Sunday, December 27, 2009

Another Product I Love


I recently came upon a book titled "25 Ways To Awaken Your Birth Power" and love it. Love it for several reasons. First off, the artwork is beautiful and inspiring. So much so that I ordered one of the prints for my Bradley bathroom that my students use. The quote is mine.


The book comes with a CD of all 25 exercises, read in a soothing Australian accent with pleasant music in the background. Your partner can read it or you can use the CD. I would recommend both.

I love the name of the book. The word "awaken" is what strikes a cord with me. All women have this instinct to give birth, to breastfeed their babies, to nurture their young. Most women, however, do not even know their capabilities. Fear of birth surrounds us in all that we see and hear. Some women know they can give birth naturally, but most, I believe, need to awaken their birth power.

And how about the words "birth power" -- that's what it is -- power. Power from her body, of course, but even more, power from her mind, her heart, her baby, her partner, her doula, her midwife. She becomes more powerful than she ever thought possible during the act of birthing her baby. This power carries her through everything that comes afterward in her life. She will reflect upon the things that she learns about herself during birth throughout her lifetime. Her power and the power that birth gave to her.

If you would like more info on how you can order your own copy, check out www.awakenyourbirthpower.com. Enjoy.

Wednesday, December 9, 2009

Scars

"Scars remind us where we've been, but don't have to dictate where we're going."
-Agent Rossey, Criminal Minds

OK, a bit strange to put a quote on here from Criminal Minds (my favorite show on television), but seems very applicable right about now. Stay tuned for a wonderful VBAC story...

Friday, December 4, 2009

Another Petition to the AAP Protesting Circumcision

This petition goes to the American Academy of Pediatrics about NOT recommending circumcision to all baby boys. Their stand for years has been to leave it alone, but they are considering changing it because of these reports out of Africa which I've been writing about.

The last petition was for the CDC. This is a different petition.

Thursday, December 3, 2009

Storytime: System Fails VBACing Mom

I have an unfortunate story to tell. Not the best line to start a post, but here goes:

Last spring I met a woman, Allison, at church who was pregnant with her third baby. She had had two previous c-sections and was going to have another because her doctor wouldn't do a VBAC (Vaginal Birth After Cesarean) after two c-sections. I told her that there were a handful of care providers who would do a VBAC for her in the area. I sent her some different names, links, and videos to check out. I was starting up a new class around that time and her and her husband, Jonathan, enrolled.

They started their "homework" immediately. They began interviewing midwives and other doctors. They hired a doula. She visited a chiropractor regularly. And Allison read like crazy. She became very informed. She truly prepared her body both mentally and physically for a VBAC.

They hired a doctor at a hospital that says they "allow" VBACs. The doctor admitted that not everyone in his practice would do it, but he would do his best to "protect" her. In the past, he has been at the births for my students and even encouraged them to eat, drink, and walk around. They felt good about their choice of doctor and comfortable with the hospital.

Her "due date" came and went, but they waited patiently for another 8 days. She visited with Hannah who worked on some acupressure points, took an herbal supplement from her chiropractor (said to put a woman in labor within a day or two), and she was in labor by the next day!

I was in contact with their doula, Nancy, throughout the evening. When they got to the hospital, Allison was dilated to about a 3 or 4 and 90% effaced. She had never really started labor on her own before, so this was so exciting! The doctor on call said that her doctor was not available and could not be reached, and after reviewing her chart, would not do a VBAC. Allison told her that she would not have a c-section at that point because everything was going fine. The doctor told her that she would either have a c-section "right now" or Allison would have to fire her. So, Allison fired the on-call doctor!

From that point, the doctor treated her very poorly and would not let her have the things she wanted, like a birth ball. The nurses were trying to help her, but the doctor made that nearly impossible. With all the questions, and needles, and stress, adrenaline took over, which is the opposite of oxytocin. Her contractions spaced out and got much less intense. They brought up the ER doctor, who concurred with the OB on call, that Allison should have a c-section. Her bedside manner was considerably better though she allowed Allison to negotiate terms for leaving the hospital without a c-section. If she was dilated less than e centimeters, she would not have her sign a paper that she was leaving Against Medical Advice (AMA). Miraculously, when the doctor checked her, she told her she was dilated 2 centimeters and was "paper thin."

So, they were "homeless." They didn't know where to go. Who would attend her birth with two c-sections under her belt, so to speak? They called a midwife that we all know and love, but without ever seeing her, the midwife didn't want to take that on. They called a well-known VBAC doctor in the area, but an hour from their home, and could not reach him. They simply drove home, with Allison in labor.

They spent days trying and wishing for labor to start, and now they were trying to get labor to stop! Allison's doctor would be back in the office the next afternoon, and this was midnight. Labor continued and got much stronger once they were out of the hospital.

As labor progressed, they made the very difficult decision to go to the hospital closest to their home, knowing they would have a c-section, no matter where they went. They wanted to have monitoring for both mom and baby and staying at home was no longer an option. When she got to the hospital, she was dilated 5 centimeters and 100% effaced. Baby was fine, mom was fine, and labor was normal. But because she had had two previous c-sections, she had a third.

Baby was about 9 1/2 pounds and very healthy. A wonderful nurser, too! They are so happy that they started labor on their own and that baby, and mom, had the benefits of labor. Her recovery has been the best of all the c-sections, and she feels that it is due, in part because of the chiropractic care she received and continues to receive.

She will reflect on this experience all her life. She did tell me that the pregnancy was better than what it would have been because she had hope -- hope for a vaginal birth. She prepared for a different experience, and while the outcome was not what she hoped for, she went through the pregnancy with a different attitude than she would have if she had just scheduled another c-section.

I have thought about this so much, and I don't know what she could have done differently. The whole experience was circumstantial. If her doctor would have been there, or one of the other doctors who support VBACs had been on call, would she have had a vaginal birth? Probably. This story illustrates the point that birth is often about policies and lawsuits, not about good health care. Allison had this c-section simply because the hospital, and the on-call doctor, had a no-VBAC policy.

The system is what failed Allison, not her body.

More Evidence About the Dangers of Ultrasound

I found a link about some other studies on ultrasound. There are a couple of posts under this link. They are short and easy to understand. The evidence is compelling. Check it out.

Next time your doctor says, "I don't know why 'Bradley' is so concerned about ultrasound," and tries to tell you how safe it is and that Bradley Instructors are the only people out there who care, they couldn't be further from the truth.

Evidence is mounting. Check it out.

Sunday, November 22, 2009

Do Epidurals Affect the Baby?

In class last week, I had a couple express surprise when I said that all drugs get to the baby, including epidurals. They have friends that are doctors that have said otherwise. I have spent the week looking up several articles and resources, and, my friends, epidurals indeed adversely affect the baby. I do not want to make this an overwhelming post, so I will touch on the highlights of how the babies are affected.

First, it is important to note that the "older" studies with very significant data were largely done by pediatricians. The newer studies, found to not be nearly as complex, have been done by anesthesiologists. Obviously, there is a conflict of interest there!

There are a couple of problems that researchers have run into with these studies. The first is that so many women that have epidurals also have other "pain relieving" drugs in their bodies that also influence and affect the babies. This makes it difficult to assess the effects of just the epidural. In addition, epidurals have different drugs in them. Different anesthesiologists and/or hospitals will often use different drugs in their epidurals.

So many of the effects on the baby have to do with the effects on the mother from the epidural. I am not focusing on the effects for the mother in this post, however, but some of these effects on the mother is what creates a problem for the baby from the epidural. For example, maternal fever is very common and can cause complications for the babies. So is a drop in maternal blood pressure. This is why a woman will receive IV fluids before the epidural is administered -- it is a preventative measure.

Effects of the Epidural on the Baby

Epidurals can change the Fetal Heart Rate (FHR), indicating that the baby is lacking blood and oxygen. This will often occur in the first 30 minutes after an epidural is placed. Opiate drugs, common in spinals and epidurals, are the likely culprit. These changes in FHR will often resolve themselves if the mom is allowed to move a bit or change position. If the baby's heart rate does not bounce back, the woman may have a cesarean section.

The supine position (lying on your back), also contributes to changes in fetal heart rate. A woman with an epidural is mostly in this position, which can deprive the baby of oxygen, affecting the baby's brain. In my case, this is why I nearly had a c-section. I had the epidural, pitocin, etc., etc., and my baby's heart rate would not come up after contractions. Moving from side to side after each contraction is what helped his heart rate. Had I remained on my back, his heart rate would not have come back up, and I would have had surgery. Had my sister-in-law, a doula, not been there, I would have had a c-section. The nurses or doctors certainly weren't telling me what to do. They would have been happy to perform surgery, I have no doubt.

Babies that are born to mothers who developed a fever from the epidural in labor are more likely to have a low Apgar score -- poor muscle tone, require resuscitation (11.5% versus 3%), or have seizures in the newborn period. One of the most common problems from the maternal fever is that the doctors do not know if the fever was from an infection involving the uterus or from the epidural. They will typically do a sepsis, or evaluation, of the baby. This involves prolonged separation from the mother, invasive tests, and almost always, antibiotics until the test results are available. In a study of first-time mothers, 34% of epidural babies were given a sepsis evaluation, but only 9.8% of nonepidural babies underwent the evaluation.

