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Stay Safe and Cool Through Your Summer Pregnancy - Part 1

Posted on June 7, 2016 at 9:31 PM Comments comments (54)
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 (49)
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



Empty Womb + Broken Hearts: Living after a miscarriage

Posted on September 11, 2015 at 10:19 AM Comments comments (0)
Miscarriage has touched our SPB community again.  We grieve with the aching hearts of those families.  There is no way I know of to erase that pain, regret, constant questioning, the loss of a dream of the new child that was supposed to join the family.  The only thing that has eased the pain for us are the sands of time.
 
We suffered a miscarriage in 2006.  We hardly ever talk about it.  We do not want to scare people, especially our students, or worry them unnecessarily.  Most pregnancies will proceed to a healthy mom, healthy baby birth journey.  BUT, the reality is that “most” is matter of numbers.  80-85% is greater than 15-20% (reference HERE).  In real numbers, that is one out of five!  If there are five girlfriends in your circle…then one of you has probably had a miscarriage.  
 
I am one of those five – “we” are, really.  The Sweet Pea Kids know about it – they noticed that there was a bigger space between birthdates between Puma and Night Owl, and asked about it, as children will.  Bruss and I have never really “talked” about it – I guess we are both okay as we are going to be now.  Maybe I should ask him.
 
We did go on to have three more children after our miscarriage, for which I am extremely grateful.  As much as I would like to say that I stopped worrying about having a miscarriage again after our "rainbow" baby, it would be a lie. 

It is something that hung over me with every pregnancy afterwards.  Hoping the floor was not going to fall out from under me again.  Praying fervently every night that this baby would be okay, breathing a sigh of relief when the dawn broke and I was still pregnant.  

The only thing that helped me start to heal was to the trust in design. I wrapped my mind and my heart around the idea that for some reason, this baby was not "okay" and was not developing well. In her wisdom, Mother Nature changed the plan.   

As it turns out, the mantra I created for myself out of that idea is actually backed up by the evidence.  One might begin their own healing journey with this fact: "Most miscarriages are caused by chromosome problems that make it impossible for the baby to develop. Usually, these problems are not related to the mother's or father's genes." (quote from this article 

YOU didn't DO anything wrong.
 
As with most things pregnancy related, the more I have learned, the better I can support others.  I encourage you not to suffer alone.  Loss and grief are isolating in our culture, where only happy, shiny thoughts are shared and encouraged.  Now, thanks to the age of the Internet, I have been able to find resources to share with the families in our community.
 
And, if you ever want to an ear to listen, please feel free to call or write me.  I can be an ear to listen, or beyond that, go to a support meeting with you.  I would be happy to sit down for a cup of tea with you – whatever I can do to help would be an honor.
 
Resource List
Here is the resource list – some are local to Phoenix, others are national organizations, and of course some social media groups as well.  I am also listing some books for those of you that process through reading – most are available as e-books as well.

Putting this at the top of the list since most of students in this situation have at least one child already ~ available HERE*

Picture Book: "We Were Gonna Have A Baby, But We Have An Angel Instead" 

"A children’s book told from a young child’s perspective about the excitement and dreams of a coming baby, and the disappointment and sadness of a miscarriage. Beautiful ink and watercolor illustrations."*

 
Support Groups & Online Communities
Arizona Perinatal Loss Bereavement Resource, Banner Desert Medical Center
1400 S. Dobson Road, Mesa, 85202
480-512-3595
Provides a network of support for those experiencing a pregnancy or infant loss. This resource gives parents a statewide network of support, current bereavement literature on a variety of topics, educational opportunities and resources in the community, state and national level.
 
Banner Health Warm Line – Support for parents who have suffered miscarriage or infant loss 
RTS Bereavement 230-CARE Line, (602) 230-2273
 
HAND Helping After Neonatal Death
HAND is a resource network of parents, professionals, and supportive volunteers that offers a variety of services throughout Northern California and the Central Valley.
 
M.E.N.D. Mother's Enduring Neonatal Death
M.E.N.D. (Mommies Enduring Neonatal Death) is a Christian, non-profit organization that reaches out to families who have suffered the loss of a baby through miscarriage, stillbirth, or early infant death.
 
M.I.S.S. Foundation
The M.I.S.S. Foundation provides immediate and ongoing support to grieving families through community volunteerism opportunities, public polic y and legislative education and programs to reduce infant and toddler death through research and education.
 
SHARE Share Pregnancy and Infant Loss Support, Inc
The mission of Share Pregnancy and Infant Loss Support, Inc. is to serve those whose lives are touched by the tragic death of a baby through early pregnancy loss, stillbirth, or in the first few months of life.
 
Now I Lay Me Down To Sleep
They offer the free gift of professional portraiture and remembrance photography to parents suffering the loss of a baby.  “The NILMDTS Foundation is there for parents and families to help aid them in their Healing, bring Hope to their future, and Honor their child.  It is through Remembrance that a family can truly begin to heal.”  They feel that these images serve as an important step in the family’s healing process by honoring their child’s legacy.
 
Bereavement and Support Website for Care Providers and Families
 
A Christian site for baby loss:
 
Glow In The Woods
http://www.glowinthewoods.com/ 
This website deals with all kinds of baby loss.  There is also lots of helpful advice for things you may have to deal with depending on the stage of loss like stopping lactation, planning a funeral, and how to help others going through a loss.   
 

