I'm certified!!! (and other info)

As of this week, I am officially:

Erin Kannon, Doula (CD CBI) and Childbirth Educator (CBE CBI)

I finished all of the births and requirements needed! The two required births were fulfilled in a non-conventional way. The first was a friend who wanted me to doula at her unassisted birth (Hi "M"!) which ended up at my house... maybe she'll OK it for me to post about it here??? The second birth ended up being for a mom that I did all of the prenatal meetings with. Did not attend her C-section, but still gave many hours in a Postpartum Doula role helping with breastfeeding, etc..


Midwifery studies: Though I'm not supposed to start officially with AAMI until Aug. 1st, I'm going ahead and doing the pre-orientation paperwork. I'm also ordering tons (probably 100lb worth!) of books to bring back from our summer visit.


Recently I have been asked how I as a midwife would support a woman in unassisted birth. Many midwives do not support women wanting this option. I am obviously a big fan of unassisted birth: I did a UC with my twins! Let me paste in one of my assignments on the topic.

Unassisted Birth

Unassisted birth is a great option for most women, if they choose to go that route. Women choose to go unassisted for many reasons, such as the need for privacy, previous sexual abuse, lack of money, lack of insurance, no caregiver with the same birth philosophy, previous birth history, or no desire for assistance. I believe that planned unassisted birth is one of the safest options for childbirth. Yes, most women choose a midwife for homebirth, but that isn’t necessarily always safe depending on the midwife’s ways of practice. It is unfortunate that little to no research has been done on this aspect of childbirth.
Living in a country with no options for childbirth other than high-intervention hospitals, I do know of some women who have chosen unassisted birth. I did labor support for one woman on one of the remote islands … over the phone! I am currently pregnant with twins and am planning an unassisted birth for my babies. I refuse the risky testing, “high risk” label, or the “necessary planned” C-section.
As a future midwife, I would be willing to offer support to pregnant women wanting unassisted births. That could be in any prenatal facet, for phone support during labor, coming over to assist when asked, to do postpartum checks, or to help with a birth certificate. The legal situation for a midwife doing this maybe be questionable, but I believe that women have the right to choose what they want for their own medical care and birth.

"crash course"

I had so much fun on Saturday that I had to share! I was approached a few months ago by a mother pregnant for the second time. She was looking for childbirth classes locally for her and a friend. I invited them to my house to just meet and answer some questions. She called me again about a month ago and asked if I could do a one-day class. She arranged lunch and childcare, and I taught. I normally teach 18hour classes, so to narrow it down to about 6 hours took some work. We covered stages of labor, how to communicate with the doctor before and during labor, breastfeeding, and a variety of other topics. Three couples attended and it was a great learning experience for them.

Now that I'm done teaching that class, I can get on to other pressing matters. In April I will be teaching the pregnancy and birth section for the highschool anatomy class. I did the same last year and have been invited back!

At some point I do need to finish those articles.

We will be traveling to the USA for June and July so of course lots of preparations to do.

And sadly... I fired our housekeeper (leaving the iron on for 2 days was the final offense) and our part-time turning full-time nanny decided to quit the next day and go back to school instead. So, for the first time in years I'm cleaning my own house. Which means no time for study. We will probably wait to hire someone new until we come back after the summer. Praise God I only have a small 800 sq. ft. apartment to take care of!

CBE class birth outcomes

All of the mamas in my first childbirth ed classes have had their babies. We had a fabulous class reunion where everyone shared their birth stories, showed off their babies, and discussed what it was like being new parents.

First birth: They were using a gov't hospital and the doctor had been talking about C-sections from day one. Guess what she got? First he tried the "your pelvis is too small" excuse. Then the "you're too fat for vaginal birth" excuse. Then the "you have PIH (pregnancy induced hypertension" excuse. Well, they fell for the PIH one. Her blood pressure was slightly elevated but in the safe range. AND the doctor recommended c-section when inducing would have been the safer, evidence-based alternative. The baby was born on its due date by C-section. The hospital kept the baby for "observation" for 2 days and breast-feeding was a nightmare. As I said in my classes, you get what you sign up for. If you know your doctor has a high C-section or intervention rate, you're playing the odds that you'll get the same. They are happy overall. Breastfeeding lasted less than 6 weeks after she went back to work =(