It is important to note that a newborn's ability to process and get rid of drugs is much less than an adult's. It must also be considered that the drugs are often stored in the newborn's tissues such as the brain and liver where they are more slowly released. Epidural babies are more likely to have jaundice. The reasons are not entirely clear on this, but it is suspected that it is related to an increase in assisted delivery (forceps or vacuum extraction) or to the increase use of pitocin with epidurals.

Neurobehavioral Effects
Epidural babies have been found to have a depressed NBAS (Neonatal Behavioral Assessment Score, devised by pediatricians) Score at five days old, with difficulty "controlling their state." Babies that received pitocin as well as the epidural had even more depressed NBAS scores, as well as higher rates of jaundice. At one month of age, epidural mothers found their babies "less adaptable, more intense, and more bothersome in their behavior."

Other differences between epidural babies and unmedicated babies include: less alertness and ability to orient themselves. The epidural mothers typically spent less time with their babies while in the hospital, finding the more drugs they received, the less time they were with their baby.

In another study, researchers found that at three days old, epidural babies cried more easily and more often and aspects of this continued for the entire six weeks of the study. In the conclusion of this particular study, researchers expressed concern about "the importance of first encounters with a disorganized baby in shaping maternal expectations and interactive styles."

Finally, the effects of an epidural on breastfeeding must be addressed. The first hour is a critical time to establish breastfeeding and if a baby has poor muscle tone or sucking reflex, or mom is hemorrhaging (more likely with an epidural), breastfeeding may be put off until well past that hour. As I write this, I have mixed feelings. It is crucial that mothers understand the effects of their actions in choosing an epidural, but if something happens and for whatever reason you cannot breastfeed immediately, do not give up since you missed out on that first hour. Babies and moms can figure this out! With that being said, I will continue on the effects of the epidural on breastfeeding.

Oxytocin is a breastfeeding hormone. If a mom has been induced with pitocin, administered an epidural, had an instrumental delivery, etc., this hormone was not allowed to be present in its natural form. There were just too many disruptions. This can adversely affect how well breastfeeding gets started. If mom is tired, baby is still feeling the effects of the drugs and not sucking well, the nurses, and even the pediatrician, may be pushing formula on this baby. And then starts the vicious cycle of nipple confusion. The baby doesn't have to work to get milk from the bottle, and when he is put to the breast, gets frustrated. Mom gets frustrated and resorts to those stupid formula samples she's been receiving on her doorstep for months!

Epidural mothers are less likely to breastfeed exclusively compared to nonepidural mothers. Epidural mothers are more likely to report having "not enough milk."

It is unfortunate that doctors are leading people to believe that the epidural is safe for moms and babies and there are no risks. There are risks, not just to our health, but to how we parent our babies. The more attached you are, the better you will appreciate your baby. You will trust your body to breastfeed and your baby will be eager to nurse.

I'd like to end with a quote by musician, Ani DiFranco, talking about her unmedicated birth: "I'm really happy in the end that I felt every last bit of the pain, and was as present as I could be. Whenever you go through something terrifying and come out the other side, you grow and have more self-respect in terms of your own strengths. I wanted that more than I wanted whatever sort of numbing the hospital would have offered."

What's good for mom is good for baby. Just say NO to the epidural! You are strong and powerful. You can do this, just like millions of women before you have done this. Giving birth is giving life. You and your baby deserve the very best start down this new road. Surround yourself with positive people who believe in you and your abilities.

Thursday, November 19, 2009

Part II: Will a Mandate to Circumcise Newborns Reduce the Spread of HIV in the United States?

I am hoping that you read the last post about the Studies that this possible mandate is based. If not, I encourage you to do so.

I have thought about the statistics all week long. When I hear that circumcision lowers risk for HIV infection by 50-60%, I automatically think in crazy numbers. When worded that way, it leads the reader to think that only 40-50% of the circumcised males may contract the HIV virus. Or that the uncircumcised males have a 50-60% increased risk of contracting HIV.

I'd just like to point out again that this 50-60% rate that keeps getting thrown in our face is based on a HALF PERCENTAGE POINT. There were many factors involved that were not kept track of. The men received extensive counseling on the benefits of using condoms and approximately 98% of the men did not contract the HIV virus.

Circumcising Newborns:
This would be a "preventative" measure that we would not see the effects of for many years. The complication rate ranges from 20%-35% (based on those African studies!), and this must be considered when weighing benefits and risks.

Ironically, we have an HIV epidemic in the US now, and the majority of those males are circumcised. The use of condoms has been shown to reduce the spread of HIV, and there has been no evidence that being circumcised and wearing condoms is any better than just using condoms alone. We have twice as many HIV infected males in the US as does Europe and our circumcision rates are significantly higher. According to many medical organizations, including the American Academy of Pediatrics, in 2005, stated that the "data on the potential medical benefits of circumcision are not sufficient to recommend routine neonatal circumcision."

The way that HIV is transmitted in the US is so different from Africa, it is hard to even compare the two. We actually have an effective social program in place with education, safe-sex practices, and consistent condom use. These methods do not require surgery, are much more cost-effective, and they work! In fact, consistent condom use reduces the lifetime risk by 20% compared to only 8% for circumcision. A recent report from South Africa shows that condom use is increasing and the HIV rates are beginning to level off. There is no evidence that circumcision will aid in this progress.

Quite honestly, it is irresponsible for the CDC to even consider promoting an intervention that will create a false sense of security, while actually increasing the risk to women. Promoting circumcision will drain resources that should be put into safe-sex education and condom promotion.

Thursday, November 12, 2009

Part 1: Will Circumcision Prevent HIV?

Two steps forward, three steps back describes the direction circumcision is taking in the United States. We have seen the newborn circumcision rates gradually decrease over the years as parents have researched and discovered that there are benefits to keeping the foreskin intact. In many states, Medicaid, as well as many insurance companies, have stopped paying for circumcisions, declaring it "cosmetic" surgery. The American Academy of Pediatrics took the stand, essentially, to "leave it alone." Is all of this education and hard work about to be dismissed? The possibility is very real thanks to a couple of poorly-done studies. The CDC is said to have an official statement on mandatory circumcision for newborns by the end of this year.

Here's the fuss: The studies have concluded that circumcision reduces the risk of contracting HIV by 50-60% in heterosexual males only. First of all, this group is not the greatest at risk, which is -- no surprise -- men who have sex with other men. If it is truly an issue of a circumcised penis being protected from HIV , wouldn't he be greater "protected" no matter what, no matter who he is having sex with?

The reasons for contracting HIV in Africa are numerous. Heterosexual sex only accounts for about a third of cases. The rest is likely transmitted through unsafe medical procedures, including injections, transfusions, and other contact with infected blood. In fact, in the journal of the American College of Epidemiology, it has been suggested that some HIV infections are resulted from circumcisions themselves.

The Studies:
This is a lot of information and when you read so many numbers, I think a lot of us glaze over. I am going to try to make this as uncomplicated as possible.

Most people are aware that the area of the world hardest hit by the AIDS epidemic is Africa. It is important to note from the beginning that heterosexual sex is NOT the leading cause of contracting HIV in Africa. Conditions are very poor in many parts of the continent.

There were two studies done over a 24 month period, one in Uganda and the the other in Kenya. In Uganda, researches began with almost 5000 men and randomly divided them into 2 groups, circumcising one group and leaving the other group intact. For whatever reason, the intact group of men had almost 50 more men in its numbers than the circumcised group. The men were given extensive counseling on the use of condoms, but the researchers made no attempt to determine the HIV status of their female partners, which is a major flaw with both studies. After the 24 months, both groups were tested for HIV. The circumcised group had 22 positive results, while the uncircumcised group had 45 test positive. The researchers derived a 55% risk-prevention figure from the numbers.

The Kenyan study was very similar. They began with almost 2500 men and divided them evenly, circumcising half of the men. Two years later, 47 of the uncircumcised men and 22 of the circumcised men tested HIV positive.

Concerns with the Studies:
First of all, the number of men tested was such a small number to apply to large populations. In the Ugandan study, 0.8% of the circumcised men tested positive and 1.7% of the non-circumcised men tested positive. The numbers sound quite different when read in actualities. Plus, look at it from the flip-side: About 98% of the men remained HIV negative, possibly because of the extensive counseling about condoms. The actual numbers from the Kenyan study are: 1.5% circumcised men became infected, while 3.3% of the intact men became infected.

The timing of the release of these results is significant. They were released to the media in conjunction with UN World AIDS Day, 2 months before being released anywhere else. This unusual move "produced world-wide publicity that was heavy on eye-catching headlines and light on details because, in the absence of the published studies themselves, few journalists took the time to dig beyond the press releases made available to them."

