I saw this guy speak at the ICAN conference this past weekend- his statistics were amazing. Go here to watch a great video that tells the truth about what is really happening in our birth health care in America.
In Birth by the Numbers, Eugene R. Declercq, PhD, Professor of Maternal and Child Health, Boston University School of Public Health, presents the sobering statistics of birth in the United States today.
View the video by clicking here:
Birth by Numbers
Tuesday, April 28, 2009
Are You Doing Your Kegels?
At the ICAN conference this past weekend, we had the pleasure of meeting the Kegel Queen. She has a wonderful book out on how to make sure you are doing your kegel exercises the right way and the benefits of doing so. She interviewed us and put her video up on the site. It is a must see for sure!
http://kegelqueen.com/videos/video_ICAN_bocce_balls.html
Want to know more about doing kegels - the why, the when, the how, and the how often- check out her site!
Wednesday, April 22, 2009
Evidence Based Medicine
Often a client or student comes to me with a question. Seems their doctor or midwife does things differently than their friend's midwife or doctor. Or they hear about what one hospital allows and what others say is outside of their policy. I believe in practicing evidenced based medicine. That means what do the actual studies say?
Do you want to know what evidence based medicine says about a particular subject? Instead of "this is what we do...." or "it is protocol here to do it this way..." perhaps you should consider looking at what the evidence- what the studies actually say about a certain procedure... so here is the place I do my research- perhaps you should as well. http://www.cochrane.org/reviews/en/topics/87.html
There is nothing better than making an informed decision. We need as consumers to take more of an active role in our health decisions. We need to understand why something needs to be done and how it can be offered to us. When you do not take an active role in the decision making and the outcome is different than you desired- you must take responsibility in the outcome being something you allowed to happen.
Do you want to know what evidence based medicine says about a particular subject? Instead of "this is what we do...." or "it is protocol here to do it this way..." perhaps you should consider looking at what the evidence- what the studies actually say about a certain procedure... so here is the place I do my research- perhaps you should as well. http://www.cochrane.org/reviews/en/topics/87.html
There is nothing better than making an informed decision. We need as consumers to take more of an active role in our health decisions. We need to understand why something needs to be done and how it can be offered to us. When you do not take an active role in the decision making and the outcome is different than you desired- you must take responsibility in the outcome being something you allowed to happen.
Saturday, April 18, 2009
Letter from Jan
This was a letter recently received for Guina from the husband of a woman who had a vaginal birth after cesarean (VBAC) with Guina as their doula.
Dear Guina,
Like most people, the most important thing in my life is the health and happiness of my family. I'm somewhat limited in all that I can do so I ask God to help me with the rest. Sometimes I fail to recognize those blessings, and I just seem to take them for granted. No doubt the birth of a child is a gift from God, but the way that Sarah was born given Amy's history and deep desire, there was definitely a bonus.
I want to thank you for your involvement. Your sensitivity, kindness,professionalism, wisdom and calm not only added to the joy of the event, but I am convinced that it was your presence that allowed Amy to realize one of her dreams. Something that we both know was so very important to her. I have to run to pick her up from the hospital...but I want you to know my gift from God included you.
Thank You so much...Jan
Dear Guina,
Like most people, the most important thing in my life is the health and happiness of my family. I'm somewhat limited in all that I can do so I ask God to help me with the rest. Sometimes I fail to recognize those blessings, and I just seem to take them for granted. No doubt the birth of a child is a gift from God, but the way that Sarah was born given Amy's history and deep desire, there was definitely a bonus.
I want to thank you for your involvement. Your sensitivity, kindness,professionalism, wisdom and calm not only added to the joy of the event, but I am convinced that it was your presence that allowed Amy to realize one of her dreams. Something that we both know was so very important to her. I have to run to pick her up from the hospital...but I want you to know my gift from God included you.
Thank You so much...Jan
Friday, April 17, 2009
Nuchal Cords
"Nuchal Cord: A nuchal cord is an umbilical cord that is wrapped around the fetus's neck. A nuchal cord occurs in about one fourth of deliveries. Normally, the baby is not harmed.
Before birth, a nuchal cord can sometimes be detected by ultrasonography, but no action is required. Doctors routinely check for it as they deliver the baby. If they feel it, they can slip the cord over the baby's head. Sometimes if the cord is tightly wrapped, it is clamped and cut before the shoulders are delivered."
Recently I have heard about several women who had to have a cesarean birth due to the baby having the cord around the neck. But it happens according to this research a fourth of the time. So why does it cause issues for some and not others? In fact my grandson was born with the cord around his neck four times- without any issues at all.
What happens is if the baby is not allowed to maneuver and stretch the cord- making his or her way down the birth canal on his or her own time. But what happens is a mom gets an epidural and then is limited in her ability to move- helping the baby move. If we want to move the baby we move the mom. But if she is immobile then that is limited at best. Then the epidural slows labor down, especially if given too early. And the need for pitocin is increased. And since she is medicated now to not feel the pain, the use of pitocin is usually much more accelerated than it is when a woman does not have an epidural and needs to be able to manage the augmentation.
Pitocin can sometimes slam a baby down into the birth canal and there is no time for the cord to be able to stretch or the baby to move to accommodate having the cord around his or her neck. So the very interventions that are selected can end with an unnecessary surgical birth due to a baby going into distress.
So, just having the cord around the neck of the baby is not a reason for a cesarean birth. I know for me as a doula, I have seen nuchal cords at least 20% of the time. It is easily slipped over the head of the baby or the baby easily slides through the loop as he or she is being born. How often are cesareans performed that could have been avoided if the laboring mom was not induced or augmented during her labor- therefore causing the very problem that would not have been a problem otherwise. Sad.
