Chandler, Arizona
Sweet Pea ​Births
Sweet Pea ​Births
...celebrating every swee​t pea their birth
...celebrating every swee​t pea their birth
Blog
Info Sheets: Gowning
| Posted on January 31, 2014 at 7:17 AM |
comments (127)
|
 *History Definition from MedTerms~
They can be used to cover the surgical patients and the bedridden. By design, hospital gowns are designed for easy access and
durability.
None of the sources I read mentioned using them for a
sanitary purpose in a modern hospital, as one might expect. The big emphasis was on the ease of access to
the patient by the care provider for treatment or cleaning, washability, and
durability. Especially in childbirth, why on earth would a laboring woman want to wear a gown used for something else by someone else, and that doesn’t come with a use history?? This list of pros and cons is a little different – it is one
of my own creation based on our knowledge as childbirth educators. No reference links this time! *PROS
*CONS
*Links for More Research I encourage you to question if you really want to wear the
hospital gown when you go to your birth place, if you are birthing outside your
home. Here is something to think about: What
kind of energy is caught in the weave of the garment that can’t be washed away
with hot water? If you are birthing in the hospital, you are among the
population there that is checking in healthy, and you are expecting to check
two (or more!) healthy people out. You
are unique individuals. You are well and
will continue to be well. As a patient,
you have the right to be treated with dignity.
And to you, that may mean refusing to wear the hospital gown. Options have come a long way since the "labor skirts" that were around ten years ago. If you would like to explore other ideas for
labor clothes besides the hospital gown, here are some companies that offer
lovely alternatives. As you look at
them, consider if they would allow you to start labor to your level of modesty
and if they would be easy to breastfeed in (again, to your level of modesty): Dressed to Deliver www.dressedtodeliver.com   milk & baby  Labor of Love  Pretty Pushers  You can also see what Robin Elise Brown has to say about "BYOG" (Bring Your Own Gown) in THIS about.com article. Did you wear the hospital gown - will you do it again if you have another hospital birth? OR Did you wear your own clothes or a specialty LDR gown like these - what worked for you? Please leave us a comment - it will be moderated and
posted. 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®. |
Labor Support: Meet the Monitrice
| Posted on March 22, 2013 at 11:33 AM |
comments (205)
|
 I am so excited to announce a monitrice service for couples that want
to have a natural birth outcome in a hospital setting. Jennifer Hoeprich, LM, is now extending her
skill set to families who want to stay home as long as possible before heading
to a hospital for their birth.What is a monitrice?
A monitrice is a professional, medically trained, labor support person, who
provides clinical monitoring within the home environment, including cervical
dilation exams, auscultation of fetal heart tones, and monitoring of general
well-being of mother and baby, during labor. The monitrice helps couples to
assess their progress in labor, to determine the best time to leave for the
hospital, where the birth is to take place. How does a
monitrice differ from a doula? The focus
of a monitrice is to provide clinical and educational support, while the focus
of a doula is to provide emotional, mental, and physical support. Our
monitrice service only provides services within the home environment. She only
accompanies the couple to the hospital if complications arise, whereas a doula
remains with the client during their transition from home to hospital. How is a
monitrice different than a midwife? In the
role of monitrice, the practitioner does not provide services at the actual
birth. She does not "catch" the baby, or provide immediate postpartum
services. A midwife provides all prenatal care, all labor and birth care, and
all postpartum care. Who would find monitrice services beneficial? Couples
who have chosen to birth in a hospital with an obstetrician, but who wish to
labor at home for an extended period of time would benefit greatly from
monitrice services. They might want to stay at home in order to avoid unnecessary
hospital interventions (such as movement restrictions, food restrictions, Pitocin
augmentation, breaking the water prematurely, epidural, etc.). Although they are choosing to wait longer before "going in", they can have that feeling of "safety" with consistent, professional monitoring, How do you
envision a couple utilizing monitrice care? A couple
would interview the monitrice at her office and determine that the services are
in line with their birth plan. They would then have two prenatal visits to get
to know each other, and for the monitrice to assess baseline vitals and good
health in the pregnancy.
The monitrice would be on call for the couple, starting at 36 weeks. When the
couple believes labor has begun, they would contact the monitrice to give her a
head's up. They may request her services at that point, to help determine if
this is the "real thing" or may wait to call her over, once a labor
pattern is clearly established.