Social Media



 
Reading List
Empty Cradle, Broken Heart
The heartache of miscarriage, stillbirth, or infant death affects thousands of U.S. families every year. Empty Cradle, Broken Heart offers reassurance to parents who struggle with anger, guilt, and despair after such tragedy. Deborah Davis encourages grieving and makes suggestions for coping. This book strives to cover many different kinds of loss, including information on issues such as the death of one or more babies from a multiple birth, pregnancy interruption, and the questioning of aggressive medical intervention. There is also a special chapter for fathers as well as a chapter on "protective parenting" to help anxious parents enjoy their precious living children. Doctors, nurses, relatives, friends, and other support persons can gain special insight. Most importantly, parents facing the death of a baby will find necessary support in this gentle guide. If reading this book moves you to cry, try to accept this reaction. Your tears merge with those of other grieving parents.
 
A purpose of this book is to let bereaved parents know that they are not alone in their grief. With factual information and the words and insights of other bereaved parents, you can establish realistic expectations for your grief. Empty Cradle, Broken Heart is meant to help you through these difficult experiences by giving you things to think about, providing suggestions for coping and encouraging you to do what you need to survive your baby's death. Whether your baby dies recently or long ago, this information can be useful to you.
 
An Exact Replica of a Figment of My Imagination: A Memoir
"This is the happiest story in the world with the saddest ending," writes Elizabeth McCracken in her powerful, inspiring memoir. A prize-winning, successful novelist in her 30s, McCracken was happy to be an itinerant writer and self-proclaimed spinster. But suddenly she fell in love, got married, and two years ago was living in a remote part of France, working on her novel, and waiting for the birth of her first child.

This book is about what happened next. In her ninth month of pregnancy, she learned that her baby boy had died. How do you deal with and recover from this kind of loss? Of course you don't--but you go on. And if you have ever experienced loss or love someone who has, the company of this remarkable book will help you go on.

With humor and warmth and unfailing generosity, McCracken considers the nature of love and grief. She opens her heart and leaves all of ours the richer for it.
  
About What Was Lost: 20 Writers About Miscarriage, Healing, and Hope
“In this intimate anthology, twenty writers explore the grief and sadness—and hope—that living through a miscarriage can bring.
Featuring such notable writers as Pam Houston, Joyce Maynard, Caroline Leavitt, Susanna Sonnenberg, and Julianna Baggott, among many others, About What Was Lost is the only book that uses honest, eloquent, and deeply moving narrative to provide much-needed solace and support on the subject of pregnancy loss.
Today, as many as one in four pregnancies ends in miscarriage. And yet, many women are surprised to find that instead of simply grieving the end of a pregnancy, they feel as if they are mourning the loss of a child. Taken aback by their sorrow, they seek solace in similar perspectives—only to find that a silence and lingering stigma surrounds the topic. Revealing a wide spectrum of experiences and perspectives, this powerful collection offers comfort and community for the millions of women (and their loved ones) who experience this all-too-common kind of loss every year.” 



Disclaimer: 
Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe 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 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 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 in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

Birth News

Posted on January 10, 2014 at 6:31 PM Comments comments (0)
Happy New Year!!  Wishing all of our readers many blessings as you welcome the new year.  I trust your holidays were wonderful and that you are looking forward to all the promise of a fresh slate.

These are probably going to keep being evening editions - thank you for your patience as we ramp up posting again in the New Year.  I am really placing a high value on being Peaceful Mama for my kiddos, which means that being on the computer is taking a back seat to homeschooling and teaching classes this season.  

I will be back in full swing soon - until then, please do not hesitate to contact me via email (krystyna{at}sweetpeabirths{dot}com) if you have any pressing questions about pregnancy, natural birth or breastfeeding!

Birth News
 
FERTILITY
NOTE: Please read this with a grain of salt - we have had students have beautiful, term babies even though they used IVF to attain pregnancy.  Simply shared as a tool for discussion with your care providers as you weigh the benefits and the risks.

IVF Pregnancies Are More Likely To Result In Stillbirth, Preterm Birth, Low Birthweight, Or Neonatal Death

Couples struggling with infertility often turn to assisted reproductive therapy in an effort to start the family of their dreams. A study out of the University of Adelaide’s Robinson Institute found that pregnancies conceived with assistance such as in vitro fertilization (IVF) are more likely to end in stillbirth, preterm birth, low birth weight, or neonatal death, compared with natural pregnancies.

"More research is now urgently needed into longer term follow-up of those who have experienced comprehensive perinatal disadvantage," said lead researcher Professor Michael Davies from the University of Adelaide's Robinson Institute. "Our studies also need to be expanded to include more recent years of treatment, as the technology has been undergoing continual innovation, which may influence the associated risks."

Medical Daily http://bit.ly/19V24Sc

PREGNANCY
NOTE:I am by no means suggesting that you *should* go get a flu shot – again, I am simply offering this as information to discuss with your care provider.  See what Dr. Sears has to say about the flu shot during pregnancy HERE and HERE 

Flu shots in pregnancy protect babies from being born too soon, Canadian studies show

Pregnant women who are vaccinated against the flu are significantly less likely to deliver premature or low-birth-weight babies compared to unvaccinated expectant mothers, new Canadian research finds.

