Doula-Natalie Sue

The Power of Birth Language

2012-01-30T21:30:00.001-08:00

30 APRIL 2010.

http://bringbirthhome.com/guest-writers/the-power-of-birth-language/

by guest blogger Morgan A. McLaughlin McFarland

The ways in which we choose to describe a situation or relationship often shed light on our beliefs (be they conscious or subconscious) about the balance of power within that situation or relationship. The language that we use also shapes how we perceive a situation and how we will act when confronted with it.

Consider if you will, the word “let” when applied to a birth or a care provider/birthing mother relationship.

How broad is the gulf between “my care provider supports my plan to give birth in water” and “my care provider is letting me give birth in water?” Both describe the same situation–a mother and her midwife/doctor both agree on the safety/efficacy of the water birth–but while the first statement places the power in the hands of the mother, the second places it in the hands of the doctor.

In the first statement, the mother has come to a decision and then conferred with her care provider, who agrees with and supports that mother’s choice to birth as she sees fit. In the second statement, the mother has sought and been granted permission to pursue a certain type of birth.

Another word that misplaces the power of birth is “deliver.”

The same birth could be described in two ways: “I gave birth to my baby [in the care of Dr. Smith]” or “Dr. Smith delivered my baby.” Where is the mother in the second statement? The difference in the balance of power in those two statements is obvious, because in the second, the mother is presented as irrelevant to the birth, which exists only as a relationship, a delivery, between the baby and doctor.

Do our babies really need to be delivered from us, liberated or saved from our bodies? Should we deliver our babies into the hands of others, as though they were pizzas or packages places in someone else’s care? An empowered mother births or gives birth to her baby; she is not delivered by a doctor or midwife. Using this language, she is the initiator of the experience, an active participant in the action, and the care provider’s role is to attend the birth or assist the birthing mother.

We believe birthing women are clients of the care provider and that the care provider works for the mother, rather than seeing birthing women as patients of a doctor/midwife authority figure to whom they must defer.

As adult women preparing to bring another life into the world, we must be empowered enough to stop seeking permission from doctors, nurses, and midwives. We must not put ours births into their hands for delivery, but claim our rightful place as the source of the birth experience. We must be careful in the language we use to describe, not just our own pregnancies/births, but the pregnancies/births of others.

If we are to own our birth experiences, we must remember that care providers require our permission to act, not the other way around.

While changing your language can’t guarantee a perfect birth experience for yourself or anyone else, being aware of your word choice can help you be more empowered through even a less than ideal birth experience. Women who believe in their right to weigh the costs/benefits of interventions, choosing the course of action they believe is safest for their babies and themselves, are less likely to feel a sense of disempowerment and anger after the birth is over.

Even if choice is between a rock and a hard place, simply owning the responsibility to make that choice is empowering. Owning your birth experience can give immeasurable strength. The first step to that ownership is language.

Take a moment to consider why you might choose words like “let/allow” and “deliver” to describe a birth experience, especially if you’re using those words in the context of expectations for an impending birth.

If you are wondering if your midwife/doctor will let you do something, consider examining why you, as an intelligent, empowered adult, need permission to do something your body already knows how to do. If you think of the birth process as a delivery, consider questioning why you frame it within the context of that language.

Giving away our power verbally or in writing creates a paradigm in which we condition ourselves to surrender our power in actuality. When your language paradigm shifts to place mothers and babies at the center, and providers on the periphery, so, too, will your beliefs shift.

As you think and write and speak, so shall you live. As you live, so shall you birth.

Home Birth is Safe says new study

2012-01-15T22:46:00.001-08:00

By Amanda Gardner, HealthDay http://www.usatoday.com/news/health/2009-09-03-midwife-home-birth_N.htm

Having your baby at home with a registered midwife is just as safe as a conventional hospital birth, a new study says.

In fact, planned home births of this kind may have a lower rate of complications, according to the study published in the Sept. 15 issue of CMAJ.

Even though the study was conducted in Canada, where attitudes toward midwifery are more accepting than in some other countries, the findings may help to calm an ongoing controversy in the United States and elsewhere.

The American College of Obstetricians and Gynecologists is opposed to home births, as are certain organizations in Australia and New Zealand. More organizations in Great Britain are supportive and Canadian provinces are currently transitioning to midwifery, said study lead author Patricia Janssen, director of the Master of Public Health Program at the University of British Columbia.

Janssen, a registered nurse who has midwife training though not certification, said: "People who function as independent midwives are not necessarily tightly regulated [in the U.S.] depending on which state you're in, so there may not be a guarantee that they have had an adequate level of training or a certified diploma or anything like that. And they may not be monitored and regulated by a particular professional college."

The controversy has resulted in a lack of clear regulation and licensing requirements in the United States, said Dr. Marjorie Greenfield, associate professor of obstetrics and gynecology at University Hospitals Case Medical Center in Cleveland.

According to Greenfield, the National Association of Certified Professional Midwives does have a certification process but many states don't recognize it. "If you're a woman who wants to have a home birth, how do you determine if this person has appropriate qualifications?" she said.

The authors of the new study compared three different groups of planned births in British Columbia from the beginning of 2000 to the end of 2004: home births attended by registered midwives (midwives are registered in Canada), hospital births attended by the same group of registered midwives, and hospital births attended by physicians. In all, the study included almost 13,000 births.

The mortality rate per 1,000 births was 0.35 in the home birth group, 0.57 in hospital births attended by midwives, and 0.64 among those attended by physicians, according to the study.

Women who gave birth at home were less likely to need interventions or to have problems such as vaginal tearing or hemorrhaging. These babies were also less likely to need oxygen therapy or resuscitation, the study found.

The authors acknowledge that "self-selection" could have skewed the study results, in that women who prefer home deliveries tend to be healthier and otherwise more fit to have a home birth.

Janssen said she hoped "this article will have a major impact in the U.S." But there is a definite "establishment" bias against home births. And the issue is an emotionally charged one, she said.

"There is a political and economic issue about controlling where birth happens, but also a deep belief by physicians that it's not safe to have your baby at home," Greenfield said. "Doctors see every home-birth patient who had a complication, but we don't see the ones that have these beautiful, fabulous babies at home who may breast-feed better or have less hospital-acquired infections. There may be medical benefits," she added.

"Midwifery needs to be regulated. It can't be under the radar because then it's dangerous," Greenfield said. "There has to be a regulatory process and a licensure process [to protect] women who are going to choose home birth anyway."

5 Ways Pitocin is different than oxytocin

2011-12-26T10:26:00.000-08:00

The numbers of inductions of labor using artificial means likePitocin and other medications has gone up dramatically in the last few years. A hospital in my area says that 90 of the women have their labors induced. Since science shows us that inducing labor can increase the numbers of complications in the labor and with the baby, you might be surprised to note that many of the inductions are not for medical reasons, but rather reasons of convenience, practitioner or mother, known as social induction.

One of the things that women tell me is that they are lead to believe that induction is completely safe and relatively easy, after all, Pitocin is just another form of the body's own oxytocin, right?

While this statement is generally true, artificially created hormones, including Pitocin do not act identically to the hormones in ones body. For example, in pregnancy both the mother and the baby produce oxytocin. The oxytocin produced by each reacts differently in the body because they each have separate jobs.

Here are five things that you may not know about Pitocin and how it can effect your labor:

Pitocin is released differently.
Oxytocin is released into your body in a pulsing action. It comes intermittently to allow your body a break. Pitocin is given in an IV in a continuous manner. This can cause contractions to be longer and stronger than your baby or placenta can handle, depriving your baby of oxygen.
Pitocin prevents your body from offering endorphins.
When you are in labor naturally, your body responds to the contractions and oxytocin with the release of endorphins, a morphine like substance that helps prevent and counteract pain. When you receive Pitocin, your body does not know to release the endorphins, despite the fact that you are in pain.
Pitocin isn't as effective at dilating the cervix.
When the baby releases oxytocin it works really well on the uterine muscle, causing the cervix to dilate. Pitocin works much more slowly and with less effect, meaning it takes more Pitocin to work.
Pitocin lacks a peak at birth.
In natural labor, the body provides a spike in oxytocin at the birth, stimulating the fetal ejection reflex, allowing for a faster and easier birth. Pitocin is regulated by a pump and not able to offer this boost at the end.

Pitocin can interfere with bonding.
When the body releases oxytocin, also known as the love hormone, it promotes bonding with the baby after birth. Pitocin interferes with the internal release of oxytocin, which can disturb the bonding process.

Your body's own natural oxytocin is superior in many ways to Pitocin. There are also ways to increase the release of this natural oxytocin including skin-to-skin contact, lovemaking, breastfeeding, and others.

So, if you are presented with the option of an induction of labor, you might want to ask your provider about whether or not it is being done for a medical reason or if it's something that a bit of time and patience will help alleviate.

_Sources:

_{American College of Obstetricians and Gynecologists [ACOG]. (2004). ACOG Practice Bulletin No. 55: Management of postterm pregnancy. Obstetrics and Gynecology, 104(3), 639-646.}

_{Glantz, J. C. (2005). Elective induction vs. spontaneous labor associations and outcomes. Journal of Reproductive Medicine, 50(4), 235-240.}

_{Kramer, M. S., Rouleau, J., Baskett, T. F., & Joseph, K. S. (2006). Amniotic-fluid embolism and medical induction of labor: A retrospective, population-based cohort study. The Lancet, 368(9545), 1444-1448.}

_{Leaphart, W. L., Meyer, M. C., & Capeless, E. L. (1997). Labor induction with a prenatal diagnosis of fetal macrosomia. The Journal of Maternal-Fetal Medicine, 6(2), 99-102.}

_{March of Dimes. (2006). If you’re pregnant: Induction by request. Retrieved May 15, 2007, fromwww.marchofdimes.com/prematurity/21239_20203.asp}

_{Sanchez-Ramos, L., Bernstein, S., & Kaunitz, A. M. (2002). Expectant management versus labor induction for suspected fetal macrosomia: A systematic review. Obstetrics & Gynecology, 100(5), 997-1002.}

_{Vahratian, A., Zhang, J., Troendle, J. F., Sciscione, A. C., & Hoffman, M. K. (2005). Labor progression and risk of cesarean delivery in electively induced nulliparas. Obstetrics & Gynecology, 105(4), 698-704.}

_{Vrouenraets, F. P., Roumen, F. J., Dehing, C. J., van den Akker, E. S., Aarts, M. J., & Scheve, E. J. (2005). Bishop score and risk of cesarean delivery after induction of labor in nulliparous women. Obstetrics & Gynecology, 105(4), 690-697.}

Low Amniotic Fluid

2011-12-26T10:24:00.000-08:00

http://www.glorialemay.com/blog/?p=60

You Can't Spoil a Baby

2011-12-26T10:23:00.000-08:00

http://www.circleofmoms.com/article/more-cry-babies-can-you-spoil-baby-00619?trk=fbfp_spoil_061611&reload=1

At some point, a grandma, neighbor or random stranger has probably served up advice (unsolicited) that you're going to spoil your baby by racing to comfort her when she cries or fusses. Or, this parenting guru wannabe has read you the riot act for for holding your baby too much. "You're going to spoil her," they proclaim. "You'll be sorry."

Well, pooh-pooh to them, say many Circle of Moms members. These moms feel strongly that you can't spoil a baby by holding or comforting her too much. In fact, they believe the opposite: that meeting an infant's need to be held and fed in a predictable fashion actually helps your baby feel more secure and will build a lasting relationship of trust between mom and child.

"Human infants are born incredibly vulnerable," says Lisa M. "They're also biologically programmed to need near-constant contact with their mothers. Basically, a baby feels out of sorts and wrong when not being carried. A dry diaper and a full belly just don't cut it," Jennifer L. says, adding that "A baby needs to be held, It isn't even that they just want to be, they actually need it. Human contact is essential for proper brain, cognitive, and emotional development."

What's more, many of Circle of Moms members feel that responding to your baby actually fosters independence. "I held my son all the time, I still pick him up when he is crying," says Nikki M. about her 13-month-old son. "I don't believe you can spoil a baby, a baby needs their mommy to comfort and soothe them. Studies have shown babies who are not left to cry are the ones who are the most independent later on, because they feel safe and secure. My son is the most independent little boy out there."

