Many midwives practicing in hospitals are still stuck w/ having to practice under hospital policies, which are often not founded on good scientific evidence. That's where it gets frustrating when you mention HBing to someone and they can't "get" why a CNM in a hospital isn't an acceptable option to you. Because the policies that those CNMs are often forced to follow is exactly what I want to avoid, kwim? And the evidence behind those policies is often nonexistant or very poor, to say the least. I had a very "med"wifey midwife w/ my oldest's birth (in a hospital) and that's part of the reason I opted for a FSBC with my 2nd and a HB with my 3rd child.

Even if you compare low-risk women giving birth in a hospital to low-risk women giving birth at home, midwives still have good outcomes.

There are different risks to hospital birth vs. a homebirth. I can't imagine anyone who homebirths who isn't aware of this. Yes, you can lose a baby in a homebirth. You can also lose a baby in a hospital due to risks inherent with hospital policies. In rare instances, a c/s may have been a life-saving measure had the birth been in a hospital. If you are looking at the broader picture, there are women who give birth in a hospital via unnecessary c/s and have babies that experience respiratory distress or other negative outcomes (death, etc.) as a result of unnecessary surgery. There are rare cases where being in the hospital could have been life-saving, but there are also cases where the very act of being in a hospital and adhering to hospital policies caused poor outcomes. There will be cases where perhaps electronic fetal monitoring might have clued in someone that there was a problem. But the overall research shows routine EFM does not improve outcomes. It does increase the c/s rate, which comes with its own set of risks. So yes, anecdotally there will be cases where EFM might have been beneficial, but on a population level, it also *creates* problems. Fwiw most homebirth midwives do intermittently monitor via fetoscope or doppler. If a woman is rushed in for an unnecessary c/s, her physician isn't going to be exactly forthcoming about it ending up being unnecessary (false alarm due to EFM reading, failure to progress, etc.). There will be reasons offered up like "the cord was looped around the neck." That isn't to say that those types of events can't result in a problem, but something like 1/3 of babies have a cord looped around their neck. Most midwives unloop it as the baby is emerging. There are women all over the US who are convinced the cord being wrapped around their baby's neck means the baby certainly would have died w/o the c/s. Certainly there are times when it is a problem, but those are rare. With a 30-40% c/s rate in this country being deemed unacceptable (by the WHO, for example), clearly women are undergoing unnecessary c/s. However, if you speak to individual mothers, the vast majority have been told their baby would not have survived without the c/s. No physician is going to say..."well...your c/s was likely not necessary." Instead, reasons and justifications are offered up. Yes, there *are* legitimate reasons and necessary, life-saving c/s. However, a 30+% c/s rate means there *are* unnecessary c/s, and those come with risks. What I don't see acknowledged often enough is that not only does c/s have risks to mom and baby's health (sometimes outweighed by true need, for sure!), but it also has an impact on the health of future babies carried by that mother. With VBAC hard to come by in many parts of the country, women are often forced into repeat Cs, with their own set of risks. There is a risk of rupture in a future pregnancy. So it isn't just the risk that the primary c/s confers, but the risk to that woman's future pregnancies, kwim? Birth is messy and imperfect and has risks. There are a different set of risks to homebirth vs. a hospital birth. Both come with risk. If you look at the studies, homebirth is not "riskier" IMO. It is a different set of risks. Some studies in the past have also tried to lump unplanned, unattended "homebirths" in with planned homebirths with a trained attendant. Clearly there are risks to not planning on a homebirth and giving birth at home without an attendant. Lumping them together is unfair. Similarly, lumping in homebirths taking place in an extremely rural area where one must drive an hour or two to a hospital vs. a homebirth occurring within a reasonable transfer of a hospital is somewhat misleading. It has not been my experience at all that homebirths gone wrong are hush-hush. I think there is obfuscation in hospital birth as well. Most women who are rushed in for an emergency C are given a "justification" of why it was necessary. If you look at the statistics, there is no justification for a 30+% c/s rate. Women never hear of the fact that perhaps it was a blip on the EFM and everyone got jumpy, or that the doc felt there was "failure to progress" and had she been given enough time, she would have been able to vaginally birth the baby. I absolutely believe there are life-saving C/s, but I don't believe c/s are without risks and I don't believe that there is a justification for 30+% of births being via c/s. I think hospitals participate in obfuscation. Who is told their c/s wasn't necessary? I'm not aware of too many women who have been informed that their c/s was not needed. If you look at the statistics, clearly there *are* unnecessary C/S (and WHO and other health organizations agree w/ this). Typing with toddler underfoot. eta: One other thing to think about. In 2006 there was a study looking at how evidence-based ACOG guidelines were. They looked at practice bulletins from 1998-2004 and presented their research at the 72nd Annual Meeting of Central Association for Obstetricians and Gynecologists. The conclusion? Only 29% of the American College of Obstetricians and Gynecologists recommendations are level A, based on good and consistent scientific evidence. Level A defined by ACOG as: Based on good and consistent scientific evidence It is available as a PDF file IIRC. American Journal of Obstetrics and Gynecology (2006) 194(6):1564-1572. I don't know if there has been a more recent look since that study. Abstract here: http://www.ajog.org/article/S0002-9378%2806%2900300-0/abstract and Jefferson has a good pdf file available online if you do a search for it.

