Monday, December 31, 2012

Joseph, Dads, and Random Thoughts to Round Out 2012

I wanted to share this picture one of my best friends got for me for Christmas to hang in my famous bathroom.   Maybe you've seen it before, but it was new to me.  I loved it. 

"Nativity" by Brian Kershisnik

The focus on nearly all nativities is baby Jesus - rightfully so - followed up with Mary.  My animal-loving 7-year-old would say the sheep and cows are the second most important feature of the nativity.  Rarely do we focus on Joseph.  This depiction was one of the most interesting I've ever seen for 3 reasons.

Reason 1:  Mary can't see Joseph's face and he doesn't know all those angels are surrounding him.  He must have felt tremendous pressure all those months leading up to the birth, about to father the Son of God on Earth.  And then the strenuous journey with his laboring wife, not able to find someplace for her to give birth.  While he didn't have the media to provide him with scary birth images, I imagine there was some anxiety about the actual birth.  After the Savior was born, the relief must have been overwhelming.  I'm sure also on his mind was what was to come.

I just want to put this out there that I think many dads feel the way Joseph might have felt.  I'm sure he loved Mary very much and wanted her to be safe and happy.  I have lots of moms in class that want to birth out of the hospital, but the dads are scared.  I've seen a lot of emotions on both sides, but I just want moms to remember that he has likely been exposed to fear in our modern culture surrounding birth.  He loves you and may still have some fear of his own to work through.  It's a lot of pressure to become a dad, supporting and caring for his wife and new baby.  Help him through education, but have some empathy along the way.

My famous bathroom
Reason 2:  Mary is breastfeeding!  This is why the picture will find it's way to my bathroom walls.  I've commented before that of course she breastfed baby Jesus, and I'm sure she co-slept too.  "Away in a Manger" always cracks me up when we sing about "no crib for a bed" - surely it was written by an American, for I don't know that other cultures would worry about not having a crib!

Reason 3:  I love the angels surrounding the scene.  I'm sure the heavens rejoiced when the day finally came when Christ was born, come to Earth to save us all.  On a much more personal level, I believe angels surround each one of us.  I believe they are actually relatives that have already passed on, sent to help us by our loving Heavenly Father, to help answer our daily prayers on our earthly journey. 

As we round out 2012, it's been a wonderful and exciting year.  Launching Birth Boot Camp was intense, but I am so proud of what my team and I have put together.  2013 promises to be another great year.  I love the goal-setting aspect of starting a new year.  We have many exciting goals to accomplish, and I truly believe that getting there is half the fun!  May there be many babies born this next year by parents who have wonderful and empowering births.  Set a goal to breastfeed your baby.  It will be one of the greatest and sweetest experiences of your life.

A quote to end with by Theodore Roosevelt:  "Be practical as well as generous in your ideals.  Keep your eyes on the stars, but remember to keep your feet on the ground."  Thank you for allowing me to be a small part of your life this past year.  Here's to 2013 and another great year!

Monday, December 17, 2012

Combating Gestational Diabetes

Jenni Rongey, a co-Chapter Leader for the Tarrant County Birth Network, wrote this post for the Banned From Baby Showers readers.  I've known Jenni for a few years - she was Jillian in the BOLD Fort Worth production of  "Birth" two years in a row.  She had a VBA2C almost 2 years ago and you can read her birth stories here. She also works as a birth assistant at a local birth center.  She is a wealth of knowledge and I hope you walk away with a new perspective on dealing with gestational diabetes after reading Jenni's comments.  Thank you, Jenni, for sharing your expertise and story with us here.

"Diabetes has affected every part of my life but none quite so deeply as pregnancy. I have personally experienced many of the complications and risks associated with Type II diabetes in pregnant mothers. Multiple miscarriages, strict diets full of counting carbohydrate to protein ratio, insulin injections, pre-eclampsia , c-section, induction leading to an emergency c-section, babies with under-developed lungs that were separated from me for hours or days after birth.

Funny thing is I’ve also seen a diabetic pregnancy where none of those complications reared their ugly head. That was my pregnancy too. So what changed you might ask? I stopped listening to my doctors list off all the reasons why I was high risk and I couldn’t have a normal, uncomplicated birth. I realized that the only thing that separated me from my friends that had normal, low risk, out of hospital births was that I had blood sugar
levels that fluctuated from high to low and they did not. I just needed to figure out how to control my blood sugar levels without medication. Figure it out I did and like so many of our modern day diseases it was all about diet and lifestyle.