Based on more than 12,000 women in Nova Scotia who gave birth in the immediate aftermath of the H1N1 flu pandemic, the study adds to mounting evidence that the flu can have “really detrimental effects for both mothers and their babies,” said first author Alexandra Legge, a fourth-year medical student at Dalhousie University in Halifax.

Ottowa Citizen http://bit.ly/1gqKeoL


BIRTH
Premature 'Water Breaking' During Pregnancy Linked to Bacteria

High levels of bacteria are associated with water breaking 
prematurely in pregnant women, a new study indicates.

Researchers arrived at their findings by analyzing samples of amniotic sacs (fetal membranes) from 48 women after they gave birth. The report is published in the Jan. 8 online issue of the journal PLoS One.

Nearly one-third of early deliveries are associated with premature rupture of fetal membranes, and it's important to learn more about why this happens, the researchers noted.

WebMD http://bit.ly/1d31rF3

POSTPARTUM

Is Placenta Encapsulation the Answer to Postpartum Depression?

It's a sad reality that a lot of moms are familiar with postpartum depression. For anyone that has suffered from this type of clinical depression, you know the impact it can have on both the lives of the individual suffering, and those around her. There have been studies upon studies to find a way to eradicate the symptoms; some have been proven helpful and others not so much. But what if you knew of something that could eradicate all the above? Something so simple, natural and readily available. Would you give it a try? What if that particular “something” just happened to be encapsulating your placenta and eating it? Ew. But what if it really worked?

Not only does it work, but it does much more than combat the “baby blues.” January Jones, Kim Kardashian, Tia Mowry-Hardrict and Tamara Mowry-Housely all rave about their experiences with encapsulation. Before you allow your stomach to churn, put down your lunch for a few moments and take a few moments to learn more about placenta encapsulation and postpartum depression.

Mommy Noire http://bit.ly/1gqI3By

BABY

New causes of diabetes in babies discovered

Scientists have found two new genetic causes of neonatal diabetes - a form of diabetes that occurs in the first 6 months of life. 

The research by the University of Exeter Medical School provides further insights on how the insulin-producing beta cells are formed in the pancreas. 

The team discovered that mutations in two specific genes which are important for development of the pancreas can cause the disease. 

Business Standard http://bit.ly/1a3eaX5

'Kangaroo Care' May Have Lasting Benefits for Human Babies 
 
At age 10, the children who had received maternal contact as infants slept better, showed better hormonal response to stress, had a more mature functioning of their nervous system and displayed better thinking skills.

LiveScience http://bit.ly/1gpnkyc

Preemies who cry a lot may have problems later on

Premature babies who cry a lot may be more likely than other preemies to have behaviour problems by the time they reach preschool, a new study suggests.

Experts said the reasons for the finding are not certain, and no one knows whether "interventions" to soothe preemies' crying would ward off behaviour issues later.

"In many ways, this study raises more questions than it answers," said Dr Andrew Adesman, chief of developmental and behavioural paediatrics at Steven & Alexandra Cohen Children's Medical Centre in New Hyde Park, New York.

Health24 http://bit.ly/1iWKgZG

Doctors report uptick in number of babies with RSV, a respiratory virus, this flu season

For older children and adults, RSV is usually like a cold. Since there isn't a good vaccine against it, Dr. Starke says parents of babies should act fast if their baby has trouble breathing.

"You notice their chest going in and out, they're breathing rapidly, those kids need to be seen right away," he said.

Dr. Starke says there's no treatment for RSV, so parents may want to be extra cautious about taking their babies out in public during this RSV epidemic.

abc13.com http://bit.ly/1gqJ8cC

BREASTFEEDING
Study Links Breastfeeding to Lower Risk of Rheumatoid Arthritis

The latest study documented in the journal Rheumatology, was conducted on more than 7,000 older Chinese women. It revealed that breastfeeding was strongly related to a reduced risk of rheumatoid arthritis (RA). Mothers who breastfed, their risk of rheumatoid arthritis came down by almost half compared to those who never breastfed.

There were studies conducted prior to this that focused on the association between breastfeeding and RA, but the results produced were mixed.  It is a well known fact that breastfeeding benefits infants. But there has been growing evidence that breastfeeding has a positive impact on the health of the mothers too. This latest cross sectional study examined the association between breastfeeding and RA and also on the intake of oral contraceptives.

Science World Report http://bit.ly/1iWMTKQ


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

Coping After A Miscarriage

Posted on January 7, 2012 at 9:40 PM Comments comments (0)
I want to share a topic that is rarely  discussed.  No one announces their miscarriages when they happen – it is a personal, private event that few people ever know about outside of the couple that lost their pregnancy.   

 We had a miscarriage between our first and second child.  Our story starts with our first pregnancy.  I had been so uptight and concerned when I was pregnant with Ysabella.  With her pregnancy we had spotting right from the beginning, and it lasted the whole pregnancy.  Very few people knew we were pregnant the first time until we were in our second trimester.  We did not buy any clothing for the baby until after she was born.  We were so grateful to hold her in our arms on her birthday – it was a joy and a relief.   

