April is Cesarean Awareness Month

April is Cesarean Awareness Month — a time to learn about and share important information about how to avoid a first-time cesarean, discover your options for VBAC, and find resources for support in healing from a cesarean. Where to start? ICAN - the International Cesarean Awareness Network — is an excellent place to find several resources related to cesarean, including educational white papers, ways to get involved with advocacy, and links to your nearest ICAN chapter where you can find local resources and information about hospitals and caregivers in your area, as well as connect with other women living near you who have experienced cesarean and VBAC.

What are your favorite resources for cesarean? Please share them in the comments!

Travel During Pregnancy – What to Bring Along

With the onset of spring — and summer just around the corner — many of us will spend time traveling on vacation, likely to warmer climates. When you travel during pregnancy, you’ll want to add a few additional items to your packing list for optimal comfort and health. Consider adding the following to your carry on bag.

 

Pertinent medical information – You never know when you may need your medical information while traveling. It’s a good idea to have a paper copy (yes, paper) of your medical history for your pregnancy. This is especially true if you’re traveling outside the country as it may prove more difficult to obtain your records electronically or by fax.

Insurance card – In case you need to go to the doctor while traveling.

Vitamins and any medication related to your pregnancy – A must-have!

Water – Staying hydrated during pregnancy is so important, since dehydration can cause preterm labor. If you’re flying, be sure to pick up a bottle after the security checkpoint to take on the plane, and then pick up a good supply once you’re at your destination. Depending on where you go, tap water may be a no-no for health reasons — be sure to check with your hotel.

Comfy shoes – Never has wearing comfortable shoes been more important than in pregnancy. Of course you can pack your cute heels, too, but for any amount of extended walking, you’ll want something more comfortable.

Snacks – High protein and easy-to-transport snacks are so important to take with you as you travel during your pregnancy, since you don’t know how long it may be between meals, depending on the availability of food.

Pregnancy pillow – This may be hard to pack on a flight, but if you’re traveling by car and there’s room, it’s can be so nice to have the same comforts of home while traveling. If you can’t pack your favorite pillow, extra pillows at your destination can go a long way to making your sleep more comfortable.

Camera – Whether it’s with your smart phone or a regular camera, snap at least a few pics of yourself during your trip to document your adventures during pregnancy.

Journal – Often, travel is a time when you can de-stress and take time out to reflect. Take a journal with you to write down thoughts and feelings about your life at the moment, including your pregnancy. Even if you never write in the journal again, you’ll cherish the snippet of history in your life.

Reading material — not pregnancy related – When you’re pregnant, so many of your thoughts and conversations center around pregnancy. When you pack reading material for your trip, it may be nice to take a break from all the belly talk and pack books and magazines on other interests.

 

 

Every Mother, Every Time – Petition for Universal Mental Health Screening

Earlier this month, perinatal mental health researcher, advocate and writer Walker Karraa, PhD, created a White House petition entitled “Every Mother, Every Time: Universal Mental Health Screening for Every Pregnancy and Postpartum Woman.” The deadline to reach 100,000 signatures for the petition to pass is Friday, April 4. Giving Birth with Confidence encourages you to take 5 minutes to sign the petition and SHARE it, asking others to do the same.

 

Tell us more about what the mental health screening for pregnant and postpartum petition, what it’s asking for, and what it would do if fulfilled.

Suicide is a leading cause of death for women during the first year after childbirth. 1 in 7 women will experience a mood or anxiety disorder during pregnancy or postpartum, yet nearly 50% remain untreated. In pregnancy, maternal mental illness negatively affects fetal development, and leads to adverse birth outcomes such as low birth weight and premature delivery. Perinatal mood and anxiety disorders (PMADs) can impair infant and early childhood cognitive and emotional development. Despite overwhelming empirical evidence, there is no universal mandate for care providers to screen pregnant and postpartum women for depression, anxiety, or family history of mental illness — a well-established risk factor. The petition calls to screen every mother, every time to prevent and treat perinatal mental illness.

