Birth and Babies

I wanted to share with you an incredible resource I found all about wholesome baby food and making it yourself.  It’s at http://wholesomebabyfood.com/ and you can actually download the entire website into a e-book for around $4.  Totally worth it.  Learn about allergies, good recipes for babies as they first start out with solids until they’re eating finger foods, how to puree, store, thaw and tons more. I downloaded the e-book and printed it out - very much worth it.

You can also go to www.wholesometoddlerfood.com for recipe ideas and information on wholesome toddler food.  This covers not only recipes and food prep, but also talks about picky eaters, toddler nutrition requirements, sample menu’s and much more (even toddler activities!).

I hope you’ll enjoy them as much as I do!

Ok now that we’ve covered reasons for cesareans and how to prevent them, let’s look at some of the risks they carry.

 Keep in mind cesarean sections are major abdominal surgery.  So of course, surgical risks will carry over to mom and baby, among others.  In the event of an emergency, cesareans are necessary as often the emergency carries more risk to deliver vaginally or wait than the surgical procedure it’s self.

Some of these risks include:

• post surgical pain
• Infection
• injuries to adjacent organs
• Injuries to the baby (accidental cuts)
• blood clots and stroke
• hemorrhage
• Emergency hysterectomy
• maternal death (women run 5-7 times the risk of death with cesarean sections than with vaginal birth).

There are also risks associated with FUTURE pregnancies and births once a woman has had a cesarean.

• increased risk for cesarean section
• infertility/reduced fertility
• placenta previa / placenta acreta
• placental abruption
• uterine rupture

And risks to future babies from prior cesarean sections:

• increased risk of stillbirth
• low birthweight
• preterm birth
• physical malformations
• centra nervous system injuriy

Take a look at this fact sheet (pdf) for more information.

Once couples learn of these risks associated, many want to work to prevent a cesarean.  Please see my previous post about preventing cesareans.  Among the ideas presented there, here are a few more:

• Develop trust in the birth process and take personal responsibility for the birth rather than expecting your doctor/midwife to take care of everything. 
• Use alternative treatments for the four major indications for cesarean section (previous cesarean, prolonged labor, fetal distress and breech presentation)
• Avoid induction of labor unless medically necessary
• hire a doula to be with you through your birth (along with your partner)
• Remember to urinate at least hourly
• if you are told you need an emergency cesarean, ask why and ask for a second opinion if time allows.

Sometimes a cesarean is necessary - it is a life saving procedure after all.  But, it is still the baby’s birth.  And the mother should still have access to options and be able to take an active role in the birth, which will also help prevent grief sometimes associated with cesarean deliveries.  Some ideas to help you avoid grief: know the reason for the cesarean and feel that it is valid, be included in the decision making process, understand what is going to happen, see or be told about the moment of birth, take pictures, be with the baby as long as possible.  Breastfeed as soon as possible after birth (breastfeeding can actually help fight depression!) and room in with your baby during the hospital stay.  Grief after a cesarean section is not uncommon.  Many women feel let down, traumatized, or as if their bodies can’t do what they were made to.  Take time to acknowledge this and talk to someone who understands - it is real and should not be ignored.

Postpartum plans are similar to birth plans in that you plan how you’d IDEALLY like your postpartum period to go.  Who is responsible for what, what gets done, what to eat, etc.  Of course, plans change.  But it’s helpful to plan an idea so that when things are going smoothly, you can know what to expect.

http://www.dona.org/resources/doula_practice_postpartum.php DONA International has a postpartum plan.

Find another at http://transitiontoparenthood.com/ttp/foreducators/babystuff/babycareplan2.pdf This is a PDF, so you’ll need Adobe Acrobat Reader (free) which can be found at www.adobe.com or some other reader for PDF’s.

