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Sara Beth Raab

Sara Beth Raab

Wednesday, 09 November 2011 01:57

How to Clean An Intact Baby Boy



Now that I’m a mom of a little dude with his foreskin left intact…I’m finding that many people from caregivers to grandparents do not realize how to care for the intact little boy.  So here is some information to be shared with your caregivers and anyone who will be watching your little guy.


As I noted in my reasons I decided to not circumcise my son, both little girl’s and boy’s sexual parts are not fully formed at birth.  For little girls, the hood of the clitoris is fused to the clitoris and for little boys the foreskin is fused to the glands (or the tip) of the penis.  With sexual maturity and/or the hormones from puberty, these parts will loosen allowing for full sexual function of the organ in later development.   In the meantime, this fusion of the foreskin to the head of the penis protects the glands from pathogens, bacteria, feces, etc.

Forced retraction can cause painful damage to the penis and should be avoided at all costs! Some complications from forced retraction are:
  • Acquired Phimosis – this is when scar tissue forms, enabling the foreskin to later have its movable function

  • Infection – the raw skin is now an easy place for an infection

  • Adhesion – it is possible for the raw surfaces to grow together which may require surgery to allow for foreskin retraction later

  • Paraphimosis – When a child’s foreskin is forced behind the glands before it has become fully functioning. Sometimes the narrow opening of the foreskin gets caught behind the glands.  This can trap blood and cause the tip to swell. You can fix this by holding the shaft of the penis and gently fusing the glans into the foreskin. If this doesn’t work, squeezing the glans to reduce swelling should help it pull back into the foreskin. If these techniques do not work you can also put ice on the glands to help the swelling.

So basically… you just wipe off the penis if it gets dirty! No pulling back of foreskin is necessary.

Later we will talk about how to care for an older child’s intact penis.



Tuesday, 08 November 2011 12:50

7 Reasons We Chose NOT to Circumcise Our Son

There are very few topics that I personally have a hard opinion on.  For the most part, I can see the point in the other person’s view and so long as they have done their research on the topic. However, the one issue that I have to say really makes my skin crawl is circumcision.  Just like anything, I began to do my research on the subject and the more I found out about the act of circumcision and the history behind why we circumcise the more I was FLOORED as to why it is seen as a perfectly acceptable thing to do in this modern day and age.

Here are a few things that got me thinking about reasons to not circumcise my son and the main reason why:




Reason #1: No medical or health organization in the world recommends routine infant circumcision - including the American Academy of Pediatrics (AAP).

The AAP does, however, state that:

  • “Babies should never be circumcised without full pain relief (anesthesia just as we'd give an adult undergoing genital cutting, reduction or amputation surgery).”
  • “Anesthesia is counter-indicated for infants and not recommended for newborn babies (any drugs in a baby's body increases risks to health and wellbeing).”
  • “No baby already facing pre-existing medical concerns or health compromises of any nature should be circumcised. (Genital cutting is risky for even healthy babies - and carries with it detrimental consequences - the foremost of which is the loss of a healthy, vital, functioning organ: the prepuce. Circumcision is exponentially riskier for premature or health-compromised infants). After analysis of almost 40 years of available medical research on circumcision, the American Academy of Pediatrics issued new recommendations (1999) saying that they do not recommend circumcision as a routine procedure." Australia, the U.K., and Canada already had instituted humane policies AGAINST circumcision.”

Did you know circumcision rate has dropped drastically from 55% to 33% in the U.S.A. from 2003 -2009 : http://www.mdconsult.com/das/news/body/213591086-2/mnfp/0/220621/1.html

Reason #2:  There is NO MEDICAL NEED for circumcision.