Second birth: Mama was at a great natural-birth hospital, totally set on natural birth. Went 8 days overdue. Decided she wanted the baby out "because it's more days I can spend with him before I go back to work." So she traded 1 or 2 more days inside for an unnecessary C-section. What happened? EXACTLY as the "mock scenario" we played out in class. She asks for her water to be broken. Never mind she'd been slowly in labor the last couple days. We had discussed the risks of the water being broken. But that's what happened, and the result? A posterior baby. The early "prodromal" labor that happens for a few days is usually the uterus rotating the baby into a better birthing position. So the baby is posterior, she has major back labor, not dilated enough to get in the birth tub, so asks for... an epidural. The epidural eventually wears out, so it gets topped off. A typical side affect happens to her... too low blood pressure. So they give her a drug to keep it up. The result? The baby's heart rate goes way up. So all of a sudden... ding ding ding. Emergency, must get out baby NOW. Aaaarrrggghhh. See the cascade of interventions here? Well, at least breastfeeding is going fabulous for them.

Third birth: Aaahh, finally a vaginal birth. I was supposed to doula for them, but she went into labor 3 weeks before her due date, didn't have my contact info with them (since they'd gone in for an appointment and they realized she was in labor), and so I missed a birth =( She was in labor, but the doctor wanted to using EFM (electric fetal monitoring) to see what was going on. It was showing the baby's heart rate reacting slowly to contractions. Her doctor said, you need a C-section now. She said, "no way." The doctor said, your baby is going to die then. She says, "no, I do not consent to a C-section." They waited a little while and she prayed and prayed and had more EFM done. Which showed the heart rate doing better, so the doctor said, yes you can "try" for a vaginal birth, but you have to have EFM during your whole labor. What that means is you are stuck on the bed during all of labor and can really do nothing for pain management. My hero stuck to her plans. Yes, her water was broken, yes, she was stuck on her bed, but 4 hours later and NO PAIN DRUGS, birthed a beautiful 5 lb 5oz baby!! She said she wanted me there so bad, but I told her when visiting her at the hospital... "What did you need me for? You did just fine." Breastfeeding went really well, until she went back to work 8 weeks later.

I have advertisements out for a new series starting up, but no responses yet. In a way, I'm hoping no one wants classes right now as I'm too tired, but I really love the teaching and want more of it!

I have a new computer!

Hello to all of my faithful blog readers! After 2 months with sporadic email on my husband's computer, I now have my own new computer to go crazy on! And a wonderful wide/flat screen to go with it, which is nice since I have to share with my daughter. She does her ABCs program on one side while I read and browse on the other. Now if only there was a way to hook up two mouses to the computer!!!

I have so so much to blog about, so these will be the topics for the next little while. Birth outcomes from my first childbirth class series. Rants on C-sections. My application to midwifery school. Unassisted birth. And much much more. I am considering doing two new separate blogs... one about our new twins on the way... one about green living.

I've really enjoyed reading all of your blogs. In fact, one of my blog readers (Hi Merri!) found me by looking up midwifery and Thailand. She has since moved to Thailand with her husband and two children (close to same ages as mine), attends my church, and is quickly becoming a fabulous friend. You just never know what blogging will bring to you or teach you!

Almost done!

I finished teaching my childbirth classes a couple weeks ago. Got really good feedback/evaluations.

Only downside? I "worked myself out of a job." I was going to attend J & R's birth but they said they no longer needed me since attending my class. Happy that they got so much out of the class but sad that I'm not needed. =( It is so hard to find births to attend! Now what am I going to do?

To complete my childbirth educator certification, all I have to do is submit my work (proof) of teaching my classes. Also have to audit a 12 hour childbirth class. I'm doing that right now at a local hospital where two local doulas are teaching. Interesting to see it from a different and non-Christian viewpoint. 6 couples from all over the world makes it interesting! To complete my doula certification, all I have to do is attend 2 more births. That's it!

Having Fun Teaching!

Sorry I haven't been posting much. All of my spare computer time (in addition to sharing the computer with my daughter!) goes to preparations for my childbirth class. Once this series is finished I'll have all handouts and materials made. For future classes, I can just make copies and alter the course as I get feedback.

So how have these classes gone?

Class One: One of the moms came to me earlier that morning (we meet Sundays after the morning service and lunch). Her husband did NOT want to come. Near the beginning of the class, I had the moms explain to their husbands why it was important for them both to be there. By the end of the class, I overheard the reluctant husband enthusiastically saying, "see you next week" to the other dads! 5 out of 6 parents are Filipino but the English level seems pretty good, so no major problems there. So funny watching them try to figure out how the fetus doll fits through the pelvis. Moms were slightly embarrassed when we talked about perineal massage and kegels. Good thing the men weren't present for that part!

