Thursday, January 25, 2007

Circumcision-to or not to?

Circumcision is one of the most controversial issues of the day among midwives, doulas, doctors and new moms. Ask 10 people and you will probably get 8-10 various opinions on the subject matter. While I hate this topic, I feel it's one that I need to address, at least a tiny bit, in this blog. The American Academy of Pediatrics says the following: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided. " In this, note that the AAP is #1leaving the decision to the parents. They are also saying that there ARE potential medical benefits, just not enough at this time to demand and require all boys be circumcised.

Circumcision is the removing of the foreskin. It's a tiny piece of skin that is approx 1/2" at the tip of the penis. Removing this, changes the look of the penis as well as the feeling and sensitivity to various degrees.

In Jewish culture, the circumcision symbolizes the entrance of a male child into the traditional covenant with God. It is performed on the eighth day after birth and the child is often held by his godfather during the procedure. Most Jews still practice this today and it is a very celebrated part of their religion and culture. It is often celebrated with a Bris Milah. Bris means 'covenant' and Milah means 'to cut'. It symbolizes the covenant made between God and the Jews. During the Bris Milah, family is often celebrated. The baby is often passed around to various people who are being honored, at some point during the ceremony. Also during this ceremony, the baby is given his Hebrew name. This is a very important part of the Bris and is often accompanied by much emotion. In Christendom, a Bris would be similar to what we would do as a baptism, christoning or baby dedication. It is held with the same honor, respect and importance. A Bris is also done by a Mohel who is trained in ritual circumcisions. The ceremony is normally performed in the home of the family or at the synogogue or temple.

Many Christians view the circumcision in much the same way as the Jews. There is a movement in Christianity that believes that since God told Abraham to cut off the foreskin of Isaac, that there must be significant reasons and meanings to do so. They also feel that when Jesus came to earth, we all inherited the same covenental rights that the Jews had, and as part of that covenant, we too should circumcise as a sign. There is some controversy around this because the New Testament does say that "There is neither Jew nor Gentile, circumcised nor uncircumcised; for all are one in Christ". This verse (and others) have been interpreted in many various ways, but many feel that it is saying that we all have to come to Christ in the same manor, Jew or Gentile".

Most in today's society have no clue what circumcision is or does. They trust the word and knowledge of their doctor and so if he says do it, they do it. I am not here to say whether one should have it done or not. I'm not on the bandwagon of having made illegal or banning it completely. I'm one to educate the reader and my clients on the process and let them decide for themselves. Just as I would never demand one have a homebirth over a hospital birth, have an episiotomy or not, etc etc, I would never force my views of circumcision on a mother or my client either. (FTR, I have 3 sons and they are all circumcised, including my youngest, who at the time of this writing is only 15 days old and has his circumcision done yesterday).

In choosing to circumcise or not circumcise, one must really face all the issues at hand and be sure to do the proper education and reading. What most people don't know is that most hospitals will accomodate your wishes when performing this procedure. It is normally not done in a sterile room and takes approx 10-15 minutes for the entire thing. My first son was born in a large hospital here in Michigan. When it was time for his circumcision, my husband asked if he could accompany him to the room and was he was allowed to. During the procedure, he stood right next to our son, holding his little hand. Our second son was born at home and therefore it was incredibly hard to find a doctor who would perform the circumcision. What I found was that pediatricians wouldn't accept him cause he wasn't there patient. OBGYNs wouldn't take him because "I" wasn't there patient. I was told to call a Urologist, who told me they don't do them and to call a Pediatric Urologist, who told me they don't do them until the child is 2 years old and then they put them completely under to perform it. I was beside myself about it so talked to my midwife who told me to check into mohels. I called a couple and found one who was also a pediatrician with his own practice. I felt very comfortable with that and so we proceeded. His circumcision was done at a local temple, even though we are Christians and not Jewish.

Our 3rd son was born on January 9th, 2007 at home. We contacted the mohel who had done our last son and he said he would do this one too. We ran into some snags and ended up cancelling with him. I contacted several other local mohels and 'interviewed' two of them on the phone and went with the one we chose, and as stated earlier, it was performed yesterday. We decided to make it a bit more 'ceremonial', although we couldn't offer our own prayers or blessings since it too was done in the temple, but my husbands two best friends accompanied him and Jacob. It was actually a very special time for all of them (something we as females and moms will probably never understand).