Once the monitrice has arrived at the couple's home, she will assess maternal
blood pressure, pulse, signs of infection, and hydration level. She will also
asses fetal heart tones, and upon request from the couple, the mother's cervical
dilation. The monitrice may make recommendations as to positions that would be
helpful, encourage eating and drinking, and may provide herbal, homeopathic, or
flower essence remedies, as appropriate, and as desired.
She will perform clinical monitoring every 30 minutes or every hour, depending
on the stage of labor and the client's wishes. She performs monitoring
respectfully, and can monitor the woman in any position the woman’s choosing,
including in the shower, or in the labor tub. Once the couple determines that
they are ready to leave for the hospital, the monitrice wishes them well and
departs.
The couple will have a follow-up visit, including assessment of mother's vital
signs, stitches (if applicable), a check for any signs of infection,
breastfeeding support, and baby weight. These
visits occur at 1 week postpartum and 3 weeks postpartum, as most obstetricians
only provide one postpartum visit at 6 weeks. In the rare event that a complication should arise during labor, the monitrice
will accompany the couple to the hospital. Once they arrive at the hospital, the monitrice will provide a report
and labor records to the staff. What kind of care is included in your fee? The fee is
$625. This includes two prenatal visits in the office, four hours of labor
monitoring, and two postpartum visits in the office. Labor monitoring above
four hours falls to an hourly rate of $50. I am happy to offer a discount of
$200 to any students of The Bradley Method®; their fee for service is $425.
As an added service to our clients, our monitrice service also rents, which
includes set up and take down, the Birth Pool in a Box
labor tub, for $200. For more information about Moxie Monitrice Services, please visit www.moxiemidwifery.com or call to
set up a free consultation. You can also search for "Moxie
Midwifery" on Facebook and @moxiemidwifery on Twitter. More about Jennifer: Jennifer
Hoeprich is a licensed midwife and monitrice, who provides services in Phoenix,
Chandler, Mesa, Gilbert, Queen Creek, Maricopa, and Casa Grande. She
attended her first birth at age six, when her dog Cinnamon had puppies. She was
the only attendant and knew then that she had found her calling. In 2001,
Jennifer obtained her Bachelor's Degree, Minoring in Women's Studies. She
experienced a natural birth with her son, in 2004 and began her journey into
midwifery, shortly after. In 2005, she became a certified doula, and in 2008, a
certified childbirth educator. She then obtained her midwifery license in 2011,
and began the practice, "Moxie Midwifery." In her spare time,
Jennifer enjoys being with her family, playing guitar, crocheting, and doing
yoga. What do you think? Would you use a
monitrice service? Why or why not? 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®. |
Failing to Progress or Naturally Aligning
| Posted on June 1, 2012 at 4:52 PM |
comments (7)
|
We have had a couple of students have had textbook “NAPS” in
the last two classes…and since we still have several couples waiting for their
babies, I thought this might be a reminder and an inspiration to them for their
labors. NAP – no, they didn’t take epic
naps in labor (although I am a big advocate for sleeping in labor)…what it
means is that they were very patient in their labors. One of the cornerstones of The Bradley Method® is a Healthy
Mom, Healthy Baby outcome. All of the
discussion below only applies if Mom and Baby are not showing any signs of
distress through labor. Mom is
maintaining a healthy temperature, heart rate and blood pressure, and Baby is
also showing that it is doing well as per the monitoring that is being
done. If Mom or Baby are starting to
demonstrate that their health is compromised, then parents are encouraged to
make the best choices for their particular situation. The words “Failure To Progress” are the sound of doom to
some of us (I say "us" because I heard this three times!). They very often mean that interventions are going to start being
suggested. How a couple acts upon those
suggestions is very individual. Marjie
Hathaway coined the phrase “Natural Alignment Plateau”, or “NAP” as an answer
to the dreaded “diagnosis”: “FTP”, or “Failure To Progress”. Failure To Progress is based on the Friedman’s Curve*. It looks like this: As human beings, it is in our nature to see this neat,
explainable graph and say, “It’s a rule!” This can have dire implications
whilst in labor if you really want a natural birth. There are no averages in the midst of a labor
– each labor on is unique and individual. Mathematically, it’s unfair for all labors to be expected to fit the average. That brings in another concept we teach in
The Bradley Method® classes: consumerism and informed consent. If there is time: ask questions, ask for
time, and then communicate and evaluate what you have heard with your partner
before you decide on a course of action.
