Thursday, September 25, 2014

Why Not Home?

{guest post by Jessicca Moore}

I gave birth to my son at home.  I was originally driven to that choice by what felt to me like a lack of other options: the only hospitals in my area that took my insurance were not very supportive of natural birth (with requirements like mandatory IVs and continuous fetal monitoring, and with cesarean section rates rumored to be well over 30%), and the nearest birth center was in another state and an hour and a half away.  As my pregnancy progressed and I continued researching, I began to realize that a home birth with a well trained and highly qualified midwife was my best option for the kind of birth I was hoping for.  And I did get just the birth I was hoping for.  It was beautiful and empowering and amazing and the strongest thing I've ever done.

I was first introduced to the Kickstarter campaign for Why Not Home? by a friend of mine who teaches Birth Boot Camp childbirth classes in Northern California.  I am backing the project because I believe that even in this day and age, too many women don't know their options when it comes to giving birth.  There are far too many myths surrounding birth; there is too much fear, too much uncertainty.  And the statistics in our country show just how dangerous this misinformation is.  The United States ranks 60th in the world for maternal mortality rates, and is the only developed country where that rate is actually increasing.  One quarter of women have their labor induced, often without an actual medical reason.  One third of babies are born via cesarean section.

Something needs to change. This documentary will be a step in the right direction, and I urge you to consider supporting it.

Photograph by Erin Wrightsman.  Used with permission.

Why Not Home?

I didn’t set out to be a filmmaker or a childbirth activist. I wasn’t spurred to action by a terrible experience or by a great fear of intervention. Quite the opposite.

My birth experiences at home were so wonderfully beautiful and empowering. It was shocking. I didn’t realize birth could be like that. I started to wonder why this was such a big secret in our culture.

Looking around, I wasn’t satisfied with the media portrayal of home birth moms. Cast as fringe or overly concerned with their own experience above the health and safety their children, this depiction didn’t resonate with me. It certainly didn’t describe the clinicians and mothers I knew who had chosen to give birth at home.

Photograph by Erin Wrightsman.  Used with permission.

Currently in the US less than 1% of women give birth at home. Of those, a quarter are unplanned or unattended. Many people wonder, “Why would anyone choose to give birth at home?” I wanted to turn the question around and ask, “Why not give birth at home?”

The film I’m working on looks at this question through the experience of doctors, nurses, and midwives who attend birth in the hospital, and chose to have their own children at home. Their stories give us unique insight into risk, safety, and the experience of childbirth in America.

Home is certainly not appropriate or desirable for all women. However, in our current system, too often women and families are forced to make decisions about place of birth based on cost or coverage limitations, fear, or misinformation.

What if instead, they could base their decision on the best evidence for their unique set of risks and their knowledge of the environment that would best support their transition to parenthood? This is my hope and why I’m making this film.

If you value informed choices, please support this film today. If we don’t reach our funding goal by October 11th the footage we’ve already shot will sit unseen. Don’t let that happen. Become a backer today.

Photograph by Erin Wrightsman.  Used with permission.

About Jessicca Moore:

Jessicca Moore is a family nurse practitioner and filmmaker in Petaluma, CA where she lives with her husband, two children, and two sheep. She is currently in production on her first feature-length documentary, “Why Not Home?” The film follows hospital birth providers who chose to give birth at home. You can watch a trailer and get more information here: and support the project on kickstarter at through October 10th.

Follow the project on twitter and instagram @whynothome and facebook at

You can find Jessicca on twitter @jessicca_moore

Monday, September 22, 2014

Review: The Healthy Pregnancy Book

Note #1:  My original review of The Healthy Pregnancy Book was written for San Francisco Book Review and appears on their website.  I have expanded that review for this post.

Note #2:  The opinions in this post are just that: my own opinions, for better or for worse.  No one paid me to write any of this.

