Sunday, December 21, 2008
I finally made it to the health food store yesterday and I bought this herbal tea made by Yogi Tea. It's called Woman's Nursing Mom, and on the package it claims to help boost breastmilk production. I brought it home and made myself a cup of it last night. After just one cup of this tea I was able to nurse my baby 3 times in the same time period I would normally be able to nurse her once.
This tea has Chamomile Flower, Fennel Seed, Stinging Nettle Leaf, Anise Seed, Fenugreek Seed and English Lavendar Flower.
The tea smells strongly of licorice (from the Anise seed), and has a strong licorice taste. I added lots of honey to it because I don't like licorice and wanted to mask the taste as much as possible. I'll just keep adding honey to it, because so far it's well worth it for the benefits.
You should be able to get this tea at most health food stores, and it's also available to purchase online. Amazon.com even has packages of 6 boxes for about $18, which is an excellent price. I paid about $5 for one box, and there are 16 tea bags in each box. I plan to drink it once a day, and hopefully it will continue to boost my milk production.
Friday, December 19, 2008
I don't like the taste of Red Raspberry tea, but I've been told about how excellent it is for good health, particularly during pregnancy. Sherri's tea has a strong taste of Red Raspberry, but if I put enough honey in it I don't mind the taste at all. It's pretty pleasant to drink with the honey.
As far as milk production goes, my doula has been telling me for a few years about a tea blend called Mother's Milk Tea that she drinks whenever she is nursing a baby. She says it's the best thing to boost milk production. I really want to try it, and I plan on buying some the next time I can get to the health food store. We have had several consecutive heavy snow storms recently, and for now I'm not venturing out anywhere that's not absolutely necessary. Once the road conditions improve, however, I plan to go to the health food store and get some of that tea.
Another thing my midwife recommended is that I snack on trail mix between meals. I have a premade mix from the store that's pretty good, but has a lot of chocolate in it and it's not the most healthy. I absolutely love chocolate, but I don't want to eat it all day long. What I want to do is go to Good Earth Natural Foods to their bulk foods section and get bags of my favorite grains, nuts and dried fruits to put together my own trail mix blend of my favorite things. Yum!
In the meantime, my good friend Heather brought over some of her homemade Holiday Granola for me to snack on. It's really good, and she posted the recipe on her blog. I suggest you try it out, whether or not you're pregnant!
Despite the exhaustion and constant need for food, which I know will subside as time goes on, I'm enjoying my pregnancy. I'm having fun finding healthy things to eat and trying new things, like the tea and the granola. I'm happy to be venturing into a new path for me, working with a wonderful midwife and planning a home birth. I still feel very positive and peaceful about these plans, and I feel so blessed to be able to do this. I simply feel blessed and grateful to have been given the opportunity to have birthed 4 amazing babies with another one coming. I love being a mother and I'm so happy to be able to fulfill this important part of my life.
Wednesday, December 17, 2008
"Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern."
Some characteristics they found related to labor dystocia (slow or stalled labor) were poor cervical presentation, including dilation less than 4 cm, tense cervix, thick lower segment, poor positioning of the baby (baby's head above inter-spinal diameter, poor fetal head to cervix contact), and the use of epidural analgesia.
I would like to point out that all of the above characteristics (with the exception of the epidural) are generally indications that the baby is simply not ready to come out. If the baby is in a poor position, such as high in the birth canal, or the cervix is not dilated or thinned, it's a strong hint that the baby is just not coming out any time soon. There are things that can be done to correct poor baby positioning (see my post about Posterior Positions), as well as things that can be done to help thin the cervix and augment labor naturally. If these do not yield more progress, then it may just be a good idea to wait and let your body and the baby prepare more and get ready for birth. Contrary to some current obstetric beliefs, there is no set time table for labor. Some women labor for just a few hours, while others (myself included) may labor for a few days or more. Women's bodies are made to birth babies and most of the time can do that in their own time unaided by medical intervention.
There are times that intervention is needed. For instance, when the bag of waters has ruptured there is a limited time that the baby needs to be born in order to avoid infection, but that is generally 24-36 hours and can still give a woman's body time to work and birth the baby. There are other instances, but I believe in most cases intervention is not needed, and in the case of epidurals, intervention actually can stall labor and make things more difficult.
Friday, December 12, 2008
Choosing a home birth was an easy choice for me with this pregnancy. It seemed like a natural step, and I immediately felt immense peace about my decision and knew it was right for me to plan this for my baby's birth. The hard part for me has been telling other people about my decision. I've been so afraid to even approach my close friends and family because I've been worried they would criticize me and try to talk me out of it. So far I've received more support than criticism, and I'm grateful for that. I think part of this journey for me is to help me develop some thicker skin and learn to stand my ground on the things that are most important to me, despite what anyone else thinks. I usually do what I want no matter what anyone else says, especially if they tell me not to do it, just because that's one of my strong personality traits. But, I generally just do it quietly without letting on that I'm going against the norm. I can't stay quiet about this.
I don't believe home birth is right for everyone. I don't believe natural (un-medicated) birth is right for everyone. I wasn't ready to do natural birth or home birth with my first baby, and here I am expecting my fifth and finally fulfilling my dream of a water birth. Many times when someone supports natural home birth they stay on that extreme side and tend to argue that everyone should do it that way. I don't feel that way. I feel I have a somewhat unique perspective in supporting women in whatever birth choices they make.
Some of my opinions expressed in my blog may seem extreme. I feel that in the United States we are inundated with medical information about childbirth from the medical community's perspective. Part of my goal with this blog is to offer alternatives that might otherwise be more difficult to learn about. There's a wealth of information advocating hospital births and medications, and not so much that supports natural birth and home birth. In some ways I'm trying to help even the playing field by presenting information so women can make informed decisions about their prenatal care and birthing options. I want all women to realize that they have options and to educate themselves about those options so they can make the best decisions for themselves and their families.
