MAYD to Birth: At Your Doorstep

Promoting gentle, empowering mother journies…

Activities (Vero and Delray)

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Delray Beach Palms Birth House – April 27th 10:30

Vero Beach – May 17th 10:30 (Dr Max Cohens Chiropractic office3730 7th Terrace Ste 302, Seacoast Bank Building, third floor)

Informal discussion with Dr. Punger on your personal “Permission to Mother” your children through childbirth, breastfeeding, mothering and more. This is free. Appropriate for mother’s with babies under two and who are pregnant. Babies and toddlers welcome.

Permission to Mother available after meeting and at the office for $10 for meeting attendees.

                                                                 Abby and I look forward to meeting you!  

Permission to Mother now available on Kindle!

Birthing Positions

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Traditional medical practice dictates having a laboring woman laying on a table during delivery. In fact, most people tend to think of birth as happening in this position. However, this is not for the mother’s benefit in the least. Instead, it is for the benefit of the doctor, so he or she can easily see without having to crouch or get on hands and knees. Can you imagine a typical doctor in the “good ol boy’s” club at your local hospital kneeling beneath a a woman to catch the baby while the mother sits on a birth stool, squats, or stands?

No, I can’t envision that either.

Despite ease for the doctor, this position is less than beneficial for the mother or baby. In fact, it is quite easily the worst position she could be in. Lying back closes the pelvic opening, making it more difficult for the baby’s head to get through. It also ensures that the mother has to work against gravity, trying to get the baby up and out. This is not a recipe for success, and along with the labor pain medication many women are given, it frequently creates serious trouble for the baby. You may have heard of terms such as “fetal distress” and “failure to progress” to describe the reason for an emergency c-section. These are listed side effects of labor drugs, but they are also caused in part by the difficulty of getting a baby through that closed space.

Convenience for the person who is not in labor doesn’t seem like a very good reason, does it?

So, if back-lying is not ideal for birth, what are the best positions? Really, a mother given freedom of movement throughout labor will generally be able to intuitively find the best position for her, and for that particular labor. However, here are what are generally the best positions for birth:



Squatting is virtually unpracticed in most Westernized countries. However, it is by far the best way to give birth. In a squat the pelvis opens up fully, and gravity helps draw the baby down. For women who live in countries where squatting is culturally normal, this is also an easy position to hold for the length of time necessary for birth. For someone unused to squatting, an assisted squat while holding onto a bar, partner, or rope is possible.

A squat is a great exercise to practice during pregnancy in preparation for birth. To do so easily, especially with a large baby belly, open a bedroom door. Place a foot close to the edge on each side and hold onto the doorknobs while you lower yourself into a squat. You can sit there a while before standing. Repeat as many times as desired. Even if you decide not to use the position during labor, it is a great prenatal exercise.


For women who prefer not to squat, sitting with knees spread wide apart is very similar in benefit. Using a birth stool or toilet (the latter is usually not recommended because you don’t want the baby to drop into cold germ-water!), just sit upright or slightly lean back or forward as desired. This is easier because we’re used to sitting like this on the toilet, and it also opens up the pelvis and uses gravity to our benefit.

Sitting up is my personal birth position of choice. The first two births I was not allowed to sit up, even though I had an overwhelming urge to. I still get frustrated just thinking about the individuals who hindered me. My third birth I was able to sit on a birth stool, and it was the best labor I’ve had. No screaming, no yelling, no frustration. Very little pain. My body was exactly where it needed to be.


Standing also uses gravity to help bring the baby down. To do this the mother stands, leaning and holding onto her partner or a chair for support. She can either face her partner, or be supported under her arms while she faces away. This also works while kneeling on a bed, facing her support. These first three positions are very beneficial because they are types of vertical birth.


Finally, kneeling is chosen by some women during labor. A woman can kneel on the floor and hold onto the bed or chair while pushing.


Really, there is no “wrong” position for birth, as long as a woman is able to choose her own position. If she is listening to her body and given the freedom to do so, then she will naturally shift and adjust to what is best for her unique birth. For labor-support, follow her lead. If she seems unsure, ask if a certain position listed above sounds good. If she tries it and hates it, no harm done, but she just may discover the perfect place for birth.

Sharing All of the Important Numbers

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Just another corny post on The Unnecesarean.

ACLU Intervenes to Help Woman Get a Trial of Labor

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The ACLU stepped into help a South Carolina woman avoid coerced surgery.

Cloth Diaper Benefits and Accessibility

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I am hooked! Sad, I didn’t start earlier,
it’s so much easier than I expected.