nak- With respect to the Mexican immigrant issue, IIRC one of the issues raised was the overcrowded housing, etc. that many immigrant farm worker families are housed in . That close contact makes it easy for the disease to spread from person to person. I don't think it was as much related to their country of origin as it was to their living conditions.

-Greek yogurt (unsweetened) sometimes with Stevia, sometimes with a few berries -Cottage cheese or ricotta -Custard -one minute muffin with flax or almond flour -chicken salad, egg salad (I personally can tolerate egg salad/deviled eggs in the morning more easily than fried or scrambled eggs) -when they are in season, I love delicata squash peeled and cubed and sauteed with chopped up bacon and onions and sprinkled with garlic and salt. A slightly sweet but very yummy version of homefries. So good. -leftovers -a piece or two of deli ham with a piece of cheddar in the middle and fried in a skillet. Like a ham and cheese sandwich sans bread. -deli meat wrapped around cream cheese -breakfast casserole. Our fav is ground beef and sausage browned, and then you add cream cheese and stir in until it melts into the meat mixture. Mix that with cooked green peppers, onions, and mushrooms. Top with 4-8 scrambled eggs (fewer eggs means it will be less eggy obviously. I don't find this very eggy at all, personally). Top the whole thing with cheese. This is great for us because I can make it on a weekend and then we eat the leftovers for another 2 days or so.

Take care of it like a finger or the tip of his nose. Rinse like a finger in the tub. Don't retract, don't mess with it. Just let it be :) Don't trust a health care provider telling you anything else at his age. You know those stories about boys who "had" to be circ'd later in life? Much of that was because back in the day parents were erroneously told to retract their baby boys before they were fully retractable on their own (and sadly, this still happens!). This causes scar tissue which *does* lead to problems. It would be like trying to rip your fingernail from the nailbed to which it is adhered. Seriously, nothing to it. Just wash like a finger.

I used the birth center in CH w/ my 2nd child, and had a homebirth with baby #3. They do have some women who travel from a pretty far distance to use the WBWC in CH. I lived about a half hour away from CH, which doesn't really help you much :(

I have not read through the entire thread yet, but I'll chime in. I have an advanced degree that I am not using (by choice, as I'm choosing to SAH and HS). I am still paying off student loans (although mine are not astronomical, thankfully). My DH has an doctoral degree in the sciences. We both entertain the notion regularly that our children may be better off *financially* choosing a trade. That doesn't mean that I don't think college is worthwhile, or that I won't prepare my children for a rigorous college experience. But from a purely financial standpoint, they may do better in a trade than in many degreed professions. However, with the current climate with respect to unions, even trades may not be as appealing from a financial standpoint in the future. On the up side, many trades can't be easily outsourced. I have many friends w/ advanced degrees who feel trapped by their student loans. They would like to SAH, or reduce to part-time work, or switch professions, but they can't because their student loans are an enormous financial burden.

I'm a long time reader, but your post finally got me registered and posting. I'm a licensed PT, but now SAH and HS my 3 kiddos. The minimal degree to sit for licensure is a masters degree in physical therapy. When I attended (I graduated in 01), this could be done as a 5 year masters program (4.5 years of classes with another semester comprised of 2 8 week internships. I had other shorter internships of 5 or 6 weeks in length prior to that). Many programs are now transitioning to a Doctor of Physical Therapy program (DPT). There are PTs who currently practice with a bachelor degree, but this is because they sat for their licensure before the new requirements went into effect years ago (they are grandfathered in) It is competitive to get into most programs and very challenging academically. In my jr. year I had 5 lab courses, one of which was 2x a week. That part is difficult as it means a lot of time hanging out in the department, as many of the subjects are difficult to study in your own home (like gross anatomy). Some schools run programs where you can transfer into the graduate portion (wheras my undergrad and graduate programs were integrated into a 5 year masters). However, IME, those can be even more difficult to get into. There are PTA programs (Physical Therapist Assistant) that are more of a "technical" type program. I worked in early intervention, primarily with children 0-3 years of age. If you have any other questions, let me know.