When a mom does not progress in dilation from one vaginal
exam to the next, or between several vaginal exams, she may be diagnosed with
“Failure To Progress”, and along come the string of possible
interventions. They can include any or all of the following, along with other interventions: an Amniotomy (intentional rupture of the bag of waters),
augmentation of labor with Pitocin, an Epidural to take of the edge of
Pitocin-induced contractions, a Cesarean. A cesarean may also be suggested if the care team suspects that the baby may not fit through mom's pelvis. Diagnosed as "CPD", this is the subject for another post altogether. For now, check the link I listed below* for more information. Instead of accepting the words, “Failure To Progress”,
Marjie decided to suggest a new phrase to her students: “Natural Alignment
Plateau”. NAP instead of FTP. Natural Alignment Plateau is a different way
of approaching that point in labor when dilation does not change. What we teach in class and hope that our
students will remember when they face this crossroads is, "Labor is much
more than dilation." Labor can be slow to start, dilation can stop and/or
contractions can slow down for many reasons.
Here are some to consider:
If your labor has been slow to start after a spontaneous
rupture of membranes, or if you are seemingly “stuck” at a measurement of
dilation, it might be time to evaluate what could be going on and change
tactics:
If Mom and Baby are doing well, you can ask for
time. There is not a medical reason for
an intervention if Mom and Baby are doing well in labor and your care team
confirms that Mom and Baby are okay. Here
are two examples for you to consider and think about if you face a point in
labor when there is no measurable progress. We had a mom from our Winter class go from 6 cm dilated
(usually considered Active First Stage – not yet in Late First Stage) to
holding her baby in 21 minutes. Yes –
you read that correctly. She went from
what most care professionals would consider mid-range in labor to holding her
baby in 21 minutes…that meant she pushed within that time, too, folks. Hers was an emotional component. She was waiting for her mom to arrive. Once her mom arrived at the hospital and
stepped into the room where she and her husband were laboring, her baby and her
body got busy. They dilated a total of 4
cm from 6 cm to “complete” at 10 cm, then pushed, and they were holding their
baby in 21 minutes. Our other story is from our Spring Class. Mom had a slow start to labor. She had started seeing some clear fluid on
Sunday, noticed some more on Monday, and went to the hospital on Tuesday. They tested her fluid and it was amniotic
fluid. Although they were in triage and
barely 1 cm dilated, the couple was strongly encouraged to be admitted. Now they are into the hospital and the expectations
of “Friedman’s Curve.” This couple did a
great job of asking, “Is Mom okay? Is Baby Okay?” After getting their “Yes”
answers, then they followed up with, “That’s great! Then let’s wait a couple more hours and see
where we are.” And sure enough, the next
time the staff and their care provider checked in, they were a little further
along in labor. Once things got going,
this mom went from being 4 cm dilated to 8 cm dilated in one hour! Within two hours of that point, they were
holding their baby. The great news about hitting the NAP is that once the Mom’s
body and Baby “get organized”, labor seems to progress very quickly. Again, remember what I said at the beginning
– things go well when a Healthy Mom and a Healthy Baby are given the time they
need. If Mom or Baby start to indicate
that “healthy” is losing out, then a family needs to make the best choice for
their situation.
What has been your experience – have you had a NAP in your
labor? What choices did you make? For a full explanation of Friedman’s Curve click here or enter this URL into your browser: http://allaboutbirth.net/pdfs/Failure-to-progress.pdf 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®. |
One More Thing
| Posted on February 28, 2012 at 3:34 PM |
comments (25)
|
 The night arrived again – when we say farewell to our
students and wish them the best for their birth and the journey of family upon
which they are about to embark. Bruss
always tells the first-time parents that he is jealous of them because there is
nothing else like the experience of welcoming your first child and discovering
parenthood for the first time.I reflect and wonder if we have told them everything, showed
them everything, practiced everything – which is of course, realistically,
impossible. I take heart in the fact
that in some classes, some babies arrive a few weeks earlier than the estimated
due dates. Even though the parents do not complete the series, the births have all gone pretty well.
We are covering enough material to allow these families to have Healthy
Mom, Healthy Baby outcomes, and at the end of the day, that is the most
important aspect of the classes we teach. Before we complete the last class, the phrase “one more
thing” is said a lot in that final session.
