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Birth Day, Your Way

December 21, 2010 By admin Leave a Comment

By Charlotte De Vries


With your body and life changing in profound ways, it isn’t always easy to feel in control as your due date approaches. Creating a birth plan helps you make decisions early on and build confidence before labor and birth. Your plan is a source of strength and inspiration, not a rigid map of what must be done. It isn’t about checklists or completing a form. Every pregnancy and birth is unique, and one plan does not fit all. Sift through information from health care providers, classes, books, friends and family, and get to know your options. Keep an open mind and a peaceful, positive outlook. A plan isn’t any guarantee that your birth will go just as you envision it. Plan for the unexpected. Consider these key factors:

Environment
You probably already know where you’ll have your baby, but you can still shape that environment so it becomes a private, safe space where your voice will be heard and your choices will be respected. Choose a few ground rules, such as closed doors, restrictions on who can come in and out, and a minimum number of machines.

Support Team
Do you want a doula? Will siblings be present? The people who will be with you to offer support during labor and birth should be central to your plan – their job is to make you feel confident, comfortable and safe. Share your desires clearly. Remember that what is obvious to you is not necessarily apparent to them.

Pain Relief
There are many natural ways to cope with the valuable and important pain of labor. Simple measures like walking, movement, massage and aromatherapy are noninvasive with no risk to you or your baby. Remember: Pain is central to the design of birth – it is not an unfortunate side effect. Express how you would like to manage it and consider the natural, safe alternatives to anesthesia. Trust your ability to cope with the pain.

Freedom to Move
Moving around as you wish and choosing your own positions for pushing is important. Make it known if you’d prefer to forgo machines, monitors and drugs.

Meeting Baby
Your early moments with your newborn are just as important as your labor and birth. This is intimate time to connect and bond. If mother and baby are well, hospital routines and procedures can wait. Protect the first moments you meet and marvel at each other as you begin your lives together.

Filed Under All Recent Articles, Birth, Birth plans, Coping with pain, Healthy Birth Practice, Working with a doula

Lamaze Breathing: What You Need To Know

October 25, 2010 By Cara Terreri 11 Comments

Once upon a time, the hallmark of Lamaze chidbirth education was “breathing” (hee, hoo, hee, hoo). Over the years, Lamaze has evolved into a comprehensive approach to childbirth, part of which are comfort measures for labor; breathing is one of the suggested comfort measures. So what does it mean to “breathe?” Here’s a little on what you should know (excerpted from The Official Lamaze Guide: Giving Birth with Confidence by Judith A. Lothian and Charlotte DeVries):

 

Breathing in Pregnancy:  A Daily Check-in
Finding the time, energy, and peace to face your fears—or do anything that requires mental focus—is a challenge in our culture. One pregnant woman shared that after years of working at her office, she’d tuned out the sounds of phones ringing and computers clicking. She didn’t even notice how noisy her office was until an older coworker looked at her across the bank of desks and said, “You’re bringing this child into a world of sounds my babies never heard.”

It’s true: In just a decade or two, technology has changed the world dramatically. From cell phones to ATMs, from microwave ovens to Facebook friends, from high-definition DVDs to iPods, technology fills our days with vivid images and messages. It’s a noisy, busy world that can crowd out the peace we need to connect with ourselves.

Connecting with yourself is an important task during your pregnancy.  It’s a big job to pay attention to all the physical, emotional, and spiritual changes you’re experiencing. It takes concentration to envision a future that includes a new role and a new person. Finding a place of stillness for a few moments each day can help you do this crucial work.

Even if your space and your schedule are crowded, you can find a place and time to keep a daily appointment with yourself. Perhaps you can retreat to the corner of your bedroom, the bathroom, a closet, or an empty room at your workplace. Perhaps you can sneak a moment before others wake up, after they’ve gone to bed, before you get in the shower, or during your lunch break. You might want to “check in” at the same time each day so you treat this appointment with yourself as the important time it is.

Your daily check-in may be a few moments of silence, meditation, or prayer. You can use this time to get in touch with not only your feelings, but also your body and the little one who is taking up more and more of it. Close your eyes for a moment and listen to your breathing, then take an inventory of yourself: Are there any tense areas in your body—neck, shoulders, throat, hands, back? Is anything nagging at your mind? Doing a full-body and -mind check will help you identify what needs to be released, relaxed, or dealt with.

