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Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

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Q&A with SPB: DIY Padsicles

Posted on January 17, 2017 at 6:27 AM Comments comments (0)
Birthing From Within and Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale

Here is PART II of our VLOGS with guest doula, Michelle Ludwig from Modern Mama Doula Services.
 
Last week, she showed us her TOP 5 picks for postpartum.  Today she is going to share her DIY tutorial for you to make soothing postpartum “padsicles” right at home during pregnancy so that they are ready for you when you are home holding your sweet pea!



 
What you need:
-Witch Hazel ~ we both really like the Humphrey’s brand – available in regular or organic)
-Maxi-pads ~ if you can find them, get some chemical-free and bleach-free; usually available online
-Cookie Sheet
-Freezer Storage Bags
 
How to:
1) Open up all the pads and leave them on the wrapper so that they don’t stick to each other later
 
2) Lay them all out on your cookie sheet
 
3) Spray the witch hazel on to the pads until they are wet BUT not dripping
 
4) Put the whole cookie tray into the freezer for about two hours
 
5) Once the witch hazel has frozen, take them back out of the freezer and fold them back up for storage.  Place them in a freezer storage bag and back into the freezer while you wait for your Sweet Pea to make their appearance.
 
6) Use them during the postpartum period on top of the large postpartum pads you will receive in your birth kit or from the hospital.
 
They will be a little chilly at first, but after the initial freeze they will feel great on your bottom.
 
I did ask Michelle what her experience was with other “add-ons”. Some info out on the internet suggests using lavender essential oil or aloe vera gel along with the witch hazel on the pads when you are preparing them.
 
As Michelle so wisely answered, less is more. Witch hazel is an extremely effective healing agent, and it would be a bummer to find out that you are allergic to lavender or aloe vera when you are trying to heal from birth, learning to breastfeed and figuring out your mothering.
 
The witch hazel and pads are part of Michelle’s especially prepared Bump Boxes.  Along with the items for padsicles, you will also receive some hand crafted postpartum essentials that she makes herself.  You can order Michelle’s specially made with love package from her HERE
 
Would you like to interview Michelle as a doula? Please read her meet the doula feature HERE
 
Contact Michelle:
WEB http://www.modernmamadoula.com/
CELL OR TEXT 7204098977


Disclaimer: 
Birthing From Within and Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, ScottsdaleThe material included in this video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog and video contain information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 
Birthing From Within and Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale

Q&A with SPB: Is there anything I can do to make more milk?

Posted on August 30, 2016 at 10:01 AM Comments comments (0)

Today's question on Q&A with SPB: 

Birthing From Within and Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
We are joined by Jennie Bever, PhD, IBCLC at the Arizona Breastfeeding Center to answer that question:




Recap:
You are not alone! This is a common question/worry that many moms have during pregnancy and postpartum.

There are many myths, tips and tricks that people share that may work for some moms, but really don't get to the core of the issue: how much milk is moving through the breast? The fact about milk production is that the more milk that is demanded, the more milk will be made.

So a lot of the time it's not really a supply issue, as much as it is a removal issue. In order to make milk, the body needs the signal that more milk is needed.

Some things to consider:
  1. Is the baby breastfeeding well, e.g., does the baby have a good latch?
  2. If the baby is working on latching, then get busy moving the milk! It's may be time to start pumping.
  3. Maybe it's time to call an IBCLC to find out what is needed for your situation.

Krystyna's little side note about pumps to consider:
  1. Do I have the right pump for the job I need it to do?
  2. Are all the parts working and do I have the right size flange?

An IBCLC can help you with both evaluating how you and baby are moving milk, and also answer any questions you have about pumping.

The bottom line:
While some of the galactagogues out there may help, you don't want to create more milk that still can't be moved...that may cause another hurdle (i.e., pugged ducts, mastitis). So before you spend lots of money on the "magic" herbs, teas, and foods that help some moms make more milk, check in with a lactation counselor to make sure that you and your baby are doing your best to remove the milk that is already being made.

Thank you again to Jenny for taking the time out of her busy day to answer today's Q&A with SPB!



Disclaimer: 
The material included in this blog is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog and related videos contain information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of Birthing From Within or The Bradley Method®. The views contained in this video and on our blog do not necessarily reflect those of Birthing From Within, The Bradley Method® or the American Academy of Husband-Coached Childbirth®.   

Birthing From Within and Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson


Stay Safe and Cool Through Your Summer Pregnancy - Part 2

Posted on June 10, 2016 at 10:05 AM Comments comments (4)
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months

As you read on Tuesday (Part 1), dehydration and hyperthermia can cause dangerous complications of pregnancy.  Remember you have permission to be a Drama Queen during the summer months!  Take it easy and take care of yourself as the temperature climbs.  You can also enlist your partner and other family members to help you take advantage of one, some, or all of these comfort measures listed below to avoid dehydration and hyperthermia in the first place. 

The simplest steps you can take are staying hydrated, getting rest, and staying out of direct sunlight and high temperatures.  Above all, good judgment is the best guide when you are out and about in the heat and sunlight. 

Here is a more detailed list of suggestions and tips I complied from having had three (!) summer pregnancies, and all the reading I did on the subject (see the articles in the reference section below). 

There are no affiliate links in this post - please feel free to click away at the other info I want to share with you.
 
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer monthsClothing and Fabrics
- Wear light-colored clothing that will reflect the sunlight.
- Stay away from dark colors that absorb heat if you are  out and about during the day.
- Wear non-restrictive clothing to minimize swelling – you want to encourage optimal circulation as much as possible.  Pay special attention to wear clothing that isn't restrictive around your waist area.
- Wear a cooling bandana – there are several brands available in the stores, or you may be able to shop local and support a crafter at an area farmer’s market.
- Wear fabrics that are breathable and keep you cool, such as Cool Max (wicks sweat), Lycra (keeps shape while being elastic) and Supplex (cottony feel and quick-drying).  Stay away from Spandex and nylon based fabrics that don’t let your skin breathe.
- Breathable fabrics can also help prevent heat rashes on your breasts and abdomen, the areas that rub against the fabric the most.
- Avoid open-weave fabrics that allow the sun to reach your skin.
 
Cool Comfort Measures
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months- Carry a spritzer bottle or personal misting fan with you.  For extra cooling, keep them in filled in the refrigerator until you need to take them with you.
- Take frequent, quick showers – air dry if you have time, or pat dry if you need to move on with your day.
- Stay cool indoors by sitting in an air conditioned space or near an electric fan. 
- If air conditioning isn’t an option, try an air filter or a dehumidifier.  These are especially helpful if you live in a humid climate.
- Find the most comfortable room in the building and make that your nest.  If your house or workplace doesn’t have one of those rooms, think about investing in a personal air conditioner that you can leave in your space, or move around with you.
- Keep beauty products such as sun lotion, moisturizer or toner in the refrigerator.  Applying a cold product to your skin will give you an instant cool down.
- Use cold packs or ice cubes at wrist pulse points, the back of the neck and on the forehead.  You can keep long-lasting soft-gel cooling strips in your car or purse when you know the freezer isn’t going to be handy when you are out running errands.  You can also decide if THESE amazing necklaces might come in handy now instead of later.
- Get long hair up and off your neck.  You can braid it, tie it in a ponytail or clip it up.  Find easy up-dos via BuzzFeed HERE .
- Raise your legs at every opportunity – encourage good circulation whenever and however possible.
- If you don’t have a swimming pool, fill a wading pool with water and place it in a shady part of your yard or patio.  Cool off as needed!
 
