Since I have been training to become a Certified Breastfeeding Counselor, I've been thinking about and learning a great deal about breastfeeding - more than I had ever imagined. Something that comes up quire frequently with many new mothers is the challenge of breastfeeding. At a certain point, once you begin to hear of so many stories of difficulty breastfeeding, and depending on how much detail you hear in these stories - you may start to hear of tongue ties, lip ties, and the procedures done in attempt to remedy these situations. Why, if breastfeeding is supposed to be so natural and necessary for the survival of our species, are so many humans struggling with it? There are MANU reasons. One of the many possible reasons might be folic acid vs. folate. Read on in this article to learn more...
A secret to a quick and easy childbirth?
CommentThere is certainly not one quick and easy solution that's going to work for everyone. I also don't even believe that this is THE way to go, but I have seen scenarios in which women do completely ignore the fact that hey are in labor, whether intentionally or not, and give birth quite smoothly and swiftly. But this is not to discount the women who need to focus and actively think in one way or another. There is no one right way to birth. But I think this article raises some interesting points worth thinking about.
Read the article here:
Can a midwife administer pain medication?
CommentFor a hospital birth, whether or not a midwife can administer pain medication depends on what kind of pain medication we're talking about. For a home birth, it depends on the midwife. Read the article from Choices in Childbirth to get more information:
Can A Midwife Administer Pain Medication? By Barbara Sellers, CNM
Flipping A Breech Baby
CommentIt happens! Babies are breeched and babies flip to the head down position. Occasionally they stay in the breech position. Ideally, baby flips! If your baby is in the breech position and you need to get them to flip, these are my recommended resources:
Spinning Babies: Breech Babies - very informational and detailed - recommend reading it all the way through
Prenatal Chiropractic Visits - ask me for a recommendation, based on where you are
Acupuncture - ask me for a recommendation, based on where you are
Good luck!!
Babies & Stress
CommentAs a birth doula, I focus mostly on birth with my clients. That's my specialty. I love helping clients find the right childbirth education class for them, the right hospital, midwife, or OB practice, figure out which baby gear they may or may not need, and of course, to prepare for labor and birth! When I see my birth clients at the postpartum visit, we usually piece the birth story back together, check in on the mother's recovery and health, and spend some time on breastfeeding and sleep. What we often don't get to is how to care for a baby. That's where a postpartum doula would come in - although often times a postpartum doula focuses more on caring for the mother, or helping with the baby so that the mother can take care of herself. There is currently a big gap and learning curve when it comes to caring for babies, as in times past, most women learned this by watching other mothers in their home or their community care for babies. Now, we have other ways to learn about caring for babies, one of which is reading articles and research on the internet :)
Stress in Babies: How to keep babies, calm, happy, and emotionally happy
US C-Sections Rate: Too High
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If you've been or are pregnant in NYC, probably one of the first things you did was to figure out who your doctor would be and where you would give birth. You may have spent hours googling something like "NYC OB low cesarean rate," or "NYC hospital low c-section rate." And you may or may not have found the answers you were looking for. Consumer Reports just released an article reviewing the current state of cesarean births and rates by hospitals around the country. Many of the hospitals in NYC that my clients have given birth in do not release their statistics. Considering that your biggest Cesarean risk might be the hospital that you give birth in, withholding c-section rates by hospital (and even by practice or doctor) just doesn't seem ethical.
You can read the full article here: http://www.consumerreports.org/doctors-hospitals/your-biggest-c-section-risk-may-be-your-hospital/
Breastfeeding & What to Eat
CommentSpice it up!! I don't think these findings are at all surprising, in fact they seem pretty intuitive. But why not have a little research on it?! It's just one more reason to breastfeed.
Here's an excerpt from the article from the NYT, which you can read in full here:
"The variety of flavors that you eat during pregnancy go into your blood and then into the amniotic fluid, which the baby is constantly drinking, in utero, and the flavors that you eat while nursing cross from the blood vessels that supply the mammary glands into the breast milk. So instead of restricting the maternal diet, there’s now good evidence that by eating a wide variety of healthy and tasty foods during these periods, we are actually doing our babies a major favor.
“Breast-fed babies are generally easier to feed later because they’ve had this kind of variety experience of different flavors from their very first stages of life, whereas a formula-fed baby has a uniform experience,” said Lucy Cooke, a psychologist specializing in children’s nutrition, who is a senior research associate at University College London. “The absolute key thing is repeated exposure to a variety of different flavors as soon as you can possibly manage; that is a great thing for food acceptance.” "
Home Birth: The Latest Article with Some Statistics
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If you haven't come across it before, Lamaze's blog, Science and Sensibility, is a great way to stay up to date on recent studies and new information in the maternal/perinatal health world. I recently came across this article and wanted to share it.
New Evidence: Give Women More Time in Labor.
