Viewing Birth

As we have talked about so much prior to this, viewing natural, normal birth is something that our Western culture is missing. This is the best, most truest form of education available to women, and so vitally important. For this reason, I encourage you to view these beautiful birth stories.


Malachi Daniel's Birth from Evie Marie on Vimeo.




Oliver Bradshaw's Birth from Evie Marie on Vimeo.



And grab some snacks for this longer one:

A Home Birth Story from TOBY MADDEN on Vimeo.

I am happy to see this article out, but it is nothing that we in the 'alternative' childbirth field didn't already know and haven't already been saying for many, many years. 40 weeks is not a fail-safe date for all babies to be evicted. In fact, the average first time mom will gestate a baby for 41 weeks and 1 day. 

The fact is, a woman who is going to keep her baby in longer, usually does so because her baby is not ready to be born.  These babies who are forced out have higher incidences of neonatal issues normally associated with preterm births (duh).

Experts Discuss Importance of the Last Weeks of Pregnancy

NEW YORK, June 7, 2011 /PRNewswire-USNewswire/ -- Every week of pregnancy is crucial to a newborn's health, and today, the March of Dimes unveiled a new public education campaign to raise awareness about the important development that occurs during those last few weeks.

The campaign, called "Healthy Babies Are Worth the Wait," encourages women to allow labor to begin on its own if their pregnancy is healthy. It aims to dispel the myth that it's safe to schedule a delivery before 39 weeks of pregnancy without a medical need.
Babies born after 37 weeks of pregnancy are full-term. However, new research has shown that a baby's brain nearly doubles in weight in the last few weeks of pregnancy. Also, important lung and other organ development occur at this time. And, although the overall risk of death is small, it is double for infants born at 37 weeks of pregnancy, when compared to babies born at 40 weeks, for all races and ethnicities.

"Some women mistakenly think that the only thing a baby does during the last weeks of pregnancy is gain weight, making labor and delivery more difficult," said Judith Nolte, a member of the March of Dimes national Board of Trustees and former editor-in-chief of American Baby Magazine Group, who worked with the March of Dimes to develop the new awareness campaign. "When the moms in our focus groups learned about the important brain and organ development that occurs, they were more than willing to put up with their own discomfort so their baby could get a healthy start in life."

Only 25 percent of women know a full-term pregnancy should last at least 39 weeks, according to research published in the December 2009 issue of Obstetrics and Gynecology.
"Women may feel worried, anxious, or simply uncomfortable near the end of their pregnancy.  But unless there are medical complications, the healthiest and safest place for that developing infant is in the womb," said Eve M. Lackritz, M.D., chief of the Maternal and Infant Health Branch, Division of Reproductive Health, Centers for Disease Control and Prevention, who outlined the health consequences of an early birth. "Term labor and delivery are not just normal and natural – they're the healthiest alternative for both the mother and the infant."

Information about the new Healthy Babies Are Worth the Wait educational campaign can be found at marchofdimes.com/39weeks.

The March of Dimes is the leading nonprofit organization for pregnancy and baby health.  With chapters nationwide, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality.  For the latest resources and information, visit marchofdimes.com or nacersano.org. For free access to national, state, county and city-level maternal and infant health data, visit PeriStats, at marchofdimes.com/PeriStats.

SOURCE March of Dimes
Back to top RELATED LINKS
http://www.marchofdimes.com/

- source 

Further information and reading:
On Pins and Needles - acupuncture for induction
Induction Increases Cesarean - the correlation between neonatal issues, induction, and cesareans
Avoiding the Pit - know the realities of Pitocin
An Australian post on Induction
Induction, Encouragement, Eviction

Unexpected Unassisted Birth

I opened my email this morning and found a wonderful note from a reader named Betsy. She wanted to share her birth story with everyone, and what a gorgeous story it is! They planned a water birth attended by a certified professional midwife. They also planned to have a professional photography team document the birth.

As she says,

"Sadly (in some ways), everyone -- including our midwife -- missed the birth. We ended up in the bathtub. My husband caught the baby. It was beautiful!"

And here is their beautiful story in video!

documentary birth film | OTPC from One Tree Photography on Vimeo.

When I asked her to share her story, she replied

My collegiate self would've never allowed this film to be seen. By anyone.
In it, I have three chins. I have rolls of belly fat exposed for all the world to see. And, in several shots, you can see my massive nipples.

But it was the 20-something me that would've focused on these bodily imperfections.

Today, when I watch this film, I see me...the strongest and bravest that I have ever been.

I went through one of my greatest challenges. I was calm. I shed no tears. And I brought my daughter into this world with peace and surrounded by love.

I don't believe that homebirth is for everyone. But I do believe that women need to see that birth is a beautiful thing. That we shouldn't be so afraid of it.

I went into labor Thursday, June 9 in the late afternoon. I started to have contractions that grew closer and more intense. My husband and I called our midwife and support team. Within two hours, my birth tub was up and everything was ready for my birth.

But...my body had other plans.

My rushes slowed down and the intensity waned. I felt discouraged as our midwife went home and told me kindly, not to be discouraged but that my body had a lot of work to do before active labor would begin.

Thankfully, my husband was able to stay home from work on Friday. I had rushes throughout the entire day, ranging from 20 minutes apart to just 8 minutes apart. I joked that I shouldn't have skipped the chapters in my birthing books about labor dragging on. Because my previous delivery was so fast, I didn't think it would happen to me.

Active labor started at around 2 a.m. Saturday morning. I woke up to intense rushes every 10 minutes. We'd just gotten two hours of sleep, so I let my husband sleep another hour before I woke him up to help me.

I labored in my bedroom -- on the bed, on my hands and knees and while rocking on a birth ball.

As the rushes became closer together and more intense, my husband called our midwife. But because things were still a bit irregular, she just wasn't convinced it was true active labor. She suggested I get in the bathtub to try and relax.