 

For people reading this who have never experienced a mental health disorder (either first hand or otherwise), can you help explain why screening for mental health, especially for women who are pregnant or have just had a baby, is so important?

Well, I think I would say that we know someone who has a mental illness. The data is just too strong to think otherwise. We might not know it, but we all know someone who is, or has been struggling with mental illness. I say we might not know it, because of stigma. Stigma about mental illness shuts people down, and shames them into silence. The stigma of being mentally ill in this culture is so strong that we simply cannot share our suffering with others at risk of rejection, discrimination, and stereotyping. We run the risk of losing out on jobs, loss of dignity within our communities, being marginalized from volunteering in our schools, communities, churches. That is how strong the stigma is for mental illness. If you talk about your disease, you run a risk of being stigmatized in all areas of your life. Even with your partner.

So we may not have had a direct conversation with someone who said, “I have a mental disorder” — but we are working with them, loving them, learning from them and engaged with them every day.

 

Why is screening so important?

Because mental illness left untreated can be life threatening. And for women who experience a mental illness during pregnancy or postpartum? The baby is also affected. We now know that as early as implantation – around 5-7 days post conception — that a woman’s stress hormones present in depression, anxiety, and posttraumatic stress are carried to the baby. We know that even before conception — in preconception — that untreated mental illness of mother and father create stress response conditions that can impact pregnancy down the line.

We know that pregnant women with untreated depression or anxiety disorders have higher risk of preterm birth, low birth weight, and babies with lower APGAR scores.

So to me, screening for mental illness in pregnancy and postpartum is not different than screening for any other health condition that poses a risk to the health of the mother and child — just like gestational diabetes, HIV, Hepatitis, and the basic blood panel drawn to screen for anemia, etc. We have our heart rate and blood pressure checked, we have our babies heart rate and growth tracked, we have our protein in our urine checked. This is routine. So why is it so hard to ask a woman about her mental health while she’s there?

By 2030, the WHO predicts depression to be the leading cause of disease in the world. Mental illness, such as depression, is a physical disease that has devastating impact on personal and public health. We know that current global estimates are that 1 in 4 people have a mental illness. Depression is the second most common cause of hospitalization for all women in the U.S.; the first being childbirth (Blenning & Paladine, 2005; Gold & Marcus, 2008). Current estimates are that in the United States, postpartum depression (PPD) alone impacts 15% to 25% of women annually (N. Gavin et al., 2005; Keyes & Goodman, 2006; Zittel-Palamara, Cercone, & Rockmaker, 2009). It has been reported that there is a seven-fold increase in the risk of psychiatric hospitalization for all women following childbirth (Harlow et al., 2007), and that perinatal and postpartum mood and anxiety disorders affect up to 48% of women living in poverty (Knitzer et al., 2008). The World Health Organization (WHO) has suggested that global prevalence rates for women suffering from PPD are as high as 34% to 55% (WHO, 2003).

The list of public health, obstetric and pediatric organizations that endorse prevention is long. But U.S. organizations fall short of mandating universal screening, despite availability of free and validated tools that include a two-question screen.

 

What are the two questions?

They are two simple yes-or-no questions:

Over the past 2 weeks, have you often been bothered by:

1. Little interest or pleasure in doing things? 

2. Feeling down, depressed, or hopeless? 

If a woman answers yes, then she is given a more complete screening questionnaire.

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What spurred you to create the petition?
I am tired of being told it can’t be done, or that it has to be done a certain way, with certain people—I just don’t buy it. I know the strength of women who have suffered from a perinatal mental illness, and we will not be stopped. Our greatest threat is trying to own different parts of a cause, or brand it for ourselves.

I have been greatly disheartened by the lack of support the petition has received. A petition for Alaska to secede to Russia received 6,000 signatures in 2 days, and yet this position has had only about 2,000 signatures in three weeks. And it’s not from lack of trying! Is it a lack of vision and lack of willingness to risk being seen as crazy to endorse something like a White House petition because it’s not guaranteed to work? We must do better — for ourselves, for our daughters, for our granddaughters, for all women.