What I want to discuss are the measures a woman that has been diagnosed with gestational diabetes mellitus (GDM for short) can take to help boost her chances of having the birth she wants. Merely getting a birth without all the interventions is an uphill battle for someone with gestational diabetes. It’s even harder if you desire a natural birth or one out of the hospital. The best thing you can do is to educate yourself and keep your blood sugar tightly controlled and educate yourself. Did I mention that you need to educate yourself?

First you should know that gestational diabetes can be readily controlled without medication. It takes some planning and determination to stick with your plan but aren’t the things that are most important in life worth a little work? Let’s get to work.

10 Things You Need to Know to Keep GDM under Control

1. Understand Gestational Diabetes – 
Gestational diabetes is a condition where a woman that has never been diagnosed with diabetes suddenly has high glucose levels in the third trimester of pregnancy. Insulin is an important hormone in the body. Its two main jobs are storing fat for future use and escorting glucose (sugar) into the body’s cells where it can be used for energy. When a woman becomes pregnant her body naturally becomes insulin resistant to a degree. This means that some of her cells start refusing to let insulin do its job. Extra glucose is left circulating in her bloodstream where it ends up being metabolized by the fetus. This is the body’s way to secure a steady stream of energy for the fetus as it grows. By the third trimester the mother’s insulin resistance is higher so that extra glucose can be secured for baby’s fat stores before birth. In most women, the insulin resistance isn’t noticed because their pancreas puts out ever increasing amounts of insulin to keep blood sugar levels normal. However in some women, the pancreas just can’t keep up and despite high levels of insulin in the blood stream, blood sugar levels remain elevated. Being diagnosed with GDM does not mean you are diabetic. It can mean however, that you have a greater chance of developing type II diabetes in the future. Learn to take care of it now and you greatly reduce that risk.

2. Understand the Actual Risks of GDM
Big Baby Syndrome - Insulin works in the body by taking glucose out of the blood and putting it in cells for energy. It drives glucose first to muscles, then to the liver, and finally to store in fat. If your blood sugar
remains elevated the baby’s pancreas is left to deal with the excess. It will produce extra insulin which will help store glucose as excess body fat. That is how an uncontrolled diabetic mother can have a baby that is
too large. If your blood sugar is tightly controlled this is not an issue. By the way, if you do have a large baby there are several squatting style birth positions that open the pelvis by an extra 30%. This is a lot of wiggle
room. A large baby alone is not a reason for an automatic c-section.

Low blood sugar in the newborn – If your blood sugar has been chronically high or is high during labor then your baby may be born with low blood sugar. Remember that your baby’s pancreas puts out extra insulin to help get rid of the excess glucose in its blood. When the supply of excess glucose is shut off by birth, the pancreas still takes a while to slow down production of insulin. This can result in low blood sugars. Symptoms of low blood sugar in the newborn can be hard to see but they include irritability, lethargy, excessive hunger, and rapid pulse. For a baby exhibiting signs of low blood sugar the best cure is to put the baby to the breast early and often. Usually no other treatment is needed to help stabilize blood sugar as long as it is not dangerously low.

Significant increase in interventions – The most dangerous risk of being diagnosed with GDM is merely being labeled as a gestational diabetic.  A woman diagnosed with GDM has up to a 50% increased chance
of induction or c-section just by being diagnosed. She may also be subjected to frequent sonograms, non-stress tests, and other invasive and unnecessary procedures. Many doctors want to induce around 38 weeks to “make sure the baby isn’t too big.” If you keep your blood sugars tightly controlled and within normal range your risk of having an overly large baby is no greater than a woman without GDM. Educate yourself so you can defend your choices if it comes to that. If a natural or low intervention birth is what you are wanting, you will need to be ready to fight for it. The best thing you can do is keep your blood sugar in the normal range. Ready for the how-to?

3. Eat a Diet That Does Not Raise Your Blood Sugar and Insulin Levels.

If a food raises your blood sugar it will also raise your insulin. The pancreas will fight hard to put out extra insulin to take care of any extra glucose in the bloodstream. The damage inflicted by excess insulin circulating in the body is enormous but for the purpose of GDM I will distill it down to one important complication, pregnancy induced hypertension. Insulin raises blood pressure and this is part of the reason that women with uncontrolled blood sugar in pregnancy are at a higher risk of developing pre-eclampsia. So exactly what foods will raise your blood sugar and insulin levels? Glad you asked!

