Press Release

UNC Family Physicians receive national award from Midwifery group

On September 26th of this year, the American Association of Birth Centers (AABC) presented Dr. Martha Carlough and the faculty of the University of North Carolina’s Family Medicine department with the prestigious “Collaborating Physician Award” for 2013. Dr. Carlough, an Associate Professor of Family Medicine at UNC, serves as the Medical Director for Women’s Birth & Wellness Center (WBWC) in Chapel Hill, North Carolina. WBWC was founded as North Carolina’s first free-standing birthing center by Maureen Darcey, a certified nurse midwife (CNM) who has been practicing in the state for over 30 years.

North Carolina is one of only six states left in the nation requiring a physician’s signature in order for CNMs to practice their vocation. Dr. Carlough and UNC faculty have been honored by the AABC for their past and current advocacy for the birth center midwifery model of care. AABC Executive Director, Kate E. Bauer said Carlough received the award to recognize and celebrate her “outstanding achievements.”  The award, for which scores of candidates were considered, was presented by Darcey at the 30th annual AABC conference in Minneapolis, Minnesota.

“Martha has kept us on our toes by religiously helping us update our protocols throughout the years, as new methods of care and research evolve,” stated Darcey during the presentation, “She’s the queen of evidence based care.” Darcey went on to praise Carlough’s commitment to maintain the highest and most up-to-date standards of care for WBWC patients and families. Women’s Birth & Wellness Center patients, families and staff are grateful to the UNC Department of Family Medicine for their support and collaboration.

UNC Family Medicine Group and Maureen Darcey, CNM

From left: Margaret Helton, MD, Maureen Darcey, CNM, Martha Carlough, MD, Warren Newton, MD

Women’s Birth & Wellness Center Staff and Martha Carlough, MD

From top left: Rachel VanBree, WHCNP, Mariah Velazquez, CNM, Carey Jefferson, CNM, Martha Carlough, MD, Maureen Darcey, CNM, Teresa Ray, CAN, Donna McBane, CAN, Tracey Jones, CAN,  Kiah Sell-Goodhand.  Bottom row from left: Brianna Honea, MBA, Nancy Albrecht, RN, IBCLC, Layne Shipley-Townsend, Alexandra Henry, CNM

My Births, My Babies: Aden

By Fatimah Faraj

 My first child, Alina, was born by C-section on Friday, April 17, 2009. Yes, I had a C-section. Not my plan, but it ended up being a beautiful birth.

My plan was to have a natural birth.  We chose Women’s Birth and Wellness Center (WBWC) as a good stepping stone for our first birth, hoping to follow it with a home birth. WBWC also offered my husband, who had no background in birth, an introduction to this world.  

At 35 weeks I found out Alina was transverse breach.  Her head was nuzzled under my left rib and her bottom sat on my right hip.  My pelvis was empty - with no baby in it.  I did everything in the book to turn her.  Inversion on my back, inversion on hands and knees, inversion off stairs, moxibustion (Chinese medicine dried mugwort herb that is burned by the little toe and used to help turn babies), acupuncture, hot and cold, hypnosis and an External Cephalic Version (ECV) performed at UNC Womens Hospital in Chapel Hill.  The obstetricians (I had two of them) tried several times to turn her during my ECV- once she flipped down with her head to my left hip and then somersaulted back up.  Did she turn with the last try? No, but I was determined to go into spontaneous labor, to see if that would turn her and if not to then go in for my c-section.  I also wanted delayed cord clamping and skin to skin.  All of these things I fought for, and it took a few hours of discussions to get the whole operating room team on board.

I vowed not to have another baby until I made peace with my c-section and until I was prepared to have another c-section (even though my plans would be to avoid it).

I got pregnant last October with Aden, who was due July 22. 2013. My plan was to go for a vaginal birth after a cesarean (VBAC).  However, I was very in tune with him and his position, and I just knew he was in the same exact position as his sister.  At our 17-week ultra sound he was breech.

 Two weeks before my 29-week position-check ultra sound I could have sworn his head was under my left rib. At our 29 week ultra sound he was -- drum roll-- head down!

