My kids were born with obstructive sleep apnea

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Before I was a childbirth educator, I was a mom of a little girl. I’ve written about her birth before; I haven’t really ever thought to talk about how both of my kids were born with sleep apnea, and how it took forever to find a pediatrician who would actually believe me.

When I first brought her home from the hospital, I noticed almost immediately that my baby girl would regularly stop breathing for a couple of seconds, only to gasp for air. Initially, my new mama instinct wasn’t sure if I was just being overly paranoid, or if she really did stop breathing for a couple of seconds before the big gasps I didn’t think were normal. Her Mayo Clinic doctor (who was a total and complete ass, BTW), ignored my concerns– he told me she was just congested, and moved on to something else.

(As an aside, I should tell you some day about the nonsense “parenting education” material they would give me every visit. Knowing what I know now, there was very little actual evidence behind it. All it did was foster doubt an insecurity by creating parenting expectations that would never be biologically normal. Even better, if I could find the sheets, it’d be a total hoot to go through it with a big red marker!)

When my daughter was about 4 weeks old, after sleepless nights and too many days nodding off during the day while I fed her on the couch, a friend encouraged me to look into safe bedsharing. I found the safety guidelines online, and during one nap time, I latched her on while in the side-lying position in my bed, and we both fell asleep for a life-changing 2 hours. I was a convert from then on out. It wasn’t until much later that I realized that since she and I started sharing a safe sleep surface, I no longer noticed that she would stop breathing. Instead of sleeping next to me in her bassinet on her back (which, until very recently, was the only AAP-sanctioned sleep scenario), she spent her nights cuddled up next to me, on her side. Sometimes I’d wake up and find out that I’d been feeding her without remembering when or how the feeding started. And then, when she was 9 months old or so, she started to turn sideways in the middle of the night and stretch out as much as she possibly could. That’s when we transitioned her to a crib in her own room. And at 9 months, she would sleep in whatever position she felt like sleeping in that night. By that point, she was not only rolling and crawling, but walking on her own, too. SIDS and back-to-sleep stuff was no longer technically an issue for her.

However– she was back having very, very audible sleep apnea. We’d listen to what I now understand was the sound made when her tongue would fall into the back of her mouth, then the little “kuh” sound she’d make right before the gasp as she started breathing again. We’d joke in a moribund manner that the gasp at least told us she was breathing…eventually. Moreover, we’d started to notice that when she slept, she always slept on her stomach or he side with her head tilted back to straighten and open her airway.

When she was 2 years old–maybe?– we brought it up again with her doctor. Keep in mind, smart phones weren’t a thing yet. iPods were big and bulky and only had hard drives and were only for music. We could really only convey what we were noticing by trying to recreate it ourselves. Her family med doc was again dismissive, though he did say he could refer us for a pediatric sleep study, but that it would take 6 months before we’d be able to get in. Shortly after that, our basement flooded, my husband got a new job that required him to commute 90 minutes each way, and then I got pregnant with her little brother… and life got super chaotic.

Once my son was born, bedsharing was started from day 1. However, he didn’t really nap on his own until he was about 8 months old, and when he did, he’d do what his sister did– he’d stop breathing. As he neared the 9 month mark, when I would put them both down for a nap in the same room, I’d listen to the baby monitor as they took turns having apnea episodes (which I’m sure did NOT help my anxiety). I can’t remember if it was at a well baby visit for him or a well child visit for her, but I mentioned the apnea episodes their pediatrician, who referred us to a pediatric ENT. She got her tonsils out shortly after her 4th birthday. At that point, they had grown so large that she barely had any room to breathe while she slept. A few days after the tonsillectomy, we noticed that when she slept–there was silence.

My son had his tonsils and adenoid out when he was 3 years old. He was also able to breathe perfectly while sleeping a couple days after surgery.

So there you go. My kids had obstructive sleep apnea, and now they don’t. I do think that both of them had and have tongue ties for a BUNCH of reasons. I had recurrent mastitis, nursing was super painful at first with my daughter, she didn’t gain weight all that fast, both kids had EPIC spit-ups. One child had speech issues that have been resolved. The other one tongue-thrusts to swallow and is very sensitive to food texture.I often wonder if I had had them sleeping on their own in a room from day 1, on their backs and not near me–would we have had a different outcome? We know (and the AAP recognizes this) that babies NEED to sleep in close range to their parents for at least the first 9 months, in part to help them regulate their breathing. When humans sleep on their backs, the tongue can fall to the back of the mouth, causing snoring and apnea.