4. Go Grain Free
Grains are the number one culprit in high blood sugar with sugar close behind. Are you surprised that sugar isn’t in first place? Unless you are drinking gallons of corn syrup laden soda and eating Snickers for snack
everyday (and if you are, quit that!) most people consume more wheat, corn, rice, and oats than sweets in any given day. This makes them the number one food to control. Do you really need to cut out all grains, even whole grains?  The answer I’m afraid is yes, at least until you have had a week or two of absolutely normal blood sugar readings. Then add in whole grains, if you must, one serving at a time. Pay careful attention to how you respond to any particular grain. I personally can’t even look at rice without my blood sugar hitting the ceiling but small amounts of corn or corn tortillas can usually be tolerated. If you monitor your blood sugar carefully you will know when you have reached the upper limit of your grain intake whether that is one serving a day or four. Along with grains you have to watch your intake of starchy vegetables, mainly potatoes and peas. White potatoes are the vegetable world equivalent of white bread. Sweet potatoes offer great nutrition with a much lower impact on blood sugar. What about sugar? Obviously sugar needs to be severely limited in your diet (even if you aren’t dealing with GDM.) Have you noticed that most of our favorite desserts and treats pair grains with sugar? Talk about a double whammy. So what’s a pregnant girl to do? Eat fruit…..just kidding! Check out recipes for grain free treats that are sweetened with honey, maple syrup, or other unrefined sugars. There are thousands of tasty recipes on the web waiting for you. If you are the experimental type in the kitchen you can start trying out wheat flour alternatives like almond or coconut flour.

Eat Whole, Real Food from Good Sources
Grass-fed meats, wild caught fish and seafood, and pastured chickens and eggs should make up the bulk of your protein. Local, seasonal, and hopefully organic vegetables will give you your best source of vitamins and minerals.  Organic fruit should be eaten in small quantities. I can hear the rumble of, “Sheesh! I’m not made of money,” out there. I know. I’m not either. Figure out your priorities. If you eat a lot of eggs but rarely touch red meat then spend your money on pastured eggs, and go ahead and buy standard grocery store meat. That small amount won’t be your undoing. You get the idea.  Dairy is questionable for some people struggling with blood sugar issues.  Usually cheese has very little impact on blood sugar but milk is actually quite high in sugar (lactose.) It will just take a little experimentation to decide whether or not milk will be an option for you. For those of you that are Weston A. Price devotees, and you know who you are, raw milk generally has less of an impact on blood sugar than pasteurized. Always eat dairy in the full fat form. It will slow the impact on your blood sugar plus the vitamins and calcium in dairy foods require fat for your body to absorb them.

6. Don’t Worry About Fat in Your Diet

If it’s good fat that is. Fats are necessary to human health. Fats feed our brain,  give our cells structure, and keep our skin glowing and wrinkle free. Fats help us metabolize vitamins A, K, and D. Good quality fats are necessary to  properly nourish mom and baby. The problem is figuring out which fats are  good and which are not.  Saturated animal fats from pastured and grass fed  animals are great! Grass fed beef is high in omega 3 fatty acids. Pastured lard  is full of heart healthy monounsaturated fats. If you eat pastured bacon save the grease and cook your eggs in it just like Grandma used to. Butter, cold pressed coconut and olive oil are all good choices that are easy to find as well.  Steer clear of processed vegetable oils, even canola oil. These oils become oxidized and rancid during processing. To hide the awful smell they are chemically bleached and deodorized. Sounds yummy right?

7. Check Your Blood Sugar Often
How can you know if you are successfully keeping your blood sugars level if you don’t check? Get a glucometer and check your blood sugar several times a day. Yes I know it’s tedious but trust me, it’s better than having to inject insulin twice a day. Your care provider should go over the values that you are looking for but just in case, your fasting blood sugar should be below 100mg/dl and under 140mg/dl two hours after a meal. Consider your glucometer your most important tool to helping you stay on track.