 

Why isn’t something like this already in place?

My personal opinion? Stigma. It condones complacency and allows for systems of care to have more invested in women staying sick, than they do systems that help women achieve health and wellness. Stigma that is perpetuated in the media—combined with horrific lack of knowledge about the facts. Additionally, many allied maternal health associations have not prioritized the issue.

 

What else, in addition to universal mental health screening, can be done to improve the detection and treatment options for women with mental health disorders?

At this point? Women have to do it themselves. We have to take it upon ourselves to learn about the risk factors, namely a family history of mental illness or previous episodes of depression or anxiety. Then, unfortunately, we have to push through the stigma and tell our care providers. Especially if we have a history of bipolar disorders, or a first-degree relative with bipolar disorder. Women have fought for rights before — this isn’t our first rodeo — we now must fight for the right to mental health.

 

Walker Karraa, PhD is a perinatal mental health researcher, advocate and writer. She has been a regular perinatal mental health contributor for Lamaze International’s Science and SensibilityGiving Birth With Confidence. Walker has interviewed leading researchers, clinicians, and advocates such as Katherine Wisner, Cheryl Beck, Michael C. Lu, Karen Kleiman, Pec Indman. Walker was a certified birth doula CD(DONA), and the founding President of PATTCh, an organization founded by Penny Simkin dedicated to the prevention and treatment of traumatic childbirth. Walker is currently the Program Co-Chair for the American Psychological Association (APA) Trauma Psychology Division 56. Her book, Postpartum Depression: Trauma and Transformation, is being published by Praeclarus Press, LLC and is based on her extensive research into the ways women experience personal growth through postpartum depression. Walker is the founder of a community blog site, Stigmama.com, dedicated to breaking the cycle of stigma against mothers who have mental illnesses.

In Celebration of World Doula Week – 10 Things Doulas Do During Labor

This week marks World Doula Week, a celebration of the wonderful things that doulas do for families during pregnancy, birth, and in postpartum. Giving Birth with Confidence recognizes doulas with this list of 10 great things birth doulas do for women and their partners during labor. Keep in mind, too, that many doulas also offer excellent assistance in the postpartum period.

 

1. Suggest position changes to keep your labor progressing and help you find optimal comfort.

2. Serve as a resource to help you find answers to your questions about medical procedures, interventions, and labor and birth.

3. Help your partner remember the comfort measures learned during childbirth classes.

4. Water refill duty — yours, your partner’s, and her own!

5. Provide you with a few healthy snacks or drinks from her labor bag if you’ve forgotten your own.

6. Call on her knowledge of comfort measures and position changes to help ease and improve back labor.

7. Offer emotional support through encouragement and understanding of where you are and what you’re going through in labor.

8. Know your birth plan/preferences to help you communicate them to the nursing staff and your care provider.

9. Stay with you continuously through labor and after birth, usually until you have fed your baby for the first time.

10. Provide tips and assistance with the first time you breastfeed.

 

Do you plan to hire a doula, or have you had a doula at a previous birth? How did your doula help you?

Keeping it Simple: An Alternative Birth Plan

When writing a birth plan, it’s important to keep your list of preferences simple and succinct. Using bullet points and including the most critical information (ie: please don’t offer pain medication; I’m allergic to latex; please keep mom and baby together after birth, skin to skin; we are delaying Hepatitis B shot) will help ensure that your birth plan is read and heeded. The traditional birth plan format includes a one-page list of information grouped into categories like, “Labor,” “Birth,” “Newborn,” and “If Cesarean is Necessary.” For an alternative format, consider using the following graphic to lay out your birth plan. This visual four-square birth plan helps the reader find information quickly and simply, and leaves just enough room for the most important information.

birth plan squares

 

 

 

 

 

 

 

 

 

 

 

 

 

Ideas for filling in the four square birth plan:

Pain/Coping

  • Please don’t offer pain medication
  • Shower/tub for comfort
  • Experiment with many positions for pushing

Special Instructions

  • Mom is allergic to perfumes
  • Partner would like to cut cord and announce gender
  • Please delay cord clamping

In an Emergency

  • Please allow partner and doula to be present in case of cesarean
  • Partner will be skin to skin with baby if mom cannot
  • If baby requires NICU, mom will pump colostrum – please, no formula

Newborn Care

  • Please delay bath
  • No eye ointment
  • Please give vitamin K shot

 

These are just a few ideas to populate the squares — and perhaps your squares will have different categories! Experiment with the best format and contents to fit your preferences for birth.