Here are the impressions we want to leave our students with… On teamwork:
On managing labor:
(To read in more detail about evaluating your labor, click here.) On Motherhood:
On Fatherhood:
Our parting wish is for them to have a very Happy Birth-Day;
and to come back to share their beautiful babies and their birth stories with
future classes. The most fun of all is
to meet again at their Bradley® Class Reunion – it is always fun to see all the
Bradley® babies “earthside,” and hear all the new families exchanging stories and
experiences. Which parting thoughts resonate with you? Please add your own words of wisdom in the
comments section. 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®. |
Healthy Mom, Healthy Baby
| Posted on January 27, 2012 at 7:15 PM |
comments (622)
|
  I finally got approval from all the families to post the
Healthy Mom, Healthy Baby pictures. Here
is a brief synopsis of their outcomes along with a birth story from one of the
moms. All of these are babies from our Fall 2011 Bradley Method®
series. Angelika got to be one of these
babies, too! The families enrolled in
our classes with the intention of having natural births. However, all of them took to heart our
entreaty to evaluate all their decision points with the Healthy Mom, Healthy
Baby filter. Most of them deviated from
their birth plan, and definitely from what their expectation were…each birth is
unique. The beautiful element of these
photographs is that these babies are all healthy, and so are their mammas. I am going to number the babies from left to right. Baby 1 is our longest labor (so far) for this
class. This family labored for 51
hours! Mom and Dad labored at home, they
went to the hospital and found out they were only 3 centimeters so they
followed Berman’s law (go home if your are less than 5 cm dilated and not
showing any physical or emotional signs of late labor) and went home. Mom rested, ate, labored and the couple had
the support of a wonderful doula. They
rested that night and labored at home most of the day. When they went back to the hospital on day 2,
mom had not progressed as much as they had hoped but they were past a five so
they stayed in the hospital. When they
had marked the 48 hour of labor, they opted to have the bag of
waters broken to see if that would speed labor.
Guess what – the on-call doctor did not want to come in to the hospital
so he told the nurse to start a Pitocin drip instead. Mom and Dad evaluated their choices and their
wise doula gave them invaluable advice, “Let’s redefine our birth plan and make
the adjustment we need to keep the vaginal birth.” Knowing that mom was exhausted physically,
and that she had been dilated to 8 cm with no progress for several hours, the
parents evaluated their situation and opted for an epidural so that the strong Pitocin-induced
contractions wouldn’t sap what was left of mom’s energy. Three hours later they welcomed their son via
vaginal birth. He was ready to nurse –
Healthy Mom, Healthy Baby. Baby 2 is our Angélika. Most of the hospital to homebirth stories we
heard from families testified to the fact that their home births were
significantly faster than their hospital births. No transfer, no poking, no prodding, no weird
or distracting noises. So here we are,
going into our home birth so excited that we are not going to have to move to
the hospital since that had always stalled our labor in the past. Labor starts and it is a completely different
pattern than we have ever had before…the water broke at the midway point
instead of at the beginning, walking slowed or stopped labor and laying on my
side made things move along. By the
middle of day 2, I gave up on having the faster homebirth and resigned myself
to be the mom that went to sleep and woke up ready to push. You can read the long version here, suffice
it to say Angélika was born about five hours
after I surrendered and went to bed! Baby number 3 was born to an experienced birth mom. She has two older boys and this was her third
child, dad’s first. She made the
decision to switch care providers at 39 weeks!
Although she had been with her OB for several years and had even
followed her when she went into independent practice, she started to get red
flags in her third trimester. They
couldn’t agree on her birth plan; and then the doctor wanted to strip her
membranes a week before her estimated due date.
Mom made the decision to switch providers and moved to an OB recommended
by another classmate that still allowed them to deliver at the same
hospital. Guess what? This baby was ten days past his due
date! Had mom stayed with her first OB,
who knows when he would have been born?
By changing providers, baby was allowed the time he needed to start
labor. This couple opted for a cesarean
section to ensure a Healthy Mom, Healthy Baby outcome. Two factors led to their decision: three
hours of pushing with no change in station, plus amniotic fluid that was
stained with meconium. “Trust birth” as the saying goes…this young man was born
with his cord wrapped not once or twice, but several times around his neck. Baby 4 was an average length labor with a painful
complication. As labor progressed, she
had a ring of pain that radiated from her uterus down to her upper thighs. The lower baby dropped and engaged in the
pelvis, the more sensation mom lost in her legs! This mom and dad endured 18 hours of posterior
labor – I award them the title of “Rock Stars” for staying drug-free for so
long. It is truly a testament to her commitment and his coaching. Her midwives recommended an epidural since
she was not dilating past an eight.