 

Breathing Benefits from Yoga Practice
Yoga, an ancient form of exercise that includes breath control, meditation, and body postures, has become popular among pregnant women. It’s easy to understand why: Many yoga exercises include movements that open the pelvis. Yoga also teaches rhythmic breathing, concentration, stamina building, and relaxation. Some women who do yoga report improved physical coordination and more balanced emotions.

 

Lamaze Classes and Breathing
Lamaze classes prepare women for a safe, healthy birth by providing the most current, evidence-based information about birth, simplifying birth, and helping women navigate the maze of modern obstetrics. Be wary of “Lamaze” classes that spend a lot of time practicing relaxation and breathing and little or no time building your confidence or discussing how to keep things simple and how to have the safe, healthy birth you want in the birth setting you have chosen.


Breathing: Finding Comfort in Labor
When allowed and encouraged to, a woman will naturally move, moan, sway, change her breathing pattern, and rock to cope with contractions, eventually finding the right rhythm for her unique needs. Such active comfort-seeking helps her baby rotate and descend and helps prevent her labor from stalling. As her contractions get stronger, her body releases endorphins—nature’s narcotic—to ease her pain.

Conscious Breathing
Conscious breathing (especially slow breathing) reduces heart rate, anxiety, and pain perception. It works in part because when breathing becomes a focus, other sensations (such as labor pain) move to the edge of your awareness.

Conscious breathing is an especially useful labor tool because it not only keeps you and your baby well oxygenated, it’s also easy to learn and use. It’s naturally rhythmic and easy to incorporate into a ritual. And best of all, breathing is the one coping strategy that can’t be taken away from you—even if you’re stuck in bed attached to an electronic fetal monitor and intravenous fluids.

Conscious (or patterned) breathing used to be the hallmark of Lamaze childbirth education. For many women, it’s still an important way to stay relaxed and stay on top of their contractions. It’s true that conscious breathing can help you relax and feel less pain during contractions.  There’s no “right” way to breathe in labor, despite what others may tell you. Slow, deep breathing helps most women manage the pain of contractions. But the right way for you to breathe is whatever feels right to you. Issues like your number of breaths per minute, breathing through your nose or your mouth, or making sounds (like hee-hee) with your breaths are only important if they make a difference for you.

It may help you to have a visual focus to accompany your conscious breathing. You can recall an image with your eyes closed, focus on a picture or special object from home, keep your eyes on your partner, or simply stare at a spot on the wall. You may also find that as labor progresses, faster, shallower breathing—like a dog gently panting—feels better. You’ll figure out what works best for you. And what works best will probably change as you move through labor.

Many women “practice” breathing during pregnancy by using conscious breathing when everyday life presents stressful situations, like being caught in traffic, running late for an important meeting, or worrying about any number of things.

Find Your Rhythm
At some point in labor, you’ll “find your rhythm” or “get in a groove,” much like a marathon runner does. You’ll be living in the moment, doing without thinking.  To others you’ll appear to be in another world. Your movements will be rhythmic; you’ll relax between contractions; you’ll respond to contractions in the same way over and over again, perhaps shaking your arms, rolling your head, breathing slowly, chanting, or praying.

You’ll be totally focused, but you won’t necessarily look comfortable. You’ll look like you’re working very, very hard—which you are. When this happens, you’ll know endorphins are working their magic—dulling your pain and helping you ride your contractions intuitively. You’ll be doing exactly what you need to do. You won’t need to be rescued; in fact, the worst thing that could happen to you at this point is to be disturbed or interrupted. A healthy dose of encouragement, support, and respect are all you’ll need from your support team.

Do you have experience with conscious/patterned breathing during labor? How did it affect your birth experience?

Filed Under Birth, Childbirth education, Coping with pain, Featured Story, Healthy Birth Practice, Labor, Pregnancy

Three Things Nurses Wish Moms Knew About Childbirth

October 6, 2010 By Cara Terreri 3 Comments

I discovered an article yesterday that lists the top three things labor and delivery nurses wish that women knew about childbirth (compiled from a poll created by the Perinatal Advisory Council). Take a look — this is positive, encouraging advice from the women who work in the trenches!

1. Almost all agree women should take labor and delivery classes (94%)

  • “Usually the more prepared women are the better the experience. The fear factor decreases and with it so does the pain.”
  • “Women think that watching The Baby Story and similar shows on TLC, etc., is preparation for childbirth, and is realistic. This is not the typical birth experience.”
  • “It should be mandatory for women to take classes prior to childbirth for the labor and delivery and baby care/breastfeeding experience.”
  • “I believe it helps the mothers be more informed, realistic and work well with labor and delivery and care of themselves and newborn.”

