2015 Twin Cities Medical Group Primary Cesarean Rates

I’m a big nerd when it comes to birth data. Maybe you’ve noticed. So when new information becomes available, it’s like Christmas to me. Yesterday, I figured out that MN Community Measurement had finally released their 2015 Health Care Quality Report. For the second year in a row, they reported Primary Cesarean rates by Medical Group.

So, some good news. The State’s rate of primary cesarean dropped from 22.2% to 21.9%. After a decade of rapid increases in cesarean rates, this is just another measure that shows we’re going in the right direction. Whee!

OK, time for the real stuff. From highest rates to lowest, here’s what the report has for Medical Groups. For comparison, I put the rate from 2014’s report in parentheses.

  1. Allina Health Specialties- 34.7% (27.9%)
  2. Comprehensive Healthcare for Women- 33.0% (30.5%)
  3. Western OBGYN- 29.2% (26.1%)
  4. OBGYN West-27.9% (24.1%)
  5. Women’s Health Consultants- 27.0% (24.9%)
  6. Metropolitan OBGYN- 26.0% (29.5%)
  7. Partners OBGYN- 25.2% (27%)
  8. Clinic Sofia- 25.1% (25.1%)
  9.  Obestetrics and Gynecology Associates- 24.8% (21.9%)
  10. Hennepin County Medical Center Clinics -24.7% (19.1%)
  11. Fairview Health Services- 23.5% (24.8%)
  12. Adefris and Toppin Women’s Specialists- 21.9% (27%)
  13. Healthpartners Clinics- 21.7% (n/a)
  14. Allina Health Clinics- 21.6% (25.8%)
  15. Southdale OBGyn Consultants- 21.5% (21.6%)
  16. Park Nicollet Health Services- 20.1% (19.2%)
  17. North Clinic- 19.6% (24.4%)
  18. Multicare Associates- 19.3% (29.5%)
  19. U of M Physicians-18.4% (17.3%)
  20. Oakdale OBGYN- 16.3% (18.7%)
  21. John A Haugen Associates- 16.2% (21.2%)
  22. Hudson Physicians- Minnesota Healthcare Network- 14.9% (11.8%)
  23. AALFA Family Clinic- 4.7% (13.0%)

You can read the full report for 2015 here.

Coming up in the next post, I’ll share my thoughts on some of these numbers. In the meantime, enjoy!

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Announcing The BabyLove Alliance’s Doula Program

As the Executive Director of The BabyLove Alliance, Ltd., I’m proud of many things. I’m proud of our 501(c)3 status. I’m proud of the little organization we’ve built. I don’t think building this or any non-profit is as hard as anyone likes to think it is, but it’s still an impressive little accomplishment. We’re working on creating a program that integrates prenatal education and birth doula support with mental health and medical risk counseling, and I’m working on raising money to open our very own Baby Cafe to provide breastfeeding help and support to families free of charge. Today, I want to tell you about our doula program.

First, a little background: I’ve been a doula for 9 years. I started my career in Southeast Minnesota. Things there 9 years ago were very different than they are in the Twin Cities now. First of all, there were (and still are) only a handful of doulas in the area; however, those doulas were some of the kindest, most caring doulas I’ve ever had the pleasure of working with and I miss seeing them on a regular basis. Second of all– do you know how much doulas cost? I charged $350 for the first two years I was a doula. That was a totally normal fee. By the time I started taking clients again after my son was born (7 years ago), I think I was charging $550. Third, many of the doulas that started as doulas the same time I did are no longer doulas. Why? Being a doula in a solo practice is brutal to maintain over any length of time. It’s hardly steady income, it’s almost impossible to balance with any other job, and if you have kids it requires many sets of extra hands to be willing and able at any given time to pitch in when a doula is called to a birth. It makes it exceptionally difficult for doulas who don’t have family at the ready. It also means almost any doula ends up having to be a stay at home mom.

As my doula fee for private clients crept up, I’ve become acutely aware that, in all likelihood, that fee was out of line with my own family could afford if we had to hire a doula today. Paying what amounts to a mortgage payment or a month’s rent on a doula? Whoa. Now, it would take a book to explain how doula costs got this high, but if you believe in market forces (and, yes, I actually do), then it’s easy to tell it was time for something to change.