Wednesday, December 10, 2008
In some states in the US Certified Professional Midwives and home births are illegal. Women from those states who want a home birth often choose to stay at Ina May's farm.
Ricki Lake and Abby Epstein, creators of the documentary film, the Business of Being Born are working on their next film, and decided to visit Ina May's farm for part of their filming. Ina May's book Spiritual Midwifery was a great inspiration for the original film, and it's fitting that they are including her work in their next film. Abby documented their trip on the BOBB blog. Please take a moment to read; it's very interesting!
Monday, December 8, 2008
With that said, I just got done with my first prenatal visit with my midwife, and it was a wonderful experience. My midwife likes to do the first prenatal visit at the client's home, which I think is great. At each visit she does a urinalysis and checks blood pressure and the baby's heartbeat. She doesn't do routine vaginal exams, but will do them at the client's request. I'm just fine with that as well! She does not do routine lab tests (blood test, glucose tolerance test, etc.) which is OK with me. I've had the routine tests with all of my previous pregnancies and have always had normal results from them. I'm not worried about any abnormalities or problems, and I don't feel the need to test for them. She does prenatal checkups at the same intervals as a physician would: once a month until about 26 weeks, then every two weeks until about 36 weeks, and then once a week until the baby is born.
My midwife does not feel the need to have a specific backup obstetrician. She says that in a true emergency in which the mother is transferred to the hospital, you will be left to the physician on duty at the time, and in a true emergency, any physician will have the expertise needed. In a less pressing emergency you may have time to call the various hospitals and find out who is on duty and choose your location based on which physician you prefer to have.
We talked for about an hour and a half. I have never had a prenatal visit with a physician last more than about 10 to 15 minutes. I loved it. Because of my passion for this subject, I was thrilled to have the chance to pick someone's brain and ask all the questions I could think of. She is just as passionate as I am, if not more, and seemed more than happy to talk with me, although it ended up being a late night for her as a result.
My midwife cautioned me about approaching my obstetrician with my home birth plans. I want to have an ultrasound with an obstetrician covered by my insurance. This is more for sentimental reasons than medical. All of my kids have tape recordings and printed pictures of their ultrasounds, and I'd like to have that record for this baby as well. I also like being able to determine the baby's gender positively in an ultrasound, so that's a nice added benefit. My midwife is concerned that my physician may be opposed to home birth and tell me horror stories and try to talk me out of it. I'm not worried about losing my resolve, but I really don't like confrontation. I haven't decided yet if I'll go for one visit and an ultrasound and pretend to be moving forward with my OB, or if I should be completely open about my home birth plans and be prepared to develop some very thick skin. My husband feels I should be completely up-front with my OB, and I'm leaning toward that option at this moment. My doctor has been excellent in working with me with my plans for natural birth and has worked well with my doula, but being open to un-medicated birth is not quite the same as being open to home birth. I have some time to figure it out, so I'll think about it for a while.
I've also decided not to hire a doula for this birth. My midwife has several apprentices, and one of them attends each birth with her. Each of her apprentices is a certified doula and is training as a midwife, so they are more than qualified to assist with the birth. When I birthed my babies in the hospital I needed a doula to act as my support and comfort, as well as be my advocate with the hospital staff and doctor to ensure that my birth wishes were followed. I feel I will have the support and comfort needed with my midwife, her assistant, and my husband there, and I won't have the need for an advocate because I won't be in a hospital setting.
Sunday, December 7, 2008
Please set your TiVo, DVR or VCR for your local ABC channel this Friday, December 12. 20/20 will be doing an hour-long special on motherhood. It will include interviews with Ricki Lake and other natural childbirth advocates. ABC has stated it will present both sides equally, and I'm very interested to see how it turns out. It airs at 9:00 pm MST. I think that's 11/10 Central. Please check your local listings.
Thursday, December 4, 2008
Here's a brief description of the types of pregnancy caregivers:
- Obstetrician - Surgeon by trade, trained specifically to handle high-risk pregnancies. Only delivers in hospitals. Services are almost always covered by insurance. Is accountable to the hospitals at which they work, and must follow all birth procedures outlined by the AMA and hospitals.
- Certified Nurse Midwife - Trained specifically for pregnancy and childbirth. Handles low-risk pregnancies . Must transfer high-risk cases to an OB. Can deliver in hospitals or birthing centers. Services are generally covered by insurance, depending on your plan and limitations within it. Is accountable to the hospitals and birthing centers at which they work, and must follow all birth procedures outlined by the AMA and hospitals.
- Certified Professional Midwife - Trained specifically for pregnancy and childbirth. Handles low-risk pregnancies. Must transfer high-risk cases to an OB. Only delivers at home or in a specific setting provided for birth without the equipment provided at a birthing center. Services are almost never covered by insurance, but many CPM's are willing to negotiate costs and possibly trade for their services because they understand the financial burden on families. Licensed and certified with the state, and must follow state laws and guidelines regarding birth procedures.
- Direct Entry Midwife (sometimes referred to as a "lay midwife") - Trained specifically for pregnancy and childbirth. Handles low-risk pregnancies. Must transfer high-risk cases to an OB. Only delivers at home or in a specific setting provided for birth without the equipment provided at a birthing center. Services are almost never covered by insurance, but many DEM's are willing to negotiate costs and possibly trade for their services because they understand the financial burden on families. Unlicensed, which allows more flexibility in birth procedures because they are not constrained by state guidelines.