Positive Pregnancy Test! Now What?

The flood of emotions that comes with a positive pregnancy test is quickly followed by pressing questions.  How do I manage the symptoms I’m feeling?  Should I change my diet and exercise, or the medications I take?  When should I tell my family, friends and co-workers?

But sometimes it’s easy to overlook other issues that can impact your pregnancy and “The Big Day.” Lamaze’s latest webinar will address one of the most important questions any newly pregnant woman can consider.

“What can I do now to increase the chances I’ll have a safe and healthy birth for my baby and me?”

The following webinar discussion (embedded below) will provide resources and perspectives on what newly pregnant women can be thinking about and doing in early pregnancy, and how they can take charge in pushing for the best possible care. The “Positive Pregnancy Test? The Top 5 Things You Should Do Next” webinar will help you to:

  • Consider options for care you might be overlooking
  • Avoid “due date” mistakes
  • Get savvy on real-world childbirth challenges
  • Equip your childbirth partner to be rock-solid support
  • Think about healthy choices in a new light

The presenter of this webinar is Jessica Deeb, MS, WHNP, CLC, LCCE.  Two years ago, she shared her first childbirth experience with fellow moms in Lamaze’s Push for Your Baby video.  Since then, she has applied her professional training in labor and delivery and her passion for better birth to become a Lamaze Certified Childbirth Educator.  She is expecting Baby #2 in December!

Red Light, Green Light – A Quiz on Getting the Best Care

Are you getting the best prenatal care from your provider (midwife, OB, or family doctor)? Take this “red light, green light” quiz to find out. Red light indicates care that is not evidence based or respectful of your choices. Yellow light indicates care that should make you question your provider further to see if she is the best fit. Green light indicates great care!

What to Pack in Your Labor Bag

At some point during your pregnancy, you will start thinking about what to pack in your bag for the hospital or birth center. Many moms focus on what they’ll need for for their stay after the birth — change of clothes, toiletries, baby’s outfit, etc. It’s just as important to think about — and pack a separate bag for — what you’ll need during labor. The following list provides suggestions for items that can help bring you comfort during labor. Please add to our list with your own suggestions in the comments!

For you:

  • A copy of your birth plan
  • Socks/slippers
  • Flip flops or other “shower shoes”
  • Your own pillow with a case that is not white and that can get dirty
  • Birth/yoga ball and pump (bring ball already pumped)
  • Chapstick
  • Toothbrush and toothpaste
  • Massage oil/lotion and massage tools
  • Your own clothes to wear in labor (if desired and if you don’t mind getting them dirty)
  • Robe
  • Reference guide or printouts for labor comfort reminders (Labor Lab and The Birth Partner are great!)
  • Focal point or special item to hold in your hand
  • Water bottle
  • Nourishment: solids, liquids, easy to digest, hard candy – bring a variety
  • Mints or gum
  • Hair ties or clips
  • Music (create a playlist or use a service like Pandora)
  • Phone/iPad/laptop and chargers
  • Heating pad or rice sock
  • Essential oils or scents
  • Anything else to make you feel comfortable ____________________________________

For your partner/birth support:

  • Change of clothes
  • Food & drinks for your partner
  • Camera
  • Phone
  • Pillow
  • 5 Hour Energy, coffee or something similar to help stay awake

Pregnant with Disabilities: Multiple Sclerosis

By Neda Ebrahimi , Teratogen Information Specialist, Motherisk

As a counselor with Motherisk, the Canadian partner of MotherToBaby and a service of the Organization of Teratology Information Specialists (OTIS), I hear many stories from women about pregnancy. Some of those stories strike cords with me. Their urgency and desire to make the healthiest decisions possible for their future children is both understandable and admirable. In honor of National Multiple Sclerosis Awareness Month, I give you Nina’s story.