I know many of you are using cloth diapers.

I have them in stock. When I first started my practice I introduced many moms to diapering and I was the only place they could get to touch and feel (and try on) in real life before purchasing. With the busy-ness of my practice through winter season in Florida, I didn’t spend a lot of time on showing you the beautiful inventory of soft natural diapers that I have. I wanted to take a moment to remind you. Please let me or Crystal know if you need more info.

1. I have cotton pre-folds for small babies including newborn and preemies (just in-case your baby was smaller than expected).
2. I have large absorbent pre-folds for over 35 pounds. Great for toddler who  is still night wetting (or won’t train yet).
3. I have four different sizes of pre-folds (these are the basic rectangle diaper). Pre-folds are classic not fad. They passed the test of time.
4. Pre-folds make good burp clothes and rags.You never out grow them. They just go to other uses.
5. Pre-folds with a few covers are the least expensive way to get started in cloth diapering with a brand new stash.
6. Pre-folds can cushion your supply of diapers inexpensively, just so you have a little flexibility to space out your washings.
7. Pre-folds can be used as liners inside many of your other modern cloth diapers. Again, you don’t outgrow your investment.
8. I have organic bamboo fitted with snaps for 12-35 pounds. These are about the softest diapers I have felt.
9. I have many beautiful covers to go over fitted or pre-folds and fitted; white, print, velcro, snaps, single and double gusset.
10. Nothing in my inventory needs diaper pins.
11. I have a few remaining All-in-One Bumkins in neutral plain white and some really cute prints.

Every style I have, I used on my own son. David was exclusively diapered in these styles. They are durable, absorbible and designed for success. There was no going back to paper once I felt how soft they were. Also, they are very photogenic when it comes to portraits. I didn’t have as many options as you have today. I diapered him right through the hurricanes,  traveling, and stomach bugs. I left the All-in-Ones for the teen sitter and older boys to use up first when I was away. When I do something, I do it 100%. This variety got me through all situations. I  never liked the popular pockets you had to stuff, but I am impressed by the variety in diapering options today.

If you are new to cloth diapering, you will find it very rewarding. I started with my third baby, but if you start with your first baby, you save over the years. You can start off cloth diaper part time if you are hesitant.

With these styles I can provide you with 100% support because I was so successful with them.

If you are an experienced cloth diaper user, there might be another print or style to add to your stash and experience.

$10 Gift Certificate
Permission to Mother by Denise Punger is available on amazon. In appreciation for your thoughtful feedback on Permission to Mother’s amazon page, we will thank you with a $10 certificate, good towards the items above. That would be like a FREE cover or a few pre-folds. Confirm that your review published and come in to the office and pick out an item. Amber beads excluded.
Permission to Mother now available on Kindle!

Higher perinatal mortality? Really?

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I recently subscribed to Essentially MIDIRS.  (Can I tell you how much I LOVE this magazine!)  The April 2011 issue presents the abstract of an in-depth review, "Examining autonomy's boundaries: a follow-up review of preinatal motality caes in UK independent midiwfery" of a study showing a significantly higher perinatal mortality rate for births booked under and independent midwife compared with births in National Health Service units.  Now what would we do if a study showed a similar finding in the United States?  Run articles touting the dangers of home birth (a majority of the births attended by independent midwives in the study were at home) of course.  Interestingly enough, in the UK, they take a different, more evidence-based approach.  They took an in-depth look at the findings for the study.  What did they discover?  According to the abstract, there were 15 perinatal deaths at term with the independent midwives. Seven of the deaths were unpreventable (ie, they would have happened in a hospital with a doctor).  The abstract notes "Elective cesarean may have changed the outcome in eight cases.  However the pregnant women had declinded this option….  Care management was judged to be clinically acceptable within the parameters set by the mother's choices."  The conclusion states, "If reality is to match rehetoric about 'patient autonomy,' such decision making in high-risk situations must be accepted" (emhasis mine). Overall perinatal mortality was low, 1.7% for independent midwives vs. .6% for the births in the National Health Service Units.

So it turns out the higher perinatal mortality rate was not due to a deficiency in care.  Hmm, I can think of similar studies in the U.S. (hmm, can anyone say Wax) that may have benefitted from a careful review of the results.

Sekou’s Birth by Fiona

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On the night of the 4th of December I was 41 weeks pregnant. We lay in bed and Nancy, my partner, searched the Internet for ways to induce labor. I was scheduled for a “no stress test” at the hospital the following day to be sure our little one was healthy inside me. Nancy found an article on nipple stimulation that suggested if you stimulate your nipples for 45 minutes then with in 48 hours labor is likely. We tried this and within fifteen minutes I was in labor.

