Natividad Medical Center is located at 1441 Constitution Blvd, Salinas, California. Natividad is one of the few county run hospitals left in California. It is a non-profit hospital, "a California survey found that women were 17% more likely to have a cesarean at a for-profit hospital than a non-profit" (Optimal Care in Childbirth by Henci Goer). Natividad is also a teaching hospital, which is sometimes a bad thing when you have doctors eager to give residents an opportunity to practice their skills, sometimes when they aren't necessary. However, at Natividad it is a positive.
Most of the doctors that catch babies at Natividad are up to date on the latest research and seem eager to work with their patients, I personally have felt an attitude of learning is encouraged. I chose Dr. Peter Chandler, Natividad’s Obstetrics and Gynecology Services director, as my doctor when I transferred to Natividad. In our first appointment he was referencing my favorite natural birth documentaries and had listed some topics for me to look up on PubMed, a refreshing change from doctors who seem threatened or bothered by an informed mother.
Natividad is the only hospital in Monterey County that offers VBACs (vaginal birth after cesarean). In 2011 Natividad had a 60% successful VBAC rate (The Holistic Hole, Monterey County Weekly). Even if you are not having a VBAC, it is good to know if your hospital allows them. If they do it is a sign that they follow the American College of Obstetrics and Gynecology's guidelines and that they provide evidence-based care, care that is supported by research and science, as apposed to fear-based care, opinion-based care, or convenience-based care. Out of the 2812 total births at Natividad in 2011, 28.3% of them were cesarean section (www.cesareanrates.com), lower than the national average of 32.8%, but still higher than the World Health Organization's recommendation of 10-15%.
In 2011 Natividad had the lowest epidural rate (45%) and lowest induction rate (15%) in Monterey County.
Like Dominican and Sutter in Santa Cruz, Natividad now offers mothers the option of having a certified nurse-midwife deliver your baby, which no other Monterey County hospital offers. This is standard care for low risk mothers in all other developed countries and has been shown to result in better outcomes in mothers and babies (read more here).
From Natividad's website:
"The Maternal Infant Unit is a 26 bed unit promoting family-centered care and provides a full range of care to childbearing women, the normal newborn, and their families. Fathers and significant others are included in our family-centered care... Education and support services, including infant CPR classes, lactation support and information on women’s topics are offered. A Lactation Consultant is available 7 days a week providing individualized instruction."
We did have our third son, Indiana, at Natividad, you can read his birth story here. We visited the hospital a few times before his birth, to tour and we were admitted a few times for various reasons, you can read about one of those visits here. Here's a picture I snapped of the beautiful light filled room we were given. Not fancy, but I loved all the windows and how big the room was. Not all rooms come equipped with bored husbands, just mine.
The following is from a Monterey mom, Wendy, who had her baby at Natividad, these are just some snippets from her incredible home birth turned induction at 43 weeks:
We arrived, birth plan in hand, and got settled into a room. From the get go, I retained as much control as one can when you are checking yourself into a hospital. Knowing that they couldn't turn me away I felt empowered to assert my right to respectfully refuse anything that I wasn't comfortable with, starting with the hospital bracelet they wanted me to wear but that I promptly took off... Dom set up our room, with a sarong over the bright light, my blanket on the bed, our music on the ipod, snacks for the nurses laid out by the sink, copies of our birth plan distributed widely... We claimed the space as our own. I dressed in the special nightgown that Bestie had given me. I texted my mom and the midwives to come join us.
More reviews from Monterey County moms:
“If I had been at any other place they probably would have done a C-section. They were just so patient. They met my every need, emotionally and physically.” (The Holistic Hole)
"The neonatologist, Dr. Bruni, was awesome. The labor room was huge and spacious, that was cool. We had some scary stuff going on, the nurses were great. The surgeon, Aguillera, was amazing. I went to visit my cousin there last week, her nurse gave me an SNS (supplemental nursing system) when I told her my baby had IUGR (intrauterine growth restriction). The way they handled my baby's transport was super great, my nurse stayed after to see her off. I would recommend them in a hot sec."