So, if you’re keeping track, there are a couple of issues at play: It’s hard for anyone who needs to work a regular job to pay the bills to work as a doula in private practice (how 99%* of doulas in the US operate). It’s hard to be a doula in private practice unless you have a ton of flexible social and family support to help with childcare. It’s hard for families to pay for doulas out of pocket (and no–I’m not going to tell parents to go to extreme measures to pay for doula care). Over 40 studies have found that doula care improves birth outcomes for mothers, partners, and their babies. No study has ever found negatives to doula care. Having access to doula care is a critical part of providing evidence-based maternity care. That’s why The BabyLove Alliance, Ltd. is doing doula care differently than anywhere else. So, here’s what we’ve come up with:

TBLA Doulas (800x800)

The BabyLove Alliance, Ltd.’s doula care is different. The fee for doula care is determined by a family’s income level, and our doulas and providers work as a group to ensure complete collaborative care.

  • Fees range from $150-$800 based on a family’s income (more here).
  • Families are matched with 2-3 of The BabyLove Alliance, Ltd.’s doulas, whom they will work with during pregnancy, birth, and postpartum. We call this a “pod”. They work together as a team to help families throughout their pregnancies and attend births based on a rotating call schedule. This way, the doulas can balance jobs, kids, life, all while being paid a fair wage for their time spent with clients.
  • The program starts with a comprehensive intake to make sure we can do our best job of supporting our clients. If necessary, we may have them work with other professionals in our organization.
  • Our doulas are accountable to the organization and to each other. They are trustworthy, professional, and kind– a must for any birth professional you’d hire!

I really, really, really believe in this model. It’s sustainable. It’s the most fair to everyone. Yes, others are doing similar things in the US (maybe?), but I think it’s enough of a difference that doulas and families looking for doulas should take a look.

To find out more, shoot me an email at info@thebabylovealliance.org or call me at 651-200-3343.

Or, attend one of our upcoming Doula Information Nights to meet our doulas, have a chance to ask questions, and to start the process of working with our program. They are: 

  • February 26th, 7PM
  • March 25th, 7PM
  • April 22nd, 7PM

At BabyLove– 4590 Scott Trail, Suite #102, Eagan, MN 55122

Having a doula is more within your reach than you think. Being a doula is something you can actually do. Hooray!

Warmly,

Veronica

*I’m totally guessing there. 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Twin Cities Hospital Baby Costs

Twin Cities Baby Costs

In case you missed it, last week I published a blog post that compiled the costs listed on the Minnesota Hospital Price Check website. Like I said then, there are some limitations on the information; those numbers don’t reflect variations in deductibles, co-pays, and co-insurance. Also, I used the “Average Cost”, which takes into account that various hospitals and various conditions have longer or shorter average lengths of stays. However, it’s a number that makes for some useful comparisons.

One thing I wanted to mention: If you’ve been following this blog over the last 4 years, you’ll know that I think this data is exceptionally important to help parents pull together the information that they need to make decisions about safe births. Giving birth is the one “medical” life event that usually allows people enough time to plan and ask questions in preparation for finding good care. Where you go and who your care provider is is THE biggest factor in determining outcome. Not mom’s health. Not baby’s health. And certainly, hospitals are businesses (although non-profits), so following the money is really important.

I love to have in-depth discussions about these things in my childbirth classes, and I love to help families who are unsure about their options or the choices they made ask the questions they need to ask to find the best care for their family. It’s a huge part of Lamaze education, and it’s something I think every parent can benefit from.

Back to today’s chart. Most births involve healthy newborns, but there are times when complications arise for baby. For this reason, I included 6 total diagnosis codes in the chart. Some hospitals, due to lack of appropriate facilities to care for sicker babies, won’t have data listed; they transfer those babies to hospitals with NICUs. Also, in the “Prematurity with Major Problems” and the “Extreme immaturity or respiratory distress syndrome, neonate” categories, you’ll notice some hospitals have very low costs listed compared to other hospitals. Those “cheaper” hospitals had very few babies in 2014 with those diagnosis codes, usually less than 10. Those are outliers that can mostly be ignored. And certainly, this doesn’t capture all the intricacies, so I urge anyone who really wants to know more to look at the data on his or her own, or leave comments below.

Baby Hospital Costs

If you think this is valuable, please check out everything I offer at BabyLove and come see me!

