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Tanning and Pregnancy: What Is Considered Safe?

May 16, 2012 By Cara Terreri Leave a Comment

By Lori J. Wolfe, MS. CGC, OTIS President

Recently while having lunch at my favorite restaurant, I overheard a conversation at the table behind me. A very pregnant lady was discussing with her friend how she was going to get tan. “Now that it is the month of May, I want to get a head start on my tan,” she was saying. They began discussing her options; tanning booths, professional spray tans, tan at home lotions, tanning pills, or laying out in the sun. What would be best and safe during a pregnancy? Well, usually I don’t jump into other people’s conversations, but I just couldn’t help myself. Being that counseling about exposures and associated risks during pregnancy is my job, I felt I just had to give her a little educated advice!

I turned around, introduced myself, learned that her name was Sally, and began discussing the options. The use of tanning booths during pregnancy can be done, but you need to take a few safety precautions. We are always worried about over-heating during pregnancy. This is called hyperthermia. When you are in a tanning booth, it is easy for your body to become over heated if the booth is not well ventilated and/or you stay in the booth for too long of a time period. The ultraviolet rays that are used in the tanning booths do not get to the baby, so that is not the problem. But if you are in the tanning booth for more than 10 to 15 minutes, your body temperature might get too high. So be sure the booth has good ventilation and limit your tanning session to no more than 15 minutes.  Also when using tanning salons and their tanning beds, please be sure to check and see how clean everything is. We do not want you laying down in dirty beds and perhaps picking up some nasty germs!

At this point Sally asked me about the use of self-tanning products, either done professionally or at home. Self-tanning products come as sprays, lotions or gels, and can be applied at home or in a salon. The main active ingredient in self-tanners is something called DHA or dihydroxyacetone. The amount of DHA can vary from 3 to 5% in products you use at home, or up to 15% in products used by professionals. We do know that only a very small amount of the DHA that is applied to your skin will be absorbed into your bloodstream. Therefore, there would be very little in your system to get to the baby. Since we do not have much information about DHA and pregnancy, we do want you to be careful to not get the self-tanning products into your eyes, nose or mouth.

“Hmm, I have heard about tanning pills,” Sally asked me. “What are those and can I use them while I am pregnant?” Tanning pills can be bought over-the-counter and contain something called canthaxathin as the ingredient that changes the color of your skin. Unfortunately we do not have any studies that have looked at taking large amounts of canthaxathin during pregnancy, and we know that you need to use a lot to change the color of your skin. Therefore, it is best to avoid the use of tanning pills when you are pregnant.

“OK,” Sally said, what if I just want to lay out in the sun and get tan the old fashioned way.” I let her know that our main worry with laying out in the sun would be the same as using tanning booths, hyperthermia or overheating. If you do chose to tan outside, be sure to use a good sunscreen product, drink lots of water, and limit your sessions to 30 minutes or less. Be sure that you are cooling off frequently if you are outside for a long period of time. If you follow these good-sense guidelines, you can gradually build up a nice tan, even when you are pregnant.

At this point, Sally thanked me, paid her bill and left the restaurant. I let her know that if she or her friends had any questions about exposures during pregnancy, they can call OTIS, the Organization of Teratology Information Specialists at 866-626-6847 or visit our website at otispregnancy.org.

**Lori Wolfe, MS, is a board-certified genetic counselor and the president of OTIS. She is also the director of OTIS’ Texas affiliate, the Texas Teratogen Information Service (TTIS), which she founded in 1991. Visit its website at http://www.ttis.unt.edu/. OTIS is a North American non-profit dedicated to providing accurate evidence-based information about exposures during pregnancy and breastfeeding.**

Filed Under Featured Story, Health and well-being, Pregnancy Tagged With tanning during pregnancy

Mother’s Day Giveaway Winner and Tributes

May 14, 2012 By Cara Terreri Leave a Comment

Thanks to all of you who entered our giveaway and for your thoughtful answers. The winner is……

Varsha, who said:

“The one moment that transformed me from a woman to a mom was the time when I felt my son’s hairy cheeks for the first time. He was frail and small but was so peaceful in my arms as if he knew already he could trust me.”

If you didn’t win, but would like to purchase the Lamaze stroller or infant seat, they are available for purchase at Babies R Us nationwide. A portion of each purchase supports the Lamaze International mission to help moms and babies have the safest, healthiest birth possible.

