I have spent a great deal of time researching and studying malpositioning and methods to get baby back in the right position to come down smoothly. Positioning refers to how the baby is lying in the uterus and how the head is presenting at the cervix and/or vaginal canal. There are so many abbreviations and different positions noted that it can get really confusing, so for the sake of simplicity I'll just compare the optimum position - Left Occiput Anterior (LOA) and a less favorable position - Right Occiput Posterior (ROP). Basically, you want baby to be facing your spine with his head down. Laying on the left side is more favorable than the right. When a baby is posterior he is looking away from mommy's spine. This causes all kinds of problems from severe back pain to the head extending and creating stalled labor or a baby "stuck". Many times when a woman in told her pelvis is too small this is why - instead of the baby flexing his head (tucking his chin into his chest) and creating a smaller diameter presenting through the birth canal, the baby's head extends and the presenting part is larger. Often, babies who are malpositioned will not put even pressure on the cervix during labor which causes longer labors and "stalled" labors because the cervix doesn't open as it would when there is even pressure from the head during labor.
So what is there to do? Fortunately - a lot! I have recently found a website (look under info for moms) that listed many of the popular ideas out there. There are also several good books out there if you want to read more(several mentioned in the article), but really knowing the simple exercises that seem to encourage rotation are probably all you need to know, that and also the knowledge that your posture matters. Apparently having good posture is extremely important. All these things are outlined in the article I sited so I won't rewrite it all here, but note the importance of this information. Most OBs will not employ these methods, and they may or may not even tell you if your baby is malpositioned unless you ask. So, get informed so you can experience all the blessings of childbirth.
Wednesday, October 28, 2009
Saturday, October 3, 2009
To VBAC or Not
A friend asked her doctor the other day under what circumstances he would do a VBAC - the answer she got was "NONE". That is becoming a reoccurring nightmare of an answer. This friend may or may not be sold out on wanting to have a VBAC, but it is definitely something she has been looking into, especially since her last Cesarian section left her in a lot of pain. Why is major abdominal surgery the only option for my friend? Well, it isn't if she wants to change doctors, change hospitals, and wrangle with her insurance company - but she most likely will not do all of those things.
The doctors not only use scare tactics to discourage women from having VBACs, they have convinced themselves that VBACs shouldn't be done using the very same scare tactics. Fear always debilitates us. It is very difficult to make rational decisions when fear has gripped your heart. So, if you are contemplating a VBAC clear your mind and do some research. Sure, ask your doctor all about it, but also look at all the information he will most likely not offer. Look at the stats... are there more complications from VBACs or Cesarians? Are there special circumstances in your case? Circumstances that would make a VBAC more dangerous than a repeat section? Do you know the risks to the baby from Cesarians? Do your homework and make an educated decision based on what is best for you and your baby. In the end, it should be your choice how your miracle enters the world.
Check out the link on my homepage for VBACs.
The doctors not only use scare tactics to discourage women from having VBACs, they have convinced themselves that VBACs shouldn't be done using the very same scare tactics. Fear always debilitates us. It is very difficult to make rational decisions when fear has gripped your heart. So, if you are contemplating a VBAC clear your mind and do some research. Sure, ask your doctor all about it, but also look at all the information he will most likely not offer. Look at the stats... are there more complications from VBACs or Cesarians? Are there special circumstances in your case? Circumstances that would make a VBAC more dangerous than a repeat section? Do you know the risks to the baby from Cesarians? Do your homework and make an educated decision based on what is best for you and your baby. In the end, it should be your choice how your miracle enters the world.
Check out the link on my homepage for VBACs.
Friday, September 25, 2009
Breastfeeding in the thick of it....