Their baby was born an hour later! Baby 5 was born to another multipara. This mom was induced with her first baby…and
she wrote her story out to share with you: "Our birth choices were
all made with a Healthy Mom, Healthy Baby outcome in mind. Our first big
decision was choosing a care provider we were comfortable with. We ended
up with a wonderful group of midwives who totally supported our birth
preferences and were obviously in favor of our choice to have a natural birth.
We had started with a group of midwives in Brooklyn, then went to an OB
in Phoenix for a couple of months while we waited for our AZ insurance to kick
in. This OB was definitely NOT on the same page as we were (he wanted to
induce before the new year so we could get a tax break...) so we switched as
soon as possible. When it came to our
labor, we chose to hire a doula and labor at home as long as we could so we
could avoid any potential pressure from the hospital for interventions.
As it turned out, my labor was so short that was pretty easy to do!
When we got to the hospital I was already 9 cm, so it was a matter of a
little time, then onto pushing, and within the hour Amelia was born. We
chose to skip the Hep B vaccine in the hospital, and waived the vitamin K and
eye ointment. We know my STD status, so we knew she was at no risk, and
we wanted her to be able to see the world as best she could with her newborn
eyes! As far as the Vitamin K shot was concerned, we did some research
and decided it wasn’t necessary unless she experienced trauma at birth, which
she didn’t. We also chose not to bathe her so the vernix could do its job
and she wouldn’t experience crazy changes in her body temperature. We
have yet to bathe her, and won’t for a while longer. We also decided to
encapsulate my placenta this time around.
It was an option presented by our Bradley® instructors, and we were
encouraged to do so by our midwife and our doula. We went home from the
hospital the day after our birth because Amelia and I were both doing well.
I wanted to see my 3 year old, and felt like I would be happier resting
and enjoying my family in our own home. It was a different
experience from our first birth. I felt like we were much more informed
and able to make more decisions that were Healthy Mom, Healthy Baby
outcome-minded. That said, I was induced with my first because of high
blood pressure, and while it wasn’t my ideal birth plan, it was a Healthy Mom,
Healthy Baby based decision. I also got an epidural after nearly 12 hours
of a Pitocin induced labor, and I was able to progress quickly after that and
go on to have a vaginal delivery. I truly believe that I would have been
too exhausted to push had I not gotten the epidural, so again, I don’t regret
that decision. An epidural was much more favorable to me than a C
section! We did have a doula with our first as well, and she was
instrumental in keeping us calm and grounded through uncharted territories!
With our firstborn Max,
though, we hadn’t researched the vitamin K shot or the eye ointment, so we did
both of those. We also were not informed about the benefits of placenta
encapsulation, so it wasn’t even on our radar the first time around. I
stayed in the hospital with Max for two nights, and felt like I needed that
amount of time! I definitely liked
working with midwives the second time around rather than an OBGYN like we did
with Max. I liked my OB with Max, but I was definitely more comfortable
with the midwives and felt like we saw eye to eye on our birth choices.
If we do have another, we will probably consider a home birth since
Amelia’s birth was so fast and relatively easy. That will be a whole new
territory to explore, but we’re definitely interested!" I hope these stories
demonstrate the importance of a care provider you trust and have a rapport
with, as well as the importance of making the choices to have a Healthy Mom, Healthy
Baby outcome. Happy New Year to all
these babies and their families – ours has been wonderful so far. Angélika started laughing today –
pure joy! 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 SeriesMarch 5, 2012 to May 21, 2012 For more information or to register, please call us at
602-684-6567 or email us at [email protected] |
Coach's Pep Talk
| Posted on December 30, 2011 at 10:07 AM |
comments (0)
|
 Coach's Corner Bruss reveals his secret to being a great coach today...this is my first insight into his process, too. He has been an amazing coach at all of our births - now I know how he does what he does for our baby and me!~Krystyna We are regularly contacted by our Bradley® students as they go into labor. For first time parents there is almost an universal excitement.
It is great to talk to the Dads and hear the excitement in their
voices...the nervous, anxious energy as they start the wonderful
experience of child-birth with their partner. When I talk to the Dads as Mom's labor starts I like to give them a little pep-talk as follows: OK.