Another concern is the short duration of the studies. Short time span and small numbers. The men who participated in the study were paid, which was significant, also, because more than half of them were unemployed when they signed up. They also received free health care for 2 years. For these reasons, it is impossible for their experience to reflect the larger population in other parts of Africa. In addition, there are more than 60 pre-existing conditions that can trigger an HIV false-positive result, including pregnancy, influenza, tuberculosis, hepatitis, and malaria.

There are other findings in the study. Circumcision does not appear to protect women. As mentioned earlier, it does not protect gay men either. Here's the reasoning behind believing that circumcision protects against HIV: "The mucosal tissue of the foreskin is more susceptible to HIV and can be an entry portal for the virus." More research has been done and has found the following: Langerhans cells in the foreskin have a protective effect against pathogens (including HIV) by secreting langerin. The original idea, stated earlier, believed these cells were an entrance point for viruses, and while this is partially true, the true mechanism at work is the cells set a trap for viruses in order to destroy them with langerin.

HIV infection is about behavior, not biology! Circumcision cannot prevent the spread of HIV. In fact, if men believe that they are safe because they are circumcised, that could make the problem worse! Circumcised men do contract HIV, they transmit HIV, and circumcised men die of AIDS. Anyone who participates in high-risk behavior, intact or not, carries a risk of contracting HIV and other STDs.

Tuesday, November 10, 2009

Why Take a Children at Birth Class

I had the privilege of spending time with a family this morning who is due with their fourth baby in a couple of weeks. This particular mom had an epidural with her first 3 babies and has decided that she wants to give birth without medication this go-round. Her and her husband have been taking my class by DVD, but we added a couple of live classes too: Techniques of Relaxation and Children at Birth.

I rarely have the opportunity to teach my Children at Birth class. As you may have noticed, there's not a lot of demand for a class preparing children for witnessing the birth of their sibling!

I've been thinking about this topic a lot lately, knowing that I would be teaching this class. There is something very special about a mom who wants her other children to be present for the birth of her new baby. It becomes the birth of a family, really. With each child the family dynamics change, and inviting older children to be a part of that is so special. Sacred, really. She is placing enormous value on her older children by allowing them this opportunity to be a part of this wonderful, life-changing event.

A few years ago, I had a dear friend who was pregnant with her fourth baby. When she told her children that they were going to have another baby, it was the oldest child that had the hardest time with it. After days of crying and consoling, she finally got to the root of what the real issue was that he was struggling with -- he remembered her going to the hospital and being gone for a long time, someone else taking care of him and the house, and then mom coming home with a baby that took up all her time! And to think, we worry about the younger babies and how they will handle a new sibling! We often think that the older ones have done this before and will be just fine. I've often wondered, if he had been invited to the birth, even after leaving the hospital after the birth, he probably would have been okay with Grandma, or whoever, running the house for a couple of days.

When I was pregnant with our last baby, we had not had any ultrasounds during the pregnancy. We just knew she'd be a boy! Two out of three of our children chose to be present for the birth. Had our only boy not been there, I think it would have been much more devastating that "he" was a "she." He found out with the rest of us. He felt a part of it. He was the first child downstairs the next morning, climbing into bed to snuggle up next to the baby, declaring, "I love her more than anything in the world." I have replayed this over and over in my mind over the years and it always comes back to him being a part of the birth.

I so enjoyed the children I met with today. The oldest was a 10-year-old boy and the younger (invited) child is a 6-year-old girl. The two-year-old will NOT be attending the birth! We talked about the process of labor and their roles and what mom will need from them. We talked about the sounds and facial expressions mom might make. We talked about the placenta, the umbilical cord, vernix, IVs, and monitoring. We watched a video where children are present for the births of their siblings. It's so good to see how these other children are "handling" birth. It's quite different to talk about birth versus actually seeing a birth. In the end, the 6-year-old decided that she may not want to be there. (My one child who chose not to be there was also six at the time.)

It is so important that children be allowed to make that decision. But how wonderful to be invited to a birth. It's an honor, no matter your age or profession, but a very rare opportunity for a sibling.

Thank you, Katie and Nick, for inviting me into your home today to teach your children. It is a special thing you are doing, not only for them, but for yourselves and your family. Make sure everyone records it in their own special way. Good luck and I'll be looking forward to hearing about this wonderful birth.

Friday, November 6, 2009

Free Pregnancy e-newsletter Through Mothering

I just stumbled upon a great resource for pregnant moms and I wanted to share. When you put in your due date, it will be "tailored to the timing of your pregnancy." Best of all, it's FREE, and second best, it's put on by Mothering.

To sign up, click here.

Find out what's happening in your body and what's happening with your baby. Lots of great info to help you along this journey and to make the most of this special, sacred experience.

Petition to CDC: Do Not Make Circumcision Required for Newborns

It took me about 2 minutes to add my name to this petition. I have done my research -- I just haven't sat down to write a post about this topic. The CDC is declaring, falsely by many accounts, that circumcision might reduce the risk of HIV for males. There is a lot to talk about, as you can imagine. In the meantime, add your name to the petition.

http://www.thepetitionsite.com/takeaction/760537185?z00m=19802998

Thanks.

Sunday, October 25, 2009

OBs Ban Doulas, Birth Plans, and The Bradley Method



In case you have a hard time reading it, it says: "Because the Physicians at Aspen's Women's Center care about the quality of their patients deliveries and are very concerned about the welfare and health of your unborn child, we will not participate in: a "Birth Contract", a Doulah Assisted, or Bradley Method delivery. For those patients who are interested in such methods, please notify the nurse so we may arrange transfer of your care."

You may have had the privilege of seeing this sign before now. I just saw it yesterday for the first time. Ironically, these OBs, Dr. Judd and Dr. Gordon, had both been recommended to me when I was pregnant with our first baby in Provo. The doctor I had, Dr. Brian Wolsey, I am certain, held the same opinion as these two doctors. In fact, when David saw the sign he even asked if that was hanging in Dr. Wolsey's office!

Well, as crazy as it seems, at least they are honest about the clients they want walking through their door. So often, I see doctors who feel this way, but are NOT honest. They tell women that, yes, they will do whatever they want, but have no intention of doing so.

Remember, birth is safe. These doctors are determined to save their clients, or "patients", from the "dangers" of a birth contract (plan), doula (they even spelled it wrong!), or the crazy Bradley teachers like myself!

If you have a doctor who ignores the evidence and/or your wishes, he is looking out for himself, not for you or your baby, despite making comments like this. This sign makes the reader feel as if these 3 things are unsafe and they are only looking out for your baby. Just the opposite! He or she wants to run the show. Waiting for your baby and body on your schedule is an inconvenience. They want you to have an epidural.

So, consumer beware. If you suspect, or know, that you have a doctor that holds these views, it's never too late to switch. You will only give birth to this baby one time. There are no second chances. Take control of your birth! Do not relinquish it to an ego-maniac doctor that tells you that you can't educate yourself, have a female companion to help you through labor, or have specific desires for this special day.

Thursday, October 22, 2009

Benefits & Stimulants of Oxytocin

This month I had the opportunity to attend the International Childbirth Educators Association (ICEA) Conference in Oklahoma City. I actually had to take a test for another certification (I passed!). The conference ran for three days and there are lots of things I'd like to share with you here.

In honor of all the women that I have due right now and in the next few weeks, I decided the first thing I wanted to write about is oxytocin - its benefits and how to make it flow!

Let's review for a moment: We hear so much about pitocin, but rarely oxytocin. Pitocin is the synthetic form of oxytocin. Oxytocin is what causes the uterus to contract. Released are also endorphins that help mom to cope -- even feel good. In other words, when oxytocin is released naturally, it crosses a blood-brain barrier to release those endorphins. When labor is started artificially with pitocin, or "pit", the uterus contracts without all these extra benefits I'm about to share.

Benefits of Oxytocin that you may not be aware of:
Mom experiences lower blood pressure and fewer stress hormones.
Her pain threshold increases.
Her sleepiness, even laziness, increases, causing relaxation.
Her muscle tension will decrease.
She will feel more calm and even more curious.
She will become more trusting and possible more daring.
She is more open to touch and be touched.
Oxytocin facilitates learning.

Wow! Who knew! Oxytocin levels are at their highest in a woman right after she gives birth. If you have given birth without medication, think back to how you felt right afterwards.

And did you know that women being together will also produce high levels of oxytocin. In comes the doula. Why is it that women are more able to relax and have fewer interventions and medications with another woman by her side in labor? We often assume that it is because she is more sympathetic or has been through this experience before. While these are often true, it's more than that. Think of when you have a girls night out. Oxytocin is flowing! Men will often report that their wives are in the mood for sex they come home from a girls night out. Oxytocin is often called "the love hormone" and makes us feel good!