I tend to go by feeling rather than facts or statistics. I find it tedious to interview several caregivers, but that's just my personal standpoint. I have chosen a Direct Entry Midwife because I know I want to birth at home. I am blessed to know a DEM who is a client of my husband's, and she had actually offered her services to me in my last pregnancy, but I wasn't ready to make the switch from OB to midwife or hospital to home at that time. She has 10 children of her own, and 15 years of experience with home births, and she is also willing to work with us in trading for most of her services to help keep costs down. I have talked with her on the phone, but not met with her personally yet. I get a good feeling about her, and that goes a long way for me. My husband also knows her very well and has a good working relationship with her, and that also goes a long way for me. I feel strongly that everyone present at my baby's birth should be able to work together well and as a team. I will meet with her next week and schedule my first prenatal checkup at that time. If at any point during the pregnancy I don't feel right about working with her, I am open to choosing a different caregiver. Afterall, this my pregnancy, my baby, and my choice.
Saturday, November 29, 2008
1 C packed dark leafy greens such as spinach, kale or collard greens
1 mango, coarsely chopped
2 C orange juice
2-4 C frozen blueberries
Blend in a high speed blender and enjoy!
You can play around with the combination of fruit and greens, and try it with different flavors of juice. It's fun, and my kids love them just as much as I do. You can't taste the greens if you use enough berries.
Nights are really hard for me right now. My baby is 10 months old and still breastfeeding. She loves food, so during the day she eats lots of solid foods and doesn't need to nurse much. At night however, she nurses several times for comfort. She's small for her age and I know how important breastfeeding is, so I've indulged her feedings at night. Last night she woke up several times and I couldn't comfort her. I tried to nurse her, but there just seemed to be no milk for her to get. She got even more mad and worked herself up into a full-blown fit. I could not figure out what to do for her, so I handed her to my husband while I went to the kitchen and filled a sippy cup with water for her. My husband got her calmed down and she drank the water in a hurry. She must have been so thirsty! I also realized that my mouth was so dry I didn't have any saliva. I got back up and drank a full glass of refreshing water. By morning I had enough milk to nurse her.
With four babies I have never had a problem with diminished milk supply. I've been blessed to always have enough milk to meed my baby's needs, and sometimes I seem to even have an over-abundance of milk. I read that during pregnancy the milk supply generally diminishes around the 4th to 5th month. I'm just about 8 weeks along in my pregnancy, so this is very frustrating. I don't know if my milk supply is less right now because of the pregnancy, or if it has to do with something else like nutrition. I'm sure I need to drink more water, so I will definitely pay more attention to that, and that should help. It's hard too because I can't take my multivitamin in the morning without feeling sick, and I have a hard time remembering to take it later in the day if I miss it in the morning. I know I need the nutritional support, but I'm struggling to get it right now. I'm also so tired every day that I need a nap in the afternoon, and I know the extra nutrition can help give me more energy. I've heard that Red Raspberry Leaf Tea is excellent during pregnancy, so I have been drinking that, but I'm not sure if it has any impact on milk supply.
My goal has always been to nurse each of my babies for at least 12 months. The shortest I've breastfed a baby is 13 months, and the longest is 16 months. I have never struggled to meet my goal until now, but I've also never breastfed during pregnancy before now. I still have that goal in mind, and we have less than 2 months before my baby will be 12 months old. I'm determined to hang in there and put more focus on giving my body what it needs so I can provide my babies with what they need. I'll start by drinking more water! I may also need to keep a full sippy cup for the baby near the bed each night just in case.
Tuesday, November 25, 2008
“Reading this book comes second only to the moving experience of having Cara deliver your baby. Candid, funny, passionate, exhilarating, and occasionally heartbreaking, this story will undoubtedly speak to readers interested in the unsung super-heroism of midwives. But it will also appeal to anyone who has contemplated how to fully integrate life and work. In this era of compartmentalizing, Cara moves with dervish like grace between baby-catching, parenthood, spirituality, travel, and, well, even parking to show us that with the right combination of humility and drive, anything is possible.”-Daphne Beal, author of In the Land of No Right Angles.
I read the excerpt this morning, and I really like it. Cara has a peace about her even though she leads a busy life, and she has a beautiful respect for life and the process of pregnancy and birth. It's an uplifting read, so I hope you'll take some time to enjoy it.
Sunday, November 23, 2008
If you, the reader, disagree with anything I say, feel free to comment with your standpoint. I'm open to discussion. I would prefer to avoid blatant bickering or inflexibility, but I am open to discussing different viewpoints and presenting whatever information I can to compare options and opinions. This is my blog, but I created it with a deep desire to connect to women all over the world and create an environment of learning and growing.
Saturday, November 22, 2008
The American Medical Association would like all Americans to believe that the only safe place to birth a baby is in the hospital, so that's what they're telling us, and have been telling us for generations now. In July 2008 the AMA issued a resolution asking for legislation against home births and Certified Professional Midwives (or "lay" midwives). They are trying to take away our right to birth at home. Why? Ricki Lake and Abby Epstein released an incredible documentary film The Business of Being Born, in which they compared home birth to hospital birth, and the film has become a sneak hit nationwide. The AMA has been spooked by the popularity of the film and the resulting increased interest in home birth. The AMA does not profit from home birth. They only make money when people go to the hospital.
DONA International released a response to the AMA's resolution in August, and their statement mirrors my own feelings on the matter. It's interesting to note that the majority of doulas assist in hospital births, so DONA and its doulas have no financial gain in supporting home birth. What they do support, however, is each woman's right to choose. Ricki Lake also fired back at the AMA in response to the resolution.
The New York Times recently published an article about more women in the New York City area choosing home birth, despite the fact that most homes in NYC are cramped apartments with thin walls. They also found that the majority of women choosing home birth are well-educated professionals, not the old stereotypical granola hippy from yesteryear.
The Salt Lake Tribune published an article on November 20 which discusses data compiled from July 2007 to June 2008 by midwives in Utah. In Utah, midwives licensed to deliver at home are required to keep studious records of the births they attend, and they report those records to a legislative committee. The study shows that more women in Utah are choosing home birth than in previous years. It also lists the statistics reported, and it's very interesting. Please note that the article cites that about 22% of the women during that time period transferred care to a doctor or to a hospital before, during or after labor either because they had complications that required the switch or they chose to. I met a Utah midwife today who told me that her transfer rate is actually about 7%.