You've been working very hard to prepare for this moment. You have
chosen a great medical team. You've studied about labor and delivery,
you've done the pregnancy and relaxation exercises, you've focused on a great diet. You are ready. Your job as labor coach is to pay very close attention to Mom. Keep mental track of all the following: - Energy level, mood, complexion color, pain level, ability to relax, ability to concentrate, hunger, thirst, fever, headache. - Notice how Mom is doing in all these areas and note any changes. Regarding the contractions: - How close are the contractions? - How intense are they? - Can Mom talk through them? Or are they intense enough that she has to focus all her energy on them and can't talk or focus on anything else? - Is there a pattern? - Is the pattern changing? Do the contractions (pattern, intensity...cadence) change with: - change in position? - walking? - laying down? - sitting down? - shower? - other? Note all of these attributes and be aware of changes. What stage of labor do you think you're in? (Note: ask this question of yourself a lot) Remember
what you and your medical team decided ahead of time about when you
would head to the hospital or when you would call in the midwives for a
home birth. Pay close attention to those thresholds. Now
while paying attention to all the little details about Mom's physical
condition and how the contractions are progressing you have to focus on
everything that you can do to support Mom as she labors. - Keep Mom hydrated - Make sure she has food (if she wants) for energy. - In early first stage labor make sure Mom rests as much as possible so she has energy for later in labor. - Help her relax through her contractions with your practiced methods. - Don't ever leave her alone. - Help her or be by her side whenever she's up and around. - Take care of all the external things so that Mom can focus on the labor. If you have any questions, concerns or intuition that something is not right contact your medical team immediately. Enjoy the process. The birthday of your child is one of the best days of your life. What coaching tip can you share with our student dads? 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 |
Having a homebirth
| Posted on July 30, 2011 at 9:14 AM |
comments (34)
|
 Why a
home birth?We are
planning a home birth for our fourth child early this fall. Personally,
I have always been a big proponent of hospital births. With our first
three children I was always adamant that my preference was to deliver in a
hospital setting. The overriding reason was the safety net. If
something goes wrong I wanted for Krystyna and our babies to be as close to a
medical team and an operating room as possible. What
changed? Education: We took
Bradley Method® classes for our first two births and then soon after the third
birth Krystyna became a certified Bradley Method® instructor. Together we have
helped educate numerous couples in the process of pregnancy, labor and staying
healthy throughout pregnancy and beyond. The key
here for me is that the Bradley® education combined with our experiences have
proven time and again that birth is a normal, natural process. Like all
things in life there are things that you can control and some things that are
beyond your control. We’ve learned, and now we teach, others to maximize those
things that are in your control to give the highest probability for a great
outcome. What’s
in your control? Great
diet, exercise throughout pregnancy, rest, low stress environment, ability to
relax, knowledge about pregnancy and the birth process, making sure you’re
ready to be parents and are accepting of the baby’s arrival *before* going into
labor and accepting of things beyond your control. What’s
not in your control? There
are a lot of things not in your control, some benign but some that would affect
a potential home birth such as pre-term labor, high blood pressure, poorly placed
placenta etc. Three
Positive Birth Experiences: We have
had three natural delivery, hospital births without pain medication. The
babies were all on the big side. Our second birth was the largest at 11
lbs 1oz. Interestingly, this birth was our easiest so far! Hospital
Experiences: Our
experience with the medical teams for our first three births was almost all
positive. I don’t think that’s due to luck. I’ve always been
of the opinion that you have a strong influence on your environment good and
bad. We sought out great OBs that supported our desire for natural birth.