Here are direct reasons from Dr. Sears on circumcision in regard to medical "needs":

  • "Decreased risk of STD's - this was a myth that we now know is not true.”
  • “Decreased risk of penile cancer - it used to be thought that circumcised men had a much lower chance of cancer of the penis. We now know that this benefit is much smaller than previously thought. The AAP determined that this benefit is so tiny; it is not worth circumcising for this reason.”
  • “Avoiding infections in the foreskin - occasionally intact foreskins get irritated. This is easily treated with warms water and washing. Rarely, the irritated foreskin becomes infected. This requires antibiotics, but is easily treatable. Even if this does happen in a person's lifetime, it is not a reason to circumcise at birth.”
  • “Avoiding the need to do it later on - VERY RARELY, someone has a problem with recurrent infections in the foreskin that need antibiotic treatment. Some of these men then need to be circumcised in an operating room under general anesthesia. This is extremely rare, however, and is not a reason to circumcise everyone at birth.”
  • “Avoiding bladder infections (or UTIs) - it used to thought that circumcised boys and men had a much lower chance of bladder infections. The AAP now knows that this benefit is very small, and is only true for the first year of life. After that, there is no difference in the number of bladder infections. Again, not a reason to circumcise.”

Reason #3: Over 200 babies die a year from this cosmetic surgery – is it worth the risk?
A baby only needs to lose 1 ounce of blood to hemorrhage, and just 2.3 ounces to die as a result of this blood loss. It can, and does, occur at a frightening quick pace.


The ironic part I find about this fact is that the AAP (American Academy of Pediatrics) continues to issue widespread warnings about choking as one of the highest causes of death among children, despite the fact that a greater number of infants die from circumcision than from choking.

Reason #4: Circumcision based on "cleanliness" assumes that the human body is unclean.

The facts are that removing this part is EXACTLY the same as removing the hood over your clitoris as in the 14 - 15th week this is the part that grows to a penis/foreskin. And funny enough, female circumcision is illegal. The intact penis is naturally clean. The common view of the penis or the foreskin as ‘dirty’ is unscientific and irrational.

Reason #5: You are effecting your son’s sexual function when you choose to have this surgery.

According to Dr. Christopher Cold, M.D. and Dr. John Taylor, M.D.:

"The prepuce is primary, erogenous tissue necessary for normal sexual function. The complex interaction between the protopathic sensitivity of the corpuscular receptor-deficient glans penis and the corpuscular receptor-rich ridged band of the male prepuce is required for normal copulatory behavior.”


Reason #6: Circumcision HURTS, BAD the child cannot decide this for himself. If he wants to be circumcised as an adult, that is his decision.

Here is one student’s account of a circumcision surgery:

"We, students, filed into the newborn nursery to find a baby strapped spread-eagle to a plastic board on a counter top across the room. He was struggling against his restraints—tugging, whimpering, and then crying helplessly. . . . I stroked his little head and spoke softly to him. He began to relax and was momentarily quiet. The silence was soon broken by a piercing scream—the baby’s reaction to having his foreskin pinched and crushed as the doctor attached the clamp to his penis. The shriek intensified when the doctor inserted an instrument between the foreskin and the glans (head of the penis), tearing the two structures apart. The baby started shaking his head back and forth—the only part of his body free to move—as the doctor used another clamp to crush the foreskin lengthwise, which he then cut. This made the opening of the foreskin large enough to insert a circumcision instrument, the device used to protect the glans from being severed during the surgery. The baby began to gasp and choke, breathless from his shrill continuous screams. . . . During the next stage of the surgery, the doctor crushed the foreskin against the circumcision instrument and then, finally, amputated it. The baby was limp, exhausted, spent." (12)


More on PAIN: http://www.drmomma.org/2009/12/circumcision-what-i-wish-id-known.html

Reason #7: Historically, circumcision started as an ancient religious ritual where the full foreskin was removed to keep boys from masturbating.