My sweet Lola has been trying to "ween" herself for about 7 months now. So says a host of well meaning people. If that is indeed what she has been trying to do then too bad - she has one stubborn momma. The interesting thing is that the kid will not drink any brand of formula, fresh milk or the like. Yogurt is about as close as we come... but she loves her momma's milk. She doesn't however like to sit for very long when she is wide awake and nurse. So what on earth do I do? Well, I let Lola be Lola. Now maybe my mom is right - if she gets hungry enough she will drink another form of milk, but why on earth would I plan to withhold what God in His infinite wisdom created for her to drink and hope that she would accept a substitute? Yes, she still wakes me up twice each night to nurse and usually ends up in my bed. I used to think this was a destestable practice. I've read all the well meaning books that have been written about training children and I even followed them with my oldest - and she complied nicely, but kids weren't made with a cookie cutter and despite my efforts to conform to the Western norm, my Lola will not conform. I'm writing this post today to encourage all the moms out there who are struggling with sleep deprivation, all those who are wondering where they went wrong with breastfeeding since their child doesn't comply with their efforts to set feeding parameters, moms who cringe at the thought of being criticized for co-sleeping, and especially for all the moms who think their sweet little babe is trying to "ween" himself and think it may be time to do so. I have wrestled with all these things and finally I have come to the conclusion that moms just do what they need to do. They do what is best for their babies. Breast milk is best for your baby so keep on keeping on! When you decide it is the right time to transition your darling to some other form of liquid nutrition then make that decision because you know it is the right time, not because you have been bullied by a cultural standard that your child may not be able to fit. Questions and comments valued!
Tuesday, August 18, 2009
Using Ritual
Rituals are something we all use in our daily lives. Sometimes rituals stem from our religious beliefs, but they are largely cultural and traditional. Some rituals you may be familiar with include praying before meals or at bedtime, locking your doors at night or maybe even during the day, and brushing your teeth every morning. These rituals are common place for a lot of people and you may not have considered them rituals at all, but they are - they give us stability and faith that all things will be ok. We pray to communicate with God and give thanks or make requests and we believe He hears our prayers and answers. We lock our doors because we believe this practice will keep us safe from intruders while we are sleeping or relaxing in our homes. We brush our teeth every morning because we believe this practice will keep our teeth healthy and keep us away from the dentist. These rituals instill faith and help us get through daily life.
In times of extreme stress or pain people often become unreasonable and out of touch with reality. Their only reality is their stress or pain. Rituals are valuable during these tough times because they give people a handhold that keeps them from buckling under the stress or pain. Whatever belief system you come from, its rituals will comfort and calm you. In America most people say they believe in God even if they have no church affiliation or daily walk with the Lord. This is obvious whenever a plane is experiencing trouble and most people begin to pray. During 911 people rallied to pray. This was indeed a coping mechanism. For some, their faith was real and still is, but for others prayer was a tool they used to get through.
Let's talk about ritual during childbirth. Coming from a technocratic standpoint (use of technology, including medicine and procedures used in hospitals) we find that people who believe in this system are often very satisfied with their hospital births. They may use the breathing techniques learned in a hospital based childbirth class (2 thumbs up) for a while, but when the pain becomes intense they will often fall back on the technocratic rituals used in the institution which may include narcotics or an epidural. They also may be completely comfortable with other procedures like labor induction or the use of forceps. If you agree with the technocratic method, then you will look to it to comfort you. I have heard innumerable times "how wonderful the epidural was" or how awesome the doctor was when he used forceps or stitched up an episiotomy. Granted, an epidural is wonderful for the moment and God bless doctors who can successfully use forceps. But if this is not where you are coming from, then you will most likely not be comforted for long. The physical pain of childbirth is real, but so is the disappointment when you realize your pain is gone but you are immobile, out of control and at the mercy of your doctor and nurses. You buckled.
Using ritual during labor is a great way to cope with the stress and pain that accompanies contractions. You must find something that works for you - tailor made because no one can pop in at the time and say, "here, say these words and you'll be able to cope" and expect that to really work. You may get lucky, but it is far better to plan in advance and know which rituals you may want to incorporate during your labor.
Many women like to take a warm bath or shower. The warm water soothes them and helps them relax. How many of us like to do that when we have had a stressful day? I know I do. Some woman don't think about this option because they are so in tune with "how things are" in the hospital that they assume laying on their back and maybe getting a back rub is their only option. Other rituals include listening to music, singing, repeating phrases or prayers, breathing exercises and even slow dancing with your partner. I suggest that people talk with their hubbies and other birth partners in advance about what rituals they may want to use. If they have something in mind they should use it as often as possible, especially during stressful times in order to practice and make their minds familiar with the ritual. If you sing or worship in the car or shower now, then this is probably a good ritual for you - it allows you to remove yourself from your surroundings and enter a quiet place. Maybe that is not the kind of singing you do - then maybe you need to think of another ritual that will work for you.
