Saturday, January 30, 2010

Joy Szabo: Don’t Roll Over and Take it

Remember this mom who traveled hundreds of miles to have a VBAC after her local hospital banned them?

ICAN interviewed Joy Szabo about her choices and her feelings, and she shares some very good advice.

Friday, January 29, 2010

Breastfeeding on Children's Television

What do you think?

I heard about an episode on Mr. Roger's Neighborhood that showed different ways that babies eat, including breastfeeding. Unfortunately the video has been removed from youtube due to copyright issues, but here is a short snippet of a video of it:

Wednesday, January 27, 2010

Delayed Cord Clamping is Best for Babies

Delayed Cord Clamping Should be Standard Practice in Obstetrics

The photo to the left is of my 9 year-old son cutting his newborn brother's umbilical cord, at least 30 minutes after birth. The placenta had been delivered and wrapped in a chux pad and placed at the baby's feet while I held him and we bonded before cutting the cord. It was very peaceful and nothing felt rushed or hectic. Notice that the cord is white because there isn't any more blood going through it at that point.

The article above discusses clinical findings that support delayed clamping of the umbilical cord after birth. I've read other books and articles on the subject which have supported this as well, and with all three of my un-medicated births we waited to cut the cord. From what I've read, it generally takes 8-20 minutes for the umbilical cord to stop pulsating after birth, and it's best to wait until the pulsating stops before clamping and cutting the cord. This is because there is vital blood being pumped from the placenta, through the cord, to the newborn, and early clamping can rob the baby of this precious blood and potentially cause problems. I'm happy to see more research being done on the subject.

Here is an excerpt from the article:

"For the majority of my career, I routinely clamped and cut the umbilical cord as soon as it was reasonable. Occasionally a patient would want me to wait to clamp and cut for some arbitrary amount of time, and I would wait, but in my mind this was just humoring the patient and keeping good relations. After all, I had seen all my attendings and upper level residents clamp and cut right away, so it must be the right thing, right?

"Later in my career I was exposed to enough other-thinking minds to consider that maybe this practice was not right. And after some research I found that there was some pretty compelling evidence that indeed, early clamping is harmful for the baby. So much evidence in fact, that I am a bit surprised that as a community, OBs in the US have not developed a culture of delayed routine cord clamping for neonatal benefit."

Tuesday, January 26, 2010

Blogging Meme - Tag, You're It!

I don't normally play blogger games, but a blogging friend of mine has tagged me in a "meme". This meme asks bloggers to share three of their favorite, newly discovered blogging reads in an effort to share great content.

And now for 3 newly discovered blogs I follow:

Public Health Doula - I enjoy this blog for really good statistically accurate information about pregnancy and birth. The author is a doula who supports natural birth and is currently working on a Masters of Public Health Degree.

Enjoy Birth Blog - This is a really fun one to follow. The author is a doula and Hypnobabies instructor. I love her positive spin on all things related to birth and babies.

this mom life - A friend of mine recently started this blog about home birth and motherhood. She is also the creator of Bring Birth Home, a website devoted to educating women about the safety and beauty of home birth.

Have fun blogging!

Monday, January 25, 2010

Why a Doula is Better Than Your Best Friend

This article by Birthing Hands of DC on facebook is really good! It discusses why sometimes family and medical staff are not enough support or the right kind of support a woman needs in labor and birth.

In my own experiences I've found what this woman writes to be absolutely true. I've had some friends tell me "I don't need a doula. My husband is a great labor coach, and he is all I need." My response to that is that my husband is a fantastic labor coach as well, but it always helps to have another set of hands and an unattached, unbiased, knowledgeable person there to support me.

Saturday, January 23, 2010

Thinking Out Loud Re: Breech Babies

This topic has become very important to me since giving birth to a breech baby last year, and I'd like to share some of my thoughts on the subject with anyone who cares to read.

Laws in many states require that mothers whose babies are in a breech or transverse position be under the care of a physician and give birth in the hospital. In cases in which the mother is planning a vaginal birth, this usually means a change in plans and a scheduled c-section. If the mother is planning a home birth with a midwife, this means changing her care to an OB and planning a hospital birth (again, most likely a cesarean section).