In 1888, Dr. John Harvey Kellogg, a well respected physician and founder of the Kellogg cereal company, spoke for mainstream Victorian medicine when he wrote:

“A remedy for masturbation which is almost always successful in small boys is circumcision. The operation should be performed by a surgeon without administering an anesthetic as the brief pain [sic, see below] attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment.”[17]

Originally circumcision was just a little knick in the foreskin as what we do today would have killed the children in early Judaic society. http://www.jewsagainstcircumcision.org/ here is a medical timeline: http://www.circumstitions.com/Chronology.html#masturbation

If you don't like to read,  here is a video: http://thebirthingsite.com/birth/newborn-care/item/319-cut-slicing-through-the-myths-of-circumcision.html

Here is a video on how circumcision felt to two adult men: http://thebirthingsite.com/newborn-health/item/162-how-does-circumcision-feel?.html

Here is PLENTY of reading for you:



And on a funny note: http://youtu.be/3yRFNciRUAk



Saturday, 05 November 2011 14:40

My Homebirthing Story

We are just a few days past one of the most memorable days of my life: the birth of my second child, Maddox Jay Raab.  He was born happily at home, in water, March 17th, 2011. I am just AMAZED at the wonder and natural power of the female body and its innate knowledge on how to birth.

I had MANY (at least 4) false starts to labor where contractions would start, were timeable and consistent for many hours, but that always seemed to fizzle by the morning.  It was a mind trip, as each time my body would gear up in anticipation of something I knew would be very intense.  It was also good to practice resting in anticipation of it, since I was very conscious of how exhausting labor is.  I eventually got pretty good at understanding the flow of contractions and relaxing with them.  Of course it was also frustrating, and after the fourth time or so I began to give into some of my fears about going to the hospital, getting induced, and disappointment crept in.  Thankfully, after a trip to my gynecologist (Dr. Anderson, who I highly recommend!), she assured me that I hadn’t stalled out, that I was progressing in all the expected ways, and she scheduled another checkup for the following week but promptly added that she did not expect to see me.  The lesson here, for me, was that it is very; very important to have people who support your birth decisions and exude positive energy on your birth team.  Birth is a team effort, and everyone on your team needs to be an all-star!

I want to pause here and say something I feel is important for mothers wanting natural births to hear: due dates are not expiration dates, and going past them is okay.  The human gestation period is different for every woman, and while having a date when you expect to give birth is good for some things, having those expectations and feeling like you’re “late” can be a burden under normal circumstances.  Hang in there, and remember to have positive, encouraging people on your team!

Finally!  On March 16th, in the evening, I started having my normal timeable contractions.  I went ahead and informed Missy (our assistant midwife), since Martina (our midwife) was out of town and she was taking the lead, and Missy informed Nikole (our backup CNM) that I may…or may not… be in labor (ha ha!).  We did our normal nighttime stuff, and went on to bed.still having contractions every 8 – 10 minutes.  Nathan and I slept until about 3 am, when my contractions started to get strong enough to wake me up!!  So we let the midwives and the rest of our birthing team know what was happening.  When morning rolled around, we did our normal routine, got Sienna to school at her normal time (8 am), and by then Missy (my Assistant Midwife), my Aunt Rhonda, and Lauren (my best friend)  had arrived!  Missy checked my blood pressure, the baby’s heart tones, and I believe we did an internal exam as well.  I was about 4 CM at that point. J We made cinnamon rolls, coffee, cereal, and fruit…got out the tub and prepared the bed and laid out all of the gear.it was a birthing party!!  My contractions were still coming on every 8 minutes, but by this time it had moved to my favorite phase: BACK LABOR.

The sensation of back labor was the exact same as it was for me in the hospital with Sienna, however, it was so much more humane I had several sets of hands willing to do the necessary counter pressure every contraction (and I mean they had to LAY INTO ME!) and I was able to walk about in my home, joke, enjoy myself and the ABSOLUTE BEAUTIFUL DAY we were so blessed to have. It was sunny and warm….70 degrees or so.  This continued for a while... I got in and out of the birthing tub…and somewhere in there Nikole, the other midwife came.

Now, I really want to reiterate that the sensation of the back labor pains felt exactly the same as they did in the hospital with Sienna, that after only about 7 hours or so lead me begging for an epidural!  I know this was because I had to FIGHT the whole time I was in the hospital with those contractions…FIGHT with the stupid IV, FIGHT with the continual monitoring, FIGHT with the nurses to allow me to move… I could only move about 3-4 square feet with the IV and the continual monitor and they wouldn’t allow me to be on all fours during the contractions b/c they would have to adjust the monitor.  This was enough to drive ANYONE mad, begging for pain relief… but contrast to the hospital birth….my state of mind was SO much more wonderful at home.  Nathan, Lauren and I were all in our room at one point, about ohhh 9 – 10 hours in and I even found myself making the comment… I’m BORED, let’s DO something!! This was with back labor contractions happening around every 5 minutes!