Countless numbers of people look to Bill & Martha Sears for advice about pregnancy, birth, and child rearing. The newest addition to the Sears Parenting Library is The Healthy Pregnancy Book, which replaces their previous pregnancy book (called simply The Pregnancy Book). This new volume contains almost everything you need to have a healthy pregnancy!

They start with some of the basics on healthy living while pregnant:
  • Food: how to eat (grazing and sipping are fantastic options) and what to eat (superfoods, important nutrients, organic foods, and more), plus a few recipes such as the Pregnancy Supersmoothie
  • Weight Gain: what's healthy for different people, where the weight goes, and why gaining too much can be bad
  • Exercise: how it's beneficial, precautions and types of exercise to avoid, types of exercise to try, and how exercise can lead to a better birth
  • Stress: why it's bad for mom and baby, and how you can reduce it
  • Sleep: why pregnant women often don't sleep well and why they need more, plus ways to help get more
  • Green Living and Lifestyle Changes: why tobacco, alcohol, and drugs should be avoided; concerns about caffeine; food chemicals to avoid; and personal care products that are better for mom and baby
The book then progresses to a month-by-month study of pregnancy.  Each month's chapter talks about how baby is growing, how you may be feeling (physically and emotionally), and concerns; the concerns span everything from physical (spotting during early pregnancy, hemorrhoids) to lifestyle (traveling, thinking about maternity leave from work) to relationships (helping Dad be more engaged, mothering other youngsters while pregnant).

I love how the book brings up choice of care providers and birth places early on; so many "mainstream" pregnancy books take for granted that you will be birthing in a hospital with an OB, and if they mention midwives and birth centers (and homebirth!) it is in a little sidebar that can be easily overlooked.  But even as The Healthy Pregnancy Book advocates a more physiological style of care (often called the midwifery model of care), it is written in such a way as to appeal to readers across the spectrum, no matter what your plans are for birth (or even if you haven't really thought about any plans at all).  The author team, along with Dr. Sears and his wife Martha, an RN, includes both an obstetrician and a midwife, to give readers a balanced perspective.  The book covers doulas, chiropractic care, prenatal testing, childbirth classes, delayed cord clamping, birth plans, VBAC, cesareans, and so much more.

Each chapter also contains pregnancy journal pages; if you're interested in journaling but at a loss for what to write about, here are ideas!

There is an entire chapter devoted to how hormones affect labor and birth, which is pretty neat.  This chapter also includes information on how medical interventions (such as induction and epidurals) can affect the "hormonal symphony" that is birth, which is a fascinating contrast for those who have never thought about it before.

The chapter on the ninth month covers labor and birth itself (although the Sears' The Birth Book covers that topic in much more depth).  Readers will learn about labor stages, labor/birth positions (with illustrations), ways to help your labor progress, and more.  Perhaps one of the best parts about this book is how up-to-date and evidence based most of the information is.  Mothers are encouraged to eat small amounts of food during labor if they desire (since recent studies have provided firm proof that hospital policies of "nothing by mouth" do not improve birth outcomes), to discuss whether electronic fetal monitoring should be continuous or intermittent, to consider delayed cord clamping if possible, to use "self-regulated pushing" instead of "staff-directed pushing," to refuse an episiotomy without a valid medical reason, and to keep upright and mobile.  A chapter also touches on the immediate postpartum period and breastfeeding, with tips on healing yourself and easing your transition into motherhood.

Only after the information about a normal, healthy labor and birth does The Healthy Pregnancy Book turn its attention to special circumstances and medical complications.  I like that the book does not focus undue attention on everything that can go wrong; the focus on normalcy and what you can do to stay healthy is a breath of fresh air compared to so many other mainstream pregnancy books the seem to reiterate in every chapter the things that you should be concerned about and when to call your doctor.  These things are not left out of this book completely (and nor should they be), but are just put at the end where readers can easily find information about their particular situation.  And the well-organized index makes it easier to locate specifically what you are looking for!

