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Did you know that 80 percent of all strokes are preventable? Learn which foods should be eaten in moderation to reduce your family's risk of stroke. Stroke is the fifth leading cause of death in the nation and a major cause for disability, killing 130,000 people each year. But did you know that 80 percent of all strokes are preventable, according to the American Stroke Association? Several stroke risk factors -- high blood pressure, smoking, diabetes, physical activity level, obesity, high cholesterol and heart and artery disease -- can be controlled, treated and improved, right down to the foods we choose to consume each day. Diets high in sodium can increase blood pressure, putting you at greater risk for stroke. A high-calorie diet can lead to obesity -- another risk factor. And foods high in saturated fats, trans fat and cholesterol will raise your blood cholesterol levels causing blood clots, which -- you guessed it -- can lead to a stroke. The “not-so-fab” five foods listed below play a large role in damaging your body and causing vascular disease, stroke and heart disease and should be avoided on a regular basis. However: Moderation is the key to life, in my opinion. Sure, everyone is going to have a soda here and there or a steak off the grill, but keep it off the main menu.  1. Packaged and Fried Food Have you noticed foods like hot dog buns and bottled salad dressings rarely go bad? Ever asked yourself why? This is due to the use of hydrogenated oils, which are trans fats. Hydrogenated oils stay solid at room temperature and do not require refrigeration. Convenient? Yes. Healthy? No. Unfortunately, many frozen foods and meals also fall into this category, except for frozen fruits and veggies. So here’s the lowdown on trans fats: They’re considered by many experts as the worst type of fat you can consume, raising your LDL (“bad”) cholesterol and lowering your HDL (“good”) cholesterol. While some meat and dairy products contain small amounts of naturally occurring trans fat, most dietary sources are formed through an industrial process adding hydrogen to vegetable oil, causing the oil to solidify at room temperature.  The FDA is in the process of restricting or possibly banning trans-fats from food in the U.S. A study published in JAMA Cardiology compared data from counties with and without trans-fat restrictions and the findings were substantial: There was a 6 percent decline in hospitalizations for heart attack and stroke in counties with trans-fat restrictions.  Bottom line: Ideally no processed food should pass your lips, but realistically, aim for less than 2 grams of trans fat per day. Skip the store-bought treats at the office and fries at lunch. Also avoid crackers, regardless of what you are dipping them in. Choose to eat fruits to satisfy your sweet cravings and veggies and hummus to satisfy the savory.  2. Lunch meat Processed meats, including bacon, smoked meats and hot dogs, are all on the DNE (Do Not Eat) list, unless you want to play with fire. Processed meats are a no-go if you want to keep your arteries clear of plaque buildup. So what is the alternative to your salami sandwich?  Try a healthy alternative like a tuna sandwich with avocado (a great alternative to mayo) or a veggie sandwich. 3. Diet soft drinks First of all, when a drink is sweeter than a candy bar but it contains zero sugar and zero calories, buyer beware. Many consumers think because a soda is labeled “diet” it’s a better choice, but studies have linked diet soft drink consumption with an increased risk of stroke and vascular disease. In a nine-year study of more than 2,500 people, those who drank diet soda daily were 48 percent more likely to have a heart attack or stroke or die from those events, compared with those who rarely or never drank soda. What else are you supposed to drink? If you must drink soda, break the everyday habit and drink it on special occasions; otherwise water rules. And if you don’t like water, try flavoring your water with fruit slices. 4. Good-old red meat So is there ANY good meat out there you ask? The answer is yes, but it’s not red. In the journal Stroke, an article showed women who consumed large servings of red meat regularly had a 42 percent higher incidence of stroke. Red meat is high in saturated fat, which clogs arteries with plaque. The alternative to red meat is a heart-healthy protein like poultry or fish, or even non-animal products like beans, nuts and tofu.  5. Canned foods Steer clear of factory processed soups, beans and sauces. Canned items all have incredible amounts of sodium or MSG or baking soda/powder to maintain their freshness and shelf life. One study showed if you consume more than 4,000 mg of salt per day, you more than double the risk of stroke compared to diets with less than 2,000 mg. Another tip: When possible, plan and make meals from scratch. Making the wrong meal or snack choices is one of the biggest contributing risk factors for stroke and heart disease. Most people know what good food choices are, but they don’t realize the serious impact the bad choices have on overall health. Learn what is most beneficial to your body to consume. It will be a life changer – literally.