I would like to point out that midwives do not take high-risk patients. If a pregnancy or labor becomes high-risk at any point, the midwife transfers the patient to an obstetrician. 90% or more of pregnancies are low-risk. Grantly Dick-Read in his book Childbirth Without Fear stated that 95% of pregnancies are low-risk, so 90% is conservative compared to Dr. Dick-Read's statement. This means that theoretically, 90% or more of babies born could be born at home with no complications. Currently in Utah, about 1% of babies are born at home.
On average, home birth costs $1,900 compared to $8,500 for a low-risk, vaginal birth in the hospital. In the current downward trend of the economy and expensive health insurance premiums and many Americans not having any health insurance at all, doesn't it also make fiscal sense to birth at home?
For centuries women have given birth at home. The move to the hospital didn't take place until early in the 20th century. When that shift took place there was a horrific upturn in maternal and fetal death because of the unsanitary conditions in the hospitals. Doctors would often go straight from the morgue to the delivery room and pass on all kinds of disease to the mother and baby. Granted, hospitals today are much more sanitary than they were at that time, but they are still rampant with disease and germs and serve as breeding grounds for stronger germs than we've ever seen before. Are they really any safer than home?
Even now when birthing in a hospital, women are exposed to unnecessary interventions. To cite just one example: a woman in labor goes to the hospital but she is in the early stages. The staff and Dr. decide that she is not progressing well enough on her own. They give her pitocin to augment and speed up her labor. The contractions get so strong and close together because of the pitocin that she can't handle the intensity and asks for pain relief. An epidural is given which relieves the pain but slows the labor to a crawl. The fetal heart rate shows distress as a result of the medication and they worry about the baby's well-being, and end up doing a cesarean. What could have been an uncomplicated vaginal birth at home without intervention suddenly became high-risk and resulted in major surgery.
Obstetricians are, by trade, surgeons. They are trained to handle true emergencies. The growing trend, however, is to treat all pregnancies as a possible emergency. Midwives are not the medieval witches many people make them out to be. They are trained specifically for and highly skilled in handling low-risk pregnancies and births. They generally treat pregnancy and birth as a natural process rather than an imminent danger.
When birthing at home a woman is allowed to progress at her own natural rate, because women's bodies were made to birth babies and can do it beautifully on their own. She is in a place that is comfortable and feels safe to her. She has specialized, medically trained and certified professionals attending to her needs, monitoring her and the baby's status and ensuring that all is going well. Everyone that I have met or heard of who has had a home birth has loved it and has been grateful they made that choice.
Thursday, November 20, 2008
The Today Show also has an article entitled "Expecting parents: What is a doula?" I think the article is excellent. It's well-written and gives some concise information and accurately depicts what a doula can offer to expecting parents. It's not very long. I hope you take some time to read it.
My own experiences with my doula have been wonderful. My doctor and hospital staff always worked well with my doula, and my doula was never overbearing or pushing her opinions on anyone. She fulfilled her job very well, which was to support me and my husband and our birth decisions and provide the comfort and assistance we needed. She was quiet but assertive when necessary and helped keep me focused. It also helped so much that the hospital staff and doctor were very good about honoring and following my birth plan.
Please check out my personal doula's family blog. Her opinions and reactions to the segment mirror my own, and I want to give her credit for the wonderful work she does.
It is very important to communicate clearly with your caregiver and labor support team (doula, partner, etc.) during pregnancy to ensure that they are aware of your wishes and willing to work together in achieving the best results for you and your baby.
Monday, November 17, 2008
It's interesting to note that in New York City most people live in cramped apartments with thin walls, and they are still choosing home birth. Another interesting and somewhat surprising fact in the article is that the reports say that most of the women who are choosing home birth are highly-educated professional women. Hooray for informed decisions!
I have had four healthy pregnancies, wonderful births and healthy babies. I no longer feel the need to have all the medical interventions in place nearby "just in case". I now want to create a birthing environment and experience that is uplifting, comforting, natural and peaceful. The hospital does not create that setting for me. Hospitals in the state I live in also have a policy against water birth.
Birthing Centers are a great option for those who want a more comfortable setting, but want the comfort of having some medical machinery and options on-hand for possible complications. If the birthing becomes high-risk, then the mother is transferred to a hospital. The problem I have is that in my state there is only one birthing center, and it's about an hour drive from our home if there's no traffic.
There are a couple of birthing locations closer to us that offer the comfort of home in a different place. These are set up like a home, with a large bed, bathroom with a large jetted tub, full kitchen, and even a play room with toys for the other kids. There is no medical apparatus or machinery at these places. The advantages and disadvantages are the same as a home birth, but provide a setting separate from home for those who want that.
I feel if I'm going to birth in a place with the same benefits and risks as home, I may as well be at home. I like the idea of not having to drive somewhere just to birth my baby, and not having to drive back home afterward. A birthing tub can be set up at home for the water birth I want to have. With a good midwife and doula the mother will be well taken care of at home. Generally after birth they clean everything up for her, including the birthing mess, but also the dishes and other household needs. By the time they leave, the mother and baby are clean and comfortably resting in bed. I have always gotten lonely recovering in the hospital because I miss my family, and the transition from the hospital to home has been difficult in some cases. I would feel more comfortable being home with my family and loves ones rather than in a sterile hospital for two days.
I plan for a low-risk, safe birth. However, should complications arise, I will have my midwife and doula to assist me and my husband in making the best decisions for me and my baby. Midwives generally have an obstetrician reserved on-call for emergency situations in case a transfer to the hospital is needed. There is a hospital about 15 minutes from our home, and another one about 20 minutes away.
I feel safe and peaceful about choosing a home birth. I've made the choice about the location, and now I need to find the right professionals to work with me in making this happen the way I wish it to.