I don't think there will ever truly be a "complete" pregnancy book, as there are just so many little things that no book can cover it all.  That being said, The Healthy Pregnancy Book does a fine job of it anyway, and will definitely be going onto my recommended reading list.  With its friendly, conversational writing style, this book is sure to be well-received by expecting parents everywhere.

Monday, September 15, 2014

Pumpkin Cornbread Muffins

Is it too early for pumpkin everything?

It's technically almost autumn, although here in San Diego the weather doesn't seem to have gotten that memo.  It has been ridiculously hot and humid these past few days.  Temperatures in the nineties, humidity that makes it pretty much unbearable to be outside after 9:00 A.M. or so.  (Unless you're in a swimming pool, which is where we spent a good chunk of our morning.)  And we, unfortunately, currently live in an apartment without central air.  And it's a "reduce your use" day, according to SDG&E, so I can't even sit in front of our little A/C unit all day in good conscience.  Sigh.

Thankfully, we got our baking out of the way early this morning.  We *always* get up early; Little Bug rarely sleeps in past 6 these days.  (What am I talking about??  I don't know that he's ever reliably slept in...)  And since we were expecting company, baking some treats seemed like a good plan.

Actually, baking yummy treats is ALWAYS a good plan.  Company or not.  Just sayin'.

Pumpkin Cornbread Muffins

1 cup flour
¾ cup cornmeal
1 teaspoon baking powder
½ teaspoon baking soda
¾ teaspoon pumpkin pie spice
¼ teaspoon salt
1 cup pumpkin puree
¼ - ½ cup brown sugar
1 tablespoon vegetable oil
3 tablespoons applesauce

Preheat oven to 425° F.

In a large bowl, mix flour, cornmeal, baking powder, baking soda, pumpkin pie spice, and salt.  (The spice isn't especially strong in these muffins, so if you like a stronger spice flavor you might consider adding a full teaspoon of pumpkin spice or even more.  Or, of course, feel free to create your own blend of cinnamon, cloves, nutmeg, allspice, etc., in whatever proportions please you!)

In a smaller bowl, combine pumpkin, brown sugar, oil, and applesauce.  (Note that I like at least a little bit of oil in my baked goods; I am generally not a fan of the texture of muffins that have no fat at all.  That being said, if that doesn't bother you, these would probably be pretty tasty with extra applesauce subbed in for that last bit of oil, if you so desire.)  Add to dry ingredients and mix until just blended; lumps are fine, and it's okay if there are occasional patches of dry ingredients.  Pour into a prepared muffin tin.

Bake 13-14 minutes, until muffins are golden on top and a toothpick or knife inserted into one comes out clean.

Thursday, September 11, 2014

Kids' Song Flash Cards

For more than half of my life, I spent ten days (or more!) of every summer working at Two Sentinels Camp.

I first started going there when I was really young, around age eight (although I can't remember off the top of my head and I'm too lazy to do the math right now to figure it out for sure).  For a number of years, I was a camper; once I was old enough, I went through the One Step Beyond program (think counselor-in-training), and then I volunteered as a counselor for many years.  Camp was one of the highlights of my year, every year; the place felt like a second home to me, and all of my fellow staff members were my *real* family.  I haven't been there in a few years, due to a combination of moving out of state and then having a baby, but I am counting down the years until my son is old enough to be a camper.  Camp family, I will return someday!

Anyway, one of my favorite staff positions was Program Director, which meant I played a major part in planning and implementing all-camp activities.  (For the record, every time I was working as Program I was always working with someone else; it's a huge job for just one person!)  It also meant I got to do a lot of singing.  Lots and lots of singing.  Aside from planning (and usually leading) two big campfires during the session, we sang before meals (when the food wasn't quite ready yet), after meals, and sometimes during meals.  We also went serenading several nights during the session, which meant that, right around bedtime for most of the campers, we would wander around camp and stop at strategic locations, where we'd sing a handful of slow, quiet, pretty songs before moving on again.  Serenading the campers to sleep.  Honestly, serenading was one of my very favorite activities at camp.