Lauren and I took a little “nap” on the couch around noon as we were both feeling a bit tired and it was my normal “naptime”(we all had a great lunch too…. I had cheese and crackers, grapes, and chips and dip…and of course I was drinking water and juice this whole time). Nathan also took this time to lie down and take a nap, the midwives walked around the block a bit, and Rhonda was checking on me and Lauren and cleaning and cooking in the kitchen. I remember lying down and really loving hearing Rhonda piddling in the kitchen during the naptime.  Lauren was also SUCH a saint…at this point I really had to have someone rubbing/touching my back at all times… and pushing MUCH stronger during contractions.  She laid with me on the couch for a good hour or so, dozing off in between contractions with me… windows open, birds chirping, and sun shining through the windows.

Now I will pause here again and just note that in normal, natural labor the body will pause and allow for the birthing mother to have a rest….the contractions may get less strong, they may space out a little bit.  Where in the hospital they may view this as a “bad” thing or that labor has “stalled” and immediately start a Pitocin drip, midwifery finds this phenomenon quite common right before the next phase of birthing and embraces it….encouraging the mother and birthing team to take this time to rest before the next phase begins.  This is nature’s way of helping the birthing mother cope with the trials of labor….

After we all had a good rest (around an hour or so) and I felt great, Nikole explained to me that now was the time to go ahead and get labor moving again… by simply getting the body moving again.  Once I got up on my feet and walked about a bit, labor quickly became what we call “active.” Havingarrived at the “active” part of my labor with a fresh start, I was ready to cope with the intense, sometimes overlapping, longer contractions.  This was about 12 hours after the “early labor” phase had begun.

And that active back labor, I tell you, was intense.  I needed every single person that was there so desperately! The encouragement and physical presence of everyone there really helped me cope with both the pain and any sort of doubt that crept in my mind.  I was able to immediately vocalize any sort of fears that I had to the team and they all helped me work through them…. Then I just simply let that fear go!  One thing that TRULY and amazingly helped my ability to cope through the contractions coming ever couple-few minutes and lasting for a good minute-minute and a half was the practice of living “in the moment” that I learned and perfected through meditation and yoga.  This ability to only live in this nanosecond of time kept me from worrying about when the next contraction would start, when this contraction would end…. And so on. So I was still able to fully relax through the resting moments and even still relish in the simple physical… I remember the sensation so clearly of the open window blowing wind on my wet back and how good that felt, of Nathan continuously rubbing my back and Lauren holding my hand….. It was these pleasant sensations that helped me to relax and continue on….. Labor was an intensely sensual experience. All the sights, smells, sounds, textures around me were so intensified that never, even through the hardest contraction, did I want to stop this process…to numb myself against it. It was truly the most spiritual experience of my life…..

Continue on, after laboring in the tub for a bit, we decided that it was time to move to the bed and check my progress…. I was complete with a little lip!  We also discovered Maddox’s position was all sorts of wonky at this time. He was, what midwife could feel…side lying posterior.meaning the back of his head was toward my spine but he was facing my left hip and he was also floating higher in my pelvis. So, though I wanted to get back in the tub immediately, Nikole had me lay on my side to help move him more centered in my pelvis and help the labor progress better. Also during this time they did the MOST AMAZING thing ever…in a few spots along my back they administered little bubbles of sterile water along specific nerve pathways.  The idea here, so well as I understand it, is that your body can only understand one type of pain in the nerve ways….so putting these bubbles of water under the skin confuses the body.  The relief was IMMEDIATE!!! The back labor contractions went from the knife stabbing pain to the oh so much easier sensation of a normal contraction.  It was positively the most amazing thing EVER! So after the water bubbles were in my back I labored on my side for a good hour or so and was so encouraged to actually feel the progression of a contraction pulling the baby down.