Before birth, a nuchal cord can sometimes be detected by ultrasonography, but no action is required. Doctors routinely check for it as they deliver the baby. If they feel it, they can slip the cord over the baby's head. Sometimes if the cord is tightly wrapped, it is clamped and cut before the shoulders are delivered."
Recently I have heard about several women who had to have a cesarean birth due to the baby having the cord around the neck. But it happens according to this research a fourth of the time. So why does it cause issues for some and not others? In fact my grandson was born with the cord around his neck four times- without any issues at all.
What happens is if the baby is not allowed to maneuver and stretch the cord- making his or her way down the birth canal on his or her own time. But what happens is a mom gets an epidural and then is limited in her ability to move- helping the baby move. If we want to move the baby we move the mom. But if she is immobile then that is limited at best. Then the epidural slows labor down, especially if given too early. And the need for pitocin is increased. And since she is medicated now to not feel the pain, the use of pitocin is usually much more accelerated than it is when a woman does not have an epidural and needs to be able to manage the augmentation.
Pitocin can sometimes slam a baby down into the birth canal and there is no time for the cord to be able to stretch or the baby to move to accommodate having the cord around his or her neck. So the very interventions that are selected can end with an unnecessary surgical birth due to a baby going into distress.
So, just having the cord around the neck of the baby is not a reason for a cesarean birth. I know for me as a doula, I have seen nuchal cords at least 20% of the time. It is easily slipped over the head of the baby or the baby easily slides through the loop as he or she is being born. How often are cesareans performed that could have been avoided if the laboring mom was not induced or augmented during her labor- therefore causing the very problem that would not have been a problem otherwise. Sad.
Wednesday, April 15, 2009
12 Secrets for A Gentle Birth
This is a collaborative effort on our group's part regarding what we felt were the most important secrets to a gentle birth.
Courage- Amy
Trust – Kim
Confidence- Teresa
Surrender – Pam
Vulnerability – Alicia
Relaxation- Jennifer
Love – Renee
Laughter – Persis
Movement- Guina
Focus – Tracey
Preparation – Melanie
Comfort- Patti
Comfort
When I think of comfort, images of warm socks, gentle embraces, soft lights, and relaxing music come to mind. We all desire comfort - it's a basic need. Nowhere is comfort more important than during labor and childbirth. Being able to relax during labor is so important and is greatly facilitated by various comfort measures. Some of the things that labor and birthing moms' may find helpful are their own lounge clothes to labor in vs. hospital gown, cozy socks, a variety of favorite music, the smell of lavender in oils and candles, a special photograph, their own pillow, blanket and lip balm. However, the most important comfort measures come from the people who are loving and supporting the mom such as a partner and doula. Gentle touch and encouraging words are the ultimate comfort tools.
Vulnerability
Good 'ole Miriam Webster defines vulnerability as “the susceptibility to physical or emotional injury or attack, or to have one's guard down.” But when it comes to birth, vulnerability has a much deeper meaning. To be vulnerable in birth requires not only letting down one's guard, but embracing the idea of allowing a process outside of one's control to take over. When surrounded by people and an environment that are not familiar, it is very easy for a laboring mom to have a “fight or flight” response. This natural reaction is only intensified when a woman has pre-conceived notions of what she should look or sound like in birth, or if she has a rigid plan for creating her “perfect” birth experience. While it may not come naturally to some women, spending time during her pregnancy working towards letting go of some of her inhibitions, and choosing to allow herself to be vulnerable in front of others can be absolutely invaluable in creating a gentle birth.
Courage
Any woman that chooses to bring a child into this world has COURAGE. COURAGE is the firmness of mind and will in the face of extreme difficulty. COURAGE is the ability to let go of the familiar. Most woman in this country do not face birth with COURAGE because we have been taught from a very young age that birth is scary and painful. When a woman goes into birth with these thoughts in her head, her body can tense up and slow down or even stop labor. This makes it even more important for us to educate ourselves on birth so that we can face it with COURAGE. Once we do this our bodies will be able to relax and open up so we can have a more gentle birth.
Move!
The old ways of walking, dancing and squatting through labor and birth are coming back!! As a doula for 6 years now I have seen the benefits of moving throughout birth and encourage mothers to do so from early labor all the way to pushing.
Slow dancing in the arms of the partner or doula, a woman feels loved and supported and her hips, moving side to side help to ease her baby down. Kneeling over the back of a bed, rolling on a birthing ball, kneeling on all fours and doing pelvic rocks are just a few ways to “move your body to move your baby” in the words of Gail Tully, BS, CPM, CD(DONA), There are times when a mom may not feel like moving, it’s easy to get ‘stuck’ in a position and afraid that moving may intensify her labor. Changing positions, even when you don’t feel like, it can help more than you may realize. The slight change of turning from the left to the right side, even with an epidural in place, can help a baby line up better for birth. Many mothers find that rocking or swaying during surges actually help to ease the pain. Have you ever seen a cat, dog, cow, or horse giving birth? They move. Sometimes very little, but they seem to know what they need to do and use their bodies assist in the birthing process. We are no different. If we listen to our bodies we will move with them..
The website www.spinningbabies.com gives helpful tools and advice about how to move through birth.
Laughter
Laughing is certainly one of the last things most women would imagine doing during a birth. However it may be, in this modern age, the best kept secret to a gentle birth. The benefits of laughter in general are extensive. Laughter reduces stress hormones...hmm, no stress certainly sounds gentle. Laughter allows muscles to relax and eases tension... relaxed muscles are a real good thing in labor. Laughter increases circulation and the delivery of oxygen and nutrients to your tissues. Laughter triggers endorphins...hey! aren't those the "pain killer" hormones?. But what’s so humorous about birthing? Ever seen Monty Python- The Miracle of Birth? Seriously, a dose of humor is a vital tool for coping with the pain of labor. This natural muscle relaxer will certainly aid you in a faster, safer, gentler birth. So for all these reasons and more, lighten up!