Suffice to say, I know a lot of songs.  A.  Lot.  I've always loved camp songs, and I made it a mission to memorize them all.  No, really.  I used to write the lyrics down in my journals.  I remember pestering my sister endlessly one year in the weeks following camp, because she knew the words to a cool song and I did not.  (For the record, it was "The Billboard Song," and I certainly know the words now, although I don't remember if she was the one who taught them to me or not.)  I spent a long and obsessive amount of time compiling a songbook of all of the songs we regularly sing at camp.

And yet, it was still pretty common for me to get in front of people, ready to lead a song, and find myself drawing a blank.  What to sing?  What haven't we sung lately?  I know so many songs; why can't I think of any now?????

Nowadays, most of my singing is directed towards my toddler.  He has quite literally grown up on camp songs.  We sing faster, silly songs during the day, and I serenade him to sleep at night with the quiet ones.  He asks for songs sometimes; lately, he's wanted me to sing him banana songs and train songs.  Sometimes we look through some of his picture books--the kinds with random pictures of animals or natural things or such--and I sing him songs whenever I see something I know a song about.  Kookaburra?  Squirrel?  Polar bear?  Camel? It definitely helps to have pictures to jog my memory.

And sometimes he just wants me to sing.  Not about anything in particular, he just wants singing.  Every time I finish a song, he chimes in with "More singing!"  (I am reminded of that episode of "The Simpsons" in which the children get a nanny called Shary Bobbins.  Sing us a song, Shary Bobbins!  I've been singing you songs all day.  I'm not a bloody jukebox.)  So I'll sing him a few, and then find myself facing a familiar problem:  I can't think of any more.  I know so many songs, but my mind still blanks out sometimes.

Thus, my idea for song flashcards was born.

And since all babies love to sing, I thought I'd share the idea!

1.  Compile a list of songs I know all of the words to, which can easily be represented by a single image.  These can be classic baby lullabies, cultural songs, camp songs, or whatever you'd like.  A few examples from my collection:
  • stars = Twinkle, Twinkle
  • spider = Itsy Bitsy Spider
  • boat = Row, Row, Row Your Boat
  • hippo = What Can Make a Hippopotamus Smile?
  • mountain = Comin' Round the Mountain -or- I Love the Mountains
  • pajamas = Pink Pajamas
  • sun = You Are My Sunshine
  • clam = Gooey Duck

2.  Find images to match your songs.  I spent some time using Google image search to find cute clipart to use on my cards.  You could cut out pictures from magazines or old, trashed children's books.  If you're artistic, you could draw your own pictures.

3.  Make the flash cards.  I formatted my pictures in Open Office (because I don't believe in having Microsoft Office) and printed them out in color.  Then, after trimming them down, I had them laminated, because I'm fancy like that (and to make them slightly more durable).  Each one is double-sided.  You could just as easily tape your pictures to index cards, or print them out on card stock.

4.  Get singing!  My little guy loves looking through the pictures; sometimes he asks me to sing songs at random, and other times I can tell he's looking for a particular picture, presumably because he wants me to sing a particular song. 

Happy singing!  :)

Monday, September 8, 2014

Meet the Birth Center: Birth Roots

Birth Roots is a freestanding birth center located at 236 F Street in Chula Vista, California.  Founded in January of 2010, Birth Roots is in a unique position to help women of San Diego's South Bay region by providing them with a safe, out-of-hospital option for childbirth.

Caregivers: Birth Roots is staffed with direct-entry midwives; the midwives have served extensive apprenticeships and are very well-trained, although they have not attended formal medical school.  Sarah and Darynée have 16 years of birth experience between them.  Both are Certified Professional Midwives (CPM) as well as California Licensed Midwives (LM).  Both practice the midwifery model of care, sometimes called the physiological model of care.