We hope everyone enjoyed their Mother’s Day. For more motherly inspiration, we’d like to share some of the awesome responses to our giveaway question: “For moms-to-be, what are you most looking forward to in your new role as mom? For moms-that-are, when was the first moment you realized that you were, in fact, a mom?”

 

Hearing that fast little hearbeat always makes if feel the most “real” to me. I was a mother months before our children were born. –Twila

Motherhood became real for me 32 years ago. I had just given birth to my daughter and although the hospital offered rooming-in, the nurse took my baby to the nursery for a few minutes. I distinctly heard Michaela crying and slowly made my way down the hall and around a few corners. The nurse met me as I was almost at the nursery door and said she was just bringing her back to me. When I replied that I heard her crying, she looked at me with surprise. There must have been 6 other little ones in there, all crying for their moms. She couldn’t belive that I knew my child’s cry. I wasn’t surprised at all. That’s when I really knew that although I was very young, I was indeed a mom.
Now my babies are having babies and I’m the grandmother of 4, with one just a few weeks old and a new baby coming in a few weeks. Being a mom doesn’t end when your kids grow up. If you are as lucky as I am, you get to watch your own kids raise their families and that is as real as it gets. BTW, if I win, the stroller and car seat go to the two newest grandkids! –Julie

I think the moment that I realized I really was a mom was when my younger toddler was sick with the flu and was throwing up… he threw up all over me, ALL over me… and I didn’t even care, I just felt sad for him. Which is very, very unlike me. –Courtney

I’m a mom-to-be with our first little one due in October. I change what things I am looking forward to, but constant is looking forward to looking our new family member in the eyes and meeting them in person for the first time, and getting to introduce them to their lovely Dad. –Yvonne

I knew I was a mom the first time I had to wake up to feed my son. I realized that there was this little person that needed and trusted me for everything. –Amanda

Although every ultrasound and heartbeat made me feel closer to being a mom, I think I was still a little surprised when there was actually a baby who came out of my body! Looking into my little one’s eyes moments after delivery I knew that I would do anything for this precious little one. When I REALLY knew I was a mom was the day I had to heat up my cup of tea three separate times and still found it in the microwave the next morning, never actually having had a chance to sit down and drink it! –Lynn

I realized I was a mom the first time I was completely alone with my newborn son. It was the moment I realized that I had no immediate backup! –Yvonne

I can’t wait to experience the kind of love only a mother can have for her child! I’ve been waiting my whole life to become a mother and now it’s happening in a couple weeks! –Debbi

I first realized I was a mom when I had everyone else referring to me as Mommy. How weird it was to hear that word in reference to myself at first. I finally got used to it and now have four little ones who call me mom. Not so weird to hear it now. =) –Aimee

Filed Under Featured Story, Giveaway

The Wonder of Mothers: Spontaneous Pushing During Birth

May 9, 2012 By Cara Terreri 3 Comments

May 13 is Mother’s Day and to celebrate, Giving Birth with Confidence will post throughout the month of May on “The Wonder of Mothers,” a series dedicated to sharing some of the many ways mothers’ bodies are beautifully designed to grow, birth, and nourish her baby. We’re also giving away a Lamaze stroller and infant car seat, so be sure to enter to win!

 

The Wonder of Mothers: Spontaneous Pushing During Birth

As a writer for Lamaze for nearly eight years now, I’ve read time and again about the point in birth when a woman’s body “just takes over” and she feels the uncontrollable urge to push out her baby. But it wasn’t until last year, during my third birth, that I truly experienced the phenomenon known as “spontaneous pushing.” After birthing two children, this was my first birth without any medicinal pain relief. When it came time for me to push (a mere 10 minutes after being admitted to my room), there was no denying the intense urge. My brain was no longer in control — my body “just took over.” At the time, I remember feeling overwhelmed by the intensity and seeming lack of control. And when you think about it, it can feel scary to lose control. What I realized after the fact, however, is that I did have control, my body was controlling and leading the way to birthing my baby. The wonder — and power — of a mother’s body is awesome.

The following is excerpted from the Lamaze Healthy Birth Practice #5 and talks about the benefits of spontaneous pushing.

Types of Pushing 
When you push in response to the natural urge to push, it is called “spontaneous pushing,” meaning you are doing what your body tells you to do. This natural urge comes and goes several times during each contraction. Each of these bearing-down efforts or urges usually lasts from five to seven seconds. However, when you are directed by your caregiver and those around you to hold your breath and push to a count of 10 seconds, repeating this two to three times during a contraction, you are using directed pushing.

