Stressed About How You and Your Partner Are Going to Pay for a Baby? Here's Our How To Guide

There’s so much excitement wrapped up in preparing for a newborn baby. Your life will never be the same - and neither will your wallet. It’s important to start preparing financially for a baby as early as possible so that you can set you & your baby’s future up for success.

Here are some tasks you may want to consider doing to prepare for welcoming a newborn into your family:

Pre-delivery Planning

Before your newborn arrives, you’ll want to start planning for the added financial costs that will come with the addition of an extra family member. Here are a few tasks you’ll want to consider:

1. Understand what your health insurance covers & anticipated costs.
   Even if you have health insurance, the medical costs of having a child can be expensive. It’s important to plan for these costs early on in the pregnancy so that you can forecast how much you’ll need to budget for prenatal, delivery, and postpartum care.
   

2. Plan for maternity/paternity leave.
   Will you and your partner (if applicable) receive paid leave? And if not, how will this affect your bottom line? Accounting for changes in household income will help you determine how much you have to alot towards budgets.
   

3. Prepare a pre-baby monthly budget (diaper bag, stroller, etc.)
   Have you considered all the additional items you’ll need to purchase for your newborn? Extra expenses like strollers, diaper bags, baby clothes, and more can add up, so you’ll want to estimate how much you can expect to spend on these items pre-baby. To save costs, you may want to consider buying items second-hand - especially for items such as baby clothes, that will be grown out of quickly in the first few months of the baby’s life.
   

4. Plan your post-delivery budget (food, diapers, checkups, clothing (how quickly they will grow out of their clothes), baby food, etc.)
   In addition to your pre-baby budget, you’ll want to consider the recurring, long-term costs post-baby. These may include expenses such as diapers, baby food, and the cost of childcare.
   

5. Choose a pediatrician within your insurance network.
   Your baby will need ongoing pediatric care once born, so it’s important to consider pediatricians that will be covered by your health insurance network so that you can avoid steep out-of-pocket costs for routine medical care. Once you’ve selected a provider, you should be able to estimate how much you’ll spend on pediatric care each month by factoring in co-pay expenses.
   

6. Ensure you have ample funds at ready in your emergency fund.
   You never know when an accident will happen, especially with kids. Make sure you have ample funds stocked away in your “rainy day fund” for use in emergencies.
   

Post-delivery Financial Tasks

Once your baby has been delivered, there are a number of financial tasks you’ll want to begin tackling. Some will need to be addressed within the first month post-delivery, and others can be addressed throughout your child’s life. Regardless, make sure to add the following to your baby-budgeting to-do list:

1. Obtaining birth certificate and social security number from the county.
   Before you’ve even left the hospital post-delivery, talk with the hospital staff about obtaining the necessary paperwork for your child’s SSN and birth certificate. Alternatively, you can contact your state’s office of vital records for the birth certificate and a local Social Security office to obtain a SSN for your child.
   

2. Add your child to your health insurance.
   As simple as this task may seem, it’s important to remember to add your child to your insurance plan within the first 30 days of birth. Doing so will ensure that you don’t find yourself with a sick baby and no coverage.
   

3. Consider a life insurance policy on your child.
   While life insurance isn’t typically something many consider until later in life, you may want to think about creating a policy for your child. Rates for children are normally fairly low and can protect your family financially should an unexpected tragedy occur.
   

4. Begin planning for childcare.
   The cost of childcare can often be one of the most expensive costs of having a baby, so it’s important to start planning early. Additionally, finding the right babysitter, nanny, or daycare to care for your child can take weeks - sometimes months - to do. The sooner you start planning for childcare and its associated costs, the better.
   

5. Begin saving for their education.
   It’s  never too soon to start saving for your child’s education. The cost of higher education has grown astronomically over the years, and the earlier you start planning for the costs of your child’s college the more easily you can take small steps towards saving for it. Prioritize your other financial obligations first and consider allocating some of the remaining funds towards saving for your child’s future.
   

6. Add them as beneficiaries on your will/life insurance policies.
   While no one wants to think about the possibility of a tragedy occurring, it's important to build plans in the event that something should happen to you and your partner (if applicable) so that your child is well taken care of. Consider choosing a designated guardian and how you may want to divide up your estate.  

Are you and your partner (if applicable) trying to conceive or expecting a child? The Cincinnati Birth center offers no-cost, one-on-one fertility consultations to help you prepare for your family planning journey in addition to a range of birthing services. Contact us to learn more about how you can schedule a consultation with one of our team member’s.

Why Are We Opening a Birth Center?

Since the Cincinnati Birth Center’s inception, we’ve been steadfast in our commitment to create a safe place for women and their families to grow. We set out to build a birthing center that made each woman who entered feel empowered and supported no matter where they’re at in their journey. While we’ve continued to serve families in the Cincinnati community since 2019, the birth center itself has been undergoing construction and renovation. Now, just in time for International Women’s Day, we’re excited to share that our renovations are nearly complete!

Soon, we’ll be opening the doors of our birth center for expecting mothers and their families who are looking to deliver their babies from the comforts of one of our rooms. Each room has been carefully designed with different styles, aesthetic, and moods in mind to provide expecting mothers with the opportunity to choose a space that best fits their personality and preference. For example, for the color-loving patient we have a colorful room decorated with bold shades of orange, purple, and pink. Alternatively for those seeking a classic aesthetic, we have a room filled with antique furniture, quilts, and a cottage-like atmosphere. Cincinnati Birth Center’s Director of Marketing and Operations, Luke Armbruster, says, “Our ultimate goal was to ensure that mothers from all backgrounds and personalities have a place that makes them feel empowered and welcomed here at the Cincinnati Birth Center.”

With the official opening of the birth center on the horizon, we thought this would be a great moment to ask Meghan and the team a few questions about their experience thus far and how they feel about the future of the center:

What is your primary motivation behind your work? In other words, what is your “why” behind the Cincinnati Birth Center?

“Right around the time that I began thinking about opening up the Cincinnati Birth Center, I learned about the staggering infant mortality rates facing women of color in Cincinnati, OH. Babies are dying in Cincinnati because they are being born too small and too soon. High amounts of stress in expecting mothers can trigger these birth issues and there's a lot that goes into that, such as lack of affordable housing, food desserts, institutionalized racism, discrimination, lack of opportunities, trauma - the list goes on.

