How to Cook Bok Choy

We grew baby bok choy in our garden and it did very well. As a result, I learned how to cook it. For four heads of baby bok choy:

1) Cut the stems off from the leaf part and wash each separately because the stems need just a few more minutes in the pan.
2) Put a tablespoon of olive oil into a fry pan and add the stems. Cook for one minute.
3) Add 1/2 teaspoon of soy sauce or to taste and a little pepper. You don't want too much soy sauce or it tastes bad.
3) When the stems are tender, add the leaves.
4) Cook leaves for three to five more minutes.
5) Add another 1/2 teaspoon of soy sauce and a dash of pepper and serve.

Try adding garlic and ginger to the olive oil if you have the extra time.

Yeah! Obamas to Plant White House Vegetable Garden

Read New York Times Article here.

Seeing the Obama's plant a vegetable garden was one of my personal wishes for them to do while they live at the White House.

My eyes swelled up with tears while reading this article. It's such a powerful message and takes some backbone to stand up against large food corporations.

Eleanor Roosevelt was the last person to plant a garden on the White House lawn and she withstood huge criticism from large food companies. I am sure that the Obama's are standing up to equal if not more pressure. Obama's are demonstrating that they really do want real change.

"The Obamas have been lobbied for months by advocates who believe that growing more food locally could lead to healthier eating and lessen reliance on huge industrial farms that use more oil for transportation and chemicals for fertilizer."

Read New York Times Article here.

Big Basin ah-ha moment

While camping at Big Basin this Winter in one of their awesome cabins, I had an "ah-ha" moment. I was reading their small paper brochure about the park's history and in it was a story about a pioneer family who were the parks first inhabitants. The woman had to give birth to her
children alone because her husband was always off working somewhere
far away and no one lived remotely close to them. The more that I digested her story the more that I realized how simple and perfect birth really is.

Birth is made to happen alone if need be. Clearly this woman was brave to be totally alone, but all women who give birth are brave. But it is reassuring that it can happen and our bodies know how to do it. It is a clean seamless process. Nothing needs to be "done" to you. The process needs to be allowed to happen freely. The umbilical cord doesn't even need to be cut at the end. It will detach itself when it dries up after a
couple of weeks like the stub does that we are all use to falling off our babies.

Processing and thinking about that pioneer woman in the woods giving birth alone to her children was one of the moments that contributed to the success of my home birth after cesarean. I remember thinking. "It's sort of crazy how long it has taken me to filter out all of what I've learned about birth so that I can finally see how simple, natural, and beautiful it is and how terribly complicated and frightening our culture has made it."

Hiring a Doula

Instead of the obstetrician model of care, I am choosing the midwifery model of care; instead of a hospital birth, I am choosing a home birth; instead of taking the McMoyler Method childbirth class, I am taking Shelley Campbell's hypnobirth class; instead of no doula, I am hiring a doula.

Now that I know what I am up against, I want all the support that I can get. Having a midwife is not enough. I had a midwife for my first birth experience and she wasn't with me the whole labor like I thought that she would be. Most midwives are focused on vitals and technical things. They are very supportive and knowledgeable but work on the big picture rather than working with each surge. I understand this now and respect their role. They save their energy for catching the baby and any emergency that may come up.

A doula's only job is my comfort and to be by my side the whole time with each surge. I understand the difference between a doula and midwife now that I've experienced childbirth for myself and appreciate the importance of each of their roles during childbirth.

My childbirth experience could be fast since it's my second child. I might not need a doula, but I am thinking of it like insurance. If I need extra support to help me through transition or driving to the hospital or any other difficult situation that may arise, I want someone there to help me through it.

Mikey was pulled out of me via cesarean at the final hour, and I think that if a similar situation were to happen, a doula could help me better transition from labor to surgery to avoid some of the trauma that I suffered the first time around. Or she might be able to help me ask for more time to deliver my baby naturally. I now know that the power of birth and the hospital are so overwhelming that any bit of help is extremely valuable and could help to postpone or avoid surgery.

In their book, Mothering The Mother: How a Doula Can Help You Have a Shorter, Easier, and Healthier Birth, Marshall Klaus, John Kennell and Phyllis Klaus summarize scientific studies which have been carried out on the advantages of doula-assisted births.

Benefits from the presence of a doula:

• Reduced the overall cesarean rate by 50%
• Reduced the length of labor by 25%
• Reduced oxytocin use by 40%
• Reduced the use of pain medication by 30%
• Reduced forceps deliveries by 40%
• Reduced requests for epidural pain medication by 60%
• Reduced incidences of maternal fever
• Reduced the number of days newborns spent in NICU (neo-natal infant care unit)
• Reduced the amount of septic workups performed on newborns
• Resulted in higher rates of breastfeeding
• Resulted in more positive maternal assessments of maternal confidence
• Resulted in more positive maternal assessments of maternal and newborn health
• Resulted in decreased rates of postpartum depression

I want my only job to be birthing my baby. I don't want to worry about what is happening around me. I want my doula to filter out the drama and deliver the truth to me in raw form. I want the information to come from someone that I trust because I don't trust unknown medical professionals like the McMoyler Method taught me to do for the first birth. Her method didn't work out so well for me. I want a doula to help protect my environment while I focus on my baby.