Finally, I do want parents to know that if your little one stops breathing and then gasps for air, that is NOT NORMAL. If they sleep with their head always tilted back—again, not normal. Listen to your gut, and if your child’s care provider dismisses you–get a second opinion. Or a third. I know that there’s so much more to learn about this, SIDS, and other sleep issues, but I do think that parents can go a long way if we share our stories and compare notes.

On that note, Happy New Year!

Warmly,

Veronica

 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

Corrected 2015 Minnesota Cesarean Rates and Insights

First of all, I had warned that last week’s post may have some numbers that end up changing. Yeah, a few numbers changed. The reality is, to calculate one hospital’s rate, you have to go on 6 separate screens to get 6 different numbers before you can figure out a cesarean rate for one hospital. And since I calculated numbers for the 89 hospitals that provide maternity care, that….that’s a lot of screen toggling.

Second, while I’ve been blogging about these rates every time they come out, the backlash to releasing the numbers was abnormally defensive. Comments on social media were not what I’d seen previously. There are a few things I want to get straight first:

  • From the joint statement from ACOG and SMFM: “In 2011, one in three women who gave birth in the United States did so by cesarean delivery. Cesarean birth can be life-saving for the fetus, the mother, or both in certain cases. However, the rapid increase in cesarean birth rates from 1996 to 2011 without clear evidence of concomitant decreases in maternal or neonatal morbidity or mortality raises significant concern that cesarean delivery is overused.” You can read through the full Obstetric Care Consensus here.
  • The sad fact is, while there are times that Cesareans are truly needed, our rising Cesarean rate is causing a rise in maternal mortality rates in the United States. Overall, Minnesota is better than the national average, but some rural hospitals have rates that are too high. Discussing these numbers is critical for protecting the health and safety of pregnant patients and their babies.
  • Multiple studies, including studies published by Consumer Reports and Blue Cross Insurance networks, continue to affirm that the biggest factor in if a birth will be done vaginally or by cesarean is the place of birth and care provider preference.
  • If you’re questioning how different clinics affect each hospital’s rates, check out my blog post from the beginning of the year with that information.

This information does matter- a lot. We believe that childbirth education and informed choices are the key to empowering families that will allow them to make the choices that best suit their situations. And I do want to point out that, at least in the Twin Cities, Cesarean rates peaked in 2009, with Abbott Northwestern reaching 37.1%. Rates have gone down overall since then.

In the next blog post, I’ll compare this year’s results with those over the last decade.

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Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

Parent Shame and Car Seats

It’s National Child Passenger Safety Week!

Last week, in a fit of irritation, I wrote a little tweetstorm on how irritated I am with the notion of “parent shaming”.

And I really meant all of it. Yesterday, I got called to help a very well-meaning family who knew something was up with their car seat and wanted it to be installed correctly. Once I got there, though, I looked at the seat and realized it was not only an expired seat, but a recalled seat. But it’s so common to buy used car seats, many parents don’t even question it.  Or what about this viral video from last month? Here. Here’s a screenshot:

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I haven’t watched the full video, nor do I care to. Why? Because every time I look at this I get sick to my stomach. Not only is this an infant seat that’s ONLY supposed to go backwards, but I’m pretty certain it’s close to 10 years old, the straps aren’t even on one of the little boy’s shoulders, and my WORD…what is going on with the seatbelt? It’s over the arm, it’s…it’s just a mess. There is almost no likelihood that this poor sweet little boy would escape a crash without major injuries or worse.

Or what about this video?

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The straps are too loose, they are falling off, and she’s too young to be facing forward. Truthfully, 99.9% of the videos and pictures parents post of their kids in car seats have at least one horrible, obvious flaw. Nothing else you buy is THIS critical to keeping your child alive. Nothing. And yes, for a variety of reasons, car seats are just really hard to use correctly. It also doesn’t help when parents so commonly are exposed to other parents making unsafe choices, such as:

  • Buying used car seats
  • Choosing to use expired car seats
  • Placing car seats on top of carts, tables, chairs….
  • Keeping babies in a car seat when they aren’t in a car
  • Turning a baby to be forward facing when they turn 1
  • Letting a baby nap in a car seat outside of the car
  • Not keeping a baby buckled in when the car seat is being used in a stroller
  • Using coats under car seat straps

Parents don’t want to hear that they’ve been doing something that puts their children in danger. I would never DREAM of going up to a parent when I see any of the above things. No matter how it’s phrased, it’s never taken well. Ever. So we try to educate broadly, and I go along and say a silent prayer every time I see a baby sleeping in a car seat, head falling forward, or a $450 car seat precariously perched on top of a shopping cart.