So how do we get it flowing? There are many different ways. I always talk about nipple stimulation and sex as the number one way. This weekend, another educator reported that some serious kissing can often get oxytocin flowing more than nipple stimulation. If you have read anything by Ina Mae Gaskin, she'll probably say the same thing. Following is a list of several contributing factors to the natural production of oxytocin:

Ways to get oxytocin stimulated:
Warmth
Sex
Stroking
Descent of the fetus
Good food
Doulas/Companions
Low light
Mediation
Visualization
Positive thought
Movement
Suckling
Pleasant smells

Adrenalin is the opposite of oxytocin. If a woman in labor, or one who is trying to start labor, is under too much stress (ie. the threat of induction!), the production of oxytocin is squelched. Too much stress can actually stop labor. We've heard of the "fight or flight" response. It applies to labor as well. You can sometimes tell if a woman is under too much stress by looking at her eyes. Her pupils will likely be dilated instead of her cervix. Her digestion will slow, while her heart rate and blood pressure will increase. When this occurs, not enough blood will get to her vital organs and muscles, including the uterus.

The mind is a powerful, powerful thing. I was talking with one of my moms-to-be this week who was due about a week-and-a-half ago. I found out she was still working because she feels great. Better than sitting around waiting for baby to get here, right?! Wrong! I told her, no matter how the baby comes out, she will be a mother by the weekend. Her brain knows, when she's still working, that she has someplace to be tomorrow. Her focus needs to be on getting oxytocin to flow.

Relax. Take some time for you. Gather your girlfriends for some plain ol' fun. Go see a movie. Take a warm bath. Close your eyes. Take some good deep breaths. Enjoy the end of your pregnancy. Burn a favorite candle. Get a pedicure or foot massage. Wrap yourself in a warm blanket and read a book. Nap. Make out with your hubby and have some great candlelit sex. Let the oxytocin flow. Don't fight it. I feel good just writing all this!

Sunday, October 11, 2009

Dr. Seuss Had a Way With Words

My son found this quote for his leadership class and I thought I'd share. I found it most appropriate for my blog:

"Be who you are and say what you feel because those who mind don't matter and those who matter don't mind."

Friday, September 25, 2009

Tim McGraw & Your Banned From Baby Showers Moments

My life has been so busy -- who isn't, right? -- but every now and then, I'll find myself thinking, "This would be so great to put on the blog." There are many topics that I have written in my head, but just have not sat down to write.

If I may, I would love to tell you some of the totally unrelated things that have been happening in my life. Those of you that know me will appreciate this, and may already know all about it!

As I mention in my paragraph about the blog, I am an enthusiastic member of the Tim McGraw fanclub. I've been a member for almost 10 years, seen him 9 times live, done a Tim McGraw Cruise, etc. Well, a few weeks ago, the fanclub members were told about a taping of "CMT Invitation Only: Tim McGraw" that would be recorded in Nashville. It was very hush-hush. Needless to say, I got an invitation and flew to Nashville 10 days later! I got to see Tim perform in a studio with 99 other people. I was one of the lucky people that got to sit front row, too. It really was a blast. I was so lucky to get to go do that. My husband is the most supportive guy ever. He was picking out my dress online when I found out I got an invite! It made the whole event that much more special, especially since I went all alone. (Actually, my aunt and uncle met me there and I was so lucky to have them all to myself, without my kids fighting for their attention.)

So if you have Dish Network, it will air on October 1. Otherwise, it will air on CMT on November 6. Exciting stuff. I, assuredly, will be the overly happy fan in the front row!

OK, on to birth stuff:

I have talked with so many people lately who have told me funny stories about conversations they have with people about birth and how they just have to keep their mouths shut. When I say, "You had a banned-from-baby-showers moment," they seem to be confused. Maybe I haven't been clear about why I really don't go to baby showers. I want to keep my friends. It's a simple decision. Either give information or zip it! Since baby showers and playgroups seems to be where I hear the most absurd birth stories or "my doctor said" stories, and I just cannot keep my mouth shut, I have to stay away. This way, I keep my friends. If they want information, they know where to find me.

So, I want to hear your banned-from-baby-showers moments. Did you speak up? Did you share your experiences? Did you want to, but didn't? Have you lost friends over birth and breastfeeding issues? I have. There are people that I simply cannot have this conversation with.

Feel free to vent! I am getting more tolerant in my "old" age (tonight someone guessed I was 28!), I like to think. I actually have read so much more material over the last year or two. It helps.

If you find yourself in these situations a lot, one of the most powerful suggestions you can make to a couple is that they look into midwifery care and why you chose to use a midwife. Birth Networks are sprouting up and are also a good place for couples to seek out evidence-based information.

I look forward to hearing your stories and how you handled these delicate situations.

Friday, September 4, 2009

Chicken Pox Vaccine

This has been a hot topic for me over the last few weeks. Our school district just announced that they require kindergartners to have, not only the original vaccine for chicken pox, but the booster as well.

This was a brand new vaccine the year my son was born. When he had it, they didn't know how long it would last or the severity of the chicken pox if he did get it. Not real helpful, but I dutifully got the vaccination, which was optional. My second and third children also received the vaccination.

Fast forward 4 years after more reading and knowing several children that have had chicken pox despite having the vaccine. The amount of time between boosters is getting shorter, too. We are the guinea pigs for this vaccine.

I talked with my pediatrician during the spring about this topic, before the school district made this their policy. She really wanted my oldest, 13, to have the booster because if he got chicken pox, it would likely be shingles at this point. I am probably okay with that decision.

I had been hearing so much more about shingles over the last few months, so I read up on it a bit more. I did not realize until a couple of years ago that shingles is basically chicken pox as an adult. It can be very painful and even life threatening. Chicken pox, when a child gets it, is rarely dangerous.

Years ago, as adults were around children -- and the population at large -- getting chicken pox, this was a good thing because it acted like a booster, protecting them from shingles. Now that chicken pox has been virtually removed from our US population we are seeing lots of older people having to get a shingles vaccine or actually getting shingles. We are giving a vaccine because of a vaccine! Just letting children get chicken pox would have been so much simpler.

So, now, if you decide to not have your child vaccinated against chicken pox and they are fortunate enough to actually get it, they will not have the natural booster of being around people with chicken pox throughout their life. They will eventually be forced into getting the shingles vaccine. Do you see where I am going with this? Americans have been forced into this system of vaccinations.

Don't get me wrong. I am not against all vaccinations. I think they have done some good things. This particular vaccination, however, is ridiculous. I am left with deciding, do I vaccinate my fourth child now, or in 10 years?

I live in Texas and it was incredibly simple to get the waiver for school. It is not a state law to immunize your child. The school nurse at my son's middle school recently sent home a paper that said that it was a state law that your child be current on his/her immunizations or they could not sit in the classroom. That is a false statement. Do not be bullied into immunizing your child if you do not feel good about it. Read up on it and be informed.

We will all be affected by this, not just our children. Good luck with this particular immunization -- now and throughout your life and your child's life.

Wednesday, August 19, 2009

Potty Training Gimmicks

On the local news tonight, there was a story about potty training your child in one day. They had my attention. My shortest attempt at this was 4 days. Four bad days, but then they were over.

Before I go on, let me remind you, the reader, that urinating and defecating are normal bodily functions that will happen no matter what you, the parent, do. Your child will learn to use the toilet and will not wear diapers forever.

Potty training is an interesting process. Some children will essentially do it themselves, as my husband seems to think ours did. Most will not. I have potty trained four children and they were all very different experiences and ages:

Child #1: 3 yrs., 3 mos. old
Child #2: 2 yrs., 7 mos. old
Child #3: 2 yrs., 6 mos. old
Child #4: Tried at 2 yrs., 4 mos., but after a month, gave up. Took an entire month to potty train at the age of 3.

Those were intense days with lots of frustration and tears from all parties (except my oblivious husband!), but we got through them. You will too.

Back to the story on the local news: A mom had attended a workshop put on by a woman who started a business to "help" parents potty train their child in just one day. The disclaimer was that it might take a week or more, and there's lots of prep time working up to the ONE BIG DAY. She sells a baby, a baby potty, and a bottle (grrrrr!) to give the baby so that it has to "pee." She charges a whopping $50! What a business woman -- playing on parents' fears and frustrations to make a buck. Think of all the human beings that have survived on the planet without paying $50 to teach their child to do something that they will do naturally. My husband says she is clever and she'll "make out like a bandit." I'm sure he's right.

Dr. William Sears advises letting your child run naked for a few days. He or she will figure out pretty quick where the pee is coming from and will start to recognize how it feels right before it comes out. I always made my kiddos help clean it up, which was a great deterrent from doing it again. Doesn't that sound cheaper?

And what about this "Elimination Communication" -- did I even call it the right thing?! I feel like John Stossel from 20/20: "Give me a break!" Do you want to enjoy your baby's babyhood, or spend it trying to potty train? The idea, apparently, is that if you read your baby's cues, you can put him or her on the toilet before they pee, or poop, in their diaper. Ok. But what if your 6-month-old has to pee and he actually knows it (which he doesn't!)? He can't get up, walk himself to the bathroom, undress, and situate himself so he can pee. Of course, I am exaggerating, but can you see how absurd this is? And what's the point? Do you care about not changing diapers that much to go through this? Do people who do this think their baby is smarter?