At 6 a.m., we called again. At time point, rushes were every two minutes and were lasting up to a minute and 50 seconds. I was moaning through every rush, but I felt calm and relaxed in my bathtub.

Our midwife still believe that the rushes were not quite intense enough to be transition. However, she got in her car -- thinking that she was coming to diagnose a bladder infection.

Just minutes after my husband hung up the phone, my water broke. Involuntary pushing began just moments later.

We had two friends staying with us who came up to assist and witness our birth. My husband got into the bathtub with me and helped me relax. A few pushes and my daughters head emerged. He cradled her head in his hands. And two pushes after that, her body slide from mine.

He placed her on my chest.

It was the most incredible moment of my life. In just seconds, all of my pain and discomfort was gone! My whole world centered around this little person laying on my chest. She was born at around 6:30 a.m. on Saturday, June 11.

We didn't know her gender at the time, but without even looking I asked my husband if "she" was okay.

My friend, who is studying medicine, said she thought that my baby was doing just fine. Because those words came from a trusted friend, I felt completely at peace and able to focus on my baby.

In the end, I was completely okay with our midwife missing our birth. I never felt worried or afraid. Instead, I felt empowered and thrilled.

My husband remained completely calm -- at least outwardly -- throughout the entire process. By doing so, he gave me the peace of mind I needed to focus on my labor and my baby.

In the end, I wouldn't change a thing.

I hope that my little story can help women further understand that birth doesn't need to be frightening -- regardless of the circumstances. I've had three babies...and it took me three pregnancies to really learn that my body can birth. It doesn't need any "help" beyond the emotional support of a partner and family.

I'm so, so thrilled to have documentation of this incredible moment in my life. I would strongly encourage women to consider it. Looking back at our birth video has solidified my sense of empowerment!

 Thank you so much, Betsy, for sharing your story with us!

"What Your Pediatrician Doesn't Know" - Review and Giveaway

I have been reading "What Your Pediatrician Doesn't Know Can Hurt Your Child", by Susan Markel, MD. I have to say that I'm completely enamored with this book and will be sure to recommend it to the families that I serve.

Bio:
Dr. Markel s a board-certified pediatrician who has a private consultative practice specializing in parent coaching and child health. A graduate of Tufts University School of Medicine in Boston, Dr. Markel became a fellow of the American Academy of Pediatrics in 1981, and an International Board Certified Lactation Consultant (IBCLC) in 1997.

Dr. Markel's philosophy of natural parenting empowers mothers to trust in their maternal instincts, and consider themselves the "experts" in raising their own children. By espousing "mindful parenting", she has allowed mothers to acknowledge and celebrate the joy of parenting.

During her years in private pediatrics practice in central Connecticut, Dr. Markel was an assistant clinical professor of pediatrics at the University of Connecticut Health Center, teaching pediatric residents. For many years, she served as a medical liaison for the breastfeeding support organization La Leche League International. She is also a medical associate at Attachment Parenting International, a nonprofit parenting organization promoting "peaceful parenting for a peaceful world." Dr. Markel has been a regular contributor to BabyCenter.com and has been featured on many television broadcasts discussing various topics related to the emotional and physical health of children.

Her practice, Attachment Parenting Pediatrics, focuses on the tenants of Attachment Parenting, providing evidence-based care for the children and families that she serves. Her practice's website is full of wonderful information on how to properly care for your children in many situations.

The Book:

I don't normally read introductions, I'm ashamed to say. But, in this case, I did without prompting, and am so glad that I did.


The book opens

"Doctors are trained to diagnose disease and use pharmaceutical drugs, and that's how they practice. They are not formally trained in health or nutrition, so asking your pediatrician for advice on either nutrition or health - meaning how to keep your child as healthy as possible - will probably be useless unless your doctor has been self-taught. If you've educated yourself in these matters, it's likely that you'll know as much or more about them than your child's doctor.


Nor are doctors educated about natural parenting or natural lifestyles - the benefits of sleeping with your baby versus having your baby "cry it out" in a crib, or the benefits of carrying your baby in a wrap, sling, or other soft carrier versus leaving the baby in a hard plastic baby-containing contraption.


A few hard truths about many of the pediatricians practicing today...

• They may say things that are not scientifically justified. It's fascinating that so many long-held beliefs in pediatrics are ultimately refuted by carefully done studies. 
• They may be advising based on their own opinion or prejudice.
• They may be prescribing out of routine, convenience, or habit. 
• They may be telling you what they think you want to hear, even if they internally disagree. 
• Their decisions may be affected by the dictates of insurance companies, drug companies, or state or federal governments."

And here, with have the premise for the book that Dr. Markel has authored. She seeks to empower parents to become conscientious and proactive consumers in their children's healthcare by teaching them to question the routine care given by the average pediatrician.


The sections of her book are broken down into three easy to read sections. These sections are Discovery, Emotions, and Maintaining Health.


Discovery is all about the early days of your child's life, considering what things are necessary or prudent for your family at the time of birth and shortly afterward. This section covers breast-feeding, baby carrying, co-sleeping, and infant nutrition in a concise and comprehensive manner.


Emotions covers a broader range of subjects. There is a lot of discussion on the parent/child relationship, early communication (not only for the child, but also the parent), discipline and and  conscious parenting choices, and how to teach your child how to appropriately express emotion. The last subcategory of this section is one of my favorites, attention. In this subcategory, attention issues (and non-issues) are discussed. These include ADD, holistic treatments, and parent training for this specific situation.


Maintaining Health is the last section. It opens with a great quote from Meryl Streep, "I'ts bizarre that the produce manager is more important to my children's health than the pediatrician." In this section, Dr. Markel makes an easy-to-read case for holistic health. She covers information on nutrition, vitamins, allergies and asthma, eczema, ear infections, fever, natural healing vs medication, and vaccinations.