Class Two: Understanding Labor. They were shocked at the sounds women make during labor. Really liked the birth video clips. Answered lots of questions.

Class Three: They were all really involved, especially trying out different labor and pushing positions. I videotaped that class. A little un-nerving to do that but I'm already a teacher anyway so not too nervous. All of the couples at this point seem to really enjoy each other's company and aren't embarrassed talking about things in front of each other.

Took 2 weeks off. Dayton was out of town for one weekend, and 2 out of 3 couples were sick for the next. Can't miss anymore though because 2 of the 3 moms are due 2 weeks after the last class!!!

Class Four: Teaching about interventions seemed to scare them a little bit. Especially because most of them are using assembly-line like Thai gov't hospitals. We talked about evidence-based information and how to make it work for them. I'm a little scared for them... In this culture, you never question a doctor about anything. I've taught them how to ask open-ended questions so that they'll know what their doctor will probably try to do. We had a mock induction. They were amazed at the cascade of interventions.

Class Five: Next week we'll be talking about Cesareans, post-partum depression, dealing with the unexpected, sex & birth control after the birth, and much more. We're starting to work our way towards the parenting topics in class six. I've had a lot of work to do on this class because most of it I've created since it's mostly topics by request from the parents.

Class Six: Breastfeeding and parenting. This one is going to be easy with the breastfeeding, but difficult with the parenting. It will be very hard for me to not be biased, especially about vaccinations and circumsizing (both I'm against). I think it's best for me to give an evidence-based handout on them and not talk on those topics. And a few handouts specific to Filipinos so that they don't think it's an American agenda. Have to tread carefully there!

So that's basically what I've been up to. I have all of these great things I'd like to blog about. But just no time right now. Am making mental notes on them.

my resources

I've had a few people ask about what resources I use in my childbirth classes. I use a combination of:

the Bible!

Childbirth International resources
some of Transition to Parenthood's pages

and many books, such as:
Henci Goer's The Thinking Woman's Guide to a Better Birth
Penny Simkins "Pregnancy, Childbirth, and the Newborn" and "The Birth Partner"
Ina May Gaskins "Ina May's Guide to Childbirth"
Myles "Textbook for Midwives"
Elizabeth Davis' "Heart and Hands"
Dr. Sears "The Pregnancy Book" and "The Birth Book" and "The Breastfeeding Book"
Mary Renfrews "Bestfeeding"
Nilsson's "A Child is Born"
and many many more I can't think of right now.

Some of my other resources come from direct conversations or online forums with other midwives, doulas, and childbirth educators.

It's official!

Introducing:

Pregnancy, Childbirth, and a New Life

A childbirth and parenting preparation class



Location: Calvary Baptist Church
Time: Sundays, from 1pm to 4pm
Dates: 6 weeks of classes, from September 10th – October 15th
Cost: 500 B donation to cover expenses for handouts and materials



What you will learn:

Week One (Sep. 10th): Pregnancy & the Pelvis
Week Two (Sep. 17th): Understanding Labor
Week Three (Sep. 24th): Labor Toolkit
Week Four (Oct. 1st): Interventions & Making Decisions
Week Five (Oct. 8th): Birthing in Bangkok & After the Birth
Week Six (Oct. 15th): Breastfeeding & Parenting



Other information: Please come to these classes prepared to learn, participate, and have fun! You will learn information and skills to assist you at this very important time in your lives. If you cannot afford 500 B, please let me know.

Questions? Call or e-mail.

(edited out a few things since this is public)

Back to Blogging

Hello readers! After a nice long visit to the USA for the summer, I'm back in Bangkok and "back to work"

I've been busy planning my first childbirth ed. class scheduled for September, making contacts with local breastfeeding consultants or teachers, studying midwifery on my own, helping my husband get ready for this school year, etc..

Began cloth diapering a week ago, and it's going well... the hard part isn't the diaper, it's getting the kid to lay still long enough to get it on!

I got a printer finally! Now I can be getting my handouts and visuals ready for classes.

I'll post some pictures in a few days.

New Life Childbirth!