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Twin Cities Hospital Birth Costs

MN Hospital Birth Costs

(Update 11/13/15 12:39PM) Please note that these numbers do NOT include charges for baby.

A long time ago, during the Pawlenty Administration, the Minnesota Hospital Administration was required to provide information about hospital costs online to allow consumers to compare prices. Lucky for us, this includes obstetric charges. There are some limitations to this information– it doesn’t give us the information on what a specific individual’s costs will be when you take into account deductibles, plan allowances, and co-pays. I also decided to use the 2014 Average Total Cost rather than the Average Daily Cost or the Median Cost in this table. There’s a million ways to slice this information, but I’m a busy mom and this is what I did.

I sorted the information by health system rather than just alphabetical. There are some big surprises– since the Park Nicollet/ HealthPartners merger, Methodist Hospital and Regions are owned by the same company, but the differences in costs are HUGE. You can find more of the information on the Minnesota Hospital Price Check website, but they only allow you to compare 3 hospitals for one kind of charge at a a time. So yeah, the work to get this was tedious. It was also really tricky to get the data from the spreadsheet to this blog.

Minneapolis Hospital ChargesI hope you find this interesting and helpful. Have questions or observations? Post them below!

Warmly,

Veronica

 

 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Where to go to prevent tearing

vaginal tears

Awhile back, I did a quick post on a few of the rates of tears at different hospitals in the Twin Cities area. The info has been slightly updated, and I decided to pull the information for all of the area hospitals.

A few notes: The website that lists this information doesn’t specify what degree of perineal tears they are talking about. Tears are rated first degree, second degree, third degree, and fourth degree. First and second degree tears can be pretty common. Most epidemiological discussions about tears focus only on 3rd degree tears and second degree tears. I’m hoping to get some clarification on what the heck they are talking about when they say “tears”, and I’ll update this post as I can.

Perineum Tears: Rates for Vaginal Deliveries without Instruments; for some reason, St. Joseph’s is missing.

Lowest rates to highest:

  1. Shakopee- 1%
  2. Ridgeview- 1%
  3. St. John’s- 1%
  4. HCMC- 2%
  5. Lakeview-2%
  6. Unity- 2%
  7. Regions- 2%
  8. North Memorial- 2%
  9. Mercy Hospital- 2%
  10. University of Minnesota- 3%
  11. United- 3%
  12. Regina- 3%
  13. Ridges- 3%
  14. Methodist- 3%
  15. Northfield- 4%
  16. Woodwinds- 4%
  17. Southdale- 4%
  18. Maple Grove- 4%
  19. The MotherBaby Center/ Abbott Northwestern- 5%

Perineum Tears: Rates for Vaginal Deliveries with Instruments

Lowest rates to highest:

  1. Regina- 0%
  2. University of Minnesota- 5%
  3. Hennepin County Medical Center- 10%
  4. St. John’s- 10%
  5. Woodwinds- 10%
  6. Regions- 12%
  7. Unity- 12%
  8. St. Joseph’s- 13%
  9. Southdale- 13%
  10. Northfield- 13%
  11. United- 14%
  12. Shakopee-15%
  13. Ridges- 16%
  14. North Memorial Medical Center- 16%
  15. Mercy- 19%
  16. Methodist- 24%
  17. Ridgeview- 27%
  18. Maple Grove- 20%
  19. The MotherBaby Center/ Abbott Northwestern- 24%

Beyond choosing your care provider and place where you give birth with a lot of thought and care, make sure you know the different ways you can make pushing and birth as safe as possible. Check out our Confident Birth and Beyond (Lamaze) classes, too, to learn how to have a safe and healthy birth.

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

6 Easy Questions to Ask Your Midwife or Doctor

Questions to ask your OB

I’m a big fan of talking to your care provider about things that have a huge impact on the outcome of birth for both mom and baby, but I know some of those big questions can seem awkward. After talking with some of my Confident Birth and Beyond (Lamaze) classes lately, I’ve come up with some questions that should be pretty easy to just slide into your prenatal appointments.

1) When’s the last time you did an episiotomy?- Episiotomies are only really necessary in very rare, very specific circumstances (victims of female circumcision can need episiotomies, for example). If you trace the history of episiotomies, it’s pretty clear that it’s rarely needed. A good answer to this question goes something along the lines of, “Well, I haven’t done one in 8 years” or “I’ve done maybe 4 in my whole career at the very most.”