Saturday, November 15, 2008
I'm approaching this pregnancy differently than my other four. I feel I'm in a much more positive place mentally, emotionally and physically. Everything that I've been learning in the past several months in my doula preparations has changed me in wonderful ways, and I'm really excited to utilize what I've learned and continue to learn. I'm opening up and letting go of past expectations, and planning for the absolute best.
I never thought I would say this, but I'm seriously considering a home birth. I have always been intrigued about water birth and always felt it would be incredible and feel so great. I really want to try it.
At this point I'll be doing more research and seriously considering my options. I don't have anything against obstetrics or hospitals, and I still really like my OB and the hospital where I birthed my last 3 babies. But I'm at a point in my life that I feel so much peace, safety and so much more capable than ever. I'm ready to completely trust in the beauty and miracle of natural birth the way our bodies were made to do it. I've done natural childbirth without medication before, but this will be a big step even further than anything I've done before, and I'm so happy to be on this path!
Friday, November 14, 2008
After my second child was born I was talking with my obstetrician about how long I should wait before getting pregnant again. There are two major points I remember he made.
- One was that there are health concerns for the mother if she has two babies (not twins) within 12 months of each other. This includes a higher risk of blood clots. He emphasized the need for the mother's body to recover after giving birth.
- The next point my doctor made was that if I were to get pregnant I should stop breastfeeding. His argument for weaning was that nutritionally it's too hard for the mother's body to provide the needs for 3 people: herself, her nursing baby and her developing baby growing inside of her.
La Leche League has some really good articles about this, and it supports my own feelings on the subject. To sum up what I read, they say that any argument against breastfeeding during pregnancy is based on conjecture and not on fact. In fact, no reliable studies have been done to support the idea that pregnant mothers should wean their nursing babies. Some things that stood out to me in the articles are:
- In a normal pregnancy there is no evidence that continuing to breastfeed will deprive an unborn child of necessary nutrients.
- Breastmilk changes during pregnancy. The taste changes because the makeup of the milk changes in a similar way as it does when weaning. At around 4-5 months in pregnancy, the milk supply generally decreases. The milk may also turn to colostrum, and the milk returns within a few days after birth.
- Each child is different and some have a stronger need to nurse than others. Some children will naturally wean themselves because of the change in the flavor or consistency of the milk, while others won't care about the milk changing and will continue to nurse throughout pregnancy regardless of the changes. It's important to consider the child's needs and reasons for breastfeeding.
- Younger babies, particulary less than 12 months old, should be monitored closely for weight gain to ensure that they are thriving on the mother's milk during pregnancy. Older babies are more likely to wean themselves or the mother may decide it's a good time to wean if the child is already eating a good amount of solids.
- Hormone levels change during pregnancy (surprise!), and the higher levels of progesterone help relax and smooth the muscles in the uterus so that uterine contractions from nursing are generally not a risk during pregnancy. As the progesterone levels drop and estrogen levels increase just prior to birth and after, uterine contractions will be stronger.
Tuesday, November 11, 2008
Join us for a Wonderful Doula Training Workshop!
Monday, November 10, 2008
Exercise during pregnancy:
- Tailor Sitting – on the floor, soles of the feet together, knees out to the sides. Gently lower the knees to the floor. Practice this 3 times daily.
- Squatting – back against the wall or against the birth partner. With feet shoulder-width apart, slowly lower yourself (keeping heels on the floor) into a squatting position, hold for 20 seconds and gently raise back up to a standing position. Practice several times per day, extending the hold time as you are able to.
- Pelvic Rocking – In hands and knees position, knees shoulder-width apart and hands below you, flatten your back, then tuck in your rear, then flatten your back again. Be careful not to let your back fall into a downward arch, but focus on a flat back and tuck in the rear. Do this 25 times, twice daily.
- Kegels – If you are new to this you can practice first when urinating with a full bladder. Stop the flow and then allow it to start again. This will help you find the muscles to use for this exercise. Take caution because this can lead to urinary tract infections, so do not do this if you are experienced with these exercises. Practice sets of 10, squeezing and releasing, up to a total of 50 to 150 per day. More information about Kegels.
- Perineal Massage - This helps to stretch the perineum (wall of tissue between the birth canal and rectum) and prevent tearing during birth. How to perform Perineum Massage.
- Birth Ball – forward leaning position is favorable to encourage the baby into a good position.
- In addition to the above, moderate exercise is recommended, about 30 to 60 minutes per day, including walking, swimming, prenatal yoga classes, and pregnancy exercise videos. With yoga it's important to follow prenatal guidelines, as some yoga holds and breathing methods are not recommended during pregnancy. More about Prenatal Yoga.
- Good health and diet during pregnancy will help the baby be strong and healthy and will help things go smoothly during birthing time.
- Low-risk mothers with healthy diets experience fewer complications and more options (like freedom of movement) during birthing time.
- During pregnancy the focus should be on what you are eating and not how much you are gaining. If you are eating healthy and getting good exercise you will gain the right amount of weight for you and your baby.
- The diet below is based on the Gerber Diet by Dr. Gerber.
- 4 servings of milk (calcium)
- 2 eggs
- 2 servings of protein
- 2 servings of dark green leafy vegetables
- 5 servings of whole grains (check labels for 100% whole grains, or make homemade bread)
- 2 servings of Vitamin C foods - Red berries, kiwi, red and green bell peppers, tomatoes, broccoli, spinach, and juices made from guava, grapefruit, and orange.
- 5 servings of fats and oils, including butter and oil, but no margarine.
- 1 serving of Vitamin A - Milk, eggs, darkly colored orange or green vegetables (such as carrots, sweet potatoes, pumpkin, and kale), and orange fruits such as cantaloupe, apricots, peaches, papayas, and mangos.
- Plenty of fluids (about 6-8 glasses) - water is best. Fruit juice is good in moderation. Just be careful of sugar intake.