Exercise
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months- Wear a heart rate monitor to ensure your working heart rate stays in a safe range while you exercise.  Ask your care provider what they feel is a safe active heart rate for you.
- Avoid exercising during the hot hours.  Wherever you are in the country, the temperature is generally the hottest between 10:00 am – 3:00 pm.
- It follows to limit your outdoor activities from the hours of 10:00 am and 3:00 pm - find as many places to stay cool inside as possible!
- Instead of walking outside, do your walking inside at an indoor track or at an indoor shopping mall.
- Swimming is a good warm/hot-weather option.  It supports your growing body, the feeling of weightlessness is awesome, it cools off your whole body, it takes weight off the sciatic nerve, and it encourages the baby into an optimal birthing position.
- Prenatal yoga can be another good option. A class taught by an experienced prenatal instructor will provide a good mix of heart healthy poses, strengthening poses, and relaxation (see "Mind Over Matter" by scrolling down in this post).
- Do the pregnancy exercises assigned by your Bradley Method® instructor.  They are designed to be gentle enough to do during any time of the year, yet there is enough repetition to strengthen the muscles you will need for your labor.
 
Fluids
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months- Drink 8-10 glasses of water per day, and more if you are active.
- Avoid caffeinated drinks.  Caffeine acts as a diuretic and it may increase the frequency of urination, which can then lead to a reduction in your body fluid levels – hello, dehydration.
- Make sure you are replacing your electrolytes...water intoxication is an actual condition that can be caused by drinking too much water in a short amount of time.  In order to hydrate safely, we have used the product made by Emergen-C.  Coconut water is a great natural "gatorade".  A third option is to use trace minerals - find a brand you trust and add them to your glass of water.
 

Food
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months- Eat little meals more often.  Large meals increase your metabolism and this could make you feel hotter.
- Eat fluid-filled foods, such as strawberries, celery, watermelon and cucumber.  HERE are more ideas for hydrating foods.
- Make healthy popsicles by freezing organic fruit juices.
- Treat yourself to a meal at a restaurant – use their air conditioning and you can keep the heat out of your kitchen since you won’t be using your stove or your oven for food prep that night.  As a bonus, pack half of your meal in a to-go container and have it as a snack later.
- Read more about eating during pregnancy HERE - archive post from Spring 2014.
 
Hustle and Bustle
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months- Do your chores early or late in the day when the temperature is cooler.
- Move slowly and avoid rushing.
- Avoid movements that could lead to light-headedness, such as repetitive bending or rushing around on staircases.
 
Mind Over Matter
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months- Relaxation – the key to The Bradley Method®.  It is easier to keep your body temperature lower if you are calm and relaxed instead of stressed and hurried.  Take the time to practice some mental imagery and move through your day with the intention to stay cool.
- Breathe – a good rhythmic breathing pattern can reduce heat production in your body.  The foundation of relaxation is breathing that supports a relaxed state.  Bradley instructors love to encourage abdominal breathing anytime and anywhere.
- Meditate – even an one-minute practice can make a difference - really!!  Find some meditation resources HERE - archive post from Spring 2015.
 
Sun Safety
Bradley Method® instructor Krystyna Bowman, AAHCC shares ideas for staying safe and cool during the summer months- Stay out of direct sunlight as much as possible.  Sunburn impairs the body’s ability to cool itself and it causes the loss of body fluids.
- If you must be or choose to be in the sun, use a good sunscreen, at least SPF 15.  The natural momma in me will encourage you to find a sunscreen that is organic, thereby minimizing the amount of chemicals absorbed into your bloodstream.  EWG publishes a sun-screen guide - find it HERE.
- Avoid mid-day direct sun exposure.  If you live in the north, this means stay out of the sun between 11:00 am – 4:00 pm.  If you live in the south, this means 10:00 am to 5:00 pm.
- Use a sun hat and sunglasses to avoid prolonged exposure or sunstroke.
- Apply a sun lotion at the end of the day whether or not you sunburn.  The ingredients will soothe and restore your skin from the drying effects of the sun.
 
Did I forget to mention one?  
What is your favorite sun safety tip?

Disclaimer:
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

References:
http://www.freedrinkingwater.com/water-education/water-pregnancy.htm

http://www.medicinenet.com/script/main/art.asp?articlekey=52172

http://www.medicinenet.com/script/main/art.asp?articlekey=51783

http://www.pregnancytoday.com/articles/healthy-safe-pregnancy/pregnant-during-the-summer-months-3185/

http://www.suite101.com/content/coping-with-the-heat-in-pregnancy-a129230 http://www.parentingweekly.com/pregnancy/pregnancy_health_fitness/hot_summer_safety.htm

http://www.courierpress.com/news/2007/jun/18/staying-cool-pregnant-women-face-greater-risks/

http://www.parents.com/pregnancy/my-body/pampering/summer-pregnancy-issues/?page=5

http://www.parents.com/pregnancy/my-body/pampering/summer-pregnancy-issues/?page=6

Stay Safe and Cool Through Your Summer Pregnancy - Part 1

Posted on June 7, 2016 at 9:31 PM Comments comments (6)
Bradley Method classes offered in Arizona - Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson, AZ

Ideas to Have a Safe Pregnancy 

During the Summer Months
Hello, Mr. Sun!

 
My friend and colleague Tina Lebedies suggested this topic.  As it turns out, there is a lot to write about when it comes to coping with the heat while you are pregnant!  So this is how I am going to organize this topic: I am going to split in two parts.  Today I am going to share why it is so important that you take extra care – be a Drama Queen when it comes to taking care of yourself if you are pregnant in the summer.  Then I am going to list the concerns with their symptoms and suggestions to ease the symptoms. 

Check back on Friday for Part 2 of this post. I am going to share some ideas and give you some tips to stay cool and live smart through the summer months.
 
We are lucky in Arizona – to stay cool we head indoors or get wet and then let our skin air dry.  In humid climates, the added moisture makes it harder to stay cool – I am glad we live in a dry heat!  I had three summer pregnancies that lasted through July, and two went through September!! We are not good planners in that department - LOL.  At least, now I am well-versed in finding to cool off and stay cool – for that I will count my blessings.  It comes in handy now that I am toting four Sweet Peas through the hot summer months :)
 
The first thing I am going to point out as a Bradley Method® instructor is that keeping track of your diet and fluid intake is of utmost importance, even more so in the summer.  Eat between 80 – 100 grams of protein per day, and include salt in that equation to keep a balanced diet.  I cringe when I read pregnancy articles that suggest a pregnant woman should reduce her salt intake if she is swelling. 
 
Cutting back on salt can cause a decrease in the amount of blood circulating through your body and placenta (a condition called “hypovolemia”), thus reducing the supply of nutrients passing to your baby.  How will you know if you are not getting enough salt?  Too little salt in the diet leads to leg cramps and fatigue, so if you are experiencing these symptoms exclusive of the heat factors I am going to write about below, try salting your food to taste and see if those symptoms are minimized or go away altogether.
 
 
BE A DRAMA QUEEN
I assure you that you are not the only pregnant person who is feeling just a tad hotter than usual this summer.  It doesn’t matter if you are still in your first trimester – you will be a little hotter even though your body doesn’t show your pregnancy yet.  In some ways it’s even more important that you protect yourself because it is a time of crucial development where overheating can have devastating effects on the baby.  If you have already been making your coach take care of you and he or she thinks you are being over-dramatic, then have them read this post, or any of the “official” articles I reference at the end of the post.
 
Why You Feel Hotter
There are several reasons why your core body temperature is elevated:
1.  Your body is undergoing hormonal fluctuations.
2.  You are carrying the extra weight of your baby, and if you are like me, you have extra padding your body insists on adding on, no matter how well you eat and how often you exercise.
3.  Your body is working to cool your body, plus the body of your growing baby.
4.  Your increased metabolism also increases your body temperature, and it works harder as your baby demands more from your body.
 