At 9:44 pm I said, “I think this is what a contraction feels like.” It felt like a mild to moderate menstrual cramp. The cramps continued varying in length from one minute to three minutes. The resting time between contractions varied from six to ten minutes. Nancy kept track of my contractions in a little book documenting the frequency and intensity. We called our Midwife Maria and informed her that we were in labor. Maria told us to call her when the contractions were four minutes apart one minute long and in that pattern for an hour. “In the mean time” she said, “Get some rest.”

At about 2am the pain during contractions became intense. I began to throw up with each contraction. Nancy massaged my back in long strokes from my shoulders to my lower back and she pressed my hips together. We lit the candles that our friends and extended community made for us.

I lay on my side in bed and tried to rest and then got up in excruciating pain and ran to the bathroom to throw up repeatedly. At some point I had nothing left to throw up. Nancy made frozen recharge drink cubes, which I sucked between contractions. With each contraction I lost the recharge I had managed to swallow. I could not sleep and neither did Nancy. At one point I stood up and bent over the baby-changing table, Nancy came behind me and compressed my hips. “I don’t know if I can do this,” I said. Nancy said, “You are doing so well.” After this Nancy often told me that I was amazing and I could do it. My confidence came back a little bit with her encouragement.

At  4:25am  I went to the bathroom and a jelly-like clot of clear mucus and blood came out. “Baby I lost my mucus plug,” I shouted from the bathroom to the bedroom. Nancy wanted to see and I showed her.  I felt excitement at labor progressing and my body opening. I thought that I should call my friend Ellen so that she and her partner Carmen could prepare to come the next day but I wanted them to have some rest.

At 5:00am I called Ellen and told her that I was in labor. I said that it would probably be a while but it would be good if she came by 5:00pm. I asked her to tell Carmen and prepare to stay a long time. In our preparation Ellen and Carmen were responsible for setting up the birth tub.

Contractions became more and more intense. In the morning at about 8 or 9 my phone rang and it was the nurse from Kaiser calling to confirm my “no stress test”. I told her I was in labor and then began having a contraction while on the phone. Her name was Jill and she told me exactly when to breathe in and when to breathe out and she coached me through the contraction. It was exactly what I needed to keep going. After the phone call I used the deep breathing shown to me. I felt light headed but able to continue.

I asked Nancy to call Maria and Nancy said that my contractions were still far apart. I called Maria and asked her to come by when she could to check the baby’s heart beat. Maria said that she would come by at noon. At some point Nancy called the rest of our birth team Ellen Carmen and Carol and asked them to come.

Maria arrived before the others, I remember saying, “The contractions are really bad”. Maria said in an enthusiastic voice, “No they are strong that’s good!”

Maria called an assistant midwife named Nile who arrived with a tool belt slung low across her hips and filled with midwife tools.

Maria checked how far I was dilated in the bedroom. I lay back on the bed and she reached her hand inside and felt around. When she removed her hand she said, “You are eight centimeters dilated we are going to have a baby.”

When the support team arrived they began to assemble and fill the birth tub in the kitchen. Nancy stayed with me in the bedroom. I bent over the bed and my acupuncturist Carol Francois came in and massaged acupressure points on one side of my body, she showed Nancy how to massage the other side. The points helped my body open and sped delivery.

Maria asked if I wanted to go in the water tub to give birth and I could not imagine moving from where I was. It turns out that the tub was only half full anyway. Maria invited my support team into the bedroom and said, “Do what you have to do.”  Carmen documented the birth; I felt Carol’s presence near me. Ellen said later that she thought to herself, “What do I have to do?” Ellen brushed my tangled and wild hair back into a neat ponytail at the back of my head.

   Maria put a birth stool at the side of our bed. Nancy sat on the bed and I sat between Nancy’s legs on the birth stool, she put her arms under my arms for support. I held onto Nancy’s hands and squeezed them tightly.  Maria said, “When you feel the urge to push PUSH.” I remembered the story of another mamma who did not feel the urge to push and was transferred to the hospital. I pushed even though I did not feel a strong urge.  I felt something pop and then water gushed out. Maria wiped it away with a chuck pad, she also discretely wiped away the little bit of poop that came out as well.

I felt a tightness around my opening that burned, I stood partially up instead of pushing and thought to myself “you are a wimp.” Both Maria and Nancy encouraged me to squat down, both told me I was doing a good job; this helped. Then the assistant midwife Nile, young caring and confident took a fan from her tool belt on her hip and fanned my hot face. It felt amazing.