2) Are you OK with me using upright pushing positions?

and

3) Are you going to make me lie down for the actual birth? Question #2 and question #3 kind of go hand in hand, but you’d be surprised how often a doctor or midwife tells a mom she can PUSH in any position, but will then, at the last minute, tell a mom that she HAS TO lie down for the “delivery”. Lamaze Healthy Birth Practice #5– Avoid Giving Birth on Your Back is best for moms and best for babies, period.

4) So, what do you think about the ACOG/ SMFM Consensus Statement on the Safe Prevention of the Primary Cesarean Delivery? When it came out in March of 2014, the Consensus Statement was a really big deal. How big? It redefined the onset of active labor from 4 cms cervical dilation to 6cms of dilation. That’s just one of the numerous guidelines published to help improve our rising maternal mortality rate in the US. Your care provider should be up to date and following these practice guidelines, because there is a need for improvement from the normal way of doing things.

5) Do you do a lot of VBACs? The issue of VBACs versus Elective Repeat Cesareans is so much bigger than just the oft-cited “rupture”. The rising cesarean rate in the US is largely a result of reduced access to VBACs, and our rising maternal mortality rate has been tied to repeat cesareans. Most women who gave birth by cesarean are candidates for VBACs; it’s a matter of finding a care provider who will “allow” them. And if your doctor “allows” them (see how I put that in quotation marks? heh), does he or she actually DO any?

6) How quickly after birth do you clamp the umbilical cord? The case of delayed versus immediate cord clamping is pretty much decided– it needs to be delayed. A recent study on cord milking following cesareans (since you can’t really wait for the cord to stop pulsing on it’s own during a surgery) had some pretty important results, including a reduction in cerebral palsy. Yeah, you know that thing fetal monitoring was supposed to prevent but doesn’t? At this stage, it’s pretty hard to defend immediate cord clamping, even when babies are born prematurely or need resuscitation. Clamping and cutting needs to wait.

  • What questions did I miss?
  • Did you ask your provider about any of these things?
  • What kind of answer did you get?

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Signs of Tethered Oral Tissues in Teeth (AKA Tongue Ties and Lip Ties)

adult tongue and lip tie

I’ve had the idea for this blog post in my head for awhile. I thought it was about time to explain what I have had medical and dental experts show me and tell me about signs of tethered oral tissues. Knowing what these things look like and why they exist has been…interesting. I instantly can scan a person’s face and get a pretty good idea of what’s going on behind their lips and under their tongues. Bizarre, I know.

First of all, yes, I had braces as a teenager, so even with major interventions, my teeth are still having these issues because of the forces that the tethered oral tissues place on them. So, with the photos above as examples, here’s what I’m talking about:

1) Gap in front teeth- This one is pretty obvious, but I don’t have a picture of it because a) My gap is being held together by bars and b) I broke the upper lip tissue at some point when I was little and it no longer goes down as far as it used to. A gap in the front teeth is not normal. It is possible to remove the extra tissue on the top lip and between the front teeth and to get the teeth to grow together. How do I know? My daughter’s front teeth are perfectly together now.

2) Receding gumlines- I apologize to Periodontists in advance, but oral tethers in the lower lip and cheek will lead to gum recession. Some people even need to have very painful gum surgery to help prevent bad, bad things from happening to their teeth. Those little pieces of tissue pull on the gums, and over time the tissue can recede.

3) Crease above lip when smiling- When someone has a tongue tie and has difficulties swallowing, they have to tongue-thrust to be able to swallow. Want to see a baby have to tongue-thrust to swallow?

Over time, this leads to an overbite. (I think. Is that an overbite that I have?) Anyway, I think that when the teeth get pushed outward over time, when someone who has to tongue-thrust to swallow smiles, their lip slides too far up, and the angle of the teeth causes the lip to crease. That’s my theory anyway.

4) Front teeth being pulled inward- This is something that I see on adults as well as kids; in children, the teeth can be pulled inward quite dramatically. If I had been perfect about wearing a retainer over the last 20 years, maybe my bottom teeth wouldn’t be getting pulled inward, but the force of the tether under my tongue did affect the teeth. I’ve seen people with very tight restrictions under their tongues have very, very crooked front teeth.

