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!


Donna Ryan said...

Katie, just this morning someone left another (long) comment under the circumcision post from last year. It has lots of references and statistics that you might be interested in. Hope you'll check it out and find it helpful.

Kristen's Raw said...

Glad I found your blog... looking forward to following it. Excellent post!

I'm VERY much happy to make my diet a priority... yet I can't help but like to take my organic, food based prenatals... just in case. Even though I'm probably getting a balanced array of vitamins through my diet... I can't say for sure if environmental aspects or stress deplete those stores, so I'm under the impression that taking the prenatals helps me cover my bases.

Thanks for a great post!

Bella said...

It's so funny because with my first child, I basically did things that EVERYONE was telling me to do. I didn't want to "spoil" her and would let her cry, and it was hard! By the time #3 came, it made it so much easier to just put him in the sling and carry him. He was so much happier, and I was so much happier because I could actually get things done without the constant crying! The only difference came at night because he HATED to co-sleep! My first two loved it, but he refused to cuddle, he liked his space! Weird kid! hahah

Sarah said...

I just wanted to add my own thoughts about baby-wearing. With my first daughter, she was very high-needs and I wore her constantly (which was nice, because she was colicky and usually would only sleep if held). With my second daughter, she usually only naps if held, but doesn't seem to need to be worn as much. However, I probably wear her just as much, but more for my convenience than for her need. My daughters are 18 months apart and wearing the youngest helps me sometimes more than it helps her! :) Even still, with my 20-month old, either my husband or I will wear her if we're going on long walks or need her close by. She loves it and we do too!

oli said...

please support breastfeeding and
please vote for me

BPC40 - Oli aka Oli


Katie said...

Thank you so much this is very helpful, and can't wait to look at new circumcision post. I have already learned a lot since asking the question a few weeks ago.

Janet said...

Have to agree with Kristen on the pre-natal vitamin issue. I'm not aware of it causing any harm so I'd rather "cover my bases" and take them. Of course this does not give me the green light to eat poorly. Reality is that the majority of Americans probably aren't giving proper attention to their diets and bad habits don't end just because a woman gets pregnant unfortuneately.

Regarding herbs I had a GREAT experience with alfalfa tabs in my last pregnancy. While reading "Spiritual Midwifery" by Ina May Gaskin I ran across information on using alfalfa tabs to decrease the chances of hemorrhage. I was slightly anemic and since being anemic can increase your risk of hemorrhage I asked my midwife about taking alfalfa tabs. She said alfalfa tabs were innocuous--more of a food supplement--and it wouldn't hurt to take them. Since I was having a homebirth with my four children present I wanted to decrease the chances of hemorrhage and the drama that could potentially create. I can't remember when I started taking them--I think it was the last month or two of my pregnancy. If I end up having another baby I will definitely take them again! My post-partum bleeding was nothing compared to my previous children. The clots were not large and I did not bleed as long. It was amazing. My midwife had strict advice for me regarding resting time in bed after my baby was born and I followed it (can't remember how long it was but I it was days, not hours). I thought that this increase time to let my body recover may have contributed to my decreased bleeding but in discussing it with my midwife she felt that the alfalfa tabs were what made the difference as she had several moms who had taken the tabs but hadn't followed her post-partum resting advice and they were reporting decreased bleeding as well. I LOVE being pregnant, I LOVE labor and birth but I DO NOT love post-partum issues so this was such a blessing for me.

I have a friend who was planning a homebirth and her husband was not on board completely because during her previous two homebirths she hemorrhaged and passed out--which really scared him. I felt inspired to tell her about my experience with alfalfa tabs and she began taking them the last few weeks of her pregnancy. Weeks later her husband excitedly rushed up to me at church with a huge smile on his face saying, "It worked! She hardly bled at all!" He was amazed and very happy with the birth.

Isabel White said...

Hey, I have two more questions for you to cover!! ;)

1. Thoughts on perineal massage.
2. I keep hearing midwives insisting that new moms not go out or even go up and down the stairs in their homes for two weeks (or more) post-partum -- thoughts?


Donna Ryan said...

Isabel, excellent questions. School starts soon and I will be back to writing!!

never said...

a good way to bring up your iron levels is raw pumpkin seeds, those suckers are yummy and have tons of Iron in just a tablespoon!!!

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