Many Circle of Moms members also agree that cuddling and holding a baby fall into the same category of basic needs as feeding and changing dirty diapers. As Angie E. explains,"The need to be held and cuddled...is as much a need as any of the other things. It's how they build attachments and learn that they are safe. Remember the baby has just spent nine months living inside of you, hearing your heart beat all day long and being warm and cozy. How scary must it be for them to suddenly be put in a big crib all alone with no heartbeat to listen to, no warm cuddly place where they can hear your voice?"

So next time someone suggests that a baby is purposefully turning on the waterworks to yank your chain and be spoiled, don't pay attention, suggests Brandy K. "If your baby is having some separation anxiety and is being extra-needy, wanting to be held all the time, the quickest way to get him through it is to be there for his every cry. [Knowing] that you are there for him all the time, whenever needed, will build [his] confidence and support him in becoming an independent person. Mothers are supposed to be nurturing, and babies need to be held and comforted."

Co-Sleeping

2011-12-26T10:03:00.000-08:00

Co-sleeping is a common practice in non-Western cultures but is growing in popularity as it promotes breastfeeding, bonding and is safer than crib/cot sleeping when practiced correctly. Some parents continue co-sleeping with their children into toddlerhood and young childhood. Co-sleep is a sleeping practice where parents have the infant sleep with them rather than in a separate bed or crib.

Co-sleeping has received a bad reputation in the Western world due to poor practices that have resulted in infants being smothered by bedding or crushed by parents. However, when done properly, co-sleeping can have many benefits. Here are a few facts to consider when co-sleeping with your baby:

1. WIll I crush or smother my baby?

It is impossible to claim that there is ZERO chance of an adult crushing or smothering a baby while sleeping as there is no infant sleep environment is 100% risk free. In the worldwide ethnographic record, mothers accidentally suffocating their babies during the night are virtually unheard of, except among western industrialized nations. However, in western culture, there are an overwhelming number of infant death cases.

Many studies suggest that mothers and infants are designed to respond to the presence of each other throughout the night. Having said that, with safe practices, you will not smother your baby while co-sleeping.

2. How can I safely sleep with my baby?

Adults should not have consumed alcohol, drugs, or any narcotics while co-sleeping
It is not recommended to cosleep on couches, sitting chairs or water beds
The bed and mattress should be firm and should fit tightly against the headboard/footboard so that an infant cannot fall between cracks
Avoid using duvets and lots of pillows
Lightly wrap the baby rather than using heavy clothing, as contact with other bodies increases the baby’s temperature
The baby should not be placed on a pillow or have their head covered by blankets
It is not recommended to sleep with other children in the bed or allow toddlers to sleep alone, as children are not always aware when sleeping with other people

3. Can I sleep with my baby and my spouse in the same bed?

Yes you can. Ensure both adults are in agreement of the sleeping arrangement and never assume that the adult is aware of the baby in the bed. One suggestion is to make both parents agree to be responsible for the baby, not one, so both are accountable for the baby and its positioning.

4. What are the benefits of cosleeping?

Ease of breastfeeding: One study found that bed sharing infants breastfeed about twice as often as regular solitary sleepers, with the total duration of nightly nursing episodes amounting to almost three times of what is observed in lone sleep conditions (see p. 124 of Natural Parenting – Back to Basics in Infant Care – by Regine A. Schön and Maarit Silvén in the Evolutionary Psychology journal)
Better sleep for mom and baby: Co-sleeping means more sleep and generally less anxiety about sleep compared to mothers whose babies sleep in another room who need to get out of bed to respond to their baby. This causes the mother to wake up more fully and makes it more difficult for her to fall back asleep. Also, she is less able to rest while tending to her baby than a mother who is in bed with her baby. This is backed up by research by M.D. Gordon and S.L. Hill in 2008 that found co-sleeping families were less likely to believe their infant’s sleep was problematic than non-co-sleeping families
Mothers can react to baby: Co-sleeping mothers are more in tune with their baby’s sleep and can take action to keep their baby comfortable and safe during the night. Parents that have a baby in a separate room and use a baby monitor will hear their baby cry, but may not hear more subtle signs that their baby is uncomfortable. Missing those subtle cues can mean that the baby needs to wake more fully in order to alert the parents, which can result in more effort and time required to resettle the baby
Bed bonding results in more independent children: (reported on p.141 of Natural Parenting – Back to Basics in Infant Care) found that “routinely sharing the parents’ bed in infancy has been associated with greater self-reliance and social independence at preschool age than a history of solitary sleeping (Keller, M. A., and Goldberg, 2004).” Other studies have also consistently reported higher self-esteem among children and adults that co-slept during childhood
Allows working parents to connect with their child

4. What are the risks of co-sleeping?

Smothering/suffocating a baby is the biggest risk of co-sleeping when not done properly
Crushing the baby
The baby falling off the bed or between bed cracks

5. Until how old can I co-sleep with my baby?

You can co-sleep with your baby as long as works for your family. It has been proven that the longer you co-sleep with your baby, the more independent and well-adjusted they will be later in life.
6. Can a baby die of SIDS while cosleeping?
There is always a chance of a baby dying of SIDS when sleeping, as it occurs when babies sleep alone in an emptied crib and in a bed with other people. However, the odds are signifigantly reduced when co-sleeping properly.

Dangers of Crying-it-Out

2011-12-12T15:46:00.000-08:00

http://www.psychologytoday.com/blog/moral-landscapes/201112/dangers-crying-it-out?page=2

Dangers of “Crying It Out”

Damaging children and their relationships for the longterm.

Published on December 11, 2011 by Darcia Narvaez, Ph.D. in Moral Landscapes

Letting babies "cry it out" is an idea that has been around since at least the 1880s when the field of medicine was in a hullaballoo about germs and transmitting infection and so took to the notion that babies should rarely be touched (see Blum, 2002, for a great review of this time period and attitudes towards childrearing).
In the 20^th century, behaviorist James Watson, interested in making psychology a hard science, took up the crusade against affection as president of the American Psychological Association. He applied the mechanistic paradigm of behaviorism to child rearing, warning about the dangers of too much mother love. The 20^th century was the time when "men of science" were assumed to know better than mothers, grandmothers and families about how to raise a child. Too much kindness to a baby would result in a whiney, dependent, failed human being. Funny how he got away with this with no evidence to back it up! Instead there is evidence all around (then and now) showing the opposite to be true.

A government pamphlet from the time recommended that "mothering meant holding the baby quietly, in tranquility-inducing positions" and that "the mother should stop immediately if her arms feel tired" because "the baby is never to inconvenience the adult." Babies older than six months "should be taught to sit silently in the crib; otherwise, he might need to be constantly watched and entertained by the mother, a serious waste of time." (See Blum, 2002.)
Don't these attitudes sound familiar? A parent reported to me recently that he was encouraged to let his baby cry herself to sleep so he "could get his life back."
With neuroscience, we can confirm what our ancestors took for granted---that letting babies cry is a practice that damages children and their relational capacities in many ways for the long term. We know now that letting babies cry is a good way to make a less intelligent, less healthy but more anxious, uncooperative and alienated person who can pass the same or worse traits on to the next generation.

The discredited behaviorist view sees the baby as an interloper into the life of the parents, an intrusion who must be controlled by various means so the adults can live their lives without too much bother. Perhaps we can excuse this attitude and ignorance because at the time, extended families were being broken up and new parents had to figure out how to deal with babies on their own, an unnatural condition for humanity--we have heretofore raised children in extended families. The parents always shared care with multiple adult relatives.
According a behaviorist view completely ignorant of human development, the child 'has to be taught to be independent.' We can confirm now that forcing "independence" on a baby leads to greater dependence. Instead,giving babies what they need leads to greater independence later. In anthropological reports of small-band hunter-gatherers, parents took care of every need of babies and young children. Toddlers felt confident enough (and so did their parents) to walk into the bush on their own (see Hunter-Gatherer Childhoods, edited by Hewlett & Lamb, 2005).
Ignorant behaviorists then and now encourage parents to condition the baby to expect needs NOT to be met on demand, whether feeding or comforting. It's assumed that the adults should 'be in charge' of the relationship. Certainly this might foster a child that doesn't ask for as much help and attention (withdrawing into depression and going into stasis or even wasting away) but it is more likely to foster a whiney, unhappy, aggressive and/or demanding child, one who has learned that one must scream to get needs met. A deep sense of insecurity is likely to stay with them the rest of life.
The fact is that caregivers who habitually respond to the needs of the baby before the baby gets distressed, preventing crying, are more likely to have children who are independent than the opposite (Stein & Newcomb, 1994). Soothing care is best from the outset. Once patterns get established, it's much harder to change them.
We should understand the mother and child as a mutually responsive dyad. They are a symbiotic unit that make each other healthier and happier in mutual responsiveness. This expands to other caregivers too.
One strangely popular notion still around today is to let babies 'cry it out' when they are left alone, isolated in cribs or other devices. This comes from a misunderstanding of child and brain development.

Babies grow from being held. Their bodies get dysregulated when they are physically separated from caregivers. (See here for more.)

Babies indicate a need through gesture and eventually, if necessary, through crying. Just as adults reach for liquid when thirsty, children search for what they need in the moment. Just as adults become calm once the need is met, so do babies.

There are many longterm effects of undercare or need-neglect in babies (Dawson et al., 2000).

What does 'crying it out' actually do to the baby and to the dyad?
Neurons die. When the baby is stressed, the toxic hormone cortisol is released. It's a neuron killer. A full-term baby (40-42 weeks), with only 25% of its brain developed, is undergoing rapid brain growth. The brain grows on average three times as large by the end of the first year (and head size growth in the first year is a sign of intelligence). Who knows what neurons are not being connected or being wiped out during times of extreme stress? What deficits might show up years later from such regular distressful experience?
Disordered stress reactivity can be established as a pattern for life not only in the brain with the stress response system, but also in the body through the vagus nerve, a nerve that affects functioning in multiple systems (e.g., digestion). For example, prolonged distress in early life, resulting in a poorly functioning vagus nerve, is related disorders as irritable bowel syndrome (Stam et al, 1997). See more about how early stress is toxic for lifelong health from the recent Harvard report, The Foundations of Lifelong Health are Built in Early Childhood).
Self-regulation is undermined. The baby is absolutely dependent on caregivers for learning how to self-regulate. Responsive care---meeting the baby's needs before he gets distressed---tunes the body and brain up for calmness. When a baby gets scared and a parent holds and comforts him, the baby builds expectations for soothing, which get integrated into the ability to self comfort. Babies don't self-comfort in isolation. If they are left to cry alone, they learn to shut down in face of extensive distress-stop growing, stop feeling, stop trusting (Henry & Wang, 1998).
Trust is undermined. As Erik Erikson pointed out, the first year of life is a sensitive period for establishing a sense of trust in the world, the world of caregiver and the world of self. When a baby's needs are met without distress, the child learns that the world is a trustworthy place, that relationships are supportive, and that the self is a positive entity that can get its needs met. When a baby's needs are dismissed or ignored, the child develops a sense of mistrust of relationships and the world. And self-confidence is undermined. The child may spend a lifetime trying to fill the inner emptiness.
Caregiver sensitivity may be harmed. A caregiver who learns to ignore baby crying, will likely learn to ignore the more subtle signaling of the child's needs. Second-guessing intuitions to stop child distress, the adult practices and increasingly learns to "harden the heart." The reciprocity between caregiver and babu is broken by the adult, but cannot be repaired by the young child. The baby is helpless.
Caregiver responsiveness to the needs of the child is related to most if not all positive child outcomes. In our work it is related to intelligence, empathy, lack of aggression or depression,self-regulation, social competence. Because responsiveness is so powerful, we have to control for it in our studies of other parenting practices and child outcomes. The importance of caregiverresponsivness is common knowledge in developmental psychology Lack of responsiveness, which "crying it out" represents. then can result in the opposite of the afrementioned positive outcomes.