8. Exercise! For Real, Do It!
Consistent exercise is a major key to blood sugar control. When you do any exercise you move large muscle groups. To fuel those large muscle groups your body will direct glucose out of your bloodstream and into the cells of the muscles. Exercise can have a large and immediate blood sugar lowering effect.  If you exercise consistently it will boost your metabolism and make you more sensitive to insulin. Over time regular exercise will help to keep your blood sugars lower. I’m not talking about hours every week at the gym. Moderate walking several times a week for as little as 30 minutes has a huge impact on your insulin sensitivity.  Consistency is what’s important here. The more consistent you are the more benefit you will see. If you find that following all of these recommendations isn’t quite getting the job done there are a few more tricks up my sleeve.

9. Great Supplements
Choose quality whole food supplements that support metabolism and lower blood sugar levels. A whole food prenatal may be in your best interest. It is generally believed that people with metabolic disorders, and GDM is one, have a harder time absorbing nutrients. A whole food prenatal vitamin is more readily available to your body. A whole food chromium supplement is a must.  Chromium is a necessary mineral that helps regulate blood sugar. With depleted soils it is impossible to get all you need from food. Cinnamon is another valuable supplement for lowering blood sugar. While you can buy cinnamon capsules, just sprinkling some on your food everyday is a tastier way to get it. Certain brands carry Chromium blends specifically for blood sugar control that contain cinnamon as well.

10. Coconut Oil 
I know I went over fats earlier but coconut oil is a special one. Coconut oil when taken as a supplement supports your adrenal system, boosts metabolism, and lowers blood sugar. You can take up to 3 tablespoons a day if needed. If you have been on a low fat diet then start small. Begin with 1 teaspoon before each meal and work your way up. You may find benefits at a low dosage or you may need to go all the way up to 1 tablespoon before each meal. You can stir the oil into herbal tea or take it straight from the spoon.

As with anything regarding your birth, the better educated you are the better chances you have of getting the birth you desire. Gestational diabetes is not a one-way ticket to a c-section or induction. With some planning and dedication you can have the birth you envision. Happy healthy birthing to you!

*I am not a doctor or licensed medical professional. I have done my research and these are the steps I took to control my blood sugar during pregnancy. If you have been diagnosed with GDM and are currently controlling it with medication you need to start this diet under supervision of your care provider. You will need to very carefully monitor your blood sugars as you wean off of medication."

For more information, I wrote a post about testing for gestational  diabetes earlier this year, including the criteria set by the American Diabetes Association.

Monday, December 3, 2012

How to Have a Natural Birth

Recently, I had a conversation with someone about wanting a natural birth and how hard it is to get that without a fight on your hands.  She asked the question, "Why can't you just say 'I don't want the drugs.'?"  It was an interesting question, really.  Why is it so difficult in American obstetrics to have a natural birth?

I think there are many factors here.  Fear is at the top of the list.  Fear of pain, fear of lawsuits, fear of the time commitment.  I think loss of control is also a factor.  We like to control everything.

And as much as we glorify the "superhero," we hate her when it comes to birth.  We want her to fail.  Her natural birth makes me feel bad about my medicated birth.  It's easier to believe that no one can do it than it is to believe I couldn't do it. 

The media is at fault here too, but it's largely because they feed the fear.  I have a mom right now doing Birth Boot Camp online classes that was thinking about transferring to a natural-birth-friendly hospital but it's an hour away.  We get this idea from all the sitcoms that the minute labor begins - or water breaks - the baby is going to fall out.  Women and men are fearful of a birth place that is more than a few minutes away. In reality, they could probably cross state lines with plenty of time to kill!

And then there's the noise factor that I've been talking about for years - the majority of the people at the hospital want you to have the drugs because of the noises you might be making, be it moaning, grunting, or even screaming.  Those noises make people uncomfortable when they are not used to hearing them. Personally, I like to hear the noises a woman is making in labor because you can tell how well she is handling things. Those noises let her support team know what she needs. Who needs a vaginal exam?!  Just listen to her!

In addition to making the laboring woman be quiet, the control is now shifted to the medical staff.  They do not have to wait for your labor to progress.  Like magic, they can force your uterus to contract whenever they want it to with pitocin.  What power!  The laboring woman is powerless at this point.

Frankly, people just don't understand why someone would want an unmedicated birth.  I was that way with my first baby.  I couldn't believe it when people would ask me if I was having the drugs.  Of course I'm having the drugs!  I get it.  I've heard a million different reasons for wanting a drug-free birth over the years, but in the end, a couple has to be willing to do what it takes.


1.  Believe that your body and baby will work together.

2.  Choose a care provider very carefully.  They may make or break this experience.  If you have chosen wisely and you do have a cesarean or are encouraged to induce, you will not second guess them EVER.

