core of my being. Surrendered I did. I thought I was going to rip straight up the front. I kept pushing. I heard myself, and the laboring noises I was making and I knew that this was the most basic, primal instinct a woman could have. I could not believe that I was doing this. I was encouraged to give one long push, and out came Haydenís head (I would find out later that his right hand was along side his head). A short rest, and I was told to keep pushing. It was so difficult, because after his head was out, I kind of lost the urge to push. I tried one push, but it was not enough. After a short rest, I pushed his body out with all of the energy I had left at 9:56 AM. Unreal. The cord was cut, and I turned over to deliver the placenta. He was soon returned to me and we began to nurse as I was sewn up. I tore along my old episiotomy scar, and to the side, where his hand had come out with his head. The birth had been perfect. A beautiful little boy. Thank God, Thank the Universe... and Thank You..... Family Nurse Midwives.
Gina Schwickrath,

Belle Vernon Pirate Men Now Available Many thanks to Julie Cameron who donated some Pirate Men figurines to our play area to be used with our Fisher Price Pirate Ship. Unfortunately the original crew disappeared this past fall, which has made it difficult for children visiting our play area to play with our Ship. Any donations of additional crew members would be deeply appreciated.

Contacting the Midwife After Office Hours Although the midwives love very much to talk to their patients when they are experiencing problems or having concerns, we would like to request that discretion be used when paging them. Please remember that the midwives can not fill routine prescriptions without your chart, so please do not page them for routine refills These calls must be made during regular office hours when your medical chart is available to them. If you do need to contact them for a medical emergency, they can be paged at 724-527-3551.

May is International Doula Month May in International Doula Month.
It also marks the 10th Anniversary of "Hearts and Hands" Doula Service, which is the largest and oldest doula group serving the Pittsburgh area that provides both birth and post partum support. What is a doula and is having a doula at your birth right for you? Thousands of years ago in Greece, the woman of the household chose her favorite female servant to attend her at the birth and afterwards. This special servant was called The Doula" In 1992, Doulas of North America was established and the practice of women being in service to other women as they became mothers were reborn. Today, there are two types of doulas, birth and postpartum. At the titles imply, one is for use during the childbirth and the other is to help at home afterwards. Both provide physical, emotional, informational, spiritual and mediatorial support. A doula is a personal handmaiden, trusted friend and reliable resource all rolled into one. Plus, she offers the woman to woman connection so many mothers find to be reassuring and confidence-building. The doula can act as a "go-between" with family, friends or health care providers if needed. Doulas do not offer medical care, advice or interpretations-only support. This is what separates them from midwives, nurses and doctors who are the ones who do have the medical responsibility. Birth doulas generally meet with the client, speak after all appointments, create a birth vision together, attend a momís appointment close to the due date, goes to the birth, assist with bonding and breatfeeding, talk regularly after mom goes home and visits about a week after the birth. In case of an emergency, a back-up doula should always be a part of the deal and should be interviewed beforehand as well. The cost can range from $350.00 to $650.00 (dependent on level of expertise of the doula) and some insurance companies or employee benefits funds reimburse for the service. Many doulas bring a gift and a birth report to the final meeting and ask that the mom check in at 6 weeks or sooner. They also provide resources and referrals to area experts and support groups. Couples using midwives often wonder if a doula is necessary for their birth. There function seems rather similar but they are uniquely different. Both offer support but when it is time to catch the baby, the midwife must put on her "medical hat". Also, midwives and nurses are on shifts and may change in the middle of a birth. A doula is there for however long it takes and is a consistent source of support. Establishing a rapport with one doula is easy. Since doulas know the midwives and are in sync with her practices, the doula can bring the birth team together in a special way. Also, births often happen overnight and the midwife must be well rested to provide medical guidance and expertise. She may require sleep to prepare for your birth- a doula can be half asleep and still function adequately. Photos or video are often taken during a birth. Doulas take great pictures before, during and after the birth which staff is often unavailable to do because of their other responsibilities. Afterwards when the staff is busy cleaning up, providing continuing medical care and documenting the details of the birth. A doula is free to assist with that special bonding time and initial breastfeeding latch-on. Postpartum doulas meet with the clients before the birth and take a tour of the house. They keep in touch, especially near the due date and begin the job within a couple of days to a week or so after the birth. Their job usually include mother care, baby care, sibling care, light housekeeping, meal preparation and short errands. Postpartum doulas are not glorified baby-sitters or housekeepers. They are specially trained and experienced women who help the parents and baby transition into being a new family. Post partum doulas do not provide medical care, advice or interpretations either. Educating the family, modeling roles, showing them organizational skills and facilitating good communication between all is the postpartum doulaís purpose. The cost can range from $12.00-$20, an hour (dependent upon expertise of the doula and number of children). Providing resources and referrals to area experts and support groups is also a function of the postpartum doula. This option has become more and more popular since family and friends are often not available to provide postpartum support needed by the new family. When interviewing doulas, keep these issues in mind: personal birth/parenting philosophy, experience and references, training and certification, service details and costs, clearances and malpractice and availability of a back-up. A face to face meeting is a great way to see if you are a good fit before signing a contract and giving a deposit. Picking an established group with a good reputation is usually a good way to find the appropriate doula for you. Being treated like "Queen of the Day" (or days, weeks or a month) seems only fair when you consider the work involved in birthing and mothering. Would YOU like to be a Queen? Article Written by Jan Mallak. 2LAS, ICCE-CD, CD-PCD (DONA) Founder and Coordinator of Hearts and Hands Doula Service