The 'cry it out' approach seems to have arisen as a solution to the dissolution of extended family life in the 20th century. The vast wisdom of grandmothers was lost in the distance between households with children and those with the experience and expertise about how to raise them well. The wisdom of keeping babies happy was lost between generations.
But isn't it normal for babies to cry?
No, babies are built to expect the equivalent of an "external womb" after birth (see Allan Schore, specific references below). What is the external womb? ---being held constantly, breastfed on demand, needs met quickly (I have numerous posts on these things). When babies display discomfort, it signals that a need is not getting met, a need of their rapidly growing systems.
What does extensive baby crying signal? It shows the lack of experience, knowledge and support of the baby's caregivers. To remedy a lack of information in us all, below is a good set of articles about all the things that a baby's cry can signal. We can all educate ourselves about what babies need and the practices that alleviate baby crying. We can help one another to keep it from happening as much as possible.
Check these out:
How to soothe babies: http://www.babycenter.com/0_12-reasons-babies-cry-and-how-to-soothe-them_9790.bc?page=2
Soothing babies crying "for no reason":http://www.babycenter.com/0_what-to-do-when-your-baby-cries-for-no-reason_10320516.bc
Soothing babies who have "colic":http://www.babycenter.com/0_colic-how-to-cope_1369745.bc
Science of Parenting, an inexpensive, photo-filled, easy-to-read book for parents by Margot Sunderland has much more detail and references on these matters. I keep copies on hand to give to new parents.
More on babies' and children's needs here, here, here.
Giving babies what they need is really a basic right of babies. See herefor more rights I think babies should expect. And see here for a new book by Eileen Johnson on the emotional rights of babies.

References
Blum, D. (2002). Love at Goon Park: Harry Harlow and the Science of Affection. New York: Berkeley Publishing (Penguin).
Dawson, G., et al. (2000). The role of early experience in shaping behavioral and brain development and its implications for social policy. Development and Psychopathology, 12(4), 695-712.
Henry, J.P., & Wang, S. (1998). Effects of early stress on adult affiliative Behavior, Psychoneuroendocrinology 23( 8), 863-875.
Schore, A.N. (1997). Early organization of the nonlinear right brain and development of a predisposition to psychiatric disorders. Development and Psychopathology, 9, 595-631.
Schore, A.N. (2000). Attachment and the regulation of the right brain.Attachment & Human Development, 2, 23-47.
Schore, A.N. (2001). The effects of early relational trauma on right brain development, affect regulation, and infant mental health. Infant Mental Health Journal, 22, 201-269.
Stam, R., et al. (1997). Trauma and the gut: Interactions between stressful experience and intestinal function. Gut.
Stein, J. A., & Newcomb, M. D. (1994). Children's internalizing and externalizing behaviors and maternal health problems. Journal of Pediatric Psychology, 19(5), 571-593.
Watson, J. B. (1928). Psychological Care of Infant and Child. New York: W. W. Norton Company, Inc.

My Birth Story

2011-09-11T19:28:00.000-07:00

You can go to this link to view pictures: http://birthstory.shutterfly.com/pictures/9

So here is the birth story! I think I have a chance now, to sit down and type it all up. It’s going to be very detailed because I don’t want to miss anything! It was such an incredible experience, that I want to save it in my memory forever.

So here’s how things happened. For about a week, I started noticing that my Braxton Hicks would sometimes feel a teeny bit crampy every once in a while. It was nothing major and hardly noticeable except for when I was sitting or lying down. I’d feel a little ache and then when I touched my belly, I noticed it was tight. I was so excited that something was happening. With my previous two babies, I’d only get Braxton Hicks if I was moving around – exercising, walking, etc – and then my uterus would get tight. These ones, this time, were happening on their own. I remember posting on facebook when I had a good one that really almost felt like a contraction. I was that excited.

I still did not expect anything to happen too soon. Both my other babies were a week overdue and induced. I assumed that my body needed at least 41 weeks to gestate and I already had my list of natural induction techniques ready if I made it to 42 weeks – which I thought I probably would. Although, in the back of my mind, I was wondering if I would go earlier than I expected….with these new signs.

Sunday the 4^th of September was a regular day. Except for the fact that I actually got a nap! It was wonderful. That evening we went to celebrate the upcoming birthday of our niece and had cake and ice cream. My neice’s birthday was on September 7^th – which was also my “guess” date. She has down syndrome and was completely convinced that this baby was also going to share her special day with her. For months she was telling everyone how “Natalie’s baby is going to be born on MY birthday.” I just knew that she was going to be disappointed when her birthday came and went, and there was no baby. Little did I know…

Later that evening, as I was sitting down checking my email, I noticed that I was having more crampy feelings….about 9 minutes apart. It was SO cool. I didn’t think it meant anything at all. Just some toning maybe. Plus I still wondered if I’d be one of those women that would have several practice sessions before my birthing time began.

I went to bed, and expected them to go away like they usually did after I went to sleep. The only thought I had about that was that I wondered if these evening tunings meant that I ‘d probably go into labor at night…one day.

I woke up a few times at night, to use the restroom, and didn’t notice anything out of the norm. Then I woke up just after 6 am, like I often did. I got up to get a bowl of cereal. I noticed that I was still having some crampy feelings. So I sat there for a while, interested if they were rhythmic. I started timing them. 6:33, 6:40, 6:46, 6:52, 6:57, 7:03, 7:11. I could NOT believe it. In fact, I decided to go back to bed, sure that things would stop again.

I woke up around 9. My little boys were so kind to entertain themselves with toys and movies that I slept so well. I got up and a few minutes later, noticed that things were still going on! Pretty exciting!

I figured that I better weed my flower beds, in case things were happening, since family would be coming over the next day, plus over the course of the next weekend. I was preparing my yard for my in-laws to come home, and for a sister-in-law’s wedding reception, so I wanted things to look nice. I got my iPod out and started listening to my Hypnobabies tracks. I listened to “Birthing Day Affirmations.” I spent about 45 minutes weeding, and I didn’t notice too much of anything as I was moving around and squatting and kneeling. But when I stopped and paid attention, they were still there.

I texted my sister-in-laws and just after 10 am….I told them that something was happening. I wasn’t sure if it meant anything or if it would turn into anything, but that it had been going on for a while. I told them to keep their cell phones on.

I went inside and puttered around the house a little bit. I made some lunch for my kids and I finally called my husband. I told him to stay in service (he’s a farmer in the country) in case things decided to start happening. He said he was coming home for lunch soon anyway.

When he got home, I decided to take a shower. You know, shave my legs, just in case. Plus I was a little smelly from weeding and needed to get ready for the day. It’s also a great way to see if you can calm down pressure waves (contractions.)

While I was in the shower, I had 6 pressure waves. Nothing was interfering with them. When I got out of the shower, I texted everyone again.

It was about 1:30 and I told them that things were pretty consistent. I wasn’t sure if they were still going to turn into anything, but to stay tuned.

I also called my mom. It was Labor Day (funny huh? ) and she had planned a family hike and BBQ. She was 3 hours away from me, so I wanted to give her a heads up and see if she would have cell phone service on the mountain. She asked me if she should get in the car and come, but I told her that I was still not quite sure if today was the day. I told her she could go on her hike.

I decided to get a few things ready. I dried my hair and did my makeup. I tried to finish packing my hospital bags. At 2:30 when things were still happening, I started to get anxious for my far-away family to get on the road. I finally thought that this might be it. I had started timing the waves and they were 5 minutes apart. I could not believe it. I timed them for an hour from 2:30 to 3:30 and they were consistent. I decided this was the day. Whoa.

That’s when I had a bit of a panic moment. I started trying to call and text everyone, and no one answered. I mean, no one. One doula was in Utah, but had an induction the next day, my back-up doula was on vacation with her family, but was supposed to be home soon, and another back-up was also 9 months pregnant. None of my sister-in-laws were answering their phones and my mom and dad weren’t answering theirs. I started to cry. I was so worried that after all this planning, that no one was going to make it to help me.

I sent out a text: Ah! Is anyone going to be able to come!?!

But I hoped I finally started getting some answers back. Two of my sisters said they could come. My mom called and she was coming down the mountain to get in the car. My local doula (who was also 9 months pregnant) could come and help. I started feeling a little more assured.

My husband wondered if he could go and bale some straw. I told him that I wasn’t sure how long I had, and that I would feel better if he stayed home. He pumped up my birthing ball for me and started packing some things. Cute little Jayden, repeated my request to my husband and said, “Mommy wants you to get her burp ball ready.”

My little boys were playing this whole time. They really wanted me to play with them, so I decided it was time they went somewhere else. I tried to play with their trains, but it didn’t last very long. They wanted me to hold them, but I couldn’t, so I figured I was really in my birthing time.

So I had to figure out what to do with them! I had a friend text about scheduling visiting teaching appointments. I told her I was in labor. She offered to take my kids for me. What a life saver and what a blessing. I then called my 3 yr old’s nursery teacher to see if she could come spend the night at my house with my kids. Wonderfully, she could. Things were working out. The friend said that she could even keep the kids over night if I needed her to.

Mores sisters called. Whew. Another sister said she could make it to the birth, while 2 others, sadly could not. But I was okay. I now realized I had 4 women, plus my mom and my husband who would be there with me. I was starting to feel okay about things. A room surrounded with 6 people who love you, would make a great birthing team!

My dear, dear, sister in law, Amanda came to the house to help me. It really calmed my nerves. She has been such a great friend and emotional support to me over the past year and a half with so many changes in my life, that I knew she would really help me at my birth. She offered to take my kids to my friend’s house so that Ladd (husband) could take a shower. No, he did not get to bale his straw that day! I think this was happening around 4 o’clock.

We got everything packed and I started timing waves again. They were 4 minutes apart. I still could not believe it. I called my mom and she wondered if I should go to the hospital. I was thinking that I should, since the hospital is an hour away, and with my 3^rd baby, I was timing waves 4 minutes apart. I still could not believe this was happening.

We left for the hospital a little after 5 PM and as we drove, I had my husband time waves for me. Some of them were 2 minutes apart. I sat there listening to my Hypnobabies tracks and focused and relaxed through the entire drive. I still did not think that things were too intense, so despite my timing, I didn’t think the baby was too close. I was hoping to maybe be at a 4 or 5 when I arrived to the hospital.

I had let called my midwife earlier to tell her that things "might" be happening. When I got to the hospital, I realized that I hadn't called her back to let her know that I was coming! Amazingly, when I got to L&D at 6:00 PM, they knew who I was and they put me into a room.

My CNM, Nicole, and the midwife in training, Patty, my cute pregnant doula, and Amanda, were there to greet me. Nicole checked me to see where I was at. I asked her if she would tell me only whether I was more than a 5 or less than a 5. She told me that I was less than a 5. So she started telling me that I could go home for a while, or stay there for a couple of hours to see what happened. If nothing was going after that, I could still choose whether I wanted to go home. I just knew at that moment that I was a 3. I asked if I could stay for a while. I really didn’t want to drive home, and have to drive back.

They put me on the monitors for 20 minutes to chart me. Never again would I be strapped to monitors though. Wonderful, huh?

So we went for a walk, down the stairs and outside. I stopped to breath through my pressure waves while Nicole and Dana (doula) rubbed my back. Then I had to go to the bathroom so we went back up to the room. By that time, two more sister in laws, Whitney and Niki were there. I was so grateful that Whitney was there. I really felt like I needed her there. We have been to several births together, supporting each other and other sisters, that I just could not imagine having a baby without her. The stars aligned and she just happened to be in Idaho with her other family. Her mom was able to watch her kids, while she brought her 8 week old to the hospital to help me. I was also so excited to have Niki there. She’s the kind of sister that everyone would want for an older sister. She is amazing in all that she does – basically is super woman and I really look up to her. She also has natural births and I knew she could help me to be strong. She also had a baby that she brought! They both had babies and the hospital was so kind to not make a big deal of it and they let them come to help me. I thought that was wonderful. We were missing three others in our usual birthing team. Tenille – who I knew I was going to desperately miss because I always envisioned her at my birth. In fact, when she told me she couldn’t come, I cried. But in the end, it was okay because so many others could come. We also missed Angie – who was in another state, working, and preparing for a wedding, and Crystal who was even farther away.

Anyway, we all decided that we were hungry so the sisters left to go and get us Subway sandwiches. During this time, I think I walked, listened to my tracks, and sat on the birth ball. My midwife was wonderful and rubbed my back the entire time.