Together Maria and Nile listened to Sekou’s heartbeat. Maria looked me in the eye and said, “Your baby’s heart rate went down, and we are going to want to get him out in the next push or two. It is time to work really hard!” After this I do not remember feeling pain; I cared only about getting Sekou out safely. I remember pushing very hard. We have a video and in the video in these final moments of pushing I was quiet and concentrated.

I reached down and felt Sekou’s hair between my legs, it was slimy. I pushed again and felt his head and then his body slide out of me. Maria said “Nancy, Fiona -somebody catch your baby!” Maria caught Sekou and put him in my arms. “Well hello” I said “you made it.” Sekou cried and then was quiet against my breast. Nancy kissed me, we  both had tears running down our faces. Then Nile and Maria wiped the blood from Sekou’s body.  They clamped his umbilical cord and Nancy cut it. He was born at 2:41pm. Ellen sent a picture of him just born to our friends and announced his birth.

The midwives asked Nancy to take off her shirt and they put Sekou on her chest for skin-to-skin bonding. I stayed seated on the birth stool to birth the placenta. The placenta slipped out easily into a large bowel and looked a little like an organ to me or an enormous blood clot.

I had a little tearing and Maria prepared to give me stitches. She asked me to lie back on the bed. Someone put Sekou on my chest. Maria asked my friends to distract me.  Ellen lay to my right and Carol sat to my left. I closed my eyes and felt Carol stroking my forehead. Maria strapped a headlamp to her head, she sprayed between my legs with something that stung and then numbed the area then she began to carefully sew up my tears. I remember an overwhelming feeling of wellbeing. As Maria stitched the tears my friends sang, “Maria, I once knew a midwife named Maria.”

Next Maria put an ice pack between my legs and I lay with my head at the headboard. At the foot of the bed the Midwifes examined Sekou from head to foot and weighed him in a hanging cloth scale. Maria asked Nancy to put her little finger in Sekou’s mouth and he began to suck on it. Sekou weighed 8lbs and 3oz.

A few significant things about preparing for our homebirth:

My partner Nancy and I conceived Sekou March 8th 2011 with a little help from a sperm donor and alternative insemination. The date of Sekou’s conception is significant to me because it stands between the anniversary of my mother’s birth date on March 7th and her death date on March 9th.

My mother used to say about my birth, “I was in labor 48 hours and they almost lost us both.”  My mother was 39 when she birthed me caesarian and 42 when she birthed my little brother Ian. I am the age of my mother when she had her second child. I expected 48 hours of labor, I expected pain and I was prepared for the possibility of transferring to Kaiser Hospital if need be. In fact we toured Kaiser to see what it was like. I also had the example of two of my friends Alli and Michelle who gave birth at home with Maria as their midwife.

My ability to birth my son at home felt bigger than me. I felt carried by the people in our lives and the extensive preparation that Nancy and I underwent. Several things significantly helped me to prepare to give birth.

To start we met with Maria our midwife regularly, her coaching about everything from nutrition to how to work as a team was invaluable. The fact of her experience having delivered over 1000 babies gave me confidence. Maria’s coaching before and during the birth of Sekou and especially after his birth was the ground on which I stood. A great doctor at Kaiser Sarah Mendel followed me in addition to Maria and she supported my decision to birth at home.

I was also part of a mamma’s group of four women. In the group we shared experiences and we read the book “Birthing from within.” We did an art exercise from this book in which we each drew our ideal labor as a landscape. The picture I drew greatly resembled the birth I had.

The preparation I did with my acupuncturist Carol Francois helped me to carry a strong healthy baby. Carol attended the birth and her presence helped me immensely.

Other mamma’s birth stories helped me to prepare as well especially Raynell’s story, which made clear the importance of staying hydrated and partner encouragement. I enjoyed going to a potluck at Maria our midwife’s house at the beginning of my pregnancy and hearing so many home birth stories. It felt like a complete circle to go again after Sekou’s birth and share our experience for others preparing for home birth.

Most helpful to Nancy and my work as a team during labor was the home birth preparation class we took taught by Jane Austin. I also did prenatal yoga with her.

My friend Ellen was there for me through out my pregnancy and she and her partner Carmen attended Sekou’s birth. She threw a shower for us in Dolores Park; at the shower friends decorated candles to light during labor, they also took a candle home with them to light. Ellen sent a message to our friends to light their candles while I labored. An altar held the lighted candles from our community as well as the picture I drew in the mamma’s group during labor. The physical reminder that I was not alone and had support from our friends and ancestors helped me.

