Wednesday, February 13, 2013

Chakras ~ how to Open or Rebalance them

From the previous blog, Chakras are energy stations or zones in the body and correspond to various glands or organs.  When a Chakra is blocked or closed or not balanced, it shows up in our lives either mentally, physically or spiritually.  Of course, this is not tangible but the power of the belief in Chakras does make sense. An inventory of the Chakra system can allow the individual to become more mindful and live with greater intention.

Root Chakra

The root chakra is associated with feelings of security, stability, and the feeling that you are grounded no matter what the situation. If your root chakra is blocked or under active, you probably feel unsteady, very nervous, full of anxiety, and fearful. If this chakra is overactive, you tend to feel very materialistic wanting more and being very resistant to changes around you.

Sacral Chakra

The sacral chakra represents deep loving feelings and sexuality. When this chakra is flowing, you are able to express emotions without being overly emotional. With a balanced sacral chakra, you will find it natural to be intimate and passionate. Additionally, your feelings are grounded and you will not be too emotional or too closed off from your feelings.  An under-active sacral chakra typically displays itself as someone who is very unemotional, does not appear very open to people, is unapproachable and appears cool or even cold to people who come in contact with the person. 

Solar Plexas Chakra

When it comes to having self-confidence, assertiveness, and feeling in control of your decisions, this has to do with the solar plexas chakra. If you tend to be aggressive and domineering, this chakra is most certainly overactive. On the other hand, if you are generally  indecisive, timid, and never get what you want, chances are this chakra is under active.

Heart Chakra

The heart chakra influences your interactions with other people,  your compassion,  love, and  friendliness. If this chakra is under active you tend to be distant and cold with those around you. On the other hand, if this chakra is over-active you may suffocate others with your affections and love.

Balance is the key and provides stability in your life!


Throat Chakra

If you ever feel that you are unable to express yourself while speaking to others, then your throat chakra could be blocked or closed. This chakra directly affects your ability to communicate with others. People with a blocked throat chakra tend to be quiet, shy, and unsure.  If you tend to interrupt others or dominate the conversation while not listening to others, this chakra may be overactive.


Brow Chakra

The brow chakra or third eye has become a major focus for many people, due to the fact that it deals with your inner vision, insight, as well as your intuition. If this chakra is fully open,  you have instinctual insight into the situations around you. However, if this chakra is blocked or unbalanced, you may have a hard time being able to think clearly.

Crown Chakra

The seventh major chakra is the crown chakra. This chakra deals with the feeling of being one with the world, spiritually connected to a Higher Power and about wisdom. When this chakra is balanced and open you will  be very aware of both the physical and spiritual world. If you are not aware of your spirituality and are often rigid in your thinking, this chakra is most likely under active. 

Clearing or balancing chakras is as individual of a process as the individual themselves.  For example, listening to music (particularly with flutes, drums and bells) can be very relaxing and provide balance.  Since aromatherapy triggers both mental and physical responses in the body due to their work on the Limbic System in the brain (which controls emotions, behavior and memory), aromas can trigger balance, too.  Movement such as yoga poses and tai chi can stimulate parts of the body that correspond to chakras.  A good workout at the gym may also be helpful for some.

Meditation is probably the biggest help in balancing or opening fully a chakra.  Meditation is more than just sitting quietly or humming or repeating a word.  It is sitting quietly and observing your body, the functions and the sensations.  It is becoming fully aware of your emotions and their influences.  It is doing interspection and inventory.  Meditation may also be quietly repeating positive affirmations.  Repeating positive affirmations can clear negative emotions and energy ~ and why not?  Negative affirmations can bring a person down and eliminate happiness so why not the opposite?  One type of meditation for Christians is Lectio Divina.  From the Catholic Faith, Lectio Divina is a slow and comtemplative praying of the scriptures.  For a step by step guide to Lectio Divina,click here.  There are many other sources of how-to guides for meditation on the internet to meet your spiritual needs.

Some people enjoy quiet time meditation.  Others prefer a guided meditation during their quiet time.  Below is a Chakra Meditation for Balancing and Healing available on You Tube.






Friday, February 08, 2013

Chakra Basics 101


As our view of other cultures and their health practices widens, it is important for birth professionals to become aware of elements that could impact a womans labor and birth.  This is true of Chakras.
Why talk about Chakras?  I believe that we are only scratching the surface of knowledge about our health, our bodies and reproduction.  It is not always about incorporation of ideas, rather it is more about keeping knowledge at hand in case it is needed as reference during a situation.  This became true of aromatherapy and birth, herbs and birth, hydrotherapy and birth – well, I think you see where I’m going with this: things that were not usually associated with childbirth are now associated with birth!

