Wednesday, September 03, 2014

Five Facts Your Care Provider May Not Tell You About Labor and Birth

Trust.

Because medical professionals have achieved a certain degree at a college or university, we generally believe that they know everything about their field of speciality. But we are human and we cannot possible know everything.  

Take labor and childbirth for example.  There are four things a care provider may not tell you about labor and childbirth.  It is not that they are keeping information from you.  They just do not know the current medical evidence.

Here's what you may be missing ~

1) Childbirth Education classes are important.

You need childbirth education classes regardless of how you intend to birth your baby.  Let's face it, situations change.  No, unless you hire a Doula, no one person knowledgeable in maternity care will be with you during the entire labor and birth.  Neither the nurse nor the physician will be there all of the time.  It is so important to know the guideposts of labor and how to handle the contractions.  Your partner/spouse will need this information also in order to better assist you. Knowledge is power - and birth is a normal biological occurrance.

To find a childbirth educator near you, look to these sites for referrals:

www.birthsource.com
www.icea.org
www.lamaze.org

2) Fear about childbirth is normal and completely understandable.

So you've been watching childbirth shows on TV.  These are not accurate depictions of childbirth - they are purposely made sensational to see commercial advertising.  If they televised a real birth, it would be boring.  Over 85% of childbirth is normal and physiological.  But the fear of the pain and fear of the birth is normal.  By reading good books, visiting quality website and attending childbirth education classes, you will be able to overcome the fear of birth and make it more enjoyable.  The key is in the understanding - if you are fearful, your body is more tense, and the tension hormones make pain more intense, which makes you more fearful....and so on.

3) All medications given during labor and birth cross the placenta and affect your baby.

Independent research confirms that any medication given during the pregnancy, labor or birth does cross the placenta and affect your baby.  Yes, the medications they use to induce labor affects your baby.  Yes, epidural anesthesia affects your baby.  Knowing the facts before you need to make a decision is the best way to enter any situation.

Speaking of induction, independent research also demonstrates that women should not be induced prior to 40 week gestation.  What happens? If a baby is born too soon, there could be multiple complications and this could mean weeks in the NICU.  Play it safe, go the full 40!

4) Formula is not optimum nutrition for your baby. 

Chemicals, insufficient nutrition and lack of ideal instructions for feeding are just some of the reasons why formula is not the optimum nutrition for your baby.  Formula does not change with the change and growing needs of the baby.  What does have the best nutrition and does change to meet the babys' needs?  Breastmilk.  

5) Cesarean childbirth is major abdominal surgery with a long and often painful recovery period.

Even though the United States cesarean rate is over 33%, that does not indicate that is is always a necessary or safe procedure.  While in many situations cesarean birth saves lives, in too many other instances it is done for convenience of the parents or care providers or because a planned induction was done too soon and the mother's body did not respond.  Cesarean childbirth is major abdominal surgery with a typically longer-than-vaginal-birth recovery and definitely a recovery with more limitations and pain.  Thoroughly research about cesarean births before deciding.




Resources for this article include:

Alliance for the Improvement of Maternity Services (AIMS) The Pregnant Patient’s Bill of Rights.
http://www.aimsusa.org/ppbr.htm
Coalition for Improving Maternity Services [CIMS]. (1996). Mother Friendly Childbirth Initiative. Retrieved May 1, 2013 from http://www.motherfriendly.org/Resources/Documents/ MFCI_english.pdf.
Hotelling, B. and Gordon, H. (2014) How to Become Mother-Friendly: Policies and Procedures for Hospitals, Birth Centers and Home Birth Services. Springer Publishing.

ICEA Position Paper.  (2014) Family Centered Maternity Care.
http://icea.org/sites/default/files/Family%20Centered%20Maternity%20Care%20PP-FINAL.pdf

American Congress of Obstetricians and Gynecologists (2012) Informed Consent. Free PDF download. http://www.acog.org/~/media/Committee%20Opinions/Committee%20on%20Ethics/co439.pdf?dmc=1&ts=20140806T1650093542

Arms, S. and Harper, B. (2011) Gentle Birth Choices. Healing Arts Press.

Childbirth Connection (2013) Understanding and Navigating the Maternity Care System. http://www.childbirthconnection.org/article.asp?ck=10081

Childbirth Connection. The Rights of the Childbearing Women.  Free PDF download. http://www.childbirthconnection.org/pdfs/rights_childbearing_women.pdf

Goer, H. and Romano, A. (2012) Optimal Care in Childbirth: the Case for a Physiologic Approach. Classic Day Publishing, Seattle WA.

Jukelevics, N. (2008) Understanding the Dangers of Cesarean Birth: Making Informed Decisions. Praeger Series on Contemporary Health and Living.
North American Registry of Midwives (NARM) Position Statement on Shared Decision Making and Informed Consent. http://narm.org/accountability/informed-consent/
Simkin, P. et al. (2010) Pregnancy, Childbirth and the Newborn (4th Edition): The Complete Guide. Meadowbrook Press.

Wagner, M. (2006) Creating Your Birth Plan: The Definitive Guide to a Safe and Empowering Birth. Perigee Trade.