I’m determined to reduce the current infant mortality rates in Cincinnati and Ohio. To do this we must improve integration of midwives in our state and provide more birthing options for families. That’s ultimately what we are doing by opening a stand-alone birth center.” - Meghan Nowland

How does the Cincinnati Birth Center empower women in the Cincinnati community?

Cincinnati Birth Center empowers by offering an additional birth option to women in Cincinnati. We provide personalized, respectful, informed care and shared decision making. I’ve found that when parents are listened to, informed about their options, and seen as active participants, women have more satisfying birth experiences. When families have a birth experience they feel proud of, it facilitates an easier and happier postpartum. Positive birth experiences increase quality of life! 

What are you most looking forward to in the year ahead?

“With Meghan as our guiding light, the Cincinnati Birth Center has shown continuous growth while keeping our full focus on the care and support of our patients. This upcoming year is going to open the doors - literally - to a new way of assisting expecting mothers that are seeking alternative birthing options in the Cincinnati tri-state area. The opening of our birth center seeks to bring life into this world within the comfort of our walls- the same walls that our birthing team first met each family in and which housed each appointment in their pregnancy journey- is nothing short of incredible. Having the ability to walk through the halls of our building and feel the noticeable energy and liveliness of the space is something I’ve been eagerly awaiting for. Our center’s official grand opening is what I look forward to the most.” - Luke Armbruster

“I’m looking forward to finishing the renovations and licensing for the birth center so that we can offer the Cincinnati tri-state area another birthing option. It’s going to feel so good after all the waiting and hard work! I am also excited for the day when we can host regular community events and be a space for the community.” - Meghan Nowland

What are you looking for in a birth center?

Let us know by commenting below.

Curious Cultural Fertility Practices and Traditions Around The World

For centuries, old wives’ tales and cultural traditions have been passed down from generation to generation regarding fertility. In some cultures, it’s believed that there are certain fertility-boosting practices and rituals that women can do to increase their likelihood of conceiving.

While the following practices have not been scientifically proven or widely recommended, we wanted to take a moment to celebrate these cultural practices and revel in the fertility traditions passed down by ancestors around the world.

*Please note: The Cincinnati Birth Center cannot be held accountable regarding the use of the following information. If you’re unsure if something is right for you and your baby, please consult your doctor.

Naples, Italy | The Miracle Chair

Said to have been owned by St. Maria Francesca of the Five Wounds of Jesus, the ‘miracle chair’ is believed to help women who are trying to become pregnant. The chair itself sit in a room that’s adorned with ‘miracle baby’ photos. Traditionally, hundreds of women will wait in line to sit in the Miracle Chair and be blessed by a nun. The nun will then cross the women who sit in the chair and the stomachs of those who want to become pregnant. 

France | Victor Noir’s Grave
Once a 19th-century political journalist, Victor Noir’s tomb sits in the Père Lachaise Cemetery in Paris, France. It has become a symbol of fertility. Rumour has it that if you kiss the statue atop the tombstone’s lips, place a flower in his hat, and rub the mysterious bulge in his pants it will bring enhanced fertility and wonderful sex life.

Latin America | Maya Abdominal Massage

Maya Abdominal massage is a traditional healing technique that has been believed to boost fertility. It focuses on aligning the uterus and encouraging optimal lymph and blood flow. The Maya believe a woman’s enter is her uterus. Don Elijo Panti says, “If a woman’s uterus is out of balance, so is she.”

Hungary | The Watering of The Girls

Each Easter in Holloko, Hungary, people gather for The Watering of the Girl festival. This celebration dates back to the 2nd century and features the throwing of buckeyes of water over young women as a fertility ritual. Women will dress in traditional costume and gather in the streets where local men will shower them with buckets of water believed to bestow fertility on them. 

China | Bird’s Nest Soup
For thousands of years, a traditional Chinese aphrodisiac dish sometimes called “birds’ nest soup” has been used to impregnate women. The soup is made from the saliva of cave-dwelling birds called swiftlets and can be extremely expensive to acquire. This tradition has evolved from a soup to food and drink additives in order to appeal to westernized markets.

Rome, Italy | Beetle Juice Shots

In the era of the ancient Roman empire, an aphrodisiac was prepared from the Blister Beetle. People would squash this poisonous bug into a juice-like concoction, which would cause swell and inflammation of the genital area. While popular at the time, this fertility boosting tactic could cause horrific and potentially fatal side effects once ingested.

Africa | Insect Food

Many African tribes once placed a high value on insect food, such as beest, wasps, beetles, butterflies, moths, crickets, dragon flies, and termites. These insects were sought after and relished by tribes throughout Africa. They are rich in fat soluble factors found in blood, organ meats, fish, and butterfat. Even those tribes who were typically vegetarian would practice the feeding of these special foods during gestation and lactation.

Are you and your partner trying to conceive? The Cincinnati Birth center offers no cost one-on-one fertility consultations to help you prepare for your family planning journey. Contact us to learn more about how you can schedule a consultation with one of our team member’s.

Sources:
femSense Team. “Old Wives´ Tales and Myths on How to Get Pregnant.” FemSense, FemSense Team, 18 Jan. 2019, https://www.femsense.com/blog/wives-tales/. 

Intent.com. “Maya Massage: A Healing Practice Every Woman Should Know.” HuffPost, HuffPost, 16 Mar. 2013, https://www.huffpost.com/entry/maya-massage_b_2388751. 

Sally Fallon and Mary G. Enig, et al. “Out of Africa: What Dr. Price Dr. Burkitt Discovered in Their Studies of Sub-Saharan Tribes.” The Weston A. Price Foundation, 22 Nov. 2016, https://www.westonaprice.org/health-topics/traditional-diets/out-of-africa-what-dr-price-dr-burkitt-discovered-in-their-studies-of-sub-saharan-tribes/. 

Trying To Conceive? Learn To Track Your Fertility Cycle With Cervical Mucus

Whether you’re attempting to conceive a child or prevent pregnancy, understanding cervical mucus and its role in your menstrual cycle can be extremely helpful in tracking your fertility. While every person is different, the following is generally how women can track their fertility cycle with their cervical mucus. 

What is cervical mucus?