I was shocked. 

I swore up and down he was in the same position as Alina, but that day he was not.  Now I really began to plan for my VBAC.  In my heart and mind I was looking for his energy and just felt something was off, but I couldn’t pin point it yet.  

Also, since NC legislation is so stringent on home births I couldn’t switch to a home birth practice as I had planned but somehow I knew this was for the best in my case.  

I started to think of my VBAC and how I wanted it to be, but I did not get my hopes up because there were some chances he would change his position.  The OB who talked to me at 29 weeks said if he is still head down at 32 weeks more than likely he would stay that way.

 At my 36-week ultrasound in late June he was still head down. Ok, now it was for sure. Right?  I started talking to the midwives and my doula about my birth plan.

 On July 19, at 39 weeks and five days into my pregnancy something shifted.  I knew I would not have a VBAC. In my heart - deep down I knew the whole time, but now it was becoming a reality. I could feel my baby, his energy, his position -I just felt it.  Over the next few days I would wake up upset.  Upset with myself for not going into labor even with all the activity I was having.  In reality this feeling was linked to the fact that I needed to take a step towards a very hard decision -- I needed to schedule another c-section.  My body was urging me to listen.  It showed me that with lots and lots of contractions my baby was not in the right spot for birth.  Since I had to believe the evidence from the ultrasound (which conflicted my gut feeling that he was transverse breech with his head under my left rib and bottom on my right hip) I just thought something was holding him back from dropping into my pelvis.   Tuesday, I woke up with clarity, and I told my husband that I had to have the baby, and I needed to schedule the c-section.  It was a passing thought that I brought up to him that he thought nothing of.
 I went into work for a bit and then started my 45-minute drive  to Chapel Hill and WBWC. I knew what I had to do. I called my doula and discussed it with her.  She pledged her support.

My midwife, Emily, and I went into the room for my appointment. I told her I felt something was not right and that I had to have him and that it was time for me to schedule my c-section.  I knew this would be a shock.  

 As much as I believe in vaginal birth, I believe more that a mother’s instinct is NEVER EVER wrong.

 The midwives accepted it, but we couldn’t get an appointment for that day because it was not an emergency.  I did do a non- stress test to make sure.  They could schedule me for the next day, but I did not like the OB on call.  Even though I knew he had to be born by c-section I still wanted the best experience possible.  I asked specifically for Dr. Alison Stuebe or a few others (I know lots of the UNC doctors).  They were able to schedule me with Alison who also delivered my sweet Alina four years ago by c-section.  The c-section was scheduled for Friday, July 26.  I started getting everything in order, making sure my child care arrangements for Alina were taken care of, and that my work was in a good place.

The day before Alina and I went to UNC for my pre-ops and to prepare, I started prepping the people who would be in the OR about what I wanted -- ie: lotus birth, skin-to-skin, no weight check until after baby nursed, etc.

 With Alina I waited to go into early labor before delivery.  With Aden I had a strong feeling that labor wouldn’t be safe this time around.  I had lots of activity, and I felt if I did go into labor it would be quick and with him in the wrong position it would just not have good outcomes especially with a previous c-section.  

 I told my husband the night before I knew his position was off and that the cord was probably wrapped around his neck several times not allowing him to get into my pelvis.

 Friday, was here. Everything was in motion. I stopped and gave Radiah my 12 year old sister a hug on the way as she was waiting for her school bus. I told her we were going to the hospital to have Aden.

 Everything was going well. At the hospital I got a private room for post surgery and recovery.

My doula arrived.  Dr. Stuebe stopped in to say everything was a go with my birth plan.  What a difference from Alina’s birth where we had to talk to every person on the birth team about what I wanted. Now I was in a pro-breast-feeding, baby-friendly hospital, which was not the case when Alina was born.  It was the same hospital but four years had allowed them to grow and change.

 I went in to the OR with my doula, Marcie Westphalen, got my spinal with a catheter for an epidural in case they needed it.  With this being my second c-section, we needed more ammo in case things went wrong.  Sarah, my midwife joined me then too.