2. Most believe a pregnant woman should prepare a birth plan (79.8%)

  • “Developing a birth plan takes conscious thought and may assist (especially first time) mothers with being more informed about options.”
  • “A birth plan is good as long as they are aware of the need to be flexible with it and not expect for everything to go exactly as planned.”
  • “I think creating a birth plan can be an educational experience for the patient.  However, I’ve noticed a lot of people use pre-made birth plans from the Internet, which doesn’t really help them to be more knowledgeable about the process of labor of delivery.  I’m not convinced simply having a birth plan will help patient’s to be more knowledgeable or prepared about the process.”
  • “Birth plans must be created with a health care professional who understands the realities of what is available at our particular hospital.”

3. More than half welcome (the right) doulas (63.3%)

  • “It depends on the doula; some are great and some interfere with nursing care.”
  • “A doula can be a great support if a woman is trying to have an unmedicated delivery. A woman really needs one-to-one care when she is laboring without any pain meds.”
  • “Continual labor support from a confident and knowledgeable support person makes a huge difference in outcomes.”
  • “Doulas can be helpful as long as they are supportive, not adversarial with the nursing staff.”

 

You can more about creating a good birth plan here and here.

Filed Under All Recent Articles, Birth, Birth plans, Breastfeeding, Childbirth education, Coping with pain, Health and well-being, Healthy Birth Practice, Labor, Pregnancy, Working with a doula Tagged With birth plan, childbirth class, doula

A Birth Story: Lauren & Baby Naomi

August 23, 2010 By Cara Terreri Leave a Comment

On Monday, June 14, I went to work just to do patient phone calls and desk work. The nurses I work with hadn’t let me hardly touch a patient for days so I knew I could get a few hours at work and not over exert myself. I worked about a half day and then went to the chiropractor for a routine visit. My midwife recommended chiropractic care to help with the baby’s positioning and also for my pelvic/hip alignment. On the way home I felt the urge to do a major grocery shopping trip, so off to Giant I went to stock up on essentials. Over an hour later, I finally got home, only to commence a kitchen overhaul…cleaning out the fridge and reorganizing the cabinets. After my nesting cravings had been satiated I was able to relax with my husband, Adam, until about 10:30 pm when I started to have some Braxton Hicks contractions. Hoping to sleep through these minor contractions, I was asleep by 11:30 pm, but then was up at 2 am due to the discomfort that was coming with each contraction. At this point, it felt mostly like moderate to severe menstrual cramps, not so bad. I was excited and hoping that maybe this was “it” so I started tracking the frequency of each surge. All night my contractions came with some regularity, but they were too inconsistent. On Tuesday morning around 8 am I spoke with my midwife who suggested I try to rest and keep my appointment for that afternoon.

On the birth ball, with Adam supporting my back.

At my appointment around 2 pm, I found out that I was only 1cm dilated which was a little discouraging at the time. Megan (the midwife) was really concerned that I was so exhausted and suggested I try to get some sleep that night because true labor could be weeks away. At her suggestion, I accepted some prescription sleeping pills, knowing that I needed the rest. Unfortunately I had a reaction to the sleeping pills which caused me to be incoherent and in and out of sleep all night. I found myself in the tub around 5:30 am, listening to my iPod and breathing through each surge.

On Wednesday morning, I didn’t feel rested and the contractions were getting stronger. I spoke with my hypnobirthing instructor on the phone and made another appointment with the chiropractor in hopes that she could help “get things moving.” I also made an appointment with an acupuncturist, hoping that maybe stimulating the right pressure points could help get me into active labor. While at home, I just sat on my exercise ball, bouncing around or trying to relax in the tub. I found that my surges were increasing in intensity but I was still able to breathe through each one and stay very relaxed, calm and positive. I’ll take a moment to note that as prepartion for birth, I listened to relaxation exercises and birth affirmations as part of my hypnobirthing class. Because of this, I was able to quickly go into a deep state of relaxation and allow my body to respond to uterine surges with ease. Around 2 pm I checked back in with my midwife requesting to be assessed prior to my acupuncture appointment; my contractions were about every 5 minutes and I was just plain curious to see if things were progressing. 

Meeting Naomi for the first time.