Cervical mucus refers to the fluid produced by and released from the cervix (the opening to a woman’s uterus). Shifting hormones cause your cervical mucus to change in texture, volume, and color throughout your menstrual cycle. These changes can be used to identify when you are ovulating and most fertile.

Depending on where you’re at in your menstrual cycle, cervical mucus plays different roles. The first is to help sperm move through the cervix so it can fertilize an egg during ovulation. Its secondary role is to prevent sperm or other substances from entering the cervix.

What does cervical mucus look like?

Every woman is different, but generally, your cervical mucus will resemble all or most of the following during the menstrual cycle:

• Dry or no cervical fluid.

• Sticky like paste. It can be white or yellow.

• Creamy like yogurt. Smooth in texture and usually white.

• Slippery, stretchy. Resembling raw egg whites.

• Wet, watery, and clear in color.

The type and texture of your cervical mucus are dependent on which stage of the menstrual cycle you’re in. Mucus generally begins as a dry or pasty texture before transitioning to a creamier texture. The closer you grow towards your ovulation phase in the cycle, your discharge will become wet, stretchy, and slippery (like raw egg whites). After ovulation, your cervical mucus will resort back to a thick, dry texture. 

What are the different stages in the cervical mucus cycle?

Cervical mucus changes as a result of hormonal shifts throughout the menstrual cycle. Estrogen levels increase before ovulation, which makes your cervix produce the fertile, egg white mucus. It’s your body’s way of making it easy for sperm to reach the egg that your body is about to release. Following the ovulation period, estrogen levels will drop and progesterone levels will rise. This rise in progesterone will help the fertilized egg implant itself into your uterus if you conceive. 

Every woman’s cycle is different. If you follow a 28-day menstrual cycle, your cervical mucus will likely follow this pattern:

• Days 1-4 after your period ends: Dry or tacky. It can be white or yellow-tinged.

• Days 4-6: Sticky. Slightly damp and white.

• Days 7-9: Creamy, yogurt-like consistency. Wet and cloudy.

• Days 10-14: Stretchy and resembles raw egg whites. Slippery and very wet.

• Days 14-28: Dry until menstruation occurs.

Women with a 28-day cycle tend to ovulate around day 14. However, this varies by individual.

How can you use cervical mucus as an ovulation indicator?

Because cervical mucus changes occur when your hormone levels change, it can be an excellent indicator of ovulation and pregnancy. When your mucus appears egg white in color and texture, you are likely ovulating. Following ovulation, your mucus will typically thicken or dry up. However, if you’ve conceived during ovulation you may continue to produce cervical mucus, indicating pregnancy. 

Of course, it’s important to note that every person is different and some women may not experience noticeable changes in their cervical mucus.

How can you track your cervical mucus?

Referred to as the cervical mucus method of family planning, it’s possible to chart or track your cervical mucus throughout your cycle. To chart your mucus, you’ll need to keep track of the changes you see each day - the mucus amount, texture, and color. Using a calendar or application to track these changes each day may be helpful in planning which days you’ll be ovulating. Once you see that your mucus has become slippery and wet, it’s time to have sex if conception is your goal. 

Schedule a one-on-one consultation with The Cincinnati Birth Center’s team to learn how to track your cervical mucous and fertility signs. Our fertility consultations will provide you with individualized advice and help you prepare for your family planning journey.

What Is The Cincinnati Birth Center Experience?

At the Cincinnati Birth Center, we’re dedicated to creating a safe and comfortable environment for mothers and their families to grow. We have a passion for guiding expectant mothers through their pregnancy and postpartum process, helping them bring their newborns into the world. 

From our first time meeting you during a discovery all the way through the postpartum period, our team will be by your side to ensure you feel supported and comfortable throughout your journey. Here’s what you can expect in every stage of pregnancy when you choose to work with the Cincinnati Birth Center: 

01. Discovery Call
Before we begin working together, we’ll set up a discovery call to introduce you to our services, cost coverage, and payment of services. We’ll also do an evaluation of the expecting mothers’ current and previous health history, including past pregnancies if applicable.

In this call, we’ll also ensure that you’re familiarized with our birthing teams process, which includes prenatal appointments, a birthing plan, and prenatal care. We recommend that expectant mothers contact the Cincinnati Birth Center as soon as possible upon finding out they’re pregnant, as this will help to ensure the most comprehensive and in-depth quality of care. Expecting mothers exceeding 34 weeks gestation, unfortunately, are not able to utilize our services due to the time constraints our birth team news to properly prepare for birth.

02. Onboarding
After your discovery call, our team will contact you with all of the further information needed to determine whether you would like to proceed in moving forward. Once you’ve taken the time to look over these documents and choose to proceed, a member of our staff will send you an official welcome email. This email will outline all the necessary tasks you’ll need to complete before setting up the first prenatal appointment.

In this stage of the process, you’ll receive technical  instructions and documentation on:

• How to properly contact our team

• How to set up your online health portal

• How to use the Quickbooks invoicing link to make payments

• How to sign appropriate documents using DocuSign 

Once all documentation has been filled out and received by our team, a team member will contact you to schedule the first prenatal visit.

03. Prenatal Care

In the months leading up to birth, you will meet with our certified birthing team members for a series of prenatal visits. Our service costs cover up to 14 visits with our birthing team and typically occur month-to-month, although appointment frequency is dependent on the individual and how far along the mother is. In general, the frequency of appointments follows the level of gestion. Until 30 weeks gestation, appointments are monthly. From 30-36 weeks gestation, they’ll become bi-weekly. Finally, after 36 weeks of gestation, appointments may occur weekly.

Leading up to a mother’s estimated due date (EDD) our birthing team will monitor the baby and mother and facilitate routine health checks. Additionally, we’ll cover any possible pregnancy updates the mother may be experiencing, dietary options, ways to better relieve pain or discomfort, the best preparation plans for home and birth center birth, and more. 

These visits not only ensure the health of mother and child, but also simultaneously help you get to know our team and vice versa. Connection and comfortability with our birthing team and staff are an incredibly important part of the Cincinnati Birth Center experience to us.

04. The Birth

When it comes to giving birth with us, you get to choose what environment you’d like to have your experience in: at home or the birth center. Both offer different wholesome experiences while offering the same level of care and attention to you throughout all stages of pregnancy, labor, birth and postpartum stages. Prenatal visits with our team will remain the same no matter which options you choose and will include regular check-ups at our birth center where all examinations and appointments take palace. 