I will be posting a few more links or files for moms who will be staying at home long term - and some ideas to prevent communication issues, common arguments and make stay at home life a little more organized.  Stay tuned

Just a note to anyone interested, you can get a downloadable cloth diapering business directory in e-book format for FREE. visit www.clothdiaper101.com and click on the business directory.  If you are considering cloth diapers, this directory will help you find what you want and the best place to get it.

Cloth diapers can save a lot of money. The main downside to them is the fact that up front, it can cost about $100 or so to get started.  Of course, over time you re-use the diapers and it saves you money after the first months of using them, but just getting started can be rough. 

Visit http://miraclediapers.org/ and get started using donated diapers! 

If you have used cloth diapers and no longer need them, consider donating them to Miracle Diapers.  I have donated diapers to them in the past and am so glad knowing my diapers are getting another life!

A cesarean section, or c-section, is major abdominal surgery.  It’s purpose was to deliver a baby in life/death situations, however in this day and age cesareans are becoming popular for planned delivery dates and times, a way for women to dodge the pain of labor, money maker for the hospital, and when things don’t go as they should per the text book (and in all honesty each labor and delivery is different and should not be judged against “the books”).  About 1 in 4 births ends in a cesarean, and it is estimted that about half of those were not medically necesary!

There is a lot a woman can do to prevent a cesarean section though.  This begins well before the first labor pain.

Read books, attend classes (both in and outside of the hospital environment), workshops, etc. Educate yourself about pregnancy, preparing for labor, handling labor and birthing your baby.

Research and prepare a birth plan.  I’ll blog on this in a few days going over what it is and what you can include on it.  If you’re really anxious, visit www.birthplan.com and you can create and print a birth plan right online!  Be sure to submit copies to your OB/Midwife, the hospital/birth facility, everyone on your support team (husband, doula, mom, etc.) and slip one in the hospital/birth bag.  Make sure everyone is on the right page BEFORE labor. Let everyone know how you’d like things to go, but also be open to change when necessary.  The idea behind a birth plan is to let everyone know that if no problems arrise, this is how you’d like your birth to go.  And in many birth plans there are plans for when things don’t go according to your plans - including what you’d prefer during a cesarean if needed.  But in emergency situations, birth plans go out the window to save a life.

Interview more than one care providers.  Ask key questions, see what their responses are and how probing influences their attitudes.  This is really important, because you want to find a care provider that is open to questions, someone who shares the same philosophy about birth that you do (there is nothing worse than seeing a care provider who degrades you for the choices you make during pregnancy, doesn’t respect your wishes during birth, and makes the whole experience stressful and unhappy). 

Tour more than one birth facility.  Note their differences, ask about their cesarean rate, epidural rate, VBAC protocol (vaginal birth after cesarean), etc.  Be aware of your rights as a pregnant woman.  A hospital that has a high cesarean rate most likely means they are not all done for medical reasons and you may be pushed into one.

Help do your part to ensure a happy baby and mom by eating a well balanced, wholesome diet.  Eating foods high in protein, vitamins and minerals can prevent complications in pregnancy, labor and birth! 

If your baby is breech, ask your doctor about exercises, external version (turning the baby manually), and vaginal breech delivery.

Learn about staying active in labor, positions that are helpful for laboring and positioning baby.

Find out the risks and benefits of routine and emergency procedures.  When faced with any procedure, the mother should ask why it is being done, what the long and short term effects will be on her and her baby, if it has to be done now or if she has time to discuss it with her partner, and what other options she has.   In many situations, routine procedures can cause more harm than good and they can lead to the “domino effect” of intervention (one procedure leads to another to prevent problems caused by the previous procedure - small example - mom is continually monitored externally instead of intermittent monitoring by the nurse, the restriction of movement doesn’t allow her a full range of options for staying active/changing positions and other techniques for pain control, so she asks for an epidural.  Now bedbound she is unable to move at all, labor stalls, pitocin must be given to augment labor, baby goes into fetal distress from the meds, a cesarean is done).  Many procedures and intervention restrict mothers movement or increase chances of infection and so questions should be asked every time the doctor or nurse comes in and suggests something be done.  If it’s medically necessary, have it done! 