 We started trying for another baby after she turned a year old.  I suspected I was pregnant because I gained five pounds overnight with no obvious reason – this had happened when I was pregnant with Ysabella, and with each subsequent pregnancy, by the way.  Another sign was that Ysabella started refusing the breast.  She would nurse and pull away making a funny face – I have read that the “flavor” of the milk changes in response to the hormonal changes of pregnancy.  On top of those signs, I took two pregnancy tests that confirmed I was pregnant.   

 So now that we had positive pregnancy tests, we were ready to tell the world. Our reason prevailed though, and we only told my immediate family we were expecting again.   

 We were so excited, and I was determined to relax and enjoy this pregnancy since our first one had turned out well.  We went on a family trip to Hawaii.  We enjoyed the sights and sounds on our vacation instead of worrying about every little thing.  I told the waiters I was pregnant so to please be sure to cook my food well.  I bought a matching outfit for Ysabella and her expected sibling.  I sent postcards to my family and signed all of our names, including "Baby Bowman".  We were on top of the world!   

 It was early in the pregnancy – I was probably 7-8 weeks along when it happened.   Since we were still on vacation, I called my doctor’s office to see if there was anything I could do to stop the bleeding, to which they said no.  We tried to take comfort in the fact that Mother Nature’s wisdom prevailed – miscarriages are a natural way of terminating pregnancies when there are gestational abnormalities.  We were heartbroken, nonetheless.   

 We called my mom and sister to tell them the news.  After I miscarried, we were back to our regular nursing schedule.  Ysabella no longer cringed at the taste of my milk.  Going back to nursing Ysabella helped me heal from the loss and sorrow. Focusing on what I had versus what I had just lost helped to comfort me. 

 I prayed like crazy the next time we got pregnant for God to take away my fear so that the new life inside me would feel our love and not my worry.  We have carried every pregnancy since then to term.  However, in that time I have talked to many other mothers who had miscarriages between live births one and two.  

 For some of us a miscarraige gets to be a private grieving, for others, it’s much more public.  In hindsight, I am grateful we miscarried early before we got to feel our baby move, and there are other stories like mine.  Other families we know of lost their babies in their second trimester when mom was already showing and they had felt their children’s movements inside of them.  

 Are we ever totally over it? I don't think so; I don't know how we can be since the difference between carrying to term and the loss of a life is so personal and intimate for us. 

 So, if by some turn of events you suffer a miscarriage, please know you are not alone.  It may help to talk to someone about it, or maybe find comfort and solace in a support group, a faith community or an on-line community.  You do not have to grieve alone.   

 Also know that it is possible to carry to term with subsequent pregnancies.  Talk to your care provider, they may have specific recommendations for your situation.

 These posts have some resources listed in them if you would like to reach out for support:


Do you know anyone who had a miscarriage?  How did they cope?

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 5, 2012 to 
May 21, 2012   

For more information or to register, 
please call us at 
602-684-6567 
or email us at 


Angels

Posted on August 30, 2011 at 7:42 PM Comments comments (0)

"This week we remember all babies born sleeping, or whom we have carried but never met, or those we have held but could not take home, or the ones that came home but didn't stay. Make this your profile status if you or someone you know has suffered the loss of a baby. The majority won't do it, because unlike cancer, baby loss is still a taboo subject. Break the silence. In memory of all lost angels. ♥"
~ Source Unknown

Have you ever seen this status on Facebook?  (To give credit where credit is due, I also paraphrased the quote on today's landing page from a quote I found on the page for a miscarriage group on facebook - see the Resource List for a link to the group.)

We had planned to end Breastfeeding Awareness Month with a post from Coach Bruss...look for that on Friday.  In the meantime, since I am punting and this subject of baby loss has touched me in some form three times in the last few weeks, I thought I would share some additional resources and offer some new insights I have gained thanks to other people being generous with their stories of overcoming adversity.

It is especially hard to write about this as we are now in our 34th week of pregnancy.  I take comfort in the fact that pregnancy and infant loss is very rare.  Most of us will have healthy, term babies who go on to live full lives well into their adulthood.  I have read that the chance of pregnancy or perinatal loss is less than one percent. 

So how do you deal with that loss if you are among that so small percentage of people who lose their precious child when the rest of the world is rejoicing at birth?  Inevitably their is someone with an infant or nursing their baby when you are in public.  How do you live without breaking down every time you leave your home? 

If you are in this devastating situation, I hope and pray that some of the information that follows helps you manage day by day as you come to terms with your loss.  If you are a friend or support person for a family that has experienced loss, please share what might be appropriate for their situation and maybe some of these resources can serve you, too.

What can you do when your unborn child is diagnosed with a terminal condition that has a high chance of stillbirth or loss in childhood?

You are usually presented with two choices in these situations:  you can carry the pregnancy to term and possibly face a loss at the beginning of life or very likely within the first few years of life; or you can terminate the pregnancy before you get much further in gestational life.

I saw one mom who commemorated her experience with a pregnancy photo session.  She and her partner had already chosen a name for their baby.  She found an artist who painted her pregnant belly with her baby’s name and an image of her son wearing angel wings.  No matter what her outcome, she will always have those beautiful artistic photos of a very special time in her life that she shared with her living, unborn son.