Giving Birth At The Birth Center
Choosing to have your child at our birthing center will allow the wonderful opportunity to give birth in a safe, warm, and calming environment with our birth team at the ready to assist the mother however possible. Immediate family is welcome to be present during the birth.

Each of our rooms offers a different style and aesthetic to what may suit each mother’s desires most. Following the birth, clients have the option to stay up to 24 hours at our facility, where a relaxing bath or shower and bed will be provided for recovery.

Giving Birth At Home
Clients who choose to give birth at home within an approved distance of the Cincinnati Birth Center may enjoy the idea of bringing their newborn into the world within the comfort and familiarity of their family home. This option allows clients to set the mood and feeling of their environment as they wish. Travel for the mother is also not involved with this option at the initiation of labor. 

Regardless of the setting each mother chooses to give birth in, our team will be on hand to help them through each step of childbirth and recovery. Following labor and birth, our team will provide routine medical care to ensure that the newborn and mother are both in good health. The comfort of the mother and child is our top priority. Skin to skin contact is important for the baby at this time, so allowing the mother the chance to hold their child will be highly recommended. 

05. Postpartum Care

With comfort and connection at the core of our team's values, we will continue to remain involved in both the mother and child’s lives post-birth. Regular postpartum visits will be scheduled up to 6 week following the birth. These visits will consist of lactation advice and instruction, recovery advice, dietary recommendations and more. Our team will be focused on the overall physical and mental health of the mother and newborn, supporting them however possible. 

It’s normal for new mothers to sometimes struggle to connect with their child during breastfeeding. If a mother finds themselves needing additional guidance on breastfeeding tactics, latching, or other needs, we encourage them to speak with their midwife/doula. The Cincinnati Birth Center offers lactation consultations following postpartum care as needed.  

Contact us and schedule a one-on-one meeting with a team member of the Cincinnati Birth Center.

Group B Strep: Here's What You Need to Know

Pregnancy can be both an exciting and stressful time for mothers. There’s a lot of information to digest regarding how to best care for your baby preterm and in the weeks that follow birth. During both periods, it’s important for expecting mothers to fully understand Group B Strep and how it could impact your pregnancy and birth.

Without the proper understanding and precautions, this common bacteria can cause life-threatening complications for newborn babies. Our team has compiled the following guide which details everything that expecting mothers should know about Group B Strep.

*Please note: The Cincinnati Birth Center cannot be held accountable regarding the use of the following information. If you’re unsure if something is right for you and your baby, please consult your doctor.

What is Group B Strep and how is it transmitted?

Group B streptococcus (otherwise known as Group B Strep or GBS) is a gram-positive bacterium that is naturally found in the lower intestine and vagina of 10-30% of all healthy adult women. A woman whose body carries GBS but who doesn’t show signs or symptoms of infection is said to be “colonized” with Group B Strep.

GBS is not sexually transmitted or contagious. Normally, GBS doesn’t cause any health problems. However, in some cases GBS may invade the body and cause serious infection called Group B Strep Disease. Babies can contract this disease from their mothers if it is present in her vagina and rectum at the time of birth. It’s also possible for GBS to be transmitted through intact membranes (before a woman’s water breaks) to the baby.

What are the risks of GBS?

In pregnant women, GBS can cause infection in the urinary tract or uterus, which are usually treated with antibiotics or alternative therapies. However, for babies GBS can pose a greater health risk. Some babies may become sick when exposed to GBS, typically within 7 days after birth. The risk of GBS is low but very serious, as it can cause pneumonia, meningitis, respiratory infections, or a blood infection which can all lead to death.

GBS is the leading cause of life-threatening infection in newborns. Preterm babies are more likely to die from GBS than full-term babies. When babies become infected with late-onset GBS disease (7 days or more after birth), it often develops into meningitis. Babies who survive any type of GBS may become blind, deaf, or have learning disabilities.

What are the risk factors of early-onset GBS disease?

Early-onset GBS is classified as babies who become sick within 7 days of birth. The risk factors of early-onset GBS disease are highest when:

• A baby is born prematurely (before 37 weeks of gestation)

• A mother develops a fever during labor

• The mother’s bag of waters are ruptured for more than 18 hours before the birth

• The mother had a previous baby with GBS disease

• The  mother is colonized with GBS in her pregnancy

**Last modified: October 26, 2021

How common is GBS disease?

Current statistics estimate that 0.34 - 0.37 infants/1,000 live births develop GBS infection. GBS causes approximately 1,200 cases of early-onset disease per year and nearly 70% of those babies were full-term. The mortality rate is 2-3% for term babies that contract GBS. In the absence of intervention, the CDC estimates that approximately 1-2% of babies born to GBS-positive mothers will develop an early-onset infection.

What are the symptoms of GBS disease?

The following symptoms could indicate GBS disease in the newborn and should be evaluated by a medical professional immediately: 

● A fever of 100 degrees Fahrenheit or more 

● Unstable temperature, either low or high (above 99 degrees or below 97 degrees) 

● Difficulty breathing (grunting, flaring of the nostrils, retraction of the ribs)
● Not eating well 

● Extreme drowsiness 

● Irritability 

● A heart rate that is either too low or too high (more than 160 beats per minute or less than 120 beats per minute) 

How can mothers know if they’re colonized with GBS?

GBS can be detected by using a sterile swab to take a sample of fluids from the entrance of the vagina and from the area around the anus. Mothers can take the sample themselves, where it will then be taken to a lab and cultured to detect the amount of GBS present. Results are usually available within 72 hours.

In hospitals, this test is routinely performed at 35-37 weeks gestation. In out-of-hospital practices, testing is offered with informed choice. Since GBS is a transient infection, the results of the swab/culture are only considered accurate for about 2 weeks. The levels of GBS colonization can make a difference, as heavy colonization is associated with the most frequent and most serious neonatal illness. At times, when there is excessive colonization, GBS can be detected in a urine culture (although it is not always possible to detect GBS in the urine). 

What are the benefits of being tested?