Why You Need To Insulate Baby
Your baby’s body temperature is 1°C (almost 2°F) warmer than your body temperature, and they cannot sweat to cool themselves down.  The only thing cooling your baby is your body’s knowledge of how to grow your baby.  If your body starts to heat up and it can no longer work to keep your baby’s temperature down, there are many things that could happen.
 
Whatever the trimester, your baby’s heart rate could start to go up.  In regards to the first trimester specifically, studies have shown that babies are especially susceptible to heat stress in the first trimester of pregnancy when the major body systems are developing.  An elevation in the pregnant mothers body temperature above a safe range has been associated with birth defects such as heart problems, abdominal wall defects, nervous system malformation and neural tube defects.  Exposure to extreme heat could also increase the risk factor for experiencing a miscarriage or pre-term labor.
 
CONCERNS DURING PREGNANCY

DEHYDRATION

Dehydration – a condition in which your body does not have the fluid it needs to maintain healthy body function.  When you are living for two, staying hydrated is even more important.  If you are dehydrated, it could cause the baby’s heart to beat too quickly.  It can also increase your risk of pre-term labor.  The decrease in blood volume causes an increase in the concentration of oxytocin.  Oxytocin the hormone that causes contractions to begin and intensify, and an excess of oxytocin is not a good thing unless you are supposed to be in labor.
 
One of the first signs that you are dehydrated is feeling thirsty.  If you are feeling like you really could use a drink, then you are already dehydrated – find a non-alcoholic, non-caffeinated beverage ASAP and drink it!
 
Other signs of dehydration are dry or chapped lips, dry skin, fatigue, constipation or decreased movement from your baby.  If you are experiencing these symptoms, get yourself to a place with cooler temperature, have a seat and drink some water or fruit juice.  If your symptoms don’t improve, or your baby doesn’t start increasing their movements within the next hour, call your care provider and ask for further instructions and/or head to a hospital emergency room.
 
Fluid Retention and Dehydration
A pregnant woman carries an average of 15 pounds of extra fluid to support the physiological changes during pregnancy.  This is considered to be a normal amount of fluid increase, sometimes called physiological edema.  A little more than half of that fluid is used to replace the amniotic fluid (it is replaced every hour by using about a cup of water that is stored in the body), it helps to hydrate and nurture the cells of the baby and the placenta.  The rest of it is used in the bloodstream to carry more oxygen and nutrients to the mom and the baby, and to remove waste products from the mom and the baby.
 
Interestingly, fluid retention, as opposed to the fluid increase I described above, may contribute to dehydration.  If you are retaining fluids, the fluid is absent within the cells where it is needed.  Instead, the fluid is retained in the space around the cells, causing the pregnant mom to look puffy and swollen. 
 
Whether it’s normal physiological edema or fluid retention, you may notice that your feet and ankles are uncomfortably swollen.  This happens since your legs are lower than the level of your heart.  It’s harder for blood to work against gravity even when you are not pregnant, so add pregnancy on top of that and you start to swell.  Add in the fact that your growing uterus puts pressure on the veins traveling up towards the heart, and voila, you have swollen feet and ankles.
 
You can relieve this swelling by making sure you are drinking enough water.  Believe it or not, drinking water can reduce your swelling!  While it doesn't seem like it makes sense to get rid of fluids by taking in more, the extra fluids will help flush out your system of waste products which may have increased the swelling in the first place.
 
On the flip side, I should also tell you that it’s possible to get too much water, also known as water intoxication.  In this case, the extreme saturation of water in your body dilutes the necessary electrolytes too much.  This can cause fatigued muscles, muscle cramps and even unconsciousness in the extreme cases. 
 
Use good judgment when it comes to your fluid intake – at least 8 – 10 glasses of water a day if you are moderately active, and more if you are more active.  As I mentioned above, if you are thirsty, you are already dehydrated.  Have that drink of water even if it means it’s the 12th or 13th drink you have had that day.  If your thirst persists, it may be time to call your care provider.
 
Here are some other things to do to decrease swelling and its discomforts:  take rings off swollen fingers, use flat and/or open toed shoes, and avoid prolonged sitting or standing positions that allow your blood to pool.  If your activity or job requires you to stay in a standing position for an extended period of time, you can get up and take a five-minute walk or march in place to encourage circulation. If you must sit, do it in such a way that shortens the distance between your heart and your feet, such as propping your feet up on a bench or footstool. The best sitting position for circulation is tailor sitting, so sit on the floor when possible, or armless chair if you are at a desk or table.  No matter what the activity, you can also try a maternity belt to lift your uterus up and allow for better circulation.
 
My favorite way to reduce pregnancy swelling is resting in a side-lying position for 20 – 30 minutes at a time, at least twice a day.  When you lay down, elevate your feet.  You can do this by putting a rolled up blanket or towel underneath your mattress, or propping your feet up on pillows.  It is easier to find time for this if you are expecting your first child – use the time to meditate about the upcoming birth and fill your mind with positive thoughts and affirmations. 
 
Even if you are mom of other children, find the time to lie down twice a day and invite them to join you.  You can use this time to tell older siblings their birth stories, look at pictures of their birth and talk about who came to visit them when they were born.  This can serve to open the lines of communication and talk about their feelings about the new baby, whatever they may be.  Finding time to talk to your children is something you will always treasure.

HYPERTHERMIA
 
Hyperthermia, or over-heating, is one of the most dangerous conditions of pregnancy.  It can start with something as seemingly benign as heat cramps; proceed to heat exhaustion, and quickly progress to the life-threatening condition of heat stroke.  May I remind you again?  It’s okay to be a Drama Queen when it comes to staying cool and comfortable during the summer months.
 
These are the warning signs of hyperthermia.  As with any sign that your pregnancy is moving outside of normal, it is important to get rest and replenish your fluids.  It is imperative that you call your care provider if you experience any of these symptoms and it’s not close to your due date, and you know you been exposed to intense sun and/or heat.  If these symptoms persist after rest and fluid intake, ask yourself if you should be heading to the nearest hospital:
1.  More than five contractions or cramps per hour
2.  Bright red vaginal bleeding
3.  Acute or continuous vomiting
4.  Low, dull backache
5.  Intense pelvic pressure
6.  Swelling or puffiness of the face or hands – this could be a sign of preeclampsia
 
Heat Cramps
Heat cramps are the earliest warning sign of hyperthermia.  This typically follows after heavy perspiration.  The loss of electrolytes leads to muscle spasms.  If and when you experience any cramping after a lot of perspiration, listen to your body.  Take steps to reduce your body temperature immediately and replenish the electrolytes in your body.  If you can recognize and ward off a dangerous rise in body temperature at the beginning, you may be able avoid the other dangers and complications of hyperthermia.
 
Heat Exhaustion
Heat exhaustion is caused by prolonged exposure to high temperatures, a restricted fluid intake or the failure of the body’s mechanism to regulate your temperature.  Signs that you might be experiencing heat exhaustion are:
- Skin that may feel cool and moist and appear pale
- Headache, nausea, weakness, dizziness, faintness, light-headedness, fatigue, exhaustion, mental confusion, anxiety, muscle cramps
- Rapid, weak pulse
- Breathing may be fast and shallow or it may feel like you have shortness of breath
- Blood pressure may drop
 
I will repeat, the best thing to do if you experience any of these symptoms or warning signs is to take steps to reduce your body temperature immediately and replenish the electrolytes in your body.  These are more serious signs, so please don’t hesitate to enlist the help of strangers to assist you to a cooler place and to bring you water or other fluids, such as juice or an electrolyte drink.
 