So, this whole blog has been written to get to this-if you are going to have a son and are caught in the middle as to what to do, sit on neutral ground and ask questions. One thing I've found is that if you visit message boards and ask questions, you will get a few who are very adamently against circumcision and they will rule the conversation. You will get very little in unbiased information or answers. Steer clear of those. ;)

Things to know & ask your doctor or mohel:
1. How many circumcisions have they done?
You do NOT want someone operating on your young sons penis as his first circumcision. The mohel that did our son yesterday has done over 12000. The mohel who did our second son had done about 300. We were confident in that. The doctor (done in the hospital) who did our first son had done approximately 500. At the time, we thought that was a great number and were confident in that. While I still am confident in that number, the 1200 is much more reassuring to me.

2. What procedure do they use?
There are 3 various procedures that are used during a circumcision. The gomco clamp is what most doctors tend to use. Most of them feel that it gives a better appearance and is easier to use. It involves stretching the foreskin over a belllike applying pressure and then the removal of the clamp and device. It takes approximately 3 1/2 minutes to complete.

The mogen clamp is most widely used in Bris Milah. It is said to be more effective, less painful and more precise. Research says that babies cry less during this procedure, have higher oxygen levels and less increase in heart rate. The procedure takes approximately 90 seconds with the mogen clamp. There is no bell shaped part of this clamp so it involves the mohel/doctor situating the clamp and closing it to complete the procedure.

The plastibell is another method used. In this procedure, the foreskin is lifted and a plastic ring is inserted. After five to eight days, the bell and dead foreskin tissue detach. In this method, there is very little extra care that needs to be done afterwards as there is no dressing to change and no stitches.

3. What is offered for pain control during the procedure?
This is one place I'm a stickler. DEMAND that your doctor or mohel offer pain management during the procedure. Some doctors will use only a topical anistetic, which in my opinion, is not enough. There are two different methods used for numbing the area through local aniesthesia. The first is to inject right into the shaft of the penis. This will cause numbness and pain relief for several hours. Most mohels will not use this method however. They believe that if you inject the anesthesia just into the foreskin, that it will create a less stressful 'recovery period' for the baby. Think about when you go to the dentist for a filling or root canal. For the next several hours, your face is tingly and then, as the numbness wares off, you get that itchy, annoying feeling. With a local anesthesia to the shaft of the penis, this is what many feel happens to the baby. For the next few hours, there is that nagging feeling as the numbness subsides. Regardless of that type of pain relief used, demand something. Some doctors still have the mistaken belief that babies don't really feel any pain during the procedure and that they are only crying cause they are strapped down. Take it from a mom of three....they are mistaken!

Just as with any other pain, Tylenol is often used, and should be used, if baby is acting distressed in any ways.

In closing, if you are giving birth to a baby boy, it is up to you, the parents, to make the right decision of what is best for your family and your child. Weigh the options, ask the questions and do the research. Don't be bullied into a choice, whether for or against, but do what you feel is best. The choice is yours...



*** Author Notification *** We ask that you notify the author of publication of her work. Kelly Milano, can be reached at: kmilano@gmail.com Please provide a link to her work on your site.
Do not publish without permission of the author.
2007

Friday, January 19, 2007

Ways to help a new mom

With having this baby, several women in my church have offered to bring us over dinner so I didn't have to cook. While this seems like a nice thought, I've learned quite a bit from it. In the future, when other women in our church, neighborhood or social circle have a baby, I'm going to head up the group who is bringing dinners over. I'm going to oversee all the volunteers and help them understand from what I've learned, what their role is. Here's what I've learned. I hope this can help someone in the future who may be taking a new mom dinner.

1. Find out if the family has any allergies or food aversions. If the family is vegetarian and you bring over Chicken Cattitore, it's just going to get thrown away and family is now going to have to frantically find something for dinner once you've left. If there are peanut allergies and you bring over peanut butter brownies, when you leave, all hell is going to break loose in the household and a trip to the ER may be needed. This is NOT helping this new mom or this family and is causing more stress.