After a while I really did want to get back in the tub.  It was amazing, moving from the bed to the tub pushed my labor into hyper drive and this is where I hit several walls emotionally. …and had to talk through them. I remember having the conversation with Nikole that I thought once you were complete that, bam, it was time to push…but she explained to me that just because your body’s cervix is complete you may not feel the urge to push until the baby’s head has descended far enough into the pelvis and pelvic floor for you to feel that urge.  Also, encouraging to me at that time was her explaining that just by giving us more time, adding some different positions and such, the baby will work his way down.  Nathan and I had the cutest moment in the tub, I don’t remember what on earth he was saying but he made me laugh and snuggled it was a wonderfully tender moment! :-D

I was complete for about 4 hours and laboring HARD in the tub when Nikole suggested I try sitting on the exercise ball in the shower.  This is actually when I think I hit my biggest mental block.  I knew that I was coming onto the next phase in my labor...that what I had grown accustomed to during this 18 hours of labor was soon going to end and the pushing phase was going to start. However, I had to admit I had grown comfortable with the labor, I knew it; I knew what to expect so the thought of doing something new actually scared me a bit! So in the shower, I went round and round in my own head…knowing and feeling that the pushing phase was going to start. And then all of the sudden…BAM…. I snapped out of it and into go mode.
My eyes flew open, I jumped up, swung open the shower door, marched over to the birthing tub, exclaimed, “Let's do this!” and sat down on my next contraction, pushing began. Now, this was the absolute COOLEST and most AWESOME part of the whole labor.  The water bubbles on my back were still doing their voodoo magic so the intense back labor was a dull roar, but the feeling of knowing my body's ability to push was so empowering and comforting.  And the MOST amazing thing was there was absolutely very little coaching.  The midwives understand and know that your body tells you how and when to push and very little coaching is needed to get the job done.  My body didn’t tell me to push every contraction, my body didn’t tell me to push for “x” amount of seconds.  Also, everyone was so very supportive that there was no doubt in my mind that I COULD do this and no one had told me otherwise!

I pushed around every other contraction for maybe 30 minutes and Maddox’s head made its appearance! The pushing phase didn’t hurt the way you might imagine… it was just a lot of pressure but felt really good and productive.   Now, to explain his position in text is difficult, but instead of me pushing out the back of his head (the smallest part) I actually pushed him out forehead and face first… and when the midwives evaluated how he was right when his head came out, they immediately had me flip over to my hands and knees and had me push hard as he also had both of his hands up under his chin and his arms crossed! I know my ability to push him out in this all sorts of wonky way is because I was never told I couldn’t do it. There was never any doubt about my body's ability to birth naturally from my midwives and I was able to present to the world my 10.5 pound huge wonky positioned baby with the confidence and peace that I had been dreaming of for years before his birth.  The water had also allowed for ease of passage in the birth canal with absolutely NO tearing or damage for such a large baby and strange presentation!

What was absolutely the most amazing thing was instead of the mad rush that I experienced in the hospital when Sienna was born. Maddox, Nathan and I simply stayed in the tub for as long as we wanted while the midwives did all of the necessary examinations of Maddox while he laid in my arms!  They kept the chord in tact until it stopped pulsing with blood allowing for the healthy full transfusion of blood from the placenta to happen and also allowed for the celebration from all of the birthing team to be so inclusive and wonderful! We all marveled at the new baby for a good half hour until Nathan and I got up and went to our own bed and after the placenta was delivered (spare you those details) and the linens were changed we simply laid back in our own bed while I fed the new little dude!

At this time, Nathan went and got Sienna from our babysitter’s house and she came and met Maddox just a couple hours after he was born.  She got to help take his temp, measure him, and listen to his heart beat.  She was immediately smitten with her baby bro. And when it came time to weigh the big dude, we all could NOT believe his size!! Then the midwives cleaned up...Sienna went to bed…Nathan and I with our new baby, Maddox, cuddled up in our own bed and slept.   