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This one is so simple, so straight forward. Give women a bit more time to labor and we can reduce the cesarean rate. This is of course assuming that everything points to the mother and the baby being in good health. As long as everyone is doing find, and the mother is game, let's create the space and be encouraging and supporting to women who want to labor just a bit longer and potentially avoid a c-section. This recent study showed that giving mothers just one more hour of time can cut the Cesarean rate in half. That's big. Here's the article you can read to learn more:
Seeding the Microbiome
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This is a relatively new phenomena that has come up in the birth world as more and more research on the significance of gut health and our microbiomes has emerged. In birth, this applies in particular to a vaginal vs. Cesarean birth. During a vaginal birth, the baby is colonized, or "seeded" with bacteria from the mother's vagina, which leads to long term health benefits; in a Cesarean birth, the baby does not have the same bacterial colonization opportunity. It is because of this that some women are looking to simulate this process at the time of a Cesarean.
We are just now beginning to understand that many modern day health conditions, such as colon cancer, Autism, and mental health (just to name a few) are likely affected by the balance, or lack of balance, in good and bad bacteria in our bodies. Think of the recent surge in the understanding and promotion of probiotics, our understanding of antibiotics, and the fermented food movement.
The recent documentary "Microbirth" focuses on bacterial health in birth, as well as some recent articles below. You can also check them out to understand how some women are choosing to take vaginal seeding into their own hands in the event of a Cesarean.
https://www.scienceandsensibility.org/p/bl/et/blogid=2&blogaid=825
http://www.positivebirthmovement.org/pbm-blog/category/gauze-seeding
http://www.mostlymicrobes.com/vaginal-seeding/
Advanced Maternal Age
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What does this mean? In the U.S., women who are 35 years and over who are giving birth are considered "Advanced Maternal Age" (AMA). According to the research, only about 15% of women who are giving birth are 35 years are older, however it's hard not to believe that rings true in NYC. I would estimate that about 1/3 of my clients could be categorized as AMA. The important thing to know about this, if you are 35 or over, is that your care provider may apply different policies to you than if you were under 35. Please read this very important article from Evidence Based Birth by Rebekkah Dekker, Mimi Niles, and Alicia Breaky for some well-rearched info on what AMA means in pregnancy:
Essential Oils in Pregnancy, Birth, and for Your Baby
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I recently attended a workshop on Essential Oils in Pregnancy and Birth. Big inhale, exhale... there are some great scents that can be used for a variety of ailments, concerns, and comforts. Some are quite powerful! So, what's the right way to use them? Read on for some more info.
https://www.youngliving.com/blog/pregnancy-and-essential-oils-a-guest-post-by-dr-lindsey-elmore/
http://doterrablog.com/ask-dr-hill-pregnancy-doses-and-zendocrine-supplements/
http://www.theessentialmidwife.com/
Herbs Safe to Use in Pregnancy and Birth
CommentIna May Gaskin Documentary
CommentLooking for a birth-related movie to watch? Here's one: a documentary on the famous Ina May Gaskin, author of Ina May's Guide to Childbirth.
Birth Story Ina May Gaskin and The Farm Midwives ( 2013 )
"Ina May Gaskin and The Farm Midwives captures a spirited group of women who taught themselves how to deliver babies on a 1970s hippie commune. Today as nearly one third of all US babies are born via C-section, they fight to protect their knowledge and to promote respectful, safe maternity practices all over the globe. From the backs of their technicolor school buses, these pioneers rescued American midwifery from extinction, changed the way a generation approached pregnancy, and filmed nearly everything they did. With unprecedented access to the midwives' archival video collection, as well as modern day footage of life at the alternative intentional community where they live, this documentary shows childbirth the way most people have never seen it--unadorned, unabashed, and awe-inspiring."
How to Avoid an Episiotomy in Birth
CommentI have not yet met a woman who does not want to avoid an episiotomy in birth!! Read on below to get some tips on how to avoid this unwanted procedure, published by Choices in Childbirth.
ASK THE MIDWIFE: HOW CAN I AVOID AN EPISIOTOMY DURING BIRTH?
FEBRUARY 16, 2016
Childbirth, Midwifery, Nutrition, Pregnancy, Sexuality
“How can I avoid an episiotomy during birth?”
Today an episiotomy is no longer a routine procedure – thank goodness – but is performed for cause. Some reasons include a tight perineum which prevents the baby’s head from distending the perineum, prior scarring of the perineum, female circumcision, and/or the baby’s heart beat is low and delivery needs to be expedited. We can decrease the problems with the perineum but not some of the other causes.
The other question is how to prevent natural tears of the vagina and the perineum. It is important for women to know that there is a group of muscles in the vagina that support the vagina, bladder and rectum. These muscles need to be strengthened and toned prenatally to increase their elasticity to allow for relaxation of the vagina and perineum during birth. These same muscles need continued exercise for the remainder of our lives. Thank Dr. Kegel for giving us the Kegel exercise!!