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Craving a snack with crunch, sweet flavor and a powerful nutritious punch? These healthy, homemade variants of this make-it-and-take-it super snack are sure to satisfy your sweet tooth and your healthy lifestyle. Who says healthy snacks and bland taste go together? We say you can have it all — nutritious and delicious snack foods that taste great and satisfy — and trail mix fits the bill. Your homemade batch can be as healthy as you like. The nuts provide fiber, protein and a whole lot of crunchy goodness; dried fruit and touches of chocolate infuse the mix with just the right amount of sweetness. We’ve compiled some simple-to-make and hard-to-resist recipes so you can easily pick up a few items from the grocery store’s bulk bins, or your kitchen cupboard, and put together a snack for your kiddos lunches or the office. Better yet, grab your mix and head out for a stroll or hike, or take along on your next road trip or adventure in Nevada’s rugged, desert locales.

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One of the best things about living in the Reno area is the beautiful mountain range that surrounds our city. Many families take advantage of the activities the mountains have to offer or travel over them to visit friends and family in neighboring areas. However, for parents of infants there is often angst over your baby’s ears and altitude changes and the associated potential for ear pain and/or “popping.” Fortunately, there are things you can do to protect your infant’s ears the next time you drive over the mountain or hop on a plane with your little one. Baby’s Ears and Altitude Changes: What Causes Them to “Pop” The simple answer is pressure. The problem originates in the middle ear where there is an air pocket that is vulnerable to changes in pressure. The Eustachian tube, which runs behind the nose to the middle ear, is constantly absorbing and resupplying air to this pocket to keep it balanced. When the pressure is not balanced, your ears feel “clogged” or like they need to “pop.” In some cases this sensation can cause significant ear pain and even temporary hearing loss. Rapid changes in elevation or altitude, like driving over a mountain, or ascending or descending on an airplane, can cause rapid changes in pressure. In order to avoid problems, the Eustachian tube needs to open widely and frequently to equalize those pressure changes. The problem often intensifies during descents as you go from an area of lower atmospheric pressure to an area of higher atmospheric pressure. This is why you hear babies screaming on planes during descent or why your infant is wailing in the car seat as you head down the mountain. What can you do to make it a more comfortable trip for your child? First, be prepared. Babies cannot intentionally “pop” their ears like adults can, but we can help them by encouraging them to swallow. Offer your baby a pacifier or bottle while making ascents and descents. If possible, it may be helpful to have an adult ride in the back seat with baby if you’re in the car to ensure this can happen. Don’t let your baby sleep during descent on a plane. Help your little traveler out by offering him or her a pacifier during this process, as descent is the most likely time for pain associated with altitude changes. If your baby is congested prior to travel involving altitude changes, seek the advice of your pediatrician since they may have other solutions, including medications such as decongestants. If you return from a trip and notice your infant is still fussy and uncomfortable, contact your child’s doctor for a thorough ear evaluation. Safe travels!

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Renown’s team of nurses and respiratory therapists discuss what you need to know before undergoing surgery, including fasting guidelines and how to improve recovery. There are several things to know before you undergo surgery, including steps to prepare at home in advance of your procedure.   Fasting Guidelines: No solid foods eight hours prior to surgery You may have clear liquids three hours before your surgery. Clear liquids include water, apple juice and lemon or lime-flavored soda water (not cola). In addition, do not chew or smoke tobacco (regular or e-cigarettes) after midnight the night before your surgery, unless instructed by your doctor or anesthesiologist.

