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	<title>maternity &#8211; Baltimore Magazine</title>
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	<title>maternity &#8211; Baltimore Magazine</title>
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		<title>GameChanger: Ana Temple Rodney</title>
		<link>https://www.baltimoremagazine.com/section/educationfamily/doula-ana-temple-rodney-healing-mothers-momcares-organization/</link>
		
		<dc:creator><![CDATA[Lauren Cohen]]></dc:creator>
		<pubDate>Tue, 13 Jul 2021 14:00:00 +0000</pubDate>
				<category><![CDATA[Education & Family]]></category>
		<category><![CDATA[GameChangers]]></category>
		<category><![CDATA[News & Community]]></category>
		<category><![CDATA[Ana Temple Rodney]]></category>
		<category><![CDATA[Black mothers]]></category>
		<category><![CDATA[doula]]></category>
		<category><![CDATA[maternity]]></category>
		<category><![CDATA[MOMCares]]></category>
		<category><![CDATA[Mothers]]></category>
		<guid isPermaLink="false">https://www.baltimoremagazine.com/?post_type=article&#038;p=108733</guid>

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			<p>Ana Temple Rodney grew up bouncing between Woodlawn and her grandparents’ backyard in Glen Burnie, where she would create herbal concoctions out of dirt, grass, and weeds. Now, as a trained doula and mother of two young boys, she’s healing others through <a href="https://www.momcares.org/">MOMCares</a>, a nonprofit designed to help under-supported mothers by providing doula care, self-care rituals, and advocacy, as well as help for the entire family unit through her Rising Mama organization.</p>
<p><strong>In 2014, you gave birth to a premature son who spent six months in the NICU.<br />
</strong>Aiden is now a bubbly, active, sweet, smart, and sensitive 6 year old. My traumatic experience turned all previous notions of motherhood on its head. Just as there is no manual on motherhood, there is no manual on how to offer support. My identity as a “strong Black woman” made it hard for people to support me, as some assumed I didn’t need help. There were so many lessons that I awakened to in those moments, both painful and joyous.</p>
<p><strong>How did you turn those experiences into work?</strong><br />
In 2018, when my older sister passed away from complications that began in her postpartum period, I realized that the narrative around mothers, particularly Black mothers, not mattering [to the medical system] after their children were born was toxic. It was proving to be fatal and traumatic. I began the work of MOMCares and Rising Mama as a way to right the wrongs. Being a longtime practicing doula, I experienced birth and postpartum regularly, but it was my own struggles that really illuminated all the opportunities for more intentional support.</p>
<p><strong>What impacts your work the most?</strong><br />
My role as a mother keeps me grounded in the mission and vision of what the programs are supposed to embody. My role as a single mother allows me to sit in the driver’s seat of what may be needed and how it can affect a household. The journey of motherhood is with you forever, and support is needed at every level and stage.</p>
<p><strong>Black women are three to four times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention. How do we make care more safe and equitable?</strong><br />
I have seen the difference in treatment, microaggressions, assumptions about partners, medical staff downplaying pain, assuming people are drug seeking, taking longer to address requests, pushing formula instead of breastfeeding, assuming income and education without any real indicators. In order to improve treatment and safety, we need more representation in the medical setting, sensitivity training, as well as bias and discrimination training, better eyes on how medical staff are modeling for medical students, and more incorporation of holistic practices in the medical setting.</p>
<p><strong>What has the feedback been from families you have interacted with through your programs?</strong><br />
My mamas are always so thankful to have the support, and many of them refuse to let us go. We become family. We just received an email from one of our community partners that conveyed thanks from a mama we are serving who said we were the only ones who responded to her needs. Which made me sad. But also invigorated me to keep going with the work. The answer is yes.</p>

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<p><a href="https://www.baltimoremagazine.com/section/educationfamily/doula-ana-temple-rodney-healing-mothers-momcares-organization/" rel="nofollow">Source</a></p>]]></content:encoded>
					
		
		
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		<title>Baby on Board: Maternity Must-Haves</title>
		<link>https://www.baltimoremagazine.com/section/health/baby-on-board-maternity-must-haves/</link>
		
		<dc:creator><![CDATA[Jess Mayhugh]]></dc:creator>
		<pubDate>Tue, 15 Sep 2015 08:30:00 +0000</pubDate>
