Matrescence by Diana

11/25/2025

A big YES to outpatient cervical ripening, Spinning Babies and better childbirth ed. My hometown (area) of Rochester NY is featured in this article!

Financial and social incentives can nudge doctors away from the operating room.

11/21/2025

The annual Volume One “Best of the Chippewa Valley” poll is open…thank you to whoever put me into this! Always makes me feel very official😅

If you are planning to vote, the link is below 👇🏼 FYI you have to “create an account” to complete the process.

https://volumeone.org/bestof/563/questions/17164-best-doula

You can also vote for your favorite midwife and birth center!

{PS— these are the glasses I am still missing, so if anyone sees them please lmk}

11/20/2025

Sometimes births collide and you have two doula babies born in one day 👶👶 both first time parents, both dealt very different decks of cards than expected.

As a doula I am proud to stand by families through ALL types of births.

The 42 weeker in long-awaited spontaneous labor;

As well as the person experiencing multiple overlapping complications resulting in preterm birth.

The person who manages to go totally unmedicated;

AND the person who needs or strategically utilizes intervention to preserve their best chance at a good outcome.

The person who achieves their goals;

and the person who bravely lays down their birth plan as the first sacrifice of motherhood.

The client who births vaginally;

and the client who needs the OR.

One is not better or stronger than the other; they are both appropriate to their unique circumstances; they are BOTH a victory and awe-inspiring.

Special thanks to fellow doula Rhonda for stepping in as backup for a few hours, and to the nurses and anesthesia team at Marshfield Clinic for getting me back to my (second) client quickly.

Please join me in celebrating these two very different births, both beautiful and powerful in their own way. The strength and resilience of people crossing their unique threshold into parenthood never ceases to amaze me!

11/19/2025

Article linked in comments

The standard method for closing the uterus after cesarean delivery, used for over 50 years, may be causing a host of long-term health issues for millions of women.

According to Dr. Emmanuel Bujold and Dr. Roberto Romero, leaders in obstetrics and gynecology, current closure practices—where sutures join the uterine lining with surrounding muscle—fail to restore the uterus’s natural structure, leading to serious complications.

Their exhaustive review reveals the risks: abnormal placenta attachment affects up to 6% of women, uterine rupture up to 3%, and premature births up to 28%. Many suffer pelvic pain (up to 35%), excessive bleeding (up to 33%), and endometriosis or adenomyosis (up to 43%). Such complications are linked directly to the scarring produced by the conventional closure method.

Bujold and Romero propose a nuanced technique: suturing tissues only of the same type, carefully reconstructing the muscle layer while leaving the uterine lining untouched for natural regeneration. Although this new method takes 5–8 minutes—twice as long as the traditional approach—the additional blood loss is minimal and outweighed by better outcomes for future reproductive health.

With cesarean rates rising globally, especially in countries like Canada where 27% of births are by C-section, prioritizing meticulous uterine repair is a critical public health concern. This shift in surgical thinking may help millions experience safer subsequent pregnancies and better long-term well-being.

Follow Science Sphere for regular scientific updates

📄 RESEARCH PAPER

📌 Emmanuel Bujold et al, "Uterine closure after cesarean delivery: surgical principles, biological rationale, and clinical implications", American Journal of Obstetrics and Gynecology (2025)

11/17/2025

Today is World Prematurity Day 🙏🏼 I also want to highlight that we have an amazing new nonprofit in Western Wisconsin Andmamatoo - A Dash of Love which makes care packages for families with babies in the NICU and/or cardiac ICU 🤍 give them a follow; they are doing amazing work

Parents of babies in the NICU are at higher risk for postpartum anxiety, depression, and PTSD. Perinatal mental health matters—for both parent and baby.