"We have encountered all common complications of labor and delivery, and several uncommon complications as well. We have supported women through home, birth center and hospital births, including vaginal birth after cesarean (VBAC), breech, twin, and cesarean birth. We maintain certifications in Neonatal Resuscitation and adult, infant and child CPR."
There are also several apprentice midwives at Birth Roots, at various stages of their training.

Home Birth: Birth Roots offers home birth services for women who are interested.

Labor/Delivery/Recovery Rooms: Birth Roots has one main birth room, equipped with a spacious birth tub and a comfortable bed.  There is a second birth room as well, on the off-chance that there is ever more than one women in labor at the same time.  (As of yet, that has not happened.)  But the midwives stress that women can labor wherever they so desire in the center; the large bathroom has seen more than one baby born there.

Standard Care During Labor:  The midwives monitor both mother and baby once they arrive at the birth center; this includes vitals, fetal monitoring as necessary, and possibly vaginal exams.  Mothers are encouraged to eat and drink throughout labor if they desire.  For the most part, the midwives to try to be as unobtrusive as possible, letting mother labor however feels best to her.  There are not "standard" procedures such as women face in most hospitals; interventions may be performed if necessary, but always on a case-by-case basis.  And, as noted before, the midwives opt to try less invasive interventions first.  Birth will be attended by at least one of the midwives, plus at least one other assistant, usually one of the apprentice midwives.

Women can birth at the center anytime up to 42 weeks gestation.

VBAC: Birth Roots does accept women desiring VBAC on a case-by-case basis.

Pain Management:  Freedom of movement, water (showers & deep tubs), and massage can help women cope with labor pain.  The midwives also offer emotional support and a wide range of other comfort measures to help women get through labor.  Medication (such as an epidural) is not available at the birth center.

Medical Equipment on Site:  Oxygen and IV fluids are kept on site, as well as medications to control postpartum bleeding.

Transfer Rate:  When I visited Birth Roots, I was unable to get a specific transfer rate; however, it was emphasized that the overall transfer rate is very low.  The midwives are very good at keeping things "on track" even during the prenatal period, and when labor deviates from a "normal" course, they are expert at using less invasive interventions (such as position changes or getting the mother to eat/drink) to get things flowing smoothly again.  I was given an estimated transfer rate of well below 10%, but this is not an exact number.  The most common reasons for transfer are exhaustion, a need for pain medication, or true failure to progress.

Newborn Procedures:  Immediate skin-to-skin is encouraged, and mom and baby are given as much uninterrupted time as possible after birth for bonding.  A complete newborn exam is performed by the midwives.

Postpartum Care:  Families generally stay at the birth center for 4-6 hours after the birth.  The mother is checked out fairly soon after the placenta has been delivered, and will be sutured if necessary.  During the first 24 hours, the midwives check in with a phone call to see how mom and baby are doing, although they will come for a visit if needed.  There is a home visit on day 2 and again after a week has passed.  The week 2 visit may be either at home or at the birth center, and a well-baby/well-mama checkup will follow at around 6 weeks.

Breastfeeding Support:  Both of the midwives are certified lactation consultants, and they are committed to helping get breastfeeding started before the new family leaves the birth center.  Additional breastfeeding support is available during postpartum appointments, and the midwives are only a phone call away whenever questions or concerns arise.

Accreditation:  Midwife Darynée Blount is one of the founding members of the National Association of Birth Centers of Color, to the birth center is certified by that organization.  Birth Roots is not, however, accredited by the Commission for the Accreditation of Birth Centers.

Fees & Insurance:  Birth Roots uses a sliding scale to determine fees.  They do accept some PPOs, but currently no HMOs, Medi-Cal, or Tricare.

Birth Roots obviously has a lot to offer to women in San Diego's South Bay!  Go check out their website,, to learn more.