Zack and I interviewed six doulas and they were all wonderful and more than qualified for the job. Each interview happened at 8pm in our living room and lasted about an hour. We didn't have a list of questions. We just chatted with each doula and got to know them. Zack and I liked them all. We wrote down all the things that stood out about each one while doing the dishes after they left.

Each doula has something unique to offer and they are all very bright and interesting people. Britt has had amazing success with hypnobirth and is a prenatal childbirth instructor. Esther was a midwife years ago and has a valuable appreciation for postpartum care. Reise is a Birthing from Within childbirth instructor and prenatal yoga instructor. Spring is an apprentice midwife and massage therapist. Jamae has had two home births herself. And, Kara has attended 150 births. The hardest part will be deciding which one of these amazing women is the best fit for us.

Please share your doula recommendations in the comment section.

Kara Engelbrecht
kara@serpentine.com
http://www.karaengelbrecht.com/

Spring Childers
springcmt@yahoo.com
http://www.thebirthdoula.com/

Britt Fohrman
britt@brittfohrman.com
http://www.brittfohrman.com/

Esther Gallagher
esthergallagher@sbcglobal.net

Reise Tanner
reise@treeinthegarden.com
http://www.seedinthegarden.com/

Jamae Tasker
mamaladysf@gmail.com

Other resources:

http://www.sfdoulagroup.com/birthdoulas.html

http://www.naturalresources-sf.com/resources.html#birthdoulas

My other posts on home birth:

On my blog:

http://www.spinachandhoney.com/search/label/Home%20Birth

On SFGate:

Read some of my other posts about birth here, here, here, here and here.

Faux-fibers Labels

Don't be fooled by polydextrose and other fiber additives.

Read in Slate about the latest way food companies are deceiving us with false food labels and how the FDA goes along for the ride.

Time Magazine: The Trouble with Repeat Cesareans

http://www.time.com/time/magazine/article/0,9171,1880665,00.html

I copied and pasted page one of two below:

To avoid another C-section, Barton has to drive 100 miles to deliver in Los Angeles. For many pregnant women in America, it is easier today to walk into a hospital and request major abdominal surgery than it is to give birth as nature intended. Jessica Barton knows this all too well. At 33, the curriculum developer in Santa Barbara, Calif., is expecting her second child in June. But since her first child ended up being delivered by cesarean section, she can't find an obstetrician in her county who will let her even try to push this go-round. And she could locate only one doctor in nearby Ventura County who allows the option of vaginal birth after cesarean (VBAC). But what if he's not on call the day she goes into labor? That's why, in order to give birth the old-fashioned way, Barton is planning to go to UCLA Medical Center in Los Angeles. "One of my biggest worries is the 100-mile drive to the hospital," she says. "It can take from 2 to 3 1/2 hours. I know it will be uncomfortable, and I worry about waiting too long and giving birth in the car." Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them. More than 9 out of 10 births following a C-section are now surgical deliveries, proving that "once a cesarean, always a cesarean"--an axiom thought to be outmoded in the 1990s--is alive and kicking. Indeed, the International Cesarean Awareness Network (ICAN), a grass-roots group, recently called 2,850 hospitals that have labor and delivery wards and found that 28% of them don't allow VBACs, up from 10% in its previous survey, in 2004. ICAN's latest findings note that another 21% of hospitals have what it calls "de facto bans," i.e., the hospitals have no official policies against VBAC, but no obstetricians will perform them. (Read "The Year in Medicine 2008: From A to Z.")

Why the VBAC-lash? Not so long ago, doctors were actually encouraging women to have VBACs, which cost less than cesareans and allow mothers to heal more quickly. The risk of uterine rupture during VBAC is real--and can be fatal to both mom and baby--but rupture occurs in just 0.7% of cases. That's not an insignificant statistic, but the number of catastrophic cases is low; only 1 in 2,000 babies die or suffer brain damage as a result of oxygen deprivation.

After 1980, when the National Institutes of Health (NIH) held a conference on skyrocketing cesarean rates, more women began having VBACs. By 1996, they accounted for 28% of births among C-section veterans, and in 2000, the Federal Government issued its Healthy People 2010 report proposing a target VBAC rate of 37%. Yet as of 2006, only about 8% of births were VBACs, and the numbers continue to fall--even though 73% of women who go this route successfully deliver without needing an emergency cesarean.

So what happened? In 1999, after several high-profile cases in which women undergoing VBAC ruptured their uterus, the American College of Obstetricians and Gynecologists (ACOG) changed its guidelines from stipulating that surgeons and anesthesiologists should be "readily available" during a VBAC to "immediately available." "Our goal wasn't to narrow the scope of patients who would be eligible, but to make it safe," says Dr. Carolyn Zelop, co-author of ACOG's most recent VBAC guidelines.