 

Nina’s Story

“I’m 31 years old, and I was diagnosed with Relapsing Remitting Multiple Sclerosis (RRMS), when I was only 22. My first relapse was scary. I was writing my finals, and 2 days before my last final, I lost sight completely in one eye, and my legs felt so week and wobbly that I couldn’t stand even for a second. After going to the hospital and receiving several courses of steroids over 10 days, I started to improve but it took 2 months for my symptoms to fully resolve. And then, everything went back to normal, as if nothing had ever happened. I received my diagnosis several months after, and it felt like a death sentence. I had 2 more relapses before my doctor put me on disease modifying drug (DMD), and I started with Infterferon-B1a. Over the last 8 years, I only experienced 5 more relapses. The last relapse I had was only a few months ago; I lost sight in my left eye, and numbness that ran from my face to my toes on just the right side of my body. I have always been able to work full-time except when I’m experiencing a relapse, for which I’ve had to take a month off. I am a dentist, so not surprisingly I can’t carry out my job when I’m experiencing numbness in my hand. I met John 5 years ago at the MS clinic I used to visit. He was a nurse there. We fell in love, and despite of my illness he proposed to me last year, and we talked about having a family, with two children, hopefully one boy and one girl, and living happily ever after. It didn’t initially worry me that one day I may want children. John is crazy about kids, and I feel my maternal instincts kick in every time I hold a baby. Since we got married, my anxiety has been increasing proportionally to my yearning for having a child.  I know my MS can’t be cured, at least not now, I know it can get worst over time, and eventually I may need support to carry out even simple tasks. Or Maybe I won’t, and I would be one of the few who never enter the progressive state. I don’t know if I’ll be able to care for a baby and meet his or her demands. What will happen after my pregnancy? I really don’t want to experience another relapse after I deliver. How am I going to manage my illness, and what will happen if I need to came off my DMD when I’m pregnant or breastfeeding? There are so many questions, and I don’t know who to turn to.”

Nina is not alone in her thirst for answers. MS is an autoimmune neurological disease with very different presentation. No two MS patients are exactly the same and symptoms can vary from just the occasional mild tingling in the finger tips to more severe symptoms that render the patient unable to walk or stand for several weeks. With Relapsing Remitting MS accounting for 85% of all MS cases, most patients will undergo a remissive state after an attack, and will resume their daily life with little or no hindrance. Some patients will continue to have modest symptoms during the remissive state which they learn to adapt to and manage by different medications and or lifestyle changes.  As there are no current cures for MS, many MS patients live for decades with this disease, and must find the means to maintain a high quality of life as the disease progresses, which can be challenging in the later stages of the disease.

MS impacts many more women than men with a 3:1 ratio in North America.  As the disease onset occurs during the reproductive ages, many women with MS face the dilemma of pregnancy at some point during their lives. Young women, like Nina, with MS planning pregnancies, have many questions. Because the disease presentation and progression varies from person to person, there is no exact answer and treatment and management must be tailored to the specific person’s need. However, I’d like to address some of the most common questions to help all of the “Ninas” out there:

1. “Would the disease adversely impact the pregnancy and my developing baby”?

Up until the late 1950s, women with MS were advised to terminate their pregnancies. With our advancement in the field, we know that this is almost never necessary. Many women with MS continue to have healthy babies, and research shows that there is no increased risk for having a baby with a structural malformation or developmental delay and many deliver healthy babies with no major complications. Although there is a trend toward lighter weight babies, the birth weight percentile remains in the normal range for most. Another observation has been the higher rate of miscarriage in the MS population with mixed results from different studies. The reason for this is not well understood, but the majority of miscarriages are in early pregnancy. While miscarriage rates in the general population are around 10-15%, in women with MS the rates are closer to 20%-30%. With successful conception, the chance of delivering a healthy baby at term is high, and women with MS should be assured that their disease is unlikely to cause harm to the developing baby.