				<category><![CDATA[Health & Wellness]]></category>
		<category><![CDATA[Style & Shopping]]></category>
		<category><![CDATA[Baby on Board]]></category>
		<category><![CDATA[Becket Hitch]]></category>
		<category><![CDATA[fashion]]></category>
		<category><![CDATA[maternity]]></category>
		<category><![CDATA[South Moon Under]]></category>
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			<p>Though I had absolutely no control over the timing, having a fall baby has provided a fantastic gestational fashion calendar. It was still cold out when I needed to hide my bump in the nascent pregnancy days, and with the help of <a href="http://www.target.com/p/bematernity-by-ingrid-isabel-beband/-/A-13742281">belly bands</a>, I cruised into the second trimester still wearing my favorite jeans. As soon as we went public with the news and the temperature promised not to go below 75 for a while, I ditched pants entirely and have spent the summer in dresses and skirts.</p>
<p>Initially, I was intimidated by maternity fashion. It’s a drop in the bucket, time-wise, which makes it difficult to figure out how to spend your clothing budget. But it’s also a really important time, during which your body becomes a science experiment and feeling pretty is both impossible and crucial for your mental health—so you’ve got to make something work.</p>
<p>Late in my first trimester, I tried on almost every dress I own, and with very little exception, I realized I’d spent the past few years accidentally padding my wardrobe with bump-friendly options. My clothes were loose and flowy to begin with, or had enough stretch to both accommodate and accentuate my growing midsection. It’s only in the past week or so that I’ve had to retire a few of my favorite non-maternity options, which is incredible considering I’m due next month and I’ve gained every bit of the recommended weight. I highly recommend taking inventory of what you’ve got; I realize not everyone will find that they’ve been walking around for years dressed like a pregnant person, but I promise you’ll see a few of your outfits in a new light.</p>
<p>Once you’ve assessed your closet situation, invest in a few basics. I purchased the “bundle” from <a href="http://storq.com/collections/bundles">Storq</a>, and it has been become integral to my maternity wardrobe. They send leggings, a tank, a short sleeve dress, and a high-waisted skirt and I’ve been able to style each piece with components of my pre-pregnancy wardrobe. The skirt has become my favorite option because somehow, almost every shirt I own still looks good with it. Button downs get tied off above my waistline, flowier tops are a little snug but hang nicely over my bump, and adding a jean or leather jacket to the look makes me feel more like an adult and less like a baby-stuffed parade float.</p>
<p>For shoppers willing to stalk a good deal, <a href="http://us.asos.com/Women-Maternity/rsry2/?cid=5813">Asos</a> is a pregnant lady’s shopping mecca. Their maternity selection is massive and on-trend, and while overall I think they are reasonably-priced, their site-wide sales are worth waiting for. I’m being as patient as possible to for the next sale to see the prices on <a href="http://us.asos.com/ASOS-Maternity-NURSING-High-Neck-Sweater-With-Split-Front/17ig02/?iid=5694843&amp;cid=5813&amp;sh=0&amp;pge=0&amp;pgesize=36&amp;sort=-1&amp;clr=Grey&amp;totalstyles=704&amp;gridsize=3&amp;mporgp=L0FTT1MtTWF0ZXJuaXR5L0FTT1MtTWF0ZXJuaXR5LU5VUlNJTkctSGlnaC1OZWNrLUp1bXBlci1XaXRoLVNwbGl0LUZyb250L1Byb2Qv">this</a> sweater, <a href="http://us.asos.com/ASOS-Maternity/ASOS-Maternity-Seamed-Swing-Dress-In-Floral-Print-With-3/4-Sleeves/Prod/pgeproduct.aspx?iid=5594188&amp;cid=5813&amp;sh=0&amp;pge=1&amp;pgesize=36&amp;sort=-1&amp;clr=Multi&amp;totalstyles=706&amp;gridsize=3">this</a> swing dress, and <a href="http://us.asos.com/ASOS-Maternity-Coat-with-Waterfall-Front/14t8q4/?iid=4679405&amp;cid=5813&amp;Rf900=1459&amp;sh=0&amp;pge=0&amp;pgesize=36&amp;sort=-1&amp;clr=Camel&amp;totalstyles=5&amp;gridsize=3&amp;mporgp=L0FTT1MtTWF0ZXJuaXR5L0FTT1MtTWF0ZXJuaXR5LUNvYXQtd2l0aC1XYXRlcmZhbGwtRnJvbnQvUHJvZC8.">this</a> coat, which will all carry nicely into my post-birth clothing collection.</p>
<p>For those of you who don’t love online shopping, try your luck at the Free People and Anthropologie sale racks. Their clothes tend toward the looser, more ethereal end of the fashion spectrum, which is perfect for your expanding torso. I snatched up a few flowy dresses (all for under $40) and, now that my bump has lifted the front hems a little too high for bare leg comfort, I’m excited to transition them into fall with tights and boots. Look for dresses that either have an empire waist or no waist (like a shift dress) or go a size up and purchase something formfitting but with a forgiving spandex-to-regular-fabric ratio.</p>
<p>Pregnancy has also taught me to embrace accessorizing. I spent seven years at an all-girls, Catholic school that adhered to a strict uniform code, and the experience left me wary of sparkly self-expression. (On my first day of college, I remember waiting for the professor to give detention to the girl next to me wearing huge hoop earrings and chewing gum.) Pregnancy has released those fears, however, and now I am super appreciative of the mileage a good necklace can give a simple dress or pair of jeans. Accessories have the added bonus of being just as effective and useful during pregnancy as after, so I deeply encourage using that rationalization while you’re shopping. Try <a href="http://beckethitch.com/">Becket Hitch</a> for clutches, <a href="http://www.southmoonunder.com/">South Moon Under</a> for bold necklaces, and <a href="http://www.forrentshoes.com/">ForRent</a> for comfortable but cool lady sneakers.</p>
<p>And finally, don’t be afraid to borrow. Pregnant people and new moms have so much <i>stuff</i>, and giving second lives to clothes and outgrown baby items is a relief. Take lunch over to your fashionable mom friend and let her reminisce about her pregnancy while you raid her closet. It’ll be good for your wallet and her new mama soul.</p>

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<p><a href="https://www.baltimoremagazine.com/section/health/baby-on-board-maternity-must-haves/" rel="nofollow">Source</a></p>]]></content:encoded>
					
		
		
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		<title>Modern Maternity</title>
		<link>https://www.baltimoremagazine.com/section/health/modern-maternity/</link>
		
		<dc:creator><![CDATA[Jess Mayhugh]]></dc:creator>
		<pubDate>Tue, 01 May 2007 09:00:00 +0000</pubDate>
				<category><![CDATA[Health & Wellness]]></category>
		<category><![CDATA[family]]></category>
		<category><![CDATA[Greater Baltimore Medical Center]]></category>
		<category><![CDATA[kids]]></category>
		<category><![CDATA[maternity]]></category>
		<category><![CDATA[pregnancy]]></category>
		<guid isPermaLink="false">http://server2.local/BIT-SPRING/baltimoremagazine.com/html/?post_type=article&#038;p=11339</guid>

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			<p>On a far-from-tropical January day, Kristen Vanneman-Gooding sits<br />
under a poster of a palm tree in the waiting room of her obstetrician&#8217;s<br />
 office at the Greater Baltimore Medical Center (GBMC). It is exactly a<br />
 week to the day before her scheduled cesarean section, and she is<br />
filled  with anticipation. This delivery, she suspects—and hopes—will be<br />
  entirely different from her last one.</p>
<p>Five  years ago, a pregnant<br />
Vanneman-Gooding came for a routine visit to this  very office.<br />
Vanneman-Gooding had stopped in for a checkup of her  as-yet-unborn<br />
identical twin boys—conceived through in-vitro  fertilization—from Dr.<br />
Claire Weitz, head of GBMC&#8217;s Division of Maternal  and Fetal Medicine.</p>
<p>The<br />
 pregnancy was a  troubled one from the start. At 18 weeks, an<br />
ultrasound had shown that  the twins were together in an amniotic sac<br />
without a dividing membrane, a  condition that is often fatal for one or<br />
 both fetuses. &#8220;Claire said  there was a 50-50 chance that either one or<br />
 both would not make it,&#8221;  says Vanneman-Gooding.</p>
<p>But in the weeks<br />
to come, she and her husband, Ira Gooding, breathed a sigh of relief<br />
when a follow-up ultrasound showed that there were, in fact, two sacs.<br />Several<br />
  weeks later, there was more cause for concern: The twins were<br />
suffering  from a &#8220;growth discordance,&#8221; in which one fetus was<br />
significantly  larger than the other. So—as is standard for most twin<br />
pregnancies—Weitz  put Vanneman-Gooding under &#8220;house arrest&#8221; to ensure a<br />
 healthy delivery  for both fetuses. (&#8220;I watched a lot of L.A. Law<br />
reruns,&#8221; she recalls.)</p>
<p>Months  later, during another ultrasound,<br />
there was more worrisome news: the  black-and-white images showed that<br />
one of the fetuses was sluggish.  Asked to return the next day to verify<br />
 the findings, Vanneman-Gooding  did; when the results were the same,<br />
Vanneman-Gooding remembers Dr.  Weitz saying, &#8220;We&#8217;re going to take them<br />
today.&#8221;</p>
<p>&#8220;We  didn&#8217;t even have a camera,&#8221; Vanneman-Gooding says. &#8220;It<br />
was a  whirlwind—it was just a matter of fifteen minutes between being<br />
in  Claire&#8217;s office on the fourth floor, walking down the hall, and<br />
being in  the operating room for the C-section.&#8221;</p>
<p>Today,  those<br />
twins—Duncan and Finnigan, both born the same size—are healthy,  happy<br />
preschoolers. And although she suffered a miscarriage several  months<br />
before her current pregnancy, Vanneman-Gooding—an assistant  teacher at<br />
Lutherville&#8217;s Havenwood Preschool Center and part-time office  manager<br />
at State Farm Insurance—is relieved that this pregnancy has  been so<br />
simple.</p>
<p>&#8220;I&#8217;ve been able to enjoy  this pregnancy more than I did with<br />
 the boys,&#8221; says Vanneman-Gooding—who  herself was born at GBMC 32 years<br />
 ago. &#8220;I&#8217;m so much more relaxed, and  knowing what to expect at delivery<br />
 time is a load off my mind—I&#8217;m not  nervous about the surgery. I&#8217;m more<br />
 concerned about what to pack in my  hospital bag.&#8221;</p>
<p>It&#8217;s hard to believe that as recently as 1930, delivering a child was<br />
  the single most dangerous event in a woman&#8217;s life: One out of 150<br />
pregnancies ended in the death of the mother (most births occurred at<br />
home).</p>
<p>In the 21st century,  standardization of practice—from the<br />
presence of fetal heart monitors  (100 percent of the time at GBMC) to<br />
advances in anesthesiology (used by  about 85 percent of maternity<br />
patients at GBMC) to the prevalence of  pitocin (a synthetic hormone<br />
used to speed up labor) and intravenous  fluids—has made giving birth<br />
very safe. In 2003, there were 12.1 deaths  per 100,000 live births in<br />
the U.S.; that&#8217;s about the same mortality  rate as that of women with<br />
lung cancer.</p>
<p>&#8220;In  terms of the safety of the mother, this is probably<br />
 the best it has  ever been,&#8221; says anesthesiologist Jonathan Hamburger, a<br />
 partner of  Physician&#8217;s Anesthesia Associates, whose group provides all<br />
 anesthesia  services to GBMC. The constant screening of<br />
Vanneman-Gooding&#8217;s first  pregnancy is just one example of how<br />
improvements help both mothers and  infants.</p>
<p>More babies are<br />
delivered at  GBMC than any other hospital in Central Maryland: some<br />
4,500 newborns  begin their lives at the hospital each year. (In 2006,<br />
Johns Hopkins  Hospital and University of Maryland Medical Center<br />
delivered 3,290  babies combined.)<br />In the past five  years alone,<br />
GBMC has delivered more than 22,200 bundles of joy. The  hospital has<br />
been the delivery destination of people from all walks of  life in the<br />
region, including former First Lady Kendel Ehrlich. Some  satisfied<br />
customers even commute from other states—Kensy Boulware, wife  of former<br />
 Ravens linebacker Peter Boulware, traveled from Tallahassee,  Florida<br />
to deliver the couple&#8217;s third child at GBMC last fall.</p>
<p>Ever  since<br />
its founding in September of 1965, GBMC (which merged with The  Hospital<br />
 for The Women of Maryland in Baltimore City and The  Presbyterian Eye,<br />
Ear and Throat Charity Hospital) has been known for  its outstanding<br />
obstetrical department. In recent years, GBMC has become  known around<br />
town as &#8220;The Baby Hospital&#8221; or &#8220;The Baby Factory&#8221; for good  reason.<br />
Despite the fact that there are numerous other prestigious area<br />
hospitals delivering plenty of babies, GBMC—in the wooded, tony suburbs<br />
 of Baltimore—has become a leader for women&#8217;s healthcare.</p>
<p>The<br />
physical plant of the 106-acre hospital campus perches atop a swell of<br />
land off of Charles Street; the tranquil campus is often called &#8220;The<br />
Hilton on the Hill.&#8221; And if the hospital as a whole is the Hilton, the<br />
second floor primarily dedicated to maternal and newborn services, is<br />
the concierge level. In the obstetrics lobby and admitting area, a<br />
hospital volunteer tickles the ivories on a Yamaha piano to soothe the<br />
nerves of anxious family members. The 17 state-of-the-art labor,<br />
delivery, and recovery rooms, known as LDRs, are currently under<br />
renovation—they&#8217;ll be redone in a tasteful green and beige palette, and<br />
 will feature bamboo flooring.</p>
<p>They&#8217;re  also thoroughly modern rooms.<br />
 There will be wireless internet service  (some mothers have been known<br />
to log on to their e-mail servers or check  their BlackBerries while<br />
dilating); handy desks to set up and recharge  cell phones, laptops, and<br />
 other gadgets; and plasma HDTVs. The 48-bed  postpartum unit, with<br />
private rooms and a dedicated 11-bed high-risk  obstetrics unit, is<br />
adorned in soft soothing colors and floral fabrics.</p>
<p>Since  2000, GBMC<br />
 has invested approximately $9.9 million in labor and  delivery room<br />
renovations, neo-natal intensive care units, and  state-of-the-art<br />
equipment. Cracks Dr. Weitz, who has two grown  children: &#8220;When I took<br />
the first tour, I said, &#8216;Gee, it&#8217;s almost enough  to make me have<br />
another baby.&#8217; I&#8217;ve been to other hospitals, and this is  about as good<br />
as it gets.&#8221;</p>
<p>And the  amenities don&#8217;t stop there. The Lactation<br />
Station retail store is the  only one of its kind on a hospital campus<br />
in Baltimore, and sells  everything from fashionable nursing shirts to<br />
breast pumps and nursing  pillows. Lactation experts have also set up a<br />
breastfeeding information  &#8220;Warm Line,&#8221; open seven days a week from 6<br />
a.m. to 10 p.m. The Warm Line  is headed up by lactation consultant<br />
Marla Newmark, who nursed 12 of  her own children (she has 11 surviving<br />
kids).</p>
<p>Additional  maternity services through GBMC Boutique include<br />
an on-staff  aesthetician who visits the maternity ward to provide<br />
things like hair  cuts, manicures, pedicures, and facials; parent<br />
education classes; and  doula (or birthing coach) services.</p>
<p>The<br />
official acceptance of doulas—women who provide emotional and physical<br />
support to expectant mothers—by a staid, suburban hospital like GBMC was<br />
  a big step for both sides.</p>
<p>&#8220;GBMC is  known as a traditional<br />
hospital,&#8221; says Lanny Dowell, doula coordinator.  &#8220;It has been<br />
interesting to introduce an age-old concept to new and  modern medicine.<br />
 A lot of doulas were worried about how the staff at  GBMC was going to<br />
take it. Did they think we were going to be dressed in  old field garb<br />
and doing voodoo?&#8221;</p>
<p>Far  from it. &#8220;We are known as the Ann Taylor and<br />
Talbot&#8217;s doulas,&#8221; says  Dowell, looking very much the part in a pair of<br />
classic winter-white  trousers, black mules, and tasteful top. &#8220;We are<br />
trying to merge the two  images. We are not this cloaky person in labor<br />
and delivery with heavy  incense. Our goal has been to soften and change<br />
 the idea of the doula.&#8221;  The list of doula services—from acupressure to<br />
 massage—sounds more like a  luxe spa&#8217;s offerings than tasks handled by a<br />
 birthing coach. GBMC  doulas also offer postpartum services, from meal<br />
preparation to infant  care to light housekeeping—and even carpooling<br />
older kids to school,  should the need arise.</p>
<p>In short, sums up<br />
Victor Khouzami, Chairman of the Department of Obstetrics, &#8220;At GBMC,<br />
there is a dedication to obstetrics at every level. This is a maternity<br />
 hospital within a general hospital.&#8221;</p>
<p>Says  Susan Bowen, Clinical<br />
Director of Labor and Delivery, &#8220;I joke with Dr.  Khouzami that we<br />
should secede from the Union and build our own  hospital.&#8221;<br />In some<br />
ways, that&#8217;s what&#8217;s  happened: GBMC&#8217;s decision to pour resources into<br />
becoming a major  obstetrics center has paid off. Year after year, GBMC<br />
has racked up  awards, including a coveted ranking in <em>U.S. News &#038;<br />
World Report&#8217;s </em>&#8220;America&#8217;s Best Hospitals&#8221; in 1997 and 2001 for<br />
gynecology, &#8220;Best Maternity Hospital&#8221; by the readers of Maryland Family<br />
Magazine every year from 2002 through 2006, number one in Obstetrics in<br />
the  Central Maryland Region by Maryland Hospital Association every year<br />
  between 1995 and 2002, and one of the top 10 maternity hospitals in<br />
the  U.S. by Child Magazine (1995). GBMC also has many other claims to<br />
fame, including the first birthing rooms in the state (1978), the first<br />
 peri-natal center in Baltimore County (1985), the establishment of the<br />
 first Lactation Department in the Baltimore area (1989), and the first<br />
 robot-assisted gynecologic surgery at a community hospital in the<br />
mid-Atlantic (2006).</p>
<p>All those awards are not exactly what Ira Gooding is thinking about<br />
as  he sits on a blue plastic chair in the hallway outside Delivery Room<br />
 1  on the second floor of GBMC.</p>
<p>It&#8217;s one  week after Kristen<br />
Vanneman-Gooding&#8217;s visit to Weitz&#8217;s office, and Ira  Gooding is dressed<br />
head to toe in disposable navy blue scrubs, and  clutches a camera.</p>
<p>&#8220;I&#8217;m<br />
 more relaxed this  time,&#8221; says Gooding, an Open Courseware Coordinator<br />
at the Johns  Hopkins School of Public Health, &#8220;but I want to get in<br />
there and for  everything to go well.&#8221;</p>
<p>Minutes later,  Ira is perched<br />
 on a leather stool within a foot of his wife&#8217;s head and  several feet<br />
away from where his daughter is about to be born. At 66  degrees, the<br />
inside of the operating room feels as cold as the January  day outside<br />
(it&#8217;s kept cool to prevent germs and bacteria from  flourishing).<br />
Vanneman-Gooding is draped in warming blankets, and wears a  surgical<br />
cap that brings out the blue in her eyes. Weitz; her first  assisting<br />
physician, Dr. Margaret Cyzeski; and a scrub technician  congregate<br />
around Vanneman-Gooding&#8217;s midsection.</p>
<p>The  anesthesiologist, Dr.<br />
Stanislav Malov, tends to the monitors near her  head. A circulating<br />
nurse and neo-natal intensive care unit team are on  standby.<br />The<br />
540-watt prism halogen  surgical lights flood the room, intensifying the<br />
 green of the doctors&#8217;  gowns, the silver steel storage cabinets, and<br />
the ruby red blood that  blossoms on Vanneman-Gooding&#8217;s skin as Weitz<br />
makes her first incision  through the skin with a number-10 scalpel.</p>