Additionally, we were very fortunate to attract some really great nurses
for our deliveries. I’ve
always been a firm believer that you bring your birth experience with you. That
being said, being in a hospital is not the most comfortable, relaxing
environment for most people and that was certainly true of us. In every
birth so far our labor progressed nicely at home and then either stopped or
slowed when we relocated to the hospital. Transport,
paperwork, triage, blood draw, bright lights, noise, internal checks,
unfamiliar surroundings and people, transfer to LDR room, new nurses, more
checks, shift changes....on and on.... We’ve
found that being secure, relaxed and comfortable are *key* aspects of Mom
progressing through a natural birth. Hospitals are not really the best
environment for this. Very
Positive Experience with Midwives: Our
experience with our Midwives has been *very* positive. In all
honestly the interview with our Midwife was the single event that tipped the
scales for me to favor a home birth for our fourth. She was
professional, highly educated and experienced and had a higher level of
personal interaction than with traditional OBs (even though our OB is/was
great). There
were two big factors in the interview that helped make the decision. (1)
Once you go into labor the Midwife and her team (Midwives-in-training) are
there with you until you deliver. This is much different that the
hospital setting where you get the nurses on staff for @ 98% of your labor and
the Dr. shows up to catch. Interesting note: In our third birth we
delivered at the same time as five other Moms and right at shift change...talk
about a zoo! The Dr. and team almost didn’t make it to the birth. (2) The
discussion around what to do in case of emergency. We discussed this at
length. The net of the discussion is that Midwives are highly trained and
are more attentive/attuned to the Mom (they’ve worked with Mom throughout the
pregnancy) than nurses in a hospital setting who are likely meeting the Mom for
the first time and also have numerous other patients to care for.
So, Midwives will be able to tell if and when something is not
right very early on and are highly likely to transport early in the event that
something is not quite right. We live one mile from the hospital
and our local fire department so a transport would literally be 10min from the
time of the call and we would be go directly to the ER...this may be quicker than
an internal transfer if the staff was busy and took more time to diagnose the
emergency situation. So
these are the reasons that I’ve become comfortable with our having a home
birth. There is one more that contributed
to the fact that we are actually having a homebirth ourselves – I have gotten “over
myself”. Krystyna has been gravitating
towards a homebirth after our first hospital experience. After our initial interview with our midwife,
I realized there was no reason left why we ourselves couldn’t have a homebirth. Check
back in about ten weeks and we’ll let you know how it goes! 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®. |
Going to Your Birthplace Part 2
| Posted on May 6, 2011 at 2:13 PM |
comments (9)
|
 How do we make a smooth transition to our birthplace? To piggyback on Tuesday’s post, I thought I would share some
ideas on how to make the transfer to the birthplace as smooth as possible. A common occurrence when changing from your
home to your birthplace is a surge of adrenaline from excitement, fear or
apprehension. In early or active first
stage labor this surge can slow or stop labor. Although it’s virtually impossible to keep adrenaline out of
the equation completely when making a transfer, especially for first time
parents, here are some things you can do to ensure that the transfer is as
smooth as possible. The goal is to
minimize the effect of adrenaline on the progression of labor. Some of these suggestions are time savers and
others are relaxation techniques. 1. Have you birthplace
gear packed a couple of weeks before your estimated due date. The major things you will need in the birthplace
(labor/relaxation tools, clothing, toiletries, baby layette) should be ready at
least two weeks before your EDD since birth usually occurs between 38 – 42
weeks gestation. If your baby happens to
be ready early, your bag will be ready to go in the car and you can focus all
your energies on your labor. Keep a list next to your bag of the last minute things you want
to bring, and keep those things close to your bag when you are not using
them. I am thinking of things like the
camera, phone or other electrical device chargers, keys, wallets or purses. 2. Have the car ready
to make the transfer at least two weeks before your EDD. Keep things like towels, waterproof pads,
bottled water, pillows, a couple of blankets and hand sanitizer in a box
somewhere in your car. We would put a
plastic bag between the pillow and the pillowcase just in case – labor can be a
goopy, drippy affair. The idea is that
you have what you need to put between mom and the car seat while you drive to
your birthplace while in labor. The
other situation we would prepare for is an unplanned delivery – we wanted
everything we needed to deliver safely just in case we didn’t make it to our
birthplace. Forgive the casualness,
however if you know our birth stories – LOL. 3. Have as much
paperwork done ahead of time as possible.
Check with your birthplace or your care provider to see what kind of
paper work they require before admission for the birth. Most venues will let you complete this work
ahead of time. If there are any
procedures you are thinking of declining, ask for that paperwork as well. It is a good idea to take a look at that paperwork
– sometimes they will outline the benefits and the risks and this may help you
make a choice. The advantage to doing
this is that you can bring it with you and give it to your care provider at
admission so that it is in your chart and with your birth plan. It will be one less set of questions to deal
with when you could instead be turning all your attention to your labor. 4. Carry extra copies
of your birth plan with you at all times.