Responding to the urge to push with short periods of holding your breath in a calm, unrushed environment has many advantages. Your baby will get more oxygen through the placenta, you will be less likely to become physically exhausted, and there is less chance of damage to the perineum and the muscles of the pelvic floor in the vagina (Albers, Sedler, Bedrick, Teaf, & Peralta, 2006; Roberts & Hanson, 2007). If you are having a very difficult time pushing the baby out, directed pushing might help. However, pushing spontaneously will usually be easiest and safest for both you and your baby.

What Research Tells Us 
According to the Cochrane Pregnancy and Childbirth Group, a respected international organization that defines best practices based on research, the use of any upright or side-lying position compared with lying on your back with your legs in stirrups is associated with the following results:

  • shorter second (pushing) stage of labor;
  • a small decrease in the use of vacuum or forceps;
  • fewer episiotomies;
  • less chance of experiencing severe pain;
  • fewer abnormal fetal heart tracings;
  • a small increase in second-degree tears (in the upright group only); and
  • an increase in estimated blood loss, although there was no evidence of serious or long-term problems from the extra blood loss (Gupta, Hofmeyr, & Smyth, 2004).

Were you able to spontaneously push during your labor? Share in the comments about your experience!

Filed Under Birth, Featured Story, Healthy Birth Practice, Hospital Birth Tagged With pushing, spontaneous pushing

It’s a Mother’s Day Giveaway!

May 7, 2012 By Cara Terreri 51 Comments

To celebrate the many moms-to-be and moms-that-are, we are giving away a Lamaze stroller and infant car seat. One lucky reader will win both!

The Lamaze Indigo Stroller is a lightweight, easy-to-use and a comfy resting spot for your baby. This durable stroller features a modular, Euro-styled design, with a reversible seat. You can always keep a close eye on your infant by simply releasing the seat and turning it to the rear-facing mode. The stroller fits to the Lamaze Via Infant Car Seat (sold separately) and includes a universal attachment to fit many other car seats. Important features for moms (and dads, of course): the stroller can be folded with one hand; its large wheels help it glide over almost any surface; and the canopy is fully adjustable and removable.

The Lamaze Via Infant Car Seat is for babies from 5 to 35 lbs and features a patented Energy Rebound management system, which helps manage the forward rotation in the event of a crash. Important features for moms (and dads, of course): easy to adjust harness (no rethreading necessary); easy-off pads; built in lock offs and LATCH are all standard features; and side angle indicators for easier installation. 

 

Here’s How to Win

Leave a comment on this post that answers the following question: For moms-to-be, what are you most looking forward to in your new role as mom? For moms-that-are, when was the first moment you realized that you were, in fact, a mom?

The giveaway will close on Sunday, May 13 at midnight, EST. The winner will be announced on Monday, May 14.

If you like the stroller and can’t wait to win one, they are available for purchase at Babies R Us nationwide. A portion of each purchase supports the Lamaze International mission to help moms and babies have the safest, healthiest birth possible.

Good luck!

Filed Under Featured Story, Giveaway

Postpartum Diary: Meagan & Adelyn @ 3 Months

May 4, 2012 By Meagan Church Leave a Comment

I am now three-months post-partum. In some ways it is sad to think that three months ago, I felt baby kicks and flips from inside the womb for the last time. I have always enjoyed being pregnant and I admit that I do miss it, not enough to have another baby, but it is sad to think that I won’t experience it again. At the same time, three months ago I was waddling my way up the stairs, out-of-breath when I reached the top and longing for the days when I could once again lace up my running shoes and hit the pavement. And so, as my son practiced soccer in the rain the other night, I had a choice to make. I could sit in the warm, dry comfort of the van and read my book. Or, I could grab my running shoes and go for a run. I chose to run.

 

I have also been enjoying sleeping on my stomach once again. At the end of my pregnancy, I was having a hard time finding a comfortable position to sleep. Now I can stretch out however I wish. Of course the amount of time I get to stay in that position depends on Adelyn. Thankfully she is still sleeping well at night. My husband and I are so grateful that our worst sleeper was our first one, when we were six years younger and didn’t have two others to care for after long, rough nights. We have realized that six years makes a big difference when you are a parent. We feel so much older and more tired now.