Other rituals that may need to be cleared with your doctor, but should not be an issue, may include wearing a favorite comfy gown or t-shirt, eating and drinking certain goodies or watching a favorite movie or movies during labor. While these kinds of things may not eliminate pain, relaxation can greatly reduce it. Being comfortable lends to being relaxed.
Grantly Dick-Read came up with the pain-fear-tension cycle in the mid 1900s. Basically it is the concept that pain leads to fear which leads to tension which increases the pain and the cycle continues. You get the picture - your pain gets worse because you get tense. So you have to find a way to chill out!
By the way, not only does being relaxed reduce the amount of pain in childbirth, it actually facilitates the opening of the cervix. Yes, labor could be shorter if you can really relax and trust in your body to do what it was created to do.
*FYI - One method of natural childbirth that uses learned ritual is hypnobirthing. I am just now getting familiar with this method, but it makes sense. Look for a post dedicated to hypno- birthing in the near future!
In times of extreme stress or pain people often become unreasonable and out of touch with reality. Their only reality is their stress or pain. Rituals are valuable during these tough times because they give people a handhold that keeps them from buckling under the stress or pain. Whatever belief system you come from, its rituals will comfort and calm you. In America most people say they believe in God even if they have no church affiliation or daily walk with the Lord. This is obvious whenever a plane is experiencing trouble and most people begin to pray. During 911 people rallied to pray. This was indeed a coping mechanism. For some, their faith was real and still is, but for others prayer was a tool they used to get through.
Let's talk about ritual during childbirth. Coming from a technocratic standpoint (use of technology, including medicine and procedures used in hospitals) we find that people who believe in this system are often very satisfied with their hospital births. They may use the breathing techniques learned in a hospital based childbirth class (2 thumbs up) for a while, but when the pain becomes intense they will often fall back on the technocratic rituals used in the institution which may include narcotics or an epidural. They also may be completely comfortable with other procedures like labor induction or the use of forceps. If you agree with the technocratic method, then you will look to it to comfort you. I have heard innumerable times "how wonderful the epidural was" or how awesome the doctor was when he used forceps or stitched up an episiotomy. Granted, an epidural is wonderful for the moment and God bless doctors who can successfully use forceps. But if this is not where you are coming from, then you will most likely not be comforted for long. The physical pain of childbirth is real, but so is the disappointment when you realize your pain is gone but you are immobile, out of control and at the mercy of your doctor and nurses. You buckled.
Using ritual during labor is a great way to cope with the stress and pain that accompanies contractions. You must find something that works for you - tailor made because no one can pop in at the time and say, "here, say these words and you'll be able to cope" and expect that to really work. You may get lucky, but it is far better to plan in advance and know which rituals you may want to incorporate during your labor.
Many women like to take a warm bath or shower. The warm water soothes them and helps them relax. How many of us like to do that when we have had a stressful day? I know I do. Some woman don't think about this option because they are so in tune with "how things are" in the hospital that they assume laying on their back and maybe getting a back rub is their only option. Other rituals include listening to music, singing, repeating phrases or prayers, breathing exercises and even slow dancing with your partner. I suggest that people talk with their hubbies and other birth partners in advance about what rituals they may want to use. If they have something in mind they should use it as often as possible, especially during stressful times in order to practice and make their minds familiar with the ritual. If you sing or worship in the car or shower now, then this is probably a good ritual for you - it allows you to remove yourself from your surroundings and enter a quiet place. Maybe that is not the kind of singing you do - then maybe you need to think of another ritual that will work for you.
Other rituals that may need to be cleared with your doctor, but should not be an issue, may include wearing a favorite comfy gown or t-shirt, eating and drinking certain goodies or watching a favorite movie or movies during labor. While these kinds of things may not eliminate pain, relaxation can greatly reduce it. Being comfortable lends to being relaxed.