2. Find out what time the family normally eats and do your best to have dinner there by that time. When the family has young kids and they are used to eating at 5:30 and you call at 6 and say you will be there around 7, only to then call at 7 and sa you are just leaving and it will be 30 minutes, this is NOT helpful to the mom who has to try to come up with snacks to keep the kids from getting cranky, but small enough to not ruin their appetite. Hungry kids make for a ROUGH night.

3. If you don't have time to make a meal because you are working later than the family eats, DO NOT VOLUNTEER.

4. Ask the family is something like Boston Market or KFC is good if you want to volunteer but know you are limited on time. Many families appreciate this type of mood just as much as something home cooked. As long as mom doesn't have to cook, just about any of it is appreciated!

5. Try your hardest to bring a complete meal. If you know that you are bringing something like enchiladas, make sure to bring the sour cream and fixings that the family may not have. Don't count of a new mom to have a fully stocked fridge. Also, try to make the meal as full as possible. Bread, side dish and a salad are great additions to a lasagna. A dessert of some sort is a nice addition as well.

6. Once you are at the families house, go to the kitchen and help prepare the meal. If it isn't prepared yet, preheat the oven so you can put it in. While it is preheating is a decent time to visit with mom and the new baby. If the meal is prepared already, ask mom if you can help set the table or get the kids fed.

7. Do NOT overstay your welcome. Most of the time, 10-15 minutes is all you need to stay to visit. Do not plan on eating with the family or staying for an hour and holding the new baby. Be courteous of the families time, especially in the early days or on the first days where dad has gone back to work and may want to come home and spend time with his new baby.

8. If you DO have a desire to stay a bit longer, ask the mom if there is anything you can do before you leave. Offer to help with vacuuming, throw in some laundry, etc. If you are a close family friend or relative, you can even offer to help bathe the kids. This can be much appreciated by a frazzled new mom. If the answer is a no and that she has it all under control, then take that as a sign to leave the house and let the family enjoy their meal.

9. Make sure all your pans and bowls are labeled if you didn't buy the cheap pans from the store just for this occassion.

10. And ALWAYS knock. Even if you are a close family friend, make sure to knock and then WAIT for someone to open the door. A new mom doesn't necessarily like that her door is revolving and wants a bit of privacy.

There is another blog that goes well with this one and is a MUST READ for all non-pregnant people. Take Notice #9 & 10 Journey to Homebirth: Dear Non-Pregnant Person

*** Author Notification *** We ask that you notify the author of publication of her work. Kelly Milano, can be reached at: kmilano@gmail.com Please provide a link to her work on your site. Do not publish without permission of the author.

Thursday, January 11, 2007

We have a baby!

Ok, I have a few minutes so am going to type this out really quick. I'm not exactly sure of all these times as things got REALLY crazy really fast last night.

On Monday morning I had some pink tinged mucus a couple different times. I told Tim that this stinker was going to be born on his due date and sure enough, he was. At dinnertime I had the other half of my fresh pineapple and then at 11:30pm, I told DH we needed to "force this baby out". About midnight I started contracting so bad. I'd never had them come on like that so wasn't even sure they were real and didn't want to get my hopes up. I told Tim we probably needed to get the hose from the garage and have it set up just in case, but then decided to time a few first. The contrax were about 3 1/2 minutes apart and 48-60 seconds long. He calls our best friends and tells them and says that this is going to be fast and if they don't get here quick, they'll probably miss it. I call my midwife and said "So, feel like delivering a baby tonight?" I was so calm that at first she thought I was joking. I told her I wasn't sure it was real since my water hadn't broken and it always broke to start my labor and maybe I would just call her back in a few minutes. She said no, she'd come out just to be safe. Later she told me that I sounded like her when she called her midwife 4 months ago saying she thought she was in labor. I was still very calm, but little did anyone know, I was panicing on the inside. lol

We had so much to do that I didn't have the ability to sit at all and work through the contractions. Tim was filling the tub and I said "I have to get in there NOW". When I got in, the water was a bit cold. We had drained the tank and it heats from the top so the water that was coming out the bottom spout was freezing cold. I told him he needed to start boiling some water, but we both knew there was no time. Ryan & Karen got here and Ryan & Tim started filling pots of hot water from the bathtub and dumping them in the tub. I was getting so uncomfortable and told Tim that I could feel the 'ring of fire' and to call the midwife and tell her she had less than 10 minutes. She said that she was 10 minutes away and it would be good timing. Well, suddenly I said that I could feel the head. I let out a few moans with the pushing and out came the head, followed closely by the shoulders. By the time the midwife got here, I was holding my new baby boy in my arms. Jacob was born at 1:00 on the dot, almost exactly 1 hour after the first contractions. It was about 15 minutes before the placenta delivered and another 15 before we got out of the tub. It all happened so fast that my body was shaking a bit. I didn't lose much blood at all, but my body was in such shock. Just before I actually delivered the baby, Tim asked if I wanted him to go get the kids. I didn't want them in there for some reason (up until that point I did), but they came in right after he was born. A few minutes later, Jacob opened his eyes and was just looking around at everyone. He loved just starting at Mikayla and Katelyn. He was so intent on watching them.

I had a small tear cause of how quick it all happened so we had to repair that but otherwise everything was truly amazing. Jacob latched on and nursed like a champ right away. My mom and dad had come down too (got here 15 minutes after he was born and thought Tim was joking when he called them and said that the baby was here already). Everyone was gone by about 3:30am and Tim and I finished getting things cleaned up a bit before we headed to bed. Jacob didn't want to sleep at first. At 4:30, he finally fell asleep and it's 10 and he's just now waking up!!! He is the most amazingly calm baby I've seen. During his checks where they are pulling on his legs, rubbing fingers down his spine, tickling his feet, he just laid there without making a sound. So amazing.

STATS:Jacob Alexander Milano
January 9th, 2007
1:00am
8lb 2oz
22" long

I do NOT wish a 1 hour labor on anyone. While it might sound incredible, it was incredibly painful. There was no time to get used to the contractions; they just HIT.

http://s143. photobucket. com/albums/ r129/BabyJacobM/ Here's some pics.

Saturday, January 6, 2007

Vagina, Vagina, Vagina

There! I said it! I absolutely HATE that word and don't know why. I think it has to do with my conservative, Baptist upbringing in a home where anything remotely sexual was not discussed. I don't have a problem with teaching my boys that they have a penis, but for some reason, teaching my girls that they had a vagina was so much tougher. For the first several years, we just never talked about it. I never called it ANY name and they never asked. One day about 6 months to a year ago, I hear the girls in the bathtub and I hear them talking about washing their 'flower'. I asked them what they were talking about and they pointed to their vagina and vulva. I asked them where they heard this was a 'flower' and they said it was from my mother in law while they were at her house that weekend before. She had been giving them their baths and told them to wash their arms, their tummies, their bottoms, their 'flower'. I was flabbergasted!! This is NOT a flower. Flowers grow outside in the dirt. The smell and look pretty for a bit, then they DIE. That is NOT what my girls have. They have VAGINAS! I talked to them about what a flower was and what their vagina was.

I never had this same problem teaching my sons that they had a penis however. I remember not long after Seth was born, we were in church and our pastor was preaching about marraige and family or something and I remember as clear as day him saying something about how families tend to make these things an embarrassement and encouraged all of us as parents to not say "ookie bookie wookie" instead of penis. Yes, he said 'ookie bookie wookie'. We still laugh about this usage of 'words'. It was at that day that it all made sense I decided to start calling body parts what they were. My friend went so far that when her boys would come into the bathroom when they were little and ask what she was doing, she'd say she was peeing. They said "Where's your penis?" and she responded with "Girls don't have a penis. We have a vulva."

I had been married for several years and my DH was having to teach me about my own body and how things worked because I had no clue. I had no clue about 'clitoris' or any of that and I don't want my girls not knowing. I want them to know it's safe to talk to me about these things and not something to be embarrassed of. I rememeber when I was about 16 or 17, my boyfriend and I would be making out and I'd feel all funny 'down there'. I remember sitting up on the bathroom counter looking at my swollen lips and vagina, wondering what was going on. It was intriguing to me, but there was no one I could ask about the hows or whys. I was embarrassed about it. Why? Because my parents had MADE me embarrassed about such things, imo. They taught me I had eyes, nose, mouth, arms, hands, feet, legs and 'bottom'. To me, my vagina was taboo and something to be embarrassed about. Something to keep completely secretive and never discuss. Imagine the first time I went to the OB for a PAP. I hear the doctor using words like clitoris, vagina, etc and could feel my face turning a million shades of red. I obviously knew what she was talking about, but to have it be so OPENLY talked about was not something I was used to. My husband still laughs at me as I'll refer to my vagina as my 'hoohoo' but it's not something I EVER say to my daughters. I want them to grow up without the embarrassment of their female parts. I want them to be as proud of their vagina as a man is of his penis! (And we all know that THAT is pride!!!) Men's lives seem to often revolve around their penis. LOL