The waves were not too intense. They were very tight and I had to close my eyes and focus and breath through them, but they were not hard at all. I didn’t know if this was because I was around a 3 or if it was my Hypnobabies working. I’d take it though. Nice and easy.

I finally asked my midwife if I was a 3, and she said I was. Dang it. We started talking about what I would do if I hadn’t progressed by the next check. I figured we could just go to a hotel so that we didn’t have to go all the way home.

At 8 o’clock she asked if I wanted to be checked again. I asked for one more hour and told her that the midwives could go and eat some dinner and put their feet up. By this time, my sister in laws were back with some food. I didn’t feel like eating too much of it though, at this point.

They helped me through some waves by rubbing my back, etc. They were getting more intense, but not really closer together. I was feeling great.

At 9 the midwives came back and I decided to get checked. She announced that I was greater than 5 centimeters and I started crying, I was so happy! We were going to stay and have a baby! I assumed that I was probably 6 centimeters. (I had my support team keep track of the real thing for me, and I found out later that I was right. I was a 6 at that point.)

I decided to get into the tub. Yay! I was so excited for this because the hospital has some amazing tubs. And in every room! They were SO nice. Big, deep, Jacuzzi tubs in the corner of the bathroom. I also ate some sandwich since I know it’s a good thing to keep nourished during labor. And no one gave me a hard time about it. Still wonderful.

By this time I was also admitted to the hospital, officially. I asked my CNM about all the questions I was supposed to get hounded with and she said I didn’t have to worry about it because they got all that information from my pre-admitting forms. So nice.

A phlebotomist came and and drew some blood for labwork, which was fine. I thought that I would also get offered and IV at this time, but no one said anything. And I didn’t mention it either! No way.

I did give them my birth preferences, and I think the nurse read them. I didn’t notice too much of anything now, I was just doing my own thing.

The tub was great. Waves were not any closer together, but they were getting more intense. This whole time I listened to my Hypnobabies tracks. Everyone was commenting about how wonderful the affirmations were. I loved them too and would repeat my favorite ones. I especially loved to smile and repeat the ones about how wonderful I was doing.

There were a couple of cues that I learned in Hypnobabies. Interestingly enough, I thought I would like the cue of “Relax” with someone putting their hand on my shoulder. But it ended up that I loved the hand on my forehead. My sisters, mom, and husband were so great about this that every time they did it, I was able to relax during my waves.

I stayed in the tub for a couple of hours. My support team helped me to concentrate. I loved peppermint essential oil during this birth too. On my head, neck, and in my diffuser. Love peppermint.

A couple hours later, my midwife wondered if she should check me. In the tub, she could only tell that my bag of waters was bulging.

Since waves were saying a consistent length and not getting closer together, we decided to get out of the tub to see if things would move along.

At 11:30pm, my support team noticed that my waves were getting really intense. I just remember staying focused and concentrating on becoming “completely limp and loose” during each wave.

I also got a little cold and got the shakes at this point, but nothing that a warm blanket couldn’t solve. I love those warm blankets!

I remember thinking how I loved these waves so much more than my pitocin-induced ones. These waves were so much more manageable. Because that’s exactly what they felt like. They felt like waves. Going up and down. The peak of the wave did not last very long at all, so I totally felt in control and felt like I could do it. Not once did I feel that I needed any medication or the epidural to relieve what I was feeling. I was totally doing it and I felt totally in control.

I went and laid down in the bed to give myself a different position. My support team was WONDERFUL. Seriously, birth is a nice spa day almost. You get to soak in the tub and then you get massages for hours on end!

During this time, I was really concentrating and really listening to my Hypnobabies tracks. I did get nervous that if things were to get more intense, or if things were to get harder, faster, and stronger, I was afraid that I wouldn’t be able to do it. But then a wave would come, I would handle it, and then it would go away. I’d realize that I was okay and that I could just keep going.

Time did not seem to exist at this point. I remember looking at the clock and thinking how I didn’t even feel tired, even though it was getting late, and that time seemed to be going so fast.

At midnight, I was checked again. She told me that I had made progress. In my mind, I told myself “no more than a 7” so that I wouldn’t get my hopes up. Plus, I still did not think that I had shown any signs of “transformation” i.e. transition. So I figured I wasn’t farther than that.

What I was, was a 7 plus. She told my birth team that I was almost an 8.

We decided to sit back up and work with gravity. I walked around. Leaned on the bed, and got on the birth ball. All I really remember is that things were intense but manageable. I loved that I was doing it and that I was just fine.

Throughout this whole night, I remember asking several times if my labor was going to keep going, or if it was going to stop and if I would really have a baby another day. I guess I couldn’t really believe that he was coming, and I was experiencing a whole new type of birth that was so much better than I expected.

At 12:30, I said that I had an achy bum, but that it didn’t seem like the pressure you normally feel (or should) feel as you are getting closer to pushing.

I felt so supported. My midwives were wonderful. Absolutely incredible. They were kind and they pampered me. They listened to my baby with a Doppler every 20 minutes during a few waves and that was all. I never was hooked up to the monitors again. The nurse would touch my belly during a contraction, but I would not even feel it. She was so nice too. She was so quiet and respected ALL of my wishes on my birth plan. My room was so peaceful and I felt like everything was going perfectly. Was I really at a hospital!?

There were people surrounding me and helping me. I didn’t know whose hand was on my forehead or who was rubbing my back or my feet, but I knew they were there and I knew I wasn’t alone. I heard words of encouragement from my Hypnobabies tracks and from my birthing team. It was perfect, perfect, perfect. Everyone was perfect.

I was able to do whatever I needed to remain comfortable and calm. I did not ever feel out of control. I was able to make it through each wave just fine.

At 1:50, I felt more pressure, which I think, was probably my bulging bag of waters. At this point, things are just blurry and I just kept going with what I was doing. I would change positions, go to the bathroom, drink fluids, get massaged, listen to Hypnobabies, etc. I was a free woman to do what I felt my body needed, and I loved it! During this time, a resident doctor had also been coming in and out so that she could see what a natural birth was like with the midwives. I was happy to have her there because I felt that more exposure to natural birth, the better.

I was checked at 2:50a,. Nicole said that I had made a little bit of progress, which was great. She said it wasn’t a whole lot, but that it was good.

I was a little disappointed because I thought at this time that maybe it meant I was still a 6 or 7. So I finally asked her to tell me what I really was. She told me that I was an 8 and 100% effaced. I can not tell you how THRILLED I was. I was elated. I was so surprised and happy. And 8! I had made it to an 8!

She suggested that I get on my hand and knees or that I break my water. She thought that if we broke my water and let the baby come down, that I’d have him very quickly. Apparently he was still at a minus 3 station.

Well, this made me a little nervous. I really wanted my water to break on it’s own. I also didn’t like that he was a high station. I sat and stewed over the decision for a while. I knew that she could be right. I knew that maybe if I broke my water, that I’d have a baby in my arms very quickly.

I so appreciate my support team and my midwives for giving me my space and giving me a chance to think about what I wanted to do. There was absolutely no pressure, even though it was the middle of the night and everyone was tired. At this point, my midwife had been up for over 2 days, yet she still was peacefully respecting all of my decisions and let me make all of my choices.

I got on the bed on my hands and knees for a little while, meantime talking with my birth team about what I should do. And I just have to say, at this point, I had to pee all…the…time. There was just not very much room in there!

I was going back and forth about what I should do at this point. Finally, I asked my husband for a blessing. He gave me some encouraging words of peace. Afterwards, I decided to have my water broken. Again, I was doing just fine, so I was nervous that by breaking my water, that I wouldn’t be able to manage my waves anymore. I told everyone, “I will break my water if you promise to really help me through this next part. AND, I will only break my water if you start filling up the tub again.”

So 3:45 am, Nicole broke my water. I was prepared for an intense pain….that never came. I got back onto my knees and leaned over the back of the bed so that I could also let gravity help that baby put pressure on my cervix. He had come down now, and I was ready to see him.

Amazingly, the waves I had, were actually easier. I don’t know if it’s because the pressure of a full bag of waters was released or what, but the waves were very comfortable. Everyone was there by my bed helping me and it was so nice. Of course, I also attribute my comfort to Hypnobabies! My tracks were still going!

I remember being completely relaxed but also calling out, “Why is the tub not being filled?” No one really answered, but I found out later that someone went over to start it and my midwife said, “We’re not filling the tub. She’s going to have this baby.”

I also went back and forth to the bathroom since there was so much pressure on my bladder... I got so sick of getting up and down to go to the toilet, that I just asked for a bed pan. We were all laughing about it. I could not believe how wonderful everyone was. I mean, my midwife was incredible. What a nuisance that could have been, but she just helped me like it was normal. I tell you, everyone there was incredible. I remember telling them all, “I have never been to a birth like this. And if I ever do, I will think it was the craziest birth! Just call me the Peeing Princess!” That was at 4:10 am.

So this is the crazy part…..after these few very manageable contractions, I was still on my knees on the bed. Literally, ALL OF A SUDDEN, a wave came on and I was pushing! I was totally consumed by this new feeling! At first it scared me to death, it was so intense. I had absolutely no warning. I expected to feel pressure at first. I expected to feel grunty. I expected some transition signs or some pushing sigs like I had seen at other births. Um, no time for that! He was right there ready to come out! I roared like you could not believe. In that moment, I remember thinking “How can I do this for this long to get this baby out!” But then, of course, the wave ended and I was surprised that all feeling went away, and I didn’t feel like I was going to explode. I got a little break. I realized that, of course, I was going to get breaks in between pushes. This made me feel a lot better. Yet, I was scared for the next one.

My wonderful husband and mom were in the perfect place for me. My husband was on one side of my head and my mom was on the other side. Just to know that they were there- two of the most important people to me- made me feel so much better. I could sense them there and I could hear their voices. They were perfect. Wonderful. Loving. Amazing. One rock on each side of me when I literally felt like I was hanging on the bed for dear life.

Then another one came. I reached down and could feel that his head was right there. I cannot describe these moments. I felt completely inside of myself and I felt myself working and moving that baby closer and closer. I heard people’s voices, but I could not tell what they were saying. Part of it is because I felt like I was so loud. And when I say roar, I mean roar.

Another push came and I remember thinking that I just did not care if I tore, because I wanted to get him out…and out came his head! I heard joyous noises in the room. Meanwhile, I could barely catch my breath in between all these pushes, it was so intense.

The next one came and with a couple of super hard pushes, the rest of my little babe came out! What a great feeling. Oh, I just can’t describe what those last moments are like bringing a baby into the world. I was totally consumed. Totally primal, totally overcome, totally burning, totally strong.

And then he started crying. THE most beautiful noise in the whole world! I think my eyes were still closed at this time and I was soaking it all in. The baby was behind me, but my midwife quickly handed him to me. He was born at 4:24 am.

Oh the moment of seeing your baby for the first time! I will always have that picture emblazoned in my mind. Holding him and seeing him right there! We did it!

I turned around and held him close. The wonderful baby nurse respected my wishes of using my own towels and we gently dried him off. She got a warm blanket and I sat and talked to my precious baby. I also asked to make sure that he was a boy.

My midwife let the cord stop pulsating and the Ladd cut it. He mentioned that the scissors were much sharper this time than the last time he cut a cord.

My husband. I loved seeing the smile on his face. What an experience! He loves our babies so much. We were so happy to have this new little guy arrive with us. And I’m sure he was also relieved that it was over.

My placenta came out soon after…with a quite a bit of blood. So I did need some help to stop the bleeding, but it wasn’t bad.

I wanted to start nursing and the hospital staff was so respectful and let me hold him without any procedures done. They did check vitals and his apgars were 8 and 9. He did have a bit of meconium but I guess it wasn’t enough that I couldn’t hold him right afterwards. Which was wonderful. He never had to get suctioned either. So blessed.

After a few attempts, baby boy started nursing. Hooray! That’s always a nervous part for me now, because my first would not nurse. But this little guy was and I was so happy.

I was able to cuddle and hold him clear until 6 o’clock when I decided I was too curious and wanted to weigh him. The baby nurse was so great and had patiently waited for me to decide this. She quickly took his measurements. 8 lbs 2 ounces and 20 ¾ inches. His head was 13.5 cm. Then she gave him right back to me, only in a diaper so we could continue skin-to-skin. What a GREAT experience.