<p>Obstetrical devices have come a long way, both scientifically and<br />
culturally. In the 17th century, when obstetrical forceps were invented<br />
 by Peter Chamberlen, the innovative instrument was such a closely<br />
guarded secret that it was used only when a laboring woman was<br />
blindfolded.</p>
<p>Other primitive practices in  the 1940&#8217;s through 60&#8217;s<br />
included putting women in a &#8220;twilight sleep&#8221;  through a potent cocktail<br />
of morphine and a powerful amnesia-inducing  drug called scopolamine.<br />
Freed of their inhibitions—but not their  pain—thrashing women were<br />
often strapped to gurneys to keep from hurting  themselves. &#8220;It was such<br />
 a powerful amnesiac, some patients would wake  up the next day and not<br />
even know if they had a boy or a girl,&#8221; says  Hamburger.<br />&#8220;Patients<br />
would run down the  hallway stark naked,&#8221; recalls Khouzami, who joined<br />
the GBMC staff in  1981 as head of the Division of Maternal Female<br />
Medicine.</p>
<p>Modern  obstetrics was still in its infancy (so to speak)<br />
when GBMC opened its  doors in September 1965. In the 60&#8217;s and 70&#8217;s,<br />
recalls Khouzami, &#8220;We had  labor rooms, delivery rooms, and recovery<br />
rooms. The woman delivered in  the labor room with no family or support<br />
services, and she pushed the  baby out for hours, and then the baby was<br />
taken to the nursery, and [the  mother] was taken to the recovery room<br />
where maybe someone would visit. It was very, very [impersonal].&#8221;</p>
<p>&#8220;The<br />
  husband dropped you off at the door of the labor room,&#8221; recalls Bonnie<br />
  Lauryssens, a retired nurse practitioner who worked labor and delivery<br />
  at GBMC from early 1966 through 2005. &#8220;Ashtrays were all in the labor<br />
 rooms, doctors would walk in smoking, and women smoked while they<br />
labored. You had to pull bars up the bed because the anesthesia made<br />
them thrash and try to climb out of bed. It all seemed so normal—this<br />
was what we knew.&#8221;</p>
<p>Women had no say in  the birthing process either.<br />
&#8220;There was [a] paternalistic attitude,&#8221;  recalls Khouzami. &#8220;The attitude<br />
 was &#8216;You do it because I know what&#8217;s  best for you.'&#8221;</p>
<p>By the<br />
mid-70&#8217;s, as more  Americans began to question the status quo on much<br />
conventional wisdom,  &#8220;Families started to demand to share and have<br />
greater participation in  the delivery,&#8221; remembers Khouzami. &#8220;They said,<br />
 &#8216;Don&#8217;t shut us out,'&#8221; and  GBMC was the first hospital in Maryland to<br />
respond to these needs. &#8220;We  opened the first birthing rooms in the<br />
state of Maryland in 1978, and we  included fathers in the process.&#8221;</p>
<p>By<br />
 the  early 80&#8217;s, birthing centers—where women delivered through the<br />
help of a  midwife and in the absence of a doctor—had sprung up around<br />
Baltimore.  GBMC added them and tried to provide families with both the<br />
warm,  nurturing feeling they would get in a birthing center and the<br />
technology  and backup staff found in a hospital setting. &#8220;That&#8217;s how we<br />
 started  changing our thinking to, &#8216;pregnancy as a natural process,'&#8221;<br />
says  Khouzami, &#8220;and we shouldn&#8217;t be intrusive, but we should be there,<br />
should  an emergency arise.&#8221;</p>
<p>Another trend in  the mid-70&#8217;s was a<br />
shortened length of stay for mother and child. &#8220;It  got to the point<br />
where the woman had a baby, took a shower, and went  home,&#8221; says<br />
Khouzami. &#8220;The length of stay kept dwindling.&#8221; By the  1990&#8217;s, the<br />
average length of stay was 1.7 days.</p>
<p>&#8220;There  was pressure put on me,&#8221;<br />
 Khouzami says, &#8220;because we thought we were  going to go down to 12<br />
hours [from admission to release]. I said &#8216;Over  my dead body. It&#8217;s<br />
going to swing back.'&#8221;</p>
<p>It  did, in 1995: Maryland was one of the<br />
first states to mandate a 48-hour  length of stay before the practice<br />
became a federal law under President  Clinton.<br />And then there was the<br />
 liberal  open-door policy for visiting family members in the LDR. &#8220;We<br />
went from  having no one in the room in the 70&#8217;s, to having to put a<br />
limitation on  how many people could get into the room,&#8221; says Khouzami.<br />
&#8220;By the 90&#8217;s,  it started to get crowded—I remember one delivery in<br />
which there were  twelve people in the room.&#8221;</p>
<p>Recalls  Lauryssens,<br />
&#8220;There were mothers-in-law, fathers-in-law, brothers,  sisters,<br />
sisters-in-law, and friends. It got to be a joke that pretty  soon they<br />
were going to let the family dog in.&#8221; (Now the policy is five  visitors<br />
for a traditional delivery, two for a C-section.)</p>