How about when your delivery goes wrong and your healthy, living baby is suddenly and inexplicably stillborn?

I heard one of the most profound and touching birth stories I have heard to-date at a meeting I attended recently.  A mom shared that everything was going well until...and then the next thing they know, their baby is gone.  She and her husband had time to hold their baby, which she said was so very special and precious.  They have grieved and continue to grieve together.  At the same time, they have decided to focus on the positive.  Both of them believe that this baby’s birth and death have a purpose and they are accepting of it and loving their child every day by talking about her within the family and when the opportunity presents itself, sharing her story. 

The family has made a gift of her short life already.  As this mother is an organ donor, it made sense to her to donate her baby’s organs - they are now providing the gift of life for children who had bleak futures until they received her organs.  The mother is also donating her milk - she says that she thinks of her baby in heaven every time she pumps and she finds that thought comforting.  She has been faithful in pumping since the loss and she has been donating her milk to a friend of hers who adopted a baby.  This adopted baby had a brain that was incomplete at birth due to the birth mother’s drug use.  Since that baby switched from formula to breast milk, her scans have shown an increase in her brain mass and she is starting to hit developmental milestones.  What an amazing legacy for a little girl who never breathed in her parents arms and whose time on earth was so very short.

This family also grieved by spreading her ashes at memorial events in their home states with their extended family.  As I listened to the story and watched this mom speak, I was moved by her faith and the journey she has taken in the last few weeks.  She has taken a situation of utter despair and turned it into one of love and sharing.

What if your baby is born with a known or unknown childhood complication and it becomes apparent that they are not going to live very long?

There are two women here in Arizona who through their own experiences identified a need for perinatal hospice care.  They met at a MISS support group meeting and realized that they could serve others through their own experiences, and thus came the idea for providing hospice services tailored to families who were dealing with the imminent loss of their infants. 

They support families by coordinating between the medical community and the family, they offer anticipatory grief education & emotional support, they help with the creation of birth and death plan, help organize memory making/keepsakes, and offer individualized childbirth education and professional doula services to make the most of the baby's birth experience.

Here are some of their stated goals:
*To help families emotionally prepare for birth and death by creating a circle of support around them
* To help families understand their babies diagnosis and the probable outcome
* To help families make decisions based on the love they have for their baby
* To assist families in cherishing the time between diagnosis and birth/death

To see a complete list of their goals, services and the hospice care they are offering, click on the CARE link below.

There is also a book that I learned of recently that may be helpful if you know of someone who might be experiencing the loss of a newborn:
A Gift of Time: Continuing Your Pregnancy When Your Baby's Life Is Expected to Be Brief
by Amy Kuebelbeck and Deborah L. Davis, Ph.D.

I can only hope and pray that everything goes well with our birth and that we will be blessed with a healthy, whole child who will grow up to be a vibrant, giving and whole adult.  If for some reason that is not the plan for any of our children, I hope and pray that I will find comfort in some degree in such a manner as these families have demonstrated.

Blessings to all.


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®.

Resource List
Comfort and Resource Enhancement, or CARE, Program
Upon referral from perinatologist, The MISS Foundation's Perinatal Palliative C.A.R.E.S. Program provides support to families facing poor prenatal diagnoses.

Perinatal Hospice and Pallative Care
Resource website for families and caregivers that lists books, resources and hospice programs on a countrywide basis.

Angel Baby - Miscarriage and loss

Arizona Perinatal Loss Bereavement Resource
Banner Desert Medical Center
1400 S. Dobson Road, Mesa, 85202
480-512-3595
Provides a network of support for those experiencing a pregnancy or infant loss. This resource gives parents a statewide network of support, current bereavement literature on a variety of topics, educational opportunities and resources in the community, state and national level.

The Compassionate Friends
The Compassionate Friends assists families toward the positive resolution of grief following the death of a child at any age and to provide information to help others be supportive.   They offer a safe place for bereaved parents, grandparents, and siblings to meet and talk freely about your child and your grief issues.

M.I.S.S. Foundation
The M.I.S.S. Foundation provides immediate and ongoing support to grieving families through community volunteerism opportunities, public policy and legislative education and programs to reduce infant and toddler death through research and education.

M.E.N.D. Mother's Enduring Neonatal Death
M.E.N.D. (Mommies Enduring Neonatal Death) is a Christian, non-profit organization that reaches out to families who have suffered the loss of a baby through miscarriage, stillbirth, or early infant death.

HAND Helping After Neonatal Death
HAND is a resource network of parents, professionals, and supportive volunteers that offers a variety of services throughout Northern California and the Central Valley.

SHARE Share Pregnancy and Infant Loss Support, Inc
The mission of Share Pregnancy and Infant Loss Support, Inc. is to serve those whose lives are touched by the tragic death of a baby through early pregnancy loss, stillbirth, or in the first few months of life.

Now I Lay Me Down To Sleep
They offer the free gift of professional portraiture and remembrance photography to parents suffering the loss of a baby.  “The NILMDTS Foundation is there for parents and families to help aid them in their Healing, bring Hope to their future, and Honor their child.  It is through Remembrance that a family can truly begin to heal.”  They feel that these images serve as an important step in the family’s healing process by honoring their child’s legacy.