This birth was absolutely amazing. I was so proud that I did it without intervention just like I had hoped. I felt so relaxed and supported the entire time. The waves were so intense, but never did I feel like I needed an epidural for what I was going through. I always had, in the back of my mind, a wonder that if things were to get worse, that I don’t know how I would be able to do it. And then they never got worse. There were peaks that I thought were going to totally overcome me, but then, at that moment, then would ease off. And my body was kind. Usually after an extremely challenging wave, I’d have an easier one the next time. I don’t feel like I ever lost control. I did have to vocalize a lot, but it helped me so much. Pushing was nuts, but I only had to do that four times, and I had a break in between. But I still could not believe the pushing phase and how much it takes to get that baby on the outside. Wow.

When everything was over, I was so happy. And I felt so great, I could not believe it. I really feel like I had the perfect birth. The hospital respected my every wish. My midwives were absolutely amazing and perfect. My support team was wonderful and never gave up on me. I felt so loved and taken care of. My environment was peaceful and I was surrounded with protection. I could not have done it any other way.

During this whole time, I prayed for strength and wisdom. I really wanted to do my best and to make the best choices. I am extremely humbled by how blessed I feel I was. My birthing time was beautiful. I cannot think of one thing that I could or would change. I keep saying that it was a perfect birth, because it was. It was the most incredible experience that I have had. I know that I’ve typed a lot, but there are just not words in the dictionary to do my feelings justice. I’m so grateful for this experience. I’m so grateful it worked out the best way possible. I feel so much humility for all of my blessings. What a wonderful, wonderful day!

My recovery has also been unbelievable. I felt so great in the hospital. We stayed on night and when I got up the next morning, we decided to go home because another whole day and night there seemed like it would be pretty boring. Now don’t get me wrong. Recovery hasn’t been a walk in the park. There’s still the after birth pain, and the nursing that makes my toes curl, but I feel so much better than I could have imagined. I mentioned to my sister in law, that I felt bad cause it almost doesn’t seem fair that things have gone so well. She reminded me of my uterine infection, problems nursing, and my crazy post partum hormones with my other births. So I guess I’ve had my share of experiences! I’m just so humbled that this one is going so well! I’m sold! (Not that I could do it again tomorrow….whew! But I’ll do it again!)

And there you have it. The birth story!

2011-08-18T22:37:00.001-07:00

http://midwifethinking.com/2011/01/22/the-anterior-cervical-lip-how-to-ruin-a-perfectly-good-birth/

IV Fluids linked to Newborn Weight Loss

2011-08-18T09:15:00.001-07:00

Maternal IV Fluids Linked to Newborns' Weight Loss

ScienceDaily (Aug. 15, 2011) — A newborn baby's weight loss is often used to determine how well a baby is breastfeeding, and concern about a baby which loses too much weight may result in supplementing breastfeeding with formula. However, many women receive IV fluids during labor, and new research published in BMC's open access journalInternational Breastfeeding Journal shows that some of a newborn's initial weight loss may be due to the infant regulating its hydration and not related to a lack of breast milk.

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A group of Canadian researchers looked at relationships among the IV fluids a mother received during labor (or prior to her caesarean section), neonatal output (measured by diaper weight), and newborn weight loss. They found that during the first 24 hours following birth there was a positive association both between the IV fluids given to mothers before birth and neonatal output, and between the neonatal output and newborn weight loss. At 60 hours post birth, the time of the average lowest weight, there was a positive relationship between maternal IV fluids and newborn weight loss.

"Nurses, midwives, lactation consultants, and doctors have long wondered why some babies lose substantially more weight than others even though all babies get small amounts to eat in the beginning," said principal investigator Prof Joy Noel-Weiss from the School of Nursing at the University of Ottawa's Faculty of Health Sciences. "It appears neonates exposed to increased fluids before birth might be born overhydrated, requiring the baby to regulate his or her fluid levels during the first 24 hours after birth."

Prof Noel-Weiss added, "We should reconsider the practice of using birth weight as the baseline when calculating newborn weight loss in the first few days following birth. For mothers and their breastfed babies, accurate assessment of weight loss is important. Although more research is needed, based on our findings, we would recommend using weight measured at 24 hours post birth as a baseline."

Alongside this article, the researchers have provided a standardized method for clinicians to collect and analyze data about newborn weight loss in their own maternity site, in the hope that this protocol will help them to make informed decisions when assessing newborn weight changes.

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The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by BioMed Central, via EurekAlert!

The Natural Cesarean

2011-07-08T11:30:00.001-07:00

The Natural Caesarean is more mom and baby friendly stressing the importance of mom seeing baby born gently, delayed umbilical cord clamping and skin to skin contact immediately following birth. This practise has been used for some time now, lower postpartum depression and more successful breastfeeding are some of the visible benefits. If a c-section is necessary this is the kinder, more compassionate way to birth the baby, resulting in significant less trauma to mother and baby.

The Myth of the Vaginal Exam

2011-07-06T23:15:00.001-07:00

Vaginal exams. I don't know a single woman who likes them.

However, there is a myth perpetuated in our society that vaginal exams at the end of pregnancy are beneficial. The common belief is that by doing a vaginal exam one can tell that labor will begin soon. This is not the case.

Most practitioners will do an initial vaginal exam at the beginning of pregnancy to do a pap smear, and other testing. Then they don't do any until about the 36 week mark, unless complications arise that call for further testing or to assess the cervix. If your practitioner wants to do a vaginal exam at every visit, you should probably question them as to why.

Vaginal exams can measure certain things:

Dilation: How far your cervix has opened. 10 centimeters being the widest.
Ripeness: The consistency of your cervix. It starts out being firm like the tip of your nose, softening to what your ear lobe feels like and eventually feeling like the inside of your cheek.
Effacement: This is how thin your cervix is. If you think of your cervix as funnel-like, and measuring about 2 inches, you will see that 50% effaced means that your cervix is now about 1 inch in length. As the cervix softens and dilates the length decreases as well.
Station: This is the position of the baby in relation to your pelvis, measured in pluses and minuses. A baby who is at 0 station is said to be engaged, while a baby in the negative numbers is said to be floating. The positive numbers are the way out!
Position of the baby: By feeling the suture lines on the skull of the baby, where the four plates of bone haven't fused yet, one can tell you which direction the baby is facing because the anterior and posterior fontanels (soft spots) are shaped differently.
Position of the cervix: The cervix will move from being more posterior to anterior. Many women can tell when the cervix begins to move around because when a vaginal exam is performed it no longer feels like the cervix is located near her tonsils.

What this equation leaves to be desired is something that is not always tangible. Many people try to use the information that is gathered from a vaginal exam to predict things like when labor will begin or if the baby will fit through the pelvis. A vaginal exam simply cannot measure these things.

Labor is not simply about a cervix that has dilated, softened or anything else. A woman can be very dilated and not have her baby before her due date or even near her due date. I've personally had women who were 6 centimeters dilated for weeks. Then there is the sad woman who calls me to say that her cervix is high and tight, she's been told that this baby isn't coming for awhile, only to be at her side as she gives birth within 24 hours. Vaginal exams are just not good predictors of when labor will start.

Using a vaginal exam to predict advisability for a vaginal birth is usually not very accurate, for several reasons. First of all it leaves out the factor of labor and positioning. During labor it's natural for the baby's head to mold and the mother's pelvis to move. If done in early pregnancy it also removes the knowledge of what hormones like Relaxin will do to help make the pelvis, a moveable structure, be flexible. The only real exception to this is in the case of a very oddly structured pelvis. For example, a mother who was in a car accident and suffered a shattered pelvis or someone who might have a specific bone problem, which is more commonly seen where there is improper nutrition during the growing years.

During labor vaginal exams can't tell you exactly how close you are either, so keeping them to a minimum then is also a good idea, particularly if your membranes have ruptured.

Okay, so there's not really a great reason to have a vaginal in exam done routinely for most women. So are there any reasons not to have vaginal exams? There sure are.

Vaginal exams can increase the risks of infection, even when done carefully and with sterile gloves, etc. It pushes the normal bacteria found in the vagina upwards towards the cervix. There is also increased risk of rupturing the membranes. Some practitioners routinely do what is called stripping the membranes, which simply separates the bag of waters from the cervix. The thought behind this is that it will stimulate the production of prostaglandins to help labor begin and irritate the cervix causing it to contract. This has not been shown to be effective for everyone and does have the aforementioned risks.

In the end only you and your practitioner can decide what is right for your care in pregnancy. Some women refuse vaginal exams altogether, so request to have them done only after 40 weeks, or every other week or whatever she feels comfortable with.

Healthy Babies are Worth the Wait

2011-07-05T09:59:00.001-07:00

Healthy Babies Are Worth the Wait

June 10, 2011 By Cara Terreri 1 Comment

Source: PRNewswire-USNewswire

Every week of pregnancy is crucial to a newborn’s health, and today, the March of Dimes unveiled a new public education campaign to raise awareness about the important development that occurs during those last few weeks.

The campaign, called “Healthy Babies Are Worth the Wait,” encourages women to allow labor to begin on its own if their pregnancy is healthy. It aims to dispel the myth that it’s safe to schedule a delivery before 39 weeks of pregnancy without a medical need.

Babies born after 37 weeks of pregnancy are full-term. However, new research has shown that a baby’s brain nearly doubles in weight in the last few weeks of pregnancy. Also, important lung and other organ development occur at this time. And, although the overall risk of death is small, it is double for infants born at 37 weeks of pregnancy, when compared to babies born at 40 weeks, for all races and ethnicities.

“Some women mistakenly think that the only thing a baby does during the last weeks of pregnancy is gain weight, making labor and delivery more difficult,” said Judith Nolte, a member of the March of Dimes national Board of Trustees and former editor-in-chief of American Baby Magazine Group, who worked with the March of Dimes to develop the new awareness campaign. “When the moms in our focus groups learned about the important brain and organ development that occurs, they were more than willing to put up with their own discomfort so their baby could get a healthy start in life.”

Only 25 percent of women know a full-term pregnancy should last at least 39 weeks, according to research published in the December 2009 issue of Obstetrics and Gynecology.

“Women may feel worried, anxious, or simply uncomfortable near the end of their pregnancy. But unless there are medical complications, the healthiest and safest place for that developing infant is in the womb,” said Eve M. Lackritz, M.D., chief of the Maternal and Infant Health Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, who outlined the health consequences of an early birth. “Term labor and delivery are not just normal and natural – they’re the healthiest alternative for both the mother and the infant.”

Information about the new Healthy Babies Are Worth the Wait educational campaign can be found at marchofdimes.com/39weeks.

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com ornacersano.org. For free access to national, state, county and city-level maternal and infant health data, visit PeriStats, at marchofdimes.com/PeriStats.

Low Amniotic Fluid???

2011-06-26T16:17:00.001-07:00

Low Amniotic Fluid. . . I don’t think so

Posted on November 28, 2008 by gloria

What will it take to stop the inductions for too little amniotic fluid? This is largely a wrong diagnosis based on ultrasound. Women are having their births wrecked by midwives and doctors who believe that Biophysical Profile is a valid testing method. We need to go back to clinical palpation skills and stop depending on sound wave fuzzy pictures to assess the amount of fluid at full term.

