Birth and Babies

Advantages & Disadvantages to having baby at home

Studies have shown that homebirth is safe for low risk pregnant women and their unborn babies.  There are many reasons couples choose to have their babies at home.  These days, homebirth is becoming increasingly popular!  Midwives are trained to handle many complications, but they are also trained to detect problems before they become serious so they can transport or call for help if needed.

Advantages for Baby

• Baby is more likely to be born vaginally, without breathing difficulties often cause my cesarean birth or anesthesia.
• Less likelihood of infection.
  • Why? Fewer, if any, vaginal exams and intervention involving the vagina are performed on mom, which can introduce bacteria and cause an infection.   As well, babies are kept with them other after birth and not transported to a nursery, where illness can also be spread.
• Baby’s experience at birth can be recognized and made as gentle as possible. 
  • Low lighting, low voices, birth happening slowly and naturally without force, etc.
  • Routine procedures such as deep suctioning, Vitamin K shot, scrubbing the baby, etc. can be avoided.
• The mother-infant bond is allowed to occur naturally as the baby never leaves mom, can nurse immediately and can have constant skin-to-skin contact with mom as long as needed.
  
  

Advantages for Mom

• Mom is not subject to routine procedures such as electronic fetal monitoring, IV’s, bed or food restrictions.
• Mom can eat, walk freely and give birth physiologically – her body works with nature.  She can birth in a position she feels is best – not on her back unless she chooses, which is a traditional hospital birthing position.
• Mom will have continuity of care with her attendants, increasing safety.
• Mom and labor will be evaluated on an individual basis.  She won’t be sacrificed to protocols or be forced to labor on a time limit.
• Mom is much more likely to birth naturally, without medication, episiotomy, instrumental or cesarean delivery.
• Mom will be more comfortable in her own surroundings.
• There is less chance for infection.
• No traveling to/from a hospital while in labor or recovering from birth.
• Mom won’t be woken up while sleeping for the routine checks done after delivery, and the frequent removal of her infant for weighing and temperature taking, etc.
• Postpartum depression is less common  since there is no seperation.

Advantages for the family

• Husbands are in their own home and can participate as fully as they want.  Many times, the husband is encouraged to catch his baby!
• Other children can be present.
• Other family and friends can be present during labor and birth if requested.
• Life can go on as usual, as much as possible, during labor.  Meals can be prepared for everyone, the family is in their own surrounding and knows the location of anything they may need, and can move from room to room, or alternate between indoor and outdoor settings as they please.

Disadvantages

• A homebirth requires a higher level of responsibility and effort from the family
• Homebirth is not often supported by society or doctors
• Homebirth is not often covered by insurance, requiring the family to pay out of pocket or in some cases barter services
• Access to some emergency equipment can be delayed and require transport.

Minimizing the risk

Birth at home, as in a hospital, carries some degree of risk.  These risks can be minimized by the following ways:

·         Following good nutrition with a quality vitamin designed for pregnant women.

·         Do not smoke, drink alcohol, or use drugs.

·         Get good prenatal care

·         Find a good midwife who is skilled, confident and experienced with birth at home.

·         Inform yourself about pregnancy, birth and postpartum through reading, childbirth and new parent classes, videos, and asking questions.

·         Make sure you have all the supplies you will need at home well before your estimated delivery date.

·         Make sure you don’t have any problems or complications that could put you at risk during a homebirth. 

·         Make sure your baby is in a favorable position (head down, unless your midwife is very experienced with breech births)

·         Have adequate support during labor, birth, and postpartum.

·         Have an emergency back up, with numbers and clear directions posted by the phone and/or in easily found areas such as your refrigerator or family message board.

You’re about to hear my jaw hit the floor.  Yep, there it goes.  Did you hear it?

Alright, that was a slightly delayed reaction because we’ve known for a few weeks now but I figured becauase this is a birth and baby blog, that this was the more appropriate area to announce the news.  Yes, we’re pregnant again and due in November!  We are planning another homebirth (this will be our third homebirth, my first was born in the hospital), and will not know the sex until s/he is born.  Exciting times lay ahead (and certainly many chaotic ones also).  My goal is to continue nursing through my pregnancy (have never been able to do that, but my other babies were ready to wean themselves anyway.  My youngest is only 8 months old so I want her to continue nursing).  One up side to nursing is that come labor day, nursing can be used to help labor progress - nipple stimulation in general will help labor.  My pregnancies have all been closely spaced but this is the closest spacing so far - 16 months apart.