At the birth center, the midwife told me I would not be making my appointment for acupuncture because I was 7 cm dilated and she wanted to admit me! I was relieved to know I really was in labor and excited to have the baby! Adam and I went upstairs and chose our birthing room, a large room with private jacuzzi tub and comfy queen size bed. Adam unpacked the car and brought my exercise ball in for me to use. After a little while I asked my nurse, Ann to get the tub ready so I could relax in there for a bit. I labored in the tub for a couple hours, Adam rubbing my shoulders and my mom massaging my low back during each contraction. My ipod speakers were set up with some relaxing music and the recording of birth affirmations previously mentioned. I was allowed to eat and drink as I wanted and was encouraged to take fluid by mouth since I did not have an IV like at a hospital.

 Around 7 pm, I was presented with the option to have my membranes ruptured. I was really exhausted from not sleeping for 2 nights and really wanted to get things moving so Adam and I decided to go ahead and do it. Afterward, the contractions became increasingly intense and I changed position from the tub to birthing stool. After pushing for about an hour I moved onto the bed so that I could be better supported. At 9:50 pm, Naomi Christine was born after about 1.5 hours of pushing.  My labor was calm and relaxed until I had to push. While I wouldn’t say that it was painful, pushing required every ounce of my being because I had been sleep deprived and unfortunately had not eaten enough that day.

Our first family photo.

While I received some sutures, Adam took off his shirt and held Naomi ”skin-to-skin” with him. Then, she went right to my chest and stayed there for 2 hours. She had absolutely no problems with jaundice, having passed two meconium stools in the first 4 hours of life, and my milk was in at 48 hours. I attribute these things to the uninterrupted skin-to-skin time of bonding and nursing in those first hours of life. I’m thankful that my first birthing experience was what I envisioned. I felt empowered, in control, and had minimal medical interventions.

Filed Under All Recent Articles, Birth, Birth Center, Birth stories, Coping with pain, Healthy Birth Practice, Labor, Pregnancy, Working with a midwife Tagged With birth story

Week of Giveaways: Maternitique Gift Certificate

August 11, 2010 By Cara Terreri 19 Comments

This giveaway is now closed.

Welcome to day three of the Giving Birth with Confidence Week of Giveaways! We have lots of fun and useful items to give away, so be sure to visit the site each day this week and enter to win. If you’re just joining us, visit Monday and Tuesday’s posts for another chance to win!

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Today’s giveaway is a $25 gift certificate to Maternitique, an online boutique that features natural products for pregnancy, maternity and baby. As a mom who has recently taken a vested interest in choosing safer household and body care products, I am in love with this site’s philosophy toward natural and organic products in pregnancy.

Maternitique’s products reflect what mothers and midwives have always intuitively known, and what modern research is only beginning to prove: that the lifestyle choices we make before, during and after pregnancy—beauty and skin care, diet, exercise, stress management, pain and symptom relief—affect fetal health, childbirth outcomes and newborn development.

Owner Tara Bloom tells us why she founded Maternitique: “I loved being pregnant, giving birth, and becoming a mother, and I want to help other women enjoy the journey to motherhood as much as I have. Women deserve the best throughout pregnancy and they shouldn’t have to worry about what’s safe. That’s why I’ve hand-picked products that pamper moms while protecting babies.”

Maternitique has a site full of awesome products, but probably one of the most unique (that I’ve seen) is their “Lighten My Labor” line, which includes naturally based, non-toxic mists, lotions and gels to encourage calmness and trust throughout labor. The Lift Me Body Mist, developed by an OB/GYN nurse practitioner, is infused with light scents of neroli and lavender oils to refresh and cool during labor transition.

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One Giving Birth with Confidence reader will win a $25 gift certificate to Maternitique!
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Here’s How to Enter

Everyone has three chances to win — choose one or all three!
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1. Visit the Maternitique Web site then come back here and leave a comment on this post telling us about your favorite product that they carry.

2. Create a login and become a member of the Giving Birth with Confidence online community. It’s FREE and easy. Leave a second comment on this post to let us know that you’re a new member or if you are already a member.

3. Tweet about this giveaway with the following text: Enter to win today’s #giveaway week: Mom Gift Certificate! To enter, post a comment at www.givingbirthwithconfidence.org & RT this message! Be sure to come back here and leave a third comment to tell us that you tweeted.

This giveaway is open to anyone, worldwide. It will end this Sunday, August 15 at 11:59 p.m. EST. Winners will be announced on Monday, August 16. Good luck!