If you’ve been committing any of these car seat cardinal sins, today should be the day you stop. Car crashes are on the rise as more and more people are driving while distracted. Nothing is more important than keeping your children safe. There’s always a solution to every car seat problem. Have a trained professional, a Child Passenger Safety Technician (like me!), help you out if you need it. But really, don’t brush it off. Please.

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

Allina’s Replacement Nurses and Patient Neglect: Another mom’s story

Nurses Union

After I shared Lisa’s story Monday and Tuesday, another mom contacted me who had given birth during the strike. This time, the circumstances were a little different; Ashley had a planned cesarean. She was still suffered from incompetent care, and she wasn’t given food, water, or medication for long stretches of time for the duration of her 4 night stay.

When you read her story, please keep the following things in mind:

A few things are starting to become clear: While staffing during the strike might have been adequate in other departments and other hospitals, the night nurses at Abbott from 7PM to 7AM did not take care of the patients. Food, medication, and water were withheld from at least 2 moms for very long stretches of time. Only very vocal family members saved these moms from total neglect.

Penny Wheeler is a former OBGYN. Again, she claims up and down that the replacement nurses took good care of patients, but no decent OBGYN would find this to be safe care. How can anyone justify the care that these moms received? I’ve spent the last decade of my life advocating for good maternity care, and nothing has angered me as much as hearing this care happened within my own city.

As before, if you have questions about your care options after Monday, contact me. If you have a story about your care that you want heard, contact me. My phone number is 651-200-3343 and I can be reached at veronica@babylovemn.com

Ashley’s story is below. It was edited for clarity, and I have been given explicit permission to post it.

I had a scheduled C-section on June 22nd, 2016 due to my son being breech. When I arrived at Abbott, I noticed that there were hundreds of people walking around protesting only to learn these were the nurses I had gotten to know over my entire pregnancy journey.

I was scheduled for surgery at 12pm, and up until I was brought into the OR everything had been going great. Then things went downhill.  The nurse who was assisting with the surgery was holding the clamp opening up my incision pulled so hard that she fell backwards off of the stool she was standing on. This ripped my incision open larger than needed and made for an extremely crooked scar. I was not allowed to hold my son for a good 45 minutes once he was taken out, but not because there was any complication. I begged and pleaded to get some skin to skin contact with him as I knew it is very important in the breastfeeding process. I was told skin to skin was unsanitary for me while being in the operating room.

Once I had been all stitched up, I was put into recovery while they made sure my uterus was shrinking and I wasn’t going to lose too much blood. At this time, they noticed my son was grunting and took him to special care to be evaluated for fluid in his lungs.

Two hours later I was brought up to my postpartum room and was introduced to my first nurse. She was amazing, and I would take her again any day. She promptly gave my meds and kept my water full, but she wouldn’t allow me to eat anything. She informed me about everything going on and kept me cleaned up well. I asked when I could go see my son and she said as soon as my catheter was removed. I was told the next nurse would do it immediately after shift change at 7pm– at that time, it was around 6pm.

When 7pm came, I paged for my nurse. I was in excruciating pain and I was bleeding so much that I had bled through the pad I had on and the blankets on my bed had become saturated. I paged my nurse at least 3 times, but nobody ever answered my calls. My dad came to visit. He found me sitting in a bloody mess,  bawling my eyes out. I was desperate for help that I was not receiving. My dad was outraged and tracked down any nurse he could to help me. At 9PM I was finally given my pain medication. I asked again about having them take out my catheter; by 10pm it was finally removed and I could go see my son.

While my son was being kept in the nursery, the staff had done an x-ray and his lungs looked clear. I had received a call from special care at 8pm saying my son had still not been fed and he was delivered at 1:18pm. He hadn’t been fed anything at all since he was born, and his blood sugar dropped to 35. I asked to breastfeed him, but I was told that was not allowed. I was told I could pump to feed him, but because I’d had a cesarean, I wasn’t allowed to breastfeed him. I was heartbroken. The only options I was given for feeding him was donor milk or formula.

I got to him around 10pm and stayed until 11pm. I went up to my room to rest and let my body recover. I was told 3am was his next feeding time, and I was welcome to come bottle feed him–but I still wasn’t allowed to breastfeed. At 3am when I came down my son had an IV in his hand. Neither his dad nor I ever gave informed consent for this to be placed. Then the nurses told me they had to give him sugar water because his blood sugar was still too low. They didn’t mention to me that his blood sugar was low when I had been there 4 hours prior. Then they also informed me they started a preventative antibiotic while I was away to stop his grunting, and he was going to have to stay in special care for at least another 48 hours. I cried as they told me if he pulls out this IV would need to put it in his head. I felt scared, sad and angry that not only they had done these things to my baby without me knowledge or consent, but that they could threaten more procedures. Infection had been ruled out prior to this IV, so I knew my son was fine without then.