Anyway, back to blogging the topic at hand.  Things have been pretty quiet on the blog and I want to start another series like I did back with cesareans and epidurals.  Maybe the process of birth?  Intervention helps and risks?  What’s on your mind?

http://picturesofpregnancystages.net/pregnancy-stages-week-8.htm

Very informative and interesting!

Induction is the term used for artificially starting the labor process.  This is used for babies that are “post dates” or “late”, are expected to get too large before the expected due date, are experiencing certain complications (either mom or baby), or for moms who want to plan the date of their baby’s birth.  As with everything that changes the course of nature, induction certainly has its side effects.

As a general rule, induction should only be used when absolutely necessary to protect the mother and baby.  It carries serious risk and can create additional problems.

There are a variety of ways labor can be induced.  It is a great idea to study up on induction while pregnant so you are aware of your options and the process should this happen to you.

Here are some questions you should ask, when faced with the suggestion of an induction from your care provider:

Questions to ask before an induction: 1.   Why is this being recommended?2.   What are the benefits of inducing labor and what are the possible risks?3.   Is this something that I need to make a decision about now or can I have time to think about it and discuss it with my partner?4.   Are there ways that I can get more information about how my baby is doing? 5.   What is my time frame?6.   If I did agree to the induction, how would it be done?7.   If I did agree to the induction, would I be able to use a telemetry unit?  Would I be able to move around, use the shower or get into the labor tub?

8. If Pitocin is used, would we be able to turn it off once the labor got active and see if I could continue laboring without it?
9. What are my options?

            As a husband or birth partner, you are probably wondering what you can do to comfort and help the laboring woman.  As an expectant mom, you’re probably wondering what you might like during your labor!  There are far too many things to list for every possible condition, but here are a few ideas to get you started.             If the mother is tolerant of you touching her, experiment with different rubs, touches, squeezes and the like. 

• Prayer
• Communication: Talk with the woman and find out what she would like at the time – she is the best way to learn how to comfort her!  Ask questions (though not during a contraction) to make sure certain things aren’t bothering her
  • Are the lights too bright or dim?
  • Is the room to hot/cold?
  • If lying in bed – Would you like the bed up/down?
  • Advocate for her if that is her desire
• Massage
• Touch Relaxation
• Imagery – did she bring a few pictures to look at to help relax her? 
• Visualization Relaxation – do you have a tape or a script to read for visualization exercises?
• Hot/Cold washcloths on the forehead/face
• Keeping the hair out of her eyes, put her hair back in a ponytail
• Bring a rolling pin and pad it with a towel, use that to help massage her back.
• Back scratching, lightly scratching the arms and legs can also bring relaxation
• Offer drinks and snacks
• Encourage her, tell her she’s doing a great job
• Encourage her to get up and stay up and active, change position often
• Match her mood – when she becomes serious and quiet, her birth partner(s) should too
• Give the mother undivided attention
• Breathe with her           
• Encourage vocalization through the contractions
• Encourage the mother to change position, use a birth ball, take a shower
• Counter pressure
• Hot and cold compresses in areas of tension – neck/shoulders, back, groin
• Bounce and sway on a birth ball, kneel on the floor and lean over the birth ball
• Have your favorite music available
• Change scenery often, walk indoors and out
• Aromatherapy
• Affirmation
• Pelvic Rocking
• Showering
• Show dancing

Certainly I think by now we all know that for most mothers and babies, breastfeeding is the most complete nutrition and healthiest form of free babyfood anywhere.  It can take some getting used to, it may take a lot of practice and time to get it right - but in the end, its worth it.

What we may not realise, is that we are subjecting our babies to problems if we choose not to breastfeed.  Here is part of an article I hand out in my classes, which shows some of these side effects and how they can effect a non-breastfed child its whole life!