Heat Stroke
Heat stroke is a life-threatening condition that requires immediate medical attention.  When you experience any of these symptoms due to prolonged exposure to high temperatures, a restricted fluid intake or the failure of the body’s mechanism to regulate your temperature, the impact on the body is much greater.  As a Bradley Method® instructor we cannot give you medical advice, what we can and always will tell you to do in these situations is to call your care provider and get yourself to the nearest hospital to ensure that both mother and baby are attended to as soon as possible.
Signs of heat stroke:
- Body temperature reaches 104°F (40°C) or hotter
- Mental confusion
- Combative and bizarre behavior
- Staggering
- Faintness
- Strong and rapid pulse (160-180 bpm)
- Skin will become dry and flushed
- Sweat very little
- Quickly lose consciousness and have convulsions

The two conditions I described today, dehydration and hyperthermia, can become medical complications that can compromise both you and your baby if you don't take simple steps to prevent them.  It bears repeating that staying hydrated, getting rest, and staying out of the heat and direct sunlight as much as possible are some of the simple yet effective steps you can take to stay safe and cool through the summer months.

Check back on Friday for a detailed list of ideas that you can use ranging from clothing to fluids and foods to sun safety.  Many of the ways to stay cool take minimal effort and do not require you to spend a lot of money.  Frugal is good in these interesting times!

Disclaimer:
The material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

References:
http://www.freedrinkingwater.com/water-education/water-pregnancy.htm

http://www.medicinenet.com/script/main/art.asp?articlekey=52172

http://www.medicinenet.com/script/main/art.asp?articlekey=51783

http://www.pregnancytoday.com/articles/healthy-safe-pregnancy/pregnant-during-the-summer-months-3185/
http://www.suite101.com/content/coping-with-the-heat-in-pregnancy-a129230 http://www.parentingweekly.com/pregnancy/pregnancy_health_fitness/hot_summer_safety.htm

http://www.courierpress.com/news/2007/jun/18/staying-cool-pregnant-women-face-greater-risks/

http://www.parents.com/pregnancy/my-body/pampering/summer-pregnancy-issues/?page=5

http://www.parents.com/pregnancy/my-body/pampering/summer-pregnancy-issues/?page=6
 
 

Uterine Rupture: Assessing the Risks

Posted on April 26, 2016 at 10:18 AM Comments comments (0)
Uterine Rupture: Assessing the RisksThis was in posted April 2012 - updated April 2016
Uterine rupture is a topic that came up when I was pregnant with Otter that I was not ready to allow into my consciousness until she was safely in our arms.  After enough time had passed and we have proven to ourselves that homebirth can be a safe option when a person is healthy and low risk, I am ready to write about it.   

I gave Stephanie Stanley, former facilitator of the East Valley ICAN group, byline credit for this because I am using her research from a uterine rupture presentation she did at a meeting for my post today.  ICAN, the International Cesarean Awareness Network, is a non-profit organization that strives to improve maternal-child health by preventing unnecessary cesareans through education, providing support for cesarean recovery, as well as educate about Vaginal Birth After Cesarean (VBAC) and options for what is called a "gentle cesarean" where the event is honored as a birth even though it's via a surgery.  ICAN’s goal is to see a healthy reduction of the cesarean rate that is patient-driven.  By providing education and support, they hope that more women making evidence based, risk appropriate childbirth decisions will lead to an overall reduction in the rate of cesareans performed.   

Uterine rupture seems to be the leading reason why care providers are hesitant to allow a mother to have a trial of labor (TOL) after a previous cesarean.  In Arizona, a licensed midwife or certified professional midwife can attend a homebirth with a mom who is striving to have a VBAC only if the mother meets certain criteria. Arizonana for Birth Options is leading a grassroots efforts to change this so that as per the ICAN vision, women living here can make evidence based and risk appropriate decisions.  They want all options to be available: for a hospital birth if mom feels that is the best option, or a homebirth if both mom and midwife agree that they are a good candidate for VBAC.   

Uterine rupture is defined as an anatomic separation of the uterine muscle with or without symptoms.  What this means for baby is that the uterus ceases to function as a sealed protective container from the rest of the blood and organs surrounding the baby.  The function of the placenta and umbilical cord may also be compromised.  Mom is subject to blood loss and shock.  A decision also has to be made about repairing the uterus or performing a hysterectomy.   

Another term used when talking about uterine rupture is “dehiscence”.  A dehiscence is the splitting or incomplete opening of the cesarean scar.  It can happen without complication for mom or baby and sometimes it is only discovered after the delivery.  It is also called a “window” by some care providers.   

As it turns out, while uterine rupture is a consideration when you are preparing for a birth after a cesarean, it's not the only one your care provider should be having a conversation about. You can read THIS post to see where the risk for uterine rupture falls in comparison to other risks of pregnancy and labor. 

So what does the research say?   

Here is the overarching conclusion: anyone can be at risk, whether you have an unscarred or scarred uterus.  At most, your risk rate is 2%.  2 percent!  Why then is it that this is such a big deal?  I believe it lies with the potentially devastating circumstance a family will find themselves in if the uterus does rupture.  While 98% of the population may have a successful VBAC, the worst case scenario of a uterine rupture is the loss of the baby and possibly a hysterectomy for mom which makes future pregnancies impossible.   Another point to ponder is that the statistics listed below are close to other statistics for labor emergencies, such as placenta accreta, placental abruption, miscarriage; for a longer list click here.   

Statistics for the risk of uterine rupture – see links at the end of this post for references: 
 VBAC: .5% - .7% 
 VBA2C: 1.7%  (vaginal birth after 2 cesareans) 
 VBAMC: 1.2%  (vaginal birth after multiple cesareans) 
 Previous VBAC: .4% - .5%  (if you had a previous successful VBAC) 
 VBAC + Augmented labor:  .9%  (stats for first attempt) 
 VBAC + Induced labor: 1%  (stats for first attempt)   

 Here is a link to the comparison of risk rates for VBAC, CBAC (a cesarean birth after a trial of labor) and ERC (elective repeat cesarean) http://www.sciencedirect.com/science/article/pii/S0002937808004213   

The risk factors when considering whether or not to do a trial of labor after a cesarean are: 
 The type of scar you have: the most favorable is a low transverse scar.  Classical T-shaped scars, vertical scars or high uterine scars are said to have a higher risk of rupture.   

 Induction of labor using cervical ripening agents, i.e., Cytotec, Cervidil: the prostaglandins that soften the cervix may also soften the scar tissue.  In addition, ripening agents can cause uterine hyperstimulation, meaning contractions that are much more intense and frequent than the uterus is designed to withstand in the course of an unmedicated labor.   

 More than one cesarean: as you can see from the statistics above, there is a slight increase of risk.   

Among factors that are disputed in medical literature are: 
 - Age of mother: if a mother is over 30 she may be considered at higher risk for uterine rupture. 
 - Obese women 
 - Size of baby: more than 8 pounds, 14 ounces 
 - Post-term baby: 40+ weeks gestation from last menses   

To compare, here are the stats and risk factors for an unscarred uterus:   “The normal, unscarred uterus is least susceptible to rupture. Grand multiparity, neglected labor, malpresentation, breech extraction, and uterine instrumentation are all predisposing factors for uterine rupture. A 10-year Irish study by Gardeil et al showed that the overall rate of unscarred uterine rupture during pregnancy was 1 per 30,764 deliveries (0.0033%). No cases of uterine rupture occurred among 21,998 primigravidas, and only 2 (0.0051%) occurred among 39,529 multigravidas with no uterine scar. 