What are Chakras?
According to Hinduist and other belief systems, chakras are centers of PrĂ£na or life forces – vital energies that swirl in the body and correspond to points in the body.  Directly translated from Sanskrit, chakra means wheel or vortex and thus refers to the seven energy centers.  These centers function as pump stations to the energy flow in our system.  We, ourselves, and the conditions we face can open or close the valves in the pump stations.  Blockage of the energy in any of the seven chakras can lead to illness so it may be important to understand what each chakra represents and what to do to keep energy flowing freely.



Root Chakra
Color associated:  Red
Shape associated: Lotus with four petals
Stones: Ruby or Red Coral
Location: Base of the spine in the coccygeal area
Physical: Through this chakra, a child feels that strong connection with the birth mother and the nuclear family.
Emotional:
Known as the grounding chakra or earth energy.









Sacral Chakra
Color associated:  Orange/white
Shape associated: White lotus with a crescent moon with six vermillion or orange petals.
Stones: Moonstone
Location: Sacrum
Physical: Acknowledge issues of control and making changes/personal choices.
Emotional: The sexual center and where individual creativity is birthed.





Solar Plexas Chakra
Color associated:  Yellow
Shape associated: downward pointing triangle with 10 petals along with the color yellow.
Stone: Yellow Topaz or Citrine.
Location: Solar plexus
Physical: Our gut helps us take action or avoid something
Emotional: Self-esteem and personal power; gut feelings.









Heart Chakra
Color associated:  Green
Shape associated: Symbolized by a circular flower with twelve green petals.
Stones: Rose quartz, Malachite, Love Stones.
Location: Heart
Physical: Learn self-love and self-care
Emotional: The love center: heartbreak, grief, pain and fear.






Throat Chakra
Color associated:  Sky Blue
Shape associated: Silver crescent within a white circle with 16 light or pale blue or turquoise petals.
Stones: Kyanite and Sodalite.
Location: Throat
Physical: Repressing anger or displeasure often results in laryngitis, strep throat, etc.
Emotional: The voice center: expressing ourselves openly and honestly.



Brow Chakra
Color associated:  Violet, indigo or deep blue
Shape associated: Lotus with two petals 
Stones: Lapis and Apatite
Location: Brow
Physical: Mental calculations and thinking process.
Emotional: Taking past experiences and life happenings and put them into perspectives.




Crown Chakra
Color associated:  Lavender or cranberry color
Shape associated: A Sahasrara or 100 petalled lotus
Stones: Diamond, Iolite, Serpentine
Location: Top of the head
Physical: Spreads life force to other chakras
Emotional: Inner communications and spiritual awakening.  Entryway for life force and relationship with God.







The next blog entry will discuss why these may be of interest during pregnancy, labor and birth.

Tuesday, February 05, 2013

More Tech for Birth! Google Hangouts!


Tired of social media just including Facebook and Twitter?  

Frustrated that Skype is just 1-1?  

Enter Google+ Hangouts!

Google+ Hangouts is a free video chat service from Google with unique features that allows 1-1 chats OR group chats with up to 10 total people at a time.  This can be valuable for birth organizations who wish to save money and use video conferencing for staff/board meetings, childbirth classes, interviews, demonstrations or even consultations.  Friends or family out of town?  Let everyone Hangout together!

Hangouts can be used on laptops as well as desktop computers and Android/iPhone mobile devices. Video chats can be recorded for anyone who missed the meeting.  Users need only to go to www.google.com/+/learnmore/hangoutplugin to download the free Plugin, which literally downloads in seconds.  Mobile users need to download the Google+ app.

I found this extremely helpful tutorial to help you set up for a Google+Hangout!  Get started today and join me for an upcoming Google Birth Hangout (GBH)!  Email me at info@birthsource.com if you'd like to be included in an invitation for a GBH!



Tuesday, January 29, 2013

And Two More Top Apps for Pregnancy & Birth

Daily Water Free - Water Reminder and Counter is a nice free app for those who struggle getting the right water intake!  It can be a great tool to remind the mother-to-be to drink water.  

Make your own schedule for reminding, see your daily progress via a chart, see your intake history by day, week and month and you can easily email your water data to your physician, midwife, doula or childbirth educator!  

Keep well hydrated 365 days per year!  Becoming dehydrated, especially during pregnancy, has risks.  What an easy way to avoid complications!

Free
Our rating: **** (4 stars)




Mindfulness for Pregnancy really can help you to practice relaxation, mindfulness, and meditation with or without a partner.  Would be especially helpful for those mothers without full time partners, or those mothers whose partners are deployed.  Relax via a body scan, recognizing relaxation or tension within your own body.  

Guided Loving Kindness Meditation helps you to further fall in love with your baby and be ready for his/her arrival.  Plus you can personalize your quiet time by selecting length of practice, how you are guided in relaxing and intervals for body scanning.  


There is even a Mindful Yoga section with simple body stretches to help with those aches and pains of pregnancy.