Gastrointestinal Illness   At least 400 infants die annually in the United States from diarrheal disease; an estimated 250-300 of these deaths are attributed to not being breastfed.  Other gastrointestinal disorders such as
Crohn’s disease, inflammatory bowel disease, and celiac  are minimized  in people who were breastfed.

Respiratory Illness. Between 500 and 600 infants die annually in the United States from acute respiratory disease attributed to not being breastfed. The risk of fatal or nonfatal respiratory infections is two- to fivefold higher among
formula fed infants.

Otitis Media occurs more frequently in infants who are not breastfed. Bacteremia and Meningitis  There is a fourfold higher risk of bacteremia and meningitis among babies who are not breast-fed.

Juvenile Diabetes  More than 100 studies indicate that breast-feeding can delay or prevent the onset of diabetes in  children said Dr Cadwell.

Malignant Lymphomas  A six- to eightfold increase in the risk for developing lymphomas among children younger than 15 years has been found in children who were not breastfed for at least 6 months.

Breast Cancer  Having been breastfed as a child  reduces breast cancer risk in women over 40 by more than 25%.

Pediatric News 33(1):37, 1999

Some great articles on health, nutrition and more for pregnant and nursing moms, as well as women in general!  Spend some time on this gem of a site, you’ll be sure to learn a LOT!

We’re looking for a few good people – maybe one, maybe several – who would be interesting in helping us develop a really good parenting Web site. We have a print publication called Monroe Parent, with a companion Web site, Monroeparent.com. We’re working on improvements to the print publication and want to dramatically improve the Web site, too (if you go to it now, you’ll see that it’s mostly broken, awaiting its rebirth).There are a lot of good “Mom” or “Parenting” Web sites developing around the country, and we’d like for ours to be right there with the best. One thing it needs is a “champion” or a group of “champions” who would give it the care and nurturing it needs. This person or persons would lead a blog or forum discussion, surf the net for useful links to good articles and Web sites, and work with our staff to pull the best content from our print publications.The idea is to give parents a place to exchange ideas – maybe in a slightly more orderly way than on MonroeTalks – and find good information. The “discussion leader” would need to be knowledgeable enough to pose good questions and steer the conversation, but would not have to be an expert with a degree in child development. The work could be done at home at any hour.We’re not talking about a full-time job – just a few hours a week. We haven’t decided yet what we’ll pay, if anything. It depends on how many people show interest and how much interest and how involved they get in the site, beyond just blogging/discussion leading.

Anyone who is interested should contact Dan Shaw at danshaw@monroenews.com or at 734-240-5749.

Everyone has their own personal favorite when it comes to babywearing.  Here are some of mine and some observations I have picked up over the years.

• Slings: One of the most versatile carriers around.  The sling will carry your newborn up to toddlers in a variety of comfortable positions.  The sling takes a little practice to learn how to adjust and snug your baby up to you, but once you have the idea they are very easy to use.  Most are very adjustable, allowing you the option to adjust the side rails and the depth of the sling.  You can nurse hands free and the tail doubles as a light cover to shield your baby from the weather or keep yourself covered while nursing.
• Wraps: Wraps are probably THE most versatile.  I can’t even count the carriers (or positions) you can use with a wrap on BOTH of my hands.  These work great for newborns up to toddlers.  The only downsides to wraps are their length (often around 5 yards), and the learning curve.  It takes a lot of practice to learn a few carries and it takes a lot of practice to be able to wrap your baby in a store or in a parking lot without having the ends touch the dirty ground… But their versatility outweighs any downsides, I think!  Using a wrap I find my baby is MOST secure on my body, and there is no hardware to worry about.  I can also wrap my baby so snugly that he or she can fall asleep and their head is so supported that I could essentially do jumping jacks and my baby would never move.  It’s not too tight - just very snug and conforms to their little bodies.
• Mei Tai: These are great carriers to use if you want easy.  They’re essentially a square peice of fabric with straps that you use to tie your baby on.  Your child sits on the square, which becomes a seat and back.  The straps usually criss cross under your baby’s bum and between his or her legs to create a no-slip chair.  Then two other straps typically go under your baby’s arms and the back of the ’seat’ reaches to their armpits.  I have seen mei tai’s that have headrests for young babies and for toddlers who fall asleep, but I’ve never used them.  I prefer the mei tai for a baby who has good head control, when it’s not close to naptime so there is no worry of a baby or child falling asleep without head support.  These are great to use on your front or back (or even side) and very user friendly!

First Prenatal Visit:

Usually the first visit is the busiest in which you and your partners health history is taken, blood is drawn for the prenatal panel, urine is collected (to check for infection or other problems), estimated due date is calculated, your weight/blood pressure is checked and sometimes the heart tones are detected via a doppler.  During this visit you may also have a full physical and pap smear.  This is a good chance to ask your care provider important questions concerning your care, and bring up any concerns you may have.

Health History

A health history is taken on you and your partner to determine special needs you may have during your pregnancy and to prevent complications.  Your care provider will want to know about your past pregnancies, bad habits, work environment, health, surgeries, etc.  It wouldn’t be a bad idea to bring a copy of your health record with you to this appointment!

Prenatal Panel

The blood drawn during this appointment is called your “prenatal panel.”  This is used to detect infection, collect basic information (such as your blood type), and to determine a ‘baseline’ to compare against future results should a complication arise that this information will help benefit.  The following tests are usually performed (and you do have the option to refuse them):

• Complete Blood Count (CBC): This blood test determines how efficiently your blood can carry oxygen, whether you are anemic, have an infection, allergies or the possibility of leukemia. The CBC measures the volume of red and white blood cells and platelets in the blood, and compares them to statistically normal range values.  If tests show a problem, your care provider will then treat accordingly.
• Hepatitis B Virus Screen: This test determines if you carry the Hepatitis B virus.  If you do, there is a chance that your baby may become infected.  If you test positive, special care will be taken after your baby is born.
• HIV: This test determines if you have HIV.  There is a risk that the virus may be passed on to your baby. If you test positive, there are several ways in which your care provider can try to prevent the spread of HIV to your baby. 
• Rh Titer: This test is done to determine if you have antibodies to rhesis factor.  First your blood will be tested to determine if you are rhesis positive or rhesis negative.  If you are Rh- (rhesis negative) your blood will then be tested to determine if antibodies are present in your blood, which will attack your baby seeing it as an ‘intruder’ of sorts. If you are Rh- and have not produced antibodies, you can be given the ‘Rh immunoglobulin injection’ around 28 weeks of pregnancy to prevent your body from producing antibodies, should your blood mix with baby’s.  If you have already produced antibodies (and are said to be ‘sensitized’) additional screening and care will be given depending upon your needs and status. Typically, if this is your first pregnancy and you haven’t yet had any invasive tests (like an amniocentesis) nor any trauma that could cause your baby’s blood to mix with your own, there generally will not be an issue.
• Rubella Titer Screen: This test determines if you have rubella, or German Measles, antibodies present in your blood.  While this virus causes few problems in adults, it can cause serious problems with your fetus.   
• Syphilis Screen: This test is done to determine if you are infected with the sexually transmitted disease called syphilis.  If left untreated, it can cause serious congenital malformations during pregnancy.  Syphilis is usually easily treated with antibiotics once it has been discovered.
• Additional tests may be performed if deemed necessary.  Ask your care provider for a list of tests that will be performed according to your specific needs and background.

Urine Specimen

Estimated Due Date

Your due date will be calculated forty weeks from the date of your last menstrual period.  This date is just an estimate, and it is perfectly normal to go into labor up to two weeks before or after your estimated due date.

Weight Check

Weight gain is healthy and to be expected during pregnancy.  Your initial weight will be noted, you will be asked for your pre-pregnancy weight, and then your weight will be checked at each additional appointment to ensure proper weight gain.  You should not diet during pregnancy.

Blood Pressure Check

Your blood pressure will be checked at each appointment to ensure it is not too high.

Doppler

Heart tones can be heard early in pregnancy using a Doppler.  This works by reflecting small, high frequency sound waves from fetal heart. These signals are picked up by the Fetal Doppler and processed then amplified so that they are audible.

Physical

A complete physical may be performed to check your health and assess the progression of your pregnancy.

Pap smear:

This is a test performed to check for any abnormal cells in the cervical area. These cells are tested to determine dysplastic, precancerous or cancerous cells.  Pap smears do return a decent number of false-positive tests, so if your test comes back positive, additional testing will be performed.