Janís Brochures are available in all of our new OB packets along with her class schedule. Jan can be reached at 724-327-6063

What Is Osteoporosis? Osteoporosis is when the bones in your body loses calcium and become very weak causing a condition in which your bones can break very easily. Bones may become so weak that they can even break when doing everyday activities such as bending over or walking. Calcium in your bones is like your money in the bank. Your body draws on this "calcium savings account" regularly to keep you healthy. At the same time, your body also takes calcium from food and makes regular deposits in your bones. Through childhood and young adulthood there are more deposits than there are withdrawals. Your bones get thicker and harder, but by the time you are 30 years old, your bones are as big and strong as they are ever going to get. Once you reach the age of 30, your body no longer stores calcium and it does not build bone as easily. For most people, the calcium withdrawals begin to outnumber the deposits. Their bones may begin to dissolve and over time the inside of the bones may begin to look like Swiss cheese. More than 25 million people in the United States have some bone weakness. Most of the people with osteoporosis are women over the age of 40. You are more at risk of getting osteoporosis if you are *White* *Are over the age of 65* *Are in poor health* *Have a family member with osteoporosis* *Are a smoker* *Are an alcoholic* *Do not get regular exercise* *Have never been a milk drinker or eaten many foods with calcium* You can not change your age, race or family history, but there are several things you can do to prevent osteoporosis. You can get regular exercise, such as walking and stop smoking if you are a smoker. Cut back on alcohol and try to consume at least 1,200 mg of calcium every day. Milk and milk products are the best source of calcium. Four cups of milk every day will give you 1,200 mg of calcium. Other good sources of calcium are sardines or canned salmon with the bones, cooked and dried beans, macaroni and cheese and dark green leafy vegetables. There are a few great websites to log onto to learn more about osteoporosis/ www,nof.org-National Osteoporosis Foundation www.laurushealth.com-Check out "Osteoporosis"in the Health Library www.cdc.gov/powerfulbones-This is the Center for Disease Control and has great information for building strong bones in teen girls and is a great site for mothers who want to encourage their daughters to be strong and healthy. Look under "Powerful Bones, Powerful Girls"

Used Baby Items for Sale

Ocean Wonders Aquarium take along Swing, only used one month........30.00

Snap and Go Stroller for Multiple Infant Car Seats, used one year...............30.00

Baby Trend Latch-Loc Infact Car Seat with Base used 8 months..........55.00

One Seat never used, six months old ..........65.00

Bottle Warmer/Cooler used 4 months ..........15.00

For more information call Mary 724-527-1417.

If you have any items that you wish to sell or give away or are in need of any particular items, please let Sue know. We now have an exchange page on our website

Third Time A Charm By Wendy Duke
It has been 3 months since the birth of Alex and it seems like just yesterday. My pregnancy was uneventful, but seemed to last forever. I guess trying to keep up with 2 and 5 year olds may have contributed to that. My second labor from start to finish was only about one hour. I know everyone says "what luck", but my feelings were "how scary". I was afraid I would be one of those women who deliver in the car on the way to the hospital. I think I voiced my concern to Gretchen at every office visit that my third would be just as quick. She calmly reassured me that she would keep close tabs and we would try not to have another close call. One October 27th, 2 weeks before my due date she went to measure my belly and I asked her to wait a minute because the baby was "pushing" out. She felt my belly and ask how often he was "pushing" I said every once in a while. She said that was a contraction not the baby pushing. When she checked me I was 3 cm. She instructed me to go home, do nipple stims, walk, come back in a few hours and we would see what was going on. I did just as she instructed. When my husband and I returned to the office around 5:30, my contractions were a little stronger and more frequent. I was 5 cm and she decided to admit me. I was so relieved. I was at the hospital and Gretchen was too!! We walked around the block on the way to Family Birth Place and called our family. My contractions were still irregular and not very uncomfortable. At 7:45 PM, Gretchen decided to break my water. WOW!!! That got things moving. These were the contractions I remembered, one on top of the other. Soon I was ready to push. I still say there is nothing in the world like the feeling of that head coming out. His shoulders were a little big and needed some help. but Gretchen remained calm and wiggled him right out-exactly one hour after she broke my water I cannot begin to tell you how fortunate I feel that all 3 of my children came into this world with the wonderful guidance of Gretchen and Sandy. Although Alex has completed our family I will continue to use the Midwives and recommend them to everyone I can.