3.  Take a thorough childbirth class.  As the founder of Birth Boot Camp®, I believe our 10-week curriculum is the best program out there, preparing both partners for an empowering birth experience. If there is not an instructor in your area, take the online course. After you have an amazing birth, become an instructor!

4.  Communicate with your partner.  This is an opportunity to grow closer together.  It's not every day you bring a baby into this world.

5.  Hire a doula.  She will help you achieve a drug-free birth.

6.  Know your options.  If your chosen birth place is not natural-birth-friendly, RUN.  If you take the attitude of  "I'll stay with my OB this time and switch to a midwife next time," they may set you on a path of cesareans that will make it harder next time around.

7.  Practice relaxation on a regular basis.  Eat well.  Stay fit.  If you become high-risk because you eat junk food and have a sedentary lifestyle, your plans for an intervention-free birth may go out the window.

8.  Surround yourself with people that believe in YOU!

9.  Don't be afraid to ask the hard questions and read between the lines with your care provider.  If you feel like you are jumping over red flags, you probably are.  As long as the baby is still inside of you, you have options.  Regardless of what you may have heard, it's never too late to switch care providers.

10. Read positive birth stories.  Read - and believe - affirmations that you can do this.  You are strong and capable.  Embrace this experience.  It is yours and yours alone.

Tuesday, November 27, 2012

#Giving Tuesday - Birth Boot Camp joins forces with Best for Babes

As part of #GivingTuesday, Birth Boot Camp® will be donating $75 from every online childbirth education class sale to Best for Babes from Tuesday November 27 through Tuesday December 4.

The Best for Babes Foundation is the only mainstream non-profit cause dedicated to helping women overcome the many barriers they face that end their breastfeeding journey too early. Their mission is to help moms Beat the Booby Traps®-the cultural & institutional barriers that prevent moms from making informed feeding decisions and from achieving their personal breastfeeding goals, whether that’s 2 days, 2 months, 2 years, or not at all; to inspire, prepare & empower™ moms; and to give breastfeeding a makeover and give moms the solutions they need to make it work and feel fabulous!

They are harnessing the power of celebrities, the media, advertising, corporations, health-care professionals, health and disease foundations, moms and breastfeeding advocates to put positive pressure on the Booby Traps® to increase breastfeeding rates and improve the health of moms and babies.

Birth Boot Camp® is committed to training couples in natural birth and breastfeeding through accessible, contemporary education and offers online childbirth classes.

Birth Boot Camp makes childbirth education easy, effective and accessible with live or online classes to best fit your needs and desires. Our unique and fun curriculum is geared towards couples working to have an unmedicated natural birth.

Sign up for the most comprehensive online natural birth classes available today and support a wonderful cause!

Sunday, November 25, 2012

It's CYBER MONDAY at Birth Boot Camp®

I have two exciting things to share with you in regards to Birth Boot Camp natural childbirth classes.  First, with Cyber Monday taking place on Nov 26, we are offering an amazing deal for 24 hours.  If you are looking for a complete - and fun - natural childbirth education course, you found it!


The 10-week course is being offered for $75 off the regular price.  You'll have access to classes for 3 months, receive the 154-page workbook, and the breastfeeding DVD "The Ultimate MRE" is yours to keep.  This is what people are saying about Birth Boot Camp online classes:

“Classes have been awesome. I don’t want this to sound creepy, but I wish I could come out to Texas and give you a hug! I just love listening to you…and you even have my husband intrigued, asking when our next popcorn/movie night will be!   I’m due on June 15th… getting closer…. trying to be patient and relax as much as possible. I feel so prepared — I’m actually excited. I can hardly wait! Thanks for a great resource!” ~ Kiera

“The videos gave us reassurance that we were not on some pilgrimage to pull off something no one had ever done before. It was great to hear that others had not only done it, but instinctually did it well. I’m very grateful our midwife recommended Birth Boot Camp for us to take.” ~Ashton

"Last night I was doula for a couple who had taken the online Birth Boot Camp classes. They were so prepared and mom and dad were both amazing! After 19 hours, they got the natural birth they wanted, a sweet 9 lb 1 oz baby girl. At one point in labor mom was very discouraged and dad was telling her how he was proud of her and how everyone was impressed with how far she had come. Then, he said, "Baby, Ina May and Donna Ryan would be proud of you too." It inspired her into a whole new round of "I can do this".