2. “Would my baby also have MS”?

There is a complex interplay between genetics and environment leading to MS. While the risk of getting MS in the general population is 0.3%, having a parent with MS will increase this risk by almost 15 times. So children of women with MS may have a 3% to 6% chance of developing MS later in life, but the environmental and lifestyle factors may play the ultimate role in disease manifestation. Hence despite the genetic contribution, the risk for your baby developing MS remains small and can potentially be modified.

 3. “If I stop my DMD when planning, what are the risks of having a relapse while I try to conceive?”

Depending on how long it takes to conceive, the drug free period prior to pregnancy may be a risky period for experiencing a relapse. While some women conceive after just one cycle, many will conceive after several months of actively trying to become pregnant. It will take 1 to 3 months (depending on the drug) to fully clear the system, and during this time, some may experience disease activity. If prior to starting the DMD you had very active disease, there is a risk that you’ll experience a relapse when you stop the medication, especially if it takes more than 3 months for you to conceive. The decision to continue DMDs is highly individualized and is determined on a case-by-case basis.  You and your neurologist will determine the best mode of action.

4. Would having a pregnancy make my MS progress faster?

Pregnancy has not been shown to speed the disease process. In fact, pregnancy is a state of remission for many women with MS, and a time for optimal wellbeing. It is well established that relapse rates reduce by 70% by the third trimester of pregnancy compared to the year prior to pregnancy. However after delivery the relapse rate increases, with 60% of women experiencing a relapse in the first 3 to 6 months postpartum. While the risk is increased in the postpartum period, the course of MS tends to return to its baseline, and no worse than what it was in the year prior to pregnancy. Some studies have found a protective effect with pregnancy, with a delay in the long-term disease progression; however, more studies are needed to confirm this finding.

5.      Would I be able to continue my DMD through the pregnancy?

Although many women with MS go through remission in the pregnancy, some will continue to experience disease activity especially in the first two trimesters. The decision to continue DMDs is dependent on several factors, including the type of medication, disease activity in the year prior to pregnancy, and the type of control achieved with the given DMD. The use of glatiramer, Interferon Beta 1a/1b, in pregnancy have not been associated with an increased risk for malformations and if you achieved great control with these drugs, and are at a high risk of relapsing, your physician may consider continuing your therapy through the pregnancy. The newer drugs, especially the oral DMDs, have not been well studied, therefore it is recommended that you discuss with your neurologist the best plan for the course of your pregnancy. There are ongoing research studies looking at the outcome of pregnancies following exposure to these medications. MotherToBaby and its affiliates are engaged in such studies. For study information or for the most up-to-date information about newer medications used to treat MS during pregnancy, call from anywhere in North America toll-FREE 866-626-6847.

6. What if I have a relapse during pregnancy?

While relapses during pregnancy are uncommon, they may happen, and can be quite severe for some women. Steroids are usually used to treat those relapses, although some success has been shown with IVIg therapy as well. A woman that experiences a severe debilitating relapse during her pregnancy, may require the standard steroid therapy, while a woman that experiences a mild flare-up may choose, in collaboration with her physician, to abstain from treatment. Systemic steroid use in the first trimester has been associated with a very small risk for cleft lip and palate, and use in the second half of pregnancy may increase the risk for having a smaller baby and for delivering prematurely (before 37 weeks gestation). However, it is recommended that you speak with your health care provider before you stop or change any medication. The benefits of taking a steroid and treating your condition should be weighed against these small possible risks. For more information, check out this fact sheet online: http://www.mothertobaby.org/files/Prednisone_6_13_1.pdf or call anywhere in North America toll-FREE 866-626-6847.