Filed Under All Recent Articles, Birth, Coping with pain, Gear, Giveaway, Labor, Newborn, Parenting, Pregnancy Tagged With Week of Giveaways

The Mother Lode of Pain: Getting It All Wrong at the Boston Globe

July 28, 2010 By judith lothian 5 Comments

This post was published in 2006 on the original Giving Birth with Confidence blog. It provides concrete information on the role of pain in labor and shares a beautiful analogy that describes why women would want to experience childbirth fully.

Dr. Darshak Sanghavi author of “The Mother Lode of Pain,” the cover story of the Boston Globe Magazine on July 23, 2006, skims the surface of historical and empirical research and presents us with the most biased and inaccurate story I have read in many years.

At the center of the story is Dr. Sanghvi’s belief that choosing to feel pain in labor is “odd.” “Especially when there is effective, safe, and available pain relief.” He suggests that women who choose to have a normal, natural birth and experience the pain that accompanies labor and birth are “attracting notice”, “setting up an artificial trial that precedes entry into a highly selective sorority”. He goes on to say “It creates drama. It captures attention”.  His most shocking, and utterly ridiculous statement is “…reliance on pain to create meaning during childbirth indicates a constricted imagination.”

If Dr. Sanghavi had actually done a serious rather than a superficial review of the literature including consulting the Cochrane Library for the most current research and recommendations for maternity care he would have discovered that pain during labor and birth is not “an utterly primitive thing” but plays an incredibly important role.

Pain early in labor lets women know they are in labor. And as oxytocin levels rise, the uterus contracts more effectively to dilate and efface the cervix, and the pain increases. Women respond to the pain they are feeling by trying to find comfort in a wide variety of ways (if allowed any degree of freedom). They moan, change position, walk, sit in a tub of water, are massaged, eat and drink, sing, listen to music. The list is endless. The key is that each woman in labor manages her pain in unique ways that work for her. What she is feeling guides her to finding just the right thing to do. Eventually endorphins kick in and the result is that women go into a dream-like, highly intuitive state and that helps them manage the pain of contractions too. Without pain there is not the same kind of endorphin release. Not surprisingly, if pain is eliminated (with an epidural) naturally occurring oxytocin is not released in increasing amounts. The normal, natural process of birth has been interfered with and there is a need for medical interventions…starting with pitocin. Being able to manage the pain of labor actually helps labor progress by insuring high levels of oxytocin and also by encouraging the mother to move helping baby to settle into and move through the pelvis. Pain is also protective especially during second stage as the baby moves through the pelvis and is born. Women who do not have an epidural respond to what they are feeling at this stage by changing position, and tensing and releasing vaginal and pelvic floor muscles, and in that process protect the birth canal, the perineum and the baby. Pain promotes the progress of labor, protects mother and baby, and helps women find comfort. It is not an unnecessary side effect and eliminating it completely alters the course of labor and sets the stage for interventions and complications.

Women choose to experience (and manage) the pain of labor because it makes birth safer for them and for their babies. At the end of the day the reward for that hard, sacred work are feelings of elation, even ecstasy. And a baby that is alert, competent, and able to nurse easily and well right from the get go. If Dr. Sanghavi had more than a rudimentary knowledge of the process of normal birth and the important role pain plays in that process he might not think the way he does.

As I write this I am looking out the window to the sea in rural Ireland. Later today I will walk down a small lane through farmers’ fields to a little cove to swim. I could get there a lot quicker if I drove it and since the walk back up that lane is very steep in several spots driving would be so much easier. And it takes so much time to walk. The swim would be the same. I would be relaxed and refreshed at the end of my outing. But this is what I would have missed. Feeling the sun and the wind on my face. The sense of well being as I walk, slowly and them more rapidly, getting into a rhythm. Stopping to pick wild flowers (not part of the plan at the start). Picking and eating a few blackberries from the bushes that line the lane. Watching a boat on the sea and wondering what it is doing. Stopping to watch a calf nursing. Smelling the honeysuckle. Chatting with a farmer friend who is moving his cattle from one field to another. And on the way home, up that steep hill, changing the way I walk, slowing up, sweating with the exertion, taking breaks, noticing the blueness of the sky, delighting in how good the wind feels blowing my hair, stopping again to talk, now about how cold the sea was, how fine the day is. Taking gulps of icy water. Eating part of a chocolate bar. Daydreaming. Shaking my legs as they resist the climb. I arrive home refreshed, relaxed and tired. The swim happened. But so much more did too. And therefore the meaning of this lovely afternoon is totally different. I wonder if Dr. Sanghavi thinks that my decision to walk not ride to my little cove is odd and indicates a constricted imagination?