$2.99
Our rating: **** (4 stars)


Have you found other helpful apps for iPhone, iPad, or Smartphones/androids?  If so, share them with us!  Email us at info@birthsource.com.

Friday, January 18, 2013

More Top Pregnancy and Childbirth Apps



Last time we looked at The Pregnancy Wheel, Safe Pregnancy and Birth, iDoula, Ilithyia, and Partogram.  Now, we explore four different apps for pregnancy and birth.  

Next time, we will focus on breastfeeding apps for the parent as well as the professional!


*Do you like an app we’ve not featured?  Let us know your thoughts…info@birthsource.com



I am very excited about this particular app!  

iBirth is an app made by childbirth educators and is truly impressive!  Co-founder Judith Nowlin is a birth doula and Bradley childbirth educator and mother and co-founder Amanda Hanson is also a Bradley childbirth educator and mother plus is a Doctor of Psychology.  Together, they have brought great videos of positions to use in labor, with suggestions for back labor and pushing, dynamic information about prenatal nutrition (complete with grocery lists!), and Tips & Lists.  Tips and Lists include tried and true birth secrets, food to eat in labor, and more evidence-based tips.  They’ve even included vocalization in labor and birth. 

I was so excited about this app, I emailed Judith and Amanda.  In the phone interview with Judith, she told me of the "conception" of this tremendous idea (or their "4th baby" as they both have 3 children)  and how the app was birthed in 2009.  Using the client-dads and their tech knowledge together with Judith and Amanda's strong backgrounds, they worked to create the ultimate pocket guide for both parents and professionals.  "We saw the value of how what we do face to face with our clients impacts their lives. We put care into the language we used in this app and didn't want to replicate other apps," said Judith.  They wanted to have an impact on maternity care - and so they have!

An updated version of the app is in the planning stages - it will make the app more interactive, and have more content and increased functionality.

There is also a 22 minute DVD + 3 extra segments for vocalization from iBirth available at Amazon or their website (www.ibirthapp.com)  for only $29.95.  You will be able to read a review about this DVD soon on this blog.
$3.99
Our rating: *****(5 stars++) ~ in other words, you need this app!






Also from iBirth is the free Simple Contraction Timer.  Data history is preserved even if the app is closed or the phone is turned off.  A great asset for dads/partners during labor.


Be sure to "like" the iBirth Facebook page too!







Hypno 4 Birth was nuilt by British certified hypnobirthing educator Dany Griffiths.  As an introduction to hypnobirthing and a pipeline to the www.tums2mums.com website.  Griffiths has included an overview of hypnobirthing, what can be learned in a class (in person, home study or Skype), samples of birth stories, fundamentals of birth affirmations, a lovely Mp3 segment with music and birth affirmations and information on how to contact her. If you are interested in learning more about hypnobirthing or know someone who is interested, this is a great way to get some preliminary questions answered.
FREE
Our rating: *** (3 stars)



My 9 Months comes from the March of Dimes Foundation but is currently an iPad only app.  This great app tells you what is happening during prenatal appointments, discusses fetal development week by week, helps you make your birth plan, suggests how to reduce stress and how to get started breastfeeding and even includes a glossary of terms. Extremely interactive.
Free
Our rating: *****(5 stars+)








Stage 1 is a fantastic free app from Arboretum Software.  Helps tell you where you are in labor so you don’t end up at the hospital too soon.  Follows Lamaze-style by providing a focal point, soothing timing ring and background picture that you choose to facilitate breathing techniques.  Great overall reviews.
Free
Our rating: *****(5 stars)


Tuesday, January 15, 2013

Top Pregnancy & Childbirth Apps

In this series, we'll be looking at the numerous apps for both the iPhone and iPad that focus on childbirth and childbirth education.  There are over 50 of them - some duplicates for the Phone and Pad.  But we're highlighting the best!  Here are the first 5!


The Pregnancy Wheel is super easy to use whether you are a parent or professional!  A swipe of the finger allows you to highlight your Last Menstrual Period Date to reveal the estimated date of conception, estimated due date plus what trimester you are to date.  And best of all, it's free!
Our rating: ***** (5 stars!)







Developed by Hesperian Health Guides, Safe Pregnancy and Birth gives information but in a negative manner in our opinion.  With topic headlines such as Danger Signs During Pregnancy, Danger Signs During Birth and Danger Signs After Birth, one would think childbirth is dangerous!
Free.
Our rating: ** (2 stars)




iDoula is more than a contraction counter.  Gives doula-type advice along with estimating the stages and phases of labor based on the frequency and duration of the contractions.  Downside, not available for the iPad, just the iPhone.  Helps give partners an edge, even if they cannot afford a doula or didn't hire one prior to labor.
$3.99
Our rating: **** (4 stars!)




Ilithyia is an app for any birth professional, especially the midwife, nurse, doula and childbirth educator.  Named after the Greek goddess of childbirth, Ilithyia is a peer reviewed and evidence-based prenatal care guide.  Recommendations are from national guidelines set forth by ACOG, CDC and peer-reviewed articles.  Reviewed and edited by residents and attending physicians of the San Jose-O'Connor Hospital Family Medicine Residency Program, affiliated with Stanford University.  Many topics, such as Herbal Teas, Medication,  and Fruits and Vegetables are supported by "consensus".  Breastfeeding is supported by "evidence".  No information about labor or birth.
Free
Our rating: *** (3 stars)


Designed for both iPhone and iPad, Partogram is meant to be used by women who are in labor between 37 and 42 weeks, having one baby who is in the head down position.  Linked to and promotes the book, Proactive Support of Labor, this app claims to be evidence based (I found very little of this info) and usable professionals such as ob/gyns, midwives, residents, GPs who do births as well as doulas and childbirth educators.  If parents choose functionality, they need to pay to activate the app.
Free
Our rating: ** (2 stars)




Monday, January 07, 2013

2012 ~ a Year in Review & What Will Be the Hot Topics in Birth in 2013?


Birth research bombards us nearly daily with new research, new studies and new opinions. Yet one thing is clear, at the end of the year, it is interesting and important to reflect back and look at the evolution of hot topics for that year.  Let’s look at 2012.

"SQUIRREL!"
You can search this blog for the “hot topics” of 2012 and also Google them.  In chronological order, they are waterbirths, Beyonce, Gisele Bundchens Birth Around the World, woman centered cesareans, homebirth vs midwifery care, Optimal Care in Childbirth: The Case for a Physiologic Approach, Mayim Bialik’s Beyond the Sling, evidence based practice, World Breastfeeding Week, mindfulness guided childbirth, Call the Midwife, Bottled Up ~ The Film, Jennie Joseph and No Woman, No Cry, Kate Middleton,  and the call for holiday elective inductions/cesareans.  This looks like a small, short list but it represents nearly 100 blog entries just on this blog alone, not to mention other blogs, websites, Facebook messages and Tweets! The media follows these hot topics for a while, giving them some good exposure but like a puppy who sees a squirrel, the media quickly changes when a star becomes pregnant (ie Beyonce or currently one of the Kardashians) or medical associations leak questionable statements about midwifery care, homebirth or waterbirth. Yes, questionable statements in plain view of substantiated research to the contrary.

The birth community, as I define it as all childbirth educators, doulas, midwives, lactation consultants, physicians and nurses who truly practice evidence based medicine, is poorly versed on the arts of marketing and immediate “fire” extinguishing (the "fire" being instances such as  the aforementioned leak of questionable statements to distract from a concrete discussion). To effectively combat the anti-evidence based practices and statements, the birth community must first come together in an effective and continuously productive way. Yes, this entails swallowing egos and pride and releasing territorialism for the sake of mothers and babies. 

After all, isn't it for mothers and babies we are in this profession in the first place?  Right?

My hope for 2013 is that more media time will be given to evidence-based practice and the pressure to actually use what is evident in the literature will become more commonplace.  I pray that breastfeeding will no longer be looked at as an option and that women will no longer have to be so militant in order to feed their children properly in public.  I want the atmosphere to be changed from “Please get to at least 39 weeks of pregnancy” to “why would you want to induce or have a cesarean and risk your baby’s health?”.  I would like nurses/hospitals and doulas to reach common ground.  And because I believe that education…childbirth education…is the turning point for both expectant parents as well as professionals – I wish that childbirth education would become commonplace and every educator’s class was full to overflowing!

You know, we can make it all happen.  

We really can. 

Are you willing to take that step with me in 2013?

Friday, December 21, 2012

Holidays Are Not Reasons for Elective Births

A special birthdate or tax exemption is never a reason to remove your baby from the optimal growing environment.  Please make your decisions with education and research to back them up.

Happy Holidays!


Monday, December 10, 2012

A 10 Minute Waterbirth Info Session!

Here are some wonderful water labor and water birth videos from You Tube!


First, some info from Barbara Harper, the world's expert on water labor and water birth:







And from Parma Community Hospital, near Cleveland Ohio:





And now the birth....

 

Friday, December 07, 2012

Did Childbirth Education Just Receive a Mandate?

A recent Bloomberg News Editorial came across my desk: Hospital Incentives Help Babies Determine Own Birth Dates.  In the editorial, a two year project in Washington State showed that hospitals could indeed reduce their elective induction/cesarean rates and subsequently the number of weak babies admitted to the NICU.  State health authorities studied health records and revealed that an astounding 15% of the 80,000 births were elective deliveries at 37 - 39 weeks; meaning that 12,000 elective early births took place in Washington State for no medical reason.

It is the assumption of many that health care providers are taught about physiologic birth during their years of training to become physicians or nurses.  Sadly, this is not the case.  Washington State legislature created a $10 million reward fund to be shared by hospitals that showed marked improvement on statistical data regarding early elective deliveries. Staff education was a part of the plan for many hospitals to reach the goal and partake in the reward.  Piggy backing the reward was a decrease in Medicaid payments that hospitals received for uncomplicated Cesareans. But why did it take money to be the incentive to respect human beings and facilitate health pregnancy outcomes?  

The evidence is clear and highly available.  Anyone now can access the CDC, Cochrane Database or National Institute of Health to find that the US infant and maternal mortality/morbidity rates are higher than ever before despite the fact that the US spends more on health care than many other countries whose statistics in this area are much better.  In a nearly 20 year period from 1990 to 2009, the number of near term babies (those born between 37-38 weeks) jumped 8% from 19% to 27% or more than 1/4 of the babies born.  Babies who are born at 37 weeks are more likely to die in their first year and are more likely to have health problems.

In the October issue of Seminars in Perinatology*, authors Chauhan and Ananth stated:

Approximately 1 in 4 women in the United States are induced, with up to 1 in 10-12 being induced for elective reasons. National guidelines by the American College of Obstetricians and Gynecologists, the Society of Obstetricians Gynaecologists of Canada, and the Royal College of Obstetricians and Gynaecologists list 21 indications for inductions; however, all 3 concur in only 14% women (3 of 21). An induction should be considered appropriate if it meets the following 4 criteria: (1) concordant with women's autonomous informed decisions and desideratum; (2) optimizes maternal-fetal outcomes, including psychological maternal well-being; (3) congruous with evidence-based medicine; and (4) cost-effective. A meta-analysis of 22 randomized trials noted that membrane sweeping reduces the likelihood of induction. Implementing policies to prevent elective induction at 37-38 weeks provides conflicting results about the rate of macrosomia and stillbirth at early term. We argue that a well-designed randomized controlled trial, with adequate power to demonstrate whether prohibiting elective induction increases the rate of stillbirth or complications such as macrosomia, is warranted. Patient education during their prenatal course is a promising strategy to decrease the rate of induction.

Were their efforts successful?  Yes!  Elective early deliveries were reduced 77%.This in conjunction with the statement that many hospitals in Washington reduced rates with patient and staff education demonstrates that education is the key to this entire dilemma.  

If this doesn't constitute a mandate for childbirth education involving both parents and professionals, I don't know what does. 




*Chauhan SP, Ananth CV.  Induction of labor in the United States: a critical appraisal of appropriateness and reducibility. Seminars in Perinatology. 2012 Oct;36(5):336-43. 



photo credit: SantaRosa OLD SKOOL via photopin cc

Wednesday, December 05, 2012

The Duchess of Cambridge helps bring Hyperemesis Gravidarum to Light


Hyperemesis gravidarum is a serious and debilitating disease.  Recently, Duchess Kate brought to light this disease with her pregnancy.

Hyperemesis gravidarum or HG is a condition that typically peaks during the late first trimester.   HG is characterized by persistent and excessive nausea, and vomiting that far surpasses the frequency of morning sickness.  With both nausea and frequent vomiting, weight loss of more than 5%, dehydration, dizziness, fainting and metabolic imbalances are common, including increases in liver enzymes, increased hematocrit and abnormal thyroid levels.  Women with HG often have nutritional deficiencies, altered sense of taste and sensitivity of the brain to motion.  Physical and emotional stress of HG is added to the physical/emotional stress of pregnancy.  Mullin et al site postpartum implications of PTSD, motion sickness, muscle weakness and infants with irritability, severe colic and growth restriction.

According to the HER Foundation, the Hyperemesis Education and Research Foundation (www.helpher.org), thiamine deficiency has been documented in women with HG and may lead to Wernicke’s Encephalopathy.  In the May 2002 issue of Obstetrics and Gynecology, Spruill and Kuller stated that Wernicke’s Encephalopathy can be positively impacted by early thiamine replacement, which may decrease the chances of miscarriage.  Women who have had visual loss due to HG induced Wernicke’s Encephalopahy have been treated with thiamine replacement and their vision has been restored.

In May of 2012, the HER Foundation held their first annual Hyperemesis Gravidarum Awareness Day.  The purpose of the Day was to further the goals of their organization:  finding a cure for HG, helping to develop a universal treatment protocol with proactive components, eradicating maternal/fetal mortality due to HG,  and the complications; provide education and support and resources.  HER works along side many entities to further research and disseminate information. The University of Southern California has an excellent professional information page titled “Symptomatology and Outcomes of Women with Hyperemesis Gravidarum as Reported in a Large Registry”.  To access this pdf, click here.  USC also has a pdf titled “Secular Trends in Treatment of HG” – click here to access.  

Not only is HG devastating, but so are the statistics.  According to www.motherisk.org, NVP or nausea and vomiting during pregnancy afflicts more than 80% of the pregnant woman population with 0.5%- 2.0% of pregnant women having HG.  This translates into an estimated 285,000 annual hospital discharges for US women with HG.  An estimated 36% of women quit their job due to HG, and only 28% return to the workforce.  The cost of an inadequately managed HG woman is estimated at $88,000.

Treatments for HG may include a multitude of therapies including both complementary/alternative therapies and traditional therapies.  These therapies may include  accupressure, psychological counselling, IV hydration at home or in a hospital setting, Vitamin B-6, Ginger, antiemetics, sea sickness bands.  If additional nutritional support is needed, a PICC line (peripherally inserted central catheter used for prolonged therapies) may be used.
 
The Duchess of Cambridge
While doulas and childbirth educators may see expectant mothers after the incident of HG has passed, the psychosocial impact may continue throughout the pregnancy and well into motherhood.  Meighan found that women suffering from HG may not benefit from regular prenatal education efforts and so postpartum follow-up by the doula, childbirth educator or a postpartum doula may be needed.  However, in our classes or in prenatal meetings with clients, mentioning HG might be an opening for helping with postpartum issues or even helping friends/relatives of that woman who may encounter HG.  Spreading evidence-based education plays a vital role in dealing with HG.





Resources:

Chitra & Lath. Wernicke’s Encephalopathy with visual loss in a patient  with Hyperemesis Gravidarum.  Journal of the Association of Physicians in India. 2012 May; 60:53-6.

Meighan & Wood. The impact of Hyperemesis Gravidarum on Maternal Role Assumption.  JOGNN 2005 Mar-April; 34 (2): 172-9.

Mullin, P. M., Ching, C., Schoenberg, F., MacGibbon, K., Romero, R., Goodwin, T. M., & Fejzo, M. Risk factors, treatments, and outcomes associated with prolonged hyperemesis gravidarum.  Journal of Maternal-Fetal and Neonatal Medicine. 2012 June 25(6), 632-636.

Spruill & Kuller.  Hyperemesis gravidarum complicated by Wernicke’s Encephalopathy.  Obstetrics and Gynecology 2002 May: 99 (5 Pt 2): 875

Monday, December 03, 2012

Bottled Up - the Film!

Last week, I found out that one US hospital had abandoned their efforts to achieve Baby Friendly status because of artificially inflated economic number presented to them.  After 30+ years in this business, I thought I'd seen everything and had become accustomed...almost complacent...to this type of corporate attack on our mothers, babies and future societies.  Oh, but wait.  This angered me more than I can tell you.

Fast forward to today when I viewed the trailer to the powerful new film, "Bottled Up - The Film".  With an advisory board that includes IBCLCs, MDs, and PhDs plus moms who breastfed, this film is one that will shake the newborn world like "The Business of Being Born", rocked the birth world.

As I watched this trailer, I was cheering that someone now shows the real dirty little truth about the business of formula companies and the cultural shift to bottlefeeding rather than the best food - breastmilk.  Yet when I heard Bill Maher say that breastfeeding was a private function like masturbating or "pissing" - I got mad.

View the trailer on their website here: http://www.bottledupthefilm.com/bottled-up-the-film/

It will encourage and empower you.  And it could make you angry. 

What are we doing to future generations...for the almighty buck and for convenience?


Thursday, November 29, 2012

No Woman, No Cry ~ Jennie Joseph

Midwife Jennie Joseph takes a brief look at the under-served access to prenatal care.




 

Wednesday, November 28, 2012

They All Want You To Ask The Hard Questions But They Don't Want To Hear The Answers

It isn't easy being an advocate for evidence-based maternity care.  

Why? Because it an advocate speaks the truth...the evidence-based truth.

On the surface, the "they" we all encounter want to have best practice.  They want to jump through all of the hoops to be a Local Leader or Credentialed, Certified or Approved.  Being an advocate involves asking
"them" the hard questions.  Hard questions such as why is that a practice guideline or what evidence is used to substantiate it.  But rarely do "they" want to hear that "their" best practice is not evidence-based, in the best interest of mothers and babies.


"They" also really don't want their decisions or practices questioned even though they want transparency and want everyone's opinion to be heard and respected.  Of course, that is the statement that they repeat over and over but do not embrace and do not own.

Being an advocate is a lot like being a mirror.  "They" don't want to see their reflection.

Perhaps it is because their reflection is not one that actually solves any problems.  As mentioned before in countless entries of this blog, the statistical data on childbearing in the United States is not one that we can be proud of.  Our breastfeeding statistics are slow to improve but not at the rate that logic would have it.  When you examine the research, as was recently done in the outstanding book, Optimal Care in Childbirth: The Case for a Physiologic Approach, the research does not hold up both types of care models currently being used, the medical model and the physiologic care model.  To quote authors Romano and Goer, "The two models also diverge in whose needs and concerns take precedence.  The medical model centers around the doctor and institutional staff."..."In marked contrast, the physiologic care model puts the woman at the center.  Mother and baby form a single, inextricable unit; what is good for the mother becomes, by definition, good for the baby."

Seems simple enough right?  We need to put the health and well-being of mothers and babies first. Ignore the law suits and the economic incentives of long labors, the use of medication/anesthesia or admissions to the NICU.  Wasn't the fact that now with the Internet and easy access to the Cochrane Database and National Institute of Health, the era of evidence-based practice was to be the panacea of all of the problems with maternity care? Well, it hasn't been.

In searching for encouragement, I stumbled upon a rather lengthy excerpt from Optimal Care in Childbirth: The Case for a Physiologic Approach.  They write: "We, along with other advocates for maternity care reform, expected that evidence-based medicine would be the antidote to opinion-based practice.  Science, not what a Lancet editorial scathingly called "GOBSAT" - Good Old Boys Sat At Table - would dictate care practice." Yet contrary to our hopes, even the evidence has been used to substantiate medical management model.  But all is not lost, as I was beginning to feel and have seen others feel.  Romano and Goer continue, "Despite the deck being stack against physiologic care, we must not give up.  The stakes are too high.  The financial costs of medical management to society are enormous - just reducing the cesarean surgery rate to the World Health Organization recommended 15% would save $3.4 billion dollars annually.  The human cost is also enormous.  As a result of overzealous use of technology in labor and birth, millions of women and babies have suffered, and all to many have died.  Without a doubt, being a change-maker is likely to be frustrating and difficult, but when the health and wellbeing of childbearing women, babies, and society is at stake, no effort is too great, no accomplishment that forwards that goal too small."

I encourage you to read or reread Optimal Care in Childbirth: The Case for a Physiologic Approach as I did.  Shove the apathy out the door.  Grasp the mirror firmly in both hands.  Let's go.




Tuesday, November 20, 2012

Extrapolating: A "SMH" Moment for Childbirth Education!

I recently came across this photo on my Facebook newsfeed.

www.theperfectbirth.com 
I sat there a few minutes and, in a mindset that my high school Algebra teacher would have loved, tried to reverse the statistics.  If 2/3 of the guidelines for medical practice that OB/Gyns use is not based on evidence- based science, that means that only 1/3 of the guidelines for medical practice that OB/Gyns use IS based on evidence- based science.

Then I went on to apply this to a human relationship:  if your partner in a relationship was only honest with you 1/3 of the time, would you stay in that relationship?

Wow, I thought, that really changes the perspective!  And if a person WOULD stay in a relationship like that, WHY?

Extrapolating, why would you want to stay in a relationship where someone lied 66% of the time?  And why would they lie 66% of the time anyway?  To make themselves look better?  To lure you? To protect themselves from....? To hide what they are doing?  Are they too afraid to admit they don't know the truth?

Now, return from that tangent and refocus on maternity care.  Here are the facts:


  1. 23% of discharges from US hospitals are childbearing women/newborns.
  2. The preterm birth rate has only enjoyed modest decline - .1% over the last year.
  3. Low birthweight births continue to rise.
  4. The US maternity morbidity/mortality stats are not improving.
  5. The US infant morbidity/mortality stats are not improving.
  6. The US cesarean rate is still climbing.
  7. The state of non-nurse midwifery is out of control (I am not implying legislative control, here).
  8. The number of "drive through" childbirth education classes are increasing.


Since "we" are not practicing evidence-based maternity care and since "our" statistics are worse than 40+ other nations in the world...

WHAT IS KEEPING "US" FROM PRACTICING EVIDENCE-BASED CARE?

WHY DON'T "WE" CARE MORE ABOUT OUR FELLOW MAN AND FUTURE SOCIETIES?

AND WHEN WILL "WE" STOP BICKERING AMONGST OURSELVES AND DO SOMETHING?

Extrapolating again, why would you want to stay in a practice where someone lied 66% of the time?  And why would they lie 66% of the time anyway?  To make themselves look better?  To lure you? To protect themselves from....? To hide what they are doing?  Are they too afraid to admit they don't know the truth?





References:
*http://transform.childbirthconnection.org/resources/datacenter/factsandfigures/ 

Wednesday, November 14, 2012

What Parents Need and What They Want in Childbirth Classes: Is there a disconnect?

My experience as a Lamaze Certified Childbirth Educator has given me the opportunity to teach in a variety of venues.  I began teaching at an adult school affiliated with a high school in a rural California, to a community college on the Atlantic coast of Florida, to private classes in Los Angeles, to volunteer teaching on an Air Force Base, to teaching for three hospitals, and finally back to private teaching now in Ohio.  From my Lamaze Seminar Trainer, Harriet Palmer, I learned that being able to empower women and families through research based information (or the truth) was the most valuable teaching tool.  And even though I had to leave one of the hospitals because I wanted to teach the truth and resisted censorship, I can still look myself in the mirror and be proud of the educator that I am.  I personally and professionally have fought against co-optation.