 

I know that Adelyn was born just three months ago, but I am struggling with the my post-baby body. Thankfully the weight has been coming off. I gained 40 pounds with my pregnancy and now have lost over 25 pounds. I know that’s good and I should be happy with that, but I cannot wait to have all the weight gone. I have been hiding out in sweats and yoga pants. I dread having to make myself presentable for the public. I have a closet full of clothes and only a handful fit. I am too frugal to go out and purchase a lot of clothes when I hopefully won’t be wearing them for too long. I know they say it takes nine months to put on the weight and you should give yourself nine months to take it off, but with swimsuit season rapidly approaching, I am anxious to get back my pre-baby body. Ironically, I wasn’t all that pleased with my pre-baby body, but I would take it without hesitation right now. After all, I don’t really want to sport workout clothes to the beach.

Filed Under Exercise, Featured Story, Newborn, Parenting, Postpartum, Postpartum Diary Tagged With postpartum body, postpartum exercise

The Wonder of Mothers: Skin-to-Skin Care

May 2, 2012 By Cara Terreri 1 Comment

May 13 is Mother’s Day and to celebrate, Giving Birth with Confidence will post throughout the month of May on “The Wonder of Mothers,” a series dedicated to sharing some of the many ways mothers’ bodies are beautifully designed to grow, birth, and nourish her baby. We’ll also be giving away a Lamaze stroller and infant car seat, so be sure to check back regularly!

 

The Wonder of Mothers: Skin-to-Skin Care

You may have heard of the phrase “skin-to-skin” or ”kangaroo” care, but if you’re new to the idea, here’s a simple definition:

Skin-to-skin or “kangaroo” care is when a newborn baby is placed unclothed on mother’s chest directly after birth and as often as possible during the newborn stage. This kind of care has been proven to have many health benefits for healthy full-term babies, as well as quicker recovery from illness and difficulties for premature and sick babies.

So what is it about a mother’s body that makes skin-to-skin care so important? Because of the unique symbiosis between a mother and her baby, a mother’s body is designed to provide the perfect environment for her newborn baby. When a baby is placed on her mother’s chest, the temperature of mom’s body not only keeps baby warm, but helps regulate a baby’s temperature to what he/she needs at that very moment. Some babies are born with the inability to regulate their own temperature. Studies have shown that skin-to-skin care is best for keeping a baby’s ideal temperature. It is often reported that artificial heat from an incubator cannot replicate the effects of mom’s touch. It also has been shown that the temperature for twins who are each placed on one of mom’s breasts are regulated independently, adjusting according to their individual needs!

Beyond temperature, skin-to-skin care has been shown to also provide newborn benefits in the way of regulating blood sugar levels, stabilizing heart rate, reducing crying, increasing mother-baby bonding, and establishing and maintaining breastfeeding. Mothers’ bodies are amazing!

Requesting Skin-to-Skin Care at a Hospital

If you are planning a hospital birth, know that many hospitals routinely perform infant procedures shortly after birth. If your baby is healthy, it is safe and encouraged to delay newborn procedures like weight and measurements, bathing, and any routine shots or ointments. Instead, use the first couple of hours after birth to spend skin-to-skin time with your baby. Talk to your care provider, your birth partner, and your doula about your preferences to hold your baby skin-to-skin after birth. And, ask your partner or doula to remind the nurses on staff during your labor of your birth preferences. You may need to speak up to get what you want, but remember, it’s your baby and your right!

Did you practice skin-to-skin care with your newborn? How do you think it helped you or your baby?

Filed Under Birth, Featured Story, Newborn, Parenting, Preterm Birth, Skin-to-Skin Tagged With kangaroo care, premature, skin-to-skin

Cesarean Awareness Month: Cesarean Resources

April 30, 2012 By Cara Terreri 2 Comments

Today is the last day of Cesarean Awareness Month. Throughout the month, Giving Birth with Confidence posted a variety of information and resources on cesarean birth. As the month comes to a close, we would like to leave you with a list of helpful resources for cesarean information. (The description for the resources below has been taken from each respective website.)

ICAN (International Cesarean Awareness Network) - www.ican-online.org

The International Cesarean Awareness Network, Inc. (ICAN) is a nonprofit organization that was founded by Esther Booth Zorn and many other motivated women in 1982.  ICAN has now grown to over 130 chapters throughout the United States and worldwide.