A meta-analysis of 8 large, modern (1975-2009) studies from industrialized countries revealed 174 uterine ruptures among 1,467,534 deliveries. This finding suggested that the modern rate of unscarred uterine rupture during pregnancy is 0.012% (1 of 8,434). This rate of spontaneous uterine rupture has not changed appreciably over the last 40 years, and most of these events occur at term and during labor. An 8-fold increased incidence of uterine rupture of 0.11% (1 in 920) has been noted in developing countries. This increased incidence of uterine rupture has been attributed to a higher-than-average incidence of neglected and obstructed labor due to inadequate access to medical care. When one assesses the risk of uterine rupture, this baseline rate of pregnancy-related uterine rupture is a benchmark that must be used as a point of reference.” 

If you choose to have a VBAC, or realistically for any woman in labor since the statistics show she has a slight risk, here are the signs that may help you recognize that a uterine rupture is occurring or may have occurred: 
 - Excessive vaginal bleeding 
 - Extreme pain between contractions – these may or may not be felt through an epidural block, though due to severity of pain it’s possible they may be felt 
 - Contractions that slow down or become less intense 
 - Abdominal pain or tenderness 
 - Baby’s head moves back up the birth canal 
 - Bulge in the abdomen, bulge under the pubic bone, or pressure on the bladder where the baby’s head may be coming through the tear in the uterus 
 - Sharp onset of pain at the site of the previous scar 
 - Uterus becomes soft 
 - Shoulder pain 
 - Heart decelerations in the baby 
 - Maternal tachycardia (rapid heart rate) and hypotension (low blood pressure)   

 If you have a true uterine rupture, then an emergency cesarean will be required.  A Chandler doctor told the ICAN group that the care provider has 5 – 7 minutes to get the baby out safely, although in reading for this post I saw some estimates as 10 – 37 minutes.    

According to a 2010 National Institutes of Health study, there have been no maternal deaths in the US due to uterine rupture. Overall, 14 – 33% will need a hysterectomy.  6% of uterine ruptures result in perinatal death, and for term babies this risk was put at less than 3%. **   

 If you do have a uterine rupture, it will have an effect on your future pregnancies.  Each cesarean a mother has increases the risk for future complications of cesarean surgery.  If you have a hysterectomy, you will not be able to carry any more children.  In today’s medical climate, a uterine rupture will most likely result in all future pregnancies being delivered via repeat cesarean.   

 There are a lot of points to ponder as a new mom or as a mom considering a VBAC.  Our Bradley® mantra is: Healthy Mom, Healthy Baby.  We teach that as long as you make all your decisions with those two goals in mind, you are likely to make the choices that have a positive outcome for both Mom and Baby. 

 What are your thoughts on VBAC and/or uterine rupture?   

 **NOTE: Stephanie’s presentation called out these statistics as inflated as the Landon study (2004) included women who had pre-labor stillbirths included in the statistics.  IN other words, women whose babies had passed away before labor and still delivered via VBAC rather than choosing a repeat cesarean were counted in the perinatal death statistics.  Please read Henci Goer’s analysis for more information   

 For the resource list, click here

 Disclaimer:  
 The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.    

Bradley Method classes offered in Arizona: convenient to Chandler, Tempe, Mesa, Gilbert, Ahwatukee, Scottsdale, Phoenix and Payson, Arizona



Info Sheet: Vaginal Exams

Posted on March 4, 2016 at 2:01 PM Comments comments (0)
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
Pelvic or Vaginal Exam during Pregnancy (3rd Trimester)

According to Mayo Clinic, “as your due date approaches, your prenatal visits might  include pelvic exams. These exams help your health care provider check the baby's position and detect cervical changes.”


*History

Pelvic examination during pregnancy is used to detect a number of clinical conditions such as anatomical abnormalities and sexually transmitted infections, to evaluate the size of a woman’s pelvis (pelvimetry) and to assess the uterine cervix so as to be able to detect signs of cervical incompetence (associated with recurrent mid-trimester miscarriages) or to predict preterm labour (see Section 11.3).

In an RCT that assessed the relationship between antenatal pelvic examinations and preterm rupture of the membranes (PROM), 175 women were assigned to no examinations and 174 women were assigned to routine digital pelvic examinations commencing at 37 weeks and continuing until delivery.233 In the group of women who had no pelvic examination, ten women developed PROM (6%) compared with 32 women (18%) from the group of women who were examined weekly. This three-fold increase in the occurrence of PROM among women who had pelvic examinations was significant. 

Based on the above study the NCBI concluded, “Routine antenatal pelvic examination does not accurately assess gestational age, nor does it accurately predict preterm birth or cephalopelvic disproportion. It is not recommended.” 

Another study completed by the NCBI concluded, “In patients with a US-documented viable pregnancy, the pelvic examination did not contribute to the patient's immediate obstetric treatment. Occult cervical pathogens may be present in these patients.” 

Sources:

*PROS

Vaginal Exams can possibly measure:


  • Cervical Dilation
  •  Cervical Ripeness
  • Cervical Effacement
  •  Station of baby (position in relation to pelvis -5 to +5)
  • Position of the baby (anterior vs. posterior)
  • Position of the cervix
  • May find cervical anomalies, like early dilation and effacement, so that appropriate changes can be made to the woman's care, including bedrest, hospitalization, tocolytics, etc.
  • May stimulate the cervix so that a medical induction does not become "necessary"



*CONS

  • Increased risks of infection, even when done carefully and with sterile gloves
  • Increased risk of rupturing the membranes
  • May stimulate the cervix prematurely
  • Information collected does not accurately predict when labor will begin and may excite or disappoint women unnecessarily 

Sources:

*Links to explore

Pelvic Exams Near Term: Benefit or Risk? Talking to Mothers About Informed Consent and Refusal

Premature rupture of membranes at term. Retrospective study of 88 cases

Chorioamnionitis in the delivery room

Bacterial vaginosis and intraamniotic infection

Premature rupture of the membranes and ascending infection

Did you have vaginal exams in your third trimester before your labor started? Thoughts?
Please leave us a comment - it will be moderated and posted. 
 

Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson

Holiday Safety Tips

Posted on November 27, 2015 at 4:39 PM Comments comments (1)
This was first published in 2011 - sharing it again today since the holiday safety tips are still relevant.  Click HERE if you would rather watch the VLOG instead of reading this post :)

It’s the most wonderful time of the year…
 
It is such a gift to enjoy this season with our children.  They are filled with wonder at the sight of our Christmas tree.  They love to look at the ornaments, especially the ones with their pictures in them.  They are so excited about Santa and presents and at the top of the list, the family coming to visit them from all across the country.
 
This year is especially poignant – like us, our older two children recognize that this Otter’s first Christmas.  They wonder what she is thinking as she sees the activity, and they are telling her all about the family that she will be meeting for the first time.
 
No matter what your faith, I encourage you to take the time out of the hustle and bustle, the imposed rush of the season, to slow down and enjoy this time of year with your children.  The root of the word holiday is “holy day”; so if your faith tradition has a holiday this month, strive to make that the central focus instead of the commercialism of the season.
 
Get down on the floor with your children and look up at the decorations you have put up in your home.  Tell your children the significance and why these symbols are important to you.  Take the time to tell them about their first holidays in your family.  If this is your first holiday with your child, tell them your favorite childhood holiday memory – you can keep this tradition going as they get older.  Even if you have an infant, know that they hear you and that you are imprinting their mind.  Though they may not have a conscious memory, you are helping to plant their roots that bind you together long after they have children of their own.
 