- Salt to taste. Salt helps maintain a healthy balance of fluid production in the body.
- Folic Acid - Important for healthy development of the baby. Good sources are dark leafy greens, legumes such as lentils and chickpeas, and whole grain breads and cereals.
- Protein – 22 amino acids – the body's building blocks.
- A protein deficiency can lead to toximia and preeclampsia.
- 80 – 100 grams of protein per day can reverse toximia!
- Pack proteins into your snacks. Instead of eating a whole apple, eat half an apple and half a meat sandwich or fruit and some cheese to get a good balance of protein and Vitamin C and other nutrients.
- Calcium is important and best to get in foods, but can be taken in a supplement as well. Preferably at night to help avoid leg cramps while sleeping.
- Antacids are not recommended as a calcium supplement, as they can create a metabolic imbalance.
- Iron is important for healthy red blood cell production. It's found in meats, legumes and dark leafy greens like spinach. Iron can be taken in a supplement, best with Vitamin C to help absorption. Avoid taking it with Calcium, as it disrupts the iron absorption.
- Take Iron in the morning and Calcium at night.
- Amniotic fluid is replaced every 3 hours during pregnancy, so sufficient water intake is important in providing adequate fluid replacement.
- It's also interesting to note that the body retains water when it's not getting enough, because the body tries to hold onto what it's got to keep from getting dehydrated. Drinking plenty of fluids can help prevent water retention!
- If water is tasteless or boring to you, try sweetening it or adding flavor. A really healthy way to flavor your water is to add fresh lemon juice to it (from real lemons, not concentrate) and sweeten it with a healthy sugar alternative (listed below). Lemons are the only truly alkaline food, so they also help lower the acidity in your body.
- Good sugar alternatives: agave, stevia, xylitol, honey.
- Soft cheese
- Fish high in mercury (deep water fish are safer, as well as tuna in moderation)
- Raw, uncooked meat
- Undercooked eggs, poultry or fish
- Harsh cleaning products (vinegar is a good safe cleaning option)
- Aerosol sprays
- Cat litter
- Nutrasweet, Splenda and other artificial sweeteners. Watch out for "sugar-free" and "diet" foods and drinks, because they can contain harmful artificial sweeteners.
Wednesday, November 5, 2008
I have used a baby sling with my fourth baby, and I wish I had bought one for my first child! They are wonderful, and so natural and comfortable to carry the baby in. Much more comfortable than the hard harnesses with straps and buckles, which I will never go back to! I use the sling more than the stroller. My baby sling is from Maya Wrap and was a gift from some wonderful friends. If you know how to sew, Maya Wrap also has sewing instructions on their website that you can print and use to make your own wrap.
For more information about what Ricki and Abby have been up to, check out the latest Bobb newsletter. These ladies are doing some great things for women's health and childbirth education and awareness. If you've been unable to find a copy of their film, you can purchase it from their website, and coming soon you will also be able to rent it for a 24-hour period online.
Sunday, November 2, 2008
My instructor is Littia Sellers, and she teaches classes in Orem, UT. Check out her website and read her own Hypnobabies birth story. This is the birth method I would love to use with my next pregnancy.
Monday, October 27, 2008
Here's a quick and simple abdominal exercise shared with me by my sister, a certified fitness instructor:
Using slow, controlled breathing, inhale deeply. Allow your belly to fill up and rise with the air. As you exhale, tighten your abdominal muscles to push the air back out. Repeat with each breath as many times as desired.
This can be done in the bath tub or whenever you have a few moments to focus on breathing. It's also safe to be done immediately after giving birth, as long as you feel up to it. It's simple and can help strengthen your stomach and core.
Thursday, October 23, 2008
Here's an interesting snippet about the history of belly binding:
"For centuries, Japanese mothers have used their “Sarashi” to speed up weight loss and toning of the abdominal muscles and skin after childbirth, while Hispanic mommies believe their “faja” helps bring all the muscles used in the birthing process back together again. No matter what she calls it, women in Indonesia, Thailand, Singapore, Latin America, Mexico, Spain, England, and the Philippines have benefited from using an abdominal compression wrap after childbirth."
My husband who is a massage therapist says that from a muscular standpoint belly binding makes complete sense. The vertical abdominal muscles separate during pregnancy to allow the belly to expand and accommodate the growing baby, leaving a large gap after giving birth. Ideally, we want those muscles to come back together, but in many cases it takes months for that to happen. He says that belly binding would, in theory, hold those muscles in their proper place and facilitate faster healing.
Another interesting note is that we see weight lifters and construction workers wear wide support belts to support their back and core. It makes sense to me that a woman who has just given birth would need that kind of support as well.
I have found a few websites about belly binding. The Belly Bandit is one that sells belly wraps starting at about $40, but they also have some good information about the history and purpose of belly binding. EZY WRAP has post-op abdominal binders available starting at about $13. Another website discusses belly binding and says there is one made by Body Glove that can be purchased at Big 5 stores for about $5-$8, which would most likely be made of neoprene. I haven't found any available for purchase online for that low a price. I think it would be worth a call or trip to your local Big 5 store for a good support belt. I'm definitely going to look into it for my next pregnancy.
*UPDATE Dec. 4, 2008 - This post gets far more hits than the rest of my posts combined. I'm glad that people are interested in this topic, but I admit that I'm not an expert and have no experience personally with belly binding. I would love to get some feedback from my readers about their own experiences with belly binding, which binders have worked for you and what the results were. Please also feel free to make suggestions on how I can improve this post and make it more informative and helpful. Thanks!*
When the baby has not moved into the OA position (about one in four begins labor in this position) is it referred to as Occiput Posterior (OP) or a posterior baby. Most babies will turn into an anterior position at some point during labor, but some will actually be born in a posterior position with their face upward or "sunny side up" as they emerge from the birth canal. When a baby is posterior it can lead to longer labors because it takes time for the baby to move into a favorable anterior position.