The Unnecesarean - www.theunnecesarean.com

Blog and site author Jill Arnold is a consumer advocate who founded The Unnecesarean in August 2008 as a collection of big baby birth stories, as well as women’s accounts of their cesareans and VBACs (vaginal births after cesarean).  After refusing a planned cesarean for suspected macrosomia based on a 38 week ultrasound estimate of fetal weight, she gave birth vaginally to a healthy baby and later found that the midwives model of care better met her needs as a pregnant woman.

Childbirth Connection - www.childbirthconnection.org

Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Their mission is to improve the quality and value of maternity care through consumer engagement and health system transformation. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.

VBAC Facts - http://vbacfacts.com

After her daughter’s birth in 2004, site author Jennifer Kamel spent the next couple years wading through the research on vaginal birth after cesarean and became frustrated. Over the years, she slowly and meticulously collected information. And after her son’s victorious birth in 2007, a home VBAC, she created VBACFACTS.com in order to make the studies she had compiled, and the analyses she performed, easily accessible to others.

Cesarean Rates - www.cesareanrates.com

CesareanRates.com is a snapshot of online cesarean rate reporting in the United States as of January 2012. The site compiles the most current hospital-level data accessible to the public online, whether reported directly by a state’s department of health or gathered from state hospital association web sites via pull-down menus.

Special Scars – Special Women - www.specialscars.org

A “special scar” is one resulting from a Classical, Inverted T, J, Low Vertical, Upright T or any other cesarean incision other than the most often used Low Transverse. The Special Scars website was born from the need to get more accurate information to women with these scars. It is a collection of information — articles, studies, & our own stories — regarding the possibility of VBAC after an these special incisions.

A Woman’s Guide to VBAC: Navigating the NIH Consensus Recommendations - http://givingbirthwithconfidence.org/

A group of maternity care experts and VBAC advocates came together to create A Woman’s Guide to VBAC: Navigating the NIH Consensus Recommendations, a free online resource guide that addresses the most common and pressing questions women may have about their birth choices in what could be called the “post-NIH-Consensus-Recommendations Era.” The guide gives you the tools you need to empower yourself to advocate for you, your baby, and your birth choices!

 

Do you have a cesarean resource to add? Let us know below in the comments. 

Filed Under Birth, Cesarean, Featured Story Tagged With Cesarean Awareness Month, cesarean support

Tips for Establishing Breastfeeding

April 27, 2012 By admin 1 Comment


From The Official Lamaze Guide: Giving Birth with Confidence.

Breastfeeding is nature’s most powerful way of helping mothers recover from birth, learn mothering skills, and fall in love with their babies. It’s also nature’s way of ensuring that babies are well nourished, protected against disease, and allowed to develop optimally. The American Academy of Pediatrics (AAP) recommends that babies be exclusively breastfed (no water, juice, formula, other fluids, or solids) for six months and continue breastfeeding until at least one year. Following are some ways you can get your breastfeeding relationship off to a good start.

Before Birth

  • Talk to women who are breastfeeding or have breastfed babies.
  • Watch babies at the breast.
  • Attend a La Leche League meeting.
  • Get the name of a lactation consultant.
  • Read about breastfeeding in Lamaze Parents magazine.
  • Buy a breastfeeding book.
  • Remember that your body knows how to breastfeed your baby.
  • Talk to your caregiver about delaying newborn testing and other routine procedures.

In the First Hours

  • Keep your baby skin-to-skin with you.
  • Watch for early infant feeding cues.
  • Nurse your baby within the first hour after birth.
  • Delay newborn tests and routine procedures until after the first breastfeeding.
  • Remember that colostrum is nutrient-rich and that your baby doesn’t need to eat much in the first hours and days of life.

In the First Days

  • Sleep in the same room with your baby and be together as much as possible.
  • Don’t limit your baby’s time at the breast or hold your baby off between feedings.
  • Let your baby finish the first breast before offering the other.
  • Learn how to tell if your baby is swallowing milk.
  • Become a confident nurser by learning how to tell if your baby is getting enough milk and trusting that you will produce lots of milk.
  • Learn how to position your baby for a good latch.
  • Don’t use bottles or pacifiers until breastfeeding is well established.
  • Be patient with yourself and your baby as you both learn to breastfeed.
  • If you choose to have your baby circumcised, wait at least twenty-four hours after birth and insist that he be given pain medication. Be prepared to provide extra soothing and wake your baby to breastfeed if necessary.
  • If you need to be separated from your baby, pump your breasts and store your milk.
  • Don’t supplement your breast milk with formula unless there is a clear, compelling health reason.
  • Remember that colostrum is nutrient-rich and that your baby doesn’t need to eat much in the first hours and days of life.