First Prenatal Visit:

Usually the first visit is the busiest in which you and your partners health history is taken, blood is drawn for the prenatal panel, urine is collected (to check for infection or other problems), estimated due date is calculated, your weight/blood pressure is checked and sometimes the heart tones are detected via a doppler.  During this visit you may also have a full physical and pap smear.  This is a good chance to ask your care provider important questions concerning your care, and bring up any concerns you may have.

Health History

A health history is taken on you and your partner to determine special needs you may have during your pregnancy and to prevent complications.  Your care provider will want to know about your past pregnancies, bad habits, work environment, health, surgeries, etc.  It wouldn’t be a bad idea to bring a copy of your health record with you to this appointment!

Prenatal Panel

The blood drawn during this appointment is called your “prenatal panel.”  This is used to detect infection, collect basic information (such as your blood type), and to determine a ‘baseline’ to compare against future results should a complication arise that this information will help benefit.  The following tests are usually performed (and you do have the option to refuse them):

• Complete Blood Count (CBC): This blood test determines how efficiently your blood can carry oxygen, whether you are anemic, have an infection, allergies or the possibility of leukemia. The CBC measures the volume of red and white blood cells and platelets in the blood, and compares them to statistically normal range values.  If tests show a problem, your care provider will then treat accordingly.
• Hepatitis B Virus Screen: This test determines if you carry the Hepatitis B virus.  If you do, there is a chance that your baby may become infected.  If you test positive, special care will be taken after your baby is born.
• HIV: This test determines if you have HIV.  There is a risk that the virus may be passed on to your baby. If you test positive, there are several ways in which your care provider can try to prevent the spread of HIV to your baby. 
• Rh Titer: This test is done to determine if you have antibodies to rhesis factor.  First your blood will be tested to determine if you are rhesis positive or rhesis negative.  If you are Rh- (rhesis negative) your blood will then be tested to determine if antibodies are present in your blood, which will attack your baby seeing it as an ‘intruder’ of sorts. If you are Rh- and have not produced antibodies, you can be given the ‘Rh immunoglobulin injection’ around 28 weeks of pregnancy to prevent your body from producing antibodies.  If you have already produced antibodies (and are said to be ‘sensitized’) additional screening and care will be given depending upon your needs and status. Typically, if this is your first pregnancy and you haven’t yet had any invasive tests (like an amniocentesis) nor any trauma that could cause your baby’s blood to mix with your own, there generally will not be an issue.
• Rubella Titer Screen: This test determines if you have rubella, or German Measles, antibodies present in your blood.  While this virus causes few problems in adults, it can cause serious problems with your fetus.   
• Syphilis Screen: This test is done to determine if you are infected with the sexually transmitted disease called syphilis.  If left untreated, it can cause serious congenital malformations during pregnancy.  Syphilis is usually easily treated with antibiotics once it has been discovered.
• Additional tests may be performed if deemed necessary.  Ask your care provider for a list of tests that will be performed according to your specific needs and background.

Urine Specimen

Estimated Due Date

Your due date will be calculated forty weeks from the date of your last menstrual period.  This date is just an estimate, and it is perfectly normal to go into labor up to two weeks before or after your estimated due date.

Weight Check

Weight gain is healthy and to be expected during pregnancy.  Your initial weight will be noted, you will be asked for your pre-pregnancy weight, and then your weight will be checked at each additional appointment to ensure proper weight gain.  You should not diet during pregnancy.

Blood Pressure Check

Your blood pressure will be checked at each appointment to ensure it is not too high.

Doppler

Heart tones can be heard early in pregnancy using a Doppler.  This works by reflecting small, high frequency sound waves from fetal heart. These signals are picked up by the Fetal Doppler and processed then amplified so that they are audible.

Physical

A complete physical may be performed to check your health and assess the progression of your pregnancy.

Pap smear:

This is a test performed to check for any abnormal cells in the cervical area. These cells are tested to determine dysplastic, precancerous or cancerous cells.  Pap smears do return a decent number of false-positive tests, so if your test comes back positive, additional testing will be performed.