Looking for some personal stories?  I do not know anyone personally who has given birth at Birth Roots, but here are some stories and additional reading to start with.
Birth Roots Testamonials
Birth Roots Reviews on Yelp
Our Home Birth Story (attended by midwives from Birth Roots)
Eco-Friendly and Frugal Featured Local Business: Birth Roots

Have you given birth at Birth Roots, or at home with the help of their midwives?  Tell your story here!

Wednesday, September 3, 2014

Getting Ample Protein During Your Vegetarian Pregnancy

(It's Not as Hard as You Might Think!)

Everyone knows that your nutrient needs go up during pregnancy, but did you know that your protein requirement practically doubles?  Most sources say that a pregnant woman should be getting at least 80 grams of protein per day!  Are you getting enough?

Some vegetarians find it especially difficult to meet these numbers; I know I certainly did!  With patience and much time spent working with my diet (and keeping an accurate food journal), I was able to get there, and you can too.  It is easier to adequately meet your protein needs if you eat eggs and dairy, but the diligent vegan can accomplish it too.

Running low on ideas?  Here are some vegetarian ideas to bump up your protein intake.  (And note that all of these protein counts may vary depending on what brand you buy.)
  • Quinoa:  Technically a seed, quinoa cooks up like a grain and has a wonderful taste that most people enjoy just fine.  It's also worth noting that quinoa contains complete protein, meaning it has all of the essential amino acids that our bodies cannot produce on their own.  A cup of cooked quinoa usually has around 12 grams of protein.
  • Beans:  Yes.  Eat lots of these.  A cup of pinto or black beans has 14 grams of protein, a cup of garbanzo beans has 12 grams, and a cup of kidney beans has 13 grams.
  • Lentils: A cup of cooked green lentils has about 18 grams of protein.
  • Tofu and Tempeh: A serving of tofu, usually about 3 ounces, has 7-9 grams of protein, depending on the brand and firmness.  Tempeh is even better; a 4 ounce serving has 20-24 grams of protein.
  • Oatmeal:  A fantastic way to start off your day; a cup cooked averages about 7 grams of protein.  Better yet, you can add toppings to boost that even further!  I always top mine with walnuts, ground flaxseed, and chia seed, among other things.
  • Other Whole Grains:  You're going to eat bread and pasta anyway; choose whole grain!  Not only is it better for your blood sugar, but whole grains have a lot more protein than refined grains.
  • Veggies:  Wait, vegetables have protein?  Of course they do!  You should be trying to eat a rainbow of veggies every day, but some especially good options for protein are green peas (8 grams/1 cup), corn (4-5 grams/1 cup), spinach (5 grams/1 cup cooked), and Brussels sprouts (4 grams/cup).
  • Nut and Seed Butters: Spread 'em on toast, crackers, celery, apples, or whatever you want!  I buy ones that have no added sugars, salt, or oil (and definitely no hydrogenated oils!).  Try peanut butter (7 grams/2 tablespoons), sunflower seed butter (9 grams/2 tablespoons), almond butter (7 grams/2 tablespoons), or cashew butter (5 grams/2 tablespoons).
  • Nuts and Seeds: I prefer completely raw, but roasted are still a good option (be wary of too much added seasoning though). Try peanuts (7 grams/1 ounce), almonds (6 grams/1 ounce), pumpkin seeds (8 grams/1 ounce), cashews (5 grams/1 ounce), or sunflower seeds (6 grams/1 ounce).  Or try store-bought nut mixes if you like variety!
  • Greek Yogurt:  Sure, regular yogurt has protein too, but Greek yogurt usually has about twice as much.  It did wonders for my diet!  Plain, with fresh fruit or honey mixed in, or blended into smoothies were all delicious.  Most brands have 20-24 grams of protein in a cup.
  • Eggs: A single egg has about 6 grams of protein.
  • Cheese: Whether you snack on cubes or use it as a topping, cheese is delicious!  Most cheeses have about 7 grams of protein in a 1 ounce serving.
And here are some recipes to check out: