Tuesday, July 22, 2014
I find that often when a client is writing up a birth plan, you should keep it short, to the point, covering the important things, but also realize this is more for you. It is a reminder for you more than anyone to be able to remember your plans and desires.
But, what if your naturally planned birth doesn't go as planned? Babies and pregnancy is unpredictable, and often little things happen that require an intervention. Does this mean your birth plan is useless? I would answer and say no, if you have following my recommendations.
When you write up your birth plan, most women that are planning a natural birth include that they want a Hep-lock instead of an I.V. What happens if that I.V is needed? Does that mean you throw out the whole plan?
An I.V is needed in the case of an epidural, or a c-section to get enough fluids to prevent your blood pressure from dropping too low and in the case of blood loss at times. However, if you are not to that step yet, it is okay to ask to wait an hour or two, to decide on that, even when you feel you need an intervention.
I believe there is a tendency to try to feel like everything needs to be decided right now. Then when you do decide to go ahead with an intervention, if it is not an emergency, often hospitals do not move very quickly. You are left with a lot of time to think about your decision.
In the case where you are faced with an unplanned c-section, I would really advise everyone to write out a short plan on c-sections.
For example, if you have a doula, talk to the care provider about having your doula in the c-section with you. It can make a huge difference in your mental recovery if you have support from more than just your husband in a c-section. Often, first it is scary to be taken to a surgical room, treated suddenly like a surgical patient, rather than them listening to your needs and you need someone that is focused on you and not the baby, (which your husband will be focused on the baby).
They can talk you through it, what is happening and stay with you if there is a problem with the baby. Sometimes, when things go awry, it seems like there is a higher likelihood of something happening with the baby, where they need to be separated from you. This can be really scary for a mom that is strapped down to a table, your husband walks across the room to be with the baby and is trying to tell you what is going on, but his mouth is covered by a mask and you don't know what he is saying. The panic sets in and complications can occur.
Many surgeons do not think about this. They are surgeons for a reason. They often like their patients sedated and do not think of their mental health in a surgery. For this reason, you need to plan ahead. Plan for support if you think there is a possibility of surgery, confirm and discuss with the care provider ahead of time that you will be having an extra support person. If they talk about how they only allow one person, there is not room etc. etc. You will need to push a bit. They allow students in surgeries all the time. They are generally concerned about liability if someone passes out. Make sure your support person is skilled and has attended surgery before, and has no history of fainting.
I have worked in different hospitals and found it curious that the one that is touted as the most "natural" has the worst policies as far as doulas and c-sections. It was as if they were naturally minded until you needed intervention and then they threw out all of that, and figured it was all a moot point.
I am going to be working on some education on that for the community benefit, but I am not exactly sure how it will happen.
For you, remember natural birth or not, if you educate yourself on all the options, give yourself the chance to make the decision, you will feel better about your choices. If you feel like you are simple taking their word for it, you will be feeling more out of control with your decisions.
Stay in charge of your birth, interventions or not. If they have a policy against something, educate yourself on those ahead of time.
Wednesday, April 2, 2014
This could pertain to anything from baby wearing to breastfeeding. I heard one mom claim that attachment parenting was a fad, a new fad, in fact. She was actually using biblical reasons for forgoing this "fad".
I would love to actually discuss and bring to the forefront that actually, some of the other parenting methods are the fads. The key components of attachment parenting have been around long before this century. I think that the idea AP is coming back around is more because it is what was done and is still done in many countries around the world. I used to stare at the foreign women that lived in the city, where I lived, trying to figure out how they kept that young child on their backs. I worked hard, outside on a piece of land, and had no place to set my baby down that was safe and longed for a way to safely wear him, just to keep him safe.
Baby wearing has been around since bible times. So has bed sharing. If you go to any historical forts and look at their sleeping arrangements, you will find that most pioneers and in history people were not as finicky about room and bed sharing as we are as spoiled Americans that believe we "need" our privacy. It didn't effect their marriage relationships too much. I think they had to use their imaginations a bit more. I have been in old cabins where there was one bed, very large bed above the oven for the whole family. Sometimes that included the grandparents as well.
This is not a fad. Much of it is going back to the roots of society.
However, I believe that above all, you need to make sure to check your heart in all things. But just because you have a wrong heart attitude about something, doesn't make it something wrong to do. I remember a mother telling me that she felt sewing had become an idol for her, so she was going to stop doing it. At that time, their family had no money, she had boxes of fabric and her children were wearing very worn out clothes. She chose to let them wear the worn clothing because she felt she had to give up her idol of sewing. I struggled with being obsessed with cooking. I remember thinking about it when my friend gave up sewing that perhaps I should step back from cooking. I immediately checked myself! I needed to change my heart attitude, not what I was doing. The same with attachment parenting...which was named by modern society. If your heart is not right about it, change it. But it doesn't make the actions of it wrong.
You want to battle it out?
There are plenty of mothers that will battle it out for you! Put 'em up!
Sleep training and the actual definition of the term "Cry-it-out" can bring up a lot of interesting thoughts. In 1985, Dr. Richard Ferber wrote a book about getting your babies to sleep. New mothers loved some of his ideas as it was formed to give them more sleep. His idea was that you can teach your babies to soothe themselves to sleep, rather than the traditional rocking the baby to sleep. This article from BabyCenter explains some of the ideas contained in the book. Here is another article by the author himself...The Truth about Ferberizing
Society was changing from the '70's where it went to some of the earth loving, peace loving, freedom society and parents were realizing that they were having to work two jobs, mothers didn't have time to cook, rock babies and they just were mostly too busy for it all. Ferberizing gave them the freedom to lay down the baby, ignore it, check to make sure he was okay occasionally, but mostly, you let the baby cry until he realized you were not coming for him, he gave up and went to sleep. This method is portrayed to work on every child, if done right.
However, Dr. Ferber has said that he did not agree with this (letting the child cry to no end). But still, much of what is in his book is still widely used by parents today, usually the ones that are sleep deprived, but occasionally, the selfish parent that is just done with the child.
I discovered in my research that some of Dr. Ferber's ideas were actually based on a book from the late 1800's. It is available on Gutenburg for free, if you are interested in reading it. The Care and Feeding of Children by L. Emmett Holt, M.D., LL.D.
The book is very interesting, but most of us would shudder in horror at what was advanced thinking at that time in child care and feeding. Yet, he was trying to encourage society for the best. This was addressing a more formal society, not the tribeswoman or pioneers that wore their babies, slept in a common room and breastfeeding was just second nature.
Many people will look back on past methods and claim "Those babies survived. My grandparents survived drinking cows milk at the age of 3 months, being aired outside in cages, and the like. Why can we say that it is not healthy now?" We have to look at the statistics as well. Infant mortality was much higher as well with this type of diets. Women gave birth to babies that were smaller, had faster deliveries often, but also lost a lot of children. It is common to also read books and families would have 2-4 living children, but gave birth to 8-10.
This is a book on infant mortality as far as it related to the occupation of the mother. Infant Mortality and It's relation to the employment of mothers.
If you read book that was by Jennifer Worth, the woman that wrote the books which inspired the "Call the Midwife" TV series. The books detail in very clear pictures, the issues that faced society, not all that long ago, where they were pushing some of the regimented schedules, feedings, and lack of care that women and children faced.
When we are evaluating a parenting style for ourself or others, let's be careful to look at a complete picture. Are we moving forward or going backward? Are we simply cycling around? Is baby-wearing a fad or something that promotes healthier babies for convenience?
When we seek info on a parenting decision, do we simply look to the internet for opinion based posts, or do we look to science based posts? Do we evaluate our decision based on society or what is really best for our own individual child?
Be careful not to parent through emotion, religious ideals or even sleep deprivation. Make sure to evaluate daily what we are doing for our children as they grow.
Wednesday, March 12, 2014
You may have a uterus that clamps down one baby and then because of many factors may not the next. Those factors include interventions as well as nutrition.
#1- They need to be fed. Protein feeds muscles, as well as other things that supply good nutrients to your muscles. Iron is a big one of these factors as well as calcium and magnesium.
#2- They need to be exercised and not over the top exercised or under exercised. This is the balance that is hard to find. Often artificial oxytocin will hyper-stimulate a uterus, which makes it unable to clamp down. This can also happen naturally too. A uterus after a hard labor, too many herbs someone took or other things can cause a uterus to be hypertonic. That is why something that is gentle can sometimes be recommended by doctors, midwives etc. to help uteruses stay healthy. Also, a uterus that stretched out, then never has had the chance to reduce in size, heal and begins stretching out again is more likely to struggle. (This would likely be the worry for you, Laura, since your babies are close in age).