 When they were ready to cut my husband came in and sat down.  When they started cutting he put his head down. I looked over and asked if he was OK.  He wasn’t , but he said that he was. He forgot he was married to a person who reads people pretty well!! Ha! Ha! A few minutes passed; they were getting ready to get into my uterus.  My husband was really not doing well.  I looked at him and asked if he needed to leave He said 'Yes.'  The nurse walked him out, and he passed out right outside of the OR.  Yep, that is my babe!  He almost passed out with Alina too, but I didn’t have a doula so he fought real hard to keep it from happening. He was fine; he got up and went to the recovery room to wait for us. They got to the baby thinking they were going to find a head and the first words out of the surgeon's mouth were, 'We have a foot.'  I repeated: 'A foot?'  'Yes, a foot.'  Then came his bottom from my right hip and his head from under my left rib. Transverse breech!  Cord wrapped around neck twice over.  Just like Alina!

I was amazed and so happy.  I was ecstatic.  It is hard to listen to your instinct blindly with no proof.  Especially in a world where we are taught to ignore it.  But listen I did, and the outcomes were amazing. With a lotus birth, and skin-to-skin, baby Aden found and nursed on his own while I was on the operating table; no weight check or separation from baby until I was ready.

Despite major surgery, Aden's birth was an amazing experience.  I knew every step of this pregnancy and birth was right.  I wouldn’t change a thing all the way down to my fainting husband.

 It was an experience of LIFE and all of its awe and wonder, and I soaked it in.  I am proud of myself for being strong, for accepting what I could not change and for doing what was necessary to make Aden's birth a beautiful experience. I know I could have done a vaginal birth if my situation had been different, but I was determined to make the best of the C-Section world as well.

My babies:

Alina 4-17-2009 9:20 pm 6lb 6.6 oz.18 3/4 inches.

Aden 7-26-2013 11:05 am 7lb 3.1oz 19 5/16 inches.

For both:

Physician: Alison Stuebe

Midwife: Sarah Akers

Day: Friday

Birth: C-Section with immediate skin to skin

Transverse Breech

Cord wrapped twice around their neck

Born at: UNC with WBWC practice

We celebrate our 10th:

For 10 years, the Chapel Hill-based Women’s Birth & Wellness Center (WBWC) has been a major community and statewide resource in women’s health and child birth. Since we opened our doors in 2003, WBWC has thrived as a unique non-profit birth center and women’s health clinic offering women an alternative to the hospital setting for prenatal, birth and post-delivery care.  

 As North Carolina's only accredited, free-standing birth center in the triangle, WBWC has become a health care resource for women of all ages. On October 20, WBWC is hosted a birthday party for patients and their families at Pullen Park in Raleigh, NC. Past fall galas have drawn hundreds of attendees, including families and WBWC staff.

 Under WBWC founder Maureen Darcey, Executive Director, WBWC offers a unique patient-centered approach to well-woman and pregnancy services. Our mission is to provide "women of diverse backgrounds with comprehensive well-woman, maternity and preventative healthcare throughout the life cycle.” We provide a dedicated staff of eight Certified Nurse Midwives, two women’s health nurse practioners, numerous registered nurses, administrative staff and lactation consultants. This team of committed women is well known for providing excellent care to their patients.

 In part, our mission statement says:

“We believe that every woman has the right to a standard of excellence in her healthcare, to be treated with respect for human dignity and cultural preferences, and to be an active partner in her healthcare.  We believe that the establishment of a freestanding birth center and women’s health center provides the best opportunity to succeed in our mission.”

 As the birth center continues to grow, we have plans to build a new and more comprehensive facility as part of our continuous effort to better serve our patients. “I have seen this practice grow immensely over the years and we are overjoyed to continue to care for the women and families across North Carolina”, Darcey said. 

Women's Birth & Wellness Center is a not-for-profit women’s health organization designed to improve the health of women in our community by providing the highest quality preventive and maternity health care services to women and families.  WBWC is a community-based center and provides services to patients regardless of their economic status. We provide affordable healthcare to women and offer sliding-fee scales to the uninsured.  