The season will be much more enjoyable if you take some common sense precautions.  I wish you all a holiday away from the emergency room or urgent care.  Here are the usual tips with my modificaitons for families with mobile infants and toddlers.  I am ever mindful that we now have students who are parents to curious, mobile and walking one-year olds!

- Use ornaments that are not fragile, easily breakable, or that present choking hazards.  This is not the time to break out your heirloom decorations.  Although they may not be as elegant, use adornments that can survive a bounce and that won’t shatter and cut your child’s skin.  Also keep in mind this tip: if it can fit through an empty tube of toilet paper, it’s a choking hazard.

We found some lovely, larger ornaments at IKEA that are pretty, as well as safe and functional.  Until our youngest children loose the fondness for touching all the moving parts (most of which break off and fit through that tube of t.p.), my collector series ornaments are safely stored for a few more seasons.

Speaking of choking hazards, watch out for small gift bows, packing peanuts and other packaging materials like twist ties and loose pieces of tape.  Wrapping paper, ribbons and bows can also be a suffocation hazard.

- Hang string lighting and place candles where little hands won't be able to reach.  This seems self-explanatory.  Remember that children are extremely curious and very creative – think about how motivated they are to reach what you are setting out, and make sure that you have lights and candles out of the reach of a “stacking things so I can climb” child.  A note about candles: their fragrance may be overwhelming for underdeveloped senses.  The chemicals used to create that fragrance are not regulated, which is another reason we personally keep “the stink” out. We have no idea what is really causing that odor and whether or not it’s good for us.  Flameless candles are easily found these days – they are a great way to create ambience, thereby passing on the chemical or fire hazard component.

- Check your electrical outlets and cords.  Parents usually keep outlets covered with safety caps.  During this time of year, you may pull them out to put in cords for string lighting.  Make sure that you are aware of your children around all the extra cords and open outlets.  Place the strings high enough so they don’t go in their mouths.  Depending on how mobile and/or curious they are, they may try to pull out the cords from the socket, which can also be an electrocution risk.

- Keep poisonous plants out of reach.  Speaking of mouths…colorful plants might be a temptation to your child.  After a cursory look at THIS LIST of plants, a rash or an upset stomach seem to be the main symptoms.  Given a child’s smaller size and the fact that each person’s reaction is individual and varied, it’s probably best not to take any chances.

- The force of gravity does not take a vacation.   Evaluate your space and see where the safest places are for your decorations and furniture so that your children will not run into them in the normal course of their day.  If you rearrange furniture to accommodate decorations, make sure that the pieces are not a tip-over hazard in their new location. If you move side tables, watch their placement and don’t put anything to heavy or unstable on top of them.  If you move larger furniture, make sure it is steady in its new position.  If you put up a Christmas tree, it can also be a tip-over hazard.  You can secure it to a wall with an eye-hook and twine, or block it off with a safety gate.

Hot, hot, hot – hot chocolate.  I couldn’t resist the reference to the Polar Express!  Slow down and be aware in the kitchen.  Accidents happen - burns and spills happen when we are rushing and when the kitchen is full of people.  Take your time preparing and moving hot foods and liquids.   Be very aware of where your children are, or maybe you can assign someone else to entertain them outside of the kitchen if you are in charge of your holiday meal. 

Along the same lines, children don’t know that tablecloths aren’t stationary – all they see is something on which they can pull up.  The next thing you may hear is the crash of china and silver, or the screams of pain if they are burned by food placed on top of the tablecloth or an overhanging runner on a sideboard buffet.  You may want to skip on the tablecloths and runners and use placemats and doilies for the time being.  They will grow up and you will deck out your holiday table again some day.

I close with this thought today:  you may have seen our past posts about pregnancy and child loss.  As much as holidays are a time of joy, they are also a time of amplified sorrow for families grieving the passing of a loved one.  I invite you to take some time this season to say a prayer for those families that have lost a loved one this year, especially those whom have had their children called to the next journey.  Their loss is ever present as they watch other families enjoy the holidays and wonder what place their child may have played in their own holiday traditions.

From our home to yours, may you have a safe, blessed and joyous holiday season!

Do you have any holiday safety tips to share – what are they?

Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 
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Natural Oxytocin Boosters

Posted on October 23, 2015 at 9:27 AM Comments comments (0)
I am going to direct you to THIS article about how oxytocin helps to reduce stress and promote peace.  It's no surprise that oxytocin is the same hormone that is released when we make love, arguably a great stress reliever and a promoter of peace for couples.  A lovely consequence of making love when the timing is right: welcome, baby, some 36+ weeks later!

In addition to being the “love” hormome, oxytocin is also produced in great quantity when a woman is in labor.  The hard contractions can only happen if the woman’s body is producing ample oxytocin.  I find it so ironic that the physical pain and the emotion of love are happening at the same time. That must be the combination that makes natural birth possible, that helps bond us to our Sweet Peas, and why people sign up for the experience more than once.  I can honestly say that I am really going to miss being in labor.  Call me crazy!  Anyway.

I wanted to call out their suggestions for non-medical ways to boost oxytocin production and talk about how they may be options to consider while you are in labor since the article was not birth specific.

Oxytocin production in labor suggestions offered by Sweet Pea Births, instructor in the Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonBreastfeeding:  If you have an older sibling who is nursing, you can nurse them during labor.  Nursing stimulates the production of oxytocin, so I encourage you to be mindful of any contractions it stimulates.  You do not want to trigger an early labor, so pay attention if you feel a pattern developing and it’s not time for baby to make an appearance just yet.



Oxytocin production in labor suggestions offered by Sweet Pea Births, instructor in the Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonTouch: one of the cornerstones of The Bradley Method® is relaxation.  Among the 11 specific relaxation techniques that we teach during the course, two of them are massage and stroking.  Even if a mother does not want to be spoken to, a Coach can use those techniques.  If she doesn’t want that either, the simple act of holding her hand is listed as a way to boost oxytocin.


Oxytocin production in labor suggestions offered by Sweet Pea Births, instructor in the Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDaydream:  Another relaxation technique we teach is related to daydreaming.  We ask coaches to recount a past experience or a future dream that makes mother feel like she is in her “happy place”.  It might be a trip, an experience, dreams you have about your life as a family together...anything that is calming, encouraging and would elicit a smile.


Oxytocin production in labor suggestions offered by Sweet Pea Births, instructor in the Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonPet you furry friend:  One of the many benefits of laboring at home.  Do you have a four-legged friend that wants to cuddle?  Go for it!  Love on them, speak in gentle tones…it will be calming for both of you.



Oxytocin production in labor suggestions offered by Sweet Pea Births, instructor in the Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonPleasant smells:  This one has the added benefit of paying dividends at your birthplace.  One of the suggestions we make in Bradley™ class is to eat your favorite meal when you think you might be in labor.  The other one is baking some yummy treats to share with your care providers.  Hopefully both of those things will generate smells that you welcome in labor.  Either way: you are producing oxytocin, mama is well fed if it’s the beginning to have energy for the duration of labor, and your care providers get treats.  We found that feeding them kept them happy and that always made for positive birth experiences for us.


Oxytocin production in labor suggestions offered by Sweet Pea Births, instructor in the Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonMusic:  Mamas or Coaches can take the time to generate a play list to use in their birth space.  I have seen couples use a music app to choose the music for them in labor – it saved them from the planning/organizing time at the outset while still providing the music that was soothing to mama.  Find something that works for you and remember to put it on your packing list so the music makes it to your birth space. 
P.S. Doula and Music Therapist Laura Pruett offers playlist creation as a stand-alone service or as part of her doula service.