Another problem with posterior babies is that it tends to cause back labor, or back pain during contractions. I had back labor with all of my babies, and I don't know whether or not it was linked to the position of the baby, because I never asked for my doctor to check the position. I know from personal experience how hard back labor is, and I would recommend if you experience it in labor, ask someone to check the position of the baby to see if the baby is possibly in a posterior position.
There are many things you can do to correct the baby's position if your baby is posterior. First, try to determine the position of the baby. You can sometimes feel where the feet and hands are by where you feel kicks and punches, and from there locate the baby's back on the opposite side from the movement. If you feel the movements in the front of your abdomen this can be an indication that the baby is in a posterior position. If you feel movement on the right side it could mean your baby is in a Left Occiput Posterior (LOP) position, and if the movements are on the left, it could indicate a Right Occiput Posterior (ROP) position. Your doctor or midwife can also help determine the baby's position by palpating your abdomen to locate the baby's back, or by feeling the baby's head by doing a vaginal exam. If the baby is found to be posterior, you can try the following positions to help turn the baby*:
- Open knee-chest. From a hands and knees position, move your knees backward and outward and lower your head and chest to the floor or bed. Make sure your buttocks are high in the air and your thighs are angled away from your belly so that your knees are slightly behind your buttocks. Try to stay in that position for 30 - 45 minutes. Your partner can help you maintain the position by kneeling next to you, facing your head, placing his or her hands on your shoulders, and pulling up and back slightly. This position can help reposition a baby in very early labor.
- Leaning forward. These positions include hands and knees or kneeling; standing; or sitting while leaning over something such as a birthing ball, bed, or a counter, and may help reposition the baby. They also help take pressure off of the sacrum to help relieve back labor.
- Pelvic rocking. In a forward leaning position, rock your pelvis forward and back or in a circle. This movement helps dislodge the baby within the pelvis, and encourages repositioning from a posterior position. I remember this movement was particularly comforting for me while in labor.
- Abdominal lifting. During contractions, while standing, use your interlocked fingers to lift your abdomen up slightly in while bending your knees. Doing this can help relieve back pain and encourage the baby to move into a more favorable position.
- Abdominal stroking. In hands and knees position, you partner can reach under your abdomen and firmly and repeatedly stroke in the direction the baby should rotate (if you know your baby is in ROP or LOP, this is especially helpful to stroke from the side your baby's back is on to the other side). It's best to do this between contractions and should feel very good. If it's uncomfortable, then stop the movement, and do not try the movement if you don't know the baby's position.
- Standing, walking, and stair climbing. These positions use gravity to encourage the descent and movement of the baby into a favorable position because of the movement of the pelvis.
- Slow dancing. Stand and sway side to side while allowing your partner to support your weight. This is a great alternative to walking.
- The lunge. Place a chair securely (so it cannot slip) to one side of your body. Place your foot closest to the chair on it and slowly lean toward the chair, allowing your knee to bend as you lunge. You will feel your leg muscles stretching. Hold the position for a count to five, and then ease yourself back upright. Do this during contractions for 5 - 6 contractions. If you know the baby's position, lunge toward the side where the baby's back is. If you don't know the position of the baby, then alternate sides and continue lunging on the side that is most comfortable to you.
- Side-lying. This is a common recommendation during pregnancy and labor. Place a pillow between your legs with your knees bent. If the baby is LOP, lie on your left side. If the baby is ROP, lie on your right side. If the baby is direct OP (baby's spine lined up with mother's spine) choose a side and watch for repositioning of the baby.
- Semi-prone. Lie on your side with your lower arm behind you and your lower leg stretched out. Place your upper leg on a doubled-up pillow with your knee bent and roll toward your front. If your baby is ROP, lie on your left side. If your baby is LOP, lie on your right side.
Wednesday, October 22, 2008
Monday, October 20, 2008
Laura Lund is another Hypnobabies instructor in Utah County. She has experienced and taught both Hypnobirthing and Hypnobabies, and prefers the Hypnobabies method. Her next class series begins in January. I've added links to both instructors websites on the right side of the page for anyone interested and for future reference.
What happens when the bag of waters ruptures spontaneously and there are no detectable contractions or progress? What if labor draws on longer with little or no signs of progress and the baby is possibly at risk for infection? What if the baby is posterior (backwards) or breech (head-up position)? What can be done to turn a baby that's not in a favorable position for birth? What can be done to help augment labor naturally? What are the risks and benefits of augmenting labor artificially? What are the risks and benefits of pain medications like narcotics and epidurals? When is a c-section medically necessary? These are just some of the questions to be considered.
Women are generally given lots of information packets and forms at the first prenatal doctor or midwife visit, but how many actually read the information given? Even when a woman is admitted to the hospital for labor and birth she is given consent forms to sign. These forms have vital information about the possible medications and procedures that will be given and used during labor and their many side-effects, and by signing them a woman is saying that she has read and understood them. But how many actually read the long paperwork, particularly if the mother is already experiencing labor and focusing her attention on the contractions rather than the paperwork? When in the middle of labor the unexpected happens, does a woman know what her options are and is she prepared to make the best decision for herself and her baby? Is her partner prepared to make these important decisions for her if she's unable to make them herself? Sometimes there is the luxury of time to discuss options and make an informed decision in the middle of labor, but many times a decision needs to be made quickly for the sake of the mother and baby.
Whether you have a doctor or midwife; whether you plan to birth at home, in a birthing center, or in a hospital; whether you are planning a natural labor without medication or a fully medicated childbirth, you should prepare yourself for what's to come.