Being tested for GBS can help you best take appropriate action to protect you and your baby from sickness. The following are key benefits to being tested for GBS:

● If you test positive for GBS and choose to receive the course of antibiotics recommended by the CDC, the chance that your baby will develop early-onset GBS disease is very low 

● If you test positive for GBS it may be an indication for you to strengthen your immune system and flora health 

● If you test negative and need to transfer to the hospital, you will not be put on the routine IV antibiotics they use for women in labor whose GBS status remains unknown (although you may receive them for other indications) 

● If you test negative for GBS or test positive and choose to receive antibiotics, it is less likely that your baby will be tested for GBS or be required to have antibiotics for GBS if they are transferred to the hospital for any reason 

What are the risks of being tested?

There are no risks to taking the test itself and the test is fairly accurate. Local hospitals only accept GBS labs as accurate if they are done within about 2 weeks of birth, so we usually do testing at 37 or 38 weeks of gestation. 

What are the risks of antibiotic treatment?

If you choose to undergo antibiotic treatment for GBS, there are a handful of risks you should be aware of:

● Currently, there is a 10% risk of developing a mild reaction such as a rash. 

● There’s a 1 in 10,000 chance of developing a severe allergic reaction to penicillin. Anaphylaxis shock requires emergency treatment and can be life-threatening. 

● Routine use of antibiotics for GBS-positive women may produce antibiotic-resistant organisms, making subsequent infections more difficult to treat. 

● Antibiotics may produce unpleasant side effects such as diarrhea or yeast infections such as thrush, which can disturb the breastfeeding relationship. 

● Use of antibiotics may allow other bacteria in the mother and baby to become resistant (especially E. Coli) and cause other complications, which in the rare worst case can be life-threatening. 

● Use of antibiotics for GBS may have simply allowed other organisms to cause disease. 

● Use of antibiotics weakens the immune system of the newborn causing significant long-term damage (Odent, M. 2012). 

Are there alternative treatments available for GBS?

There are alternative treatments available; however, none of these treatments have been tested with scientific rigor. The healthier you and your intestinal tract are, the lower your chances are for colonization. General recommendations include obtaining enough sleep, eating a whole-food nutrient-dense diet that includes probiotic foods and low levels of processed foods. Eating vitamin C rich foods with bioflavonoids may help to strengthen your amniotic sac and reduce the chance of GBS transmission.

Here are a handful of alternative treatment methods available (which have NOT been tested with scientific rigor):

● Chlorhexidine washes during labor
There is medical evidence to suggest vaginal washing with chlorhexidine during labor is as effective as ampicillin in preventing vertical transmission of GBS. However, chlorhexidine has not been shown to reduce GBS disease in babies. A Cochrane review of the studies on chlorhexidine washes during labor led to the conclusion that there is not enough evidence to support using chlorhexidine on GBS-positive women during labor (Stade, B., Shah, V., Ohlsson, A. 2008). 

● Prenatal oral therapies (these should be done until your baby is born) 

These include high potency probiotics (20 billion or more) and multiple strains (8 or more) taken with each meal. Echinacea tincture by mouth 2-4x per day for no more than 2 weeks. Astragulus root tincture by mouth 2x per day. Vitamin C with bioflavonoids found in foods such as citrus peels, citrus, cabbage, cherries, rose hips, berries, and dark leafy greens. Garlic supplements are taken with each meal. Bee propolis (avoid if allergic to bees), several drops 2x per day. 

● Vaginal therapies 

These may include garlic sewn with a thread and inserted into the vagina at night for 12 hours. Garlic has been shown to kill GBS (Slohme-Cohaine, J., 2007). Additionally, “yoghurt sex” that is, using yogurt as a lubricant during intercourse to encourage a healthy vaginal flora. Rephresh, an over-the-counter pH balancer that will encourage the pH of your vagina to be normal, which will discourage infection. You may insert a yogurt-covered natural tampon into your vagina for 2 hours each day and/or insert a probiotic capsule into your vagina and leave it there every day. 

Is there a law requiring treatment?

Currently, there is no law requiring treatment of GBS. The state of Ohio recommends routine testing at 35-37 weeks gestation and antibiotic treatment as per CDC guidelines. 

Antibiotic treatment during labor is also recommended if the mother: 

● Has a urinary tract infection 

● Delivered a previous baby with GBS disease 

● Develops a fever during labor 

● Has not delivered her baby within 18 hours of her water breaking

● Goes into labor before 37 weeks and has not been tested for GBS 

Antibiotics usually are not needed if the mother has a C-section delivery.”

What are other important factors to consider regarding GBS? 

There are additional factors that are important to consider in regards to GBS. For one, if you carry GBS it is important that you maintain the health of your immune system. 80% of your immune system is in your gut bacteria. Avoid refined sugars and flour and eat fermented foods such as kefir, yogurt, and homemade sauerkraut or take a probiotic supplement. 

Also, it’s important to note that GBS germs can travel or be transported into the womb by vaginal exams, even in early pregnancy, and if the exams are done with sterile gloves. GBS organisms can take hold of the genital tract and even cross the mucous plug and penetrate the membranes and infect the baby or damage the placenta, which could result in miscarriage or stillbirth. In later pregnancy, GBS may be introduced by routine cervical checks and other invasive procedures such as stripping the membranes, intrauterine fetal monitoring, and the application of cervical ripening medications. Unless there is a medical indication, we do not do routine internal examinations. Some indications for internal examinations are to assess the dilation of the cervix during pre-labor or at the onset of labor and birth care, to strip the membranes after 41 weeks, to determine fetal position, to provide information for a prolonged first or second stage of labor, and to rule out cord prolapse. 

References and Resources:

CDC (2010) GBS Recommendations and reports. Retrieved from: 

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5910a1.htm?s_cid=rr5910a1_w Prevention of Perinatal Group B Streptococcal Disease 

Cheng, P., Chueh, H., Liu, C., Hsu, J., Hsieh, T., Soong, Y. (2008) Risk Factors for Recurrence of Group B Streptococcus Colonization in a Subsequent Pregnancy. Obstetrics and Gynecology. Retrieved from: 

http://journals.lww.com/greenjournal/Fulltext/2008/03000/Risk_Factors_for_Recurrenc_of_Gro up_B.17.aspx 

Falcao, R. Group B Strep. Retrieved from: http://www.gentlebirth.org/archives/gbsAlt.html Fraser, D., Cooper, M. (2009) Myles textbook for midwives, 15th ed. London, UK: Elselvier. Odent, M. (2012) Childbirth from a bacteriological perspective. Midwifery Today, Issue 102, summer. 