Proper overall fitness is important so consider walking and squats for toning. Proper nutrition is also key. Make sure that you get adequate protein and other nutrients for your tissues to respond well to the stretching of birth.
Keeping the vagina healthy and reporting any signs of an infection to your provider promptly to maintain good vaginal tissue integrity is hugely important. Perineal massage is advocated by many to be helpful in preparing the vagina and the vaginal muscles for birth. This needs to be initiated at 34 weeks and done for approximately 5 minutes 3-4 times per week.
When it comes time to push, your position is important, as is the use of warm compresses on the perineum. The lateral position or squatting for birth is protective of the perineum.
Finally, a slow, controlled delivery of your baby’s head will definitely help to decrease tears. This is difficult when you have a very strong urge to push. I recommend practicing techniques learned in childbirth classes such as focused relaxation.
Susan Papera, CNM,MSN received her undergraduate degree from Cornell University and her Master’s degree and Midwifery from Columbia University. She joined the staff at NYC Health + Hospitals/North Central Bronx as a staff midwife shortly after the Obstetrical services were open in 1978 and she has been helping to care for the women and families in the Norwood section of the Bronx ever since. Presently, she is Director of Midwifery Services. Working with such a richly diverse group of women is extremely rewarding and also an on going learning process as she says. Ms Papera is particularly proud of the fact that she is an NCB “Grandmother”- babies she has helped into the world are returning and she has had the privilege of helping their babies into the world.
Midwife Thinking: Birth From the Baby's Perspective
CommentSuch a fascinating article! Excerpt below, and definitely head over here to read the article from Midwife Thinking in its entirety, as well as watch the videos.
Here are the bullet points from the article on treating a newborn with respect:
"A humane approach to welcoming a baby to the world
Whilst in some cases it is not possible, I believe that we should aim for all babies to have the opportunity to:
- Make their own way through their mother’s body and into the world (ie. no unnecessary pulling).
- For their first touch to be from the hands of a person who loves them (mother, father, family member, friend).
- To be held immediately by their mother skin-to-skin.
- To be sustained by their placenta until the placenta stops functioning (ie. leaving the cord intact).
- To be left in peace to find their mother’s nipple and latch on.
- To be treated gently and with dignity and respect during any ‘checks’ that their mother chooses to have done."
Spinning Babies!
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Ever since I became a doula, I've been fascinated with the concept of fetal positioning. With my background in dance and yoga, and my interest in alignment, optimal fetal positioning is right up my alley when it comes to birth! A baby that is positioned well can make for a smoother birth. How does a baby get positioned well? Some of it relates to the mother's physical structure, and some of it is related to lifestyle. The good news is that during pregnancy, there are daily and weekly exercises that women can practice to encourage balance. What if you are about to give birth and haven't practiced any of these exercises? You can rest assured that most babies do turn in labor, if they haven't rotated into the optimum position already. And some babies just make their entrance in whatever position they want to be in, regardless of how "optimal" it may be.
Interested in learning more about Spinning Babies? This is something I cover with my clients during their prenatal sessions. In addition, you can also watch the parent class, available on DVD or as a download. Visit the site here to purchase: http://spinningbabies.com/shop/
New Birth Plan Template
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Many of my birth doula clients - whether they are planning a natural birth in a hospital or birthing center, or birth with medication, or a home birth - want to create a birth plan. One hospital in NYC (NYU) provides a fairly succinct birth plan template, which is great, however I don't know many other hospitals that do provide a template. You can find some templates online, some simple and some that are pages and pages long (which I don't recommend). The image above is of a new one that I came across and thought I'd share - link below. Enjoy!
https://thebestseasonofmylife.wordpress.com/2015/08/20/a-downloadable-visual-birth-plan/
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Breastfeeding: Do Older Babies Need Night Feeding?
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I have the honor of witnessing my clients give birth as they become mothers in an instant, and then visiting them several days after their baby is born. I love being able to answer newborn questions, to process their birth with them, and to answer newborn care and breastfeeding questions. Many of my clients prefer to go as holistic or natural as possible with caring for their baby in the early days, and even beyond. By the time my clients have "older" babies, I'm long gone! I thought this article would be a great help for parents who are attempting to breastfeed in the most "natural" way possible. This article is by Nancy Mohrbacher, breastfeeding expert.
"Has somebody told you that your baby doesn’t need to breastfeed at night past a certain age? This age often varies by advisor. However, science tells us that in many cases, this simply isn’t true.
Why? Babies and mothers are different and these differences affect baby’s need for night feedings. Some babies really do need to breastfeed at night, at six months, eight months, and beyond. This is in part because if their mother has a small “breast storage capacity” and tries to sleep train her baby, her milk production will slow, along with her baby’s growth. To find out what this means and if this applies to you, you need to know the basics of how milk production works."
Read the rest of the article here.