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At 85, James Domingos is still enjoying life as a cowboy, thanks to a transcatheter aortic valve replacement. Always rolling with the punches when it comes to life, 85-year-old James Domingos faced his health issues with the same grit. For many years, he roped cattle for friends and rounded up horses for the Bureau of Land Management. In recent years, a pacemaker controlled the rhythm of his heart, but didn’t slow him down. “We used to be able to take walks for 15 minutes in one direction and take the dog,” says Domingos’ wife, Joy. “Then it got to be less and less.” Tests at Renown Health revealed a heart valve was nearly closed. His heart doctor, Jake Ichino, MD, FACC, FSCAI, suggested a transcatheter aortic valve replacement, known as TAVR, which repairs a heart valve without removing the damaged valve. The procedure is recommended for patients who are at high risk for open heart surgery.

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If you’re having surgery on your shoulder, why does it matter what’s in your stomach? We asked Dr. Matthew Hoberg to explain more about pre-surgery directives, including fasting. If you have an upcoming surgery, your care team likely gave you instructions to fast before your procedure. But why? We asked Matthew Hoberg, M.D., medical director of Renown Surgical Services, to explain why it’s important to forgo food and drinks before surgery. Why are patients instructed to fast before surgery? Regardless of surgery type or site, we want the stomach to be empty before having anesthesia, because anesthesia can reduce your body’s ability to protect and prevent food or acids from the stomach from entering the lungs. Normally, your body is able to prevent this, but anesthesia medicines make it harder for your body to do so. When food or liquids from the stomach get into the lungs, doctors call it “aspiration.” This is rare, but can be dangerous if it does happen. Solid foods and liquids leave the stomach at different rates too. Solid food takes longer to empty from the stomach than liquids, so the time to stop eating solids (eight hours) is longer than that for clear liquids (two hours). The body has energy reserves to produce needed nutrients and fuel during fasting. Recently, studies have shown it is important to stay hydrated and have some carbohydrates in clear liquids up to two hours before surgery, so clear liquids are allowed until two hours before surgery. There are also special rules for babies and young children who need surgery. For example, you may give breast milk up to four hours before surgery. If your baby drinks formula, you should stop six hours before surgery, and all solid foods you should stop eight hours before. Your child’s doctor or nurse will give you exact instructions. What if you show up for surgery and have broken the no-eating rule? Will surgery be re-scheduled? If patients have not followed the fasting guidelines, surgery will be postponed or rescheduled due to the possible increased risk associated with not having an empty stomach. The exception would be emergency surgery that cannot be delayed in which case special precautions are taken to help prevent anything from getting into the lungs. What other pre-operative rules should be followed to the letter? All instructions given to patients before their surgery or procedure should be followed. There are specific medical reasons behind all the instructions and they are designed for safety — to minimize risks, lower complications like infections and enhance the recovery process to help patients get back to normal as quickly as possible. Also, many patients ask if they should continue taking medications before surgery. The answer is: It depends. Your doctor or nurse will tell you which medicines you should take and when. Some medicines need to be stopped before surgery. But for others, it’s important you keep taking them as usual. You may also get new medicines to take before surgery. You may be asked to take some medications before surgery as part of advanced pain management protocols. If you need to take medicine right before your surgery, you can take it with a sip of water.