All in all, this book is extremely informative, easy to read, and a must-have, on-hand book for every parent. I have a number of books on a number of these subjects, but this is the first of it's kind that I have found that I can reference to all of these key subjects within one binding. For this reason, I will recommend Susan Markel's book to all new parents that I come in contact with.

Now, if you want a chance to win a copy of this book, the rules are simple. Just share this giveaway on some social site (messageboard, facebook, myspace, twitter, etc..) and then come back and tell me that you did and where you did. 

I will draw a winner on the weekend of July 1st and will post the winner yet that weekend. The winner will have until July 7th to notify me of their mailing address. If I haven't heard from the winner by that date, a new winner will be drawn. 

Good luck!

*This giveaway is open to residents of the continental U.S.

It takes a Village...

It has become increasingly clear to me that it takes a village to get a VBAC.

I have written posts on the importance of choosing your birth team, and this is doubly important when seeking a VBAC. Your birth team includes:

• Your care provider (this is your doctor or midwife)
• Your partner (this would be your lover, husband, family member, or life partner)
• Your other support people (doula, mother, sister, aunt, mother-in-law, etc..)
• Your place of birth (hospital or birthing center)

This is so very important people think, 'well, it's only one day'. Trust me, without the right support team, your chances of a successful VBAC are not in your favor.

Recent news has shown just how important this is.

Amber Marlowe was a seasoned pro at delivering big babies — her first six each weighed close to 12 pounds. So when she went into labor with her seventh last winter, she brushed off doctors who told her the 11-pound, 9-ounce girl could be delivered only by Caesarean section.


But the medical staff at Wilkes-Barre General Hospital wouldn’t budge, not even with her track record. “All my others, I’ve done naturally,” Marlowe recalled telling her physicians. “I know I can do it.”

So Marlowe checked herself out and went looking for a new doctor.

While she was on her search, Wilkes-Barre General’s lawyers rushed to court to get legal guardianship of her unborn child, giving the hospital the ability to force Marlowe into surgery if she returned.

- Read the rest of the story here.

If you want to do something about a local VBAC ban, consider this article on getting proactive, getting your voice heard. Because it really is true, it takes a village to get a VBAC... or just choose to stay home and out of the village in the first place.

For information on how to best your chances of a successful VBAC, take a look at So You Want A VBAC. For information on the studies and articles of interest regarding VBACtivism, see The First Cut is...

Postpartum Rituals

We talk a ton about pregnancy and birth, and even a lot about after birth/postpartum options. But what about rituals and postpartum care for the families healing/lying in time?

This is a great article about postpartum traditions around the world. You could easily adopt one of these or help arrange for something similar for women in your community who are having babies.

I know one of the 'traditions' in my community is to set up a list of women willing to bring meals to the new families every evening for the first 14 days. We deliver ready-to-serve meals that nourish the body and soul, and, as they sit down to eat, we do the day's dishes, sweep the kitchen and clean the counters, fold a load of laundry, or any other number of things. This is a small way in which to ease the transition into familihood.

One of the things I have considered doing for awhile is making a postpartum basket for moms and bringing it to their homes after baby is born... Perhaps this will even become my staple gift for mom's baby showers. Regardless if they choose hospital, home, or birth center births, I think that the items lovingly chosen in this basket could help them on their way to a speedy recovery:

• Homemade herbal sitz bath - this is an awesome recipe I found online
• Natural Nipple Cream - this can be made by combining equal portions of coconut oil, shea butter, and cocoa butter, then storing in old baby food jars.
• Homemade Mother's Milk Tea - this is a great one. Every breastfeeding mama wants to make lots of milk.
• Lactation Cookies - yummy, nutritional, and easy to snack on when mama needs an energy boost.
• Washable Breast pads - a great alternative to disposables, with less risk of getting mastitis or thrush.
• Mom and Baby Massage Oil - This can easily be made with two simple ingredients. 8 ounces of oil (olive, almond, apricot, or sunflower) and 1 ounce calendula flowers. Place the oil and calendula flowers in a crock pot on low temperature for about 4 hours to extract the beneficial properties of the calendula into the oil. Check very carefully that your oil is not getting too hot! Allow the oil to cool and then strain it using cheese cloth, store in a canning jar. Attach to the lid or the body of the jar instructions on mom and baby massage.

All of these projects combined would take me around 4-5 hours in one afternoon to make, and they are so beneficial and healing.

Let's get creative. Who else has good ideas for home made postpartum gifts?

Induction, Encouragement, Eviction...

Induction, Encouragement, Eviction... these are all words that have been used in conjunction with artificially stimulating labor in order to get baby to come out.

Induction: to move by persuasion or influence: to call forth or bring about by influence or stimulation: effect, cause: to cause the formation of: to produce (as an electric current) by induction: to determine by induction; specifically: to infer from particulars

Encourage: to inspire with courage, spirit, or hope: hearten: to attempt to persuade: to urge: to give help or patronage to

Eviction: to recover (property) from a person by legal process: to put (a tenant) out by legal process: to force out: expel
- Merriam Webster Dictionary

Induction is the medical term used to encourage labor and birth of your baby. The term, induction, is misleading, though, as it infers something persuaded or 'influenced'.

Some people call it labor encouragement; I reserve this term for when a woman is choosing true encouragement techniques and they will not be influential unless the body is ready.

Some more jokingly refer to induction as an eviction. This is the closest term, in my opinion, when considering medical induction. Eviction is truly forcing baby out, one way or another.

For consistencies sake, though, we will call it induction.

Unfortunately, most first time mothers are faced with the dilemma ‘to induce or not to induce’. When you figure that the majority of obstetrical providers like to have mom deliver between 39-41 weeks, and you also consider that the average first-time mom will go into labor at 41.1 weeks, most women encounter this choice.

Remember, it is a choice in most instances and not necessity. In fact, we clearly know that induction increases risk to mom and baby.