There are some things you can do during labor:

Stay at home during early labor.  Walk and change positions frequently.  Labor in the position that is most comfortable for you, but try to avoid laying flat on your back.  Continue to eat and drink lightly.

Avoid pitocin augmentation for a slow or stalled labor if at all possible.  There are natural ways in which you can help augment labor such as nipple stimulation and acupressure.

Minimize how many vaginal exams that are done if your membranes have already ruptured.  This is to prevent infection.  Vaginal exams are done to help determine where you’re at in labor and to determine what type of position the baby is in.  In many cases, there are less-invasive ways to determine labor progress. 

Recent studies have shown that the routine use of continued electronic fetal monitoring contributes to an increase in cesarean sections, without related improvfements in fetal outcome.

Epidurals and other anesthesia can slow down labor and can also cause complications for mom and/or baby. Moms with epidurals can request that the pump is turned off and the medication wears off so she can push effectively.

Gosh where do I begin?

The misunderstanding between husbands who work out of the home and their wives who stay home with their children is getting out of control.

Some husbands seem to think their wives “sit at home all day” doing “nothing” and can’t understand why they have to come home to a still cluttered house and a frazzled wife with dinner being late.  Wives on the other hand feel unappreciated and feel their husband is expecting too much from them day by day.  Misunderstandings lead to a lack of communication because both parties seem to be too frazzled to begin and marriages fall apart.

I am seeing way too much of this.  I thank the good Lord above that I have an understanding husband.  I stay at home, but I also own a business (teaching expectant and new parents about pregnancy, birth and beyond!) and write books.  Of course I’m a wife, and a mother of soon to be three small children.  I have a lot on my plate - but it allows me a great opportunity to try out new ideas!  And I also help other couples find ways so a partner can stay at home with frugal ideas and strategies - only to hear of the frusteration that continues to mount after a period of time.

It seems as if all the planning in the world is not enough to prevent problems.  Some husbands complain that they come home to a messy house, bills are forgotten about, dinner isn’t ready, mom is frazzled and starts complaining the moment he walks in the door or hands a fussy baby over to him as she walks away saying she needs a moment to herself.  Mom on the other hand has been working around the house all day making meals, cleaning up children, picking up after the messes kids make, play with the kids, trying to get kids down for naps.  For moms with very young children, breastfeeding or bottle feeding can take up a lot of time in the early months, diaper changing can take up a lot of time, then there are baths, bedtime and oh yea, dinner (whoops!).

Let’s admit it.  No one has an easy job.  Many moms claim their out of the home jobs pre-baby were easier than staying at home with the kids.   But then again - they wouldn’t trade this job for anything.  Even if dad seems to have an easy job (and might even be accused of sitting on HIS behind all day!), dad has a lot to worry about.  He’s the one providing financially for the family!  There is a LOT riding on dads shoulders.  His stress can lead to a lack of feeling appreciated, or even resentment against his wife because he hasn’t yet spent a day in her shoes and he has to work all day only to come home to an unkept house.  The wife, on the other hand, starts to resent the husband because he has such an “easy” job and she’s been at home with the kids all day - again, not having spent a day in his shoes.

Let’s back up a minute.  When did the lack of appreciation, resentment and frusteration first begin?  How much planning went into the decision to stay home?  Was it a joint decision, or did mom put her foot down and claim she was not returning to work?  Resentment can start building up right at the start if staying home is not a joint decision - and the outcome is never pretty.  But maybe it was a joint decision, but there are expectations dad may have never mentioned, and as a result they are not being met.  He doesn’t want to nit pick his bride, so he doesn’t say anything.  But frusteration starts to build and a sense of resentment or lack of appreciation comes about because certain things are just not getting done.  Maybe as soon as mom starts staying home, the husband hands over all household and childcare duties, as he thinks he should (or even thinks that is what his wife wants!), leaving mom feeling unprepared, overwhelmed and overworked.  There are many scenarios that can lead to problems.