And what if I had not been permitted to eat and drink on my walk, what if I had been tethered to an intravenous and continuous monitoring (just in case I slipped and fell and broke my ankle), what if my pulse was taken every few minutes to make sure I wasn’t too stressed? What if I had to do it all in great haste? That walk would most certainly have lost its allure. In fact instead of a delightful challenge it would become a misery. The ride in the car would seem reasonable!  Like medication in labor — safe, effective and available?

I am irate that thousands of women will read an article that perpetuates the myths that pain in labor serves no purpose and that working hard in labor is “odd.”

Filed Under All Recent Articles, Birth, Coping with pain, Healthy Birth Practice, Labor

One Mom-to-Be’s Experience with Childbirth Class

July 26, 2010 By Cara Terreri 2 Comments

Kate at 33 Weeks

Kate, blogger at This Place Is Now a Home, writes about her experience and surprising reaction to attending childbirth education class. This post is being republished with permission and was originally posted on June 14, 2010 on Kate’s blog. Since that date and just two short days ago, Kate gave birth to a beautiful little boy. Congratulations!

Over the weekend Benjamin and I attended a 2-day long chilbirth class. Me? I’m a junky for learning (GEEK alert!), and I was looking forward to the weekend, notebook and pen in hand.  Benjamin, however, has never really been a fan of sitting in a classroom for hours on end, and not surprisingly, he was NOT really looking forward to 2 full days of talking about babies and vaginas and breathing techniques. But being the wonderful husband that he is, he humored me, and we packed our pillows in the car and headed for class early on Saturday morning.

We were one of only 4 couples in the class, so it was very small, which was nice. The class was taught by a labor and delivery nurse who had three kids, so she really knew her stuff! She was verging on a little too enthusiastic (even for me), but her information was good and her experience was vast. The first day we went through the mechanics/logistics of childbirth. The second day we went through interventions (c-sections, forceps, vacuums, pain management options, etc.) and worked on some relaxation techniques with our partners to practice getting through tough contractions and the physical/emotional stress of labor. Even though 90% of the material was not new information for me, I was still struck by just how amazing my body is. What it has already accomplished in creating a life and nurturing that child almost to full-term is unbelievable. And the process of getting that little baby OUT of my nurturing womb? Even more unbelievable.

I expected to see a movie akin to “The Miracle of Life” or whatever that movie is that everyone watches in 7th grade (the one I probably covered my eyes through at the time, since I don’t remember a second of it). But instead, we were shown an equally dated but far more interesting movie of three different births and how they played out. You see, when it comes down to it, I don’t need to know the biology behind the baby’s creation… I need to know what I need to do to get him out when the time comes. This movie showed three couples who each went into labor with a certain idea of how things were going to go, and all three of them ended up surprised by how they actually went. If there’s one thing I learned from this class, it’s that you cannot plan or control your birth story — the baby’s directing this show.

I went into the class thinking that I would like to try to manage my pain on my own for as long as possible once I go into labor, and then I would get an epidural and hopefully pop my baby out without too many medical interventions. That was my “plan”.  To be honest, that’s probably still my “plan”. But the frank discussion of all the little things epidurals require (being pumped full of fluids, getting a catheter, not being able to walk around due to numb legs, possibly not being able to feel when/where to push if the epidural is too strong, getting a gigantic needle stuck in my back, etc.) scared me more than the thought of contractions. Believe me, I realize I may be singing a different tune when I actually feel what an active labor contraction feels like, but the class definitely opened my eyes up to some of the realities of the labor process that I wasn’t really aware of before and gave me some new things to think about.

When we first started class, our instructor asked us what we were most scared/nervous about. Everyone in the class mentioned something about labor (the pain, not getting to the hospital in time, the pain, having something wrong with the baby, and oh did I mention the pain?). Except me. I am mostly worried about the recovery. I’m nervous about bleeding for weeks on end and recovering from tears and stitches. I’m nervous about not being able to walk my dog or lift my baby or be active again. Maybe I have some mental block that has kept me from being scared of the actual birth? Or maybe I just figure that is a finite period of time and I can get through it? Not sure why I still feel so calm and serene about that part.

All in all I think the class was definitely worth attending. It was a little long, and it took up an entire weekend that we might have preferred to spend doing other things, but it certainly helped me begin to grasp the reality of what my body is about to go through, and what Benjamin and I can do to make it easier/better. And hey, the deep breathing and massage techniques we practiced weren’t so bad either.