It is recommended that you not begin classes until you are at least 25 weeks pregnant.  If you would like to take advantage of this once-a-year sale, but aren't quite 25 weeks yet, go ahead and register and we'll delay your classes until you reach 25 weeks.  In the meantime, we will send out your workbook and breastfeeding DVD.  If there is a live instructor in your area, check out their schedule.  (Some instructors may be willing to take the Cyber Monday coupon if you register on Nov 26.)

The second exciting bit of news is, when you go to the Birth Boot Camp website, you have an opportunity to receive a FREE PREGNANCY NUTRITION REPORT.  We are so proud of it!  Not only is it beautiful - and full of scrumptious recipes - the information is invaluable.  The email pop-up will appear when you go to the website and it'll take you no time at all to complete.  The report will be emailed to you.  If you are not interested, simply "x" out of it and continue on to the website.  

Couples are having amazing Birth Boot Camp births all over the world and we are proud to bring modern, contemporary childbirth classes to you, no matter where you are located.  

Monday, November 19, 2012

Fear of Rupture

I received a Facebook message from someone wanting to have a VBA2C, but dealing with a lot of fear.  I sent the message on to Abbey Robinson. I asked if I could post it here.  I hope you will find it helpful if you too are wanting a VBAC but dealing with the fear that is spoon-fed to our VBAC mamas.

First of all, congratulations on your pregnancy.  I, personally, had a VBA3C so I can definitely understand where you are coming from.  VBAC is a huge commitment and learning everything you can about the process is crucial to success.

I think that it’s normal to be fearful when you hear so many scary stories on the internet and through friends, family, and acquaintances.  From what I am hearing, your major concern is that you may not know/feel when/if you have a uterine rupture.  I will try to address this for you.

I never speak in absolutes regarding anything, so I’m not one of those people who will reassure you that there is no risk and everything will be fine.  Simply being pregnant and carrying a baby has risk.  Having a 3rd c/section places you at risk for many complications, much more than your 1st c/section would have been likely to cause.  Your risk of 
•    major complications is a whopping 7.5% (including but not limited to are listed as  uterine rupture, hysterectomy, additional surgery due to hemorrhage, injury to the bladder or bowel, thromboembolism, and/or excessive blood loss.)
•    Placenta accreteta: 0.57%
•    Risk of hysterectomy: 0.9%
•    Risk of blood transfusion: 2.26%
•    Risk of dense adhesions: 32.2%  (can cause life long pain/bladder and bowel problems/back pain (from everything sticking together) and will heavily complicate any future c/sections)  If you want statistics on a 4th c/section (if you plan to have more children, let me know.  The risk goes up many more times for each complication)

That leaves you with VBA2C and the risk of “uterine rupture”.

There was an Australian study of over 29,000 women who spontaneously went into labor where the risk of UR without augmentation (pitocin, prostaglandins, cytotec, etc.) with one prior incision was found to be a very low 0.15%  Once you introduce labor augmenting and induction drugs, the risk of uterine rupture increases to 1.91%.  HUGE difference.  From the studies that have been done on VBA2C or more, there isn’t much difference in the UR rates.  Cochrane reviews have identified true UR rates to be around 0.4% when no augmenting drugs were used.  Most of those cases were uneventful and mother and baby were healthy and fine.

SOOOOO, now that we’ve established that statistically, you have much better odds of having a VBAC with no uterine rupture than the risks of having a 3rd c/section, let’s talk about what you might feel and how to identify a UR.

Much of what we refer to as ‘uterine rupture’ is what is medically known as ‘dehiscence’ or a ‘uterine window’.  This is where the scar tissue begins to separate but a thin piece of tissue is left so the muscle doesn’t completely rupture but it’s so thin you might even be able to see through it.  Even though this ‘window’ is included in the statistics for ‘rupture’ when it is identified (usually when a mother is having a RCS either scheduled or after a trial of labor) It has mostly been found as harmless…usually no repair or special care is needed and it heals on it’s own.  There’s not enough information to know if it increases your risk of rupture for the next pregnancy or not.  But if you didn’t have it last time, there is no reason to believe you will this time.

Sometimes a rupture is painful.  Sometimes there is absolutely no doubt that you are having one, but as you have found out, it’s not always that way.