Some reasons that your care provider might encourage induction:

• Postdate pregnancy (care providers vary on what is considered ‘overdue’, but it is thought that anything beyond 40 weeks is ‘overdue’ – see my handout on due dates)
• Premature rupture of the membranes (your water breaking without contractions)
• Pregnancy-induced hypertension (high blood pressure) or preeclampsia
• Chorioamnionitis (an infection of your amniotic fluid and/or the bag of waters)
• Intrauterine fetal growth retardation (IUGR – baby is not growing anymore – this can be because of placental decay)
• Large baby
• Oligohydramnios or polyhydramnios (too much or too little amniotic fluid)
• Significant maternal medical problems, such as diabetes mellitus with pregnancy at term

What are the risks of induction?
There are many risks to induction that should be weighed very carefully. In addition to the risks that normally occur with labor and delivery, induced labors tend to increase the incidence of pain medication use (which increases another set of risks), and the induction itself carries its own risks.

Some of the risks include: uterine hyperstimulation, fetal distress and a greater likelihood of postpartum hemorrhage.

As a result of the added risk, fetal heart rate (FHR) monitoring will be performed using a high-risk protocol, and a physician able to perform a cesarean section must be informed and available at all times. If you are considering an induction or your care provider has offered/requested an induction, evaluate the situation carefully; the risks of remaining pregnant should outweigh the risks of an induction before it is considered.

How do I know if an induction will work?
You don’t; in fact, no one does. You should ask your care provider about your Bishop’s Score (explained later). This is a system whereby you and your care provider can determine if your cervix and body are ready for labor. If your score is a 7 or over, you are a good candidate for a successful induction (meaning you won’t have a cesarean because your cervix didn’t dilate), but many of the other risks are still possibilities.

How can I tell if I am a good candidate?
As stated previously, a care provider can assess your likelihood to successfully dilate with an induction by something called a Bishop’s Score. If your score is 7 or over, you have a very good chance of dilating fully through induction. The table below is the adapted midwifery model, as it tends to be more accurate than the medical model.

If you would like to see the medical model, click here.

Keep this chart on hand and, in the event that induction is mentioned by your care provider, refer to this chart and be sure that your chances for successful dilation are in your favor.

Modifiers to this table include -
Add 1 point to score for:

• Preeclampsia
• Each prior vaginal delivery

Subtract 1 point from score for:

• Postdates pregnancy
• Nulliparity (never having birthed children)
• Premature or prolonged rupture of membranes

You can deduce your score by adding your points.

• If your score is 7 points or less, your chances of successfully and fully dilating without the assistance of a cervical ripener are not in your favor.
• If your score is 9 or more, your cervix is favorable to attempt to induce.
• If your score is 12 or more, your cervix is ready for labor (perhaps even in early labor), and a small amount of encouragement often gets things moving.

How are inductions done?
There are a few different types of inductions to consider. These include stripping your membranes, artificially rupturing your membranes (AROM – breaking your water for you), cervical ripening, and pitocin induction.

Types of induction:

• Stripping Your Membranes - When a care provider wishes to encourage labor to start but is not ready to commit mom wholeheartedly, they might suggest stripping your membranes. This will encourage labor to start by a) aggravating the uterus because of the weight of the amniotic sac sagging against the cervical opening as it is no longer held up by the mucosa, b) causing your body to release prostaglandins because of this irritation, and c) which might result in cervical softening and contractions.
• HOW IT’S DONE – the care provider completes a cervical exam. While they are near your cervix, your care provider inserts a finger into the cervical opening and sweeps their finger over the thin membranous mucosa that connects the amniotic sac to the wall of your uterus.
• WHAT YOU CAN EXPECT – vaginal exam with a gloved hand, possible intense cramping with bloody show, outpatient procedure.
• RISKS – risks that increase with stripping your membranes include: infection, PROM (premature rupture of membranes), bleeding.

• Artificially Rupturing The Membranes (i.e., artificially breaking your bag of water) – When your care provider is ready to commit mom to labor, the cervix is opened a few centimeters, and babies presenting part (usually head) is well applied to the cervix and low in the pelvis, they may suggest breaking your water to get labor started. This can work for many of the same reasons as stripping your membranes, plus there is the added irritation to the cervix of the sac being released, which causes more friction/pressure on the cervical opening.
• HOW IT’S DONE – the care provider completes a cervical exam. While they are near your cervix, they insert a plastic or metal device that looks very similar to a crochet hook (or they will wear a specially designed surgical glove with a hook on the end of one finger), snag the amniotic sac, and tear a small hole in it, releasing the waters.
• WHAT YOU CAN EXPECT – vaginal exam with a gloved hand, possible discomfort at onset, gush or small trickle of warm water, possible bloody show, many times fetal monitoring, inpatient procedure
• RISKS – In most practices, ROM puts mom on a 24 hour window to birth baby and the procedure possibly won’t create contractions or won’t create strong enough contractions, necessitating pitocin use. If mom does not have baby within the allotted time for ROM, she will be encouraged to have a cesarean. Increase risk of infection, fever, cord prolapse, internal cord prolapse, fetal distress, fetal heart decelerations, fetal malpresentation or malposition.

