Current issue of Baton Rouge Parents Magazine, BR Baby section.

My article was a lot different than this. They attributed Jackie's quote about the tubs to Rene'. And I didn't realize I wouldn't get any writing credit for the piece. But oh well, at least the info is out there for BR moms.

Good article, but that aggravates me that they gave that quote to Rene seeing as she is opposed to Home Birth. At least so I've heard......

Here's the original artical I submitted.





Your Choice of Birth

Baton Rouge Birth Options Increasing



While Louisiana ranks above the national average regarding labor inductions, epidurals, and cesarean section births, there are a growing number of women who have begun to equate medical management with health risks rather than benefits. Many women now seek out a birth doula to support them through a minimal-medical-intervention birth. Waterbirths are also much more common now than a decade ago. The presence of in-hospital midwives has increased as well. A general awareness of birth options is steadily growing in the Baton Rouge area.

Nicki Solomito Pugh, a local Bradley method instructor for the past two years, regularly encounters women seeking personal ways to manage their own births and affirms, “I certainly have more students now than when I first started.” In the past few years, Baton Rouge has had greater exposure to choices centering around non-medicated births. The annual Preserving Normal Birth workshops have promoted great discussion on how to ensure better births. This past April, Penny Simkin highlighted the 3rd consecutive workshop, attended by several Baton Rouge birth professionals. Also, “The Business of Being Born” documentary enjoyed a packed January 2008 screening at The Red Shoes, followed by a panel discussion.

René Johnson has practiced locally since 1980 as a birth doula – a knowledgeable, experienced companion who stays with a woman through labor, birth and beyond – and comments “I've noticed a marked increase in waterbirths, interest in unmedicated birth, etc. About 4 years ago Birth Help [my doula practice] was invited to teach full day inservice workshops (several per year) for L&D nurses, and we still do several a year.” Johnson has noticed the classes taking affect, saying that “Because almost all of their nurses are at least exposed to natural birth philosophy and hands-on techniques, we have seen a shift in attitude at Woman's Hospital.” Woman's Hospital has even begun allowing women to labor, but not birth, in birth tubs.

When asked about the changing birth scene in Baton Rouge, Jackie Macaluso, a doula with Mother’s Touch Doula services, says, “Definitely, water births have increased. We now have three Aquadoula tubs and one inflatable homebirthing tub.” She attributes this increase in part to the certified nurse midwives, or CNMs, who work in-hospital with Ochsner, the practice which now includes four midwives whereas a year ago there was only one. Macaluso appreciates that “They have greatly encouraged the mothers in their care to use these tubs,” yet asserts that “We need more doctors and even more hospitals to embrace the relief moms receive from being submerged in water.”

While there is more interest in the use of hypnobirthing, birthing balls, and nonsupine (upright) birthing positions within the hospital, some women choose to opt out of the hospital altogether. These women proclaim safety and “avoidance of unnecessary medical interventions common in hospital births” as their top reasons for avoiding hospitals. Some groups are not so enthusiastic about the out-of-hospital option. On Feb 6th, 2008, The American College of Obstetricians and Gynecologists (ACOG) issued a “Statement Against Home Birth” saying that “ACOG does not support programs that advocate for, or individuals who provide, home births” and that childbirth decisions should not be “dictated by what’s fashionable, trendy, or the latest cause célèbre.”[ii][ii] That last statement is questionable since the population of women which births out-of-hospital comprises less than 2% in the United States – that’s in free-standing birth centers, at home with midwives, and unassisted births combined.[iii][iii] According to the National Perinatal Association,“This statistic [of US homebirths] has remained stable over the past few decades.”[iv][iv] Even national birth advocates like Penny Simkin, say that “home birth has a small niche that is really not growing very much.”[v][v] If homebirth is not a threat, then why did ACOG bother to issue a statement against it? Perhaps the real issue is that women are speaking up about their dissatisfaction with traditional hospital birth and the steady increase of medical interventions.

Such dissatisfaction is not unfounded. Studies show that women birthing at home under care of a certified profession midwife (CPM) have a cesarean rate of less than 5%.[vi][vi] The comparison is not exactly fair, since midwives do work only with low-risk pregnancies, yet it is interesting to note that the national average for cesarean sections for hospital births was on par with this optimal rate in 1965 (4.5%) when cesareans were first measured.[vii][vii] The rate has since risen to what the 2005 CDC National Vital Statistic Report proclaims as “the highest level ever reported in the United States, 31.1 percent.”[viii][viii] Louisiana is above the national average at 36.8 percent.[ix][ix] While ACOG admits that “the cesarean delivery rate has concerned [them] for several decades” they shrug their shoulders, explaining that “there is no scientific way to recommend an ‘ideal’ national cesarean rate as a target goal.” They point instead toward multiple health factors as the culprits of America’s skyrocketing cesarean figures, factors headed by “maternal choice” as well as the rising tide of high-risk pregnancies due to “maternal age, overweight, obesity, [and] diabetes.”