Ohio Department of Health. Retrieved from: 

https://odh.ohio.gov/wps/wcm/connect/gov/7844bfac-dba5-4518-a287-0ecf8954b99b/s ection-3-strep-b-newborn.pdf?MOD=AJPERES&CONVERT_TO=url&CACHEID=ROOTW ORKSPACE.Z18_M1HGGIK0N0JO00QO9DDDDM3000-7844bfac-dba5-4518-a287-0ecf8 954b99b-mymaxb. 

Ohlsson A, Shah V. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD007467. DOI: 10.1002/14651858.CD007467.pub3 

Slohm-Cohaine, J. (2007). How to treat a vaginal infection with a clove of garlic. MidwiferyToday. Issue 38, summer. Retrieved from: 

http://www.midwiferytoday.com/articles/garlic.asp 

Stade, B. , Shah, V., Ohlsson, A. (2008). Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection. 

DOI: 10.1002/14651858.CD003520.pub2 Retrieved from: 

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003520.pub2/references 6

2021 Year In Review At The Cincinnati Birth Center

Wow - what a year it’s been! After experiencing a massive surge in at-home births in 2020, we entered 2021 knowing that it would be full of its own challenges, triumphs, and lessons in business growth. What we didn’t know was just how quickly this year would fly by and the sheer growth we’d experience as a company.

This year, we welcomed over 65 families into the Cincinnati Birth Center. With support from our team of midwives and birth assistants, we had the opportunity to be a part of 61 births so far this year (and counting -- there are still a few days left in 2021!)

Since the start of the year, the Cincinnati Birth Center itself has grown both as a team and a facility. Currently, our team is made up of three full-time employees and two part-time birth assistants. Additionally, we have two backup physicians on hand to assist us as we grow and a robust team of five Board of Directors. Together, this small but mighty team has gone to great lengths to ensure that every family that visits our center receives the highest quality of personalized care possible. We’ve also been working hard to make progress on the construction of the Cincinnati Birth Center itself and create a safe space for women and their families to grow.

As of this November, we’ve obtained necessary operation permits and have renovated the second-floor bathroom, upstairs office, and will begin construction on the ADA bathroom any day now. We’ve installed a wheelchair ramp and handrail, decorated the downstairs waiting and exam rooms, and are finishing painting throughout the center.

Due to some hold ups in obtaining permits, renovations to the property have been moving slower than we initially anticipated. However, we’re so proud of how far we’ve come and all that we’ve been able to accomplish together amid a global pandemic and a record-setting number of home births.

"Reflecting on 2021, I feel so thankful. While it took many months longer than expected to obtain the necessary permits from the City of Cincinnati for the ADA bathroom and wheelchair ramp, it all worked out so that we could chip away at other projects in the meantime. Our practice has continued to grow and we are working to create a seamless experience for our clients from their first phone call through their six-week postpartum visit, with births occurring in family homes while the center finishes renovations. A lot of credit goes to Luke Armbruster, our Director of Marketing and Operations. He has helped to write policies, polish our client documents, and build our email and marketing strategy. With the purchase of the neighboring lot, we have been able to draft up a parking lot and are undergoing a consolidation of lots to be able to offer a 10 car parking lot with a children's play area and garden for those visiting our birth center. We’ll be starting to create the ADA bathroom any day now. All of this is in addition to the opening of the birth center for births in 2021. Stay tuned!"

 -- Meghan Nowland, Owner of Cincinnati Birth Center

At the Cincinnati Birth Center, our goal is to break down barriers, create connections, and assist those seeking alternative birthing services allowing them to begin and grow their families in a personal, intimate, and calming environment. We are so proud to have this opportunity to serve our community in such a meaningful and impactful way and look forward to what we’ll accomplish together in 2022.

Wishing a happy new year to you & yours from all of us at the Cincinnati Birth Center!

Now tell us what you’d like us to provide to you in 2022 by commenting below.

How to Take Control of Your Health and Get Started with FEMM

Many women are used to tracking some aspect of their lifestyle regularly - their diet, financial spending, physical activity - but what about your ovulation? As a woman, learning how to track your body’s ovulation cycle is imperative to unlocking your health.

Whether you’re trying to become pregnant or are trying to prevent pregnancy, understanding the way your reproductive system works can help you and your partner make decisions about your family planning that feel right to you. It can also help you understand and monitor hormonal symptoms such as acne, anxiety, depression, cycle irregularity, and migraines. While there are many different methodologies for tracking your cycle, one of the most highly regarded natural methods of tracking is called FEMM. 

What is FEMM?

FEMM stands for Fertility Education and Medical Management. It’s essentially a form of natural family planning that uses scientific information about your body, such as cervical mucus observation and urinary hormonal levels, to signal how fertile you are at any point during your cycle.

Why use FEMM?

FEMM uses science-based information and research to help you understand your unique cycle. What we love about FEMM is that it emphasizes that while there are certain common health parameters for reproductive health, every woman’s body and cycle is unique. Using FEMM’s guiding principles, you can better understand your individual patterns and monitor your health.

We also love that when a woman encounters gynecological issues, FEMM aims to treat the root of the cause rather than the symptoms. Additionally, FEMM helps women become more engaged with their health and ultimately make informed decisions that are right for them.

Tips For Getting Started With FEMM

At the Cincinnati Birth Center, we aim to create a safe place for women to grow throughout every step of their reproductive journey. We believe that for women to feel safe and supported, they need to also feel informed about their health. FEMM is an excellent way to unlock your health and get comfortable at listening to your body and its needs.

Interested in getting started with FEMM? Here’s what our team recommends:

• The simplest way to start is to download the free, FEMM App 

• Schedule a fertility consultation with our team at the Cincinnati Birth Center and we can show you how to use the app and start tracking hormonal health

• You can find a certified FEMM provider by visiting https://femmhealth.org/medical-providers/. 

Still have questions about FEMM and how you can take control of your reproductive health? Schedule a free consultation with us by calling 513-399-7263 or send us a message.