Placenta Encapsulation – Wendy Diaz, PBi™ PES
Encapsulation services are free for bereaving mothers.  Wendy will also add herbs to the capsules that help dry up the milk supply.

Recommended Reading:
Empty Cradle, Broken Heart: Surviving the Death of Your Baby
by Deborah L. Davis, Ph.D.

A Gift of Time: Continuing Your Pregnancy When Your Baby's Life Is Expected to Be Brief
by Amy Kuebelbeck and Deborah L. Davis, Ph.D.



“When Are You Due?”

Posted on May 24, 2011 at 3:01 PM Comments comments (0)
So your due date came…and went…what do you do now? 

One of Dr. Bradley’s sayings was, “It’s Not Nice To Fool Mother Nature”.  There is a whole chapter of his book, Husband-Coached Childbirth, devoted to that topic, in which he talks about the concerns he has with trying to rush the process.

Did you know your due date was, at best, an estimate?  Did you know that only 4% of babies arrive on their actual due date?  There is no hard and fast rule for when your baby is going to make his or her entrance.
There is not a calendar or a PDA in your uterus with an alarm that will ring telling them that it’s “go time.”

The current way of estimating your due date is based on a model that is 181 years old.  A doctor named Franz Carl Naegele who was an ordinary professor and director of the Lying-in Hospital in Heidelberg, Germany devised this method of estimating due dates.  He published it in a “Textbook for Obstetrics”, intended for use by midwives, in 1830. 

During the infancy, if you will, of obstetric medicine, one person published that a woman’s due date was going to be approximately 280 days, or 40 weeks, after the date her last menstrual period.  This was not based on empirical evidence, but rather on a common belief of the time.

There is a more recent Harvard study published in June 1990 edition of the medical journal Obstetrics & Gynecology that we give to our students on the first evening of class.  It is a retrospective evaluation of pregnancies between April 1, 1983 and March 31, 1984.

The conclusion of that study was that the median estimated due date for primiparas (first-time mothers) should be 8 days later than Naegele’s rule, and that multiparas should have an estimated due date that was 3 days later than Naegele’s rule.  Per their study, if you are 41 weeks as a first-time mother, your baby might just be arriving to the point when he or she is ready to be born.

We ask our students to do a couple of things on the first night of class.
First of all, The Student Workbook asks them recalculate their due date.
We ask them to think about considering that new date of 41 weeks and 1 day as their “due date”.  We then encourage them to start saying they have an “estimated due date” or a “due season” to take some of the pressure off of themselves and their bodies.  The reality is that your baby is going to come when your body and your baby decide to start labor, and not a moment sooner.

While no one who is or has been pregnant wants to tack on an extra eight days when they are feeling big, uncomfortable, hot and ready to be done with pregnancy, you just never know when your baby is going to arrive.  Giving yourself eight extra worry-free, stress-free days might be the best thing for you if you happen to be one of the moms who will go past her 280-day due date.

WHY DUE DATES ARE AT BEST, AN ESTIMATE
It is assumed that most women ovulate on day 14 of their menstrual cycle.  If you ask anyone who has had a difficult time conceiving, they will tell you that this is not always true.  Some women ovulate as early as day 11, and some as late as day 21.  This makes for as much as a two-week difference when estimating a due date.

There is a second variable: when was the egg fertilized?  Did you know sperm could live in a woman’s body for seven days?  We found this out the “baby way” with our third child.  Just when we thought we had stopped trying to avoid another summer pregnancy, surprise – I was pregnant!  I joked that Bruss had bionic sperm until I discovered this little fact.  Oops.

So back to the point: Once the egg is released, it lives 12-24 hours, but sperm could live for seven days.  When do they meet?  Only your baby and your body know, and they are not telling.

Here is the third variable:  Once the egg is fertilized, it could take anywhere from 6-12 days after you ovulated to implant.  Until it finds a home in the uterus, cell division is on hold.  (If you think about how IUD’s work, they make the uterus inhospitable for implantation, therefore it makes it highly unlikely you can establish a pregnancy with a fertilized egg.)  So, if your fertilized egg does take twelve days to implant, now you have more time to add on to your estimated due date.

There is the also fact that all babies are not created at equal rates of development.  There are certain milestones in gestation that doctors expect to find, however, not every baby is going to develop at the exact same rate.  Nature’s bell curve deems that some babies will be ready early, the majority of babies will be ready around their estimated due dates, and then some of the babies will be ready after their due dates.  Once upon a time, a pregnancy was considered to be"normal" if a baby was born between 37-42 weeks of gestation.

With so much variation in the actual process, it is so hard for me to watch moms go past their due date and wonder if their baby’s are going to make it without having to be induced.  As with all things pregnancy, there is no perfect rule.

There are times when a care provider will start to be concerned because either mom or baby starts to show signs that they are not physically handling the prolonged pregnancy.  If and when we are faced with this possibility, it falls on us as parents to make an informed decision about how to go forward when faced with that situation.