Grantly Dick-Read came up with the pain-fear-tension cycle in the mid 1900s. Basically it is the concept that pain leads to fear which leads to tension which increases the pain and the cycle continues. You get the picture - your pain gets worse because you get tense. So you have to find a way to chill out!
By the way, not only does being relaxed reduce the amount of pain in childbirth, it actually facilitates the opening of the cervix. Yes, labor could be shorter if you can really relax and trust in your body to do what it was created to do.
*FYI - One method of natural childbirth that uses learned ritual is hypnobirthing. I am just now getting familiar with this method, but it makes sense. Look for a post dedicated to hypno- birthing in the near future!
Monday, August 17, 2009
Becoming a Doula
Greetings to all the lovely pregnant women out there, as well as all those who have been pregnant or plan on being pregnant. I have joined the quest of helping women have a more empowering, natural birth experience. Why? Because the milestone of child birth is life changing! Sure, if you don't have the birth you envision, yet you have a healthy child at the end of the day - you are still blessed! Definitely and without question! However, if you, like many women I know, desire to have a natural childbirth experience and things just don't go that way - you may feel a bit let down at the end of the whole affair. That is where I want to be a blessing to pregnant women. I want to support women through natural childbirth. Now, maybe you say "Oh, I admire women who can do that, but not me!" Well, why not try? If it ends up not so natural - well you haven't lost anything by trying. Let me share my story.
Almost 4 years ago I arrived in the maternity ward in my sleepy ice covered town to give birth to my first child. I had ideal thoughts of natural childbirth and believed I could do it. I read a few books, but I was mostly ignorant about what lay ahead. I did write a birth plan and talk with my doctor at length about what I wanted. He rejected my suggestive remarks about a squatting bar, leaving the umbilical cord attached for more than 10 seconds, and other ideas I had come across in the books I read. He was however supportive about me walking, not having an episiotomy, and giving birth without medication. I thought I had bargained a great deal. I also thought I could do it with the support of my husband, my mom, and mother in law.
One thing you should know is that no birth is predictable. You cannot know what kind of birth experience you will have, but one thing you can know is that you will need support. For some women the nurse and doctor are all the support they want and need. For others, they have no grand ideas about natural childbirth - an epidural or c-section is part of the deal. I am definitely not here to poo poo their ideas or their desires, but for me I wanted my experience to be as natural as possible.
So, laying on a bed in triage that faithful morning in December, hardly able to contain my excitement, I wondered what all the fuss had been about. My water broke before the contractions started and the early stages of labor were quite manageable. I talked freely with my husband and my mom while we waited for the doctor to arrive. I didn't pay too much attention to the fact that the nurses were not allowing me to walk around and no one else seemed to think much of it either. I asked several times, but they said I had to wait for the doctor since the strips that prove the fluid that gushed from my body was indeed amniotic fluid were reading negative. That seemed silly to me at the time, but now I wonder - why in the world did I allow them to tell me I had to lay on that bed for hours on end because they weren't sure I was in labor. What? Gush of water? Yes. Contractions? Yes. Dilated? Yes. I was becoming a victim of hospital procedures and managed care and I didn't even know it. I needed an advocate. I needed a Doula.
By the time my doctor arrived I was almost 5 cm dilated. He seemed exasperated with the nurses over the trivial test strips. Of course I was in labor. He said I could move to the birth suite and I got up and started gathering some of my things. My husband and I began the journey which led to a room about 50 feet away, but before I could get there I was hit with a big one. One after another they came. Rushes - that is what Ina May calls them. Yes, that is indeed what it was like. Like the first time I stepped into the Pacific and was hit with a battering ram of waves. I had no control and was thrown to and fro. I was completely caught off guard by the intensity and regularity of the contractions. My support team were like a family of does caught in the high beams on a back road in the middle of the night. No one said a word to encourage me to carry on without an... EPIDURAL was what I screamed for between my sobbing prayers to Jesus that he would help me through the pain. My poor family cried along with me.