Relaxation
Giving birth is a normal physiological event and healthy part of a woman’s life cycle. To be able to relax during labor is important because it allows us to get out of our own way and just let our body birth. It needs no help from the outside; it is perfectly capable of giving birth on its own, as labor and birth are automatic, hormonally driven healthy, processes. Labor is hard work and the physical and emotional feelings that usually surface during birth are often unfamiliar and can therefore be scary and create a sense of anxiety in the mama. Anxiety increases pain. Pain increases anxiety. But relaxing the body as well as the mind can allow these intense emotions to just pass thru and not get the best of us. Birth requires our total focus and total strength. Learning to ride the waves of contractions, to dance with the pressure and intense sensations thru calm, natural breathing, closing our eyes, visualizing gentle images will enable our bodies to birth with gentleness.
Preparation
It’s no secret that a woman’s body goes through a lot of physical preparation in the weeks and months leading up to the birth of her child. She can assist this process by taking care of her body, getting plenty of rest, and maintaining a well-balanced diet. What’s just as important, however, yet many times overlooked is mental preparation – doing the work of her mind that will be necessary to achieve the birth she desires. That work begins long before the first contraction ever starts. This includes open communication with a trusted caregiver, partner, and/or anyone else that will be present during her labor to begin to develop her wishes and goals for birth. A good next step is to take a well-rounded childbirth education class which will allow her to learn about and explore all of the options available to her. Finally she should seek out and address any fears and concerns she has about the birth process and then do what’s necessary to release those inhibitions, realizing that nothing in birth is certain, but if she keeps an open mind she can deal with whatever she might face. Only then can she let go and truly just be – be the strong warrior woman that lies within all of us, and go on to enjoy the benefits of the work of her mind that she was willing to do. This is what a gentle birth is truly all about, regardless of the uncertainty of labor!
Trust
Trust during labor and birth needs to be placed in 3 areas: in yourself, in your provider, and in those who are there to support you. When you trust in yourself you believe in your body's ability to give birth. You have faith in your instinctual voice and in your body and how it is telling you to move, breathe and sound in order to allow your birth to progress. When you trust in your provider you know that they believe in the birth process as you do. You both acknowledge that you have hired them to be there in the exceptional circumstance that you need their medical expertise and not to take control of your birth. They are there to follow not lead. Finally, when you have trust in the support people you surround yourself with during birth, you know they will be there to protect and hold both the emotional and physical space you create during your labor. They are able to support your choices and any suggestions made are geared to your goals not their own. When a woman has trust in herself and her preparation for birth, in the provider she has chosen and in the people she has invited to witness her birth she is able to feel safe and protected and know that she can relax into her birth and just let it happen.
Focus
As a woman moves through her pregnancy towards birth, her FOCUS shifts from the day to day mundane to the task ahead of her, the task which will bring her child into the world. This shift in FOCUS is necessary – and involuntary - as it forces the mother to pause and reflect upon the things which are truly most important. When her womb begins to let her know her babe’s time has arrived, she can only hold on for the ride as the birth energy repeatedly moves through her body. The energy of birth is sizable, sometimes feeling overwhelming for the mother, and riding the waves requires the mother to FOCUS, which can take great effort. Some women FOCUS outwardly, zeroing in on sounds around the room or in another nearby space, but many women find it more effective to FOCUS inwardly on the rushes of energy as they surge through their body. Every woman experiences her births differently, as each of us are unique women birthing uniquely new people, but the universal experience of birthing women includes that of FOCUS on the task at hand.
Love
A woman in labor must have LOVE. Love for herself as a woman and mother, love for her baby, or love from her partner. Here's what some real moms have to say about why they needed LOVE during labor and birth:
"My LOVE for my baby is what helped me make choices during labor that were better for him, even if they were harder on me."
"LOVE is the strongest emotion that we have, and it's important for a baby to come into the world feeling that emotion versus anger or turmoil."
"During a birth you are completely vulnerable. If you don't have LOVE during the labor then it could be embarrassing /shaing to the woman instead of the beautiful thing that it's meant to be."
"It's very scary to go through and you need LOVE and support to let you know that it's okay and you WILL make it."
"I could actually feel my husband's love in the form of pain management. It was like an all over warm feeling."
"After my birth, I had a new-found LOVE for myself and what I was capable of."
"I didn't have anyone I LOVE there for my labor. I was lonely and scared, but my LOVE for my baby got me through it. Really, it was all I had."
Confidence
I looked up the definition of confidence and found these phrases: Trust or faith in a person or thing, a trusting relationship, a feeling of assurance and belief in ones own abilities. And I thought about how all of those things enter into a woman’s confidence in birth. She needs to trust the process- that her body already knows how to birth. But she must go beyond just trusting this but she needs to fully embrace it and believe it deeply. She needs to have confidence in those who surround her- her support team: her partner, care provider and perhaps a doula. If she does not have full confidence in this team, it may cause her to waiver in her own belief. She needs to have confidence in herself. That means preparing by taking classes, reading good information and looking very introspectively regarding her desires and expectations. If she goes into her labor and birth with doubts and fears, she is sabotaging the outcome. Confidence is what helps her let go and just birth.
Surrender
The word surrender is frequently used to describe being defeated, giving up. But, it also can mean to yield or resign oneself to something. The latter is a very different way to surrender. In labor and birth, a mother can spend most of her physical and emotional energy trying to control or even just manage her contractions. Fear plays a part when a mother resists the intensity of labor. Trust in her body and in birth as a normal function of her body, allows her to move beyond that fear. It allows her to surrender to her labor. It’s not about giving up anything except the fear. It is about giving in to the reality of the moment. In this moment there may be pressure, exhaustion, even pain. But it probably also includes support, love, and eager anticipation. The next moment will be different. It may hold ease, relaxation, rest. Surrendering to the reality of each moment frees a mother from her story about what is happening. And because suffering only exists in the stories we tell ourselves about something, surrendering to the reality of each moment enables a mother to have pain without suffering. It’s just what is happening now. It is temporary. Birth isn’t about making something happen – it’s about letting something happen.