This blog post explains in detail about breech babies: Breech Presentation: Risks and Options.

There are ways to try to turn a breech baby into a favorable position before birth. My blog post above describes some of these, and there is also an excellent online resource called Spinning Babies that gives great information about breech babies and how to attempt to encourage a fetus to turn into a vertex (head-down) position. Sometimes the baby moves on its own or with help and the mother is able to plan a normal vaginal birth. Sometimes however, the baby stays breech, and the mother must seriously consider her birthing options at that point.

A recent study was done which found that the risks of c-section outweigh the risks of vaginal breech delivery: C-Section Not Best For Breech Birth. The study states that vaginal breech delivery is the preferable option of birthing breech babies, and that doctors should be trained to support women in this option.

The sad truth is that doctors are no longer trained in vaginal breech delivery. With cesarean section becoming more widely used, it has become the common method of delivering a breech baby. Unless you have an older doctor who has had experience with vaginal breech births, your doctor is likely unqualified to support you in birthing your breech baby if you want a vaginal birth. With many midwives, however, the skill of vaginal breech birth is still being taught and passed down.

The laws however, do not support the evidence. Automatic transfer of care of breech babies, in my opinion, should NOT be required. I feel the laws should allow for the care provider and the expectant parents to make an informed choice in how to birth their baby.

As explained in my blog post above, there are different types of breech presentation and some are more risky than others. For example, a full-term baby in frank breech position is the best candidate for a vaginal breech birth, and a woman with a baby in this position should be given the option of vaginal birth with a provider who is skilled to support her. This could be a midwife or a doctor, as long as he or she has the proper training, and depending on the woman's preferences and choice of birth place. If the baby is a stargazer (looking upward) there is a great risk to the spinal cord if a vaginal delivery is attempted, and experts agree that a c-section is warranted. These are just two examples of breech presentations.

Transfer of care should be a case-by-case decision based on the precise presentation of the baby. A woman should be informed of her options of attempting to turn the baby, as well as the risks and options associated with her infant's presentation and all proposed methods of birth.

This may not be a realistic expectation with current trends, but I hope that in time changes can be made. If doctors are not trained in their regular curriculum about breech birth, then perhaps additional training should be made available to those who are interested in learning and offering the service to their patients. This training should be evidence-based and consistent, and available to midwives as well. Perhaps a certificate could be given, such as with CPR and NRP (neonatal resuscitation) training. Ideally, it would be a requirement for all birth care providers, as basic as any other training they receive.

Wednesday, January 20, 2010

Men At Birth - First Male Doula Certified by DONA

"Keith Roberts is unfazed by the attention given him as the first man to be certified as a doula by DONA. He has has spent over 30 years in the field of holistic care, specifically focusing on pregnancy massage therapy and birth support for the last fourteen. The prenatal massage work he does was a segue to following one mother right into labor where he found expert massage therapy was extremely beneficial to her in labor. She was the first of fifteen more mothers he supported in labor before he determined to pursue certification as a doula."

This is a really interesting article about a male doula, and how he feels his support in labor is so helpful. The article also lists some really good advice for expectant parents.

Friday, January 15, 2010

Power in Birth

For me choosing unmedicated birth is partially a matter of control. When I was in labor with my first child I felt completely out of control, helpless. The hospital staff were telling me what I should do, and since I didn't know I had other options, I fearfully complied. I gave in to the epidural because I felt I had no other choice, and I couldn't handle the pain in those circumstances. I felt I had somehow failed for giving in, but I couldn't see how I could have done any differently.

The more I learned and the more support I sought, the more I was able to claim my own power and take control of my birth experiences. I feel powerful when I give birth without medication. I would rather feel everything, from the most intense pain to the unbelievable ecstasy of birth, than to be numb to the whole experience. There's nothing that compares to it, and being able to master the kind of control you have in birth is a monumental accomplishment. It's a beautiful balance of control and submission, and once you experience that you are never the same person again.