#3- Uteruses need support after birth; they look like a heavy ball of muscle, hanging limply on ligaments in your pelvic area. When you are lying down, those ligaments tighten; the contractions of the uterine walls tighten and reduce it in size. When after birth, we stand for long periods of time, especially the first two weeks, sometimes we stretch out those ligaments, cause the uterus to not be able to go back to it's original size and struggle all the way around. Then if you get pregnant in the first 5-6 months PP, before it has had a 9-month healing time, you uterus can struggle.
Something else is hormone level. This can affect things with the uterus as well. If your hormone levels are not right you may not produce normal amounts of oxytocin on your own, or sometimes the baby is struggling to produce it.
Another big one is not your uterus as well, but your pelvic floor. If your pelvic floor is weak, when your uterus contracts, it sort of has a smooth pushing down motion and pushes against the pelvic floor.
I think though, sometimes you can do all you can, and some people just have a weaker uterine muscle than others. That is something you have to be thankful that we have artificial medications to force it to comply.
So, what is a good calcium and magnesium supplement? It differs for everyone. One that I find easy to take and many clients enjoy as well is Lifetime Liquid calcium. I prefer the strawberry flavor, but it comes in a variety of flavors. Vitacost has it for a fairly reasonable cost. Here is a link that as a referral will give you $10 off your first order! https://www.vitacostrewards.com/jTSZGtY Here is a direct link to the calcium Liquid Calcium and magnesium- Strawberry
Where can you go to find pelvic floor exercises? That varies, but there are some online resources available. This website offers some great exercise routines. I have not researched to see what they have available for pelvic floor exercises yet though. http://fit2b.us
These websites talk about for helping with bladder control issues, but it is the same muscles that help support the pelvic floor. They are easy and cheap to do. https://patienteducation.osumc.edu/Documents/IncontinenceExerProg.pdf
And another one.... http://mydoctor.kaiserpermanente.org/ncal/provider/juliealmeria/resources/dc/article?article=article_506667.xml&contentTitle=Ball%20and%20Band%20Exercises%20for%20Urinary%20Incontinence I hope these resources are helpful for you!
Thursday, January 9, 2014
We are ready at the end to have our babies, aren't we?
This question usually brings on a flurry of activity, opinions, ideas on what actually starts labor. First of all, we need to look at the facts. For each person, the reasons may be different as to why a care provider may be suggesting an induction. Most of them, have protocols they have set up and follow. Unless there is a medical reason or it is a law, you usually have an option to opt out of their normal protocols and choose an alternative course of action. An induction is not something they can force on you, unless you or the baby is in medical need of it, even then, it can be difficult.
You are not trying to be difficult. You just want what is best for your baby, so you turn to "natural" methods. You are done being pregnant and since the care provider has said the baby is ready, you are ready. First of all: We need to know what has to happen in order for labor to begin. There is a series of events that have to happen. Generally, while preterm labor can be an issue, often, in a healthy pregnancy, labor begins when the baby decides it is ready to be born. (Science of what happens)(Layman's article on the same topic)
When the baby is ready, the hormones are released to begin the process of labor. However, if these hormones are stirred, and baby is head down, but not quite in the right position, often contractions start, stop, start, stop. This can also happen with larger babies, uterus that needs a little more exercise, or positions like posterior, breech etc. Or if the mom has encouraged labor on her own with herbs, castor oil or other means. The hormones are often not steady when they are being induced by alternative means, natural or otherwise. Drugs used for inductions are often powerful enough to override the hormones and induce labor anyhow, but sometimes they can even fail. The danger in natural induction methods, especially when not overseen by a medical professional is the risks of overdosing on herbs, exhaustion, lack of sleep from up and down contractions, dehydration, and others. Often moms will have lack of sleep and when labor really hits, they are too tired to go through it and put themselves at risks of other interventions.