There is also a condition called "postmature".  It could be as simple as an error in estimating a due date, in which you could negotiate for time if mom and baby are doing well.  True postmaturity means that a baby is seriously ill: the placenta or mother are not supplying the baby with needed nutrients, the baby's skin is loose, the baby starts losing weight, the subcutaneous fat layer is gone and the baby looks like an old, dying person.  You can see that there is a cause for real concern in this situation.  It is very rare, however, no care provider wants to be the one who waited too long and then has to be the one to deliver a stillborn child.  And no parent in their right mind would intentionally harm their baby...hence the ever-so-important questions arise and it is so vital that we weigh all our options carefully.

WHAT YOU MIGHT CONSIDER
If you find yourself going past your due date, there are several options you might consider.  We encourage you and your coach to have these conversations with each other and your care team before you are faced with making an emotional decision.  Talk about these options well in advance of your estimated due date when you are calm, under no pressure to make a decision, and you still have time to research different options and induction methods should they become part of your care plan.

If your care provider is a midwife:
- If you are with a Licensed Midwife, you need to find out what the state law says about what her practice parameters are.  Here in Arizona, midwives can only deliver babies born between 36-42 weeks of gestation.
If you are baby is born early or later than that, you need to think about a “Plan B” option now before it becomes a critical decision.
- If you are under the care of a Certified Nurse Midwife practicing under the umbrella of a doctor’s office, you need to discuss whether or not her practice will allow her to care for you past 42 weeks gestation, or how your state’s laws applies to their care situation.

If your care provider is a doctor or doctor group:
- Stay healthy and low-risk so more options are available to you.
- You could show the Harvard study to your care provider and see if they will agree to give you an extra two weeks past the 41-1 date, based on the fact that your due date might have been estimated incorrectly.
- You could find and change your care to a care provider who is willing to give you more time than your current provider.  Bradley teachers are a great resource, as are any relatives or friends who have been in your situation.
- You could negotiate to do fetal movement counts, non-stress tests or biophysical profiles on a schedule you and your care provider agree to, and agree to consider interventions if you or your baby starts to show signs of stress.

WORKING WITH YOUR BODY
- You could try drug-free, non-consumption methods such as nipple stimulation, thumb sucking, or other acupressure massage points that stimulate the production of oxytocin, the same hormone your body produces to cause contractions. (Discuss with your care provider.)
- Sexual intercourse could help – semen contains the natural prostaglandins that medicine tries to mimic with the prostaglandin inserts used to ripen the cervix.  (Discuss with your care provider.)
- You could do some focused meditation and connect with your baby, encouraging him or her that you are ready for them and that you are waiting to meet them.
- You could continue with staying well nourished and getting plenty of rest so that when the day does arrive, you are rested and ready instead of tired and stressed.

INDUCTIONS AND INTERVENTIONS
There are many different ways to try to “speed things along” that are stimuli by application or consumption.  I am not going to comment on them because I do not want to bias you or be interpreted as giving you medical advice.  I will refer you to Husband-Coached Childbirth by Dr. Bradley or Thinking Woman’s Guide to a Better Birth by Henci Goer for you to do your own research.

It’s up to you and your coach to draw your own conclusions about which of these you would consider and in what order you would place them on your list of things to do.  I list them in alphabetical order:
- Acupunture
- Amniotomy (artificial rupturing of the membranes)
- Castor Oil
- Enema
- Herbs
- Mechanical Dilators
- Oxytocin
- Prostaglandin E2 inserts
- Stripping/sweeping of the membranes
- TENS machine

BEST WISHES
I hope and pray that if you are reading this, you are doing so to gather information instead of reading it as one of your last resorts looking for answers.  There is no right or wrong answer, just the one that works best for your peace of mind and for the best outcome anyone could want: Healthy Mom, Healthy Baby.

If you are looking at this because you are facing tough decisions, do not hesitate to drop me a line ([email protected]) and ask us to pray for you.  I am a believer in the power of prayer, and we will add our prayers to yours and ask that God’s will be done for you and your baby.


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:
Husband-Coached Childbirth, Dr. Robert Bradley, 2008, pgs 16-42

Thinking Woman’s Guide to a Better Birth, Henci Goer, 1999, pgs 49-74

Obstetrics & Gynecology, Vol. 75, No. 6, June 1990, pgs 929-932

The Bradley Method® Teacher’s Manual, 2010, page 120

http://www.americanpregnancy.org/gettingpregnant/understandingovulation.html

http://www.transitiontoparenthood.com/ttp/parented/pregnancy/duedate.htm

Preparing for Variations and Complications

Posted on April 26, 2011 at 7:23 AM Comments comments (0)
Last evening’s class was the topic of “Variations and Complications” during Pregnancy and Labor.  As much as we all hope and pray for an easy pregnancy and labor, for some of us, there are some bumps in the road.
 
The Bradley Method® includes a class on how to handle those “bumps” so that parents are at least aware of what the variations and complications are, what the possible reasons are for them, and the options available to them should they encounter these situations. We also encourage our students to do additional reading on these situations – it is never good enough to take an instructors word on these, especially for the decisions that impact their child.  It is important for students to decide how they would probably want to handle these possible variations and complications while there is time to consider all the options and make a thoughtful choice that they can fall back on in case a moment of decision and/or urgency does arise.
 
In addition, we encourage our couples to discuss their options with their care team.  Each provider has a their own set of policies and protocols based on their experience as practitioners.  It is important that your preferences match with the practice your care team employs so that you are able to work with them and have their support for your choices.
 