Carmen documented Sekou’s birth leaving us incredible photographs and video we will one-day share with him.

Birth is empowering!

(In Stock!!) Amber Beads for Teething and Pain

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I have been impressed with the personal testimonies from mothers when their baby wears Baltic Amber Bead Necklaces. I’ve been hearing about calmer babies, less fussing, better sleeping, reduced need for medication. It takes about 25 days to get it when placing an order. They come from Lithuania, from now on I am going to keep stocked up on baby necklaces and occasionally mother (adult) necklaces and bracelets.  Baby can start wearing them when the drool starts at 8 weeks old. You may come by the office during regular hours. I will consider shipping either contact us at or 772-466-8884 ext 2. 

I am expecting the next order to arrive mid-April. 

Since remote times, the beauty of Baltic amber was attracting attention. Amber jewelry is a treasure to own, for centuries was worn only by nobility and not affordable to the masses. Amber jewelry is fashionable and soaring in popularity even today. Amber jewelry balances person’s mood, pleases the eye, lessens depression.
Because amber was ascribed many healing properties it came to be used medicinally in many cultures. Wearing close to the skin is a traditional European remedy for teething. Its healing properties effects will calm your child without applying to drugs. Most of our amber teething necklaces are processed to softly rounded shape amber beads to keep intense healing effects to reduce stress but give general sense of wellness.
Baltic amber is an excellent natural antibiotic. Women suffering from goiter uses unpolished natural raw pieces of amber to wear close to neck. Amber stone produces positive effect on the heart, nervous system and the kidneys.

How it works? When a baby is wearing amber teething necklace on the skin, the skin’s warmth releases healing oils from the amber (a resin) which are absorbed via the skin into the bloodstream.Amber is not a stone and therefore warm to the touch, as well as very comfortable and light to wear. Children wearing amber is a very old traditional custom in Europe and the Far East. Amber is known to reduce inflammation of the throat, ear and stomach and to fight inflammation, infections and respiratory disease. Traditional beaded amber necklaces are a less intrusive remedy for the pain and side effects of teething, such as lack of appetite, upset tummies, ear ache, fevers and colds. A natural analgesic, amber will help calm a baby without resorting to drugs. Amber’s anti-inflammatory and therapeutic properties are also recognized by allopathic medicine. These necklaces are long known for the healing properties of amber which include calmative, analgesic, antispasmodic, expectorant, and febrifuge (anti-fever) functions. 
At the S&S restaurant in Ft. Pierce.

Whom are they for? Wearing Baltic Amber baby teething natural pain relief necklaces are suitable for babies (toddlers) and children. They are not designed for chewing them with teeth, parent supervision is recommended at all times when baby is wearing necklace. Amber is associated with sunlight and warmth and reputed to boost the immune system, reduce inflammation and accelerate the healing of wounds and is thus the perfect help for babies and toddlers who wear it when they are teething. Designed for boys and girls. These necklaces are a must have for teething symptoms. Baltic Amber is completely natural pain relief with no side effects.The necklace can be worn from 8 weeks and up. Although you can start you child wearing this necklace at any time, the earlier the better. If your child wears it at a young age they will not even know it is there and they will not touch it or pull on it. 

How are they made? What happen if necklace gets torn? Sizes colors and shape of stones and the length of the necklace may vary from necklace to necklace. All amber stones we use for our amber jewelry are genuine, authentic, natural Baltic amber stones. It is not artificial, plastic, synthetic, reconstituted or substitute for amber. Every bead is knotted in between to prevent choking hazard. Even if string got torn only one bead would come of. Strong silk, matching to amber color is used for every necklace uses twist screw closure, clasp or strong magnetic clasp for safety.String is very strong and breaking is unlikely to happen, even if the necklace would break only one bead would come of. The Baby Amber necklace beads are light and small. The bead is therefore too small for a baby/child to choke on. But, if a baby or child should swallow a bead from the Baby Amber necklace, it won’t be harmful since it is not poisonous. It used to be ground up and swallowed in medicinal mixtures. 

Permission to Mother now available on Kindle!

Everything’s Bigger in Texas

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Cesarean rates are no exception.

Radio show tonight – Unassisted Childbirth

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Tune in tonight (March 19th) at 9pm Central as I’m interviewed by Gena Kirby on the Progressive Parenting show. We’ll be talking about unassisted childbirth, orgasmic birth, and the upcoming Trust Birth Conference. After the show (at 10pm Central) I will be doing a half hour TV show on Vokle. One lucky TV viewer will [...]