Continue reading here.

Huffingtonpost reports on Vaginal Births after Cesarian (VBACs)

http://www.huffingtonpost.com/pamela-paul/childbirth-without-choice_b_168652.html

I copied and pasted the article here:

It would seem perfectly natural that a woman could give birth naturally if she wants to. Guess what? She can't.

An increasing number of hospitals in this country are refusing to offer women the option of delivering the way nature intended, if she had a cesarean section the first time around (and guess what -- chances are she has
because the 31% of all births are now C-sections -- up 50% in 10 years).

I wrote an article in this week's issue of Time magazine called "The Trouble With Repeat Cesareans" on the subject of women's diminishing patient's rights. I won't repeat the story here, since you can link to it here, but will give some of the back story for those who want more:

This was a story I've been wanting to write for a long time. The short version is, doctors and hospitals are no longer allowing many women to have a vaginal birth after cesarean (or VBAC, pronounced "vee-back") because the "medicolegal" costs are too high. Or, as one ob-gyn put it when I asked why she and other doctors no longer allow VBACs, ""It's a numbers thing. It is financially unsustainable for doctors, hospitals and insurers to engage in a practice when the cost of doing business way exceeds the payback. You don't get sued for doing a C-section; you get sued for not doing a C-section."

Now, I think most of us realize that many hospitals are for-profit institutions and that doctors need to make money too, increasingly hard in this era of managed care. It is nonetheless tough to hear a physician talk about medical care in such bare-bones financial terms. So, um, we can't get the most appropriate care because it costs too much? What's especially galling is that VBACs are actually a much less expensive "procedure" (if childbirth can be termed that way) than cesarean sections, which are major abdominal surgery and require days more in the hospital. The costs the doctor is referring to are the malpractice insurance costs passed on to doctors. And those costs aren't even reasonable, but are largely in response to a few high-profile cases of VBACs gone awry dating back 10 years, many of which involved a labor-induction drug called Cytotec, which is no longer used during vaginal births after cesarean.

Meanwhile, according to the International Cesarean Awareness Network (ICAN), out of 2,849 hospitals with labor and delivery wards nationwide, 28% have total outright bans on VBAC and an additional 21% have de facto bans in that they say they'll do it but none of the doctors on staff will do it. That's half of American hospitals, but the numbers are probably much worse. Many of the rest will allow what's often termed "Cinderella VBACs" (a term coined by Henci Goer ) -- "yes, you can have a VBAC as long as you have it Monday - Friday, between 8 am and 5pm and you aren't over 40 weeks and we don't think your baby is too big".

Moreover, even if the hospital allows VBACs, it doesn't mean that all the doctors there are willing or eager to perform them. Take my own case. After I had a cesarean with my first child, I made a point to find a new practice that was VBAC-friendly. (I would have stayed with my first doctor, but my insurance switched, a whole other story). The practice I eventually signed up was very encouraging, telling me that VBACS had a 60-80% success rate and that their particular practiced boasted a 75% success rate. All good. Right?

Except, when I hit the 6 month point, my doctor said to me casually, "OK, let's schedule your C-section now."

"Excuse me?"

"Oh," he said, "You know, you only have a 13% chance of success with your VBAC." He went on to explain that since I had reached the "pushing" phase of my first labor, my chances of a successful VBAC were dismally low and therefore it made no sense to attempt one.

Furious at the bait-and-switch (doctors love, love, love C-sections -- in and out in an hour! No messy labor! No pesky doulas or family members hanging around!), I asked him to produce the study that said so. It turns out that the study, which dated back to 1999, was contradicted by several later studies, all of which showed a significantly higher rate of success -- between 40-60%. One study showed no difference in success rates at all, no matter where the first labor ran into trouble.

The doctor on call when I ended up giving birth on Thanksgiving weekend, was, needless to say, very much put out by my inconveniencing him. His revenge? He refused to talk to me while I was in labor, and didn't answer his pager when I was ready to push. So that's an example of a hospital that allows VBAC and supposedly pro-VBAC doctors for you. The truth is, doctors who are truly VBAC-friendly are few and far between. The good news is, I gave birth, via VBAC, to a perfectly healthy little boy and had a much quicker, easier recovery than I did with my C-section (which was hell, but another story).

I'll end with this story, much more dramatic than mine: After giving birth to her first child via cesarean, Alexandra Orchard, a CPA in Colorado Springs, was told her second baby measured too large to be delivered vaginally. "My doctor said, 'You're not only risking her life, you're going to break her collarbone when you push her out,'" Orchard recalls. Through tears, she scheduled a second cesarean. "I was in so much pain after each surgery that I don't even remember when I met my children." With her third child, Orchard was determined to get a VBAC, but her doctor refused. Orchard researched the risks and with the help of a midwife, labored for 30 hours and gave birth at home to a daughter, now almost two years old. Orchard is apprenticing to become a midwife because, she says, "I don't want my daughter to have to fight like I did."