In the First Weeks

  • Remember that responding to your baby’s needs does not spoil him; rather, it’s the only way you can teach your baby to trust you.
  • Sleep in the same room with your baby and be together as much as possible.
  • Wear your baby in a sling or other soft baby carrier throughout the day.
  • Nurse your baby whenever he or she shows signs of hunger (eight to twelve times every t

    wenty-four hours).

  • Learn to nurse lying down in bed so you don’t need to wake fully to nurse at night.
  • Remember that breastfeeding is a top priority.
  • Be patient with yourself and your baby as you learn to breastfeed.
  • Stay confident, even if your breastfeeding journey is bumpy.
  • Call a lactation consultant, your local La Leche League leader, or the La Leche League hotline (847-519-7730) if you have breastfeeding problems or you’re concerned about whether your baby is getting enough milk.
  • Remember that breast milk is all the nutrition your baby needs for at least six months.

If You’re Not Able to Breastfeed
Here are some tips to promote bonding and development even if you’re not able to breastfeed your baby:

  • Sleep in the same room with your baby and be together as much as possible.
  • Wear your baby in a sling or other soft baby carrier throughout the day.
  • Respond to your baby’s needs before he or she cries.
  • Hold your baby, make eye contact, and talk to your baby during feedings.
  • Hold, look at, and talk to your baby even when you’re not feeding.

Filed Under Breastfeeding, Featured Story

Communicating with Your Care Provider: Are You on the Same Page?

April 25, 2012 By admin Leave a Comment

By Anna Deligio, MSW, Labor Doula, LCCE, Reiki Master

 

First, do no harm.

This instructional value statement is often attributed to different versions of the Hippocratic oath medical doctors take as they embark on their healing careers.  It seems simple enough and certainly it would be easy enough to assume that its interpretation is universal.

We all know what happens to you and me when we assume, though, and to do so within conversations with your medical practitioner can often lead to more than just a need for clarification. Ensuring that a shared understanding exists of the language being used is critical to ensuring that you receive the care that is best for you.

Take the idea of “doing no harm.” Let’s say you’re in active labor and have been going strong for some time without any medicated pain management. You are working through your contractions well but are tired, overwhelmed, and lacking good support. You are starting to feel like you may not be able to continue without medication. The next time your nurse comes in, you say that you’d like to talk about getting an epidural. The nurse alerts anesthesia and soon you are talking with that person about the potential of getting an epidural.

Drawing on what you learned during your pregnancy from your own research and your childbirth preparation class, you know that epidurals can come with increased risks. You ask the anesthesiologist if the epidural will harm your baby. The anesthesiologist gives you a quick and confidant “absolutely not.”

Does that mean that you move forward with the procedure? Not necessarily. First it is important to make sure both of you are operating from the same understanding of “harm.” You might be thinking that “harm” includes the potential for a sleepy baby after the birth and one who may struggle to establish good breast-feeding. The anesthesiologist may be thinking that “harm” means the epidural would kill or permanently damage your baby.  Without clarifying follow-up questions such as “What impact will it have on the baby?” and “How long can I expect that impact to last after the birth?” you are risking approving a procedure that is not in line with your values of birth.

An online search for “tips on communicating with doctors” reveals a theme of writing down questions before the appointment, remembering that you are the consumer, bringing someone with you to appointments, and writing down the answers you get. Added to this needs to be, “ask clarifying questions until you are confident that you and your provider are using the same definitions for words.”

In many childbirth preparation classes, the acronym BRAIN is used to teach participants what questions to ask when faced with a decision. The letters cover the Benefits, Risks, Alternatives, your Intuition, and the potential of doing Nothing and are a way to remember which questions to ask in order to ensure that the procedure undertaken is the one you want.  This model is a wonderful first step, but can still lead to miscommunication if clarification of terms is not established through follow-up questions.

This can be a laborious process and not one you necessarily want to step into during your labor. More the reason to have these conversations during your prenatal visits, write a succinct and clear birth plan, and make sure that you have a support person with you during labor who understands your intent during the birth and can support you in communicating that intent to your medical staff.