"I loved my [labor & delivery] nurse. The after care? Not so great. They stuck me in a back room and basically ignored me."
"They explained every step they were going to take... When it came to pushing my doctor was in the room the whole time. She as well was pleasant. We had a good relationship, she was trying to make jokes to ease some of pain. If I told her I felt like I had to push, she wanted me to push, if I felt like I couldn't anymore, she wanted me to take a break... My overall experience delivering at Natividad was positive. Would recommend any one and everyone to deliver here."
I include every review that is sent to me, if there is helpful information that you would like me to include, please let me know.
Learn more about local hospitals and read reviews from local women:
Community Hospital of the Monterey Peninsula
Natividad Medical Center
Salinas Valley Memorial
Sutter Maternity and Surgery Center
Did you give birth at Natividad Medical Center? Please share your experience in the comments below!
I'm sharing this post from my personal blog, posted exactly a year ago. Since I wrote this I have had another son, and we chose to not circumcise him. This post is really about the journey that led to that decision.
4/22/15 - We have welcomed a 4th son and he is also intact. Caring for intact babies has proven to be much easier than circ'ed. Two circ'ed boys and two intact, and no one thinks it's weird.
Right now the natural birth and parenting community is blowing up over the American Academy of Pediatrics revision of their policy on infant circumcision. In 1999:
"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."
And now this just in:
"Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it."
They repeat this about a bazillion times then sneak in:
"Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns."
Whatever. Either circumcision is a good idea for non-medical reasons or it's not. I'm not going to labor on over this because so many others are saying it. No new evidence is provided, but suddenly the AAP is making a stronger case for the benefits. It looks like the steady decline in infant circumcision (80% in 1950's, 65% in the 1990's, now 55% nationally and 30% in western states) and the loss of the hundreds of millions in revenue for both preforming the procedure and selling the foreskins for research/cosmetics AND the decline in insurance companies covering the procedure when there is no medical indication for it are all making the AAP and the American College of Obstetrics and Gynecology (who are endorsing this statement) sweat. What? Why are the vagina doctors getting involved? Most circumcisions are actually done by OB/GYN's, not pediatricians.
However, this isn't another why you shouldn't circumcise your baby post with statistics, studies and a picture of a screaming baby. It's a post about why Eric and I have remained unconvinced by the intactivist movement and what finally tipped the scales.
Eric and I watched the circumcision episode of Penn & Teller's Bullshit while we were dating, maybe we were engaged. At the end of the episode we had a big "would you circumcise your kid" discussion. He felt like it was an easy decision because noncircs look horrible and he always felt bad for people who weren't circumcised. I felt like it was perhaps risky and unnecessary, but not unlike when women look in the face of science and say "nope, breastfeeding is weird, pass the formula," I couldn't get passed my personal dislike. No man should have to live with that... off with their heads... or whatever.
I still hoped we would not have boy because I just didn't want to make that decision for him. We found out we were pregnant with Milo so we had the talk again. I had statistics and descriptions of the procedure, but the gross factor won and we chose circumcision, which we watched and it seemed to go smoothly, we didn't know that babies sleeping through a circumcision was a stress response, but like so many other parents we found it comforting.
Another pregnancy, another boy, and another dive into the research. It really felt like for every study that showed a few benefits like an association between fewer cases of penile cancer or STDs, there was another study showing the opposite or an article showing why the first study was flawed -- and we are talking less than a percentage point in increased or decreased incidences of some things! Then there was all the information about how circumcision can disrupt sexual function later in life because the usually protected skin on the head thickens and gets less sensitive... and because like 50% of the nerves are removed during circumcision. But... Eric and I were also thinking, how many guys need to be more sensitive? Isn't that a problem? Has anyone ever thought "this would feel so much better if I had 20,000 more nerves." Probably not. Plus, the studies about actual sensitivity differences are often small, and again for every conclusive result there is another study with the opposite or an inconclusive one. Huge headache. And... then our kids wouldn't match, would that be weird? Would that be telling Milo his penis was a mistake. Sorry son, you only get one and we fucked it up, good luck with that. So we circumcised Ash, for me, mostly based on that last issue. The evidence was not great enough to risk Milo feeling bad. It was one of my weaker decisions, and Ash and I both paid for it.
