Evidence Based Maternity Care

http://childbirthconnection.com/pdfs/evidence-based-maternity-care.pdf

This is an awesome article...very LONG, but great about evidence based maternity care and how we in the USA stack up. It give loads of references and is well written. It can be a wonderful resouce for anyone wanting to gather stats, make an informed decision or look at the cost of intervention, both financially, physically and emotionally.

Postpartum-Dads

I am hearing more and more moms saying they are going to pump breast milk so that dads can be involved in the care of the baby. I have such a difficult time understanding this logic. Let's look at some ways dads can be helpful in the postpartum period and be very involved in the newborn babies life.

Mom and baby have co-existed for nine months, this relationship is not going to change overnight. Moms and babies need to continue to co-exist after birth only now the position of the baby has change. If you look at the physical needs and psychological needs of the newborn, it would appear that if it were not for size, the baby would stay inside for a longer period of time. This same rate of develop that baby had inside mom, continues outside...baby continues to get nourishment, comfort and care from the mom once outside. What does that mean, the time of separation is not at the time of birth, but is a gradual process over the next few months. The reason the baby is expelled from the body is because if it stayed inside, it would no longer fit through the pelvis. Some look at this period after birth as the fourth trimester. Moms and babies should not be separated at this point for both of their sakes.

Dads continue to do for your wife what you did during pregnancy for the fourth trimester

• help with household chores (keeping the house clean or at least not messing it up any more is huge.
• making sure moms have food to eat (this doesn't mean you have to cook, you may pick up a meal, coordinate friends and family to bring in meals, heat up a frozen dinner)
• be her legs ( she is likely tired and sore, get her things so she doesn't have to get up)
• take care of other children (again you don't have to do all this yourself, coordinate with friends and family)
• encourage her verbally ( she is likely to feel inadequate, hormones are doing crazy things, don't try to fix it, just let her cry if needed, tell her things will get better and hold her)
• be patient ( you will get your wife back :)

Some wonderful women wrote on labors of love face book...check it out. You can just hear the love in their hearts as the tell of all the many wonderful, little things their husbands did for them.

Risks of C-section

This organization have some wonderful handout on many different issues facing pregnant women. Since I had just written about avoiding a c-section, I thought I would post the risks of having one. I find the hazards of repeat cesareans particularly interesting. We hear so much about the hazards of VBAC and the lack of accessibility, I think if most women sat down and looked at the long term risks and benefits, they may work harder to avoid them in the first place and then would fight harder for their right to VBAC. http://www.vbac.com/pdfs/CesareanFactSheet.pdf

Avoid C-Sections

As I read this article this morning I was saddened by the fact women have, in many areas, lost their ability to birth naturally after a c-section. This makes birth choices even more important.

The thought that kept coming to my mind was how can we avoid the first cesarean. I have a heart for those women who have had cesareans and want the option of a VBAC, but my hands are tied. Most women do not go into childbirth desiring to have major abdominal surgery.

Here are some things to consider:

1. Educate yourself. Even if you don't desire to have a natural birth, take a non-hospital based class. You will learn about many other aspects of pregnancy, labor, birth, postpartum, baby care and self care. These classes are usually several weeks long. There is a reason for this. You can only retain so much information at one sitting. You will have questions come up after you get home, write them down. If you don't take a class, read and research on your own, ask questions, prepare for you birth. I love The Thinking Woman's Guide to Better Birth by Henci Goer. The other reason to educate yourself is you don't know how things will go with your birth. Your epidural may not work, you may have a very fast labor and there not be time for medication, you may be stranded on a desert island...ok that one is a bit of a stretch. Would it not be better to be prepared than terrified of what is happening to you.


2. Choose your care provider carefully. Find out what their c-section rate. Find out how many of those c-sections are primary vs. secondary. What is their attitude towards c-sections? This can be altered due to the number of high risk patients they work with, but even that may be a clue to you. Interview the hospital or birth center where you plan to deliver. Ask the same questions. Some facility protocols are normal birth friendly than others. Remember in the rest of the world midwives care for normal, low risk women, doctors care for high risk women.


3. Choose carefully who is with you during birth. Your support person is vital to the success of your birth. Only invite people expect a positive outcome. If you are birthing in a hospital setting or a birth center that does not offer labor support, hire a doula or invite a friend who can help you reach your goals.


4. Avoid induction. The rate of induction has skyrocketed! There is a convenience factor for both families and care providers but the risk are huge. When you are induced, you opportunity for having a vaginal birth plummet. There is a delicate dance between mom and baby as to the right time to be born. Babies go through the final stages of developement, moms bodies prepare for labor. Everything works in perfect harmony, leading to shorter, more productive, more satisfying labors and births. The old addage the apple will fall when it is ripe is so true.


5. Avoid unnecessary intervention. Intervention, when necessary, can be life saving. When used unnecessarily, intervention can lead to higher risk. An example, the simple introduction of IV fluid in the bloodstream distrupts the natural balance of hormones needed for labor to continue. To get labor back up to a productive level, pitocin must be added. Pitocin leads to more painful contractions because of the way it acts of the uterus and brain. Pitocin requires closer monitoring which inhibits movement. It can also lead to fetal distress. Less movement, more restraint and more pain often leaves moms with little option other than asking for pain relief. This is usually in the form of epidurals. Epiruals limit mobility which can cause malpresentation making labor longer and more difficult if not impossible. Most women don't realize when the allow an IV to be placed, they are actually signing up for a "package" deal which could very likely completely sabbotage their orginal plans of a normal birth.

Childbirth is a normal process. Let's not give up our ability to have babies normally. Count the cost ahead of time.

http://www.time.com/time/magazine/article/0,9171,1880665-2,00.html?iid=perma_share

Snow is SC

We drove home today from the coast. It rained most of the day so travel was a bit slower than usual. Once we got home the snow started and now we have a winter wonderland. I always like the snow. It cleans the air and the mind. Everything looks so pure and white. The crispness of the air is refreshing. I love to walk in the snow.

Winter is a natural time of pruning. The snow is heavy and burdensome. Old branches fall from the weight of the snow. If the tree has been well cared for by professional pruning, well fertilized, good root system they fair much better.

Labor is that way also.

Women who have a good support team, supportive husband, loving family, and care providers who are respectful of their wishes fair better. Those who have grounded themselves with a good childbirth class are not easily swayed in the tough times. They don't break under the pressure. They are confident in their ability and they stand strong.

Women who go into labor well nourished and healthy have more stamina to sustain them through labor and birth. Exercise such as walking, swimming, yoga, and strength training prepare the body for the hard work that is ahead. It also give confidence in knowing what you are capable of doing.

Pruning back you life and focusing on the priorities is also helpful. This might be getting rid of excess baggage around the home, trimming back schedules, eliminating activities or streamlining material possessions. It may also be a great time to get rid of emotional baggage. If there has been sexual abuse or trauma in your past, this is a good time to talk with a couselor or your care provider. You probably don't need to rehash the details but acknowledge it and recognize there are going to time you are going to feel very vulable during labor and establish for yourself safe boundries.

Birth is a process of releasing. Releasing your fears, surrendering to the contractions and finally releasing the baby from you body.

Just like the tree that is well pruned, well nourished and has strong roots, your body too will produce the most glorious fruit.