Language is wonderful in its ability to convey specific ideas and still leave room for interpretation. While it may be fun to explore the intended meaning behind words when reading a piece of creative writing, it is critical to explore the intended meaning when discussing your care with your medical provider.

Insurance and funding permitting, the ability to pick a provider from the start that shares your values will go a long way in making sure language meaning is shared. That said, you will likely interact with many medical providers during your labor and, like us, each brings his/her own lens, values, histories, and definitions to the conversation.

Practicing asking clarifying questions during your appointments will give you the confidence needed to draw on that tool during your labor with each provider with whom you interact. Each question will get you closer to creating a shared understanding with your providers and build your confidence in your ability to participate actively in the labor you intend to have.

 

Anna Deligio is a Lamaze Certified Childbirth Educator and Labor Doula through her business Nourishing Roots, work that is greatly informed by her previous experiences as an MSW working with families in crisis and babies in foster care, a Special Education teacher of high school students with learning and emotional challenges, a marketing writer, and a waitress at a French restaurant. She loves working with pregnant people and their support people during the transformative time that is pregnancy and birth. When not enjoying the company of pregnant people, she enjoys relaxing with her partner Cathy at their home in Salem, OR.

 

Filed Under Birth, Birth plans, Choosing a care provider, Featured Story, Pregnancy Tagged With birth plan, care provider

Cesarean Awareness Month: Postpartum Recovery Tips for Cesarean Birth

April 23, 2012 By admin 4 Comments

April is Cesarean Awareness Month. What should you be aware of? Be aware that a cesarean, while it can be a life-saving procedure for mom and baby, is often prescribed when vaginal birth is a safe and sound option. Be aware that you have options, that you have a right to ask questions, and a right to know your risks. Educating yourself about birth is your best and first defense against an unnecessary cesarean. 

Throughout the month, Giving Birth with Confidence will be posting cesarean resources for moms. We encourage you to add comments with your experience as well as any questions — we will tag cesarean questions and answer them in a subsequent post. For more information and stories this month, check out the International Cesarean Awareness Network Blog.


Postpartum Recovery Tips for Cesarean Birth

By Sharon Muza, CD(DONA), BDT(DONA), LCCE, FACCE

 

Giving birth, whether vaginally or by cesarean, is a major physical event. A mother’s body goes through immense physical changes in the minutes, hours and first days after birth.  Recovering from major abdominal surgery while making the transition to not being pregnant and caring for a newborn can be extra challenging.  Here are some tips for the very first days after you have had a cesarean, and some of this information is just good info for the first days after birth, no matter how your baby arrived.

1. Discuss with the anesthesiologist about the possibility of having them administer Duramorph for immediate post-op pain.  This medication is placed through the spinal needle or epidural catheter during the surgery, and usually provides effective regional pain relief for 18-24 hours.  After that, you can switch over to oral medications as prescribed by your doctor or midwife.

2. Stay on top of your oral pain medication.  This is not the time to be a hero!  Make sure you are taking the right dosage of meds at the right time, even if the pain has not returned fully yet.  It is really hard to play “catch-up,” so taking your medication in a timely manner allows you to feel your best, be more open to moving and functioning, and gently participating in baby care. You may even want to set your smart phone to “alarm” a few minutes before each dose is due, to help you track and remember what is needed and when. Give yourself some time before you try and reduce the amount of oral pain meds you need. The more you move and do some gentle, easy walking, the faster your recovery may be. Adequate pain medication will help in this process.

3. Think about your recovery set up at home?  Where is your bedroom?  Is your bed very low to the ground?  Where are your baby changing stations?  If you have a lot of stairs, consider relocating your sleeping area to one that is more accessible, close to a bathroom and the kitchen/place to eat.  It will only be a temporary move, but may make things easier for taking naps and resting.  If your bed is very low, consider placing it temporarily on cement or wooden blocks to make it higher.  It will be easier on your abdominal muscles to get up and down from a higher bed.  You can set up a portable changing area for the baby close by or in the same room as where you will be spending most of your time.

4. Use a pillow to “brace” your abdomen when getting up from a chair, couch or bed.  Sometimes, when you are laughing, sneezing or coughing, that can be helpful too.  If your couch or favorite chair is too low, think about adding some extra pillows for the additional height that you need in the early days.