Plan for the best, but prepare for the worst. I certainly don't feel we should expect the worst, but prepare ourselves to be ready to make informed decisions when needed. With the last two of my baby's births I had a birth plan outlining how I wanted things to be done, as well as providing contingency options for possible changes to the plan. I knew beforehand what decisions I would make in various circumstances and felt fully prepared for what was to come. My doula and my husband were both instrumental in assuring that my plan was carried out by the hospital staff and doctor, and everyone worked together as a team. This is why I feel education and preparation is so vital in preparing for the birth of a child.
One metaphor I've heard is that when someone is making a big change or purchase they do research and explore their options before making the final decision. When one buys a new car they may visit several dealerships and look at different models, options and prices. They take their time finding the best deal for what they want and need. We should approach childbirth with as much interest in exploring options and making the best decision for ourselves and our family.
Friday, October 17, 2008
Women have complex needs during childbirth and the weeks that follow. In addition to medical care and the love and companionship provided by their partners, women need consistent, continuous reassurance, comfort, encouragement and respect. They need individualized care based on their circumstances and preferences.
DONA International doulas are educated and experienced in childbirth and the postpartum period. We are prepared to provide physical (non-medical), emotional and informational support to women and their partners during labor and birth, as well as to families in the weeks following childbirth. We offer a loving touch, positioning and comfort measures that make childbearing women and families feel nurtured and cared for.
Numerous clinical studies have found that a doula’s presence at birth
- tends to result in shorter labors with fewer complications
- reduces negative feelings about one’s childbirth experience
- reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
- reduces the mother’s request for pain medication and/or epidurals
Research shows parents who receive support can:
- Feel more secure and cared for
- Are more successful in adapting to new family dynamics
- Have greater success with breastfeeding
- Have greater self-confidence
- Have less postpartum depression
- Have lower incidence of abuse
The word "doula" comes from the ancient Greek meaning "a woman who serves" and is now used to refer to a trained and experienced professional who provides continuous physical, emotional and informational support to the mother before, during and just after birth.
Studies have shown that when doulas attend birth, labors are shorter with fewer complications, babies are healthier and they breastfeed more easily.
A Birth Doula
- Recognizes birth as a key experience the mother will remember all her life
- Understands the physiology of birth and the emotional needs of a woman in labor
- Assists the woman in preparing for and carrying out her plans for birth
- Stays with the woman throughout the labor
- Provides emotional support, physical comfort measures and an objective viewpoint, as well as helping the woman get the information she needs to make informed decision
- Facilitates communication between the laboring woman, her partner and her clinical care providers
- Perceives her role as nurturing and protecting the woman's memory of the birth experience
- Allows the woman's partner to participate at his/her comfort level
A birth doula certified by DONA International is designated by the initials CD(DONA).
*This is an excerpt from DONA International, the largest association of doulas which helps educate and certify doulas all over the world. It's also the organization I am certifying through as a doula.
Thursday, October 16, 2008
The U.S. ranks 29th out of 37 countries, with statistics showing that nearly seven babies die out of every 1,000 live births. Each year in the U.S. more than 28,000 babies die before their first birthday. Premature birth is a factor in more than two-thirds of infant deaths. From 2000 to 2005, the U.S. preterm birth rate went up from 11.6% to 12.7%.
"The U.S. infant mortality rate is higher than rates in most other developed countries," note CDC researchers Marian F. MacDorman, PhD, and T.J. Mathews. "The relative position of the United States in comparison to countries with the lowest infant mortality rates appears to be worsening."
I don't post this to scare anyone. I feel it's an important piece of information, and in my opinion emphasizes the need for better education and choices in prenatal and postnatal health care. The U.S. has greatly improved its infant mortality rate since 1960 when there were 26 deaths in every 1,000 live births, and we certainly have modern technology and medicine to thank for those great improvements. What makes me sad is that the United States is apparently not keeping up with other developed countries in improving those rates further.
Monday, October 13, 2008
Friday, October 10, 2008
The clip is just over 3 minutes long. In it, Leila talks about her feelings that women should find out what their birth options are and choose what is best for them. I feel that her feelings mirror my own on this subject, and it's an important message.
Wednesday, October 8, 2008
I have done some research on Hypnobirthing and Hypnobabies, so I'll explain a little bit about them for you. Both are based somewhat on Grantly Dick-Read's Fear-Tension-Pain Syndrome, covered thoroughly in his book Childbirth Without Fear. The concept is that fear, conscious or subconscious, creates tension in the body, which is what causes the pain in childbirth. Women have been conditioned over the years to believe that childbirth is always painful, and Dr. Dick-Read disagrees. He postulates that in many cases is it the fear of the unknown or fear of outcomes that lends to the physical pain in labor and delivery.
I know from personal experience that there can be a number of fears for a woman approaching childbirth. With my first labor I was afraid of having a c-section, afraid of being out of control, of not understanding what was happening with my body, despite my best efforts to educate myself. I was afraid of pain and the unknown. I know a woman who has always wanted a natural childbirth. She had a c-section with her first baby and has had more than one vaginal birth since then, but still the fear of possible uterine rupture keeps her from being able to let herself go without an epidural. Fear is powerful! Dr. Dick-Read wrote that the key element to dispelling fears related to childbirth is prenatal education, along with proper nutrition, exercise, relaxation techniques, and proper support from friends, family and professionals.
Hypnobirthing and Hypnobabies are the only childbirth methods I'm aware of that offer the option of natural, pain-free childbirth. Hypnobirthing was designed specifically after Dr. Dick-Read's extensive research and practice, and Hypnobabies incorporates the Fear-Tension-Pain Syndrome in its method, along with other practices including learning to tap into the body's natural anesthesia and send it to specific parts of the body, particularly during childbirth. Many women have used these methods and have felt no pain, and had beautiful, exhilarating birth experiences.
The concept of natural, pain-free childbirth is incredibly appealing to me. In the natural births of two of my children there was much pain, albeit well-managed. I will be taking a full 6-week Hypnobabies series in November as part of my doula certification requirements, and I'm very excited!