Here is where the problem begins:

Many North American women are being told at the very end of their pregnancies to go to an ultrasound clinic and have a biophysical profile done. Most are impressed by the thoroughness of their practitioner and have no idea what this test involves or what sort of harm could follow from consenting to this diagnostic procedure. They will probably not be told that there is no scientific basis for having faith in the test results and that no improvement in health has been proved from large numbers of fetuses being “profiled.” Certainly, no one will mention that the only benefits of the procedure are: 1) the ultrasound clinic will earn $275; and 2) the medical practitioner will be able to cover themselves legally in the very rare instance that a baby might die in utero.Until recently, physicians and midwives would tell women who were carrying their babies beyond 41 weeks gestational age to do “kick counts.” If the baby has 10 distinct movements between the hours of 9 a.m. and 3 p.m., it is widely accepted that the baby is thriving under the mother’s heart. In a culture that loves technology and with the push to expand the commercial use of ultrasound, it was inevitable that someone would come up with a more complex strategy to provide reassurance of the baby’s wellbeing in late pregnancy. Thus the biophysical profile (BPP) was born. Here is the content of the testing, as it appears on the Family Practice Notebook Web site (www.fpnotebook.com/OB44.htm):

Cost: $275
Criteria (2 points for each)
1. Fetal Breathing
  1. Thirty seconds sustained breathing in 30 minutes
2. Fetal Tone
  1. Episode extremity extension and flexion
3. Body Movement
  1. Three episodes body movement over 30 minutes
4. Amniotic Fluid Volume
  1. More than 1 pocket amniotic fluid 2 cm in depth
5. Non-Stress Test
  1. Reactive
Scoring
1. Give 2 points for each positive above
Interpretation
1. Biophysical Profile: 8-10
  1. Low risk or Normal result
  2. Repeat Biophysical Profile weekly
  3. Indications to repeat Biophysical Profile biweekly
    1. Gestational Diabetes
    2. Gestational age 42 weeks
2. Biophysical Profile: 8
  1. Delivery Indications: Oligohydramnios
3. Biophysical Profile: 6
  1. Suspect asphyxia
  2. Repeat Biophysical Profile in 24 hours
  3. Delivery Indications
    1. Repeat Biophysical Profile less than or equal to 6
4. Biophysical Profile: 4
  1. Suspect asphyxia
  2. Delivery Indications
    1. Gestational age 36 weeks
    2. Lung Maturity Tests positive (L/S Ratio 2)
5. Biophysical Profile: 0-2
  1. Likely asphyxia
  2. Continue monitoring for 2 hours
  3. Delivery Indications
    1. Biophysical Profile ‹ 4

“Breathing” above refers to movements in the lungs that show activity of the lungs in preparation for life outside the womb. The baby’s oxygen supply in utero comes via the placenta and umbilical cord while in the mother’s womb.

In the past year, I have had a number of letters and phone calls from doulas, midwives and childbirth educators about a flaw in this testing method. An unusually large number of diagnoses seem to be made that “there is not enough amniotic fluid.” This seems to be the factor in this outline that is most often used as an excuse for induction. It is important for parents to know that this is likely an inaccurate assessment. What the ultrasound technician is doing could be compared to viewing an adult in a see-through plexiglass bathtub from below the tub. In such a scenario, it would be difficult to assess how much water is in the tub above the body that is resting on the bottom of the tub. You might be able to get an idea of the water volume by measuring how much water was showing below the elbows and around the knees, but if the elbows were down at the bottom of the tub, too, you might think there was very little water. This is what the technician is trying to do in late pregnancy—find pockets of amniotic fluid in little spaces around the relatively large body of an 8 lb. baby who is stuffed tightly into an organ that is about the size of a watermelon (the uterus). If most of the amniotic fluid is near the side of the uterus closest to the woman’s spine, it can not be seen or measured. This diagnosis of low amniotic fluid frightens the parents-to-be into acquiescing to an induction of labour. Even though the official BPP guidelines do not require immediate induction for a finding of low amniotic fluid, in practise, the parents are pressured to induce. Stories abound of mothers who are induced for this indication and then report having abundant fluid when the membranes released in the birth process. The risks of induction, which can be catastrophic, and the resulting increase in the need for pain relief medication and cesarean section are usually not discussed with the parents prior to embarking on induction of the birth. Be warned that this latest suspect diagnosis using ultrasound is increasing in frequency and causing increased harm to mothers and unborn babies through aggressive use of induction.

After I published the above explanation in Midwifery Today Magazine in 2004, I received posts from women who had experienced being induced for this diagnosis. Here’s an example:

Thanks for writing this article, Gloria. It was the one that made me fully realize that my induction (at 41w1d – due to “low” amniotic fluid) & subsequent c/s due to failed induction were almost certainly unnecessary when I first read it in 2004. Everything you wrote happened to me. The BPP was perfect besides the fluid measurements. And then I did have “abundant fluid when the membranes released in the birth process”.

Cathleen in MA

——————

DS 5/03

DD 2/06 (HBAC!)

Here are some medical studies that confirm my alarm over using Amniotic Fluid Index as the reason to do an induction:

Low Levels of Amniotic Fluid No Risk To Normal Birth (2004)

Doctors may not have to deliver a baby early if it has low levels of amniotic fluid surrounding it, Johns Hopkins obstetricians report.

In a study to be presented Feb. 7 at the annual meeting of the Society for Maternal-Fetal Medicine in San Francisco, researchers show that babies born under such conditions fared similarly to those born to women whose wombs held normal amounts of amniotic fluid. No significant differences were found in the babies’ birth weights, levels of acid in the umbilical cord blood, or lengths of stay in the hospital.

Typically, doctors have been concerned about women with low levels of amniotic fluid during the third trimester – a condition called oligohydramnios – because too little fluid can be associated with incomplete development of the lungs, poor fetal growth and complications with delivery. Amniotic fluid is measured by depth in centimeters. Normal amounts range from 5 to 25 centimeters; any amount less than 5 centimeters is considered low.

“These study results are very surprising – they go against the conventional wisdom,” says Ernest M. Graham, M.D., senior author of the study and assistant professor of gynecology and obstetrics. “Amniotic fluid stems from the baby’s urine, and the urine results from good blood flow, so if we see low fluid we assume there probably is not good blood flow and the fetus is compromised. This study shows the fluid test is not as good as we thought, and there is most likely no reason to deliver the baby early if other tests are normal.”

The researchers studied 262 women (131 with oligohydramnios and 131 with normal amounts of amniotic fluid) who gave birth at The Johns Hopkins Hospital between November 1999 and July 2002, comparing the babies’ health at birth. Patients with oligohydramnios were delivered sooner, but were less likely to need Caesarian sections. Babies born to moms with isolated low amniotic fluid were normal size and were at no increased risk of respiratory problems, immature intestines or brain disorders.

Study co-authors were Rita Driggers, Karin Blakemore and Cynthia Holcroft.

Abstract # 318: Driggers, R. et al,

“Are Neonatal Outcomes Worse in Deliveries Prompted by Oligohydramnios?”

Related Web sites: Related Web sites:

http://www.nature.com/jp/journal/v24/n2/abs/7211034a.html
Journal of Perinatology (2004) 24, 72–76. doi:10.1038/sj.jp.7211034 Published online 22 January 2004

An Amniotic Fluid Index 5 cm Within 7 Days of Delivery in the Third Trimester Is Not Associated with Decreasing Umbilical Arterial pH and Base Excess

Rita W Driggers MD¹, Cynthia J Holcroft MD¹, Karin J Blakemore MD¹ and Ernest M Graham MD¹¹Division of Maternal-Fetal Medicine, Department of Gyn-Ob, Johns Hopkins University School of Medicine, Baltimore, MD, USA.Correspondence: Ernest M. Graham, MD, Johns Hopkins Hospital, Department of Gyn-Ob, Phipps 228, 600 N. Wolfe Street, Baltimore, MD 21287-1228, USA.

You Can Eat and Drink During Labor

2011-06-25T13:44:00.001-07:00

By Megan Brooks

NEW YORK | Wed Jan 20, 2010 11:18am EST

(Reuters Health) - There is no reason why pregnant women at low risk for complications during delivery should be denied fluids and food during labor, a new Cochrane research review concludes.

"Women should be free to eat and drink in labor, or not, as they wish," the authors of the review wrote in the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

Dr. Jennifer Milosavljevic, a specialist in obstetrics and gynecology at Henry Ford Health System, Detroit, who was not involved in the Cochrane Review, agrees that pregnant women should be allowed to eat and/or drink during labor.

"In my experience," she told Reuters Health in an email, "most pregnant patients at Henry Ford are placed on a clear liquid diet during labor which includes water, apple juice, cranberry juice, broth, and jello. If a patient is brought in for a prolonged induction of labor, she will typically be permitted to eat a regular diet and order anything off the menu in between different induction modalities."

Milosavlievic has "not seen any adverse outcomes by allowing women the option of liquids and/or a regular diet in labor."

Standard hospital policy for many decades has been to allow only tiny sips of water or ice chips for pregnant women in labor if they were thirsty. Why? It was feared, and some studies in the 1940s showed, that if a woman needed to undergo general anesthesia for a cesarean delivery, she might inhale regurgitated liquids or food particles that could lead to pneumonia and other lung damage.

But anesthesia practices have changed and improved since the 1940s, with more use of regional anesthesia and safer general anesthesia.

And recently, attitudes on food and drink during labor have begun to relax. Last September, the American College of Obstetricians and Gynecologists (ACOG) released a "Committee Opinion" advising doctors that women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. They fell short of saying food was okay, however, advising that women should avoid fluids with solid particles, such as soup.

"As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common," Dr. William H. Barth, Jr., chair of ACOGs Committee on Obstetric Practice, noted in a written statement at the time.

But based on the evidence, Mandisa Singata of the East London Hospital Complex in East London, South Africa, an author on the new Cochrane Review, says "women should be able to make their own decisions about whether they want to eat or drink during labor, or not."

Singata and colleagues systematically reviewed five studies involving more than 3100 pregnant that looked at the evidence for restricting food and drink in women who were considered unlikely to need anesthesia. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks.

The evidence showed no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.

Singata and colleagues acknowledge that many women may not feel like eating or drinking during labor. However, research has shown that some women find the food and drink restriction unpleasant. Poor nutritional balance may be also associated with longer and more painful labors. Drinking clear liquids in limited quantities has been found to bring comfort to women in labor and does not increase labor complications.

The researchers emphasize that they did not find any studies that assessed the risks of eating and drinking for women with a higher risk of needing anesthesia and so further research is need before specific recommendations can be made for this group.

SOURCE: Cochrane Library, 2010.

10 Commandments for Expectant Fathers

2011-06-23T13:09:00.000-07:00

1. You Shall Be Sympathetic to Morning Sickness....All Day....

I don't know who decided to call it morning sickness, but the name is misleading. Morning sickness can happen all day long, from the moment she wakes up until the moment she sleeps. You must be sympathetic and offer to hold her hair while she pukes. She'll probably yell at you to get the heck out of the bathroom, but your offer will go a long way.

2. You Shall Not Ask her to "Hold It"

Don't ever ask her if she can hold it. She can't. Get her to a restroom immediately. Be very concerned. She may ask you to pull the car over so she can pee on the side of the road. Do it. Don't question her or you will have a problem on your hands. In fact, never question a pregnant woman who has to pee; you're just asking for trouble. (I, personally, have wet myself on several occasions and it's not pleasant. )

3. You Shall Not Take Her Hunger Lightly

A hungry pregnant woman is more threatening than stumbling across a bear cub in the woods and then seeing his mama 10 feet away eyeballing you. Get her some food now, you fool! And then go get her more food while she's eating that food. I don't care if it's three in the morning; you can't go wrong with food. I cannot stress the importance of keeping a pregnant woman full. It could save your marriage. Oh, you thought I was kidding, didn't you? That's cute. I’m not.

4. You Shall Not Covet Cologne

Pregnant women develop super powers - they can puke like a fire hose and they can smell better than a bloodhound on the hunt. That cologne that used to be so sexy on you now sucks, so stop wearing it. And that spray deodorant is making her feel murderous and you would be the first victim. It's not her fault she can smell you three hours after you leave for work, it's yourfault (just play along with this for now).

5. Honor Mood Changes

Don't even think about blaming it on hormones unless you're looking to get hurt. You don't know what a pregnant woman is capable of doing. She probably doesn't know either, but do you really want to find out? Just keep in mind that in conjunction with these mood changes it will take your lady a fraction of the time to get upset compared to the good old days, which means your escape window is now significantly smaller. (Remember this in case you break a commandment.)

6. You Shall Not Bear False Witness Against Female Anatomy

Most everything seems to change! Things expand, change color, stretch out, and leak. Listen dude, you won't look at women the same way, but you must smile and nod and try to look sympathetic to all these bodily changes. Think about how sad it was when Apollo Creed died at the end of Rocky IV. If you keep that image in mind while the ladies talk private parts, you will appear compassionate and everyone will love that none of this grosses you out in the slightest.