Unlocking Your Health: Gestational Diabetes

Each year, approximately 2-10% of pregnant women in the United States are affected by gestational diabetes. The commonality of this diagnosis among pregnant women can feel intimidating and scary. However, it’s important to learn about gestational diabetes - including how to identify, treat, and prevent it - to ensure that you have a safe and healthy pregnancy.

*Please note: The Cincinnati Birth Center cannot be held accountable regarding the use of the following information. If you’re unsure if something is right for you and your baby, please consult your doctor.

What is gestational diabetes?

Gestational diabetes is a type of diabetes that can develop in pregnant women who did not have diabetes previous to their pregnancy. It occurs when your body can’t naturally produce enough insulin, thus causing high blood sugar. Oftentimes, gestational diabetes will go away in the weeks following delivery as hormone and blood sugar levels return to normal.

What causes gestational diabetes to develop?

While researchers still aren’t entirely certain why some women develop gestational diabetes and why others don’t, it’s believed that excessive weight before pregnancy often plays a role. 

Usually, your body will regulate its hormones to keep your blood sugar levels in check. However, when pregnant your hormone levels are constantly changing, making it more difficult for your body to process blood sugar efficiently. This can cause your blood sugar to rise.

How can I identify if I have gestational diabetes?

Gestational diabetes often doesn’t show noticeable symptoms. You may notice an increase in thirst and urination, which can be possible symptoms. There are, however, common risk factors that may make you predisposed to gestational diabetes. These include factors such as:

• Overweight & obesity pre-pregnancy

• Lack of physical activity

• Previous gestational diabetes or prediabetes

• Previously delivering a baby of 9lbs or greater

• Race - Women who are Black, Hispanic, Native American, and Asian American are statistically at a higher risk of developing gestational diabetes

In order to confirm whether or not you have gestational diabetes, you’ll need to be tested. For more information on identifying risks and testing for gestational diabetes, contact your doctor.

Treatment of Gestational Diabetes

If you are diagnosed with gestational diabetes, your doctor may prescribe you a treatment plan. This may include:

• Checking your blood sugar regularly

• Eating a healthy diet or following a prescribed meal plan

• Getting physically active

• Monitoring your baby’s growth & development regularly throughout the pregnancy

If you have gestational diabetes and do not follow recommended treatments by your doctor, you may be at risk of facing complications. Gestational diabetes complications that may affect your baby include excessive birth weight, preterm birth, breathing difficulties, low blood sugar which can cause seizures, obesity and Type 2 diabetes later in life, and stillbirths.

Additionally, untreated gestational diabetes can cause complications for mothers. These may include high blood pressure and preeclampsia, a higher likelihood of C-section, and future diabetes. 

How To Prevent Gestational Diabetes

There are no guaranteed ways to prevent gestational diabetes. However, there are precautions you can take to lower your likelihood of risk. These include:

• Eating a healthy diet

• Remaining physically active

• Beginning pregnancy at a healthy weight

• Not gaining excessive pregnancy weight

Have further questions about gestational diabetes prevention and treatment that you’d like to ask our team? Contact us. 

Sources
“Gestational Diabetes.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 10 Aug. 2021, https://www.cdc.gov/diabetes/basics/gestational.html. 

“Gestational Diabetes.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 26 Aug. 2020, https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339.

What Is Postpartum Care? Here's What It Should Look Like

Following childbirth, women enter a period called “postpartum.” During this period it can be overwhelming to know what to do in the days and weeks following the birth of your newborn. Mothers not only face the challenges of taking care of a new baby, but they also often face challenges in recovering from birth and pregnancy themselves. To ease any uncertainties you have and help make your postpartum experience a positive one, our team is sharing the Cincinnati Birth Center’s postpartum instructions that we provide new mothers with:

*Please note: The Cincinnati Birth Center cannot be held accountable regarding the use of the following information. If you’re unsure if something is right for you and your baby, please consult your provider.

Postpartum Care For Babies (First 24 Hours)

Sleep
Your baby’s first sleep may last up to 4 hours. Afterward, the baby should be awake to nurse every 2-3 hours. The American Academy of Pediatrics recommends babies be put to sleep on their back to reduce the risk of Sudden Infant Death Syndrome (SIDS). However, during the first few days of life, your baby will be working up mucus in their lungs or may spit-up. In order to prevent choking, we recommend the baby be put to sleep on their side by propping the baby up using rolled-up blankets. The baby should be kept close to you while sleeping.

IF THE BABY BECOMES LISTLESS, LETHARGIC, OR DIFFICULT TO WAKE CONTACT YOUR MIDWIFE USING THE 24-HOUR URGENT ON CALL NUMBER PROVIDED BY THE CINCINNATI BIRTH CENTER.

Eating
Breastfed newborns should nurse at least every 2-3 hours for 10 minutes (minimum) can have 1 combined sleep stretch per every 24 hour period (4-5 hours). Your breasts will produce enough colostrum the first few days. This food is perfect for your baby by providing them with everything they need, including antibodies that help prevent infections, until the mother’s milk comes in (naturally). Your baby does not need anything else, including water. Wake the baby if they skip more than one feeding.

IF THE BABY REFUSES TO EAT MORE THAN TWO FEEDINGS IN A ROW, BECOMES JITTERY OR HAS A HIGH-PITCHED SHRILL CRY, CONTACT YOUR MIDWIFE USING THE 24-HOUR URGENT ON CALL NUMBER PROVIDED BY THE CINCINNATI BIRTH CENTER.

Elimination
Your baby’s stool, known as meconium, will be sticky and dark for the first two days on average. They will have several bowel movements each day. Urination should occur within the first 24-hours and stool movements should take place within the first 48-hours. Urine is sometimes difficult to see. Placing a toilet tissue square in the diaper can help you  identify urine more easily.

IF YOUR BABY HAS NOT URINATED WITHIN THE FIRST 24-HOURS, CONTACT YOUR MIDWIFE USING THE 24-HOUR URGENT ON CALL NUMBER PROVIDED BY THE CINCINNATI BIRTH CENTER.

Skin Care
Olive oil, coconut oil, or an unscented non-mineral based lotion or oil can be used on the baby’s bottom to help the meconium not stick or for very dry skin. Do not use powders on the baby because these can irritate the lungs. Blue hands and feet are normal in the first 24 hours.