I am witnessing too many needless arguments, fights and both partners needing a place to vent their problems, then the main problem is (or seems to be) LACK OF COMMUNICATION.  There are a few key points to making your SAHM career work. First - communicate before baby is born.  Even if you don’t think you’ll ever want to be a stay at home mom, talk about the “what if” with your husband.  Many a husband has been taken by surprise when their wife assumes her maternal role and decides she doesn’t want to return to work and without some advance notice this can be quite shocking!  Second, work out a budget, make some cuts, and decide if staying home is even an option.  Do not make this decision alone.  Discuss ways in which you can contribute to the household income if needed either by working part time or even working from home.  Third, plan and prepare for life after baby. Decide who will be responsible for what.  Of course things are going to change, you both may forget to do certain things, etc. This is to be expected.  But having a basic outline of what BOTH of your expectations are will be a huge help.  I have some postpartum planning guides if anyone wants one I can freely distribute them.  In fact, I’ll see if I can upload them on this blog.  Fourth, make time for each other.  I know, everyone says this but it really is important.  You as a couple need to come first for each other and foster your own relationship in addition to your relationship as mom and dad.  In the early months time together will be hard.  When baby naps, try to cuddle with each other.  Don’t close down the lines of communication.  Openly express yourself, your frusterations and have frequent “heart to heart” conversations.  Stay up a little later than usual after baby is in bed.  When baby is old enough and you’re comfortable leaving baby with a sitter, take some time to just be a couple.  Go for a walk, go for a drive, just be together.  heck, if you aren’t yet comfortable leaving the baby alone with a sitter (admittedly I wasn’t until my firstborn was 18 mos!), leave a friend with the baby and just sit outside on the porch sipping a cup of coffee or tea.  Hold hands, hug, kiss freely and love each other.  The more you can foster your personal relationship, the more your baby will benefit.

I’ll blog a few times on this, as I want to cover some ideas that can help the SAHMs (stay at home moms) and WOHDs (work out of home dads). 

But for now, I’d like to hear from the SAHMs and WOHDs.  What is your situation like?  What are your roles?  What are your frusterations?  What do you wish your partner would understand?

Cesarean sections (surgical delivery) are done as the result of several complications during labor (unless the cesarean is scheduled) - some of which can be combined at once.

I’ll blog a few times on cesarean sections but right now I want to cover the most common reasons for a cesarean section.  Then I’ll talk about prevention and risks.

CPD/Cephalopelvic disproportion (whew, that’s a mouthful!): This is essentially the inability for baby’s head to pass through the pelvis.  Sometimes with a mix between activity and positioning, the baby can pass through the pelvis.  Other times the baby may simply be too large or in a few cases moms pelvis may be smaller than average.

Dystocia / abnormal progress of labor: This is the 2nd most common reason for a cesarean - failure to progress (labor has stopped or slowed with no progress in sight), failed induction, ineffective contractions (uterine dystocia) or slow dilation (cervical dystocia)

Maternal indications: heart disease, severe pre-eclampsia, insulin-dependent diabetes, active herpes, obstruction of the birth canal.

Fetal indications: fetal distress, prolapsed cord (I’ll explain this in a later post), malpresentation (such as breech, transverse or brow presentation - though breech and brow presentation can be delivered vaginally with the right circumstances), and in some cases twins or more (though twins too can be delivered vaginally - just depends on their positioning).

Placental considerations: placenta previa (placenta covers the cervical opening partially or completely), abruptio placenta (the placenta starts detaching from the uterus prematurly).

Then there are also scheduled cesareans - for preexisting conditions, safety precautions and for those simply wanting to avoid labor and have a date set for the birth (though before deciding on this really research cesarean sections as recovery is often longer and more painful and there are more risks associated with them than vaginal for both mom and baby).