Today, on World Prematurity Day, we honor the incredible strength of babies born too soon and the courage of the parents who walk this unexpected journey alongside them. 💛 From the tiniest hands to the bravest hearts, preemies inspire us every day with their resilience. We also recognize the parents, families, and caregivers who navigate the NICU, celebrate every milestone, and provide endless love and support. Your journey is seen, your courage is celebrated, and your hope lights the way. 💛 ”

Tell us about your Preemie below:
💜35-36 weeks
💛 32-34 weeks
💙31-28
💚27- 22

11/14/2025

Happy ONE YEAR to this sweet babygirl and her mama, who overcame so much to make it to each other. After 2 prior complicated births, fertility struggles, and hard work to heal her body and heart, client was able to birth this baby gently and peacefully, at home, wrapped in her husband’s arms, surrounded by her older children, beloved midwives, and both her parents. A true family-centered, healing birth for all. I love EVERY client, and every birth, but this one will always have a very special place in my heart.

{Image shared w client permission to inspire & educate}

11/14/2025

Some clips of our very own local treasure, Dr. Hartung!

11/13/2025

✨Under the Full Moon + Aurora✨

After 2 prior cesareans…

One emergent before labor, one a TOLAC…

The hospital her first two were born at, shutting down without warning

Losing a beloved midwife who had followed both her previous pregnancies

Being unable to find a supportive provider *anywhere* in Eau Claire, yet also being denied a transfer to Baldwin

Being told her weight was a contributing factor in her outcomes

Considering if maybe an out-of-hospital birth was the only way she’d get support for this VBAC…

When finally, a rare window of opportunity opened…

Client made a power move and took it, somehow managing to sneak in with a VBAMC legend who hasn’t been taking new OB patients in over 2 years 👏

Two prior brushes with “hypertension”

An almost 9lb baby last time

Never had spontaneous labor before…

But he supported her.

Slowly, cautiously, she started enjoying appointments again.

For the first time, her pressures were not an issue. There was no talk of big babies or induction. She relaxed as the scrutiny lifted.

Instead of being profiled, she was asked questions like, “what do YOU think?” and “what do YOU want to do?”

For over a week, client walked around 3-4cm.

Contracting regularly, not sleeping well, losing pieces of her mucus plug. But still pregnant.

After a false alarm on day 7, client went home from the hospital with no change, feeling defeated.

I told her to trust that something was different, even if her cervix hadn’t caught up yet.

“No way I can do this for another week,” she said. She resigned herself to an induction on Monday.

Well wouldn’t you know it, the next day…something shifted.

Some sleep, positioning and good ol’ surrender. Plus it was the Supermoon, so my doula antenna was all the way up 📶

By the evening, she called me over, where I found her laboring so beautifully with her partner.

Before long, it was time to head in. As we drove, the northern lights danced vividly overhead 🌌

At 40+5, the longest gestation she had ever experienced…

Client walked into the hospital 9cm dilated, and under the light of the full moon AND the aurora…

Had a totally unmedicated vaginal birth ~90 minutes later 💫

Dad got to catch babygirl, and announce her surprise gender while crying, “you did it! You did it!” with so much pride and emotion in his voice.

As if that wasn’t enough magic for one night, we had some extra excitement when the OB announced baby had a true knot in her cord. Perhaps the reason this birth had to be such a slow build 🌀

This client overcame SO much to get here— please join me in celebrating her INCREDIBLE journey to this third baby. Happy vaginal birth after TWO ✌️cesareans!!

11/10/2025

Sounds like this is in response to the prior announcement that Mayo is withdrawing OB staffing from Owatonna, leaving Allina to cover both locations.

Allina Health, which owns and runs the hospital, says it will consolidate labor and delivery services for Southern Minnesota in Owatonna, while it will close its birth center at its Faribault hospital.

11/10/2025

Yawn. When these articles come out, I have such mixed feelings.

I’m actually not here to jump on the “continuous monitoring sucks” bandwagon.

This has been known.

Articles like this bypass many deeper issues that deserve exploration.

Here’s my 2 cents.