I have been just too busy to blog! We are leaving for a visit to the States in less than 4 weeks. Things to order online, packing lists, to buy lists, collecting things to keep Grace busy on the plane, finding places to stay. If our families only knew just how much is involved for a 7 week trip!

New Life Childbirth. That's the offical chosen name for the business. It'll work for what I'm doing now and will still work for midwifery as well. It is not overtly Christian, but obviously has the double meaning. I'm still working on coming up with a logo. Not a good artist. I'll have to try to get Dayton to make something for me... though he tends to be better at drawing armor, tanks, airplanes, and guns...

And, it's official! I've been asked to teach a childbirth education class in September. Now I'm trying to finish up the requirements I need so I can count it towards my certification with CBI. I need to find a place to teach it that has the facilities I need. I'd teach it at my house, but it feels too crowded with just 4 adults in it! I'm now hunting for the supplies and videos I need. I wasn't planning on bringing the laptop with us for our trip, but I'm going to have to if I plan on getting all of my handouts, lessonplans, and visuals done in time.

Have I mentioned I have my first official doula client as well? She is so excited and has plenty of questions. Her mom is happy that someone who's had a baby before will be there to support her. There are 2 other expecting couples at my church so I'm hoping they'll be interested in either doula support or a childbirth class.

My neighbor is about ready to have her baby. I told her that if the baby comes to fast, send someone to get me and I can help. I just say that I'm studying to be a midwife, not fully trained, but I can try to help. Now I'm just hoping for a precipitious labor LOL I can only dream, but it would be fun!

Had a nice mother's day. Or "Monster's Day" as Grace called it. Here's a pic from Sunday.

Back to work

After a week of various sicknesses, I am back on track doing my CBI work.

I guess I got a little "realist" over what I'm deciding to do. I keep telling myself, that it's pointless to pursue midwifery when I just can NOT see a way to do it legally here. Why pursue it at all? Sigh. I just have this mental battle going on all day with it. It's so consuming that I don't study much else and shirk my chores at home.

So. I'm back to doing my doula and childbirth educator studies as a foundation. Taking my time doing it. Back to cleaning my house. Back to Bible reading. Remembering that every thing will fall into place how God wants it in HIS timing.

2 more friends are pregnant, due in mid-November. One may want me to teach their childbirth class. If so, I have lots of work to do. Lesson plans to write, handouts to make and collect. Supplies to buy. It's a lot of work, too, but I think if I pace myself instead of working in spurts it's doable.

Chat with my midwife

My midwife returned from her 2 month visit home in Australia. She bought a house... waaaaaah, she's moving away in July!! But she did say that if I want to have more babies at home, she'd come back and catch them. Her husband has a business here that he'll have to visit 2x a year, so they can arrange their visit schedule around a due date if they have to. I guess the bad news was kindof good news.

We also discussed the local childbirth educators. They are awful. She was a fabulous one and I would love to follow in her footsteps. She was so encouraging and positive about me wanting to be a CBE and is even willing to mentor me while she's here. Dayton had even said to me a few weeks ago that when she leaves, who is going to fill her shoes... maybe I could. BAMBI (look at my links) will need CBE's and more doulas as guest speakers and to offer services, so that's a place I can start.

We also discussed me becoming a midwife. Her opinion is that if I want to that's fine but don't ever even think about practicing here legally. The only midwives here are Thai nurse-midwives who are not allowed to catch babies. In fact, if a baby is born before the doctor arrives, they get in trouble. She has spoken with midwives who have NEVER caught a baby with years of working in hospitals. So basically, just because I'd have the education, and if I were gifted enough to learn the language to pass the exams here to be licensed, what Thai doctor would ever approve of me, let alone be a backup. Just because I was licensed does not mean that I could work in a hospital in a real midwife capacity. She was not legally licensed here but worked as a doula/CBE/labor assistant.

Her opinion is good in her experience, but I do know of nurse-midwives here who have caught plenty of babies. Outside of Bangkok, homebirths are no big deal. My Thai teacher's aunt just had a homebirth with a local midwife, so I know there are paths that I can explore. And maybe in 10 years, it will be possible. I've read so many papers published by Thai nursing associations about how they need to be more open to foreign educated practitioners. They need to follow through and start the work to make it happen. But it's a big cultural issue as much as it is a legal one.

Overall, a VERY exciting conversation. A few months ago when I first spoke with her about my plans, she was like, yeah whatever, you just had a baby, this will pass. But now she can see the passion, the education I've begun, and the need for someone like-minded to follow behind her.