On day 2 of my stay again my morning nurse did a fantastic job. My night nurse completely neglected me; she never filled my water or told me where I could go to fill it. She didn’t bring me my pain meds until 6am– right before the end of her shift. This occurred all 4 nights I was there. By 7am I was begging my good nurse to help me get the pain managed again. And it would continue to relapse at shift change every time.

My last night I was finally able to have my son with me in my room. The morning nurse was there to help me breastfeed him finally for the first time. He latched great and stayed on 30 minutes each side she was so supportive of me the entire time wanting to breastfeed my son. She promised the second I got him I could feed him myself and kept her promise.

A week and a half after I was discharged, I developed a staph infection in my incision. Originally, they told me I was mistaken. I insisted on a culture. They finally did it and sent me home that I would get results later. Next day they called me and told me I had a serious staph infection;  they sent antibiotics to my pharmacy that I needed to get immediately. If nothing got better in 3 days I was to go to urgent care. Thankfully, the infection cleared.

I encourage anyone due during strike to do your research before going through with your delivery. I also want to apologize to any other mothers who had a terrible experience during their deliveries. The delivery of my son turned into the biggest nightmare I could have never imagined. I expected it to all be so happy and didn’t imagine I’d be so depressed throughout my hospital stay. Thankfully my son and I are both extremely happy and healthy since being home.

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

More Allina Strike Concerns

Monday’s post on the Allina strike has hit 4,000 views—in 48 hours. People are reading it, people are sharing it, which is great, but you guys? I’m not being hyperbolic when I say this– it’s going to be worse than I thought. I met Lisa in person, who was super brave to share her story, today. She’s been amazed at the response, that anyone cares what her experience was. And yes, she gave me permission to share all of this. But the more I learned as we spoke, the more disgusted I am with Allina’s CEO and administration to allow another strike to go on.

Once the strike started and after her Cesarean, not only was Lisa (and at least one other mom) left in recovery for HOURS– at least 2, maybe 3—without a single staff person checking in (AFTER SURGERY), once Lisa and her baby were finally taken to the postpartum wing, the room she was in didn’t have any diapers, and all attempts that Lisa and her husband made to get a nurse to help with anything were refused. They would not bring medication. They never asked what she was doing to feed her baby.  She was at least experienced enough with breastfeeding that she knew what she was doing, but if she needed formula, I don’t know if anyone would have been there to bring her any. The replacement overnight nurses did not check to see if her son was being fed. LISA WAS NEVER FED, save for some crackers her husband managed to find, until she reached out the next morning and after her midwife raised hell to get Lisa any care in any way, shape, or form.

So, let’s get this straight: I have seen union propaganda. I have been very diligent in getting as much detail as I can on all sides of this issue. I am not sharing this as union propaganda. I am sharing this because I am TERRIFIED to learn what hundreds of other moms and babies were subjected to during the strike. I’m sure Lisa’s experience was what everyone else had to go through. In 4,000 page views, nobody has told me anything was inaccurate. I’ve had people reach out and confirm that Lisa’s experience was a fair representation of what it was like and will be like during another nurse strike.

Someone needs to tell me why this is ok: A mom who gave birth at Abbot Northwestern during the June strike gave birth via major abdominal surgery, was left for hours immediately following with no care, was brought into an actual room with no diapers, nobody checked her vitals or her son’s vitals after major surgery. Allina’s replacement nurses did not care if she was fed. They did not care if the baby was fed. It wasn’t until an outside party stepped in that Lisa and her son had any care whatsoever. Most people who give birth at Allina don’t have the access to their OBs that would have allowed them to have an advocate that would have raised hell and gotten them care.

I’m sharing this because somehow, someone needs to speak up. This isn’t about not having a birth go a specific way. This is about a hospital system refusing to make sure that their patients are cared for in the slightest. Allina’s powers that be need to tell me why they are OK with letting their patients get not just sub-standard care, but likely absolutely no care, no food, and without their basic medical needs met. Allina’s CEO kept saying the staffing levels were adequate. She was either misinformed or outright lying.

As women, we are often told that as long as are babies are here and alive, we should shut up and be thankful. I’m here and I’m going to rock the boat for Lisa and for that other mom in the recovery room with her and for the hundreds of moms and babies that I have no doubt weren’t provided basic care. I have a blog. I have this platform. I can share Lisa’s story and hope it gives others the courage to speak up. Otherwise, I’m mad, I’m sad, and I’m scared.

