Birth and Babies

We’re pregnant with #3!  I have morning sickness and all, and am only almost 8 weeks along.  I have to keep reminding myself of the things to do - after all, I teach students about this all the time.  Proper rest (though admitedly hard with two young kids already…), keeping something in the stomach all the time, ginger tea, something to keep in your mouth to suck on is also helpful.  Morning sickness is triggered or “enhanced” by low blood sugar - so short, frequent, healthy meals are key.  Fresh air, keeping busy, lying on your left side are also more ideas that help with nausea.  What’s worked with you?  Sometimes the nausea just won’t go away and you just have to get on with your day.  Ironically, the only time I’ve had all-day “morning” sickness (which can strike at any time of the day - or all day!) is with my daughter.  When I had my son I had a little bit of nausea but nothing bad.  I wonder if the old wives tail will be true again?  You know, the one that says if you have morning sickness you’re having a girl?

A VBAC stands for Vaginal Birth After Cesarean.  It is important to know that “once a cesarean, always a cesarean” does not always apply.  Certain things about your cesarean will come into play when it comes time to determine if a VBAC is for you - but they can be safe, empowering experiences for women who were not able to experience a vaginal birth before.

Once in a while I come across a mom or two that does not want birthing classes - they are either planning a medicated or surgical birth.  Sometimes, these plans can become interfered with and you may be forced to labor for a period of time - or until you birth!

Remember that emergencies do happen - and anesthesiologists and OB staff will give preference to emergencies.  It may also mean that you may have to labor without pain medication until the anesthesiologist is available, which can be a while. Even if there is no emergency, anesthesiologists are busy people, and it can take 15-30 minutes before they get to you - or longer. When an epidural is placed,it is not instant relief - those, too, can take about 30 minutes to take full effect.

Just recently a student of mine was planning a natural birth, but decided she wanted an epidural during labor.  The anesthesiologist was away for an emergency cesarean and when finally available she was ready to begin pushing.  Luckily she was prepared and could handle her labor!

A birthing class is not just for those who want a natural, medication free birth.  They are designed for everyone, even those who don’t plan to feel the pains of labor, because you just never know what mother nature has in store for you.  Your labor, even if unexpected, can be much more tolerable if you know a few tools and techniques to get you by.

A doula is essentially trained labor support.  They work in every environment, from home births, to birth center births, to hospital births.  Their job is to help you achieve the birth you want and will support you physically, verbally and with information.  They stay with you your entire labor and for a few hours afterward, so you can have continuous care, someone to ask questions to without having to wait for a nurse, someone to take care of your desires (pictures, juice, snacks, change position, etc.), someone to talk to, ask for help with newborn care, breastfeeding, etc.

Doulas do not, however, do anything medical.  They will not take blood pressure, perform vaginal exams, or give medical advice.

Doula also do not replace dad.  Instead, they help teach the dad how he can better support his partner, and have an ACTIVE roll in the birthing experience instead of being shoved to the side!

The doula will take pictures, get ice chips or juice, adjust lighting or temperature while mom and dad work through labor - or, the doula can help mom work through her labor and take turns with dad.  She can be totally hands on, or hands off.  What do you desire?

Interview as many local doulas as you can find, ideally before your third trimester.  Find the one that you like the best.  Generally doulas like to do 2-3 prenatal visits to get to know you, your desires, and help educate you before your birth.  Most will also have a follow up visit after the birth at your home.  Then, when you think you are in labor, give your doula a call.  She can meet you at your home or at the hospital - and she’ll stay with you through your labor so you are never without a knowledgable person.

Don’t think you can afford one?  Think again.  Many doulas will accept payment plans, barter, or even do volunteer work (but please offer to give them something for gas, meals, and/or childcare if applicable). 

Are you a doula?  Thinking of hiring one?  Let me know - if you need help looking I can provide some links!  If you are a doula in the local Monroe area, please reply to this so people can contact you.