Pictures from this years birthday party!

Fall Recipe: Eating healthy can sweeten your life.

  Pumpkin Pie Smoothie

Ingredients (Makes 4 cups)

·         2 cups almond milk

·         1/2 cup rolled or steel cut oats

·         2 tbsp chia seeds

·         1 cup canned or fresh pumpkin

·         2 tsp blackstrap molasses

·         1 frozen ripe banana

·         2 tsp cinnamon

·         1/2 tsp ground ginger

·         1/4 tsp ground nutmeg

·         5 ice cubes

·         1.5 tbsp pure maple syrup

·         Coconut whipped cream topping (optional): see below

Instructions:

1. In a medium-sized bowl whisk together the milk, oats, and chia seeds. Place in fridge for 1 hour or preferably overnight. 2. Add soaked oat mixture to blender along with the pumpkin, molasses, frozen banana, and spices. Blend until smooth. Add about 5 ice cubes and blend until ice cold. 3. Add maple syrup to taste. 4. Serve with Coconut Whipped Cream and a sprinkle of cinnamon on top!

Optional garnish: Coconut Whipped Cream Topping

1. 14 oz can full-fat can coconut milk.  It must be full-fat because you will be whipping the solid cream. Do not use light coconut milk.

It will not whip into cream properly

2. Place can in the fridge overnight to chill till firm.

3. Remove the chilled can from fridge and flip it upside down. The liquid coconut milk (the part that doesn’t harden) will now be at the top of the can. 

4. Open the can. See the liquid at the top? You won’t be whipping this part.

5. Pour the coconut liquid into another bowl. You should have just under 1 cup of liquid, but this yield will vary a bit by brand and even

by can. Don’t discard the liquid as it can be used for another cooking project.  It is good in fruit smoothies, baking or cooking.

6. Scoop the coconut cream into your chilled bowl.

7. Whip the cream. Grab a hand mixer (alternatively, you can do this in a stand mixer – just chill the bowl first) and whip the cream until fluffy.

8. Add in a touch of sweetener and vanilla extract and whip it again. You can use regular cane sugar, confectioner’s sugar, or even a touch of maple syrup. 2-3 teaspoons of maple syrup should be perfect. You may also like to add about 1/4-1/2 tsp pure vanilla extract.

Click here to learn about the health benefits of Black Strap Molasses: http://www.whfoods.com/genpage.php?dbid=118&tname=foodspice

Black Strap Molasses is mineral dense and a grood source of iron and calcium. 
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News from our board

Fall greetings from the board! It was great to see so many families and long-time friends at the Tenth Anniversary Birthday Party celebration at Pullen Park this weekend. After days of gloom and rain, the sun shone brightly on our very special day. Thank you especially to Layne Townsend and all other staff who helped "behind the scenes" to make it such a great day.

We look forward to ten years and more, providing the women and families of our area the kind of health care and birthing experiences they desire.

Congratulations, Women's Birth & Wellness Center!

Bringing Rhythm to Your Baby

Excerpt by Kristen Burgess with permission from christopherushomeschool.org

A rhythmic, ordered life is nourishing to the young child.  This includes the littlest children as well!  Bringing rhythm into your baby's days and life will benefit you and your baby, as well as the rest of your family.

Remember that a life of rhythm and routine is not about harshly scheduling your baby.  Rhythm is more natural, organic, and can flow.  It is always there to hold the family, and to carry the family - but it does not bind the family.

Once your baby is between 2 to 4 weeks old you can begin working with rhythm.  Begin based on your own feelings about it - just don't try to tax yourself too soon after giving birth.

Start by deciding a guiding rhythm for your own day.  If you have older children this may be easy since you probably already have set waking, eating, and bedtimes (if not, this is a good time to work on it!)  If this baby is your first you will need to have more discipline with yourself.  It was far easier for me to give my second and third child a rhythmic babyhood than it was with my first.