There are also things that are very evident with tongues when there is a tongue tie/ tethered oral tissues. However, my tongue is not a good example, so a later post will cover that info.

Warmly,

Veronica

Disclaimer: This post is for educational purposes only. I am an educator, so this information is from research, discussion with other professionals, and personal observations. This information is not meant to diagnose or treat any conditions. 

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Cesarean rates in US

The CDC has crunched the numbers, and the preliminary data for Cesarean rates in 2014 were published last week. There was a good amount of good news; as ACOG put forth their recommendations for the safe prevention of primary cesarean in March 2014, cesarean rates did, in fact, go down. Many thanks as always to Jill from cesareanrates.com for this info. (And if, like me, you’re forever grateful to all the work she’s done in the arena of maternity care advocacy, you can thank her with a monetary contribution. Ahem.)

In 2013, Cesarean rates for the US were 32.7% for total cesareans, and 26.8% for low-risk pregnancies; in 2014, the US preliminary total cesarean rate was 32.2% and 26% for low-risk births. Minnesota does better than the US average. in 2013, Minnesota’s total cesarean rate was 26.9% and 21.3% for the low-risk cesarean rate. Those numbers were 26.5% and 21.1% in 2014. So, yes, progress! YAY!

I’d like to think that increased transparency is helping move these numbers in the right direction. In fact, a study done at the University of Minnesota that was published this month showed that public reporting improves outcomes. And while I love, love, love the push from organizations and nonprofits to pull together information on outcomes and costs, it’s critical for providers to get asked about outcomes by the parents who are coming to them for care, and then parents need to be able to make a thoughtful, deliberate decision based off of that information that’s in the best interest of both mom and baby.

If you’re curious about who has the highest and lowest cesarean rates….well, check it out:

Highest 2014 total cesarean rates

1) Louisiana – 38.4%

2) Mississippi- 37.7%

3) New Jersey- 37.4%

4) Florida- 37.2%

5) Alabama- 35.4%

Lowest 2014 total cesarean rates

1) Utah- 22.3%

2 ) Alaska- 23.7%

3) New Mexico- 23.8%

4) Idaho- 24.2%

5) Hawaii- 24.6%

I’d love to add some information to this about costs, etc. I’ll see how the week goes; maybe I can pull some more into this information.

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Meet our new doulas!

As you may remember, I announced the launch of Metro Doula Agency, LLC just over a year ago. Since then, my doula partner Liz and I have been taking clients as a team, and it’s been wonderful. We know our team model improves the quality of support that families receive and it makes life easier on us and our families.

The word “agency” implies there will be other doulas…and I’m excited to announce that we’ve brought on two wonderful women. They will be working as a team as well. I’ve had a chance to spend time with them and I could not be more thrilled with their gentle hearts and bright spirits. Below you’ll find pictures and introductions from Liz R. and Katelyn. They are both trained and have experience, but are working on their certifications.

We know that the agency model is something new to the area, but I’m confident families and providers will come to know that our doulas are the most professional doulas around, that they are highly knowledgeable, and that families will never be without support for their birth, no matter what. Metro Doula Agency stands behind our promise to support families, even through long labors, epidurals, or cesarean births.

With the addition of these two fine ladies, we are able to offer doula services on a sliding fee. So if you’ve been wanting to hire a doula, but have been trying to scrape together pennies to pay for one, we may be a wonderful solution to give you continuous labor and birth support. Contact us at info@metrodoulaagency.com metrodoulaagency@gmail.com and we’ll get you the excellent doula care you deserve.

Warmly,

Veronica

Minneapolis birth doula

Hi!
My name is Liz Ripka. I am 30 years old and have been a birth doula for the past year. I have always been fascinated with pregnancy, birth and the postpartum period.  After many of my friends, and family told me how wonderful I would be as a birth doula I thought I would look into it. A few weeks later I found a workshop and began my training. I have never felt so passionate about my job! I love being able to help and support women and their partners.  I focus on offering a nurturing presence, educating, supporting a woman’s choice, and making the birth of their child as special as possible to each family. I believe that laughter and love are important in the birth process. In addition to working with BabyLove as a birth doula, I am a nanny for two adorable little boys. I love serving each and every family and I feel so honored to be welcomed into their life story. I look forward to this journey!

St. Paul Birth Doula

Hello!