7. Remember, She Will Get Freaked Out

All these articles she is reading online are driving her mad. It’s your job to find another article that debunks the first article, print it out and highlight it. You must also rage at the author of the first article, ‘Blank is an idiot! He/she doesn't know what they're talking about!'

8. Do Not Expect her to Maintain her Pre-Pregnancy Activity Levels

She tires easily and won't be able to keep up with her normal activities, so you will have to take on more. This may include doing the dishes, laundry, vacuuming and possibly some light dusting. Do it, don't complain. If you complain, immediately reread commandment number 5. Get out of the house now, you are in danger. Don't come home until you bring food.

9. You Shall Not Take the Word Pee in Vain

If she says she has to pee again, she does. Yes, she just went 10 minutes ago, but she has to go again. Seriously.

10. She is the One, The Only One

You will do well to smile and nod and pretend that she’s always right because as horrible as you think it is to bow to your goddess right now, it is twenty times more horrible being pregnant and then pushing a human being out of very sensitive lady parts. But guess what? It's all worth it. Just wait until you hold your son or daughter for the very first time — you will look at your wife and know that yes, she is in fact, a goddess. And that goddess will look at you with the same awe.

Doulas: Easing Birth

2011-06-21T16:41:00.000-07:00

Doulas: Easing Birth

Labor Coaches

By Star Lawrence
WebMD Feature

Reviewed by Charlotte E. Grayson Mathis, MD

When Barbara and Christopher Lawton were planning for the birth of their son almost two years ago, the midwife practice they were using in Pittsburgh asked them if they were going to use a doula during childbirth. "I didn't even know what that was," says Barbara.

A doula, Lawton found out, is a private labor assistant ... not a doctor, not a nurse, not a midwife. Indeed, a doula (a Greek word meaning "women supporting women") is not a medical professional at all. Rather, she provides support and encouragement throughout labor and delivery, and often, after the baby is born, as well.

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Doulas are a centuries-old tradition, but have become popular again in the U.S. in the past 15 or so years. "Having another woman's presence during childbirth is very helpful," says Pam Lesser, RNC, MS, manager of women's support services at Barnes-Jewish Hospital in St. Louis, Mo. While many labor-delivery nurses would like to provide the encouragement that delivering moms need, the fact is that because of the time constraints nurses face in today's hospitals, it's not likely that one nurse will be able to provide the support that most women need during this time.

Doulas do not take the place of a woman's partner. "The mother's partner is an integral part of the experience and an extremely supportive one," Lesser says. "But it's unreasonable to expect the partner -- who is as emotionally involved as the expectant mom -- to provide all the support."

Continuous Support

According to the organization, DONA (Doulas of North America), doulas are women who are trained and experienced in childbirth, whether or not they have actually given birth themselves. The doula provides physical, emotional, and informational support to women and their partners during labor and birth. She offers help and advice on such measures as breathing, relaxation, movement, and positioning. She also helps the mom-to-be (and her partner, if one is there) gather information about the course of her labor and options during labor and delivery. And perhaps most important, she provides continuous emotional reassurance and comfort.

It's that word -- continuous -- that is such a vital part of a doula's role. "My doula met me at the hospital at noon, and was still there the following day at 4:30 when I finally saw my son for the first time," says Lawton.

"That continuous presence is extremely important," says Lesser. "It's a great asset. The doula never leaves the mom's side. That's her job."

Barnes-Jewish Hospital thinks so much of the value of doulas that in 1998, the hospital established its own doula program. Today, there are approximately 50 doulas on staff, so that any woman who would like to have a doula during her labor and delivery can request one. The service is provided free of charge. Approximately 25% of the women delivering at Barnes-Jewish ask for a doula, says Lesser.

Fewer Complications

Research findings seem to back up the value of having a doula during childbirth. In the late 1970s, Drs. John Kennell and Marshall Klaus looked into ways to enhance the emotional bonding between mother and newborn. They found that having a doula in the labor room not only improved that bond, but also seemed to decrease the incidence of complications.

"Studies have shown that doulas can lead to fewer Cesarean sections, a shorter labor, fewer requests for pain medication or epidurals, less need for oxytocin, and fewer instances of forceps delivery," says Lesser. "The role of the doula has increasingly been adapted as part of a positive birthing experience."

Sarah Pinkner is a doula at Barnes-Jewish Hospital. While many doulas are hired privately by expectant parents, Pinkner enjoys being part of the hospital's staff. "Women of so many different cultures come into Barnes-Jewish," she explains. "This is an opportunity for them to take advantage of a service they may not have known about, or perhaps could not afford on their own." The cost of a doula varies throughout the country, but generally ranges from $200-$800.

Hiring a Doula

There are no state licensing requirements for doulas, but many do go through a 16-hour certification process offered by DONA that includes training in:

The emotional and psychological process of labor and birth.
The anatomy and physiology of reproduction, labor, and birth.
Comfort measures and non-pharmacological pain-management techniques.
Appropriate topics for prenatal and postpartum discussion with clients.
Discussion of ethics and standards of practice for the doula.
Referral sources for client needs beyond the scope of the doula.
Communication skills and values clarification.

If the birthing center you are planning to use doesn't provide doulas as part of its services and you are interested in hiring one privately, DONA recommends asking the following questions:

What training have you had?
What has been your experience with childbirth, personally and as a doula?
What is your philosophy about childbirth?
May we discuss our birth plans and what kind of role you can play in supporting me through childbirth?
May we call you with questions before and after the birth?
At what point do you come to us? Do you meet us at home or at the hospital?
Do you meet with us after the birth?
Do you work with any other doulas in case you're not available? May we meet with them?
What is your fee?

"My doula was a very important source of encouragement," says Lawton. Which is just what the doula herself is aiming for, Pinkner says.

"It's a chance for me to make a difference."

http://www.webmd.com/baby/features/doulas-easing-birth

10 Questions about Water Birth

2011-06-15T22:15:00.003-07:00

1. How long is the baby under water after birth?

The amount of time the baby is under water will not harm or help the baby. Many practitioners usually bring the baby up within 10 seconds or mom or dad can lift baby out of the water themselves. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth videos that depict leaving the baby under the water for several moments after birth and the babies are just fine, because babies can breathe under water as long as they haven't taken their first breath of oxygen.

Physiologically, the placenta is supporting the baby with oxygen during this time though it can never be predicted when the placenta will begin to separate causing the flow of oxygen to baby to stop. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to remove the baby, without hurrying, and gently place him into his mother's arms.

2. What is the cost of a water birth?

The cost of a water birth is significantly less than that of a hospital birth and some provinces and states are now insuring them as standard coverage. The rental of the pool can be anywhere from $0 if you use your own home tub or a pool (or your midwives have them to borrow), if you rent or purchase it can be a few hundred dollars.

3. What should the water temperature be in the pool?

Water should be monitored at a temperature that is comfortable for the mother, usually between 95-100 degrees Fahrenheit. Water temperature should not exceed 101 degrees Fahrenheit as it could lead to an increase in the mother's body temperature which could cause the baby's heart rate to increase. It is a good idea to have plenty of water to drink and cold cloths for the mother's face and neck. A cool facial mist from a spray bottle is a welcome relief for some mothers as well.

4. When should I get into the water?

You should get into the water whenever you feel you are ready. When you begin to feel strong contractions, you brain will desire comfort, this is usually a good indicator. However, test the water prior to immersing. When you enter the water, your brain sends relaxation hormones to your body within 20 minutes of entering the pool and peak around 90 minutes. It is recommended to get out and walk around as a change of scenery and reimmerse to re-engage the relaxation chemicals in your body.

5. Who should I have with me?

It is recommended to have a midwife or doula at all times to monitor the baby and you. You may have any other support people around to encourage and relax you as this is the most important goal. You can even have a spouse or partner in the tub with you for periods of time.

6. What should I wear in the pool?

You can wear anything that feels comfortable that will not impede the delivery of the baby or many women wear nothing at all.

7. How long does a typical water birth take?

A water birth takes as long as any natural birth. The water is a means of relaxing. There is no evidence that it speeds up or slows delivery.

8. What if something goes wrong?

Have a backup plan and be flexible. A birth does not go always as planned and may move faster or slower than expected. There are many things that can be remedied by itself through birth and listening to your support staff and doula or midwife for their guidance. If a medical intervention is required, ensure you have items packed prior to the birth and any other support measures needed on call.

9. What can prevent the baby from breathing under water?

There are four main factors that prevent the baby from inhaling water at the time of birth:

- Prostaglandin E2 levels from the placenta which cause a slowing down or stopping of the fetal breathing movements. When the baby is born and the Prostaglandin level is still high, the baby's muscles for breathing simply don't work, thus engaging the first inhibitory response.

- Babies are born experiencing mild hypoxia or lack of oxygen. Hypoxia causes apnea and swallowing, not breathing or gasping.

- Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. So, even if water were to travel in past the larynx, they could not pass into the lungs based on the fact that hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence.

- The last important inhibitory factor is the Dive Reflex and revolves around the larynx. The larynx is covered all over with chemoreceptors or taste buds. The larynx has five times as many as taste buds as the whole surface of the tongue. So, when a solution hits the back of the throat, passing the larynx, the taste buds interprets what substance it is and the glottis automatically closes and the solution is then swallowed, not inhaled.

10. What types of pools can I use?

There are many types of pools women choose to use or rent. There are designated water birthing tubs you can rent for about $300-$500. Many women suggest using a deep kiddie pool, a trough or your own tub if it is large enough as these are often the same benefit and a smaller price.

Further Reads and Resources Sources

1 http://www.waterbirth.org

Hypnosis birth preparation cuts caesarean rate

2011-06-15T22:15:00.001-07:00

Embargo until March 21
As the NHS is funding research into the use of hypnosis and birth (the SHIP tirial), a detailed survey of more than 1250 women who learnt self hypnosis as part of their birth preparation, indicates that these techniques will lead to a significant reduction in caesarean sections. The findings from the online survey are being presented at the 1st World Congress of Obstetrics, Gynaecology and Andrology (WCOGA 2011) to be held at the Queen Elizabeth II Conference Centre, London, during March 20-23.

The results of the survey of 1251 mothers, including 853 first time mums, who listened to the Natal Hypnotherapy CDs during their pregnancy, indicates that women using these techniques are likely to have a more positive, less painful, often less interventionist birth with a significantly lower caesarean rate with only 15% requiring a caesarean compared with the national rate of almost 25%.

A staggering 89% said using the techniques had enabled them to overcome any fears connected with giving birth; 72% reported feeling calm during the birth with 61% feeling able to manage the pain in labour. Overall, 95% of women felt they had benefited from learning self hypnosis as a way to help them have a more positive birth experience.

As the popularity of hypnosis in birth continues to grow in the UK, it is a significant move forward for the NHS to back clinical trials into the use of these techniques as a low cost, safe and practical antidote to the drug-dependent labour management culture that has developed in the UK over the last fifty years.

- ends -
Notes to Editors

1. To receive a preview copy of the Natal Hypnotherapy CD and book, to arrange an interview with Maggie Howell or for birth and midwives testimonials, case studies and Natal Hypnotherapy research, please email: maggie@natalhypnotherapy.co.uk, Call 07710 019068 or 01428 712615 and/or visit
www.natalhypnotherapy.co.uk.

2. The full paper A RETROSPECTIVE SURVEY ON THE PSYCHOSOMATIC AND PHARMACOLOGICAL OUTCOMES OF WOMEN USING NATAL HYPNOTHERAPY CDS DURING PREGNANCY will be presented by Maggie Howell on March 21st at the 1st World Congress of Obstetrics, Gynaecology and Andrology (WCOGA 2011) – Psychosomatic and behavioral perspectives on clinical controversies to be held at the Queen Elizabeth II Conference Centre, London.

3. Over 2,300 midwives and birth professionals across the UK are now recommending Natal Hypnotherapy techniques. Hypnotherapy has been an accepted therapeutic practice recognised by the British Medical Association since 1955.