I could go on and on about this. It seems to be a new fad. One I think is totally lame. Changing diapers is part of being a parent. Your baby does not need this "pressure," if he's even old enough to understand that he's not doing what you want him to do. How much of a person's day must be spent doing this who buys into this crazy philosophy?

ENJOY YOUR BABY! POTTY TRAIN WHEN YOUR TODDLER IS READY. You cannot potty train a baby. Sorry.

Saturday, August 15, 2009

Google Searches Leading to My Blog

When I check my Google Analytics, it is so fascinating to see how people get to my blog. First of all, I have my blog address on the back of my car with vinyl lettering. I get a lot of traffic from that. People are curious about the title. Someone even asked if I was banned from all such social gatherings -- weddings and the like. Did I have a Texas-sized opinion and couldn't keep my mouth shut? Something like that! David reminds me though, that my "opinions" are based on FACT that are supported by evidence.

But the number one topic that concerned parents have been googling is "ultrasound and autism" and their connection. I am relieved to know that parents are concerned about this and are gathering information before just jumping in. Month after month, it is the number one concern.

Number two, most of the time, is parents trying to find out about the different birthing techniques: Bradley, Lamaze, and Hypnobirthing.

Number three, typically, is "the big baby." As we know, moms are being freaked out by their doctors and told that they "need" c-sections. Again, glad to see that moms (and dads!) are doing some research on the subject. Trust your body!

I also get lots of parents questioning co-sleeping and bed-sharing. It's gotten a lot of publicity over the last year or so, and I suspect that parents are being told that it is not safe. Parents are checking that out. As a former bed-sharer and co-sleeper, I highly recommend it. I miss it terribly -- some of the time!

Lots of questions, also, about breastfeeding and gassy babies. Women are looking for a list of foods NOT to eat while they are breastfeeding. It's on the blog.

Every now and then, I get some really funny things that people have googled, like "how big is too big for a baby shower?" or "how do I manually dilate my cervix?" or "can my husband check my cervix?" I don't check this list too often -- maybe two or three times a month -- just enough to know what parents are researching, and hopefully getting some information they find helpful here.

Someone in India was looking for breastfeeding quotes. I'll leave you with my favorite: "Breastfeeding is a mother's gift to herself, her child, and the Earth."

Just an Observation...

As a birth professional, I have noticed something interesting: the majority of women who have given birth, believe they are a "birth professional" simply because they have had a baby, even if it was with medication or a c-section. They "had to be induced" because... They "had to have a c-section" because... Most of the time, those reasons are totally bogus. But they think they really know about it because they have a child. It makes my profession much more difficult. The "student" is often not teachable. Just an observation...

Just because I drive a car doesn't mean that I understand how it works, how to fix it, or how to make it run better.

Sunday, August 2, 2009

Random Questions and Answers

There are lots of questions that have come up, some even through email. I have wanted to sit down and write for a long time, but just haven't had the time. At the current moment, my husband is watching a nature show on TV with the kids, the laundry is put away, and I'm going to write until someone is demanding my time. Only 3 weeks left of summer vacation...

Question #1: Genie asked:
Could you talk about what you know and your experience with herbs (before and during labor and with oral and internal use)?

Answer: Genie, my response is probably not very exciting. I really do believe that the body knows what to do and when to do it. I believe that labor starts when the mom and baby are both ready. I know a lot of midwives love to use herbs the last several weeks of pregnancy to soften the cervix. This is a personal choice for each couple to use them or not. I do not believe that it is necessary in the majority of labors. My personal experience, which has definitely helped me arrive at this conclusion, was the use of herbs with my third pregnancy. It was our first homebirth and our midwife was a huge proponent of taking herbs the last 5 or 6 weeks of pregnancy. I did exactly as she prescribed. I did have my baby at 39.1 weeks, but it was my longest labor and what I consider my most difficult. "Emotional relaxation" was a challenge with that labor, and I had not prepared as I should have. I just don't think that the herbs made a difference for me.

To be perfectly honest though, I don't know anything about using internal herbs and most of what I have read about deals with using herbs to either soften the cervix prior to labor or using them to start labor. I have not read anything about using them during labor itself.

If you are contemplating using herbs, learn all you can about why you being advised to take them. Find out if there are any side effects to their use. Is there any danger in taking them? I am sure there are people out there who will have plenty to say about this response, and that is ok. I have not read that much on the topic because I don't believe that all women should use herbs in pregnancy. It's just not a part of the natural process.


Question #2: Genie asked a follow-up question:
The mixture 'start up' caused my hands to start swelling (according to our midwife) during labor - can that affect the cervix as well?

Answer: I'm curious what was in your "start up" mixture. When I lived in Albuquerque, I had developed a breast infection when my 4th baby was 3 weeks old. My wonderful midwife, Barb Pepper, recommended I go to a specific herb shoppe to get a "mastitis remedy." She emphasized how important it was to deal with someone who knows exactly what they are doing because mixing herbs was a very delicate science. That made a big impression on me. The herbalist told me that it was very important to take the tincture exactly as prescribed, as it could be lethal if taken inappropriately. I never had to take antibiotics, I followed her instructions, and was better within a few days.

Sometimes, I think we get this attitude that "it's just herbs," not medications, and don't take it as seriously. I don't know your midwife, or her background with mixing herbs, or where she got her "start-up mixture," but swelling hands in labor isn't normal (unless you have an IV) and I would find it bothersome and maybe even uncomfortable. I don't know if the mixture would affect the cervix, but it affected your hands! Again, it just goes back to these concoctions not being a part of the natural process. Your body knows what it is doing without being confused by adding herbs to the laboring process.


Question #3: Jess asked:
I've heard pushing too soon can harm the cervix, but I was told to push at a 9 or 9 1/2, to "push out the last inch." Apparently I pushed out my cervix with my baby's head. No one seemed to think much of it and I can't seem to find out if this 'means' anything. My baby is almost a year and as far as I know everything down-there is ok. Could there be problems in the future?

Answer: There is conflicting information about pushing "too soon," as you discovered by your own experience. I'm curious if you had an uncontrollable urge to push or if you were just told that it was ok to "push out the last cm." Sounds like it was the latter of the two. Physiologically speaking, I don't think it is possible to push out your cervix with the baby's head. When you are dilated, especially at a 9 or 9 1/2, the cervix pulls up over the baby's head. If there is that little cervix left, it is still very high, certainly not something that would be "pushed out" with the baby's head. I hope that makes sense.

Briefly, on this subject of dilation, it is somewhat subjective. One nurse, or doctor or midwife, may check you and find the cervix at a certain number of cm., and then another will get another "reading." You easily could have been fully dilated. Did you have pain when you were pushing? That sounds like a crazy question, I know! But I am talking unusual, intense, internal pain. If the cervix were truly being pulled down with the baby's head, that would be intensely painful. Anytime the cervix is being forced to move in an unnatural manner, there is intense pain. For example, pushing a lip, or rim, of cervix back, or pulling the cervix forward. Your description of how you feel now leads me to believe that everything is just fine!


Question #4: Christina asked:
What are your thoughts on Prenatal Vitamins? Like prescription kind, vs like natural herbs and supplements?

Answer: Truthfully, I don't know what the difference between prescription and OTC prenatal vitamins would be. The American perception is that the prescription must be better because it's harder to get, but I highly doubt this to be true. My honest opinion on this topic is that if you are a mindful, thoughtful eater, aware of eating a variety of foods, vitamins and minerals, proteins, calcium, etc., etc., you probably don't need prenatal vitamins at all. Some people reading this are up in arms, I am certain!, but I think everyone would agree that it is better that your vitamins and minerals be taken from your food instead of a pill. This is up to each woman to decide early on in her pregnancy, or earlier if possible, if she is willing to really be on top of her diet and nutrition. If she isn't, or she knows that she doesn't eat enough of a certain food group, taking a prenatal vitamin will give her a peace of mind.

As a side note, some women report feeling sick to their stomach from taking their prenatal vitamins. Taking them before bed is helpful, but talk to your pharmacists about other things you might be taking at the same time. For example, I was taking iron supplements with my first baby, along with my prenatal vitamin, and Tums for heartburn. I would take them all at once, right before bed. My iron levels were never coming up. When I mentioned this to the pharmacist, he said that the calcium in the Tums and prenatal vitamin were interfering with the iron absorption and to take the iron supplement with a glass of OJ, or vitamin C -- something that would encourage iron absorption.

As far as taking herbs or natural supplements, I think you should question exactly why you are doing so. A prenatal vitamin is just that -- full of vitamins and minerals that may be lacking in your diet. Herbs are not vitamins and/or minerals. Something else to consider is that while there are plenty of medications, etc. that pregnant women are told that are safe, nothing has been proven to be safe. There are medications, such as ibuprofen, that have been proven to be unsafe, but it would be unethical to try to prove a medication safe. My advice is to take as few as possible medications, herbs, or supplements, into your body while pregnant. Eat a variety of foods and take good care of yourself. Your baby will thank you!


