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Sweet Pea ​Births
Sweet Pea ​Births
...celebrating every swee​t pea their birth
...celebrating every swee​t pea their birth
Blog
Q&A with SPB: DIY Padsicles
| Posted on January 17, 2017 at 6:27 AM |
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 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 EMAIL [email protected] Disclaimer:
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 |
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Today's question on Q&A with SPB:  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:
Krystyna's little side note about pumps to consider:
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 |
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 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  - 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  - 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  - 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  - 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  - 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: 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 |
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 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 QUEENI 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: 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 (0)
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 This was in posted April 2012 - updated April 2016Uterine 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®.  |
Info Sheet: Vaginal Exams
| Posted on March 4, 2016 at 2:01 PM |
comments (0)
|
 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.”
*PROS Vaginal Exams can possibly measure:
*CONS
*Links to explore Pelvic Exams Near Term: Benefit or Risk? Talking to Mothers About Informed Consent and Refusal 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®. |
Holiday Safety Tips
| Posted on November 27, 2015 at 4:39 PM |
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®. We are now enrolling for our Spring Series March 11, 2016 to June 3, 2016 For more information or to register, please call us at 602-684-6567 or email us at [email protected] |
Natural Oxytocin Boosters
| Posted on October 23, 2015 at 9:27 AM |
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|
 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.  Breastfeeding: 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. Touch: 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. Daydream: 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.  Pleasant 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. Music: 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.
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:  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®. |
Q&A with SPB: Writing a Birth Plan
| Posted on October 20, 2015 at 7:18 AM |
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|
 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: |
Patient Rights
| Posted on September 25, 2015 at 9:39 AM |
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:
INFORMED CONSENT What is informed consent?
According to Doris Haire: "Most courts consider that the patient is
'informed' if the following information is given:
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:
If both are well enough and there is time, then you can
continue with questions such as:
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:
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.
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. 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®. |