If you need or want to reach me, the office phone is 651-200-3343 and I can be contacted by email at veronica@babylovemn.com

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

The Allina strike will put birthing families in grave danger

I have been blogging for almost exactly 5 years in this space, and maternity care outcomes and transparency hold a special place in my heart. I don’t know if anyone gets as excited as I do when new info comes out. After a lot of thought over the weekend, I am posting this. Buckle in.

The Allina nurse strike saga continues. In June, the nurses went on a 7 day strike. Back then, I had concerns about the safety of giving birth with replacement nurses. Now that a strike date of September 5th at 7am has been set, and after careful consideration, I can’t say this without enough emphasis: DO NOT HAVE YOUR BABY AT AN ALLINA HOSPITAL DURING THE STRIKE. CHANGE PROVIDERS AND/OR PLACE OF BIRTH NOW!!!!!

I may not make any friends with the system’s physicians or administration, but the evidence is more than circumstantial to back up my warnings. While I understand the political forces at stake with public opinion of unions in general, staffing ratios and staff safety are always issues at Allina. And in fact, the National Labor Relations Board ruled that the Minnesota Nurses Association’s complaints about unfair labor practices were with merit.

Historically, Allina’s hospitals have had some of the highest cesarean rates in the Twin Cities Metro Area. Recently, a change was made and births are no longer done at Unity Hospital, but in 2014, the c-section rate for Abbott Northwestern was 30.2%, it was 28.3% at Mercy Hospital, and 30.4% at United Hospital; all of these are above the state average of 26.9%. In 2014, 11,207 births occurred at Abbott, United, Mercy, and Unity–an average of 217 per week. With such high volume, Staffing problems will hit maternity services hard. Lactation services are sure to be hit hard as well, as union IBCLC RNs will also be on strike, so moms will have a very hard time getting appropriate breastfeeding help.

The last strike, which was limited to 7 days, cost Allina $20 million. On social media pages, nurses from other parts of the country are posting information they’ve received from staffing agencies recruiting workers to fill in for the striking nurses. Replacement nurses are being offered $6,900 per week and are not required to be licensed to practice in Minnesota. Additionally, because of such a high cost to replace nurses and because of the very large number of striking nurses (4,800), there is absolutely no way that Allina’s hospitals will have adequate staffing– in fact, only 1,400 nurses were brought in during the strike in June. A hospital system with a whopping 71% reduction in nursing staff is without a doubt incapable of providing safe care. While this creates a dangerous situation for all of the hospital units, because safe staffing ratios are so high– 1:1 nurse to patient ratios during labor and birth, and 1:3 nurse to patient ratios postpartum, there’s no doubt that having less than 1/3 the normal number of nurses will put mothers and babies in grave danger.

Very specifically, replacement nurses can’t provide appropriate care in the “Mother Baby Centers” of Allina hospital because:

  • Nurses will be much slower at charting in a system that they aren’t familiar with. Even if the nurses are familiar with EPIC, the most common EHR in our area, each organization has their own unique configuration. In births, charting is extensive– many, many things need to be documented in real time, taking away the nurses’ ability to provide patient care.
  • Maternity Care practices in our area are very different from those in other parts of the country. We tend to have better outcomes than in other parts of the US–meaning the replacement nurses will probably be used to maternity care practices that are considered outdated or unsafe. So, for instance, while Allina hospitals have Nitrous Oxide as an analgesic option for birth, it’s still rarely used outside of our metro area. Because the replacement nurses won’t have the training needed to provide Nitrous, parents will very likely find that options they expected to be available aren’t.
  • Patients with high-risk pregnancies are very likely to have replacement nurses that lack the higher training needed to keep medically fragile conditions under control.
  • Staff morale in hospitals during strikes always takes a major hit, distracting from the real need-providing patient care.
  • Even if the nurses were perfectly trained to work as Labor and delivery and postpartum nurses, even if they knew exactly how to use the Electronic Health Record System– In no way, shape, or form will there be nearly enough nurses to provide safe care.

When I previously wrote about my concerns, I wasn’t sure what birthing mothers would end up experiencing. However, last week, I made contact with one mother who gave me permission to share her story. Her name is Lisa, and her story follows:

I planned birth at Abbott due to VBAC.  I was aware of the strike and very concerned that I would go into labor during that time, but I was planning to birth with my midwife and with my doula and I was reassured that I have nothing to worry about. In fact I’m going to say what no one said to me when I was worried about the strike: RUN! I know everyone might not agree with that, but I speak from personal experience. I moved back from Alabama so that I could receive the care we’re accustomed to here in MN, and I still ended up with nurses from states where I would never give birth.  My due date was 6/19.  Same day as the strike. Water broke 6/16.  Labor never started so I went in 6/18 at 4am for Pitocin.