Courage- Amy
Trust – Kim
Confidence- Teresa
Surrender – Pam
Vulnerability – Alicia
Relaxation- Jennifer
Love – Renee
Laughter – Persis
Movement- Guina
Focus – Tracey
Preparation – Melanie
Comfort- Patti
Comfort
When I think of comfort, images of warm socks, gentle embraces, soft lights, and relaxing music come to mind. We all desire comfort - it's a basic need. Nowhere is comfort more important than during labor and childbirth. Being able to relax during labor is so important and is greatly facilitated by various comfort measures. Some of the things that labor and birthing moms' may find helpful are their own lounge clothes to labor in vs. hospital gown, cozy socks, a variety of favorite music, the smell of lavender in oils and candles, a special photograph, their own pillow, blanket and lip balm. However, the most important comfort measures come from the people who are loving and supporting the mom such as a partner and doula. Gentle touch and encouraging words are the ultimate comfort tools.
Vulnerability
Good 'ole Miriam Webster defines vulnerability as “the susceptibility to physical or emotional injury or attack, or to have one's guard down.” But when it comes to birth, vulnerability has a much deeper meaning. To be vulnerable in birth requires not only letting down one's guard, but embracing the idea of allowing a process outside of one's control to take over. When surrounded by people and an environment that are not familiar, it is very easy for a laboring mom to have a “fight or flight” response. This natural reaction is only intensified when a woman has pre-conceived notions of what she should look or sound like in birth, or if she has a rigid plan for creating her “perfect” birth experience. While it may not come naturally to some women, spending time during her pregnancy working towards letting go of some of her inhibitions, and choosing to allow herself to be vulnerable in front of others can be absolutely invaluable in creating a gentle birth.
Courage
Any woman that chooses to bring a child into this world has COURAGE. COURAGE is the firmness of mind and will in the face of extreme difficulty. COURAGE is the ability to let go of the familiar. Most woman in this country do not face birth with COURAGE because we have been taught from a very young age that birth is scary and painful. When a woman goes into birth with these thoughts in her head, her body can tense up and slow down or even stop labor. This makes it even more important for us to educate ourselves on birth so that we can face it with COURAGE. Once we do this our bodies will be able to relax and open up so we can have a more gentle birth.
Move!
The old ways of walking, dancing and squatting through labor and birth are coming back!! As a doula for 6 years now I have seen the benefits of moving throughout birth and encourage mothers to do so from early labor all the way to pushing.
Slow dancing in the arms of the partner or doula, a woman feels loved and supported and her hips, moving side to side help to ease her baby down. Kneeling over the back of a bed, rolling on a birthing ball, kneeling on all fours and doing pelvic rocks are just a few ways to “move your body to move your baby” in the words of Gail Tully, BS, CPM, CD(DONA), There are times when a mom may not feel like moving, it’s easy to get ‘stuck’ in a position and afraid that moving may intensify her labor. Changing positions, even when you don’t feel like, it can help more than you may realize. The slight change of turning from the left to the right side, even with an epidural in place, can help a baby line up better for birth. Many mothers find that rocking or swaying during surges actually help to ease the pain. Have you ever seen a cat, dog, cow, or horse giving birth? They move. Sometimes very little, but they seem to know what they need to do and use their bodies assist in the birthing process. We are no different. If we listen to our bodies we will move with them..
The website www.spinningbabies.com gives helpful tools and advice about how to move through birth.
Laughter
Laughing is certainly one of the last things most women would imagine doing during a birth. However it may be, in this modern age, the best kept secret to a gentle birth. The benefits of laughter in general are extensive. Laughter reduces stress hormones...hmm, no stress certainly sounds gentle. Laughter allows muscles to relax and eases tension... relaxed muscles are a real good thing in labor. Laughter increases circulation and the delivery of oxygen and nutrients to your tissues. Laughter triggers endorphins...hey! aren't those the "pain killer" hormones?. But what’s so humorous about birthing? Ever seen Monty Python- The Miracle of Birth? Seriously, a dose of humor is a vital tool for coping with the pain of labor. This natural muscle relaxer will certainly aid you in a faster, safer, gentler birth. So for all these reasons and more, lighten up!
Relaxation
Giving birth is a normal physiological event and healthy part of a woman’s life cycle. To be able to relax during labor is important because it allows us to get out of our own way and just let our body birth. It needs no help from the outside; it is perfectly capable of giving birth on its own, as labor and birth are automatic, hormonally driven healthy, processes. Labor is hard work and the physical and emotional feelings that usually surface during birth are often unfamiliar and can therefore be scary and create a sense of anxiety in the mama. Anxiety increases pain. Pain increases anxiety. But relaxing the body as well as the mind can allow these intense emotions to just pass thru and not get the best of us. Birth requires our total focus and total strength. Learning to ride the waves of contractions, to dance with the pressure and intense sensations thru calm, natural breathing, closing our eyes, visualizing gentle images will enable our bodies to birth with gentleness.
Preparation
It’s no secret that a woman’s body goes through a lot of physical preparation in the weeks and months leading up to the birth of her child. She can assist this process by taking care of her body, getting plenty of rest, and maintaining a well-balanced diet. What’s just as important, however, yet many times overlooked is mental preparation – doing the work of her mind that will be necessary to achieve the birth she desires. That work begins long before the first contraction ever starts. This includes open communication with a trusted caregiver, partner, and/or anyone else that will be present during her labor to begin to develop her wishes and goals for birth. A good next step is to take a well-rounded childbirth education class which will allow her to learn about and explore all of the options available to her. Finally she should seek out and address any fears and concerns she has about the birth process and then do what’s necessary to release those inhibitions, realizing that nothing in birth is certain, but if she keeps an open mind she can deal with whatever she might face. Only then can she let go and truly just be – be the strong warrior woman that lies within all of us, and go on to enjoy the benefits of the work of her mind that she was willing to do. This is what a gentle birth is truly all about, regardless of the uncertainty of labor!