What WILL happen is your body will act differently.  If your uterus has a tear, it will not function like it did before.  It may become boggy and limp.  It may suddenly change shape.  You will probably have actual bleeding (bright red blood rather than normal bloody show).  As long as you are not medicated (don’t have an epidural or narcotics) you will feel that something is different. 

Much of the time, when a mother goes back for a section and there is a dehiscence, the OB will make a point to tell the mother that her uterus was rupturing, she is then terrified into scheduling a RCS for any future births.  The OB only knows what he has seen and the mother only knows what she is told and even though there was no negative outcome, both are scared of VBAC from then on.

As long as no harm was done, there is no reason to assume that it’s a dangerous situation.  The pregnant body is AMAZING, and if there is a problem with your uterus, most of the time it will send that signal to your body and labor may slow or even stop to protect itself.  Contractions may space out and be gentler on you than if you didn’t have a scar.  Embrace it and enjoy your labor.  Even when babies are stressed out, the body will get the message and contractions will not intensify, changing positions will get things going again, because baby is getting more oxygen and sending the signal to get going again.

NOW, catastrophic uterine rupture is what we are really afraid of.  It’s what we always *think when we hear the term “uterine rupture”.  This is when the baby literally breaks the uterus and is born into the abdominal wall.  You better believe that this will be painful and you will bleed and this is very scary and dangerous.  It accounts for a VERY VERY tiny percentage of the statistics.  It has most often been reported with labor induction and augmentation.  We hear a lot about this kind of rupture when we think of induction on a VBAC with cytotec.  

Find out if you have an anterior placenta (the placenta is on the front of your belly, near the old c/section scar).  An anterior placenta makes UR more dangerous and gives you only minutes to get to the operating room.

Do you have access to your OP reports from previous c/sections?  Do you know how you were sewn up?  Double sutures don’t matter quite as much as whether the OB took time and care sewing you up.

No one can promise you any specific outcome.  You have to be willing to be accountable for the risk of either VBAC or RCS.  No choice is 100% risk free…but statistically you are MUCH safer having a VBAC than you are having a 3rd c/section.

I will promise you that if you are not able to let go of the fear and apprehension, you will sabotage your ability to labor and give birth.  Please find a way to move past your fear.  I highly recommend a great childbirth class, yoga classes, stellar diet (to build strong, healthy muscle tissue), seeing a Webster-certified chiropractor (to make sure that everything is lined up correctly and prevent obstructed labor and decrease the risk of rupture) Make sure your chiropractor can come and adjust you during labor to help things move along or keep them going. is the most amazing resource for getting and keeping baby in a good position so that you aren’t ‘stuck’ in labor.

Do everything within your power to have an uneventful labor and your risk of rupture goes down.  Belly breathing was HUGE for me in labor and I believe it made the difference between success and failure for me. 

Ultimately, you have to be willing to accept the risk of getting your baby out, one way or another.  Build yourself up and be positive if you go through with labor.  Read positive affirmations daily out loud. 

Monday, November 5, 2012

Her First Period

When I was in 3rd grade, I read Judy Blume's "Are You There God? It's Me Margaret" and became obsessed with getting my first period.  Unfortunately, I had another 4 long years to wait.  It happened at church on a Sunday night in late October of 7th grade.  It was the best day of my life.  My mom took me to the store for pads and told me I was now a woman.  Wow.  From a girl to a woman just like that.

At almost 42, I can tell a big shift in my cycles.  Two days and I'm done.  My two oldest daughters have both started in the last year.  One was excited (then 7th grader) and the other, not-so-much (almost 6th grader).  They both knew about it, but you never really know what to expect until it happens.

I asked the question this week on my Banned From Baby Showers Facebook page if women remember the exact date they first started and if they were happy or upset.  I've thought a lot about the answers this week and wanted to talk about it a bit here.  Here is a sampling of the responses:

I was scared out of my mind!! My mother never told me anything and I had major cramping as a teenager. I literally thought I was dying!

I remember it was August and I was 14 1/2. I was a late bloomer and embarrassed that my mom told EVERYONE! My dad hugged me and said that his little girl was becoming a woman. I had people from out of state calling me. I was so upset.

Dec 1st, 7th grade. It was a good day. Both of my parents made me feel very special. Took me out to dinner to celebrate.