Birth has also been very faith-promoting for me, as I put my faith in God, and He is the one I trust to guide me in the process of working with my body and my baby. It's not about pain.

Wednesday, January 13, 2010

Breath-Taking Photo Slide Show of Home Birth

I realize I post a lot about home birth on my blog. I support hospital birth as well as home birth, but I feel we see enough about hospital birth in the media and in society in general. My goal is to inform people of the safety and beauty of home birth to offer a wonderful alternative to those who may be looking for such.

The Birth of Amerlyn Grace

This site has a breath-taking slide show of a home birth. I love how the photos accurately portray the progress of labor, and you see that the birth is not necessarily easy but it is beautiful and miraculous. In the slide show you see how the birthing mother and her support team work together in the birth of a healthy baby girl.

Monday, January 11, 2010

Skin to Skin Contact Reduces Infant Pain

A Mother's Breast Means More Than Milk

As reported on baby gooroo

A team of Brazilian researchers recently explored the use of skin-to-skin contact and/or concentrated sugar water (dextrose) for pain relief in newborns during procedures such as a heel stick or an injection.

The effects of skin-to-skin contact were previously summarized by Moore and colleagues in 2006. Previous evidence exists for Sucrose alone as an effective measure for alleviating pain, but whether a combination of the two measures is more effective than either by itself has not been investigated .

A total of 640 healthy, term babies 12-to-72-hours of age participated in the study. Babies scheduled to receive an injection of hepatitis B vaccine were randomly assigned to one of four groups:

  • Group one received standard care which consisted of 1ml of water placed on the tip of the tongue 2 minutes prior to the injection.
  • Group two received 1ml of 25% dextrose solution (concentrated sugar water) placed on the tip of the tongue 2 minutes prior to the injection.
  • Group three received continuous skin-to-skin contact starting 2 minutes prior to the injection and continuing throughout the procedure.
  • Group four received both the sugar water and continuous skin to skin contact.
Neonatal Facial Coding System and Neonatal Infant Pain Scale scores were measured in all babies prior to the procedure, during thigh cleansing, during the injection, and 2 minutes after the injection.

Babies who received sugar water or continuous skin-to-skin contact experienced less pain compared to those who received plain water. However, babies who received sugar water and continuous skin-to-skin contact experienced the least amount of pain. The combination of the two methods of pain relief was more effective than either method alone.

The researchers theorized that the beneficial effect of skin-to-skin contact is likely due to multisensory stimulation in which the touch and smell of the mother and the sound of her heartbeat block nerve transmission. Another possibility is that the sensory stimulation triggers the release of endorphins or peptides, substances produced in the body that have pain-relieving properties similar to narcotics.

The Bottom Line
Mothers and fathers should be encouraged to hold their babies skin-to-skin whenever possible especially during painful procedures. In addition, parents should talk with their baby’s health care provider about giving the child a sugar solution prior to any painful procedure.

Previous research found that breastfeeding in addition to the use of sugar water did not improve pain relief. However, more research is needed to determine how the relief achieved with skin-to-skin contact and sugar water compares to that of skin-to-skin contact and breastfeeding.