<p>A drape hung near her chest prevents Vanneman-Gooding from seeing the<br />
  C-section occur. On the other side of the drape, Weitz is the model of<br />
  calm and confidence, and she cuts side to side along the turgid<br />
abdomen,  then cuts through the fascia covering the abdominal muscles,<br />
through  the peritoneum en route to the thick, muscular uterus. Using<br />
numerous  white gauze pads, the team of three stanches the deluge of<br />
blood that  pools and pours from Vanneman-Gooding&#8217;s body.</p>
<p>Even<br />
though it is possible for Ira to avert his eyes, he watches as Weitz<br />
pulls and probes inside the deep exposed cavity in his wife&#8217;s abdomen<br />
and then, using a suction device, eases the crown of the baby&#8217;s head out<br />
  of the womb.<br />&#8220;Ira, get your camera  ready,&#8221; calls out the<br />
circulating nurse—and then, baby Wren arrives,  about 12 minutes after<br />
the first incision.</p>
<p>&#8220;It&#8217;s a girl,&#8221; says Weitz. &#8220;I thought you told me it was a boy—I was all set to say, &#8216;Three boys, you&#8217;re screwed.'&#8221;</p>
<p>The<br />
  baby is weighed (7 pounds, 6.2 ounces) and evaluated (an APGAR score<br />
of  9—nearly perfect). APGAR—an acronym for activity, pulse, grimace,<br />
appearance, respiration—is a 10-point scale used to provide an<br />
immediate, if rough, status report of a newborn&#8217;s health.</p>
<p>While<br />
that&#8217;s going on, Weitz cuts and ties Vanneman-Gooding&#8217;s fallopian tubes<br />
 (a procedure Kristen and Ira had decided to undergo after their third<br />
child), before closing the C-section incision with sutures.</p>
<p>The<br />
circulating nurse methodically counts the instruments—the bladder<br />
blade, the retractors, the sutures, the scissors, the scalpel, the<br />
clamps—three times to ensure that nothing gets left behind in the<br />
patient&#8217;s body. Ira snaps a digital photo of their new daughter, and<br />
hands the camera to his wife, which lets her study her beautiful baby<br />
girl for the first time.</p>
<p>On January 22,  2007, Wren Dorothianne<br />
Gooding is logged in the hospital&#8217;s official  record book at 10:57 a.m.<br />
She&#8217;s the 278th baby to be born at GBMC this  year; Kristen will return<br />
home four days later.</p>
<p>Anesthesiologist  Malov offers a little comic<br />
relief. &#8220;How soon before there are no more  [natural] deliveries?&#8221; he<br />
asks, only half joking. &#8220;In the next century,  babies will probably be<br />
genetically engineered, and there will just be  this zipper across<br />
here,&#8221; he says, pointing to his abdomen.</p>
<p>Malov&#8217;s quip is not entirely in jest. Cesarean section on demand has<br />
become de rigueuramong  professional women in modern, industrialized<br />
nations like Japan where,  according to Khouzami, the C-section rate is<br />
90 percent. In the U.S.,  nearly 25 percent of births today are by<br />
cesarean (in 1970, it was only 5  percent).</p>
<p>C-sections offer benefits<br />
  (greater control over time of delivery and the removal of some risks<br />
from the childbirth process) with a bit of risk (it is surgery, after<br />
all, and long-term effects may include more postpartum pain and<br />
infertility issues).<br />&#8220;We knew this was  coming to the American<br />
workplace sooner or later,&#8221; says Khouzami. &#8220;We  knew the day would come<br />
when women would start asking for it. We are  simply coming to a time<br />
when women are saying, &#8216;This is how I want to  deliver,&#8217; but the East<br />
Coast is very slow to change. We&#8217;ve had maybe a  handful of C-sections<br />
on demand in which women have said, &#8216;I don&#8217;t want  to labor. Get me a<br />
date.&#8217; But the trend is not here yet.&#8221;</p>
<p>Dr.  Weitz seconds the notion.<br />
 &#8220;There will be an increasing demand for  elective primary C-sections,&#8221;<br />
says Weitz, who jokes that for some women,  natural childbirth means<br />
delivering without makeup. &#8220;We are the old  prudes,&#8221; she says, &#8220;the last<br />
 to jump on the bandwagon. We are taking it  cautiously, but I do<br />
foresee a tremendous increase in patient requests  for elective<br />
C-sections. When you really look at it, women can get nose  jobs, breast<br />
 implants, tummy tucks. Why does society say that we must  make them<br />
deliver vaginally? It&#8217;s your body and your decision. We  respect the<br />
woman&#8217;s autonomy.&#8221;</p>
<p>To date,  the C-section rate at GBMC is about 22<br />
percent—higher than the national  average, but misleadingly high because<br />
 of GBMC&#8217;s high-risk patient  population. These include mothers with<br />
multiple births (many of whom  medically must deliver through<br />
C-section), older mothers, and repeat  patients (at higher risk), and<br />
the fact that the local Catholic  hospitals will not perform tubal<br />
ligations (often done in conjunction  with C-sections), so many<br />