I don't remember the day but it was just before my 10th birthday and it was a Saturday. My mom was sleeping in and I got up to pee and made my discovery. My mom is not a nice person when she wakes up, but on that day when I woke her up to tell her what was going on she shot out of bed, got me what I needed, and went on and on congratulating me on my entrance into womanhood, she treated me like a queen and called me a "woman." It was a really good day.

May 12 1996, I was excited but embarrassed to tell my mom who never told me what was going on. She was red in the face while standing at the store trying to pick out pads.

My Mother was on the phone with some relative and she proceeded to blather the news out to everyone she could, despite the fact that pieces of my soul were crumbling into ashes. Because of this, my sister told me vs. our Mom when hers came, so she wouldn't call people and tell them.  I was so ANGRY that day. I felt ashamed and betrayed by my body and full of the sort of powerless rage that I'd never experianced before or after. I just HATED my body for doing that to me. I was a couple months shy of turning 11. I was too young.  It was horrendous. Not a good memory, sorry.    

I was in 7th grade and cried... I didn't want my childhood to end. I was mad that I was becoming grown up. Or so I thought in 7th grade. Plus my mom is not great with that stuff and we didn't really talk about it. My dad was much better about it. Still not a great day in my life.

I was eleven and mum was so happy she rented a movie and bought pizza.

I got mine Sept. 9th.  My mother had explained it to me but never actually mentioned blood. I knew I would get my period. I knew it meant I could become pregnant etc...I came home from school feeling awful and went to the bathroom. There was BLOOD!!!! I had watched enough episodes of Emergency - yes, dating myself - to know that internal bleeding meant I was going to DIE! After my mother got me to stop screaming, she found it all very amusing - I did not.

Thursday, May 12, in 6th grade. I've always said that nothing ever happens on Friday the 13th. It's Thursday the 12th that will get ya.

I was 12. I woke up and used the bathroom and saw blood in my underwear. It was long-awaited because I had an older sister who had it. I was so excited!!

Summer camp and completely uninformed and unprepared. Totally terrible.

13 years old. I was home in bed, with strep throat. My mom sat down on the steps of our house and cried, "My baby's growing up!"

Now that I'm older I appreciate my body and the miracle of motherhood, but I pray that all my girls are much older and more prepared when they first start.

I do remember my first cycle. My mom had just moved out so it was just my dad & I. I woke up several times that night with horrible cramps, was in & out of the bathroom thinking maybe I had to have a bowel movement....  By the morning I knew what was going on (it was pretty much like labor in that way).  My father had heard me all night getting up & down & had a pretty good idea of what was happening, poor guy. He ran out that morning & picked me up some pads & let me stay home from school!  Major props to my father for taking care of me in what must have been a very awkward situation for him. I was 15.       

I was mortified, but she (mom) was all happy and wanted to take me out to lunch. And I told her I didn't want lunch or to ever talk about it again. Also, to make sure no one said anything to me about it. And that was that.

I couldn't wait to get my period until I got it. As soon as I saw the blood, I thought "Oh no." Darn you Judy Blume and your romanticizing of it!

September 11th 2001. Yep. I was 14, my mother was in the states (we live in Canada) so it was a bad day. We didn't know where she was, couldn't get a hold of her, not to mention. I couldn't talk to my dad about these things so I was very embarrassed and just kept it a secret, luckily my mom had prepared me well so I knew what to do but I just needed my mom!  I had really bad cramps, was really emotional and on top of that scared about 9-11. When my mom came home a week later she walked into my room at midnight, I remember so clearly... before bed I had done my own laundry because I was embarrassed my dad would find out, so I had them folded by my bed... when she walked into the room I was half asleep and I said 'Mom!" and pointed at my clothes (like that explains it) and first she was like 'What? I dont get it.. What? You did the laundry? Wow you never do laundry.. WAIT!" and she knew just like that. 

A few final thoughts...
As embarrassing as it may be for you as the mother, remember how you felt -- or were made to feel -- when you first started.   If you think it is the most awful week of the month, don't tell your daughter(s) that.  She'll come to expect it.  It's just like birth - if you hear enough awful stories, you'll think that is what it is like for everyone.  It's terrible to think of a young girl scared of what is happening to her and the adults in her life are not helpful.  

While a menstrual cycle may be inconvenient and even uncomfortable, it is a sign that your body is working right.  It is an honor to be a woman and having a period each month reminds us of the sacredness of our bodies.  Arm her with the facts, but more importantly, empower her with the joy of growing older, into a lovely young woman whose body can and will do amazing things.