The midwives were on call overnight, Rhonda was in charge of checking on me and Maddox throughout the night making sure we didn’t have a temp, Maddox didn’t have any respiratory symptoms and all that and the midwives came back the next day…a few days later….and were always on call.
The recovery was so beautiful…I felt “other worldly” for the longest time after Maddox was born.  Like I had somehow, for just a little second, felt the power of our nature … like I had brushed the side of Heaven and took it down and shared it with my new little guy.  I cannot fathom the thought of numbing myself against this most empowering, emotional, and spiritual experience… nor can I imagine allowing the medical industry to take away from me the most wonderful process of natural childbirth. It saddens me to no end to hear these most terrible birthing stories as to birth naturally is to truly feel your own glory as a woman…all the  emotions, weakness, sensuality, love, and power.  

A further note:

    “We welcomed Maddox into our family that night without a circumcision. We decided that we want him to live in a world without violence, so we welcomed him without violence. We decided that we want him to live in a world in which he is free to experience the fullness of the pleasures of his body, so we welcomed him with all his fleshy nerves intact. And we decided that we want him to live in a world in which male entitlement is a waning memory, and in which women and men are seen--in both ritual and in reality--as full equals and partners. So we welcomed him equally."

Here are the 7 Reasons We Chose NOT to Circumcise Our Son


Wednesday, 02 November 2011 00:12

Night Waking Is Part of Parenthood

If your baby is waking up in the middle of the night, there are many reasons that play a factor.

Here are a few things I check for:

First of all, IS THE BABY SICK?: When my baby had been waking up a ton...I kept my head down and used my "emergency mode" every night (see below) and low and behold, my baby had an ear infection. My reaction was correct so my first instinct is to treat the baby like he is sick and if nighttime waking continue, consider a doctor visit. Often times, sickness is difficult to pinpoint for moms and dads so a doctor visit may help you decide what’s going on.

Other culprits of nighttime waking are:

  • growth spurt (very hungry baby at night)
  • teething (pain is more intense at night)
  • nightmares (they start much earlier than one would think!),
  • separation anxiety (love through separation anxiety, it’ll go away faster!)
  • often in toddlers, it maybe a discipline situation.

This is the “emergency mode” plan I implement when we are going through a bad streak of night waking:

DO NOT LOOK AT THE CLOCK:  When the baby or child is waking up, do your best to get rid of the clock, hide it, put tape over the time, whatever you can do so you don’t look at it. You need to tend to your child's needs (or older child's disciplining) without knowing what time it is. This keeps you from reacting to the time first and the child next. It also keeps you from counting how many hours of sleep you’ve had or haven’t had.

TAKE NAPS: Do whatever you can do planning wise to insure you can take a nap. Figure it out for your family and your situation. But you need a few moments so you don't loose your mind. Everyone in the family needs to work to help you get a little rest.

COFFEE: A little bit of caffeine in a good cup of coffee when I wake up first thing in the morning goes a long way to help with nighttime waking. You can always back down when you are getting a tad more rest.

ATTITUDE: It will not be like this forever…repeat this over and over. Do what you can do to keep your attitude positive. Demand help, take a walk, smell a rose, complain on Facebook or to a trusted friend during the day. At night, you need to keep a level head for your child. You are the adult so you have the responsibility and ability to control your emotions and reactions. Don’t react or do anything out of sleep deprivation only. You will regret it!  

KEEP YOUR SLEEP TO YOURSELF: Try to keep from comparing sleep with other parents unless you trust the parent and are asking for advice. For some reason sleep has become a barometer on how good you are at parenting, know this is simply not true and that every baby and situation is different. Also, if you don’t look at the clock when baby wakes then you can honestly say that you don’t remember how many hours your child slept.  It’s a great “out” for a potentially awkward conversation and saves you an awful lot of grief.

CO-SLEEP: Some parents use co-sleeping to help put the baby or child to sleep as it relieves separation anxiety and can calm both you and the child down. This works for many families and you have to decide what works best for your family.

Most of all, love your baby and good luck!!! :-D

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