So you like to read birth stories?  Every once in a while I get the urge to see how other moms have birthed.  I find it interesting to see how moms utilize all of the options they have surrounding their birth.

The place I like to visit is a site called Birth Diaries - which actually shows pictures of births along with the birth story. 

I’d love to hear the story of your childs birth - would you like to share it?  Maybe I’ll share mine, too!

Here are some ideas to try, to encourage your transverse or breech baby to turn into a favorable position for birth:

• Somersalts or handstands (in a pool!)
• Walking on hands and feet, kneeling on knees and hands (let your belly hang), laying on an ironing board tilted from a couch with your feet high and head low,
• Place headphones low on your belly (later in pregnancy your baby can hear - and may turn in the direction of the music.  Try a soothing type of music).
• Your baby can also see light  later in pregnancy, so you can also shine a flashlight low on your belly or between your legs, as baby may try to turn towards the light.
• Amazingly, your baby can also feel later in pregnancy - and can turn away from ice cubes, frozen veggies, or anything cold that you place on the back of his or her head if you can feel where the head is.

 Ideally, you want your baby in the correct position for birth by 36 weeks.  If all else fails and you cannot encourage the baby to turn on your own, you can seek our acupuncture, chiropractic care (you want the Webster Technique) or your care provider can do what is called an “external version” in which he or she will try to manually turn the baby by manipulating your belly and the baby.  This can trigger labor though, sot his is usually done as a last resort.  Unfortunatly, it is not a guarantee that the baby will turn to begin with - or stay in the correct position after turning.

Breech babies can be born vaginally (the preferable method seems to be a waterbirth, to prevent the baby from breathing before the head is out as the water is body temperature and won’t stimulate breathing right away), however most hospitals and some midwives will transfer for a cesarean section as some babies will do better via cesarean than attempting a vaginal delivery, especially those that appear to be in distress.

Does anyone have additional ideas for turning a breech baby?  Has this happened to you?  Tell me about it, if you will?

This is a pretty personal topic, but I have found most moms are willing to at least try breastfeeding once they know of the benefits.

I think it’s pretty well known that breastmilk is the most nutritious for your baby.  But  here are some other facts you may not have known.

• Breastmilk is easily digested and specific to the baby’s development.  Every mother will have milk uniquely formulated for their own baby - even premature babies will be getting breastmilk that is different than what a term baby would recieve, and breastmilk will change over time to suit the needs of your baby as he or she grows and matures.
• Breastmilk contains infection fighting properties not found in formula
• Breastfed babies have fewer problems with ear infections
• Breastmilk offers protection against gastroenteritis, allergies, diabetes, heart disease, multiple sclerosis and juvenile rheumatoid arthritis
• Breastmilk reduces the risk of SIDS after the first month
• The act of breastfeeding helps develop proper oral and facial development
• Breastfed babies have lower cholesterol in adulthood
• Breastfed babies have fewer caveties
• Breastfed babes are less likely to become obese later in childhood
• Breastfeeding helps the uterus contract and return to pre-pregnancy size, as well breastfeeding women have less vaginal bleeding and less risk of hemorrhage after birth!
• Moms who breasfeed have a lower risk of pre-menopausal breast cancer, cervical cancer and osteoporosis, in addition moms who breastfeed loose weight quicker after birth because nursing burns calories!
• Breastfeeding is quick and free. No mixing formula, cleaning bottles, running to the store for formula.  Breastmilk is always available.
• Breastfeeding provides time for mothers to nurture their babies with touch, nourishment and emotion. 
• Breastfeeding provides an instant soother for infants, and breastfeeding helps babies to cope with pain (from shots, teething, etc.)

There are a ton of reasons to breastfeed.  Will you give it a try?  Set a little goal - go for a few days.  If things go well, plan for a week or a few.  Educate yourself during pregnancy with a breastfeeding class, and then get phone numbers of lactation consultants and support so that if you have a problem or question, you can contact someone.  Even nursing for a few days will benefit your baby! 