Birth professionals who have been active since the 60s and 70s will no doubt remember the writings of Eugene Declercq in the Birth & Family Journal (now the BIRTH journal) and Polly Perez and myself in Lamaze's Genesis, pointing out the side effects of co-optation....when former community based childbirth education classes become part of the hospital revenue stream.  The fear then was that childbirth education classes would be censored, restricted, condensed and basically not resemble anything close to childbirth education.  They would be, in a sense, what to expect from THE HOSPITAL while you are in labor.

The time arrived and co-optation did occur as predicted and in most (yes, I say most because there are still a few hospitals who value evidence-based uncensored childbirth education classes) cases, there have been censorship, restrictions, and condensed versions.  In most situations, labor and delivery nurses are asked to teach childbirth education classes and I must tell you that nursing school does not prepare you to teach childbirth classes.  While it does prepare you to do snippets of education at the bedside, childbirth education is another animal altogether.  And in many cases, these labor and delivery nurses are not required to become certified childbirth educators in order to teach classes.

Why does this all of this matter?  It matters for several reasons:


  • Co-opted childbirth classes are not in the best interest of the expectant parents.
  • Certification DOES matter.
  • Teaching informed decision-making and evidence-based information impacts everyone.
  • Birth matters to the baby.
  • Birth matters to the mother/parents.


Midwives are particularly suited to add childbirth education to their repertoire of services as they have had the emergent and normal/physiologic side of childbirth in their education....nurses typically do not receive the normal/physiologic information in their classroom studies.  Midwives can take the time to teach and explain thus empowering their clients to achieve and enjoy this once in a lifetime birthing opportunity; to not be rushed through a process which can leave a lasting imprint on a woman's heart and soul.

Educating expectant parents of today takes more skill and cleverness, resourcefulness and constant marketing.  Today's parent needs to be exposed to something nearly 10 times before acting on it, as opposed to the 3-4 exposures for parents in the 1980s.  Educators must make their classes timely, evidence-based and truly innovative to meet the ever changing learning needs of parents.  Parents still need the information, the evidence and the facts, but they need all of this in a concise package with minimal fluff and tricks ~ otherwise they get very bored very fast.

Get certified.

Become well-versed in social media marketing to reach the parents of today.

Write your own curriculum - tedious, yes but more valuable than you can ever imagine!

Evaluate your curriculum including the dates of the evidence for topics as well as the teaching strategies.  

Remember we aren't in Kansas anymore Dorothy and the bottom line is we can't teach like we are!









Tuesday, November 13, 2012

Becoming a Midwife!

Everyone needs to view this incredible and wonderful video! Please share and forward!

Friday, November 09, 2012

Midwive's Diner!

If you have NOT seen this short video, you need to right now!  So cute and innovative!  Great analogy and wonderful introduction to midwifery care.  Kudos to the creators of Midwive's Diner!



Tuesday, November 06, 2012

Call The Midwife

If you have not yet seen this delightful and engaging series on PBS/BBC, please follow it on You Tube!


Thursday, November 01, 2012

Taking A Look At Mindfulness Guided Imagery as an Add-on to Relaxation


Research shows that relaxation during labor and birth allows for a dramatic reduction in the stress reaction.  When subjected to stress (of any kind) or fear, be it real or anticipated, body changes take place that trigger a defense mechanism and institutes the fight or flight mechanism.  The fight or flight mechanism is started by the autonomic (or involuntary) nervous system and includes body changes such as an increase in respirations and mild/moderate rapid heart rate.  With this stress response, females have a strong tendency to take flight or flee.  Obviously this is not practical during labor/birth.

Most of us teach about the Fear-Tension-Pain Cycle as first described by Dr. Grantly Dick-Read in the late 1950s.  Fear (due to lack of education and practical knowledge), leads to tension in the body – tension in the muscles of the body uses oxygen that would have normally been made available to the fetus and the uterus.  This, in turn, decreases the efficiency of the uterine contractions and thus slows or in some cases, stops the labor process.  Tense striated muscles contribute to an increased in lactic acid build up that impinges on pain receptors, magnifies pain perception and increases fatigue. Fatigue decreases the pain threshold, further increasing pain perception and reduces the laboring mother’s ability to conserve energy for the expulsive efforts needed during the second stage of labor.

Conscious relaxation and practicing coping techniques may be some of the first items removed from childbirth education curricula when timing in the class becomes an issue.  However, initiating a relaxation response to contractions or pain stimuli can decrease metabolism, slow down the heart rate, calm breathing, reduce blood pressure and relax muscles – all of which has a positive effect on the baby, mother and labor.   Click here to read entire article