Filed Under All Recent Articles, Birth, Birth plans, Childbirth education, Coping with pain, Dads, Pregnancy Tagged With childbirth class

Practices that Promote Healthy Birth: Avoid Common Interventions

July 16, 2010 By Danielle Elwood 4 Comments

Today, childbirth is viewed as and transpires as more of a medical procedure than a natural bodily function. Women who seek to have a natural birth often look for resources and information on how to achieve a more natural experience instead of one that is over-medicalized.

Truthfully, if you want to avoid all common hospital interventions, the best place to give birth (for low-risk women) is either at home or in a birth center. In my own experience, confronting hospital staff to avoid simple things like an IV line can bring added stress that just isn’t part of an enjoyable birth experience. That being said, birth should take place where you feel most comfortable, and if that is in a hospital, the best thing to do is educate yourself about the choices and risks and related to common medical interventions.

 

Common Medical Birth Interventions

  • IV for fluids
  • Epidural anesthesia
  • Continous electronic fetal monitoring
  • Pitocin
  • Artificially breaking the bag of water
  • Episiotomy

Most of these interventions are medically unnecessary, but are used in many hospitals today in the United States. An IV, for example, is used to administer fluids and medication, if necessary. However, when women are allowed to eat and drink during labor, an IV for fluids is not necessary. Recent studies show that there is no need to prevent a woman from eating and drinking while she is in labor. 

Continuous electronic fetal monitoring is also over-used in low-risk women. In recent years, The American Congress of Obstetricians and Gynecologists (ACOG) has shown that in the 40 years that electronic fetal monitoring has been the norm, there have been no improved outcomes in mothers or babies. Of course, like anything, there are some situations when it is necessary, but mostly in high-risk cases. 

Epidurals for those who choose to use them for labor can be the right fit, but they are not risk free. Epidurals can slow labor and pose other risks to mothers and babies. There are other, more natural and effective ways to help relieve the pain of labor. 

Pitocin can cause contractions, but it can also cause contractions that are too strong and result in fetal distress and bring on a cascade of interventions. 

Episiotomy has been shown in recent years to be medically unnecessary in the majority of cases. 

Skipping Common Interventions

There are several ways to avoid routine hospital interventions.

  • Hire a birth doula to help be your advocate and employ natural pain relieving strategies
  • Write a birth plan and provide copies to your provider and hospital staff on call during your stay
  • Talk to your provider about your expectations and practices and procedures you are concerned about
  • Take a tour of your hospital
  • Research your chosen hospital’s cesarean and intervention statistics prior to giving birth

These simple steps can help you avoid common medical interventions and increase your chance of having a safe and healthy birth experience.

Filed Under All Recent Articles, Birth, Birth plans, Childbirth education, Choosing a care provider, Coping with pain, Health and well-being, Healthy Birth Practice, Labor, Pregnancy, Working with a doula Tagged With epidural, Healthy Birth Practices, hospital birth, interventions, natural birth

Practices that Promote Healthy Birth: Continuous Labor Support

July 8, 2010 By Danielle Elwood 4 Comments

There was a drastic difference in the labor experiences I had for both of my children. Besides labor induction in one case and not the other, I had a labor doula who provided continuous support for me while I was making the journey to have my second son. Looking back and reflecting on the number of benefits I had through Karen (my doula) I wish I had opted for one with my first child also. The differences in my labors and experiences are partially contributed to my doula. This brings me to third practice that promotes healthy birth: Continuous Labor Support!

Support from my incredible doula Karen Kilson, who passed away last October.

Not everyone must have a doula to experience continuous labor support; a partner, husband, friend, or other support person can make up an effective labor support team.

Continuous labor support means :

  • Physical support – Help moving into more comfortable positions, massage, back rubs, feet rubs, and helping the mother in whatever needs, from laboring in the shower to getting in and out of the bath tub.
  • Informational Support – Someone to help provide mom with unbiased support regarding decisions she would have to make in labor, from interventions to critical surgical choices. Also, the support person can assist in relaying a mother’s birth plan or discuss any issues she is having to staff members.
  • Emotional Support – This can come in many forms. From the showering of love and encouragement, to helping her to relieve stress. High levels of stress in a laboring mother can cause problems and increase her pain levels.