Here are some articles to read on the pros and cons of natural and drug induced induction. http://midwifethinking.com/2010/09/16/induction-of-labour-balancing-risks/ http://avivaromm.com/labor-induction-low-natural-approaches-midwife-md
My encouragement to mothers is to have patience. The baby usually knows when it should come. If your doctor insists on medical reasons for an induction, pay close attention. Check out the baby. Listen to your doctor and weigh what they say with care. They care for you for a reason. However, research the pros and cons of induction and discuss them with your doctor and why you are not wanting to go that route. Ask them if there would be any reason why you cannot have a couple more days and then reevaluate.
Here are some things usually that you can do, without risk, in most cases, to you or your baby. As with any exercise or regime, speak to your care provider before beginning anything.
At 32-34 weeks, I recommend all mothers, if okayed by their care provider, begin seeking chiropractic care on a weekly or twice weekly basis to help with position. Regular exercise should be repeated, walking, swimming and other low level forms of exercise.
At 38 weeks on, I recommend a repeating pattern of exercise to help encourage a good position. This is if the baby is in a head down position. 25-30 pelvic tilts - Rest 25-30 hula hoop motion in either direction on an exercise ball- Rest 10 lunges with leg up on chair on each leg - alternating legs (View this to see what I mean by lunges Lunge-Spinning Babies) Rest. Repeat this pattern twice a day. When you get closer to your due date, repeat this more like 3 to 4 times a day. The repeating motion helps encourage the baby into a good position, which also will help your aches and pains as well. These exercises can be repeated while in labor as well! In the end, research even natural methods of natural induction. They are not always worth trying!
Babies usually come when they are ready! Labor is much easier when left to it's own timing usually as well.
Monday, November 25, 2013
Friday, August 16, 2013
So, what is the reasoning behind paying for a doula. Often I hear the comment...."If you can't afford a doula, there are free or volunteer doulas to be had." While that is often true, I am hear to tell you that if you want the best experience, pay for one.
There are times when a close friend may be trained as a doula, and can, because of the closeness, be able to provide the same level of support that a paid doula can. But one of the interesting studies that talk about why you might want a doula, they found that while there was positives from having support from female relatives and friends, a companion that was not related to you had the best results.
Here is a link from DONA on some of the results.... http://www.dona.org/publications/position_paper_birth_table1.php
But why would I say that it is important to pay your doula?
I am a frugal person! You can ask most anyone and I can usually find a way to save some money! I have scrimped and saved money like most people never even think of! But.....I have come to realize that when we pay for something, we appreciate it more. We tend to be more careful in how we might care for a table that we paid $300 for, rather than the table we got for free, even if the table we got for free is worth $300. It is something about the human mind that tends to cause us to believe that if others did not value their service or item for more than that, it is not really worth the cost. I have learned this over the years in doing some volunteer doula work...it is those births that you can work yourself to the utmost, supporting the client in pregnancy, and the last minute, she forgets to call you when she is in labor or when you arrive, you find the family members are resentful of your presence as they were not notified of her desire. We are a culture that values what we pay for! Now, I am not encouraging you to go into debt to hire the most expensive doula you can find! I am encouraging you to think outside the box for paying your doula, but pay your doula!
Here are some alternative ideas to traditional payment: -Bartering- think of anything you could do for your doula. She is giving you a service, so think of a service you could do for her. Some ideas may be cleaning, handcrafts, haircuts, weeding a flower or vegetable garden or other things along that line.
- Home baked goods or freezer meals- If you are on a very low income, you may have extra food stuff and be able to offer this in exchange.
- A piece of nice furniture or other items
-Labor work- perhaps your partner or if you have older children have skills they would be willing to offer to do work such as painting, yard work etc. Someone suggested recently having a collection at your baby shower for a doula. I was thinking about it and we have often done raffle drawings for a small gift where the entry ticket was the bag of diapers or wipes at a shower. Another idea would be to do a similar raffle drawing with raffle tickets for $2 each for a prize, to help raise money for your doula. In the scheme of things, most of us really would have the money to pay for a doula if we look hard enough. But I have met people whom truly do not have it. I have been one of those people myself. Often though, while you are not really out being able to get a job at the moment, you usually can offer some services, once a month to help pay for your doula!!
Think outside the box and pay for your doula....one way or another! She is worth it....and you will be grateful for the extra care.
So, what is the #1 reason I would want to pay for a doula than for taking the cheapest and free doula? I truly believe you will both get better care and have a better experience. The doula will feel like you appreciate her service and will be on her top game. You will value what you paid for and be more on top of actually using the services you paid for!