24 hours later [early in the morning of June 19th, the day of the strike], I’m laboring hard on Pitocin. I have a wonderful supportive Allina nurse. The best nurse I’ve ever had, but there’s a tension in the room so thick that you could cut it with a knife. We all know she has to go home at 7am, when her shift ends and the strike begins. In just 3 more hours. It was awkward. There was an elephant in the room. I considered asking her if she would stay with me but that seemed awkward and inappropriate.

So 7am came and she said “I’m sorry, I have to go now. ”

After that I had a stream of nurses. “I’m you nurse now. ..no I’m your nurse now. No I’m your nurse again.” I was in the shower and they kept interrupting me. I had a doula and a very supportive husband. I just wanted some privacy at this point, I wasn’t asking for extra support.

At another point I had nurses just standing around me with their arms crossed. Just watching me. Like they had never seen a woman labor before. Like I was a fucking zoo animal!!!!

At another point, one nurse was giving another nurse a tour of the room. “Here’s the warming station…” and then the two of them stand in front of the computer and discuss how the medical system works. I just hear whispering and taping on the keyboard. I’m butt ass naked, standing at the foot of my bed, huffing nitrous every 2 minutes for 90 seconds. I can barely speak. I’ve been at this for 30 hours. I wave my hand at them “They need to go. They’re distracting me.” I’m begging/irritated. My midwife then shooed them away.

This still pisses me off. I shouldn’t have to protect my own birth space like this. My midwife was there and my doula and my husband. But no one said anything. I had to ask them to leave.

It’s no surprise that soon after this I lost my ability to handle my Pitocin induced contractions. I asked for an epidural. Then my contractions went to 18 minutes apart and I ended up with a cesarean, again. Cesarean was 6/19 at 6pm.

They surgery itself had some parts that were less than what I would expect from Abbott and my post surgery care was grossly negligent.

I actually had to page my midwife on call during the overnight hours.  When the baby was born (unplanned cesarean ) we were told he could stay with us but would need to have his temp closely monitored due to prolonged rupture of membranes.  But they never checked his temperature the entire night.  Nor did they check my bleeding on the night shift.  It literally felt like everyone had left the hospital,  apocalypse. When she [the midwife] called me back I told her that I wanted to transfer with my baby to another hospital because no one was taking care of us. I paged her just after 7 am.  I knew I was supposed to have a new nurse and still no one had come to check on me or the baby.   I told her I was scared because we weren’t being monitored  and wanted us to be transferred to another hospital,  by ambulance if necessary.  She said “hold tight,  I’ll see what I can do and I’ll call you back.”

It’s my belief that when she hung up with me she called up there to the hospital and raised hell, because within a few minutes I has my day nurse and the charge nurse there.  They helped me clean up the blood that was dried from my waist down, changed my sheets and got me some food.  And filled out the white board.  There was definitely a turnaround of my care at that point.  My midwife called me back about 8am on June 20 and asked if I still wanted a transfer,  and  told me she could make it happen.  At that point I said we had a new nurse and I  felt safe again.  I told her we would stay.

Hiring a doula won’t be enough. Every single birthing family  with babies due in the next month needs to change plans on where to give birth, which likely will result in also changing providers, and they need to do it NOW. Changing is easy– I’ve outlined the process before. If you’re late in the game, you may need to change to a Family Med Provider who does OB care or an OB group. If you need help sorting your options, I’m happy to help. Call or email me– 651-200-3343 or veronica@babylovemn.com.

And Allina union nurses? I have your back. Allina’s C-suite? You are putting people at risk with your ongoing actions, and you need to be ashamed of yourselves.

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

What the Allina Nurse Strike Means for Birthing Families

Given the news that nurses at 5 Allina hospitals are set to strike starting Saturday Sunday, there are a few things to keep in mind if you’re due soon and are facing the chances of going in to give birth and were planning to have your baby at United, Abbott, or Mercy, there are some things you should be aware of.

The replacement nurses will be trained in Labor and Delivery. That’s the good news. The bad news is that they will bring in their own ideas, which will very likely be very different than the hospitals regular protocols and policies. We have far better outcomes in Minnesota than, say, the South. Many of these nurses will be coming from areas with very high c-section rates, where waterbirth is banned, where there are de facto VBAC bans, etc. Be aware that you may face huge opposition from your nurse if she’s not normally around these things that families in Minnesota have come to expect as the norm.