(1) In some cases— tricky labors riding the edge in particular— there ARE benefits to continuous monitoring that may actually allow us to avoid a cesarean and keep going.

As someone big on cesarean PREVENTION, and labor strategy in difficult cases, I wish this was also discussed.

A trusted homebirth midwife once told me, “you know Diana, they can push it a lot farther in the hospital than we can at home, BECAUSE of continuous monitoring”.

And that really opened my eyes.

I have seen many cases where a fetal scalp electrode or hooking up for a complete tracing when heart tones did not sound reassuring actually DISPROVED fetal distress, and gave us a longer leash to keep going.

And obviously - some babies are truly in trouble, and we want to be able to catch that and do cesareans timely when needed.

(2) Plus… nobody likes to acknowledge this, but as someone who works with a more complex patient population, it’s true that there ARE many legitimately high risk pregnancies in which IA would not improve outcomes. It's not actually reasonable to suggest that we just Doppler everyone.

So what is the alternative? What is the call to action of this tired discussion.

CEFM is not going away.

In general, pregnancies are only getting less healthy, not more.

I think we’d do better to focus on helping borderline patients improve their risk stratification by helping them on the FRONT END to have a healthier pregnancy/placenta, promote spontaneous labor, and more functional labor from the get-go…

AND getting providers more comfortable with continuing as long as possible in that Category II window. Depending on the complete picture of course. It's the human element of interpretation and narrow comfort that makes CEFM a problem.

It goes without saying that we need greater access to out-of-hospital birth, and that labor units still in the dark ages need to get themselves a protocol for IA and get their nurses/providers comfortable with it. I am SO grateful for the facilities in my service area that are very practiced with the Doppler in labor, and don't jump to the discs and bands for every little thing.

—Diana’s Monday morning hot take ☕️

Decades of research have shown that round-the-clock fetal monitoring does not reliably predict fetal distress, and experts say it leads to many unnecessary surgeries. But it’s still used in nearly every birth in the U.S. because of business and legal concerns, a New York Times investigation found. https://nyti.ms/3WF7yLx

11/09/2025

Many people hire me for VBAC & cesarean prevention, but I want to be very clear on my account that I am not anti-cesarean.

Yes, I got into this to improve outcomes, reduce trauma and help people understand how to navigate the system to increase chances of success.

However, I encourage all clients to understand that a cesarean may happen or be needed despite our best efforts, and we have to be ready and able to engage with that.

Not in a surface way; like writing a “just in case” cesarean birth plan.

I mean a “we are going to look hard at our deepest darkest fears and come to peace with them” way.

🔮 What are the narratives we are carrying about what a cesarean means?

🔮 Where did we gather our understanding about c-section from?

🔮 What are we telling ourselves it means if we end up with this outcome?

🔮 What are we afraid we can’t cope with?

🔮 How can we SEPARATE the macro-level abuses & statistics from what is actually happening in OUR birth? The system is a separate issue and bringing it into our decisionmaking is a red herring.

Trauma-informed care & truly COMPREHENSIVE VBAC prep *must* include a careful look at these things.

When I trained with Pam England recently, she said that in preparing for her VBAC, she *also* prepared just as hard for what she called a “spiritual cesarean.”

“I’m actually kind of sad I didn’t get to experience it,” she said. [Footnote: Pam England herself had both a cesarean & VBAC]

This is what I encourage clients to think about.

Not the statistics. Not the evidence. Not the system.

Not what a cesarean means about you, or how terrible or overused or traumatic they are.

But how can we take the power out of them & still own our story if that’s what happens.

Remove the external narratives we are carrying around, deconstruct our own internal voice, and instead turn inward, toward the ACTUAL birth WE are having and OUR own values/coping.

This is where VBAC prep is lacking.

Cesareans can still be sacred & meaningful; they are a VALID way to give birth and safest for some people. Hard fact.

Let’s cultivate the tools to live into the birth we are actually getting, not just an ideal we’ve created in our mind.