4. Natal Hypnotherapy was awarded the Practical Parenting ‘Pregnancy Product of the Year’ award for its CDs and the Practical Parenting ‘Editors’ award in 2006. The CDs reached the final of these Pregnancy Product awards in 2009 and 2010.
5. Other CDs in the Natal Hypnotherapy range include:
The IVF Companion Home birth preparation* Fast post natal recovery*
Prepare to conceive Prepare for a Caesarean* Breastfeeding companion
Overcoming Morning Sickness Hospital birth preparation* VBAC preparation
Pregnancy Relaxation* Relaxation and Stress Management

*denotes twins version available

6. Natal Hypnotherapy was founded in 2001 by Clinical Hypnotherapist and doula, Maggie Howell (d. Hyp. C. Hyp, LHA,UK HypReg), following the birth of her first child in which she used hypnotherapy techniques which she then went on to develop into the Natal Hypnotherapy product range following further research with mothers and antenatal groups. Maggie has since gone on to have four more children.

Pregnant women show an amazing lack of knowledge about childbirth options, study shows

2011-06-15T10:36:00.000-07:00

By Shari Roan, Los Angeles Times / For the Booster Shots blog

June 14, 2011

Fewer pregnant women and their partners are attending prenatal education classes these days and appear to be quietly following whatever advice the doctor or midwife recommends, researchers said Monday.

Doctors, led by Dr. Michael Klein of the Child & Family Research Institute and University of British Columbia, surveyed 1,318 healthy pregnant women. They found many seemingly unprepared to make their own decisions regarding childbirth options, such as whether to have natural childbirth or a Cesarean section.

Fewer than 30% of the women, all first-time mothers, said they had attended prenatal childbirth classes. Many said they used the Internet or books to become informed about childbirth. Still, a shockingly high number could not answer basic questions regarding the pros, cons or safety issues associated with epidurals, episiotomies, Cesareans and other childbirth options. The women who were receiving obstetrical care from midwives tended to be more informed about their options compared with women receiving care from a medical doctor.

"[E]ven late in pregnancy, many women reported uncertainty about benefits and risks of common procedures used in childbirth," Klein said in a news release. "This is worrisome because a lack of knowledge affects their ability to engage in informed discussions with their caregivers."

The study was published in the June issue of Journal of Obstetrics and Gynaecology Canada.

The type of provider mattered greatly in terms of what kind of care women received. The researchers published a related study in May in the journal Birth that showed younger obstetricians were much more likely to favor the routine use of epidurals and expressed more concerns about the safety of vaginal birth compared with older obstetricians. The younger obstetricians seemed to view C-sections as the preferred option for childbirth, the authors noted. In the United States, efforts have begun to reduce C-section rates. About one-third of all U.S. women have a surgical birth.

Return to Booster Shots blog.

http://www.baltimoresun.com/health/boostershots/la-heb-childbirth-20110614,0,5102722.story

Too Many C-Sections: Docs Rethink Induced Labor

2011-06-13T09:20:00.001-07:00

By TIFFANY O'CALLAGHAN Monday, Aug. 02, 2010

LWA-Stephen Welstead / Corbis

The rise in cesarean-section deliveries in recent years has been characterized by some as a key indication of the overmedicalization of childbirth. While the procedure undoubtedly saves lives and leads to better health outcomes for mothers and infants who face problems during pregnancy and labor, many experts say the procedure is being performed too often, and in many cases for nonmedical reasons, putting healthy women and babies at undue risk of complications of major surgery.

The rate of C-sections has reached more than 31% in the U.S., a historical high, according to 2007 data from the American College of Obstetricians and Gynecologists (ACOG). The reasons for the increase are many and have been widely discussed: the rising rate of multiple births, more obesity in pregnant women, the older age of women giving birth. In fact, C-sections have become so common that many women may have an inflated sense of safety about them. "For the most part, moms and babies go through the process healthy and come out healthy, so maybe there's this sense that we're invincible," says Dr. Caroline Signore of the Eunice Kennedy Shriver National Institute for Child Health and Human Development.(See pictures of pregnant-belly art.)

But C-section carries all the attendant risks of major surgery; and data show that compared with vaginal birth, cesarean delivery increases the odds that a mother will end up back in the hospital after birth with complications such as bleeding or blood clots.

Now obstetrics experts are actively seeking ways to drive down the number of C-sections. On July 21, the ACOG issued new guidelines recommending that hospitals allow most mothers who desire vaginal birth after cesarean, or VBAC, to attempt a trial of labor, including some mothers who are carrying twins or have had two prior C-sections. Despite studies showing VBAC to be safe for most women — ACOG data suggests that 60% to 80% of women who attempt VBAC will succeed — many hospitals have urged women to undergo a repeat cesarean over the past decade, largely to avoid medical risks and malpractice suits.(Read how postpartum depression can strike fathers.)

Another factor contributing to high C-section rates is the increase in induced labor, especially between 37 weeks and 38 weeks of gestation — a period obstetricians describe as "early term." (While any birth between 37 weeks and 41 weeks is considered full term, some experts distinguish the earlier period.) The use of labor induction in the U.S. has risen from less than 10% of deliveries to more than 22%, between 1990 and 2006, according to data from the Centers for Disease Control and Prevention, and research suggests that induced labor results in C-sections more often than natural labor. A study published in the July issue of the journal Obstetrics & Gynecology found that among more than 7,800 women giving birth for the first time, those whose labor was induced were twice as likely to have a C-section delivery as those who experienced spontaneous labor.

The study's lead author, Dr. Deborah Ehrenthal of Christiana Care Health System in Newark, Del., says that she was not surprised to see an association between induction and risk of C-section, since previous studies had come to the same conclusion. But Ehrenthal says she was surprised by the high rate of induction overall. In her study of ethnically and socioeconomically diverse mothers delivering before 41 weeks' gestation, who did not have pregnancies complicated by breech presentation, 44% of women had their labor induced.(Read about the risks of late preterm births.)

The rate is significant because ACOG guidelines, which have been in place since 1982, recommend against elective inductions in the early term, or anytime before 39 weeks. Research shows that after 41 weeks' gestation, at which point it is standard policy to induce labor, it may lower the risk of medical complications for mother and baby — including the risk of stillbirth — and even decrease the likelihood of C-section delivery, but those same effects are not seen in women who induce labor before the 41-week mark.

Medical reasons for earlier induction may include advanced size or lack of proper growth of the fetus and maternal issues like diabetes. But in an editorial accompanying Ehrenthal's paper, Signore also suggests that the high rate of early-term induction may reflect lifestyle choices: health care providers' and new parents' desire to control the timing of delivery. "Many women believe that delivering a few weeks early is just as safe as delivering on the projected due date and may request delivery for any number of reasons of comfort or convenience," Signore writes. "However, we must remember that incautious use and timing of interventions — particularly in elective cases — can lead to unnecessarily poorer outcomes for women and newborns."

Among the women whose labor was induced in Ehrenthal's study, nearly 40% of cases were categorized as elective. In other words, there was no pressing medical indication for induction. Extrapolating from the study findings, Ehrenthal suggests reducing the use of elective labor induction could lower the national C-section rate by as much as 20%.

Several hospitals have already begun reducing medically unnecessary induction as a way to lower the rate of cesareans. In 2006, the Magee-Womens Hospital in western Pennsylvania began limiting the pool of women eligible for elective inductions to those delivering after 39 weeks. The hospital also established stricter protocols for elective induction in women after 39 weeks — insisting on high levels of cervical "ripeness" as measured by the standard Bishop score before induction — and prohibited other labor-hastening efforts, such as the use of cervical ripening agents. Additionally, the hospital instituted a new scheduling system requiring physicians to document specific reasons for induction when used.

Researchers found that under the new policy the overall induction rate dropped 33% and the rate of elective inductions fell by roughly the same amount. What's more, the total number of C-sections among first-time mothers who underwent elective induction dropped 60%. The results of the Magee-Womens study were published in April 2009 in the journal Obstetrics & Gynecology.

If a relatively simple policy shift based on medical evidence can successfully cut the rate of induced labor and C-sections at a single hospital, experts say similar changes applied broadly may help lower the rate of C-sections on a national level.

But as with the new guidelines regarding VBACs, decisions about labor induction and other issues surrounding childbirth must be shared by women. Patients should be informed and included in the decisionmaking process, Ehrenthal says. "Unlike the decision to do an emergency C-section where there's no time to talk, usually there is time to have a discussion about induction," she says.

Dads and Doulas

2011-06-09T18:42:00.000-07:00

Dads and Doulas

5 Reasons Dads Should Demand a Doula

From KH Weiss, About.com Guide

When my wife told me that she wanted a doula, I was hurt. I truly thought with our first baby that I’d be able to be the end all be all for my wife. She showed me the research. She let me meet some of the doulas. I still wasn’t convinced that it would be the right choice for us. I subscribed to the “If you weren’t at the conception, you shouldn’t be at the birth rule.” My wife wound up vetoing me. Here are the reasons I’m glad that she did:

A doula can spell you.
I really thought I’d be able to stay awake for a big event like childbirth. Who didn’t pull an all nighter in college? Bathroom breaks? Ha! I mean, if I could ride my bike for hours, drinking lots of water and not needing a bathroom break, surely I could wait a few hours while my wife was in labor, right? Wrong.
Thirty hours into my wife’s first labor and I was toast. I’d been up walking with her for what seemed like days as labor began. We’d come to the hospital and there wasn’t any sleeping for me. I was physically tired and mentally shot. The doula really helped me out. With my wife’s blessing, that 30 minute nap I caught helped me to refocus and be back on my game for the big event. And we won’t even talk about how much fun my wife made of me for my small bladder. Needless to say, having the knowledge that my wife had someone else with her while I scarfed down food, went to the bathroom and grabbed a few winks kept me sane.
A doula remembers what she learned in childbirth class.
I paid attention in childbirth class. I’d hear enough horror stories to realize that there was a huge, comprehensive final exam for this course – childbirth. But when push came to shove, no pun intended, the knowledge went out of my brain. Those early hours of labor I couldn’t remember if we were supposed to eat or sleep, which positions were good or not so good. Thankfully, when the doula arrived, she saved my skin and made me look like the good guy. My wife never really realized that it wasn’t my idea that she try certain positions, but that I’d been privately coached by our doula.
A doula knows the questions to ask.
When we arrived at the hospital, everyone was bombarding us. Questions were flying from all directions. I was busy trying to help soothe my wife, who was not happy with the bumpy car ride to the hospital. Our doula stepped in and gave them all the information that they needed. Magically doors opened and we were offered a prime birthing room.
Our doula also was very helpful in getting information. A nurse or a tech would come in and ask us if we wanted something, like a procedure or a medication. I had no clue. (See above where I forgot my childbirth class information!) Our doula would very calmly ask questions of them and of us until we had enough information to make the decision that matched what we wanted. It was never pushy or mean, just questions. She even reminded us that we could take some time alone to make a decision. That turned out to be a real blessing.
A doula speaks the language of labor.
Our doula was an amazing translator. I’d ask a simple question like, “How’s the baby?” And the nurse would respond with something like, “The EFM indicates that there are no decels during periods of stimulation.” I’d give her my biggest smile and nod, like I knew what she was saying. Once she left the room, I’d ask our doula, who would carefully explain each part of what had been said. She also helped us decipher what AROM was as well as second stage.
A doula keeps you calm.
Hard. Labor was so hard. And that’s just how it felt to me. Thankfully, when the going got tough and my wife was in hard labor, it was difficult for me to keep anything in my brain. I forgot everything from childbirth class and all I could think of was “Surely this isn’t normal!” Our doula would smile at me from across my wife on the birth ball and as if she had read my mind, would mouth the words “This is normal.” Her calm smile helped me focus again on loving on my wife and keeping her calm. She showed me how and where to touch, she modeled how to behave quietly and efficiently and she made me the star in my wife’s eyes.

When I first heard about doulas, I thought of them as birth interlopers. Now I don’t know how anyone could manage to give birth without one. Our doula really helped bring me together with my wife as she gave birth. My wife remembers my constant support and never failing love or knowledge. She remembers the doula as a nice person who did some stuff in the background. We won’t give birth without a doula.

Doula-Natalie Sue

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Too Many C-Sections: Docs Rethink Induced Labor

By TIFFANY O'CALLAGHAN Monday, Aug. 02, 2010

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Dads and Doulas

Dads and Doulas

5 Reasons Dads Should Demand a Doula