Key Questions

“If you don’t know your options, you don’t have any.”

-Diana Korte

One of our favorite quotes at BBC, and exactly where our name came from.  Knowing your choices is key.  Key to support, key to using your voice, key to walking towards the kind of birth you hope for, key.

In our childbirth classes, we review what we call the ‘Key Questions Card.’ It’s this little golden nugget that you can carry around in your back pocket, birthed out of trainings from Penny Simkin and DONA International, carried through Lamaze, Passion for Birth, and Birth Matters, and now it’s a BBC must have. Here’s what it says:

  • What is it?
  • How does it impact mom?
  • How does it impact baby?
  • Are there any natural things we can do first?
  • How long can we wait?

Now, first I want to say that this key questions card is not meant to question your doctor’s knowledge, experience, or training.  Of course their input is incredibly valuable, but sometimes their road and yours look different. The primary goal here is to be informed, and to make choices that put you on a mutual path.  So often, the leap of, ‘You don’t trust me’ is made before the bridge of, ‘Let’s talk about options’ is ever crossed. Find the bridge, walk it together early on in your pregnancy, and make sure you’re on the same path.

Think about it this way.  If you were talking with a well known car manufacturer and could ask any question you wanted about the vehicle that you were about to spend your life savings on, what would you ask?

  • How does it run?
  • What happens if I do this?
  • How was it made?
  • What’s the best way to keep it running well?
  • What kind of information can you give me about this?

Or, would you just drive it off the lot and never question at all?

You are seeking knowledge in order to make good, informed decisions about your investment.  You are the consumer.  You have choices.

So, when options about pregnancy and labor come along, and they will, ask. And ask early on – start this process now.  Be informed.  Get wise counsel, seek your care provider’s thoughts, weigh your options, and make your beautiful birth choices.


On a trip recently to the National Women’s Hall of Fame in Seneca Falls, I came across something surprising to me and maybe to some of you! Most of you have heard of the term “Apgar Score”, but what is it and where did it come from?

The APGAR score was developed in 1952 to help assess an infant at 1 minute and 5 minutes of age. The babe is given a score of 0, 1 or 2 on the 5 categories: Appearance (Skin Color/Complexion), Pulse rate, Grimace (Reflex Irritability), Activity (Muscle Tone) and Respiration (Breathing). Technically, a baby can get a perfect 10 (although sometimes there is a tendency of giving a 9 instead for superstition says a perfect 10 is asking for trouble).

Apgar scores are usually said out loud during those first vital minutes of life but usually the parents are, for some reason, distracted by their new beautiful baby or something, and the score goes unheard. When I am present as a doula, I always make sure I get those scores to later give to the parents because they are good to know. Be sure and ask what your babies scores are! I would assume (although not always best practice to assume things) that the babies care provider is given that information and I believe I have seen it charted in the computer at all the births so might be on the labor and delivery records from your care giver. Either way, just ask.

What I found interesting at the National Women’s Hall of Fame was that the APGAR score is not only a backronym (a backward acronym) to help remember what the 5 criteria, but was also the name of the women who created it.  Dr. Virginia Apgar was interested in birth defects and preventing them.  Because gestational age is directly related to an infant’s Apgar score, Apgar was one of the first at the March of Dimes to bring attention to the problem of premature birth, now one of the March of Dimes top priorities.

Apgar scores are being used now as a potential predictor in future learning disabilities.  That is one reason it is good to know what your child’s Apgar scores were, if situations arise later in life.

So shout out to you, Dr. Apgar, for helping us understand the immediate and future health of our children a bit better!


Transition unto Transformation

My family is currently experiencing what I believe to be the throws of transition… So it got me thinking about birth (of course), because what we’re doing is birthing a new day for our household. For a couple of years now we have been juggling the idea of actually settling into Rochester, finding that ‘permanent job,’ buying the house in the country, rounding off our family with this ‘last’ little one. Finding our groove. Basically ~ early labor.

Exactly a year ago we hit active labor hard and heavy ~ my husband landed a great job in a career of his choice, we gave birth to baby number five, and we sold our wonderful home in the city and moved out to a beautiful (but totally different!) country location. What a year. Non-stop action for twelve straight months. One might think that was it… labor pains done, on to greener pasture.

Along comes transition. Ahh – what a word. According to Wikipedia, ” ‘trans’ is a Latin noun or prefix, meaning “across”, “beyond” or “on the opposite side [of].” Transition is that incredibly real and somewhat treacherous part of the journey to the other side. Typically short-lived, it is the embodiment of pain, challenge, questioning and fear. What is happening? Why did we do this? I want to go home! Make it go away.

This is exactly where my family finds itself right now… worn out from active labor and in the midst of major transition. We’re trying desperately to settle in and claim this new way of living – to find the rhythm of our labor as it moves fast and furious through our home. Gardens, flower beds, new work schedules, commutes to the city, new neighbors, pool maintenance, a busy toddler, bugs, snakes, chicken coops, clothes lines, wood burning furnaces, school work, major lawn mowing, children that grow like weeds, new doctors – dentists – hair dressers – stores – sports groups – clubs and more. The list goes on and on. Transition ~ crossing over ~ can be painful and it’s hard work. But wait a minute…

A word about transition – it is most definitely not without its’ merits. Transition is undoubtedly the most painful and frightening part of labor… the time when you wonder if you can possibly make it through. Many women contemplate the use of pain medications during transition (I’m currently considering chocolate by the truck load), they doubt their ability and strength (My husband is trying to figure out who this person is that he’s married to and what happened to his wife) and they need access to unlimited support and reassurance (I’m about to call in the ‘mother ship’ for reinforcements). But this is also a time for ‘crossing over’ in our lives as women ~ finding a new strength and passion inside ourselves that we might not know exists. Drawing courage from deep within, leaning on the strengths in your life and moving forward with perseverance. You will be a different person for the experience ~ completely transformed.

Let transition work for you.

Now second stage… pushing! That is what I’m hanging on for. Work ~ with reward. Children running the countryside in bare feet, vegetables peeking their heads up out of the rich soil of my new garden, chickens laying eggs for little hands to collect, laundry blowing in the breeze, hot and lazy days of summer to jump in the swimming pool, a warm and cozy home heated with our own fire when the days once again turn cool, routine. Second stage just feels different, and the gifts are visible and within arm’s reach!