Ash's circumcision when horribly. The pediatrician would not let us be in the room, Ash was hysterical the whole time and I cried in the waiting room. This went strongly against my instincts to protect my baby and something still wasn't adding up. I began hoping circumcision would just become illegal before we had another boy.
Our third pregnancy, and the intactivist's articles are flooding my news feed and my favorite blogs following the leaks of the AAP's coming announcement. I decided to reopen the case on circumcision and Eric agreed to keep an open mind.
There are buckets of studies and facts to support my decision to birth naturally and to breastfeed, but even if they didn't exist I would still do both. Not because they are super fun or because I'm competing for some better mom award (if you are, there isn't one), but because I believe we are designed. My faith in the fact that God made no mistakes when He created our bodies and their functions prevents me from being able to believe that most women are not meant to birth normally without drugs or medical assistance, and if we have breasts that make milk that babies like that we aren't meant to feed them that way. It's important for me to reach all women, not just those who subscribe to my belief system, so I inform myself of all the facts and studies as well... but for me... I don't hold my breath and hope everything I know about birth doesn't crumble every time a new study is published.
When I applied the same way of thinking to circumcision, my brain just about short circuited. God designed foreskins, organs with functions. He also commanded the Jews to circumcise themselves as a covenant with Him. We know that for Christians this is a non-issue with the sacrifice of Christ and New Covenant we now have. But why would God command His people to do something that could potentially lead to sexual dysfunction, hemorrhage, and infection? Eric and I believe in the inerrancy of the Word of God and that scripture in the original language and historical context is perfect, Old and New Testament. Any kind of perceived contradiction must be an error in the English translation or a misunderstanding of the context.
I checked the Hebrew word for circumcise, muwl, and it means to cut, some argue it means to cut and not remove, but my usual sources simply said to cut.
So I checked the history of Jewish circumcision. I rarely feel like the Jews lead me astray if we are talking Old Testament. For the most part their traditions seem to be more closely aligned with scripture than Christians'. Perhaps it's because they have a better understanding of their history, which is obviously Biblical history and how scripture matches up to that, or because more of them speak Hebrew and less is lost in translation. Because I feel rabbis' have a better understanding of scripture than many pastors, it's hard for me to not trust that their bris is not how God intended it.
Turns out... it's not...
Brit milah is the cutting of the end of the foreskin, enough to draw blood necessary for the sacrifice and to look different, marking the skin of God's people. To see a drawing of what it looked like, you can go here. The foreskin still covered the head/gland and function was preserved. It would have been a minor procedure compared to the full removal of the foreskin that is done today. It seems it should be obvious that if under medical supervision and access to antibiotics nearly 200 babies in the US die from circumcision that many more would have died in ancient times. Weren't many of God's commandments for the Jewish people to preserve their race? In case you are about to argue with me, yes... they were.
Commanding His own chosen people to take part in a ritual that could potentially kill many and cause sexual dysfunction for others does not make sense. Neither history or scripture support that this was the case. So where did the full removal of the foreskin come from?
"Many Hellenistic Jews, particularly those who participated in athletics at the gymnasium, had an operation performed to conceal the fact of their circumcision (1 Maccabees 1.15). Similar action was taken during the Hadrianic persecution, in which period a prohibition against circumcision was issued. It was probably in order to prevent the possibility of obliterating the traces of circumcision that the rabbis added to the requirement of cutting the foreskin that of peri'ah (laying bare the glans)." - The Oxford Dictionary of the Jewish Religion, ed. R.J. Zwi Werblowsky and G. Wigoder. Oxford University Press, 1997, page 161.