Our goal is to inform the parents, give them a basis for a conversation, encourage them to either write down their decisions or make a mental note, then file that information away and turn the focus back to having a normal, uncomplicated, low-risk pregnancy and labor.
 
Here is a great resource to help a couple do some emotional preparation for labor ~ http://www.birthingnaturally.net/encourage/encourage.html
There are several questions and thoughts to consider as you prepare for different aspects of pregnancy and labor.  Again, the goal is to help you come to some conclusions, and then set forth an action plan if through the exercises you realize that there are any unresolved issues or aspects of your pregnancy and labor that you want to discuss with your care team.  Once you face the different possibilities or the fears you might have and make a plan, the idea is to file away the information and focus on having the pregnancy and birth that you want for your family.
 
The one topic that is so hard to talk about and the situation that none of us want to face is pregnancy loss.  There is an outside possibility that this joyous time of preparation and anticipation sometimes ends with a miscarriage, stillbirth, or the loss of a healthy child due to unforeseen circumstances or events.
 
It is hard for me to get through this part of class without getting emotional.  It is one of the fears I have and that I try to turn over in prayer during our pregnancies.  If it is hard for me as the instructor, I can only imagine it is something hard for our students to face and talk about, too.
 
I provide this resource list today with the prayer that you (or anyone close to you) will never have to use it.  On what I hope and pray is a very outside chance that something unthinkable happens, here are several organizations and providers that offer counseling, comfort and free services to support the grieving family.
 
Arizona Perinatal Loss Bereavement Resource
Banner Desert Medical Center
1400 S. Dobson Road, Mesa, 85202
480-512-3595
Provides a network of support for those experiencing a pregnancy or infant loss. This resource gives parents a statewide network of support, current bereavement literature on a variety of topics, educational opportunities and resources in the community, state and national level.
 
The Compassionate Friends
http://www.compassionatefriends.org
The Compassionate Friends assists families toward the positive resolution of grief following the death of a child at any age and to provide information to help others be supportive.   They offer a safe place for bereaved parents, grandparents, and siblings to meet and talk freely about your child and your grief issues.
 
M.I.S.S. Foundation
www.missfoundation.org
The M.I.S.S. Foundation provides immediate and ongoing support to grieving families through community volunteerism opportunities, public policy and legislative education and programs to reduce infant and toddler death through research and education. 
 
M.E.N.D. Mother's Enduring Neonatal Death
http://www.mend.org
M.E.N.D. (Mommies Enduring Neonatal Death) is a Christian, non-profit organization that reaches out to families who have suffered the loss of a baby through miscarriage, stillbirth, or early infant death.
 
HAND Helping After Neonatal Death
http://www.handonline.org
HAND is a resource network of parents, professionals, and supportive volunteers that offers a variety of services throughout Northern California and the Central Valley.
 
SHARE Share Pregnancy and Infant Loss Support, Inc
http://www.nationalshare.org
The mission of Share Pregnancy and Infant Loss Support, Inc. is to serve those whose lives are touched by the tragic death of a baby through early pregnancy loss, stillbirth, or in the first few months of life.
 
Now I Lay Me Down To Sleep
http://www.nowilaymedowntosleep.org
They offer the free gift of professional portraiture and remembrance photography to parents suffering the loss of a baby.  “The NILMDTS Foundation is there for parents and families to help aid them in their Healing, bring Hope to their future, and Honor their child.  It is through Remembrance that a family can truly begin to heal.”  They feel that these images serve as an important step in the family’s healing process by honoring their child’s legacy.
 
Placenta Encapsulation – Wendy Diaz, PBi™ PES
http://naturallybirthing.webs.com
Her encapsulation services are free for bereaving mothers.  Wendy will also add herbs to the capsules that help dry up the milk supply. 
 
Recommended Reading:
Empty Cradle, Broken Heart: Surviving the Death of Your Baby
by Deborah L. Davis, Ph.D.
Product Description from Amazon.com:
The heartache of miscarriage, stillbirth, or infant death affects thousands of U.S. families every year. Empty Cradle, Broken Heart offers reassurance to parents who struggle with anger, guilt, and despair after such tragedy. Deborah Davis encourages grieving and makes suggestions for coping. This book strives to cover many different kinds of loss, including information on issues such as the death of one or more babies from a multiple birth, pregnancy interruption, and the questioning of aggressive medical intervention. There is also a special chapter for fathers as well as a chapter on "protective parenting" to help anxious parents enjoy their precious living children. Doctors, nurses, relatives, friends, and other support persons can gain special insight. Most importantly, parents facing the death of a baby will find necessary support in this gentle guide. If reading this book moves you to cry, try to accept this reaction. Your tears merge with those of other grieving parents.
 
A purpose of this book is to let bereaved parents know that they are not alone in their grief. With factual information and the words and insights of other bereaved parents, you can establish realistic expectations for your grief. Empty Cradle, Broken Heart is meant to help you through these difficult experiences by giving you things to think about, providing suggestions for coping and encouraging you to do what you need to survive your baby's death. Whether your baby died recently or long ago, this information can be useful to you.
 

Disclaimer:  The material included on this blog and 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 and this site 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 on this blog and this site do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.