Gratitude bestows reverence, allowing us to encounter everyday epiphanies, those transcendent moments of awe that change forever how we experience life and the world. --John Milton

Friday, November 28, 2014

Delayed Cord Clamping Objections and Answers

Fascinating! Here's an article answering objections to delayed cord clamping written by Mark Sloan M.D. I was especially informed by numbers 10 and 11. 

Many maternity care providers continue to clamp the umbilical cord immediately after an uncomplicated vaginal birth, even though the significant neonatal benefits of delayed cord clamping (usually defined as 2 to 3 minutes after birth) are now well known. 
In some cases this continued practice is due to a misunderstanding of placental physiology in the first few minutes after birth. In others, human nature plays a role: We are often reluctant to change the way we were taught to do things, even in the face of clear evidence that contradicts that teaching. 
Though there is no strong scientific support for immediate cord clamping (ICC), entrenched medical habits can be glacially slow in changing. Here are some often-heard objections to delayed cord clamping (DCC), and how an advocate for delayed clamping might respond to them:
...
 10) You can’t have both the benefits of DCC and immediate skin-to-skin contact. If you place a newborn on his mother’s abdomen (i.e., above the level of the placenta), gravity will reduce the flow of blood from placenta to baby.Gravity does matter, but mainly in terms of the speed of the placental transfusion. A baby held below the level of the placenta will receive a full transfusion in about 3 minutes; one held above the placenta (e.g., a baby in immediate skin-to-skin contact) will also receive a full transfusion—it just takes a little longer (about 5 minutes). (1,13) 
 11) But what if the baby needs resuscitation? Isn’t it best to hand her over to the pediatrician immediately?One of the first things a truly sick baby in the NICU is going to receive is fluid support—often as a 20 to 40 ml/kg bolus of normal saline or blood. Yet that is exactly what’s left behind in the placenta with ICC—about 30 ml/kg of whole blood. There is considerable evidence that sick babies, both term and preterm, have better outcomes with DCC. It’s better to let nature do its own transfusing. (14-16)
...

Please join the discussion, sharing your comments below.

Wednesday, November 26, 2014

When Labor Slows: A Home Waterbirth Story

Often active labor starts and then stops for a while. Did you know that a cervix having opened can even close back again in the middle of labor? Here's a wonderful story that explains why.

I've included an excerpt of the post from Birth Without Fear.

 We were just waiting for the Braxton Hicks contractions to turn into the real deal so we could get our daughter here.  Sunday morning was spent with the church family and then the afternoon was spent with Greg’s family celebrating his mom’s 55th birthday. 
I was feeling pretty good and honestly didn’t feel like I’d see my daughter anytime in the next few days.  I was nervous that when it was finally time that Greg would be late getting home and I’d labor alone, that the midwife would barely get there in time, and that everything would happen so fast, I wouldn’t hardly remember the experience!  Needless to say, that was not what occurred. ...
Did you enjoy this story? Was there any part where you felt uneasy? why?

For more info on the Sphincter Law or even an un-dialating cervix: Try the blog post "The Sphincter Law and Childbirth" on Prenatal Yoga Center or America's foremost midwife Ina May Gaskin on YouTube



Monday, November 24, 2014

When the Law Says No Home Midwives (PART 1)

I prefer to have a midwife, but our situation doesn't reasonably allow for it. That's not stopping us from exploring what we can do towards a gentle birth experience.

I knew there was a little one inside before the test confirmed it. Let's see ... a Christmas baby. This one would be two years younger than our first child.

I was set on using the same birth center where I had already enjoyed a good experience. Months before we had chosen to save up, rather than pay into an insurance plan, partly because many plans don't cover birth center costs well.

My husband and I sat down with costs and budget laid out and reevaluated. Were there any other options, perhaps less than the $6,000 birth center package? What about a midwife at home?

I soon found that most midwives had been chased out of state or out of practice by a restrictive law. The two I located were about as far away as the birth center. They spoke at length about our needing to consider possible ways to work around the midwife law in order to employ services. Finally, I determined that having a possibly stressed midwife who may not make it to the birth in time wasn't worth hiring an experienced attendant. Besides, the cost would still be about $4,000.

I was still thinking that the birth center was our best option, though I was intrigued by a local friend's home birth without a midwife. She had creatively compensated for not having a midwife's support, and maybe I could too.

I began to explore possibilities and research extensively. The more I envisioned home birth, the more I wished to deliver in the comfort of my home. As welcoming as it had been when we got to the birth center, I relished the idea of skipping the awful hour-long car ride.




Thursday, November 20, 2014

Homebirth Statistics

Interested in well-documented statistics about home birth verses hospital birth? Bethany shares three studies. She provides a helpful summery for those of us who would rather not take the time to read entire research papers.

Is home birth safe? 
Most doctors in the US will say no, absolutely not. But is that really true? Here are a couple studies so that you may decide for yourself. 
1. 2009 study published in the Canadian Medical Association Journal (CMAJ)Conclusion: “Planned homebirth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric intervention and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician.” 
 Details: This is a very good study because it looked at only women who were low-risk; even the women who gave birth in the hospital would have qualified for a home birth if they had desired. Therefore, the study is not biased in favor of homebirth, but is as fair as humanly possible. For a planned home birth, rates of perinatal (baby) death per 1000 births was 0.35. For the planned hospital births with a midwife, rates of perinatal death per 1000 births was 0.57. For planned hospital births with a physician, rates of perinatal death were 0.64. Notably, the study finds that women who had planned home births were significantly less likely to have bad maternal (mother) outcomes, such as severe tearing or hemorrhage. ...


Let's be as informed as we can and understand our decisions about birth. Read the rest of the blog post here. What do you think of the research?