The medical procedure that exists today is not what God commanded Abraham to do to himself or his people, it was invented by men to support their religion. I'm forced to review my other reasons to circumcise and nothing holds up in the context of design. There is just no reasonable reason to circumcise your perfect new baby!
When we were making the decision for our first son I thought I personally didn't like the look, but first off, God designed me to want the man He made me for. He knew Eric's parents would circumcise him (which Eric now wishes had not happened), and that's what I like. But also, a lot of my dislike had nothing to do with what an intact penis actually looked like. Have you seen one? Erect they look the same as a circumcised penis. What I did know were the joke about the intact penis. The reality looks very... normal. Because that's what it is. Either way, it's not for us to decide if it looks good or not. God made it, it has to good.
And if you do not believe in God... this all still applies. What is more important to any species that the reproductive system? Every mammal has a foreskin, that would be a pretty huge evolutionary mistake!
I'm not worried about our sons, even if we end up with both circ'ed and intact littles. Children are accepting of differences when they are explained in a matter of fact way. I remember one mom shared that her son just said he was "differs" from his brothers. I don't feel any guilt over circumcising Milo or Ash so they or future sons would not be able to pick up on that. They were not mistakes, just different decisions made with different information.
So now a year later with a new little boy, this one kept whole, my feelings have changed some. I do feel regret over circumcising Milo and Ash. The truth is that Eric and I don't know what kinds of consequences our decisions will have for them in the future. I wish I didn't have the memory of Ash's screams, or Milo's long... honestly quite disturbing... healing time. That bothers me, but sometimes regret is what drives us to do better. As parents we will never be perfect, but we need to at least do better when we know better, and Eric and I feel good that we are at least doing that.
Sutter Maternity & Surgery Center is located at 2900 Chanticleer Ave in Santa Cruz, California, right across the street from Dominican Hospital. Some people (myself included) have mistaken Sutter for a freestanding birth center. We do not have any freestanding birth centers on the central coast. A freestanding birth center, like Sutter, employs both midwifes and sometimes obstetricians, but do not offer epidural or narcotic pain relief and do not do cesarean sections like Sutter does. Sutter, however, still may be a good choice for couples planning an unmedicated birth and prefer a less hospital like environment.
From Sutter's website:
"We have both doctors and midwives on staff, which means you have a choice in your obstetrical care. We have 12 birthing suites to accommodate you before, during and after your baby is born. Some of our suites include an in-room Jacuzzi. For suites without an in-room Jacuzzi, a private one is available."
Sutter is supportive of women who choose to birth vaginally after having a cesarean (VBAC). Out of the total of 978 births at Sutter in 2012, 23.5% of the births were by cesarean section, (www.cesareanrates.com). Though this rate is below the state average of 33.2% and lower than all of the Monterey County hospitals, it is above the World Health Organization's recommendation of 10-15%. Sutter is a non-profit hospital, "a California survey found that women were 17% more likely to have a cesarean at a for-profit hospital than a non-profit" (Optimal Care in Childbirth by Henci Goer).
Sutter is certified as Baby-Friendly, meaning they utilize evidence-based practices in the postpartum such as immediate skin to skin, support in breastfeeding, and rooming in.
An expecting Monterey mom shared her thoughts and a couple pictures from her tour:
"The rooms are huge, bright and sunny, with a balcony you can walk out on (Dominican has patios but they don't let you out on them for security reasons)."
"And half of their rooms have the jacuzzi tub in them. The other half have only the shower, but there's a separate tub room those rooms can share. My pic doesn't show it, but they even have fake candles to make a soothing environment.
"They have a nutrition closet where you can grab drinks and snacks any time, plus you can order food from their cafe 24/7.
And another Monterey County mom shares her birth experience:
Hands down Sutter Maternity was amazing. We toured CHOMP, Dominican, and Sutter and immediately knew where we were going.