Trust
Trust during labor and birth needs to be placed in 3 areas: in yourself, in your provider, and in those who are there to support you. When you trust in yourself you believe in your body's ability to give birth. You have faith in your instinctual voice and in your body and how it is telling you to move, breathe and sound in order to allow your birth to progress. When you trust in your provider you know that they believe in the birth process as you do. You both acknowledge that you have hired them to be there in the exceptional circumstance that you need their medical expertise and not to take control of your birth. They are there to follow not lead. Finally, when you have trust in the support people you surround yourself with during birth, you know they will be there to protect and hold both the emotional and physical space you create during your labor. They are able to support your choices and any suggestions made are geared to your goals not their own. When a woman has trust in herself and her preparation for birth, in the provider she has chosen and in the people she has invited to witness her birth she is able to feel safe and protected and know that she can relax into her birth and just let it happen.
Focus
As a woman moves through her pregnancy towards birth, her FOCUS shifts from the day to day mundane to the task ahead of her, the task which will bring her child into the world. This shift in FOCUS is necessary – and involuntary - as it forces the mother to pause and reflect upon the things which are truly most important. When her womb begins to let her know her babe’s time has arrived, she can only hold on for the ride as the birth energy repeatedly moves through her body. The energy of birth is sizable, sometimes feeling overwhelming for the mother, and riding the waves requires the mother to FOCUS, which can take great effort. Some women FOCUS outwardly, zeroing in on sounds around the room or in another nearby space, but many women find it more effective to FOCUS inwardly on the rushes of energy as they surge through their body. Every woman experiences her births differently, as each of us are unique women birthing uniquely new people, but the universal experience of birthing women includes that of FOCUS on the task at hand.
Love
A woman in labor must have LOVE. Love for herself as a woman and mother, love for her baby, or love from her partner. Here's what some real moms have to say about why they needed LOVE during labor and birth:
"My LOVE for my baby is what helped me make choices during labor that were better for him, even if they were harder on me."
"LOVE is the strongest emotion that we have, and it's important for a baby to come into the world feeling that emotion versus anger or turmoil."
"During a birth you are completely vulnerable. If you don't have LOVE during the labor then it could be embarrassing /shaing to the woman instead of the beautiful thing that it's meant to be."
"It's very scary to go through and you need LOVE and support to let you know that it's okay and you WILL make it."
"I could actually feel my husband's love in the form of pain management. It was like an all over warm feeling."
"After my birth, I had a new-found LOVE for myself and what I was capable of."
"I didn't have anyone I LOVE there for my labor. I was lonely and scared, but my LOVE for my baby got me through it. Really, it was all I had."
Confidence
I looked up the definition of confidence and found these phrases: Trust or faith in a person or thing, a trusting relationship, a feeling of assurance and belief in ones own abilities. And I thought about how all of those things enter into a woman’s confidence in birth. She needs to trust the process- that her body already knows how to birth. But she must go beyond just trusting this but she needs to fully embrace it and believe it deeply. She needs to have confidence in those who surround her- her support team: her partner, care provider and perhaps a doula. If she does not have full confidence in this team, it may cause her to waiver in her own belief. She needs to have confidence in herself. That means preparing by taking classes, reading good information and looking very introspectively regarding her desires and expectations. If she goes into her labor and birth with doubts and fears, she is sabotaging the outcome. Confidence is what helps her let go and just birth.
Surrender
The word surrender is frequently used to describe being defeated, giving up. But, it also can mean to yield or resign oneself to something. The latter is a very different way to surrender. In labor and birth, a mother can spend most of her physical and emotional energy trying to control or even just manage her contractions. Fear plays a part when a mother resists the intensity of labor. Trust in her body and in birth as a normal function of her body, allows her to move beyond that fear. It allows her to surrender to her labor. It’s not about giving up anything except the fear. It is about giving in to the reality of the moment. In this moment there may be pressure, exhaustion, even pain. But it probably also includes support, love, and eager anticipation. The next moment will be different. It may hold ease, relaxation, rest. Surrendering to the reality of each moment frees a mother from her story about what is happening. And because suffering only exists in the stories we tell ourselves about something, surrendering to the reality of each moment enables a mother to have pain without suffering. It’s just what is happening now. It is temporary. Birth isn’t about making something happen – it’s about letting something happen.
Thursday, April 9, 2009
What does the Law say about Breastfeeding in Public?
Many of you have heard me teach about how the law protects breastfeeding moms and babies in the state of Georgia. Some of my recent students asked me about where they could find the law. The suggestion was made that you make a sign with the law - perhaps laminate it and carry it in your diaper bag so that if you are stopped and asked to not nurse in public you could whip it out and enlighten those who were ignorant and give them the facts. So, here you go!
http://www.ncsl.org/programs/health/breast50.htm#g
"Health professionals and public health officials promote breastfeeding to improve infant health. Both mothers and children benefit from breast milk. Breast milk contains antibodies that protect infants from bacteria and viruses. Breastfed children have fewer ear infections, respiratory infections, urinary tract infections and have diarrhea less often. Infants who are exclusively breastfed tend to need fewer health care visits, prescriptions and hospitalizations resulting in a lower total medical care cost compared to never-breastfed infants. Breastfeeding also provides long-term preventative effects for the mother, including an earlier return to pre-pregnancy weight, reduced risk of pre-menopausal breast cancer and osteoporosis. According to the New York Times, approximately 70 percent of mothers start breastfeeding immediately after birth, but less than 20 percent of those moms are breastfeeding exclusively six months later. It is a national goal to increase the proportion of mothers who breastfeed their babies in the early postpartum period to 75 percent by the year 2010.