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To be on the move is a scary concept when you’re recovering from surgery. But did you know getting up and at ’em could be the key to a quicker recovery, post-surgery? Here’s some expert insight from Renown Surgical Services. The team at  has some news for you: Rest and movement are important to prevent serious complications. Here are some tips about how to get mobile after your procedure — and why it’s fundamentally important. Tip 1: Start Simple While you’re in bed, move your legs and feet up and down. Be sure to ask the nurses to help you get out of bed and into the chair for all your meals, or walk to the bathroom when needed. If you feel up to it, take a walk in the hallways with the nursing staff. Tip 2: The Sooner, the Better This may be surprising, but too much rest is not necessarily a good thing. The old saying “You use it, or you lose it” rings very true to maintaining the strength needed to get yourself out of bed. Beginning the mobility process early in your hospital stay will not only help you maintain strength and function, it may also help you get home sooner. Though it may seem counter intuitive, lying in bed all day can delay your healing time and cause serious complications to arise, including pneumonia, deep vein thrombosis or blood clots, pressure ulcers and sometimes constipation. Tip 3: Mobilize Your Support System Getting out of bed, sitting in a chair for meals and walking around your room or hospital unit can help reduce your risk of complications. The nursing staff will help you out of bed the same day of your surgery if it’s cleared by your doctor. Tip 4: Safety First The nursing staff is here to keep you safe, so make sure you call them for assistance getting out of bed. Even if you think you can do it yourself, use your call light to notify the nursing staff you are ready to get up and move. In addition, new medications can sometimes impair our judgment, balance and safety, so it’s always better to have help even though you may not need it. This is also why you may have a “bed alarm” on, to remind you to call for help and keep you safe while you are recovering. Tip 5: Move, But Manage Your Pain Many people find that getting up and moving actually helps their pain, rather than making it much worse. Taking the right amount of medication at the right times will minimize your pain and help you to get moving. Your care team will work with you on how much pain medication is right to manage any postoperative pain, with the goal for you to be comfortable enough to be able to move and gradually increase your activity each day. Tip 6: Maintain that Momentum at Home Mobility doesn’t end once you’re discharged from the hospital. It’s key to keep moving to maintain health and function. When you first arrive home, it’s crucial to take frequent movement breaks throughout the day. Increase activity as it becomes more comfortable, and be sure to ease back into an active daily routine. If you have concerns about your mobility once home, be sure to discuss this with your doctor at your follow-up appointment. Renown Surgical Services | 775-982-3993 Ask your doctor if you have any questions about your medical condition or the specific surgical procedure planned, or contact the team at Renown Surgical Services. Learn More

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Friday, April 12 is National Grilled Cheese Sandwich Day! So Let us help you create a healthier melt-in-your-mouth version to this popular cheesy sandwich. Ah, the grilled cheese. It’s the quintessential comfort food that not only pairs easily with a cup of soup, but it’s easy to whip together with just a few ingredients. There are many reasons to celebrate the gooey cheesiness of this toasted sandwich, but at nearly 700 calories, it’s definitely an occasional treat. But with just a few ingredient swaps — think light mayonnaise or toasting the bread in a toaster instead of slathering it in butter — you can remake your grilled cheese into a mouth-watering and nutritious meal. We’ve compiled a couple of easy substitutions, and some of our favorite healthy twists, so you can try a new variation of an old favorite. Be Choosy with Your Cheese It’s the star of your sandwich, but do you need to always grab the yellow slices? Try to opt for stronger flavors, like blue cheese or extra-sharp cheddar, to help you retain flavor while using less cheese on your sandwich. Better Bread Goes A Long Way Plain old white bread might be your toast of choice, but by choosing a whole wheat or multi-grain bread for your sandwich you’re not only adding in new crunch and flavor, you can also increase your fiber and nutrient intake. Hold the Butter Your mom, and maybe even your grandmother, probably spread a layer of butter on your grilled cheese throughout your childhood. But know this: It isn’t necessary. While butter helps crisp the crust, it doesn’t add too much in the way of flavor. Instead, brush the bread with olive oil, or try using a thin layer of reduced-fat mayonnaise or a creamy spread. Or skip grilling altogether by toasting your bread and then baking your sandwich open faced in the oven for a few minutes at 350 degrees. Healthier Options Looking for a new twist? Here are three incredibly tasty (and healthier) versions of the traditional grilled cheese sammy. 1. Baby Swiss And Tomato Grilled Cheese 2. Green Grilled Cheese 3. Spinach, Pesto & Havarti Grilled Cheese