Question #5: Genie asked:
I have another thought. Have you heard anything about midwives trying to manually dilate the cervix? I just discovered that this was attempted on me while at 3cm!

Answer: I bet you know what I'm going to say before I even say it! This is not a part of the natural process! Labor is about so much more than just dilation! First of all, manual dilation is usually very painful. Sometimes, if a mom isn't dilating, it is because the baby is still high in the pelvis, not pressing down on the cervix, helping it to dilate. Forcing the cervix to dilate is not necessarily going to bring a baby down. Lots of movement, rotating the hips, changing positions, etc., will encourage a baby to come down. The rest will take care of itself. I rarely hear of a pleasant birth experience when the mom's cervix was manually dilated. Not a fan.

With that being said, everyone knows that I am an advocate of midwifery. You will almost never hear of an OBGYN manually dilating the cervix. He or she will use pitocin to dilate the cervix. Meanwhile, no one is doing what really needs to be done, which is to get the baby into a better position by helping and encouraging the mom to change her positions!

Question #6: Katie asked:
If you have any other thoughts or ideas about circumcision (besides the 2008 post) I'd love to hear about it. I had no idea there were so many people not doing it anymore.

Answer: No, Katie, I really don't have anything else to add. The information I've included in that post is what I teach in my class. I've had a number of interesting discussions about circumcision on Facebook over the last few months, but a lot of them end up in a religious discussion, or debate, as the case may be! I have a feeling that you have a specific question or want specific information. Feel free to ponder that and get back with me!


Question #7: Katie asked:
How about baby wearing. I know you are for it and realize there are tons of benefits to wearing. I've been wondering if you can do it to often or long. I googled it and didn't find much definitive information just lots of people for or against it. Thanks!

Answer: Katie, that is an excellent question. I think a lot of people probably have that question, or concern, but don't ask it. I think our parents generation really emphasized "spoiling" their children, or rather NOT spoiling their children. They really pushed us to be independent. "Attached" would have been a bad word a generation ago!

As far as wearing your baby "too often" -- all mother-baby sling relationships will be different. Some babies want to be in the sling more often than others. Some babies are high-need babies and need to be held more often, for whatever reason. Some babies are content to be on the floor more often. If wearing your baby more often makes your baby more happy and content, you can't do it too much. A happy baby equals happy parents! A great chapter to read on this topic is found in "The Baby Book: Everything You Need to Know About Your Baby - From Birth to Age Two" by Dr. William Sears. The chapter is titled "Babywearing: The Art and Science of Carrying Your Baby."

As far as carrying your baby "too long," most children, especially attached children, will develop a healthy sense of independence and desire to explore on their own. They will want to walk. This is bittersweet as a parent. It's at this point that you wish they still wanted to be in the sling! And sometimes they will. Let them. They will let you know their needs. Let them know that they can trust you to meet those needs. All of my children quit using the sling between 2 and 3 years. We were rarely using it at that point, but it was always in the car to be used in a pinch. The last time Daymon was in his sling was in a furniture store at 2 1/2 years old. The last time Darcy was in her sling was when I was ordering food at Six Flags and couldn't have her running around where I couldn't see her. She was 3 years old. I probably hadn't used it in months though.

All of my children are very independent and none of them would describe themselves as "spoiled!" Wear those babies as often and as long as they'll let you. That time is so short and it will end. Your children probably won't even remember it, but they'll remember the feelings fostered by knowing their needs were met. You'll remember it, and treasure it, and long for those days again, long after your children are taller than you are.


Question #8: Regina let us know that she watched "The Business of Being Born" -- and she was going to have her husband watch it too! Yea! Such a great movie. If you haven't seen it, what are you waiting for? You can watch it through Netflix or even check your local library.


I also received some questions through email and Facebook that I wanted to put up, but I think my family is ready for me to be done with this "project." Hope this was helpful. As always, feel free to add your two cents!

Sunday, July 12, 2009

Questions? Topics? Gripes?

I have not forgotten about my blog! My kids stay up late in the summer and I usually write when they go to bed at night. Thus, I have very few posts written since school has been out.

I have a live class going and 3 couples taking my class by DVD. Movie screenings, forming a Birth Network, and working with fellow Bradley instructors has kept my birthing corner busy! Not to mention water parks, sleeping in, and road trips.

I am working on a post based on the 10 questions to ask your doctor by CIMS. If you want to peek ahead, you can check that out at www.motherfriendly.org.

In the meantime, throw out any questions or topics for me. Let's talk.

Thursday, July 2, 2009

"Orgasmic Birth" Screening July 11


"Orgasmic Birth" will be shown at the Mansfield Public Library, Mansfield, TX, on Saturday, July 11 beginning at 7:00 p.m. "Orgasmic Birth" was featured on 20/20 recently, and has contributed heavily to couples seeing a completely different side of birth that we have been taught to believe. I was fortunate to meet Debra Pascali-Bonaro, the director and creator of the movie, at the "Controversies in Childbirth Conference" and am excited to share some of her thoughts about the movie, including how she came up with the name!

If you live in the DFW area, I encourage you to come. Bring a friend, or better yet, your spouse! It is free and we'll have discussion afterwards. Hope to see you there.

Tuesday, June 16, 2009

Beta-Endorphins and Their Affects on Pain Perception in Labor

I have come across the most fascinating graph dealing with beta-endorphin levels at different times in a woman's life. I want to share it with you.

This made me think back to the "Is Labor About How Tough You Are?" post I wrote several weeks ago. Interestingly, we all agreed that labor is NOT about how tough you are.

I have previously mentioned that the body produces endorphins in labor -- when drugs do not interfere with the natural process -- to help a laboring woman "deal with" the intensity of labor. When an epidural is introduced, those endorphins are squelched. It used to be advised that women let the epidural wear off when it's time to push, but most women found this too difficult. (I was one of them with my epidural birth.) A big part of the problem is that her body is not producing those endorphins at an increasing rate to coincide with her labor. Being flat on her back is a pain-inducing position to a woman about to push her baby out, so it is a double-whammy!

Beta-Endorphin Changes During Pregnancy and Labor:

Non-pregnant: 58
First trimester: 58
Second trimester: 33 +/- 1.9
Third trimester: 49 +/- 2.7
Early labor (cx < 4 cm.): 202 +/- 32
Advanced labor (cx > 4 cm.): 389 +/- 78
Postpartum: 177 +/- 22
Awaiting cesarean birth (not in labor): 151 +/- 23


This, to me, is proof that our body knows what to do. "Pain tolerance" is a moot point when looking at these numbers.

Thursday, June 11, 2009

The Milk Study: Using Breast Milk to Screen for Breast Cancer and Assess Breast-Cancer Risk

A friend of mine just sent me a very interesting link that I wanted to put up here for those interested. There is a study done through Army of Women to test breast milk to weigh the odds of a woman developing breast cancer. Check it out.

According to their website, here is a brief summary of the study:

The purpose of this study is to determine if breast cancer and breast cancer risk can be accurately assessed from a breast milk sample. Currently, there is no accurate way to give women information about their personal risk of developing breast cancer. We will use the cells naturally present in breast milk to examine changes in DNA that occur in association with benign and cancerous breast lesions. Learning about the genetic changes associated with both breast cancer and non-cancerous breast lesions will help us develop a way to provide women with information about their breast cancer risk. Using breast milk to screen for breast cancer will reduce unnecessary biopsies among nursing women.

Who can participate? Women who are currently breastfeeding a baby, or women who are either going to have a breast biopsy in the near future or you have had a breast biopsy in the past.

This is what is involved in participation:

You will be shipped a milk collection container, informed consent form, and questionnaire. You will be asked to complete the consent form and questionnaire and to donate about 2.5 ounces of fresh breast milk from each breast. You will put the consent form, questionnaire, and breast milk in a box that will be picked up by Fed-Ex. You will be asked to provide a copy of the biopsy report. Approximately 1 year after sending your breast milk sample, the researcher will contact you to ask about any breast problems you have had in the last year.

As with all testing, I'm sure there is a false-positive, as well as false-negative, rate that will have to be considered. Women should continue with self-exams, regular check-ups, and mammograms. Science is amazing. I hope this will be a helpful tool in the cure for breast cancer and early detection.

Sunday, May 24, 2009

Can Your Husband Be Your Doula?

It seems like a very long time ago that I posed this question! In fact, I think it was two weeks ago. I bet y'all had about given up on me to ever write the post. You would not believe how much I have gotten done around my house over the last two weeks, in preparation for summer vacation. So, while those things have gotten done, the blog has suffered. I apologize.