Saturday, January 9, 2010

12 Questions to Ask BEFORE Being Induced for Labor

12 questions you shoud ask BEFORE you are laying in a a hospital bed hooked to an IV, monitor and Blood Pressure cuff!
  1. Why are you being induced? Are you overdue or are their some health concerns?
  2. Would they be opposed to following the ACOG's stanadards and monitoring you till 42 weeks then inducing?
  3. How favorable is your cervix? This can affect how they induce and how likely the induction is to be successful. Ask for your Bishop's Score.
  4. How do they plan to induce? Are they going to use a cervical ripener to soften your cervix? Are they going to go right to Pitocin? The answers should be tailored to how favorable your cervix is.
  5. Ask what they would do if you don't go into labor? Do they send you home and wait it out? How do they manage things?
  6. Will they let you eat and drink?
  7. Will they let you move about, use water, change positions...?
  8. Do they require continuous monitoring or do they do intermittent?
  9. Can you have pain meds? When can you have them? What narcotics do they have standard orders for? What dose? Is there a cut off point to recieving painmedications (if you are 8+cm, will you be able to get anything?)
  10. If labor is progressing well can we turn OFF the pitocin for a while and see if my body will take over? I would like to have the opprotunity to have the kind of contractions that are perfect for my body and I would like to be able to get off of the monitor for a while so I can walk and change positions easily. I know that this will help ensure proper fetal alignment, more so than laboring in bed. What reasons are there that I couldn't have the pitocin turned off?
  11. Is there a time limit on my induction before it is considered a failed induction or turns into a c-section? Do you follow active management? Do I have to progress Xcm in X amount of time? If I am well and the baby is well, can we take it slow and steady instead?
  12. Can I decline having my amniotic sac ruptured as part of the induction process? I know that I can reconsider later, like if I get stuck at 8cm for a few hours, but as a matter of routine I would rather not have it ruptured. I worry about the added stress baby could face with the pitocin contractions if they don't have the benefit of the cushion. Fetal malpresentation, cord prolapse and cord compression are other concerns, as well as infection.

Thursday, January 7, 2010

Birth Preparation and Empowerment

I recently had a dream about birth.

In my dream I was pregnant with my 6th child very soon after the birth of my 5th. I was so busy with my family and life in general that I didn't take any time to make plans for my baby's birth. I went into spontaneous labor earlier than expected and went to the hospital. While the hospital staff tried to find me a room my labor progressed very quickly and I birthed my baby and caught it myself in the hallway of the hospital. I had my husband with me and no one else. It was chaotic and confusing, and I wondered why I was even in the hospital to begin with.

This story is unlikely to happen personally to me, but it does happen in reality to other women. Rather than birthing a baby in a hospital hallway, many women give birth in a car on the way to the hospital, or within minutes of arriving at the hospital before they can get checked in, or at home without assistance before they have a chance to go anywhere. The details may differ, but this story is not as far-fetched as it may sound. These situations sound scary for the unprepared.

I woke up feeling unsettled. I thought about my dream and how I felt about it. If I had planned in my dream for my upcoming birth I would have been better prepared and known what to do, and the story would have unfolded very differently and much more peacefully.

If we fail to educate ourselves about pregnancy and birth, we don't make informed choices or plan for our baby's birth, we are then subjecting ourselves to management by others. We leave the decisions to them rather than take ownership of our own bodies and trust in the natural process of birth. I would even go so far as to say that by ignorantly trusting in other people we show a lack of faith in not only ourselves and our bodies, but also in God.

I recently found a quote by Henci Goer that I really like:

"You can’t be said to make a choice when you only have one option."

When we fail to educate ourselves and prepare, we severely limit our options.

Tuesday, January 5, 2010

My Busy Life Gets Busier

I have so many exciting things happening right now!

I'm already busy with my family and 5 young children, and I wouldn't ever expect to take on more than I've already got on my plate. However, my passion for pregnancy and birth runs deep, and it's pushing me forward to do more. I'm stretching and growing, and I'm happy, excited and nervous at the same time.

I'm moving forward with my midwifery apprenticeship

I'm apprenticing under the same midwife who attended my own home birth less than 6 months ago. This is something I decided to do during my last pregnancy, but the timing wasn't right for me to start at that time. I can do this apprenticeship somewhat at my own pace, and that works for me since my first obligation is to my home and family. I can't tell you how happy it makes me to be taking the next steps to become a midwife. It will take about 5 years (hopefully not longer than that), and I plan to become a Direct Entry Midwife who will attend home births. I haven't yet decided if I'll become licensed or not. I have my first official apprentice meeting this week, and I've got some serious reading to get started on. This will add to what I've learned as a mother and a doula, and I hope to help support many many women in the coming years.

I'm involved in the very early stages of a collaborative effort in educating expectant parents about pregnancy and birth options

That's all I can really say about it for now. I'm teaming up with some amazing women and I'm so excited for what we will do!

Friday, January 1, 2010

Peaceful Childbirth with Hypnosis

This is a really good example of how birth can be when the mother is prepared and fully supported.

For more information about Hypnobabies, see the links on the right side of this page.