5. Consider using a TENS (Transcutaneous Electrical Nerve Stimulation) unit to help with post-surgery discomfort.  Several studies show that women who used a TENS unit around the incision area needed less narcotic pain medication during their cesarean  recovery. (TENS units can be purchased online or may be acquired from your care provider.)

6. You may want to consider using a gentle belly binder or even a rebozo to “hold things together” for the first days or even weeks post cesarean.  Some women find that the gentle support offered by these products helps them to feel less sore and more supported.  Just be sure that whatever you use does not irritate the incision. (Some care providers offer belly binders automatically during your hospital stay. If not, you can ask for one.)

7. Work at becoming an expert in the side-lying breastfeeding position, which I consider the hardest to master for the mother-baby dyad, but the most useful once you do.  This way, you can rest as much as possible, and even doze for a few minutes during those extended feedings.  The key to doing this successfully is lots and lots of pillows!  A couple for your head, one between your legs, one behind your back at a minimum.  In general, your milk may come in a little slower after surgery than after a vaginal birth, so frequent nursing sessions, and lots of skin-to-skin time with your baby will help this to happen sooner.

8. Be sure to use stool softeners, stay very hydrated and eat food with lots of fiber. Oatmeal is a galactogogue (food that helps increase milk production) and is high in fiber at the same time.  Narcotic pain medication can cause constipation, and post surgery, the thought of having to strain to have a bowel movement can be emotionally challenging.  Most women find the fear is worse then the reality, but it is good to do what you can to keep things “moving,” so to speak.  Also, your bladder and urethra may be a bit irritated from the foley catheter that was placed to drain urine during surgery and the first hours of recovery. You may want to take cranberry pills or drink cranberry juice to help with bladder health and prevent a urinary tract infection.  Also, you will have received IV antibiotics before or during the surgery to prevent infection, and some women are more prone to getting yeast infections after receiving antibiotics.  A  yeast infection on your nipples (Thrush) is no fun either, and can be shared between you and the baby. You may want to use some probiotics (found over the counter in a pharmacy) or eat yogurt with live cultures, to help restore the balance of good bacteria normally found in your digestive tract.

9. Create a “nursing bag” full of all the things you need during a nursing session.  Cell phone, snacks, filled water bottle you can operate with one hand, something to read, burp cloth, breast care products, etc. can all be put in a bag or basket, and moved around with you, so that you have everything you need when you sit down to nurse.

10. Ask your friends and family to do some of the more physical household tasks and contribute meals during your recovery.  Use a website like Takethemameal.com or Care.com for scheduling assistance and for letting people know how and when they can help.

11. Recognize that you will have lifting restrictions that limit the weight you can carry to just the baby for at least a couple of weeks or even more!  It is recommended that you not lift the carseat with the baby in it until you have done some healing.  You also may not be driving for several weeks, (and certainly not while on narcotic pain meds) and your partner may have returned to work already, leaving you feeling a bit isolated.  It would be nice to have someone stop be every day to help, visit, or take you out for a short trip if you are up for it.  You may want a baby carrier (sling, Moby Wrap etc.) to help you hold/carry your newborn while your physical recovery moves forward and your mobility returns.

12. Working with a massage therapist who specializes in postpartum recovery can also help with postpartum pain and minimize the development of internal adhesions and promote healing.  Get a recommendation for someone skilled in this type of scar work and see if they make house calls!  Some massage therapists will come to the house in the first days of your postpartum period.

13. Connect with your local International Cesarean Awareness Network chapter, (www.ican-online.org to find one near you) and consider joining their online group or attending a meeting when you are ready.  This peer-to-peer support is invaluable as you process your birth and recover from a cesarean.

 

Go easy on yourself after you have had a cesarean birth.  It is hard to recover from surgery and ease into parenting a newborn at the same time.  Ask for help, make little changes around the house to support your recovery, and take it easy to give your body a chance to heal.  Laying low and resting will give you plenty of time to connect and snuggle with your new little one while you get your strength back.

 

Sharon Muza, CD(DONA), BDT(DONA), LCCE, FACCE, is a birth doula, doula trainer and Lamaze Certified Childbirth Educator in Seattle, WA.  Sharon is also the co-leader of the Seattle chapter of the International Cesarean Awareness Network, (ICAN.)  Sharon can be reached through her website, www.newmoonbirth.com, if you would like more information. 

Filed Under Birth, Cesarean, Featured Story, Postpartum Tagged With cesarean, Cesarean Awareness Month, postpartum care
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