• Prostaglandins – prostaglandins are the hormones that ripen and soften your cervix, making it nice and pliable for dilation. To better the chances of a successful vaginal induction, the cervix must be ‘favorable’, meaning that it should be soft and more ready to dilate. When a care provider encourages induction and the cervix is not favorable or ripe, they might recommend a cervical ripener. There are two main types of cervical ripeners, Prostaglandin gels (Cervidil, Prepidil, etc..) and a pill called Cytotec (Misoprostol). For information on Cytotec, see the special section on Cytotec.
• HOW IT’S DONE - The prostaglandin gels are applied directly to the cervix via a tampon like applicator. Once contractions are established, or the prescribed amount of time has passed to see if this mode of induction is successful, they will remove the device. Cytotec, on the other hand, is inserted in pill form into the external os of the cervix (cervical opening).
• WHAT YOU CAN EXPECT – intermittent to continuous fetal monitoring usually is completed, mom is often required to remain in bed, inpatient procedure. Cramping, bleeding, possible loose bowels, general discomfort. If contractions are not established within an allotted amount of time, and if your water has not broken during this time, there is the very good chance your care provider may send you home. If your cervix does become more favorable during this time, but contractions have not become established, they may recommend pitocin.
• RISKS – increased risk of infection, uterine rupture, ,uterine hyper-stimulation, fetal bradycardia, when uterine rupture does occur, fetal death rate is 25% 
• see here for more information or here for more information

• Pitocin – pitocin is a synthetic oxytocin. Oxytocin is the hormone that produces contractions. When a medical induction is indicated or suggested, this is the most aggressive means of inducing. Pitocin works by stimulating and simulating contractions.
• HOW IT’S DONE – the care provider or nurse will administer the synthetic hormone through an IV drip in your wrist, hand, or arm. Along with the hormone, you will be given IV fluids. The dosage is usually started at a low drip and then increased every 30 minutes or so until your contractions reach a regular and productive pattern.
• WHAT YOU CAN EXPECT – IV pole, IV fluid bags, IV catheter in your hand/wrist or arm, continuous fetal monitoring, inpatient procedure, discomfort, increased pain because of an unnatural labor pattern (seemingly more intense), possible SROM, spotting and cramping from dilation, possible blood pressure increase, loose bowels, possible nausea.
• RISKS – increased risk of titanic contractions (contractions that last too long), double peaking contractions, increased risk of uterine rupture, postpartum hemorrhage, increased risk of fetal malpresentation or malposition, increased risk of using pain medication, increased risk of cesarean for failure to progress, shoulder dystocia (baby), and fetal distress. Increased risk of fetal bradycardia.
• We now know that there is a correlation between pitocin use and the incidence of ADHD. See here for more information on pitocin.

• **Cytotec is becoming more popular as a means of induction. It has been shown to start labor faster and result in faster labors than pitocin. It is a small pill that is inserted (whole or in pieces) into the vagina near the cervix, where it dissolves. There is no standard dosage for this medication as it was not intended for induction. Once it is administered, unlike prostaglandin gel or pitocin, it cannot be removed, even in the case of maternal or fetal distress. There are many risks, and a high incidence of them. 
• Risks include: increased chance of uterine hyperstimulation, uterine rupture, no safe/effective dose, not approved by the FDA for this use, fetal malpresentation, fetal malpositioning, fetal distress, postpartum hemorrhage, fetal bradycardia, and, when uterine rupture occurs, the fetal death rate is 25%. 
• For more information, please see here or here.

What about alternative method of labor induction?
I will start by saying that, if you are interested in homeopathic means of encouraging labor, you should consult a midwife, herbalist, acupuncturist, homeopathic practitioner, chiropractor, etc... The information below is to provide information on these alternatives, but are not to be used as a suggestion or prescription.

That said, just like with any other intervention, there is always added risk when we tamper with nature. The positive aspect of homeopathic or alternative methods of induction is that, if your body isn’t ready, it won’t work. That is why I prefer to call these alternative labor encouragers.

Methods for alternatively encouraging labor:

• Relaxation/Visualization/Meditation – when a mom is in labor, she moves into this place where the world cannot worry her anymore. Oftentimes, stress, workloads, worries, fears, marital issues, etc…, can all cause upsets in naturally occurring labor. It is no surprise, then, when these same things can inhibit labor from starting at all. The great thing about this particular encourager is that it can be easily paired with a medical induction to increase the chances of it working. 
• HOW IT’S DONE – you would remove yourself from noise and disturbances, a place where you can relax and let your mind go blank. You could use hypnosis techniques (if you are a student of Hypnobabies, they have a Baby Come Out CD), visualization (picture your baby pressing down on your cervix, your cervix nice and soft and open, your uterus pressing in on your baby), meditation (positive affirmations about your body and baby). This destressing can be done with a warm bath, candles, incense, your partner.. anything.
• WHAT YOU CAN EXPECT – a sense of peace, lowered blood pressure, perhaps gentle tightening. Some women report a pop when their waters spontaneously break, slight cramping, mild abdominal discomfort, spotting.. or you might expect no signs of labor, but a clear mind, a positive outlook, and the fortitude to wait a little longer.
• RISKS – you may not be so anxious to have the baby, you may begin to enjoy having baby inside.

• Prostaglandins – Semen is a great natural source of prostaglandins. Having intercourse regularly throughout the last trimester will keep your cervix coated in prostaglandins, which will encourage a favorable cervix.
• HOW IT’S DONE – Well, it is done however you would normally have intercourse with your partner. Your odds will increase in effectiveness if your hips are elevated for awhile after intercourse to increase the saturation of semen on your cervix.
• WHAT YOU CAN EXPECT – feeling closer to your partner, a sense of euphoria, relaxation, sleepiness.
• RISKS – possible cramping and bleeding, possible SROM if your cervix is open quite a bit and you are very aggressive.
• Intercourse – likewise, intercourse itself is a great uterine stimulant as orgasms (by the mom) produce oxytocin. The combination of semen and orgasm can cause a great environment to encourage cervical ripening and regular contractions.
• HOW IT’S DONE – the same as above. Additionally, taking special attention to the woman achieving orgasm, as well as the man.
• WHAT YOU CAN EXPECT – feeling closer to your partner, a sense of euphoria, relaxation, sleepiness.
• RISKS – possible cramping and bleeding, possible SROM if your cervix is open quite a bit and you are very aggressive.