As I leave you with these ideas, I want to remind mamas and coaches that even if you are doing all of these things, labor cannot progress by oxytocin levels alone.  One of the key components of birth is surrender.  Do the things that boost your oxytocin and then let go, give in, and open up to the whole experience of labor and the birth journey.  The best gift is at the end when you meet your baby – it is SO worth it!

Best wishes for your upcoming birth – we hope some of these natural oxytocin boosters will help you stay on course with your wish list!

Which one of these do you like and/or have you used?
Please leave us a comment - it will be moderated and posted.  *I think* that the amount of traffic you so generously generate has led to a lot of spam posting.  In an effort to keep the spam to a minimum, I am taking the time to moderate comments now.
 
Disclaimer:
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.
Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this
blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Q&A with SPB: Writing a Birth Plan

Posted on October 20, 2015 at 7:18 AM Comments comments (0)

Q: How do I write a birth plan?
A: Have a good conversation with your partner and your care provider, write down a wish list, and then be prepared for your birth journey, taking into consideration there might be a detour or two!





Here are the basics of what we share with our students:

1. EXAMINE YOUR FEELINGS
What is important to you?
What would you be willing to compromise?
What are your absolutes?

2. CONSIDER YOUR PRIORITIES
List your choices in order - Mother ranks hers, Coach/Birth Partner ranks theirs, and then compare notes and arrive at some sort of compromise.

3. EVALUATE YOUR SITUATION
Are your choices realistic given yoru choice of birth setting?
Does your birth team support your wishes?
If you find yourself wanting to make changes in birth setting or care provider, what are your options?

4. MEET WITH YOUR CARE TEAM
Ask for etra time during the "birth plan" appointment.
Bring a draft of your wish list to get their input, and listen with an open mind and a grain of salt - more on that below.

5. PREPARE FOR A POSITIVE EXPERIENCE
Are you doing daily exercise?  Bradley Method Exercise Program
Are you eating the best whole food diet possible?  Brewer Diet for a Healthy Pregnancy

Those two things are the foundation for the possibility of a low-risk labor. Add in daily meditation for a good measure of positive energy for your upcoming birth journey.

6. BE FLEXIBLE
Bruss's mantra: "You are the birth that you bring with you."  Consider going into your birth journey with the idea that something is going to surprise you, something will disappoint you, and at the end of the day, transform you into the parent you need to be for your child.

Consider this: what is more important - sticking to your plan at all costs? Or, surrending to the birth journey, wherever it may lead you, and discovering something new about yourself? For the birth journey is an initiation of sorts; however it happens, it transforms us from maiden to mother, or from stag to father.

So, as instructors, we encourage our students to at least go through the process of preparing a wish list.  It allows the birthing family the opportunity to discover their priorities, evaluate whether or not they are in the right setting and with the right care provider for their dream of their birth, and then sets the compass for the general direction you want to travel along on this upcoming journey. This is the left-brain preparation for the birth journey.

Then, when the birth journey starts, there is a guideline to evaluate the path that is being traveled. When the birth partner has to take over being the mother's voice, they know what's important, what is not.  The birthing mother is free to surrender her unnecessary baggage along the way. I imagine it kind of like the settlers of old, leaving what they really did not need along the side of the road to arrive at their destination.  As we go deeper into "laborland", we surrender to the right brain that turns off the lists, turns off expectations, and simply does what needs to happen to birth this baby, wherever the path may lead.

For us, the compass was always set to "Healthy Mom, Healthy Baby". Each birth achieved that in a different way, and each one grew me in just the direction I needed to be the mother of our new family.

Here are some resources to consider:

A priority exercise we use in our classes HERE

A list of possible options to learn more about and prioritize for your wish list HERE

A starting point for writing a wish list HERE.  We encourage our students to use a list like this to clarify what they are dreaming of, and then using their own words when they write their dream down on paper.  Try to keep it to one page; if you go beyond one page, print on the front side only so that it is easily read when it's inserted into your file.

Finding the right care provider:
If you are getting red flags from your care provider when you start talking about the dream for your birth, consider if there resistance to your preferences is aligned with evidence-based care or personal opinion.  Explore their resistance: what experiences are filtering their response to your requests? And then listen to them: they have been around birth and have seen a lot of outcomes as trained professionals.

When you sit quitely with all the information you have gathered, what does your intuition say? If it's telling you that your requests are not extreme and you know that other families have been supported in them, go on a fact-finding mission: who was their care provider? How did that choice work out for them when they look back at their experience? If your fact-finding mission comes to the conclusion that you need to change providers, then change: you only have one journey to birth this baby.  Surround yourself with the right care for the path you are about to embark on.

Good resources to find about local care providers are childbirth educators or doulas in your area, any "birth circle" type gatherings, or your area ICAN chapter.  The birth community in your area will have an idea of who you might want to consider as your care provier for the birth journey that you are dreaming of for your family.



Please do not hesitate to reach out to us if you have questions about care providers in the Phoenix area:  [email protected]

We wish you all the best as you prepare for your birth journey with your Sweet Pea.

Disclaimer: 
Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe material included in this blog and video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog and video contain information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Patient Rights

Posted on September 25, 2015 at 9:39 AM Comments comments (3)
Thank you to one of my colleagues, Rachel Davis, for suggesting this topic.  

I originally shared this after one of our couples had an unplanned unassisted birth couple encountered in the hospital, and they were not treated very kindly upon arriving or throughout their hospital stay.
 
Most people would not expect their baby to be born at 35 weeks.  In addition, they had not counted on dealing with hospital protocols since they had planned a homebirth.  The other situation they hadn’t planned on was giving birth away from their community.   They were familiar with their local hospital in northern Arizona - it was beyond their imagination that they would spend their first week of their child's life having to deal with a major hospital in central Phoenix.
 
Their situation underscores the importance of having a well-thought out and written birth plan no matter what kind of birthplace you have chosen.  Wherever you are planning to give birth, Bruss and I suggest that you think about writing two birth plans.  Write one for a normal, uncomplicated birth at your chosen birth place. Also consider writing one that has your wishes written down in the event of complications, and that factors in hospital care if you are planning to birth at home or birth center..  Once you have talked these out between yourselves and your care providers, write them down and have a copy handy at all times.
 
You just never know how the birth journey will unfold…in the event of unforeseen circumstances, your birth plan can act as a compass for your decisions.  It can also remind you of the decisions you made when you took the time to research your options and when you were not under pressure.  You can then evaluate the current situation with a little less emotion and a little more reason.

There are two sections to this post.  First, I highlight the main points of your rights as a patient in the hospital. I encourage you to remember that you are the CONSUMER of health care, not a helpless being at the mercy of the staff.  The second section reviews some basics of informed consent so that you have an idea of how to receive the right care for you after asking questions that other people have found helpful to gather complete information before accepting or declining treatment.
 
PATIENT RIGHTS
For a full Pregnant Patient and Obstetric Patient Bill of Rights, I am going to refer you to a link on Doris Haire’s Alliance for the Improvement of Maternity Services (AIMS):
http://www.aimsusa.org/ppbr.htm
 
One of the reasons so many of us feel pressured to make choices against our instinct or desire for as natural experience as possible is that sometimes information is relayed in such a way that implies that you are a bad parent if you deny treatment to your child, or they imply that by not choosing something you could harm your child.  How many parents are strong enough to follow their instinct with pressures like time, fatigue and shock also factoring into the situation?
 
Whether you are planning to give birth at home, in a birth center, or a hospital, I encourage all pregnant mothers and their coaches to become familiar with the AIMS Pregnant Patient Bill of Rights in the event that you end up in a hospital for whatever reason.  I suggest that you print out the American Hospital Association's "Patient's Bill of Rights," (http://www.patienttalk.info/AHA-Patient_Bill_of_Rights.htm)  as well as the AIMS Pregnant Patient Bill of Rights and bring them both with you in the event of a hospital visit during your pregnancy and labor.