7. Should I breastfeed or start my DMD right after delivery?

The postpartum period is a period with a high risk of experiencing relapses. Data on whether breastfeeding has protective effect has conflicting results. Some studies suggest a protective effect, possibly due to the delay of menses returning, while others show no impact. Information on safety of DMDs in the breastfeeding period are scarce, however given the large molecule size of glatiramer acetate, and Interferons, it is unlikely any will transfer into milk. If they do, they are likely not to be absorbed from the baby’s gastrointestinal tract. There is no information regarding other DMD usages during lactation. The benefits of breastfeeding baby are numerous, but, ultimately, your functionality and ability to care for your child take priority. The decision to breastfeed or not may depend on your ability to breastfeed, especially since the demands of a newborn and the hormonal changes in the postpartum period can be very taxing on your energy levels and if you experience chronic fatigue due to your condition.  Thus, if a woman (while consulting her physician) decides to breastfeed she may do so. However, if she needs to restart her DMD, currently she may be advised to stop breastfeeding.


Bottom line: While having MS poses physical and emotional challenges, it does not jeopardize a woman’s capacity to mother. With careful planning and close collaboration with your doctors and healthcare providers, and especially with some support from family and friends, you will be able to have successful pregnancies, healthy children, and out of control teenagers, just like any other woman. So if becoming a mother is something you have always wanted and looked forward to, having MS is more of a bump in the road rather than a life sentence, and with some maneuvering you can achieve your dreams. Happy parenthood!                                                           

 


Neda Ebrahimi is a research associate and counselor at the Canadian Motherisk program, a non-profit MotherToBaby/OTIS affiliate that aims to educate the public about medications and more during pregnancy and breastfeeding. The Motherisk program is also a center for teaching and clinical research in the area of exposures in pregnancy and breastfeeding. Neda is pursuing her PhD in the field of Multiple Sclerosis in Pregnancy. To learn more about her work and about her study, email her at neda.ebrahimi@sickkids.ca or call 416-813-7654 ext. 204928. You can also call the Motherisk Helpline at 1-877-439-2744 and ask to be referred to the MS study.

 

MotherToBaby and its affiliates are services of the international Organization of Teratology Information Specialists (OTIS), a suggested resource by many agencies including the Centers for Disease Control and Prevention (CDC). If you have questions about MS, medications or other exposures during pregnancy or breastfeeding, call toll-FREE 866-626-6847 or visit www.MotherToBaby.org.

Provide Good Labor Support with 5 Easy Tips

When learning how to be a good labor support person, it can be overwhelming for a partner — How will I remember everything, How will I know what to do, How can I help her? It’s true that there is a lot of information to know when it comes to labor and birth. But you can rest easy knowing that providing good labor support can be as easy as remembering this acronym: DEPPS. Drink, Eat, Pee, Position, Support/Soothe. Birth partners, when mom is in labor, you officially take on the role of DEPPS Manager. Good labor support can be boiled down into five easy tips:

Drink – Staying hydrated in labor is so important. Encourage mom to drink water after every contraction so she can stay hydrated throughout labor without the use of IV fluids.

Eat – No one would run a marathon without refueling, and the same is true in birth (which is generally much longer than the average marathon!). Keep track of the last time she had something other than water. If it has been longer than 2-3 hours,  offer and encourage mom to eat something, even if it’s light (honey sticks, juice, apple sauce, nuts, granola). Be sure to pack your labor bag with a range of nutrition options. And yes, it IS safe to eat during labor!

Pee – Seems silly that a person would have to be reminded to pee, but a mom in labor has other things on her mind! Emptying her bladder once an hour can help labor progress — an empty bladder makes more room for baby to come down.

Position – Changing positions frequently in labor (about once an hour) helps labor progress and allows mom to continue to find comfort in different ways. For resources on different positions to use in labor, check out this resource from Lamaze, or this guide from Penny Simkin.

Support/Soothe – This one is HUGE. Providing continuous support to a laboring woman is the key to a better birth experience. This can be done in a variety of ways, but usually includes hands-on soothing through touch and massage, and verbal encouragement (you’re doing great, you’re so strong, you’re almost there). You can learn and practice the most effective ways to support a laboring woman by taking a quality childbirth class.