Also, when replacements are brought in to any strike situation and cross the picket line, patient safety becomes a concern. Nurses unfamiliar with even where various items are kept or who will be struggling with an unfamiliar Electronic Health Record system won’t be able to provide the same level of care that the staff nurses can provide. Also, if staffing agencies had a hard time recruiting enough L&D nurses, patient ratios may be even worse than normal– a long time sticking point between the nurses union and Allina.

So, what can you do if you’re facing an impending strike and you’re days away from birth?

If you have the option to give birth at a non-Allina hospital with your current maternity care practice, do so. If you don’t have a non-Allina option, speak with your doctor (and since Allina is the only hospital group without a midwife group, it’s probably just a doctor that you have) about how he or she is planning to help keep patients safe during the strike. Will they be spending more time in the hospital while patients are laboring?

And even at this late stage, consider hiring a doula. She can’t provide medical care, but she will be able to be another set of eyes and hands and can help protect your birth, even with replacement nurses. It may be possible to hire a private doula, but I can get families birth doulas my non-profit. Our fees are on a sliding scale, too. You can find more info here.

It was stressful for patients during the last widespread strike, even though that strike only lasted 24 hours. Hospital administrators will always spin things to try to reassure patients, but parents have a right to understand that things won’t be the same.

If you have any specific questions, post them in the comment section!

 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

Will the new Evenflo car seat prevent heatstroke deaths?

car seat heatstroke

Last week, Evenflo and Wal-Mart announced that they had partnered up to create the ADVANCED SensorSafe™ Embrace™ DLX infant-only car seat. The seat has special technology in the chest clip that goes to a wireless receiver to alert the driver when a child is being left behind in a car. I’m not going to get into how the technology works or if it’s reliable. There are a few things I want to delve in on, though, when it comes to the issue of kids dying of heatstroke in cars and if this is going to be a good solution to reducing deaths.

So far for 2015 (as of this writing), we have seen 11 children die of heatstroke after being left in a car in the US. There were 44 and 31 deaths in 2013 and 2014, respectively. In the Upper Midwest, we do have fewer heatstroke deaths than in the South or the West, but it does still happen. Since 2003, 3 children have died of heatstroke in a car in Minnesota; 8 kids have died in Wisconsin during the same time frame.

According to information collected in Heatstroke Deaths of Children in Vehicles by Jan Null, CCM of the Department of Meteorology & Climate Science at San Jose State University, most of these deaths (for the years 1998 through 2014) occur under 3 main circumstances:

  • 53% – child “forgotten” by caregiver (336 Children)

  • 29% – child playing in unattended vehicle (186)

  • 17% – child intentionally left in vehicle by adult  (111)

This new car seat technology is really only designed to address the first and third scenarios. It’s critically important to teach your kids to never, ever, EVER play in cars and make sure that a car is locked when it’s parked. Kind of like you need to teach your kids to not play with lighters or matches. Remember the gut-wrenching case in Wisconsin 2 years ago with the toddler who was hiding in a car truck and died? Cars are not toys.

Back to the car seat in question, I have a few issues with someone buying this seat.

First of all, this is an infant only seat, with a maximum weight of 20 35 pounds and a maximum height of 30 inches. The average baby is 30 inches by around the age of a year, but some babies outgrow an infant-only car seat before they are this old. Currently, the technology isn’t offered on a convertible car seat. Less than one-third of heatstroke deaths were in babies less than a year old. 22% of the deaths were in kids ages 1-2 years old, and 13% were in ages 2-3 years old. This is a solution for a very limited time period, and ONLY if your car is model year 2008 or newer.

Second, this piece of technology increases the cost of the seat from $90 to $150. That’s a $60 clip! While that’s not to say that saving lives isn’t important, is this cost increase worth it when it’s only useful for a very limited length of time?

Third, will this lull parents into a false sense of security?

Ideally, technology like this will become standard in all car seats. My cynical guess is that it’ll take 10 years or more before something like this is universally adopted, if ever. In the meantime, there are some common sense tips out there, but probably the best one is this:

Get in the habit of putting your phone, either in your purse or diaper bag on the floor whenever you put your child in the car seat. Do it every time, without fail. Not only will it serve as a reminder to always check your back seat, but it also removes the cell phone as a distraction while you’re driving. Really, the cell phone is a danger in of itself that should be removed from the process of driving, baby or not. As my neighbor Anna says, “Phone down, eyes up.”

What tips do you have to keep your kids safe in cars in hot weather? Share below!

Warmly,

Veronica

 

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

Summer Baby Safety

Summer Baby Safety

Today is our very first 90 degree day of the year, so it’s time to get everyone up to date on the things you need to know to keep your baby safe.