• Evening Primrose Oil – unlike popular belief, Evening Primrose Oil (EPO) does not cause contractions. It only prepares and softens the cervix. For this reason, many women choose to start taking EPO around 36 weeks. This will encourage your body to produce its own prostaglandins. 
• HOW IT’S DONE – You would purchase 500mg gel caps. Starting around 36-37 weeks, you would take 2 of them in the morning. Then, roughly a week after starting that regime, you would begin also inserting 2-4 vaginally at night. During the night, the gel caps will be dissolved by the damp environment of your vagina.
• WHAT YOU CAN EXPECT – possible softer stools, more discharge in the morning when the oil runs out of your vagina, softer perineal tissues, softer labia, some women report it increases their sex drive by feeling the increase lubrication.
• RISKS – it can be messy, some women report nausea from orally consuming too many, some women report loose stools from orally consuming too many.

• Nipple Stimulation - nipple stimulation, like orgasm, releases oxytocin, which contracts the uterus. Midwives have been using nipple stimulation for induction of labor for many centuries.
• HOW IT’S DONE – there are a number of ways: manual stimulation, artificial stimulation, or hydrostimulation. For manual stimulation, you or your partner would find a dark, relaxing place to tweak and gently manipulate your nipples for about 15 minutes. Take a break for about 2-3 hours, then start again. For artificial stimulation, you would do the same as previously explained, but you would use a breastpump instead. For hydrostimulation, you would run a warm shower and then, while in the shower, place a washcloth over your breasts. Allow the showerhead to stimulate your nipples through the washcloth for the same time regime.
• WHAT YOU CAN EXPECT – mild to moderately irritated nipples, possible arousal, possible cramping or spotting, 
• RISKS – possible sore nipples, possible abdominal cramping with no labor, possible hyperstimulation when not using a safe protocol.

• Acupressure/Massage - there is a stimulation point on your calf called the Spleen 6 which can cause oxytocin productions. Additionally there are pressure points in your lower back, upper neck region, and pad of your foot which can also cause uterine stimulation or oxytocin production.
• HOW IT’S DONE – you would ask your doula, midwife, massage therapist, or reflexologist to assist you or teach you this practice. 
• WHAT YOU CAN EXPECT – mild discomfort at pressure point (similar to other deep tissue massage), afterward relaxation and better circulation. 
• RISKS – possible dehydration as your body moves toxins through your body and stimulates hormone production – be sure to stay hydrated, possible abdominal cramping with no labor.

• Castor Oil – castor oil is a stimulant; it irritates the bowels and, as such, can irritate or stimulate the uterus as well. The result is, most often, diarrhea, and sometimes, labor.
• HOW IT’S DONE – you would procure castor oil from a local pharmacy or food store. It can be consumed in apple or orange juice, in scrambled eggs, in milk shakes, or with baking soda. Most commonly, the dosage is around 3-4 teaspoons. Some women have simply taken a few spoonfuls of castor oil, but most women cannot get past the gag reflex. Many midwives recommend not eating anything afterward for at least 2 hours to maximize the effect.
• WHAT YOU CAN EXPECT – oily dosage, difficulty swallowing it, possible cramps and show within 3 hours of taking it. possible mild to moderate nausea, possible vomiting, most probably diarrhea.
• RISKS – possible mild to moderate dehydration from diarrhea, be sure to drink plenty of water, possible severe diarrhea, possible severe vomiting, possible severe abdominal cramping with no labor, possible meconium staining from the castor oil use, which can increase the risk of meconium aspiration.

• Consumables – Spicy food, pineapple, basil and eggplant have all been recommended as ways to encourage labor throughout the centuries. Purportedly, spicy food works because it irritates the bowels, which, in turn, irritate the uterus, similar to castor oil. Pineapple might encourage labor because it contains bromelain, and Basil and Eggplant because, well, I am not honestly sure where those came from.
• HOW IT’S DONE – prepare any of these foods in your favorite way and enjoy a wonderful meal.
• WHAT YOU CAN EXPECT – hopefully you will enjoy eating a good meal and feel full. There is limited research done on the validity of these claims.
• RISKS – spicy food and pineapple could produce heartburn, eggplant and spicy foods could produce loose stools, indigestion could occur as well.

• Chiropractic Adjustment – when your spine is misaligned, it might produced on and off again labor (start and stop, or prodromal labors). Having an adjustment by a chiropractic skilled in prenatal chiropractic care may be what your body needs to be able to start things on their own. Additionally, oftentimes, chiropractic adjustments can touch on the pressure points for induction of labor, unless the chiropractor is going out of their way not to touch those trigger points. Chiropractors also routinely place mom in a position that facilitates something called a pelvic floor release, which can ‘unwind’ tense pelvic floor muscles and allow baby to sink lower in your pelvis, potentially stimulating contractions and causing dilation from gravity.
• HOW IT’S DONE – schedule an appointment with your chiropractor, letting them know that you are looking to encourage labor and would also like to have a pelvic floor release performed.
• WHAT YOU CAN EXPECT – if you have never been to a chiropractor before, they will manipulate your muscles and joints through changing your positions on either a bed with a drop out section for your belly or on a specially designed chair for pregnant women. You may experience popping as they manipulate these joints and you may experience a slight humming or brief warming where it occurs.
• RISKS – dehydration may occur from the release of these joints and muscles. Drink plenty of water afterward.

• Blue/Black Cohosh, Cotton Bark, Squawvine, or Goldenseal – These herbal tinctures do carry some medical risk, it is best to take these only under the close eye of a holistic practitioner. These tinctures can cause stimulation of the uterus and are rather reliable. They are considered the most aggressive alternative labor encouragement method of all.
• HOW IT’S DONE – According to Anne Frye, (Holistic Midwifery Volume II ) you would take 10 drops of both Blue and Black Cohosh four times a day, or as often as every hour, depending on how aggressive you would like to be and your bodies tolerance to the protocols. 