But begin by setting a time to wake (or to wake baby if you prefer to rise earlier) in the morning, a time to eat your meals (and you should really be getting snacks too!), and a time put baby to bed.  You do not have to be rigid about these times.  A general "around 8 o'clock, around noon, etc." is good.  I do recommend you research bedtime and choose an early bedtime for your baby.  My own children go to bed at 7 o'clock!

Now that you have those cornerstones begin to live life with your new baby - or older baby!  Wake in the morning, dress or freshen up.  Get baby ready for the day.  Eat breakfast and nurse baby.  Then you may want to do some housework with baby in the sling, take a walk outside with baby, or nurse baby some more.

When you sit down to have your snack, nurse baby.  Your baby will come to associate this snack-time with nursing.  Gradually you can work towards the morning nap being just after this snack-time.  It's a matter of gradually adjusting your baby into this rhythm and routine.  My second baby fell into this quite by accident because I simply always had the morning snack and nursed him.  I encouraged it with my third baby!

The same is true for lunch.  Nurse your baby right after lunch, or during lunch.  I set out a meal for my first and then nursed my second on my Boppy at the table while we ate lunch.  Then I put my second into the bouncy set next to me to sleep and had my lap free to rock my first for her nap.  I did the same with my third.

Have your baby in a sling as you work around the home in the afternoon and have her nearby during supper - or at supper if she's an older baby!  Your young baby will probably want to nurse upon waking from the afternoon nap and during the evening time, but do try to encourage him to stay awake in the couple of hours before bedtime.

Begin a soothing bedtime routine early.  A small baby can wake at four in the afternoon and still be ready for bed by seven.  You'll find a routine that you like and works for your baby.  The picking up of toys together, closing the curtains, washing hands and face, a fresh diaper and pajamas, and lullabies and rocking will help your baby to know bedtime is coming.

Rock and nurse your baby, then lie him down to sleep.  If you have a family bed you may want to lie down with your baby and nurse until he is asleep, then get back up.  I always preferred nursing my young babies down and then putting them into a bassinet near me, out front, while I read or worked for a bit.

If your baby wakes again, simply nurse her to sleep again and put her back to bed.  This early bedtime will give you time for you.  To bathe, shower, spend time with your partner, read, chat with friends on the phone or computer, or just have some silence.

This gentle start will develop as your baby grows.  Keep the cornerstones of your day and other rhythms will develop with it.  Of course there will be days when you are dancing the entire day through with a fussy baby, or nights where your baby will not sleep - these are part of having an infant!  But a rhythmic day will be wonderful for you and your baby.

It will also encourage you to be home with your baby!  Schedule your errands for one or two weekday mornings and honor baby's routine. Honor the afternoon nap and especially bedtime.  This is sacrifice on your part but it's best for your baby, and it will be best for your child for many, many, many years.  Happiness for your baby is being with you, riding in the sling as you do housework and taking walks in the neighborhood and nature. 

This simplicity of life and peacefulness of rhythm is a gift that comes with having babies and young children.  I also encourage you to cover your television with a pretty cloth.  Your baby and your young child doesn’t need it.  Show your baby your home and neighborhood instead.  Include baby in your life - not at the center, and not occupied by a television at the edges of it - and your baby will be happy.

Sing to your baby as you move throughout the day.  Your baby loves it and doesn't care how good your voice is!  You may also like to learn some simple nursery rhymes and children's verses to associate with your rhythm.  For instance - Three Men in a Tub at bath-time, Polly Put the Kettle On at snack-time, and so on.

Know your cornerstones and gently guide your baby into your daily routine.  Honor baby's rhythm.  Sing some songs and learn some verses.  Let baby see your home life and nature from the sling.  Remember there will be some days that are hard.  And trust that this life will nourish and uphold your baby, and you, too!

For more support around rhythm for you and your baby, the Emerson Waldorf School, emersonwaldorf.org, invites you to explore our Early Childhood programs.  For new parents, join us for our weekly, 12-session parent-infant Morning Garden class.  Fall Registration is open.  Contact our Admissions Director, Raelee Peirce at 919.967.1858 ext. 14.