Monday, November 17, 2014

My Husband Won't Get in the Birth Pool

Good for the man who will get in the birth pool with his laboring wife. My husband is not that guy.

He's fully supportive of my natural approach, but he'd rather be smoking his pipe in the other room during the birth then be in the middle of it. So it's tremendous of him to hold my hands and let me scream in his face.

I'm still learning to let him be who he is, supporting me in the way he does. To not assume of him. And to ask him what he thinks and then really listen.

Any other wives know what I'm talking about?

When I read someone else's birth experience that I admire, I can think her story must be mine. Then I remember: every birth is unique. I'm a mama like no other. And the Cowboy - well, that's why I fell in love - he's him and no other.

I do make suggestions, like that he might cut the cord. Or I ask him to help support me while I practice laboring positions.

But when I push too hard, we both feel stressed. When I let go, we both relax and enjoy our unique experience.




Want more info? Try Special Delivery: The Complete Guide to Informed Birth by Rahima Baldwin.

Thursday, November 13, 2014

A Mama Who Has the Courage to Question

Some have a wonderful experience with an OB/GYN and other hospital staff. If that's you, please share. It varies place to place, person to person, doesn't it? I'm convinced there are unfortunate tendencies in the emergency-minded hospital setting for the majority of births that aren't an emergency, but good things can be said too.

I share this gals story, because it reminds me a little of my own interaction with some (not all) hospital personnel.

She has a lot of courage and love for her baby. Here's part of what she shares:
We've been through a lot these past few weeks. My OB practice and I parted ways on bad terms. Technically, they kicked me out, but at the same time as I was already looking for a new provider. They refused to explain the reasons behind their recommendations and became shockingly belligerent, aggressive, and threatening towards me when I wouldn't just follow blindly and stop asking questions.
So I tried transferring to a midwife practice, assuming I would be accepted as the healthy, low risk, attentive mom-to-be that I am. All it took was a call to my previous provider and before I knew it, I had been declined from their practice. It was "too risky" to accept a patient who was kicked out of another practice for non-compliance and high results from a 1-hr glucose test (that I later found out hadn't even been administered properly). I couldn't retake the test correctly. I couldn't provide my 2 weeks of glucose monitoring results showing I'm below diabetic levels after every meal. I couldn't explain my side of the story of why I was kicked out. I'm just a risk. ...
Please read the whole to story to find out the happy ending.



Monday, November 10, 2014

My Baby Swims (Part 2)

"Touch the top of your baby's head."

I'm scared. I eye her doubtfully, but the midwife nods. I touch his slimy head. He's so real. This is actually happening.

And then he swims.

"Reach down, and pick up your baby."

For real? I scoop him close. A slight cry, a cord loosened from his neck. Those eyes - so alert.

I slump, spent. Relief. I'm simply relieved. I hold, just hold him.

Then a new Dad holds his son while I totter out of the pool, shivering. My purple son warms on my chest under freshly heated towels. This tiny, beautiful person - so tiny. I tuck my arms around him while he contentedly nurses. Moments before connected by cord, now connected at breast.

After a few minutes, I think I'm ready to wash up. I pass out. Someone's putting the most annoying smell up my nose! It pulls me from a deep dream. I'm out again. Why won't that sharp smell leave me alone!

I'm helped back to the bed and sleep.





How was your water birth different?

Want more info on water birth? Try Gentle Birth Choices by Barbara Harper. Or a thorough, beautiful, real story of a water birth on BirthWithoutFear.com

Wednesday, November 5, 2014

Story of a Beautiful Breech Birth

Many of us were nervous about birth and particularly breech until we understood it better. Here's a video giving us a glimpse of a precious welcome. 

This is a third baby, her second natural (vaginal) birth and first home birth for this family. The baby was small and full term. Apgar Scores were 10 and 10. You also see the first 30 seconds after the birth. 
The t-shirt was worn to make Robin Guy and the women of Coalition for Breech Birth smile --they made these t-shirts for the CBB conference in 2009. It says, "Whose afraid of a little bum?" and on the back, "Not me." I almost didn't wear it because of magical thinking, but choose faith instead of fear, community instead of isolation. Thanks, CBB community!Thanks especially much to the brilliant Jane Evans, UK Midwife and the full-hearted Drs. Anke Rietter and Frank Louwen of Germany for their Day at the Breech training in Ottawa which improved the way I attend breech births. I'm no expert, but simply responded to this woman's clear determination.
She had a cesarean for breech with her first, and had a homebirth for breech with her second. 
If she'd have been able to have a hospital breech birth she wouldn't have gone looking for a homebirth midwife. That being said, I do believe we gave her excellent care. This birth is probably safer than what would have happened in a typical US hospital right now. Being hands-off allowed her baby to do the cardinal movements. ...
What's your breech story?

Want more info? Check out breech birth on SpinningBabies.com

Tuesday, November 4, 2014

My Baby Swims (Part 1)

I arrive at the birth center. I'm eight centimeters dilated - oh good! Apparently I'm moving along quickly for a first timer. That thought doesn't make the next contraction any easier. I'm swept away. So much for being in control! I wail.

The water. Oh the warm water is instant comfort. But then another contraction - wasn't there something about water being less painful than with an epidural? How could pain get worse? Then it does. I scream. I don't know the full capability of my lungs until I scream. Now so does my husband - ten inches from my panic.

This baby's not going to fit. I can't do this. I suddenly decide I don't want to give birth. It's too terrifying, too real. (So this is me in transition.) "Is he going to fit?" I implore my unflappable midwife. She assures me, yes.

I collapse again over the side of the birth tub til the next one. Then she says it: "Instead of screaming, push down." And I remember the words of a long-time mom, "When it's too much, and no one else can go there with you - God will." I think, the only way, is through this.

I close my mouth. And push.