“For induction, Cotton Root Bark tincture is perhaps the most effective of all labor-inducing herbal remedies.” After using the Cohosh tinctures as directed therein, if it has little to no effect, Anne Frye recommends,” First, you can give a dropper of blue cohosh tincture at 30 minute intervals for 1 to 2 doses. Then switch to cotton root bark tincture in dropper doses spaced as often as every 15 minutes the for next 3 to 6 hours.”

• WHAT YOU CAN EXPECT – the tinctures taste very herb-like and, if you have chosen an alcohol based one, may have a residual after burn in your mouth for short term. Cramping, spotting, increased discharge, possible heart palpations, possible strong contractions, possible loose stools.
• RISKS – contraindications include: history of anemia, history of postpartum bleeding, high blood pressure, or history of clotting disorders. Cohosh can cause blood pressure drop, so be sure to drink lots of water. Cohosh can also cause nausea or fetal heart rate fluctuations.

• Various other methods – Additionally, there are the options of going curb walking, blowing up balloons, walking through a pool with weighted ankles.. all of these are entertaining options, but the available validity of these claims are very sketchy.

In conclusion
Did you know that you can worry yourself right out of labor? I have encountered woman after woman who asks how to encourage her body to go into labor naturally. The best way to encourage your body to go into labor naturally is to relax and let it go into labor naturally!

Your body knows how long to grow your baby, what size of baby to grow, and how to start labor. I highly encourage women to know their options, but only act on them when the risks of baby remaining inside outweigh the risks of forcing nature’s hand at the act of induction.

Whenever we tamper with natures design, we introduce unnecessary risk, emotional, mental, and physical stress - none of which are good for labor and birth. Trusting the process and only interfering when there is a true medical indication for it will ensure the safest, healthiest, most satisfying outcome for all involved.

For Additional Reading:
On Pins and Needles - acupuncture for induction
Induction Increases Cesarean - the correlation between neonatal issues, induction, and cesareans
What A Difference A Week Makes - avoiding premature babies 'at term'
Avoiding the Pit - know the realities of Pitocin
An Australian post on Induction


References:

• Gülmezoglu AM, Crowther CA, Middleton P. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004945. DOI: 10.1002/14651858.CD004945.pub2.
• Dodd JM, Crowther CA. Elective repeat caesarean section versus induction of labour for women with a previous caesarean birth. Cochrane Database of Systematic Reviews 2006, Issue 4. Art. No.: CD004906. DOI: 10.1002/14651858.CD004906.pub2.
• Irion O, Boulvain M. Induction of labour for suspected fetal macrosomia. Cochrane Database of Systematic Reviews 1998, Issue 2. Art. No.: CD000938. DOI: 10.1002/14651858.CD000938.
• Harman & Kim. "Current Trends in Cervical Ripening and Labor Induction" American Family Physician 1999; 60:477-84. 
• Pregnancy, Childbirth and the Newborn by Simkin et al.,
• TheThinking Woman’s Guide to a Better Birth by Henci Goer
• Romney S et al, editors: Gynecology and Obstetrics: The Health Care of Women, ed 2, New York, 1981, McGraw-Hill.
• Holistic Midwifery Volume II, Anne Frye, Labrys Press
• Wise Woman’s Herbal
• Naturally Healthy Pregnancy
• http://www.mother-care.ca/induction_meth.htm
• http://www.gentlebirth.org/archives/natinduc.html#castor
• http://www.mothercare.ca/bishop.htm
• http://www.cdc.gov

A Simple Question

Lesley is a wonderful woman, and fellow doula, that I have been privileged to get to know while I lived in Michigan. I asked her to write a post awhile back, and she has graced my blog with this poignantly honest glimpse into her personal life. TRIGGER WARNING: loss is mentioned.

“How many children do you have?”

A simple question many new moms have been asked in a variety of social settings right?  For most women the answer is simple, they state the number of children they have, their ages, girls or boys, and it sparks a conversation, maybe even a friendship.

For me, the answer is far more complex.  I assess the situation- ‘who am I talking to? How are they going to react?  Are they going to judge me?  Will they never talk to me again?’  I usually say “I have three living children.”  Or “I have three boys at home”.

Why would I say three LIVING children?  Because I carried a baby girl who was stillborn at 20wks. 

Many people in our society today do not think I should count the baby I lost. The death of a baby is still very taboo in our society.  No one wants to talk about it. They would prefer to think that is doesn’t happen, or at least it won’t happen to them or to someone they love.  I know this because I used to think that way, until it happened to me. 

I have been told that because she never took a breath outside of my womb that she didn’t exist. I carried within me, a tiny precious life.  My daughter was her own little person, 10 fingers, 10 toes, a tiny little body with her own cells, and DNA.  I have proof that she was alive within me.  There was a recent article posted here on this blog that said “In addition to all of the nutrients flowing from the mother to the fetus, some of the developing child’s cells pass back into the mother’s body.”  When I read those words it made my heart smile.  To me, this means that my daughter is literally a part of me, she changed my physical make up, and she gave me a part of her to live on.

People often have no idea what to say when they hear that a baby died and many choose to say nothing.  Nothing could be less comforting than silence.  Not talking about it will not make it go away.  People are afraid that if they say something, it will make me think about my daughter, or that it will make me sad.  My daughter is never far from my thoughts, others speaking her name is music to my ears.

Talking about her will not break me, for I am already broken, her death shattered life as I knew it.  I have slowly and carefully put a lot of those pieces back together.  Talking about her and remembering her is often the glue that holds some of those pieces in place.  Talking about her may bring a tear to my eye, because I love her and miss her. But it would be the same for any family member someone has lost.  If someone’s parent dies, do they never speak of them again?  No.  They fondly remember and pay tribute to them.  Why should the death of a baby be any different? 

My tribute to my daughter comes in the form of helping other families that have lost a baby.  Shortly after my daughter was stillborn, family and friends started asking my husband and I what they could do to help, we requested donations be made in our daughters name to a local non-profit, MomsBloom (They provide free in-home postpartum doula support to families after they have had a baby).