IF SKIN COLOR BECOMES BLUE AND APPEARS ANYWHERE OTHER THAN HANDS AND FEET CONTACT YOUR MIDWIFE USING THE 24-HOUR URGENT ON CALL NUMBER PROVIDED BY THE CINCINNATI BIRTH CENTER.

Cord Care
Keep the diaper folded under the cord. Do not put anything on the cord. The cord usually falls off in 3-5 days. There may be a slight odor as the cord dries and decays.

IF THE CORD BEGINS TO SMELL ROTTEN OR THE BELLY HAS STREAKS OF REDNESS COMING FROM THE CORD AREA CONTACT YOUR MIDWIFE USING THE 24-HOUR URGENT ON CALL NUMBER PROVIDED BY THE CINCINNATI BIRTH CENTER..

Temperature
Your baby will not be able to regulate their own temperature for the first 24 hours, so skin-to-skin contact with you is crucial. Normal under-arm temperature in the newborn is 97°-99°. If temperature seems to be above or below normal, adjust clothing and retake temperature in 30 minutes.

IF THE BABY’S TEMPERATURE DOES NOT RETURN TO NORMAL RANGE OR THERE IS A CONTINUOUS RISE AND FALL IN TEMPERATURE, CONTACT YOUR MIDWIFE USING THE 24-HOUR URGENT ON CALL NUMBER PROVIDED BY THE CINCINNATI BIRTH CENTER.

Breathing
It is normal for your baby’s breathing to be irregular. Signs of difficulty include nasal flaring, chest retractions, grunting with breathing, or breathing very fast. Normal respiratory rate is 30-60 breaths per minute, but you must count for a full minute. Count the breaths anytime they seem unusual.

Sunning the Baby
Jaundice is not normal during the first 24 hours. To help prevent jaundice, begin sunning the baby daily. Remove clothing and place the baby in direct sunlight for 3-5 minutes on each side twice a day. Protect the eyes from light and the baby from drafts. If the weather is cloudy or below freezing, place the baby in front of a window (inside) for 20 minutes 2-4 times a day.

Postpartum Care For Mothers

Recovery
After birth, it’s important that you continue taking your prenatal supplements and remember that you are not only recovering from birth but from 9 months of pregnancy as well. Eat lots of food with protein and iron. Rest and try to sleep when the baby sleeps. Ask for help around the house. Use the peri bottle to rinse after you urinate and avoid wiping with toilet tissue (you may use it to blot dry).

Postpartum Bleeding

The amount and length of postpartum bleeding is dependent on many things. In the first 24

hours, expect to bleed like a heavy period. It will smell like it too. If you bleed a dinner-plate-sized amount onto a chux pad in less than an hour, or are soaking a pad within 20 minutes, you are bleeding too much. Keep in mind, when you lay down, your blood pools in your vagina and will flow outward when you arise.. Urinating every few hours and skin-to-skin contact with your newborn will help to minimize bleeding.

IF YOU SUSPECT TOO MUCH BLEEDING CONTACT YOUR MIDWIFE.

Expect to bleed fresh blood for about 1-2 weeks following birth. This will taper off and become whitish or brownish for an additional week or two. Nursing and resting will reduce postpartum bleeding. Other signs that indicate you may want to contact your midwife:

● Temperature above 100.4.

● Hot, burning pain in the calf or thigh.

● Blurred vision, dizziness, or fainting.

Postpartum Checklist (Cincinnati, OH):

● Call your pediatrician within 5 days to schedule an initial visit for your newborn. Ask them if they perform the newborn PKU screening. If they do not, you will need to have it performed at Children’s or the City of Cincinnati Health Department located on Elm Street. 

● If you choose to circumcise your newborn you can schedule it with Dr Schwartz (513) 241-4288, Sara Ferguson (859) 512-7472, Rabbi Herszage (614) 580-0416, or Rabbi Heinemann (513) 835-5005. The cost is $300.
● Schedule a newborn hearing screen with Children’s Hospital Audiology at (513) 636-4236

Plugged Ducts
The specific cause of plugged ducts is unknown, but they are usually found in mothers who have an adequate milk supply and have not adequately drained each breast. It is a stasis or clogging of milk that occurs more frequently in the winter season. Plugged ducts can lead to mastitis if ignored and not properly treated.

Plugged ducts symptoms include:

● Tenderness, heat, and a palpable lump with well defined margins which is not accompanied by a generalized fever.

● Redness in one area of the breast.

● Sometimes a plugged duct can be visible as a tiny, white plug seen at the opening of the duct of the nipple.

If you have signs or symptoms of plugged ducts:

● Breastfeed often. Feeding should begin on the affected breast to promote drainage. Your infant’s chin or nose should be pointed in the direction of the lump.

● Avoid wearing constrictive clothing such as an underwire bra or the straps on a baby carrier

● The affected breast can be soaked leaning over a basin of warm water, then massaged

● Change positions of the infant during feedings to ensure drainage of all the sinuses and ductules of the breast. Massage the affected breast before and during feeding to stimulate flow of milk.

● Massage breasts in a hot shower or bath.

● Having plugged ducts predisposes you to mastitis, so it is important to address plugged ducts right away

Mastitis

Mastitis is most likely to occur in the first weeks following delivery. About one third of all cases occur after the infant is six months old and another one fourth of the cases occur after the infant is twelve months old. Factors predisposing women to mastitis are: stress, fatigue, cracked nipples, plugged ducts, constricted breasts, engorgement, milk stasis, and an abrupt change in frequency of feedings.

Mastitis symptoms include:

● Fatigue, localized breast tenderness

● Flu-like muscular aching

● A temperature above 100.4 F

● Tachycardia (fast heart-rate);headache; flu-like symptoms

● The appearance of a hot, reddened area on the breast, or the appearance of a boil on the breast

If you have signs and symptoms of mastitis:

● Rest, nurse, hydrate, and eat well

● Contact your provider if your signs and symptoms are worse after 24 hours and we will discuss with you the possibility of beginning treatment with antibiotics

● Contact your provider if your signs and symptoms have not improved after 48 hours and we will discuss with you the possibility of beginning treatment with antibiotics

We hope these instructions prove helpful for you and your family as you enter the postpartum period. Have further questions about postpartum care that you’d like to ask our team? Contact us.