Dick-Read, G. (2013) Childbirth Without Fear: The Principles and Practice of Natural Childbirth. Pinter & Martin.

Gabriel, C. (2011) Natural Hospital Birth: The Best of Both Worlds. Harvard Common Press.

Goer, H. and Romano, A. (2012) Optimal Care in Childbirth: The Case for a Physiologic Approach. Classic Day Publishing.
Lothian, J. and DeVries, C. (2010) The Official Lamaze Guide: Giving Birth with Confidence. Meadowbrook.

Bardacke, N.  (2012) Mindful Birthing: Training the Mind, Body and Heart for Childbirth and Beyond.  HarperOne.

Delisle, M. Guide to What to Do When Pregnant.  Free. http://pocketpregnancyplanner.com/books/PocketPregnancy-Free-PDF2.pdf

Romm, A. and Gaskin, I.M. (2014) The Natural Pregnancy Book (3rd Edition): Your Complete Guide to a Safe, Organic Pregnancy and Childbirth with Herbs, Nutrition and other Holistic Choices. Ten Speed Press.

Sears, W. Et al. (2013) The Healthy Pregnancy Book: Month by Month, Everything You Need to Know from America’s Baby Experts.  Little, Brown, and Company.

Avery, M.D. (2013) Supporting a Physiologic Approach to Pregnancy and Birth: a Practical Guide.  Wiley-Blackwell.
Douglas, A. (2012) The Mother of All Pregnancy Books. Wiley; 2nd Edition.

Frye, A. (2014) The First Stage of Labor: A Collection of Articles from Midwifery Today Magazine. Amazon Digital Services.

Kitzinger, S. (2011) The New Pregnancy & Childbirth: Choices and Challenges. D.K. Publishing.

The Midwifery Group of Canada.  The Birth Process. http://www.midwiferygroup.ca/downloads/labour/The%20Birth%20Process.pdf

Dye, J. (2011) Aromatherapy for Women and Children: Pregnancy & Childbirth. Ebury Digital.

Frye, A. (2014) The First Stage of Labor: A Collection of Articles from Midwifery Today Magazine. Amazon Digital Services.

Hodnett, E.D. et al. (2011) Continuous support for women during childbirth.  Cochrane Database of Systematic Reviews.  Issue 2, Art No. CD003766.

Jowitt, M. (2014) Dynamic Positions in Birth: A fresh look at how women’s bodies work in labor.  Amazon Digital Services.

Morelli, K. (2012) BirthTouch® Shiatsu and Acupressure for the Childbearing Year. Amazon Digital Services.

Morton, C. (2014) Birth Ambassadors: Doulas and the Re-Emergence of Women Supported Birth in America. Praeclarus Press.

Odent, M. (2014) Water, Birth and Sexuality: Our Primeval Connection to Water and Its Use in Labour and Therapy. Clairview Books.

Simkin, P. and Ancheta, R.  (2011) The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia. Wiley-Blackwell.

Simkin, P. (2014) The Birth Partner – Revised 4th Edition: A Complete Guide to Childbirth for Dads, Doulas and all other Labor Companions. Harvard Common Press.

Sprague, A. (2011) Water Labour, Water Birth: A guide to the use of water during pregnancy, labour and birth. Published by Annie Sprague.

ICEA Position Paper. (2014) Cesarean Childbirth.
http://icea.org/sites/default/files/Cesarean%20Childbirth%20PP-FINAL.pdf

ICEA Position Paper. (2014) Episiotomy. http://icea.org/sites/default/files/Episiotomy%20PP-FINAL.pdf

ICEA Position Paper.  (2014) Induction. http://www.icea.org/sites/default/files/Induction%20PP-FINAL.pdf

ICEA Position Paper. (2014) Delayed Cord Clamping. http://www.icea.org/sites/default/files/Delayed%20Cord%20Clamping-PP-FINAL.pdf

ICEA Position Paper. (2014) Infant Feeding.


Mohrbacher, N. (2014) Working and Breastfeeding Made Simple. Praeclaus Press.

Odent, M. (2012) Birth and Breastfeeding: Rediscovering the needs of women during pregnancy and childbirth. Clairview Books LTD. 2nd Edition.



Tuesday, August 19, 2014

Using You Tube to Enhance Childbirth Education Part 2

Yes, you can use social media and You Tube to enhance your childbirth education classes. Referring couples or potential clients to videos to give them a preview of what they will learn in your childbirth class or look back on after class is over, can be helpful.   Below, are some great video segments on labor positions and comfort measures for birth, including water labor.




Positions for Labor from iBirth - included in the iBirth App.





Exercises for Optimal Positioning of the Baby - nice demo on birth ball and also pelvic rock!
But please stress caution at 4:03 and the Forward Leaning Inversion.





About water labor and water birth......

Friday, August 15, 2014

Using You Tube to Enhance Childbirth Education Part 1

Using social media is an important part of childbirth education in this decade!  As with other social media, there are wonderful resources and not so wonderful resources.

Thanks to Injoy Video and You Tube, I have selected some video clips that you can use in your childbirth education class to give that vital element of historical perspective.