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Breast milk. It's often referred to as liquid gold. And fortunately, it can be safely refrigerated or frozen for later use, which can allow you to be a bit more flexible in your new routine with baby. Whether you're getting ready to return to work, planning for the chance date night out or just exclusively pumping, it's crucial to understand the guidelines for proper breast milk storage. Storing Breast Milk Use clean bottles with screw caps, hard plastic cups that have tight caps or nursing bags (pre-sterilized bags meant for breast milk). Be sure to label each container with the date the milk was pumped and your baby's name if the milk is going to childcare providers. You can add fresh, cooled milk to milk that is already frozen, but add no more than is already in the container. For example, if you have two ounces of frozen milk, then you can add up to two more ounces of cooled milk. For healthy full-term infants, milk can be stored as follows: Room temperature - six to eight hours (no warmer than 77°F, or 25°C). Refrigerator - up to five days at 32°-39°F (0°-3.9°C). Freezer– Varies depending on freezer type. Up to two weeks in a freezer compartment located within the refrigerator. Three to six months in a freezer that is self-contained (standard kitchen fridge/freezer combination) and kept at 0°F (-18°C). Breast milk should be stored in the back of the freezer and not in the door. Six to 12 months in a deep freezer that is kept at -4°F (-20°C). Be sure to leave about an inch of space at the top of the container or bottle to allow for expansion of the milk when it freezes. Thawing Breast Milk Place frozen breast milk in the refrigerator to thaw (about 24 hours) then warm by running warm water over the bag or bottle of milk and use it within the next 24 hours. If you need it immediately, remove it from the freezer and run warm water over it until it's at room temperature. Never microwave breast milk and do not refreeze it. Once your baby has started to drink from the bottle, you should use it within one hour. You may find that different resources provide different recommendations about the amount of time you can store breast milk at room temperature, in the refrigerator and in the freezer. Talk to your doctor or lactation consultant if you have any concerns or questions.

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Watch what happens when a family’s matriarch finds out she has to have heart valve replacement surgery. Thanks to supportive cardiac care, she is now back to health and enjoying her extended family with a healthy heart.  Marilyn O’Gorman has a full heart full of love: Just ask her six children, 15 grandchildren and six great grandchildren. However, in 2009, tests showed that same heart had medical issues. So her close family was by her side when she underwent heart valve replacement surgery. O’Gorman says her heart doctor, Athan Roumanas, MD, FACS, put her at ease about the surgery. “You’re very nervous — you’re scared,” says O’Gorman. “You don’t know: Are you going to come out of it? Is it going to work?”  Heart Valve Replacement Surgery Comes with an Unexpected Question O’Gorman was asked to choose whether she’d prefer a pig or a cow valve — ultimately inquiring of Dr. Roumanas which one he’d choose for his own mother.  “And he said, ‘Well, probably pig,'” she recalls. “And I said, ‘OK, I’ll oink for you.’ And that’s how I got that, and he did a wonderful job.”  O’Gorman continues her care at the Renown Institute for Heart and Vascular Health, so she can stay heart healthy and spend her free time with the many generations of family in her life.

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By taking our pregnancy and birth class, you will gain the tools necessary to have a safe and empowering birth experience for both you and your baby. Chris Marlo, Childbirth Educator at Renown Health explains why birth classes are important. For questions regarding classes or tours, contact Chris Marlo: chris.marlo@renown.org 775-982-4352 What is a Certified Childbirth Educator/Doula? If you are expecting a baby, Renown has a wide variety of classes to help prepare you for birth. Classes are taught by certified childbirth educators and doulas. A certified childbirth educator is a trusted resource who has a passion for educating expecting parents about childbirth, and will provide you with non-biased, evidence-based information. A doula is a professional labor assistant who provides physical and emotional support during pregnancy, childbirth and postpartum. As you prepare for birth, our certified educators will guide you each step of the way and ensure you receive the quality care you deserve. Why Should I Take Pregnancy and Birth Classes? For expecting parents, taking a childbirth education course is an important step in preparing for their new arrival. We cover topics such as labor and delivery, postpartum care, breastfeeding, nutrition, pain management techniques, and more. Our experienced instructors will provide you with the information you need to make informed decisions during your pregnancy and childbirth. With our classes, you can be sure that you have all the knowledge necessary to have a positive experience before, during, and after your baby’s arrival. Our classes will help ease your fears as we practice breathing, relaxation and the many tools you can utilize for birth. At Renown we understand that there is no right way to give birth, and our educators will offer a supportive environment where questions are encouraged, and everyone is respected. Childbirth Class Options: Baby and Family Suites Tour & Virtual Tour Breastfeeding Basics and Beyond Class Breathing & Relaxation Techniques for Birth Pregnancy and Birth – 5 & 7 Week Series Pregnancy and Birth Class Additional Resources: Baby Safe Class Babysitter Class Grandparents Virtual Class Infant CPR & Choking Class Newborn Care Nurturing Your Newborn Preparing for Postpartum Virtual Class