You may find this article interesting - 101 reasons to breastfeed your child

By the time a female baby is 18 months, there is ductile tissue forming to become lactiferous tissue in adulthood.

The process of lactation begins as early as the 16th week of pregnancy and continues a short time after breastfeeding has been discontinued.

The nipple can contain up to 20 openings for milk to flow through

The areola darkens during pregnancy to become a target for baby!

Estrogen and progesterone cause the milk ducts to proliferate and expand, oxytocin is the contracting hormone that contracts the uterus and also contracts the myoepithilial cells surrounding the alveoli causing “let down” while breastfeeding.  Synthetic oxytocin, called Pitocin, is given during pregnancy to induce or augment labor.  Did you know that nipple stimulation can act in the same way as Pitocin to help trigger or augment labor?  Prolactin is the hormone that triggers the synthesis of milk from components in a mother’s blood, and also keeps estrogen levels low which can keep a woman from ovulating during breastfeeding (though breastfeeding should never be used as the only form of birth control, pregnancy can still occur!).

The production of milk is hormonally driven - even moms who have never been pregnant or have breastfed before can still induce lactation to nurse an adopted baby!  What a wonderful way to bond!

When the placenta is expelled, the mothers body prepares for the next stages of lactation.

Early and frequent nursing  and good support is the key to successful breastfeeding.  Your milk won’t come in for a few days after birth, but your breasts already contain colostrum - the best first food for your baby.  This is often referred to as “liquid gold” and there is absolutely no reason (unless truley medically necessary - which is very rarely) to supplement with formula until your milk comes in.

Unless you have an epidural or a condition that will keep you bed bound during your labor and birth, staying upright and active can keep your labor more managable (both in feeling and length of time) and help keep or improve your baby’s position to allow an easier descent.

By keeping upright, this means don’t lay down for your entire labor and birth.  Laying down slows the process because your body cannot work with gravity!  By being upright (sitting, standing, squatting, leaning, etc.) you are helping your baby descend with the help of gravity and your uterine contractions.  By being active, you are helping yourself stay energized, encouraging effective contractions, helping baby stay, or move, into a favorable position which can all help improve your labor and contractions.  Being active can include walking, swaying/squatting/bouncing on a birth ball, rocking, climbing stairs (slowly, it isn’t a race!), changing positions often, rocking on all four’s, etc. 

Staying active does not mean you cannot lay down at all - lay down when you need to, but beware your contractions will probably feel much stronger when you are laying down compared to when you are up.  When you have to lay down, try to lay down on your side instead of flat on your back.

When it comes to birthing - experiment to see what feels best for you so you can get the best push.  This differs for every woman, and can even change throughout delivery.  If you feel like you need to change position, ask for help and change. Kneeling or on all four’s, squatting (especially helpful for big or badly positioned babies as this is the position that opens your pelvis up to it’s widest capacity - ask if your birth place has a squat bar!), semi-sitting, sitting on a birth chair, standing (with support), laying on your side, etc. are all examples of the positions you might want to take up for delivery.  Believe it or not, pushing flat on your back is the most unfavorable position to birth in for both mother and baby, although it does offer your care provider a good view and access should help be needed (though you can change position with help during delivery if you are in an upright position, if assistance is needed).  If you have an instrumental delivery (forceps or vacuum), you will need to lay on your back.

Remember that your due date is an estimated due date.  That means that your baby can arrive approx. 2 weeks before or after your due date and any time inbetween.  So long as the mother and baby are not in distress or experiencing what could be life-threatening complications, there should be no reason to hurry the process with induction or cesarean section.  Babies will come when they are ready, and due dates can often be miscalculated, leading moms to worry when they go overdue.

 The last few weeks can be especially trying for moms, so you can put yourself to work by organizing your baby things, packingyour birth bag, visualizing the birthing process, educating yourself and helping your body prepare by walking, drinking red raspberry leaf tea, keeping up with your nutritious diet, and being sure to drink enough water and stay rested.