While continuous support can come from anyone, hiring a doula for labor can help alleviate the worry from your partner, who may at times feel stressed or helpless during labor and birth. According to DONA International, a well-respected Doula certifying association, a birth doula:

  • Recognizes birth as a key experience the mother will remember all her life
  • Understands the physiology of birth and the emotional needs of a woman in labor
  • Assists the woman in preparing for and carrying out her plans for birth
  • Stays with the woman throughout labor
  • Provides emotional support, physical comfort measures, and an objective viewpoint, as well as helping the woman get the information she needs to make informed decisions
  • Facilitates communication between the laboring woman, her partner, and her clinical care providers
  • Perceives her role as nurturing and protecting the woman’s memory of the birth experience
  • Allows the woman’s partner to participate at his/her comfort level

So who should be part of this team supporting you through your labor?

  • Choose people who you know will be helpful, instead of those who you think may distract you from being focused during labor.
  • Choose people who you are familiar with, or who are willing to learn about the birth process and what you would like to achieve in your experience in labor and birth.
  • Pick people you know will learn your birth preferences and who will be an advocate for you.
  • Ask your support person(s) to attend your birthing classes with you.
  • Before labor, practice relaxation techniques and other techniques you want to try during labor.

To understand more about continuous labor support, view the Mother’s Advocate & Lamaze video for Better Birth on labor support:

Numerous clinical studies have found that a doula’s presence at birth:

  • Tends to result in shorter labors with fewer complications
  • Reduces negative feelings about the mother’s childbirth experience
  • Reduces the need for pitocin, forceps or vacuum extraction and cesareans
  • Reduces the mother’s request for pain medication and/or epidurals

Research shows that parents who receive support:

  • Feel more secure and cared for
  • Are more successful in adapting to new family dynamics
  • Experience greater success with breastfeeding
  • Have greater self-confidence
  • Are less likely to have postpartum depression

Support during labor, whether it is from a doula, another form of hired labor support, or a friend or family member, is your key to having a healthy and positive birth experience.

 

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Practices that Promote Healthy Birth Series: Moving During Labor

July 2, 2010 By Danielle Elwood Leave a Comment

Walking, moving, changing positions is something we do not often hear women doing during labor anymore. The new standard of care is typically a laboring mother on her back in bed. Which brings me to the second practice that helps promote healthy birth: Moving around during labor. If you ask women who have given birth naturally–without any type of pain medication–they will tell you the number one thing that helped was staying mobile during labor.

To get a better understanding of movement during labor, check out the Mother’s Advocate & Lamaze video for Better Birth on moving around :

There is no right or wrong way to move during labor, or any specific movements that may help more or less than another. It is all up to the mother to determine while she is laboring what works best for her. It is the act of moving itself and having the freedom to move which is key in the situation.

Position changing and moving during labor helps to make labor easier by:

  • Walking around and moving helps your uterus work more effectively.
  • Actively responding to labor and “embracing” your contractions helps to make you more confident about your experience and the outcome you will have.
  • Staying active helps to move your pelvic bones and guide your baby through the pelvis in the most effective way.
  • Laying on your side, leaning forward, or being upright helps to encourage the blood flow to you and your baby to help descrease the chance of your baby going into distress.
  • Upright positions help to assist the baby to come down into the birth canal with gravity.

Me, moving during labor

Maintaining mobility certainly is key. A 2005 survey of women who birthed in hospitals found that only 1 in 4 women were free and able to walk freely while in labor, so it is important to talk to your health care provider about your mobility options during your birth experience.

During my second birth I was able to move around, walk, dance, sit on my birth ball, shower, and freely move. I found a drastic difference in my labors and the amount of pain I was in with contractions. Moving around helped me with pain relief greatly. I find most other mothers I talk to had the same experience with moving during labor.

Some different moving options during labor include:

  • Walking
  • Soaking in a bath tub or birth tub
  • Squatting
  • Sitting on a birth ball, which can also be used in a squatting position
  • Different comfortable furniture, such as rocking chairs, couches, or chairs
  • Use a CD player with some music that may help you to move or groove to a rhythm

Some things that may hinder movement during your labor experience are IVs and continuous electronic fetal monitoring. Some hospitals may require an IV during labor. If that is the case, speak to your provider about having a hep lock in the place of an IV if possible. A hep lock opens a line in your hand or arm that can quickly be attached to an IV if necessary. As for continuous electronic fetal monitoring, ask your provider to be monitored intermittently or for a portable fetal monitor if available. These things will make it so you are not continuously attached to anything allowing for more freedom to move around and remain active during labor.

 

 

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