If you have never given birth before you have no idea what to expect. When labor gets the best of you - and you know what I mean if you have labored without drugs - you think you may not make it through. But you will make it through. That is when you need someone who is trained, ready for the waves, and can communicate to you that you are doing great. Yes, it hurts but you are almost there. You need someone who can remind you of all those remedies you read about or practiced before hand. Someone who can perform massage, run a hot bath, or just look you in the eye and say it is ok. Oh how I wish I had had someone like that when I gave birth to my dear Gracie. But, I didn't. My husband wanted to rescue me from the pain. My mom wanted to rescue me from the pain. No one can rescue you from the pain, but some one can support you through the pain. The pain doesn't have to be so intense. There are methods to reduce pain. You can actually relax during labor. You need to know and be reminded to release and give in to the rushes. Stress balls usually create other stress balls... and they feed off each other.
So my labor went like this - easy, intense, epidural (pain free), miserable (not able to move my legs, confined, and freaking out because I had no control), tired (from pushing 4 hours), nervous (because I relented to the use of forceps), elated! (Grace was on my chest!) All that happened over a 14 hour period.
In the end, I had a perfect 9 lb. 4 oz. baby girl and I was pleased! I am still pleased! But I wonder? What if I hadn't laid in triage for 4 hours in the beginning of my labor? What if I had withstood the pain a little longer? Would I have been able to push my baby out? Would I have needed a bazillion stitches which kept me from sitting down for 6 weeks? Who knows? No one knows, because I didn't do any of those things I had thought I would do. And we can never go back and do it over again. If I could, I know I would definitely have a Doula by my side. Would I have been able to withstand the pain? I don't know. But I know I would have at least had someone there to support me through trying.
So that is what I want to do. I want to support women through childbirth. Maybe the mother I support will look in my eyes and say I want an epidural. That is her decision. Maybe she will kick me out. Well that is her decision too. But maybe she will look at me and say, "I'm dying." and I will look back at her and say, "You're doing great! You can do this." And she will make it through one more contraction. In the end, only the mother can make decisions about her birth experience. My job is to help her make informed decisions and support her through them.
What is an informed decision? It is knowing all the details, the pros and cons and then making the best decision for you. Your doctor wants to induce labor? What does that mean? I can tell you. What are the stats for a given situation? I can tell you. Want to talk to your doctor but don't how or what to say? I can help support you through that too. Water birth, hypno birth, home birth.... so many options, which one is right for me? We can discover the answer together. Will my husband be left out? No way! He will be able to support you fully, the way he knows how. He can do as little or as much as he wants or you want. Having a Doula is not an either - or, it is a both - and. Birth is a blessing. I want all women to experience the empowerment and joy of the birth experience.
Contrary to popular belief:
I can not deliver babies - I am not a midwife.
I will not tell people what to do - making decisions is the mother's job.
I will not judge you for the decisions you make - I will hold your hand.
I will:
give you scientific based information.
help you make informed choices.
seek to give you tailor made support according to your request!
Life is full of blessings! Birth is one of the greatest!
Almost 4 years ago I arrived in the maternity ward in my sleepy ice covered town to give birth to my first child. I had ideal thoughts of natural childbirth and believed I could do it. I read a few books, but I was mostly ignorant about what lay ahead. I did write a birth plan and talk with my doctor at length about what I wanted. He rejected my suggestive remarks about a squatting bar, leaving the umbilical cord attached for more than 10 seconds, and other ideas I had come across in the books I read. He was however supportive about me walking, not having an episiotomy, and giving birth without medication. I thought I had bargained a great deal. I also thought I could do it with the support of my husband, my mom, and mother in law.
One thing you should know is that no birth is predictable. You cannot know what kind of birth experience you will have, but one thing you can know is that you will need support. For some women the nurse and doctor are all the support they want and need. For others, they have no grand ideas about natural childbirth - an epidural or c-section is part of the deal. I am definitely not here to poo poo their ideas or their desires, but for me I wanted my experience to be as natural as possible.
So, laying on a bed in triage that faithful morning in December, hardly able to contain my excitement, I wondered what all the fuss had been about. My water broke before the contractions started and the early stages of labor were quite manageable. I talked freely with my husband and my mom while we waited for the doctor to arrive. I didn't pay too much attention to the fact that the nurses were not allowing me to walk around and no one else seemed to think much of it either. I asked several times, but they said I had to wait for the doctor since the strips that prove the fluid that gushed from my body was indeed amniotic fluid were reading negative. That seemed silly to me at the time, but now I wonder - why in the world did I allow them to tell me I had to lay on that bed for hours on end because they weren't sure I was in labor. What? Gush of water? Yes. Contractions? Yes. Dilated? Yes. I was becoming a victim of hospital procedures and managed care and I didn't even know it. I needed an advocate. I needed a Doula.