No water for newborns 

Your baby should ONLY be given breastmilk or formula for the first 6 months. Nothing else. Water can actually be dangerous; their kidneys aren’t able to get rid of the excess water and it can make babies very ill. And really, we take access to safe water for granted (BIG TIME). Even some things in the water supply that an adult body can handle, a newborn’s body can’t.

Nurse that baby!

When the weather gets warmer, don’t be surprised if your little one has more frequent feedings. We get thirsty more often, and your baby does too. So watch your baby for cues and listen to what he’s trying to tell you: It’s hot and he’s thirsty. It’s OK. It won’t spoil your baby.

Stay in the shade

The AAP cautions against using sunscreen on babies under the age of 6 months. Their skin isn’t mature enough to handle it. Get a hat that allows for decent ventilation with an SPF and use an umbrella or anything else to make sure you avoid prolonged sun exposure.

Cover that car seat

If you’ve been through at least one summer with kids, you’ll know this, but it’s still important to repeat: Car seats get very hot in the sun. Kids and babies alike try to avoid getting burned (smart kids!). While your car is sitting out in the sun, cover the car seat with a thick blanket to keep it from getting too hot.

Rethink the beach

Here in Minnesota, in the land of lots of lakes, going to the beach in the summer seems like a birthright. Yeah, not so fast. While nobody is claiming that lakes should be squeaky-clean, the reality is that our lakes aren’t very clean. The Minnesota Department of Health has a wonderful set of resources to help you figure out if your favorite spot is safe, but again– what we can tolerate as adults can easily make babies and toddlers sick. Stick to the pool instead.

Nobody wants to miss out on our precious summer days because of injury or illness. Any other summer safety concerns? Let me know!

Warmly,

Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.

Am I biased? You bet.

BiasedBiased

Recently, although I’ve heard it before, the charge was leveled at me that I am biased in my classes. I was called, “Pro-breastfeeding, anti-drugs.” I spoke with a few other Lamaze Certified Childbirth Educators, and it seems that this charge is something that we’ve all heard. So, I think it’s time that I out myself for all of my biases.

First of all, I teach what’s best practice, what’s evidence-based, and what’s biologically normal. Now, keep in mind that it takes, on average, 17 years from the time something is deemed best practice (ie. safest) in maternity care before it used on a regular basis. 17 years. When new practice bulletins come out from ACOG, when the American College of Nurse Midwives issue statements, when the AAP put out new guidelines, guess what? That’s what I’m teaching. If I only taught what was being done by doctors and midwives– well, I have major ethical concerns with that. In an environment of “shared responsibility,” there’s a moral imperative to give families the information that they need to know if they are getting safe and competent care.

As for the “pro-breastfeeding” charge; I’m always interested to know why someone’s motivated to make that charge. Yes, I am a Certified Lactation Counselor. So? In classes, I teach the American Academy of Pediatric’s guidelines on infant feeding and mention what the World Health Organization’s stance is on the issue. Maybe the issue is that my classes meet the standards as set forth in the Baby Friendly Hospital Initiative. Again…so? We have 6 hospitals in the Twin Cities that are certified as meeting the Baby-Friendly requirements, all of the Healtheast system, one HealthPartners hospital, HCMC, and the U of M hospital, I hardly think I hold a renegade position. If those hospitals want to maintain Baby-Friendly status, they need to make sure their childbirth education classes have the same content as mine do. With almost 90% of moms initiating breastfeeding, I’ll stand with and support them. This is not about condemning one feeding choice, it’s about helping moms reach the goals they have for themselves.

What else?

I believe that it’s important to teach an understanding of the processes that are the biological norm.

I believe in maternity care transparency.

I believe that moms need to be responsible for finding competent care. They need to learn what that looks like and how to find it.

I believe that infant car seats are usually a waste of money and, since they are more often recalled and used incorrectly, can quickly become not as safe as convertible car seats. I also hate that parents aren’t taking their babies out and more than half of kids now have flat heads by age 1.

I believe in teaching about healthy choices and safe choices.

I believe in judging a hospital and birth center by their outcomes, not their wallpaper.

Are these things really that bad? Is it wrong to make sure parents aren’t being lied to? Is it wrong to be critical of those “educators” who are giving parents unsafe information because it’s the cultural norm? Is it wrong to help parents seek out safe care? Is it bad that I advocate for the right of a mother to be listened to? I hope not.

Every day, I hear birth stories and breastfeeding stories from moms who didn’t get the education or support that they needed and either they ended up with poor outcomes or their babies did. And you know what? I’m going to stay the course, because moms, babies, and families deserve it.

-Veronica

Veronica Jacobsen, BA, CD(DONA), CLC, CPST, LCCE, FACCE

DONA-Certified 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.