I also knew that I have so much information on this topic, so much to say, that I was probably a bit overwhelmed to sit down at the computer to write it. I'd like to post some of the email from a former student/Bradley-teacher-in-the-making that started it all:

"There are a few things I think Bradley has a little off, and I think the whole idea of the husband being "the" labor help person is one of them. It probably sounds preposterous, especially since I am looking into becoming a Bradley instructor. But I agree with Martha Sears in The Birth Book where she says that it is better for the husband to be freed up to be "just" a husband to his laboring wife by a doula being there to help. I think you may agree with me slightly, since I remember you encouraging our classes to hire doulas if we could (and at the time thinking, "Why would we hire a doula? We're taking this class. This--husband--is my doula.").

Now, I am not saying that Bradley should not teach about husbands' involvement. I think it is one of the biggest reasons Bradley is one of the best preparations for natural birth. However, I believe that one of its greatest strengths (educating the husband about the physiological components, benefits and risks of different choices, as well as ways he can be a help in labor) is also a great weakness (raising the woman's expectations that he will be all these things she's been taught in class, even if that person doesn't remotely resemble who he has been throughout the pregnancy). In my experience, it did not happen that way, and I felt let down by my husband that he wasn't there for me the way that I needed him in Ruby's labor. I don't think I would have felt as let down if my expectations not been raised with the Bradley books and classes. What I eventually came to grips with is that I just can't have those kinds of expectations for my hubby (suggesting things, being observant, thinking of things on his own--like food, drinks, frequent bathroom breaks, how to make me more comfortable, verbal encouragement, the works!) and it does not say that he is a terrible husband because he didn't remember to do those things. When it comes to things like this, he is happy to do them, he just DOESN'T think of them himself. Especially on birth day. He needs coaching, and I am not the kind of person to do that while in labor. I just want him to KNOW."


Our results from the poll a couple of weeks ago were:

Can Your Husband Serve as Your Doula?

Even better! 30%

Are you kidding? 13%

He did alright. 56%


Hurray for the dads that did "even better" than a doula could have! I was surprised that the "Are you kidding?" category had so few votes! The majority, as I expected, fell into the "He did alright" category. This is where I would place my husband.

Thank you, also to those who contributed their experiences with their husbands and/or doulas. Some great comments. There was no right or wrong answer, obviously.

Quick history of "doulas" in America: Before birth moved into the hospital, approximately 100 years ago, men were not a part of birth. Birthing women had their mothers, sisters, aunts, best friends, and midwives attend their births. When birth no longer took place on their own turf, they could not take all these women with them. They were alone. Male doctors administered drugs that wiped women out entirely. The nurses, having several women to tend to, were all the female companionship a woman would have as she gave birth. Needless to say, her needs, emotionally and physically, were not met.

In the 1960s and early 1970s, the doctors and hospitals began to be pressured to allow husbands in the delivery room. Dr. Robert Bradley, with the publication of his book, "Husband-Coached Childbirth" advocated for women to birth without intervention or medication with their husbands "coaching" them through the experience. This was an exciting time for women and their husbands. A funny side-note to this time period: They wanted to give the husbands something to do, so the job of cutting the umbilical cord became his. They figured that he couldn't mess this up and he would feel like he had done something significant. It's really rather demeaning to think this is all the husband can do when it comes to birth.

In the 1990s, we started hearing the word "doula" or labor assistant. My first baby was born in 1996. My sister-in-law, who happened to be a doula, was present at our birth, and without her, I am certain that I would have had a C-section. And while I never paid an actual doula money to attend my subsequent births, I was always surrounded by my friends and family. And, of course, I had my Bradley-trained husband! (He was fantastic on the 4th birth!)

Many of the women who commented on their experiences, said that their husbands were a better doula with later births. There are many things that play into this: First of all, he has been through it before! But perhaps even more importantly, he has listened to his wife talk about what she likes and doesn't like in labor, probably many times over the years! He has attended other births and that gave him knowledge and experience. He knew what to expect. Imagine hiring someone who has attended dozens or hundreds of births -- the experience she brings is beyond helpful -- not just for the laboring mother but for the father-to-be.

There is a page in the Bradley workbook that is titled "Whose Job Is It?" Fortunately it appears in Class 11 instead of Class 1 because if I was a husband, looking at this list, I'd have to insist that she have an epidural because I didn't sign up for this! It is a list of 50 things that Dad should be doing. So if the mom has a C-section or an epidural, does that mean Dad failed at his list? He didn't do his job? It's just too much to put on a new dad.

With that being said, I do feel like my Bradley class prepares Dads extremely well for labor and birth. He comes away with good general knowledge of pregnancy, labor, how to help his wife in labor and birth, interventions, avoiding a C-section, consumerism, questions to ask, adjusting to life with a new baby, and breastfeeding. But the fact remains, when his wife is dilated to a nine, but the cervix has a lip, will he remember what positions are good to help with that? Maybe, maybe not. But a doula, who sees this very often, will know how to help. It's like the comment in the beginning: a lot of husbands want to help, but often need to be told how to help. Even with 12 weeks of class, a lot of husbands will not think of helpful laboring positions depending on what "symptom" mom is having. The more one reads about and attends births, the more experience and expertise they will have. In my expereince as a Childbirth Educator, the dads are not the ones reading about birth!

Dads must be advocates for their wives. It is important, even crucial, that he understand the birthing process, and that they do everything they can, as a couple, to prepare for this life-changing day. Doulas cannot speak for their clients, but husbands can speak for their wives in the delivery room. She will not be able to be her own advocate when she is in labor. A doula is familiar with the birth setting and terms, equipment used, etc., and it is easy for many dads to be overwhelmed by it all, especially the first time through. A doula, as Hannah said, is not so emotionally involved and can often help navigate the way through to a great birth.

Here are the simple facts:

Women have better obstetrical outcomes when they are accompanied throughout labor by a doula. She will provide emotional, physical, and informational support to a couple in labor. The presence of a doula reduces the C-section rate by 50% (!), the length of labor by 25%, the use of pitocin by 40%, the need for forceps by 40%, the request for pain medication by 30%, and the use of epidural anesthesia by 60%.
If you are planning a VBAC (Vaginal Birth After Cesarean), statistically you are more likely to achieve a VBAC with a doula by your side.

Women who have a doula are more likely to report feelings of having coped well with labor and a greater satisfaction with their birth. They report having less anxiety after the birth and even an improved relationship with their partners after the birth. (Perhaps, in part, because the pressure was off of dad and he could lovingly support his wife without the "coach" role.) In addition, women who have a doula report higher self-esteem and lower postpartum depression and anxiety 6 weeks after the birth.

Babies also benefit from a doula being present for their labor and birth. They have fewer neonatal complications, fewer workups for sepsis, and fewer health problems at 6 weeks of age.

If you decide to have a labor assistant at your birth, ask around. Interview. Some cities have "Doula Teas" where you can go and meet lots of doulas and find one you like. Find out their personal statistics. I once heard of a doula that had a 90% epidural rate! That tells you that she isn't sure how to help you! You also might consider having a friend or two with you. Be sure they are supportive of natural birth and/or have given birth naturally.

Congratulations for making it to the end of this insanely long post. I hope you can appreciate why it took me so long to sit down and type it out.

I want to leave you with a single thought: Many times over the years, I have heard couples say how glad they are they hired a doula, but I have never heard anyone say, "That was the biggest waste of money."

Friday, May 8, 2009

Can A Husband Be a Doula?

I throw out this question because I want your opinions and experiences before I continue from here. I had a former-student-turning-Bradley-Instructor pose this question to me a few weeks ago, and I've been thinking about it ever since. Remember, the Bradley Method of Natural Childbirth is based on the book by Dr. Robert Bradley, "Husband-Coached Childbirth."

Let's hear what you have to say before I throw out statistical data, etc. Looking forward to hearing from you.


Sunday, May 3, 2009

"Orgasmic Birth" Needs Your Help by June 1st

Debra Pascali-Bonaro, Director of Orgasmic Birth, along with Elizabeth Davis, CPM, are putting a book together and they need our help. Here's your chance to be famous! These are Debra's words from Facebook:

"Elizabeth Davis, CPM and I are writing Orgasmic Birth: Your Guide to a Safe, Satisfying and Pleasurable Birth Experience to be published by Rodale in spring 2010. If you have any great comments about sex during pregnancy please share and encourage other too and/or pleasurable, ecstatic and orgasmic birth stories. Thanks!

We appreciate all stories and comments to us by June 1. The sooner the better, especially any comments about how women felt about sex during pregnancy. Thanks so much for your help. I really appreciate it! Please ask people to submit to us on our web site www.orgasmicbirth.com/share-your-birth-story"

Don't be shy. Rethink your births and submit them. What an exciting subject to be famous for! Good luck!

Thursday, April 30, 2009

Autism Links to Ultrasound and Other Obstetrical Procedures

No one wants to believe that there could be complications or problems with using this device that American parents are so in love with!

Simply put, ultrasound changes the way cells grow. Ultrasound has been linked to a number of things, but the one I want to focus on here is autism.