I will summarize some of the points here and encourage parents everywhere, that pregnant or not, if you are in a hospital, there is very little that you can be forced to do or take for yourself or your child.  You have every right to ask and be told the benefits and the risk of EVERYTHING they recommend as treatment, and you have the right to refuse.

These are what I chose to pull our from both of the Bill of Rights documents as your rights as a pregnant and an obstetric patient:
- to considerate and respectful care.
- to obtain from physicians and other direct caregivers relevant, current, and understandable information concerning diagnosis, treatment, and prognosis. 
- to ask and be informed of the existence of business relationships among the hospital, educational institutions, other health care providers, or payers that may influence the patient's treatment and care.
- to make decisions about the plan of care prior to and during the course of treatment and to refuse a recommended treatment or plan of care to the extent permitted by law and hospital policy and to be informed of the medical consequences of this action.
- to be informed of any potential direct or indirect effects, risks or hazards to herself or her unborn or newborn infant which may result from the use of a drug or procedure prescribed for or administered to her during pregnancy, labor, birth or lactation.
- to be informed, not only of the benefits, risks and hazards of the proposed therapy but also of known alternative therapy.
- to be informed about how a drug or procedure may adversely affect her unborn baby, directly or indirectly, and that there is no drug or chemical which has been proven safe for the unborn child.
- if Cesarean birth is anticipated, to be informed that minimizing her intake of nonessential pre-operative medicine will benefit her baby.
- to be informed of the areas of uncertainty if there is NO properly controlled follow-up research which has established the safety of the drug or procedure with regard to its effect on the fetus and the later physiological, mental and neurological development of the child.
- to be informed of the brand name and generic name of the drug in order that she may advise the health professional of any past adverse reaction to the drug.
- to determine for herself, without pressure from her attendant, whether she will or will not accept the risks inherent in the proposed treatment.
- to know the name and qualifications of the individual administering a drug or procedure to her during labor or birth.
- to be informed whether that procedure is being administered to her because a) it is medically indicated, b) it is an elective procedure (for convenience, c) or for teaching purposes or research).
- to have her baby cared for at her bedside if her baby is normal, and to feed her baby according to her baby's needs rather than according to the hospital regimen.
- to be informed if there is any known or indicated aspect of her or her baby's care or condition which may cause her or her baby later difficulty or problems.
 
INFORMED CONSENT
What is informed consent?  According to Doris Haire:
 "Most courts consider that the patient is 'informed' if the following information is given:
•    The processes contemplated by the physician as treatment, including whether the treatment is new or unusual.
•    The risks and hazards of the treatment,
•    The chances for recovery after treatment.
•    The necessity of the treatment.
•    The feasibility of alternative methods of treatment.”

You can ascertain this information by asking questions.  For a more comprehensive look at positive communications and informed consent, refer to page 55 of The Bradley Method® Student Workbook.
 
I suggest that you start with questions that establish how the mother and the baby are doing.  Always use names to remind the care providers that they are making recommendations for another human being, not an ambiguous test case:

  • “How is (Mother’s Name) doing?  Are her vitals still within an acceptable range?”
  • “How is (Baby’s Name) doing?  Are his or her vitals still within an acceptable range?”
  • “Do we have to make a decision right now?  How much time do we have?”

 
If both are well enough and there is time, then you can continue with questions such as:

  • “What is the problem?”
  • “What are the symptoms or test results causing concern?”
  • “Could this be normal?”
  • “What is the most likely cause?  Are there any other possible causes?”

 
If the care provider agrees that Mother and Baby are well enough to let labor proceed and let nature take her course, continue to trust that Mother and Baby are working together and that you will be meeting your baby in due course.  You can address other probable causes – is mom hydrated?  Is she emotionally ready and relaxed enough to accept her labor?  Are you using the best positions in the appropriate stage of labor to allow gravity and physiology to move things along?
 
If after asking this series of questions Mother and Coach decide that further action is worth exploring, then you can continue with these questions:

  • Paraphrase it back to ensure you understand what the recommendation is.


  •  You want to listen well, and paraphrase again.  You can also ask if their opinion is based on fact or observation.


  • Ask to see the insert if it is a drug and there is time to read it – you may be surprised at what is in the fine print and the care provider fail to mention.


  • Side effects are very important to know, especially if it is something whose short-term or long-term effects on an unborn child or a newborn are unknown.


  • Again, care providers have routines based on what their protocol is – sometimes there are other options that they don’t mention, not from malice, it could be simply because they are not accustomed to being asked for alternatives.


  • Who are you talking to?  Nurses come in many varieties: a student nurse, an LPN (one year of schooling), an ASN nurse (two years of schooling), a BSN (four years of schooling).  Beyond that, how long have they been working as a nurse?  If you are talking to a doctor: are they a resident (student) doctor, or an attending (more experienced) physician?  How long have they been a resident or an attending? 


  • Knowing the level of experience of the information giver is an especially important question to ask if you are in a teaching hospital.  Every family needs to make a decision regarding their comfort level with students literally practicing on you based on their individual preferences.  On a personal note, while I am all for medical students learning, when it come to my body and our child, I want a trained and experienced professional to work on us.  I am okay if a student wants to observe, however, only someone with extensive experience and knowledge is going “to do” something or administer something to us.


  • In the interest of full disclosure, here are other very important questions:  1.) You want to know how they will measure the efficacy of the intervention.  2.) When you accept one medical intervention, it is likely that other interventions or compromises will follow.  If there is time, you want to hear all of the other interventions or protocol they will have to follow that may be a result of the first intervention you agree to have. 


  • Back to full disclosure – there are ways to phrase things that force you to make an immediate decision.  If you ask "how will you know it's working, and what happens next" questions, it provides the opportunity for the care provider to tell you the other side of the story, or the whole story in regards to their recommendations.

 
One of the reasons it is so important to take care when choosing your care providers and medical facilities is that sometimes there isn’t time to ask all these questions.  If Mother and Baby are already compromised and there is no time to ask questions, you must trust that the care providers and the birthplace will do the best for your family.  Do you have this level of trust with your care provider?  Do you have this level or trust with the birthplace?  If you answered “no” to either of these questions, it’s time to seriously consider making a change.  Although true complications are rare, if you are part of the small percentage, you want to ensure that you have the best chance for a good outcome despite any complications that may arise.
 
You have a couple of options in a hospital setting in the event that you want to choose differently than your care providers are recommending and/or if you feel like your concerns are not being heard by your care provider.
 1.  If you have done your research and you have heard the benefits and the risks of a procedure or drug, and you are confident in your decision and want to refuse, hospitals have documents called “Against Medical Advice” that you can sign.  You accept the risks inherent in your decision and relieve the hospital of liability.

2.  You can ask for an Independent Patient Advocate.  This person acts as a liaison between the patient and the care providers.  It puts someone in between you and the care provider, and it is implied that they would convey information in a neutral way.  Sometimes taking away the “authority” of the person conveying the information relieves the pressure and lets a patient make a decision without feeling the pressure of “The Doctor” or “The Nurse”.
 
There is no decision, big or small, that you will regret making as long as you keep in mind Dr. Bradley’s ultimate outcome: Healthy Mom, Healthy Baby.  As long as your decisions are made with the best results for these two people in mind, then you can find peace of mind that you are making the right decision for you and your family.
 
 
Bradley Method classes offered in Arizona. Convenient to Chandler, Tempe, Gilbert, Mesa, Phoenix, Ahwatukee and PaysonDisclaimer:  
The material included on this site is for informational purposes only.  It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 

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