Archive for the ‘Choices’ Category

Preventing First Cesareans- Consumer Statement

May 14, 2014

Many expectant parents are concerned about the high rate of cesareans. Indeed, they have reason for concern. One in three women in the United States (32.8%) now give birth by cesarean, and the dramatic rise in the cesarean rate has not improved outcomes for women or babies.  The World Health Organization recommends a cesarean rate between 5 and 15 percent, because data suggest that rates above 15 percent may do more harm than good. Cesareans can be lifesaving when they are needed, but when they are used without a medical reason, the risks can outweigh the benefits.

In order to bring down the rising cesarean rate in the U.S., the American College of Obstetricians and Gynecologists (AGOG) and the Society for Maternal-Fetal Medicine (SMFM) released guidelines for the “Safe Prevention of the Primary Cesarean” in February 2014. These groundbreaking guidelines recommend changing many standard elements of maternity care and have the potential to dramatically improve the quality and experience of maternity care for the women of New York City and across the United States. CiC has created a summary, available for free download, of some of the key recommendations made by ACOG and SMFM so that you can discuss them with your doctor or midwife.

Ask how your doctor or midwife and your hospital or birth center are responding to these new recommendations

Preventing First Cesareans- Consumer Statement


Choosing a Care Provider Education Class

November 26, 2013

Choices in Childbirth hosted our free monthly workshop this past Thursday (11/21/13) at the 14th Street Y; this month’s topic was Choosing a Care Provider.  As the CiC intern with no plan of baby in my near future, I have thought little of what my potential care provider will look like. Yet as the room filled up with expectant women and their partners, it became clear that this is a topic on a lot people’s minds.  Tanya, a member of our education and program committee, and a student midwife and child educator herself,facilitated the discussion and introduced couples that struggled to find their right fit.  As the stories accumulated, this idea of choosing the right care provider felt a lot like Goldie Locks and the Three Bears: you have to test all the beds until you come to the one that makes you feel comfortable and safe. 

Each couple shared their stories of starting with an obstetrician, midwife, doctor, hospital, birthing center, etc. and feeling as though they weren’t part of “the team”: they weren’t being included in the decision making process, despite feeling like they knew and trusted their bodies.  They also described the shame and embarrassment that their former providers caused.  For instance, all three women were told they had gained too much weight in a short span of time, and how this would negatively impact their pregnancy, labor, and baby.

Another common theme throughout their stories was their feeling disconnected from their provider. Their provider took no time to get to know them and thus learn what they wanted from their birthing experience.

All the women ended their stories with this pearl of wisdom: keep looking until you find the provider whose values align with yours. If you go into your birth experience with someone who doesn’t have the same vision, then it will likely be bad. But if you’re able to find the person who you feel understands what you want, then it will be good. That, and get a doula.

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Unveiling Nassau University Medical Center’s New Birthing Center

October 14, 2013

How many hospitals do you know of that offer waterbirth or fully support the midwifery model of care?  How many L&D departments are run by a chairman convinced that mother-friendly care is the gold standard that all hospitals should strive to provide to birthing women? While the answer should be “many” if not “all, “ImageImageImage the opposite is the norm.

As an Ecstatic Birth advocate and Choices In Childbirth (CiC) board member, I am often asked “Where can I have the best birth experience?” The majority of women aren’t comfortable with the answer “home.”  Yet the alternatives, birthing centers or mother-friendly hospital programs are sorely lacking.

This week, I  had the pleasure of accompanying CIC’s Executive Director Elan McAllister to a community outreach forum at Nassau University Medical Center where they are unveiling a new birthing center this fall. We were thrilled to discover that NUMC is is a bright light of hope in an otherwise dark landscape of birthing options on Long Island.

The forum began by acknowledging each and every midwife present with a rose in honor of Midwifery Week. This touching gesture set the stage for an uplifting panel of presenters where we learned that NUMC has successfully been integrating midwives and mother-friendly care into their labor and delivery program for years. We witnessed an incredible air of collaboration and mutual respect between the doctors and the midwives that work at NUMC.

In an era where it feels challenging to find consistent mother-friendly care in a hospital setting, NUMC provides a great model for how it can and does work. Their outcome statistics fully back the program up. They boast the lowest c-section rate on Long Island by far- (at 28.1% in 2011, they were the only hospital in the county with a rate below 42%).

Elan was invited to share CIC’s work, a large part of which involves advocacy to make sure that women have access to a full range of evidence-based best practices when choosing where and how to birth.  The last decade has been heartbreaking in the NY area as many programs that delivered mother-friendly options to women have closed down- despite the fact that all the evidence shows that such models deliver better outcomes for moms, babies, AND our health care system. CIC is currently undergoing a huge initiative known as the NYC Report to better illuminate the birth landscape and pave the way for better options; NUMC’s program is a prime example of what works.


Sheila Kamara Hay is a writer, Ecstatic Birth advocate, CIC board member and super-mama to three little ones. She can be found writing about pleasure and childbirth at