One in every 150 kids has a form of autism in the United States. This rate has grown tremendously over the last decade. Now let's talk about ultrasound for a moment. When I had my first baby, in 1996, nearly 13 years ago, I remember desperately hoping that my insurance would cover it. Back then, they didn't do them unless there was a "medical reason." (I don't remember my "medical reason".) Gradually, the reasons started including things such as accuracy of the estimated due date. Now, everyone's insurance covers ultrasound, usually not just one, but several. I even had a student last year who had a doctor who routinely did ultrasounds every week starting at 36 weeks. Parents are excited about this, not knowing the risks they are taking with their baby's well-being. Rates of increased ultrasound usage correlate with the rate of autism diagnosis. They have both risen dramatically, simultaneously.

I had read about the possible link between ultrasound and autism about 5 or 6 years ago. It made so much sense to me. There has always been warnings linked to ultrasound, but I rarely talk with a pregnant woman who has been made aware of any warnings before having an ultrasound.

For example, a study in 1993 found that babies exposed to ultrasound were twice as likely to develop delayed speech. According to the FDA, "While ultrasound has been around for many years, expectant women and their families need to know that the long-term effects of repeated ultrasound exposures on the fetus are not fully known."

Researchers reported, in 2005, "Obstetric ultrasound should only be done for medical reasons, and exposure should be kept as low as reasonably achievable (ALARA) because of the potential for tissue heating. Temperature increases in utero have been shown to cause damage to the developing central nervous system of the fetus." In 2006, a study warned that exposure to ultrasound can affect fetal brain development.

Because there are no obvious deformities or problems at birth, we assume that all is well and "normal." It is likely several months or even years later, as the parents are going through testing, no one asks -- yet -- "How many ultrasounds did you have in your pregnancy?" I think that day will come though. As a side note -- what did you learn from all those ultrasounds? Probably that everything was just fine. Even if you were checking for something periodically, what would the difference have been in just waiting until the baby was born? Rarely can anything be done in utero. So why have all these ultrasounds to begin with?

Ultrasound, just like ANY drug in labor or pregnancy, has NOT been proven to be safe. Think about that for a minute. Take Tylenol for example. Women are told that it is "safe" to take it, but that is not necessarily true. It just hasn't been proven to be unsafe. Ibuprofen, on the other hand, has been proven to be unsafe. We know ultrasound changes cellular growth, we just aren't sure exactly what this means long-term. Links are starting to be made now, finally, after 30 years of use -- and damage.

Other research shows that populations exposed to ultrasound have a quadrupled perinatal death rate, increased rates of brain damage, nerve cell demlyienation, dyslexia, speech delays, epilepsy, and learning difficulties.

One more interesting note about ultrasound and the development of the baby. Ultrasounds, along with many obstetrical testing practices, has a high false-positive rate, meaning that parents are told something is, or may be, wrong with the baby. This causes the production of stress hormones in the mother which can have long-term effects on the baby's neurological development and behavior.

It is important to know that ultrasound is not just the scan where you see the pictures of the baby. Ultrasound includes the doptone used to hear the baby's heartbeat at your appointments with your doctor or midwife. (You can hear the baby's heartbeat with a stethoscope after about 20 weeks. This takes more skill, and if your provider is younger, they probably have no idea how to find the heartbeat of the baby without the doptone. If this at all concerns you, you should request to hear the heartbeat by stethoscope.) Another form, and perhaps the worst of them all, the Electronic Fetal Monitor, or EFM. This is often strapped to the mom for hours in labor, especially if she has drugs in her system. Once again, I have just given you another reason to not have drugs in labor. You'll still be monitored, but only a fraction of the time will be required, or needed.

I have to end this post with a simple, trust your body. Trust your baby. You will be seeing him or her in a short time. The risk of ultrasound simply is not worth it. If your doctor or midwife is pushing you to have more than one ultrasound (I understand wanting one to check things out), examine the reasons and the possible results. Can anything really be done during the pregnancy? Usually not.

For those of you who are curious, I pulled this information from a magazine called "Pathways to Family Wellness". Other obstetrical procedures linked to autism include: mercury in pregnancy, including the Rhogam shot, flu shot, dental fillings, and fish. Other procedures linked to autism: induction, epidurals, restricted laboring positions, forceps and vacuum extraction, C-sections, and umbilical cord clamping. Of all these things, ultrasound was at the top of the list.

Tuesday, April 28, 2009

Consumer Reports: 5 Things You Shouldn't Buy For Your Baby

Consumer Reports, who I usually respect, has come out with a list of 5 things that you shouldn't buy for your baby. Among them were co-sleepers and slings, stating that these items are dangerous, and even mentioned babies that have died when parents used them improperly. So they have stated that no parent should buy them at all. They didn't say a thing about all the babies that have died in cribs!

They went as far as to state that the safest place for a baby to sleep is in a crib. Evidence-based information will tell otherwise. No where did they mentioned having the crib in the same room as the mother, as this decreases the chances of the baby dying of SIDS. Not to mention for every 87 babies that dies of SIDS, only 3 breastfed babies will die of SIDS. I believe that FORMULA should top that Consumer Reports list.

And the slings... Oh my. I don't even know if this ridiculous claim that they are unsafe is worth addressing, and yet, we can't let it go! They claim that 4 babies over the last 5 years have died due to "skull fractures, head injuries, contusions and abrasions. Most occurred when the child fell out of the sling." Because of 4 babies dying, they are saying that no one should buy a sling? While this certainly is a tragedy, and I do not want to take away from that, the parents I sell slings to are obsessed with making sure they feel secure with their baby in the sling. I have NEVER had a baby fall out of the sling -- not even come close. I have seen, however, babies flip out of car seats when the handle was not locked and the baby wasn't buckled. Accidents happen. Maybe these parents had a faulty, poorly-made brand. Maybe the parents were not shown how to properly use their sling.

For the benefits of babywearing, you can read more about what I have written on this topic.

As for the credibility of Consumer Reports, I do really love my very reliable Toyota Sienna with almost 208,000 miles. They said it was a solid, "reliable" car. At least they got something right.

Saturday, April 25, 2009

Is Labor About How Tough You Are, Part 2

Sarah, a former student, brought up an excellent point which she posted as a comment under the "Is Labor About How 'Tough' You Are?" post. I want to share her comments before I comment:

"I'm glad you addressed this issue, Donna. Funny. It seems many women get told they must be "tough" to have handled NCB. I can't remember *one* time I've been told that. But most people who don't know me well don't know that I do NCB, either. I don't exactly advertise it! (Perhaps that makes a difference?)

Most of the time, if it does get brought up, women will think I must have had really easy labors. (Especially because I'm so positive about it--I'd love to do it again!) Some will even reply that *their* labors were **hard,** so *they* **couldn't** go natural; essentially cheapening all the hard work that went into my "easy" births.
I've said it before, but these responses remind me of a Napoleon Dynamite favorite quote of mine: "Lucky." Like I just *happen* to have NCB! It's annoying and a little demoralizing. I know I'm not alone in this, because I've had this conversation with my sister. But it seems like it's common with your commenters that people assume they're tough.

Like you say, it isn't about being tough. And, like you say, it isn't about labor being easy, either. I feel like all the education and preparation I did is completely overlooked when people assume that it was easy. (I think this may be why I don't advertise that I "do" NCB to general acquaintances.) It feels like a slap in my face, whatever it is they assume about me. And, no, it never has been that I must be "tough." I almost wish it were! At least that would be a compliment, right? The "easy" assumption is by far the usual response I get. Am I alone among your readers? Please address this issue, if you have anything to say about it! Thank you!"


My friend, Janet, after having a 3-hour labor with her second baby, routinely heard other women say to her, "Well, if I had a 3-hour labor, I could do it without an epidural too!" This totally undermines the work of that mother. Sarah has heard me say a number of times that a longer labor is "easier" than a shorter one. Your body builds up to the longer and harder contractions. Fast labors are usually one contraction on top of another, while the cervix dilates very fast.

I rarely have students go through my class who just decide that labor is too hard, give up, and have an epidural. But a few years ago, I had this woman go through my class who had an epidural when she was dilated to 4 cm. I was so surprised, and disappointed. I'll never forget what she said to me: she said that she thought her labor must have been harder than most women's labors. Aaarrhh!

Deep down, I believe that women know what is the right thing to do -- for themselves and their baby -- but they CHOOSE to ignore that intuition or instinct, and make excuses (my labor was too long, too short, too painful; I have a low pain tolerance, etc.) so they do not have to take responsibility for their actions.

I also liked your commentary, Sarah, on the fact that people believe that if you actually ENJOYED labor, it must have been easy. Part of why I enjoyed my labors was because it was HARD, and I did it! You cannot beat that feeling of accomplishment.

Comments such as these are meant to lessen what you have done. When my friend, Alisa, the one I wished would fail at NCB, had her baby without drugs, I easily could have made up reasons as to why she was able to do it and I wasn't. My reaction was different though, for some reason. I thought, "If Alisa could do it, I could do it!" I wish those of us who choose NCB could inspire that sort of confidence instead of these ridiculous comments that people make.