Birth Images




 Birth Postures of the 1800s


Thursday, July 31, 2014

The Fetal Biome: The Beginnings of Prenatal Parenting

In 2001, I was reading a book titled Prenatal Parenting.  The author was Dr. Fred Wirth, a staff neonatologist at Reading Hospital and Medical Center in Reading, Pennsylvania. 

Wirth brought to light communication with the unborn child and called the womb the “intrauterine temple of learning”.  He believed in the empowerment of women and that they should take charge of their health care, not only as a means to a more satisfying birth experience, but as an optimal pregnancy and birth outcome catalyst.

“Faith and prayer are pivotal to my belief that you can increase the safety of your pregnancy by taking more responsibility for its outcome.  Thinking you are incapable of handling such responsibility will only work against you.  You must have faith in your ability to do this.”

And why not? Women are creating a wonderful environment both physically and emotionally for this baby.  The “faith” and “prayer” do not have to be religious.  But faith and prayer in a higher power or meditation and relaxation can help alleviate fear – and fear begets tension and tension begets stress hormones, which can have multiple negative effects on the growing baby and the pregnancy.
 
Fear is a huge topic today – with media input such as television views of childbirth and certain books and embellished stories from friends!  Fear of childbirth or tocophobia may include nightmares, panic attacks and psychosomatic symptoms.  The fear may be rooted in the misunderstanding of the pain in childbirth or apprehension in being at the hospital during the birth.  In our society hospitals are the place of illness and death – not the ideal location for pregnancy which is mostly a situation of health and wellness.  Again with the media, we have created a culture of avoiding pain: this medication for a headache, this medication for arthritis, this medication for menstrual cramps – we don’t have time for the pain.  And why should we – just take medication.

Therefore protecting the fetal biome is more than eating the right foods or consuming enough liquid to avoid dehydration.  It is a psychosocial journey of learning about the roots of fear, education on methods of comfort measures for the tension, as well as understanding the mechanism of pain and how to use the pain to the advantage of both the mother and baby.

When the above skill set is in process of being mastered, a powerful emotional bond begins to take place between the mother and child.  As childbirth educators and doulas, we can help mothers establish this reverence for the fetal biome and facilitate prenatal bonding.  What we teach our expectant clients has an impact on their relationship with their baby and may greatly influence the pregnancy.  Focus education not only on the expectant mother or the growing baby but the two as a dynamic dyad where love flows back and forth.


Want to read Dr. Wirth’s book Prenatal Parenting?  There are copies available on Amazon: click here.  And as former US Surgeon General C. Everett Koop said, “Read this book!  You will learn how to improve your birthing experience, as well as the health and happiness of your unborn child.”

Monday, July 21, 2014

Climate Change in Birth

There is much discussion regarding climate change in the world.  There should also be conversations about climate change in birth.

Current conversation about birth talks about what is happening now: maternal morbidity/mortality, infant morbidity/mortality, breastfeeding rates à but what about the future?  How will the way we required women to give birth now, impact birthing in the future?

And furthermore, why should we care?

In his book, Childbirth in the Age of Plastics, Michel Odent points out that we just do not know
how interfering in the normal reproductive physiology impacts the future.  We already see an increase in autism and anorexia nervosa.  Could these be caused by a birth intervention, an alteration in the oxytocin system?  Odent says that the evidence points to yes.

What about labor pain?  Either women are fearful of it or they do not want to face it at all.  Regardless, the physiology of labor pain is not being taught in nursing or medical schools and only a handful of childbirth educators and midwives teach about the physiology of labor pain.  Hence, we are raising several generations of both parents and professionals who do not understand that labor pains are a guide for how the laboring mother’s body needs to respond to the labor.  The pains tell the mother how and when to move to assist with the Cardinal Movements.  Labor pain is unlike any other pain humans experience and should not be treated in the drive-thru method of getting rid of it.  It should be considered, contemplated and cooperated with.

During labor, mothers have restricted movement (inhibiting Cardinal Movements), have the pain removed by anesthetic/analgesics (inhibiting Cardinal Movements) and restricted in food and fluids.  Simply put, the medical community, in its zeal to care for laboring women, put those women at a distinct disadvantage and enable fetal and maternal distress to occur.  The medical community promotes the notion that labor and childbirth are emergencies waiting to happen and facilitate the self-fulfilling prophecy.

The aforementioned anesthetics/analgesics cross the fetal blood brain barrier and we are unsure of the results.  Natural pain and coping techniques such as positioning, touch, relaxation, breathing and hydrotherapy are systematically being removed from choice options for pregnant women. Many childbirth education classes minimize or remove exploration of these options due to perceived time constraints (“parents don’t want lengthy classes”), when in reality, parents don’t know what they want and are often disappointed when abbreviated classes are over. And besides, what tools can they use between onset of labor and getting “their” epidural?

Women are not encouraged and often miss out on falling in love with their babies during pregnancy.  They then miss out on the right of passage called labor with the glorious hormonal dance. 

Do we really want assembly line childbirth in the future?  And at what cost?




Odent,M. (2011) Childbirth In The Age of Plastics, Pinter & Martin LTD.