Do you remember when Kindergarten Cop came out? Remember the scene where the little boy raises his hand and says "Boys have a penis. Girls have a vagina." You could hear the gasps of all the moms and dads in the room. This is NOT something that was openly discussed, even in 1990. (WOW! Can you believe it's been 17 years since 1990???) This little boy knew something that so many little girls didn't. They were taught they had 'flowers' or 'bottom'. (The same is true about their breasts. We tell them they have 'buttons' instead of nipples or breasts. ) And most of the nicknames for a vagina are quite absurd or offensive. Why do we allow this? Why do we allow words like 'beaver' or 'cunt' in refering to our parts? Look at this horrible list of names!!! http://www.blap.com/joke.php?query=188

We need to make sure our daughters are being taught to be be proud of who they are, how they were created and what parts they possess.

*** Author Notification *** We ask that you notify the author of publication of her work. Kelly Milano, can be reached at: kmilano@gmail.com Please provide a link to her work on your site.Do not publish without permission of the author.

Tuesday, January 2, 2007

To Every Non-Pregnant Person

I personally think this should be sent to every MIL, every meddling relative and every 'best friend'.

Dear Non-Pregnant Person,
I hope you find these guidelines helpful in your interactions with pregnant women as failing to follow them may result in serious physical harm. If you are thinking, surely she doesn't mean me- then you should probably read this twice.

1) The appropriate response to a couple telling you they are having a baby is "Congratulations!" with enthusiasm. Any other response makes you an a$$.

2) Through the wonders of science, we now know that babies are made ONLY by the mother and father- not grandparents. Unless the baby is in your uterus or you are the man that helped put it there, you may not ever use the phrase "my baby".

3) On the same note, unless you made the baby as defined in #2, the pregnancy, birth and raising of the child are not about you. You do not have input. No one wants to hear your opinion unless they ask for it.

4) The body of a pregnant women should be treated the same as any other body. You would not randomly touch someone's stomach if they were not pregnant, nor would you inquire into the condition of their uterus, cervix or how they plan to use their breasts. Pregnancy does not remove all traces of privacy from a woman.

5) Likewise, no women wants to hear comments on her weight- ever. A pregnant woman does not find it flattering that you think she is about is pop, must be having twins, looks swollen or has gained weight in her face. Telling her she looks too small only makes her worry that she is somehow starving her baby. Making such comments invite her to critique your physical appearance and you may not act offended. The only acceptable comment on appearance is "You look fabulous!".

6) By the time we are 20-30 years old, most of us have picked up on the fact that the summer is hot. We are hot every summer when we are not pregnant. We don't need you to point out that we will be miserably hot before the baby comes.

7) There is a reason that tickets to L&D are not yet sold on Ticketmaster. Childbirth is actually not a public event. It may sound crazy, but some women really do not relish the idea of their mother, MIL or a host of other family members seeing their bare butt and genitals. Also, some people simply feel like the birth of their child is a private and emotional moment to be shared only by the parents.

8) Like everything else is life, unless you receive an invitation, you are NOT invited. This includes doctor appointments, ultrasounds, labor, delivery, the hospital and the parents home. You do not decide if you will be there for the birth or if you will move in with the new parents to "help out". If your assistance is desired, rest assured that you will be asked for it.

9) If you are asked to help after the birth, this means you should clean up the house, help with cooking meals, and generally stay out of the way. Holding the baby more than the parents, interfering with breastfeeding and sleeping schedules and making a woman who is still leaking fluid from multiple locations lift a finger in housework is not helping.

10) The only people entitled to time with the baby are the parents. Whether they choose to have you at the hospital for the birth or ask for you to wait three weeks to visit, appreciate that you are are being given the privilege of seeing their child. Complaining or showing disappointment only encourages the parents to include you less.