The cesarean rate is of particular interest since the occurrence of vaginal birth after cesarean (VBAC) is comprised of 90.3% repeat surgeries.[x][x] A woman seeking VBAC is rarely allowed to attempt this in a hospital, and highly discouraged from doing so in a birth center or at home with a midwife, despite the evidence that a repeat cesarean surgery has been shown to involve greater risk than VBAC.[xi][xi]

The out-of-hospital birth option for Baton Rouge residents is now more available, yet still minimal. In June 2006, Gentle Choices, A Birth Center opened in Lafayette, offering services to Baton Rouge residents. As for homebirth, Family Centered Birth Services, based in Ponchatoula, thrives while serving the New Orleans and Baton Rouge areas. The big question however is obstetrician backup. Louisiana is one of several states requiring women under a CPM’s care to have obstetrician check-ups and back-up.[xii][xii] This puts the ultimate power in the hands of the obstetrician, who is discouraged, in accordance with ACOG’s position, to support clients planning a midwife-assisted homebirth. Thus, while ACOG “acknowledges a woman’s right to make informed decisions regarding her delivery and to have a choice in choosing her health care provider,” that choice often remains a hypothetical non-reality. Solomito Pugh says that while few of her Bradley students choose homebirth, “Who is to say how many moms would birth at home if OB backup and/or cooperation with CPMs were available?”

Currently, non-medicated births remain a small fraction of all hospital deliveries.[xiii][xiii] Yet birthing options are increasing. Awareness of medical management alternatives is growing. And more women are working with their health care providers to create a more optimal birth experience.

Good article, but that aggravates me that they gave that quote to Rene seeing as she is opposed to Home Birth. At least so I've heard......

I don't think that's true. I know she's doulaed homebirths before.

I don't think she is opposed to homebirths at all....I don't think she advocates for homebirth but that doesn't mean she is against it.


I was dissappointed in the ending they put on the article. Seems like they are saying homebirth is rising but that might not be good cause the ACOG still says it is not safe. Of course the ACOG is against homebirth, it goes against everything they stand for, it drives me nuts that they get the last word on something they know nothing about. They opinions are not based on facts, the nubmers show homebirth can be safe and in some cases safer. urgh

Good article, but that aggravates me that they gave that quote to Rene seeing as she is opposed to Home Birth. At least so I've heard......

I don't think that's true. I know she's doulaed homebirths before.

My experience with Rene and homebirth: Back in 2005 when I was pregnant with Lillie I called Rene (This is WAY before I got involved with ya'll or even an LLL Leader yet)

I asked her if she knew of any HB midwives in the area.. She flat out told me "Homebirth in Louisiana is Illegal" But if you want a doula I am available" Emmy lived in the same town as me, at that time Kami was practicing about 20 min from my house.. And I was told by a DOULA that HB was ILLEGAL in this state.. So please, don't try and tell me she is for HB, she is obviously against it!

Seems like they left out a lot of your homebirth, csection and VBAC comments.....

Myriah, you need to send that article to another publication ... it is such a good article. I am so annoyed that BR Parents had to mess with it.

Tera, thats what I remember hearing her say! That it was illegal... That is not pro or even slightly for HB.

I decided to actually ask Rene what her feelings about homebirth instead of merely relying on the hearsay of the this message board. She said that is in fact very supportive of home birth. She has lunch on a regular basis with Emmy Trammel and Sherri Daigle. If you were "against" HB, would you get together on a regular basis with the two most popular homebirth midwives in this area?? In addition, she was there 25 years ago when the legislation was originally being written to certify and professionalize midwifery in the state. When I asked her specifically about the conversation that Tera was referring to, she said that she remembers stating that "lay midwives", those that do not hold the CPM license, are illegal in Louisiana and she would not be comfortable acting as a doula unless the midwife was licensed. I am in no way questioning Tera's version of events, but I did think that Rene's version deserved mention. When a woman contacts Rene and mentions an interest in HB she immediately refers her to Sheri and Emmy. What is wrong with Rene basing her business on hospital births? Doesn't that open up a niche for other doulas in the community to serve women seeking HB? Is that a bad thing? I don't get it?

This thread is a perfect example of what is wrong with this message board in my opinion. Instead of trying to create an air of cooperation and change in the support and options that pregnant women can have in Baton Rouge, the bickering, ulterior motives, anger and passive aggressiveness etc.... gets in the way. Change in birth options is a slow process not just here in BR, but across the country. It takes education, teamwork, and consumer demand. There should be enough business for 10 doulas in this community, but because of the constant, immature backbiting, it is the pregnant women here who suffer. This is a subject that I discussed with the president of DONA last month when I took her out to a personal lunch during our training session. She was very disappointed to hear what was happening here.

What I think is important to remember is that change has to be gradual in order for mainstream society to accept and embrace the changes. When women come to this message board who have a doctor at Woman's, or have actually made the leap to use the CNM's at Oschner (I say leap b/c for many women this is already somewhat radical among their families and friends) and are looking for support in reaching their goal of a natural birth they often find is that they are not being "radical enough"; that they are not going to be able to reach their goals at Woman's, that HB is the only way to have a natural birth, that the CNM's at Oschner aren't "real" midwives. You have to start where the person is, not where *you* think she should be. I guess I see this as not very supportive or helpful.

There should be supportive, evidence based information on this board for all women. Amy, Myriah I think you guys are AWESOME and do an excellent job of trying to mediate all sides. This board has so much power to do good. I hope that it stops having a toxic, immature attitude. It just makes it lose its legitimacy among the members in the birth community (hospitals, CNM's, physicians etc..) who have the power and resources to make changes at this time.