Forty-one states, including Georgia, allow a mother to breastfeed in any location where she is otherwise authorized to be, provided that she acts in a discreet and modest way. "
Ga. Code § 31-1-9 (1999, 2002) allows a mother to breastfeed in any location where she is otherwise authorized to be, provided that she acts in a discreet and modest way. (Act 304; SB 29) The statute was amended in 2002 to add that the breastfeeding of a baby should be encouraged in the interests of maternal and child health. (2002 SB 221)
Ga. Code § 34-1-6 (1999) allows employers to provide daily unpaid break time for a mother to express breast milk for her infant child. Employers are also required to make a reasonable effort to provide a private location, other than a toilet stall, in close proximity to the workplace for this activity. The employer is not required to provide break time if to do so would unduly disrupt the workplace operations.
So there is the law- unfortunately we fought to have the words discreet and modest removed - and I had thought they were - but there it is in the law. Yuck- words that are too subjective for my thoughts- but there none the less.
And disrupting your workplace operations is another one of those phrases... so if a worker goes downstairs to step outside to smoke- is that disruptive? I do think that is subjective but would be hard to prove to be a problem. So- if you were able to take a break at all it should be allowed to be one where you could pump.
This could easily fit on a card and slide into your diaper bag. Shoot perhaps we need to put it on a small chain around the strap of the diaper bag like those formula ads that show some safety tips.
Wednesday, April 8, 2009
Newborn Procedures
There are several things that will happen once the baby is born when you are at a hospital- several of these things are not done routinely at a home birth. A great resource for looking at evidence based medicine is here
www.update-software.com/publications/cochrane/
I will offer some things for you to consider in making the choice that is right for you and your baby.
www.update-software.com/publications/cochrane/
I will offer some things for you to consider in making the choice that is right for you and your baby.
Monday, April 6, 2009
Podcast with Teresa
Brenda at South GA Birth Services has a blog and offers podcasts of different birth related subjects. She recently interviewed me and has the podcast up for you to listen to if you are so inclined. It is about being a doula- becoming a doula and what a doula does. http://bellycaster.blogspot.com/ or you may access it by searching the podcasts in ITunes for "Bellycast" (all one word) or by going here on the internet:
http://www.facebook.com/l.php?u=http://bellycaster.blogspot.com
Hope you enjoy it!
http://www.facebook.com/l.php?u=http://bellycaster.blogspot.com
Hope you enjoy it!
Saturday, April 4, 2009
Midwives and Doulas
I received a call yesterday from a first time mom who had hired a midwifery group for her birth. There had been several changes during her pregnancy in the practice and she had begun to question if she needed to stay or find a new practice. I assured her that it is more than just about the midwife- it is about the location for the birth- the mindset of the staff at the hospital and about her preparation and support. But for some reason she had thought that the midwifery approach meant they would "labor sit" with her - being with her the whole labor.
Ronnie Falco discusses the roles of the support people in your labor on her site http://www.gentlebirth.org/archives/doulacar.html and I think it enlightens a person on the differences of each role. Most nurse midwives in a hospital setting will need to be taking care of several women in labor- some may also be seeing patients in the office- and others may be sleeping or eating as they can be on call for entire weekends. For those who select homebirth as an option, most homebirth midwives will come to your home once labor is established or may send an apprentice midwife to you earlier. But they usually believe that the less interference the better. So they will read a book in another room and wait for the mom to truly need her before entering into her space. But the idea of a midwife being able to labor sit with a mom during her entire active labor is a misnomer for the most part.
The midwifery model does lend itself to longer prenatal visits. The average is twice as long as the doctor visit. So she lends herself to a more gentle paced visit where more questions can be asked and answered. She looks at birth as a natural process, not an emergency about to happen. She tends to see things as normal rather than a problem that needs to be fixed.
But the history of midwifery does not show midwives as labor sitters per se. In a village there may have been one midwife. Since birth control was not common in the early villages, often there were many women who were pregnant at the same time. She would be offering prenatal care of sorts to each of those women and would be present at the birth of most of those women. So in the history what we see are five women present during a labor and birth.
These five women include the mom herself, her mother- giving her confidence as the woman who birthed her and offering confidence in her lineage, her maiden- a younger sister or friend who had never seen birth- it is her time to serve and learn by doing so in preparation for her birth, the crone- this was the wise older woman in the village that was there to guide the new mom- this is the modern day doula, and then as birth was more imminent the maiden or the partner retrieved the midwife for the birth. She may have just gotten home from a prenatal or a birth of another mother.
So the question arises all of the time, "If I have a midwife, do I need a doula?" The answer is yes. Many midwives will agree. There are a few who will say you do not need one, that they will be with you. But I have to say in 17 years of doulaing I can count on one hand the times a midwife was with the mom the whole labor. Those situations occurred in either fast labors or where the midwife made a special concession and came in for that mom specifically. So don't count on it.
But if you are looking for a low interventive birth- one where you have the most options and most consideration- see a midwife for your prenatal care and use her for the birth of your baby. On rare occasions you will find a doctor who offers care that is similar in some ways to a midwife... but it is very rare.
If you are looking for continuous physical, emotional and information support during labor then hire a doula. She will meet you at your home if you are laboring there and want her- she will remain with you throughout your labor and stay for an hour or two afterward to help you get settled. She will not do the clinical or medical things that a nurse, midwife or doctor does... but she offers a skill set that is different and provides that emotional support they often would like to give but are unable to do in a hospital setting. At a home birth a doula provides the same services to help you along your journey.