My name is Katelyn Hinrichs. I was born and raised in Minnesota and currently reside in the suburbs of Minneapolis with my family of four. My interest for birth came about when I gave life to my firstborn. I found myself reading anything I could get my hands on, and it was then that I realized this was my calling and there was no looking back! When I’m not spending time with my family, I love to grab some coffee and go shopping, snowboarding, and getting cozy with a book! I love to collect glass containers in hopes to give them another use down the road. My favorite subject in school was my fine arts acting classes. Being a doula means supporting my fellow sisters through this transformative time; giving them the support and means to feel empowered throughout their pregnancy, birthing experience, and beyond.

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.

Breastfeeding Help…And Why You Can’t Get Any

Minnesota Breastfeeding Help

I’ve been thinking about this for a long time, and I need to get this off of my chest. I’ve written a little bit previously about some of the issues moms face in getting competent breastfeeding help, but after having this conversation with many providers recently, I think it’s time to have a little bit of a discussion about the state of lactation support in Minnesota.

So, first of all, the advice that ONLY IBCLCs are qualified to help moms with lactation issues is ludicrous. When we’re talking about something that about 90% of moms start doing right after giving birth, there’s no need for stupid turf wars. There are a number of breastfeeding trainings and certifications, some with more rigorous standards than others, but just as Minnesota doesn’t mandate one specific type of training or certification for midwives who want to attend homebirths, a rational breastfeeding supporter would acknowledge that there are a few different ways that professionals can gain the information that they need to help moms figure out how to make breastfeeding work. Even the CDC, when they issue their annual breastfeeding report card, reports not only how many IBCLCs there are in a state, but also how many CLCs there are.

Second, it’s time to acknowledge that hospitals don’t have enough inpatient resources to help every mom get breastfeeding well established before being discharged. Although I don’t have any hard evidence to prove this, but anecdotally I’ve heard from families who gave birth in Baby-Friendly hospitals got absolutely no one-on-one support, perhaps because the dedicated lactation staff was either reduced or eliminated completely. Sometimes administrators think that by paying for 20 hours of trainings for all of the nursing staff, they need to recoup that money by getting rid of the experts. Or something. Whatever it is, the access to help is not improving.

Third, once moms get discharged, finding outpatient help can be nearly impossible. One health system makes everyone in their system go to one clinic in St. Paul, which may or may not have more than one IBCLC on staff. Visits from a public health nurse can help, but visits are not universally done, and not all nurses have the time to properly assist moms with breastfeeding. Many outpatient clinics report waiting lists of up to a week. And while there are LCs in private practice, most of them require moms to pay out of pocket upwards of $200 per visit, despite the fact that the Affordable Care Act mandates that insurers cover breastfeeding help at 100%. Now, there are some barriers to becoming an in-network provider, but those hurdles can be overcome. The larger issue is getting providers to understand reality versus the whispered lies and half-truths about insurance reimbursement they’ve heard in the past.

My point? Fixing our broken breastfeeding system in Minnesota is going to require that the IBCLC turf war goes away. It’s going to require that hospitals hire more lactation staff. Private practice lactation specialists need to to think outside the box (rather than only trying to build one box) to make sure families don’t have to pay out of pocket for services they shouldn’t be asked to pay for. After all, for every mother that gives up on breastfeeding sooner than desired, I’ll show you a mom who had little or no competent support. That’s just not fair to moms or babies. They deserve better.

Two things we’re doing at BabyLove to address these issues: First, Mama Cafe, free breastfeeding support on Tuesday mornings, has been around since day 1. Second, you can get one-on-one breastfeeding help in our office or in your home, with some insurances accepted, and more being added. It’s my way of not just talking the talk, but walking the walk.

Warmly,

Veronica

Veronica Jacobsen, BA, CLC, CPST, LCCE, FACCE
Birth Doula, Certified Lactation Counselor, Child Passenger Safety Technician, Lamaze Certified Childbirth Educator, Fellow of the Academy of Certified Childbirth Educators

Opening BabyLove in September of 2011 has allowed me to build a space where all families can come to get good information in a caring, welcoming environment. I have found that not only do I love teaching more than ever, but I also really love running a business. Hopefully my passion for every aspect of BabyLove shines through.
I live in Richfield with my husband, and I am a mother of a two great children. When I can steal a few free moments, I love to go on adventures with my family, cook, garden, thrift, can, and craft.