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Giving birth expends as much energy as running a marathon. And just like you would only run a marathon with training beforehand, there are exercises you can do to prepare for birth. But instead of a coach, you'll have your birth team. Your birth team exists to help you navigate pregnancy and labor and support your choices. Let's say you've never put together a birth team before and are wondering where to start. Today we'll go over the three main positions to fill for your birth team's starting lineup. Birthing Person The birthing person is the leader of the team. After all, you can't have a birth team without someone giving birth. This person could be the baby's mother, gestational surrogate, birth parent before adoption, a transgender father or a non-binary parent. If you are not the birthing person, don't presume to know what the ideal labor and birth circumstances should be. And if you are the birthing person, don't allow anyone else to tell you what you want. This is your body and your birth; you are the boss in the birth room. Doula No birth team is complete without a doula, and although doulas have increased in popularity lately, many people still don't know what a doula is. Simply put, a doula is a birth professional – not a medical provider – who offers emotional, physical and informational support during pregnancy, labor and beyond. Most doulas' services include at least one prenatal visit and one postpartum visit, as well as continuous care throughout active labor. Some doulas provide more than one prenatal/postpartum visit, so be sure to ask what is included in their fee. Even if you have a partner who will support you during labor, studies have shown that a doula can significantly increase your likelihood of a positive birth outcome. Even the most supportive partner needs to rest, and a doula can ensure that you still get the care you need while your partner gets a break. Midwife or Obstetrician Finally, you'll want to choose the medical professional who will attend your birth. Many folks choose to give birth with the OB/GYN who does their annual check-ups, but there are many reasons someone might choose a different provider for their birth. The first step to finding the best attending provider for your birth is to decide which model of care aligns closest to your values and goals: the Midwifery Model of Care or the Medical Model of Care. .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-qm8j{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} .tg {border-collapse:collapse;border-spacing:0;} .tg td{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; overflow:hidden;padding:10px 5px;word-break:normal;} .tg th{border-color:black;border-style:solid;border-width:1px;font-family:Arial, sans-serif;font-size:14px; font-weight:normal;overflow:hidden;padding:10px 5px;word-break:normal;} .tg .tg-gqvw{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-weight:bold; text-align:left;vertical-align:top} .tg .tg-8vim{background-color:#ffffff;color:#56266d;font-family:Arial, Helvetica, sans-serif !important;font-size:18px; font-weight:bold;text-align:left;vertical-align:top} .tg .tg-2rvk{background-color:#ffffff;color:#000000;font-family:Arial, Helvetica, sans-serif !important;text-align:left; vertical-align:top} Midwifery Model of Care Medical Model of Care Philosophy Birth is physiological. Birth is potentially pathological. Interventions Medical interventions can cause more complications, and therefore are only used as needed. Medical interventions should be used, even in non-emergency situations and sometimes as preventative measures. Decisions Birthing person is the key decision maker. Medical professional is the key decision maker. Provider’s Role Providers monitor labor and will intervene or transfer to hospital if needed. Providers assess and control the birthing process.

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