By the time my doctor arrived I was almost 5 cm dilated. He seemed exasperated with the nurses over the trivial test strips. Of course I was in labor. He said I could move to the birth suite and I got up and started gathering some of my things. My husband and I began the journey which led to a room about 50 feet away, but before I could get there I was hit with a big one. One after another they came. Rushes - that is what Ina May calls them. Yes, that is indeed what it was like. Like the first time I stepped into the Pacific and was hit with a battering ram of waves. I had no control and was thrown to and fro. I was completely caught off guard by the intensity and regularity of the contractions. My support team were like a family of does caught in the high beams on a back road in the middle of the night. No one said a word to encourage me to carry on without an... EPIDURAL was what I screamed for between my sobbing prayers to Jesus that he would help me through the pain. My poor family cried along with me.
If you have never given birth before you have no idea what to expect. When labor gets the best of you - and you know what I mean if you have labored without drugs - you think you may not make it through. But you will make it through. That is when you need someone who is trained, ready for the waves, and can communicate to you that you are doing great. Yes, it hurts but you are almost there. You need someone who can remind you of all those remedies you read about or practiced before hand. Someone who can perform massage, run a hot bath, or just look you in the eye and say it is ok. Oh how I wish I had had someone like that when I gave birth to my dear Gracie. But, I didn't. My husband wanted to rescue me from the pain. My mom wanted to rescue me from the pain. No one can rescue you from the pain, but some one can support you through the pain. The pain doesn't have to be so intense. There are methods to reduce pain. You can actually relax during labor. You need to know and be reminded to release and give in to the rushes. Stress balls usually create other stress balls... and they feed off each other.
So my labor went like this - easy, intense, epidural (pain free), miserable (not able to move my legs, confined, and freaking out because I had no control), tired (from pushing 4 hours), nervous (because I relented to the use of forceps), elated! (Grace was on my chest!) All that happened over a 14 hour period.
In the end, I had a perfect 9 lb. 4 oz. baby girl and I was pleased! I am still pleased! But I wonder? What if I hadn't laid in triage for 4 hours in the beginning of my labor? What if I had withstood the pain a little longer? Would I have been able to push my baby out? Would I have needed a bazillion stitches which kept me from sitting down for 6 weeks? Who knows? No one knows, because I didn't do any of those things I had thought I would do. And we can never go back and do it over again. If I could, I know I would definitely have a Doula by my side. Would I have been able to withstand the pain? I don't know. But I know I would have at least had someone there to support me through trying.
So that is what I want to do. I want to support women through childbirth. Maybe the mother I support will look in my eyes and say I want an epidural. That is her decision. Maybe she will kick me out. Well that is her decision too. But maybe she will look at me and say, "I'm dying." and I will look back at her and say, "You're doing great! You can do this." And she will make it through one more contraction. In the end, only the mother can make decisions about her birth experience. My job is to help her make informed decisions and support her through them.
What is an informed decision? It is knowing all the details, the pros and cons and then making the best decision for you. Your doctor wants to induce labor? What does that mean? I can tell you. What are the stats for a given situation? I can tell you. Want to talk to your doctor but don't how or what to say? I can help support you through that too. Water birth, hypno birth, home birth.... so many options, which one is right for me? We can discover the answer together. Will my husband be left out? No way! He will be able to support you fully, the way he knows how. He can do as little or as much as he wants or you want. Having a Doula is not an either - or, it is a both - and. Birth is a blessing. I want all women to experience the empowerment and joy of the birth experience.
Contrary to popular belief:
I can not deliver babies - I am not a midwife.
I will not tell people what to do - making decisions is the mother's job.
I will not judge you for the decisions you make - I will hold your hand.
I will:
give you scientific based information.
help you make informed choices.
seek to give you tailor made support according to your request!
Life is full of blessings! Birth is one of the greatest!
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