Ronnie Falco discusses the roles of the support people in your labor on her site http://www.gentlebirth.org/archives/doulacar.html and I think it enlightens a person on the differences of each role. Most nurse midwives in a hospital setting will need to be taking care of several women in labor- some may also be seeing patients in the office- and others may be sleeping or eating as they can be on call for entire weekends. For those who select homebirth as an option, most homebirth midwives will come to your home once labor is established or may send an apprentice midwife to you earlier. But they usually believe that the less interference the better. So they will read a book in another room and wait for the mom to truly need her before entering into her space. But the idea of a midwife being able to labor sit with a mom during her entire active labor is a misnomer for the most part.
The midwifery model does lend itself to longer prenatal visits. The average is twice as long as the doctor visit. So she lends herself to a more gentle paced visit where more questions can be asked and answered. She looks at birth as a natural process, not an emergency about to happen. She tends to see things as normal rather than a problem that needs to be fixed.
But the history of midwifery does not show midwives as labor sitters per se. In a village there may have been one midwife. Since birth control was not common in the early villages, often there were many women who were pregnant at the same time. She would be offering prenatal care of sorts to each of those women and would be present at the birth of most of those women. So in the history what we see are five women present during a labor and birth.
These five women include the mom herself, her mother- giving her confidence as the woman who birthed her and offering confidence in her lineage, her maiden- a younger sister or friend who had never seen birth- it is her time to serve and learn by doing so in preparation for her birth, the crone- this was the wise older woman in the village that was there to guide the new mom- this is the modern day doula, and then as birth was more imminent the maiden or the partner retrieved the midwife for the birth. She may have just gotten home from a prenatal or a birth of another mother.
So the question arises all of the time, "If I have a midwife, do I need a doula?" The answer is yes. Many midwives will agree. There are a few who will say you do not need one, that they will be with you. But I have to say in 17 years of doulaing I can count on one hand the times a midwife was with the mom the whole labor. Those situations occurred in either fast labors or where the midwife made a special concession and came in for that mom specifically. So don't count on it.
But if you are looking for a low interventive birth- one where you have the most options and most consideration- see a midwife for your prenatal care and use her for the birth of your baby. On rare occasions you will find a doctor who offers care that is similar in some ways to a midwife... but it is very rare.
If you are looking for continuous physical, emotional and information support during labor then hire a doula. She will meet you at your home if you are laboring there and want her- she will remain with you throughout your labor and stay for an hour or two afterward to help you get settled. She will not do the clinical or medical things that a nurse, midwife or doctor does... but she offers a skill set that is different and provides that emotional support they often would like to give but are unable to do in a hospital setting. At a home birth a doula provides the same services to help you along your journey.
Friday, April 3, 2009
All Childbirth Classes Are Not Created Equal
We recently had a student say that although her friends told her it was a waste of time and money to take a childbirth class, she felt she learned things that would be helpful for her preparation for labor and birth that she did not even know she needed to know before taking the classes. Her friends told her the classes they took- more than likely the wham bamm classes that hospitals feel compelled to teach since that is what folks say they want- were full of what the hospital required of them and the medication options they had. I laugh when I hear this and say, "Oh you took the how to be a good patient classes!"
I do think our classes are different. It is more about the mind body connection- the thing that most classes don't even cover. We cover the other basics- positions for labor and birth that enhance labor, the how to time contractions, the how to know when to go to the hospital, the how to ask questions in order to get answers... but we also cover things like: what fears do you have that may hold you up in labor? what roles do you expect your nurse, midwife, partner, doula to have? what is going to change the most as you become parents? what would need to happen to cause you to change your mind in labor about pain medication? what tools do you need in order to avoid interventions in labor? This is more than the yoga 3 hour session to learn how to "breathe and move" in labor- although we cover that. We do not show films on how an epidural is placed, if you need it you don't care how it is placed- only that it gets placed. We do show films on what real birth looks and sounds like. It is not the sanitized view you get from the half hour baby TV shows. We get you to expand your thinking about birth- about your ability- about your body... and we have fun doing it!
You leave our classes feeling not only prepared for labor and birth but perhaps also as new parents. We discuss how to make the transition easier as a couple to a triad or more. We help you in self discovery rather than just feeding you information. It causes you to have to work through things in the process- having lots of conversations with your partner. We really do believe this is a journey. And we believe that it is not about a specific outcome but instead about learning what works for you- what is right in your specific situation- and what is the next best thing as events occur that change your initial goals.
We do not teach a slam bamm class due to the amount of information we feel needs to be shared. We teach a six week series and we do teach a two weekend immersion but even that class started out as a long weekend and we just did not feel great about the absorption of the information- there needed to be a bit more time. This is an investment. Labor is a day in your life but the birth will effect you for the rest of your life. Trust me, childbirth classes are not created equal.
I would love to hear your comments- what were your classes like? If you did not take classes, why not and how did that work for you?
I do think our classes are different. It is more about the mind body connection- the thing that most classes don't even cover. We cover the other basics- positions for labor and birth that enhance labor, the how to time contractions, the how to know when to go to the hospital, the how to ask questions in order to get answers... but we also cover things like: what fears do you have that may hold you up in labor? what roles do you expect your nurse, midwife, partner, doula to have? what is going to change the most as you become parents? what would need to happen to cause you to change your mind in labor about pain medication? what tools do you need in order to avoid interventions in labor? This is more than the yoga 3 hour session to learn how to "breathe and move" in labor- although we cover that. We do not show films on how an epidural is placed, if you need it you don't care how it is placed- only that it gets placed. We do show films on what real birth looks and sounds like. It is not the sanitized view you get from the half hour baby TV shows. We get you to expand your thinking about birth- about your ability- about your body... and we have fun doing it!