Being a lay postpartum doula, I wanted to find a way to offer that same tender, postpartum support, to bereaved families.  After discussing the need for more support for families that have lost a baby, the grief support program started taking shape, this was the beginning of Cameron’s Garden Grief Support Program.  I want to be able to give newly bereaved parents somewhere to turn when no one else understands, to offer a hand to hold, a shoulder to cry on, someone to help these families get started on a journey towards hope and healing.

When you ask me how many children I have, I will answer you honestly, “I have four beautiful children, three wonderful boys that bring me joy each and every day, and a daughter that I can not hold, but will carry in my heart forever.”

Make an on-line slide show at www.OneTrueMedia.com

Lesley is a SAHM to 3 boys 6 ½ , 4 ½ , and 14m, four time survivor of PPD, and survivor of stillbirth. She blogs on her work and healing here. She is a lay postpartum doula and works in Grand Rapids, Michigan. MomsBloom is the community organization that she works within. To make a donation to Cameron's Garden, please go to their website and select 'make a donation'. Be sure to put "Cameron's Garden in the memo line.

She recommends the following resources for families experiencing a baby loss:

• Glow in the Woods
• Grief Share
• Compassionate Friends
• Now I Lay Me Down To Sleep
• National Share
• Journey of Hearts - booklet

Thank you, Lesley, from the bottom of my heart, for sharing!

What You Don't Know About Your Cervix

Just in case you haven't seen it, this is a great article.

The first time I learned about basic reproductive anatomy, I was pregnant with my first child, and the only thing I really learned about the cervix is that it was at the bottom of my uterus (liking my cervix to the opening of a balloon and my uterus was the balloon part waiting to expand), and was supposed to dilate to from 0 to 10 during labor.  It was also supposed to thin out (efface) and go from what is like the tip of my nose to the web of skin between my index finger and thumb…melt away kind of like a lifesaver.  And that my cervix might need to be checked during labor to asses its progress.

But that was it.  It wasn’t until I was well into being a childbirth educator and a doula did I find out some other things about the cervix.  Things that would change how I forever approach supporting women in labor and birth.

- Read the rest of What You Don't Know About Your Cervix Can Ruin Your Birth.

ETA: And yet, one more great blog post on the cervix.

MamAmor WINNER.. Take 3..

Wow, I can't deny that I am flabergasted that we had to do the drawing three times! I am hoping this one replies..

ok...


one more time...




the NEWEST winner is...

Nicole said...

As a new MOM (I just turn 7 months with my daughter today! :D) and CBE completing my training to be a Doula and Breastfeeding Consultant, MamAmor Doll - Julia will be such an awesome Mother's Day gift for me! Julia will also be such an awesome help in my classes to visually demonstrate baby's position in mommy's tummy, the birthing process and breastfeeding! Julia will also star in my videos and snap shots of my explanation and I'll give them to my clients so that they can refer to them whenever they want! And if you allow, I'll post them on FB to share with the world too! I'm sharing my drug-free natural birth experience in an article in the local (Singapore) magazine this month. It talks about doulas assisting births, how they make a difference to births and that it is possible to give birth to a baby as big as 4.4kg naturally, even peacefully! My husband and I were so relaxed that we even fell asleep in the tub at one point! When I see your dolls, I fell in love with them immediately because they gave a meaning to my career and passion as a mother to share the wonderful, peaceful way of birthing and beauty of breastfeeding to more family and new parents out there. I really hope to win Julia cause it will mean so much to me.

Nicole (nice name, by the way) - contact me within 3 days of this post (June 10th is the last day - one June 11th, I will have to make a new drawing). There are LOTS of ladies chomping at the bit to get Julia!

Booby Traps

http://mybrownbaby.blogspot.com/2010/06/salma-hayek-kim-kardashian-and-creepy.html

Best For Babes has an awesome series up called Booby Traps™. This series has, so far, gone through all of pregnancy and how your pregnancy care, choices, etc.. might affect your milk production. Now, they are moving on to how your birthing time might affect your milk production.

Their latest post is awesome!

Of course, sometimes supplementation is truly necessary (Rule One:  feed the baby), but when done without trying to protect your milk supply, it can be devastating.


Poor intake can also make your baby sleepy, which can make him or her a poor feeder – one who falls asleep at the breast early in the feeding.  And that in turn can make babies take in too little milk, which makes them even more sleepy.  It also puts babies at higher risk of jaundice, which in turn creates makes even sleepier.  See the vicious cycle you have to turn around to make breastfeeding work?

What many of us don’t know is that there are things about your birth experience which can make it more likely that your mature milk will take longer to come in.  And that’s where the Booby Traps come in.

Read the rest here.

I love this series and highly recommend every woman read through it and continue following the series until close. I know I will be.

BTW, I got the picture from My Brown Baby. She has both an old and new site, I have only read the old one and love some of her posts, very inspiring! Go check it out!

Arms Wide Open - WINNER

The winner for the Arm's Wide Open giveaway is....

Jenn!

Congratulations Jenn! If you wouldn't mind, when you are done reading the book, go to Amazon and write a review for her! It will help

MamAmor WINNER

ETA: We had to redraw as I didn't hear from Kendra S... so, read on.

And the NEW winner of the MamAmor doll giveaway, in celebration of International Doula Month is....


.....


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....

 

 

...

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Brandie Lekovic said...

Delightful. I can't image how excited I would be to have a doll of hers! I am a doula & CBE so Julia would be helpful to break the ice, entice questions, and demonstrate her baby love - honestly though, it's at dinner parties, and when my boys have friends come over that I most want to have her available. Learning happens in the most unexpected places! xx

Brandie, please know you have 3 days to get back to me. :) Otherwise, I will draw a new winner. :)

BTW, the winner of the "Arms Wide Open" giveaway is up. :)