Nurse Midwifery Week Please mark your calendars for the first full week in October as this is Nurse Midwifery Week. Our practice needs your support to help us recognize and celebrate this very special week. We will be hosting a patient reunion tentatively on Thursday, October 06 th from 6-8PM in Founders Hall. This will be a great opportunity to network with other patients and show your support. Other activities will be scheduled during this week such as an Open Orientation night. More details will be planned over the summer months. If you have any creative suggestions for either our patient reunion evening or any other events to help increase public awareness of nurse midwifery, they would be greatly appreciated.

Changing Bodies in 2005 Let 2005 be the year that you finally take those extra steps you need to take to lose those extra pounds. Obesity is on the rise and along with it there is a sharp increase in hypertension, diabetes, heart disease and other health conditions. With the warm months approaching us, take the time to put yourself first by taking the time to exercise and make healthier eating choices. Our office has recently seen an increase in women who are trying to make these lifestyle changes for both themselves and their families. The midwife would be more than happy to provide you with suggestions and Sue has Diet Journals available at the front desk. Many patients recently have shown an interest in starting a support group to share ideas and healthy recipes. If you are interested, let Sue know, and she will help coordinate such a group. Need someone to account to for your weight loss? Let us know. We will be more than happy to weight you in at the office on a routine basis and cheer you on. Let 2005 be the year to make the change for a healthier you. You are important to your family. By placing yourself first, you can have more energy to do activities with your family and will help prevent many life threatening health problems

Physical Therapy and your Pelvic Floor Like many other muscles in your body, the pelvic floor muscles need to strengthened to help provide you with their optimal level of usage. The pelvic floor muscles play an important role in bladder control and the prevention of bladder leakage and incontinence. There are techniques available that done consistently will provide a stronger pelvic floor. Pelvic floor exercises or Kegels have been shown to improve mild to moderate urge and stress incontinence. Through regular exercise one can build and improve the pelvic floor as well as increase overall indurance. This will help maintain and improve bladder and bowel control. These exercises are also appropriate for pre- and post-natal care. The muscles of the pelvic floor are located in the base of your pelvis between the pubic bone and the tailbone. These muscles have three main functions. They are to help support the abdominal and pelvic contents from below, help control bowel and bladder functions and are involved in sexual response. Like other muscles in your body, these muscles can become weak therefore decreasing our level of function and efficiency. The pelvic floor muscles are sometimes difficult to find. They are the muscles that hold back gas or stop/slow down the stream of urine. For instance, imagine "bomber" doors on an airplane. The bomber doors are pulled up and in to close. The same with the pelvic floor muscles. They squeeze and lift the rectal and vaginal area up and in without tightening the buttocks or abdomen. Another way to find these muscles is to try and stop your flow of urine. Do not do this on a regular basis though. Use it only to find these muscles. A mirror may also be helpful for location. There are two types of suggested exercises for the pelvic floor. The first type works on the ability of your muscle to hold back urine. It is done by slowly tightening by lifting and drawing in the pelvic floor muscle and holding it for a count of five. You may only be able to hold for a few seconds in the beginning, but after a period of weeks, you should be able to progress to a 7-10 second hold. It is important to rest 10 seconds between each hold. This allows for proper recruitment of the muscles. Make sure you exhale with each contraction. The second type of exercise is a quick contraction know as "quick flicks" The muscles are quickly tightened, lifted up and released. A 2 second hold and 4 second rest. This works the muscles that quickly shut off the flow of urine to help prevent accidents. Remember it is important to exercise only the muscles of the pelvic floor. The muscles of the pelvic floor are between the pelvic floor and tailbone. Do not tense or contract the legs, buttock or belly. These exercises should be done on a daily basis. Three positions should be utilized. Lying down, sitting and standing. To improve muscle function you must challenge the muscle to work harder than they are used to. Ten repetitions of each exercise in each position should be performed 2-3 times per day. Some women see improvement in 2-3 weeks, others in 3-6 months. Always tighten the pelvic floor muscles before you lift, cough, sneeze or laugh. This helps prevent leakage. By strengthening these muscles you can suppress the strong urge to urinate until you can reach a restroom. Pelvic floor exercises should be incorporated into your daily exercise program. For many women, physical therapy may be required to help with incontinence. "Physical Therapy for Women" is a local group which is available to those who need additional assistance. For more information about incontinence or their programs call either the Harrison City office at 724-527-3999 or their Monroeville Office at 412-373-9898 This article was written by Lauren Mazzei, MPT.