You leave our classes feeling not only prepared for labor and birth but perhaps also as new parents. We discuss how to make the transition easier as a couple to a triad or more. We help you in self discovery rather than just feeding you information. It causes you to have to work through things in the process- having lots of conversations with your partner. We really do believe this is a journey. And we believe that it is not about a specific outcome but instead about learning what works for you- what is right in your specific situation- and what is the next best thing as events occur that change your initial goals.
We do not teach a slam bamm class due to the amount of information we feel needs to be shared. We teach a six week series and we do teach a two weekend immersion but even that class started out as a long weekend and we just did not feel great about the absorption of the information- there needed to be a bit more time. This is an investment. Labor is a day in your life but the birth will effect you for the rest of your life. Trust me, childbirth classes are not created equal.
I would love to hear your comments- what were your classes like? If you did not take classes, why not and how did that work for you?
Thursday, April 2, 2009
Formula with Rocket Fuel
Seems like a joke doesn't it? Well it is not a joke!
http://health.yahoo.com/news/ap/baby_formula_perchlorate.html
The beginning of the article says, "ATLANTA - Traces of a chemical used in rocket fuel were found in samples of powdered baby formula, and could exceed what's considered a safe dose for adults if mixed with water also contaminated with the ingredient, a government study has found.
The study by scientists at the U.S. Centers for Disease Control and Prevention looked for the chemical, perchlorate, in different brands of powdered baby formula. It was published last month, but the Environmental Working Group issued a press release Thursday drawing attention to it.
The chemical has turned up in several cities' drinking water supplies. It can occur naturally, but most perchlorate contamination has been tied to defense and aerospace sites.
No tests have ever shown the chemical caused health problems, but scientists have said significant amounts of perchlorate can affect thyroid function. The thyroid helps set the body's metabolism. Thyroid problems can impact fetal and infant brain development."
So just one more time that something harmful has been found in formula. We remember the articles last month that is at http://www.cnn.com/2008/HEALTH/11/27/infant.formula.melamine/index.html This is the same level that caused China to bring about Death Sentences Over Melamine Milk Formula Scandal to the company's leadership and determined that the melamine was way too high for baby's safety.
And if it is not formula then it is the carrier of the formula that is under investigation.
The article about this is located at http://health.yahoo.com/news/ap/baby_bottle_ban.html and starts with "NY county ban on baby bottle chemical is official
Associated Press
By KAREN MATTHEWS, Associated Press Writer - Thu Apr 2, 3:41 PM PDT
NEW YORK - A suburban New York county has adopted the nation's first ban on the chemical found in plastic baby bottles and sippy cups.
The measure banning the sale of baby bottles containing BPA was signed by Suffolk County Executive Steve Levy on Thursday after county legislators passed it last month.
Several states including California, Oregon and Hawaii are considering bans the chemical formally known as bisphenol A, but Suffolk County, on Long Island, is the first place in the nation to enact one.
Canada announced in October it was banning BPA in baby bottles, becoming the first country to restrict sale of the chemical, which is commonly used in the lining of food cans, eyeglass lenses and hundreds of household items."
So rather than being concerned about nipple confusion causing problems with breastfeeding or allergies to formula or issues of natural, healthy bacteria being destroyed by that one bottle- now we need to realize there are hidden dangers that can cause severe damage to our babies... so the quick answer is please breastfeed. Get help beforehand to learn the proper way to latch and the ways to avoid problems. Get help afterwards if you have problems. Realize that it is really the best way to feed your baby and is the safest too!
http://health.yahoo.com/news/ap/baby_formula_perchlorate.html
The beginning of the article says, "ATLANTA - Traces of a chemical used in rocket fuel were found in samples of powdered baby formula, and could exceed what's considered a safe dose for adults if mixed with water also contaminated with the ingredient, a government study has found.
The study by scientists at the U.S. Centers for Disease Control and Prevention looked for the chemical, perchlorate, in different brands of powdered baby formula. It was published last month, but the Environmental Working Group issued a press release Thursday drawing attention to it.
The chemical has turned up in several cities' drinking water supplies. It can occur naturally, but most perchlorate contamination has been tied to defense and aerospace sites.
No tests have ever shown the chemical caused health problems, but scientists have said significant amounts of perchlorate can affect thyroid function. The thyroid helps set the body's metabolism. Thyroid problems can impact fetal and infant brain development."
So just one more time that something harmful has been found in formula. We remember the articles last month that is at http://www.cnn.com/2008/HEALTH/11/27/infant.formula.melamine/index.html This is the same level that caused China to bring about Death Sentences Over Melamine Milk Formula Scandal to the company's leadership and determined that the melamine was way too high for baby's safety.
And if it is not formula then it is the carrier of the formula that is under investigation.
The article about this is located at http://health.yahoo.com/news/ap/baby_bottle_ban.html and starts with "NY county ban on baby bottle chemical is official
Associated Press
By KAREN MATTHEWS, Associated Press Writer - Thu Apr 2, 3:41 PM PDT
NEW YORK - A suburban New York county has adopted the nation's first ban on the chemical found in plastic baby bottles and sippy cups.
The measure banning the sale of baby bottles containing BPA was signed by Suffolk County Executive Steve Levy on Thursday after county legislators passed it last month.
Several states including California, Oregon and Hawaii are considering bans the chemical formally known as bisphenol A, but Suffolk County, on Long Island, is the first place in the nation to enact one.
Canada announced in October it was banning BPA in baby bottles, becoming the first country to restrict sale of the chemical, which is commonly used in the lining of food cans, eyeglass lenses and hundreds of household items."
So rather than being concerned about nipple confusion causing problems with breastfeeding or allergies to formula or issues of natural, healthy bacteria being destroyed by that one bottle- now we need to realize there are hidden dangers that can cause severe damage to our babies... so the quick answer is please breastfeed. Get help beforehand to learn the proper way to latch and the ways to avoid problems. Get help afterwards if you have problems. Realize that it is really the best way to feed your baby and is the safest too!
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