expectant women choose GBMC to have their  C-sections so they can also<br />
get their tubes tied.</p>
<p>So  are we professionalizing childbirth—turning<br />
 it from an arcane, vague,  mysterious process into a regulated,<br />
structured, guesswork-free  procedure?&nbsp;</p>
<p>Susan Bowen, clinical director of<br />
 labor and delivery,  believes we&#8217;re well on our way. &#8220;I joke that one<br />
day we are going to get  our hours down to nine to five, Monday through<br />
Friday,&#8221; she says. &#8220;I  think the sad part of it is that our whole lives<br />
are planned from the  minute we step out of bed in the morning until the<br />
 minute we get back in  bed at night. And this should be a wonderful<br />
experience for a woman. I  worked nights for nine years, and the thing I<br />
 enjoyed most was that  natural labor that came through the door and you<br />
 could be so supportive  and really help the woman and her family.&#8221;</p>
<p>However<br />
  women deliver these days, what&#8217;s clear is that they are having a much<br />
 greater say in the process. &#8220;We try to do what the woman wants us to<br />
do,&#8221; says Bowen, &#8220;as long as it&#8217;s okay with the doctor and within the<br />
policy of the hospital.&#8221;<br />&#8220;Years ago, if  someone told me they wanted<br />
to breastfeed for two days,&#8221; says lactation  consultant Marla Newmark,<br />
&#8220;I would tell them &#8216;It&#8217;s not worth the work.&#8217;  Today, if they tell me<br />
they want to breastfeed for two days, I give them  the same amount of<br />
attention as if they planned to do it for a year. We  are out to please<br />
the consumer. What the patient wants is what we do.&#8221;</p>
<p>Something else has changed too: the patient and the doctor now look a<br />
  lot more alike. The influx of women entering obstetrics has caused<br />
sweeping changes in a formerly male-dominated field. At GBMC, there are<br />
 57 OB-GYNs: Nearly half are women. &#8220;We used to have the token female,&#8221;<br />
 says Khouzami laughing. &#8220;Now we have the token male.&#8221; Susan Bowen<br />
agrees. &#8220;Women have made a big difference in the field because they have<br />
  experienced labor. This is not a disease—it&#8217;s a natural process so we<br />
 have a lot of influence when it comes to how we want to give birth.<br />
Women are more assertive. You don&#8217;t have the little housewife who comes<br />
 toddling through the door saying, &#8216;I&#8217;m here. Take me.&#8217; It&#8217;s not that<br />
anymore. We have a lot of career women who know what they want, we have a<br />
  very educated client base—everyone&#8217;s doing research on the internet,<br />
the women take classes, they want what&#8217;s best for their baby.&#8221;</p>
<p>Claire<br />
  Weitz was the only female resident in obstetrics when she did her<br />
training at Johns Hopkins Medical School in the mid-70&#8217;s. &#8220;When we would<br />
  show up [to put on scrubs for the OR], the locker rooms would say,<br />
&#8216;Doctors&#8217; or &#8216;Nurses.&#8217; I would go into the &#8216;Doctors&#8217; room, and it would<br />
 be the men&#8217;s room. We are the majority now. Women have brought a new<br />
perspective. Things become a little more personalized [for the patients]<br />
  because they&#8217;re often dealing with someone who has experienced<br />
pregnancy—been there, done that, and gotten the T-shirt—but it doesn&#8217;t<br />
mean that the men are unsympathetic to pregnant women. Some of the<br />
kindest, most sympathetic men I&#8217;ve ever known have been obstetricians,<br />
and that&#8217;s a loss for the field because men are not being encouraged to<br />
 go into it anymore.&#8221;</p>
<p>&#8220;When technology  first came in, nurses felt<br />
put out,&#8221; says Bonnie Lauryssens. &#8220;They let  technology take care of<br />
their patients—they would go in a room, look at  numbers, and write them<br />
 down on a chart. Now, it has evolved. The nurses  are even more into<br />
the deliveries and are incredibly encouraging. Half  the nurses probably<br />
 have hemorrhoids from pushing with the patients.&#8221;</p>
<p>Khouzami  couldn&#8217;t<br />
 agree more. &#8220;I remember as a student, I had a teacher from  Virginia<br />
who was a real gentleman,&#8221; says Khouzami. &#8220;He was part  philosopher,<br />
part obstetrician, and he said that a delivery should be  &#8216;by art, not<br />
by force.&#8217; It&#8217;s art, not science. Yes, some part of OB is  science, but<br />
if you make it purely science, you take all the emotion out  of it. You<br />
have to have a solid foundation in science, you have to have<br />
technology, but it has to be tempered by humanity.<br />&#8220;Obstetrics  is<br />
more humane than ever. The technology is better than ever. As we  move<br />
ahead, we have found this wonderful balance.&#8221;</p>

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