You can read more reviews of Sutter on yelp, here are a few excerpts:
"If you want to have a low-intervention or non-medicated childbirth, this is the place. It's the best of both worlds. Although I had a natural childbirth, I was glad the technology was there when we needed it, because my son had some heart rate issues during delivery."
"I do not care where you live....if you are pregnant...and you want an amazing birth experience.... GO TO SUTTER MATERNITY!"
"Giving birth here was like being a VIP, staying in a 5-star resort hotel. The nurses were so amazing and the chef downstairs whipped up gourmet meals daily."
"Staff was AMAZING. With my first child, I had a nurse by my side for 24 hours, literally. One nurse spent the night by my bedside (Due to some complications, but where else can you say you get your own private nurse?)"
Learn more about local hospitals and read reviews from local women:
Community Hospital of the Monterey Peninsula
Natividad Medical Center
Salinas Valley Memorial
Sutter Maternity and Surgery Center
You can view and download a chart comparing hospital options and amenities here.
Did you give birth at Sutter Maternity & Surgery Center? Please share your experience in the comments below!
The Gentry family has pizza once a week, at least, and I always make my dough from scratch. It's not so bad, but between the mixing and kneading and rising I need to remember to give myself at least an hour just for the dough. Enter my fave cooking related show, The Chew. There are a lot of cooking shows that I enjoy: Lidia's Italy, America's Test Kitchen, even New Scandinavian Cooking - mostly because they cook right on the shore and it's super pretty...
But if I'm really honest with myself I will probably never cook anything on any of those shows. Even watching Rachael Ray I'll be like "Oh maybe that IS what's for dinner tonight!" but it never is, I mean who keeps pancetta on hand?
But the recipes on The Chew I really use! There's one in particular that totally blew my mind: Daphne Oz's Easy Pizza Crust AKA Daphne Oz's Greek Yogurt Pizza Crust! No more kneading or waiting for dough to rise! ...or less waiting at least.
The best part of this recipe is that it's made with Greek yogurt. I prepare something for my students every week and really my class may as well be titled: "Ways to Use Greek Yogurt." When you are pregnant you should be shooting for 80 grams of protein a day and 1 cup of plain Greek yogurt packs in 23 grams of protein! I use it in muffins, in dip, with fruit, as a substitute for sour cream... and now I use it in pizza! Daphne Oz's pizza crust is 2 ingredients: 1 cup of plain Greek yogurt and 1 cup of self rising flour. Mix, let it rest for 30 or so minutes, then press out and top. So simple. However I don't keep self rising flour on hand, so here is my recipe
Depending on what kind of flour you use (Wheat Montana is my fave) 1 small pizza crust (depending on how big you press it out you could make a personal size pizza or share with another person) will have 47 grams of protein! So lets say you share it with your husband, top it with just cheese and veggies and that's still 30 grams of protein for each of you... and you could still chicken or a turkey pepperoni or sausage for even more protein. You'll need: 1 cup of whole wheat flour 1 cup of plain Greek yogurt 1 tsp celtic sea salt 1 tsp baking powder Combine til smooth-ish. Knead out a bit. Let rest for 30 minutes, which is about the amount of time it takes me to wash and chop veggies with three babies demanding my attention. Press out, it will be sticky so use some flour. Sauce, cheese, and toppings! My fave toppings are artichokes, red bell pepper, olives and spinach... but sometimes plain ole turkey pepperoni is just this "this feels so bad but it's really not" meal I've been craving. Bake at 400-425... til crust is crispy.
Natural Birth Series
Sept 28 – Nov 15
Infant Sleep for Expecting & New Parents
6:30pm - 9:00pm
Gentle Cesarean: Planning & Recovery
Toro Park, 3-6:30pm
Natural Birth Refresher
Salinas, 1– 4pm
Preconception & Early Pregnancy Class
Salinas, 1– 4pm
Sibling Prep for Parents & Kids
November 4th & 5th
Toro Park, 2:-4pm
Fall Home & Birth Center Birth Series
Nov 7 – Dec 12
Natural Birth Series
Nov 29th – Jan 17th