We all imagine that we will go into labor at home, and for most of us,
we do. However, in the case that you are
out and about, or if you face an unexpected situation, then it is a better to
have a birth plan handy so that no matter under which circumstances you get to
the hospital, as long as mom and baby are doing well, you will have a good
opportunity to have the birth for which you have been practicing and preparing. I also suggest that you have extra copies of your birth plan
in your packed bag. I suggest keeping
them in an outside pocket so that they are easily accessible. Make sure that one is put in your chart upon
admission to your birthplace. Offer them
to everyone who enters the labor room.
Remember to use positive communication techniques when asking your care
providers for their help in meeting your birth plan. 4. To make sure you
are not going to your birthplace too early, run through Dr. Bradley’s list of
things to do to confirm you are in actual labor versus pre-labor. He suggests that mom’s eat, drink, walk,
shower and nap. The idea is that if
changes in activity or position don’t hinder the progression of labor, then the
mother’s body is progressing towards the birth of her child. If mom does all of these things and her
contractions keep progressing in frequency, duration and intensity, then it is
likely that you are in actual labor. 5. Check a mom’s
physical and emotional signposts against an overview of labor chart, such as
the one found in The Bradley Method® Student Workbook on pages 38-39. A laboring mom and her coach would use this chart
as a guideline along with the parameters set by their care provider. It is a good idea to highlight the signposts
that you are looking for that will indicate that it is time for a transfer to
the birthplace. When the mom is clearly progressing
and close to those signposts, then it is time to make the final preparations to
head to your birthplace. 6. Take a warm bath
or shower. Warm water is one of nature’s
relaxation tools. If mom’s water is
intact, she can take a bath. You will
need to do your reading and research ahead of time if you want to use a bath as
a relaxation tool after the bag of waters has ruptured. The information on the subject varies. Most care providers agree that moms with a
broken bag of waters can take a shower without a risk of infection. 7. If there is time,
have mom do a good relaxation exercise before she gets in the car. At this point, I would suggest that a coach
uses a good mental imagery exercise, or read mom the birth story she has
written for a peaceful birth, or to read some affirmations while doing some
good abdominal breathing. The idea is to
reassure mom that although she is leaving her current space, her labor and her
baby should continue progressing toward the birth. 8. Have an assistant coach drive the car so that coach can focus on keeping mom relaxed. If your car seat is already installed, then coach can sit in the back seat and talk to mom or give her a massage, or whatever it takes to keep her in a state of relaxation. If the car seat is not installed, then mom and coach can travel together in the back seat. The point is that if the coach isn't driving, he or she can focus all their attention on mom while someone else ensures that the team arrives safely at the birthplace. Closing thoughts: If you are having a home birth, keep in mind that most midwives will let you know before you are in an emergent situation that it's time to start talking about and deciding if it's time to go to a hospital for a different type of care. In a non-emergent situation, many options on this list are still available to you. It would be up to you to decide if you want to take care of hospital paperwork ahead of time "just-in-case", or if you feel better trusting that the birth will go as planned and this would be a step in the wrong direction. Whether you are planning a hospital, birth center or home birth, I must emphasize that once it is clear that mom is in actual
labor rather than pre-labor, it is imperative that mom has the coach or an
assistant coach by her side at all times.
It would be very unfortunate if mom had an incident happen that would
put you on the path to your birthplace sooner than you wanted to go (or in a home birth, make the hospital an unintentional reality). In our case, I fell down very hard in the shower because I was by
myself. Oops. And this was with our third birth! So even when we should know better, we get a
little confident and make mistakes. We
ended up going to the hospital much sooner than we wanted to. Because my
bag of waters was already ruptured, we were encouraged to stay or else spend the rest of
our morning signing paperwork to leave against medical advice. We never imagined that we were going to be in
labor there for two days, or believe me, we would have signed the paperwork to
go home once we confirmed that the baby was okay. As a reminder from Tuesday’s post, I also want to reiterate
that even if you take all these steps and your labor slows or stops when you
get to your birthplace follow Berman’s Law.
Be okay with going home if mom is less than 5 cm dilated and she is not
showing any physical or emotional signs of late first stage labor. I trust this list will give you some good ideas on making
the transfer to your birthplace a good one so that labor continues to progress
despite the change in venue. As with
most things related to pregnancy and labor, some things will work for you and
others won’t. Take a look at the list
and decide what works best for you in your situation. 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®. |
Getting to Your Birthplace
| Posted on May 3, 2011 at 2:47 PM |
comments (60)
|
 Getting to Your Birthplace...if you are not already thereQuestion: “When Should I Go To The Hospital?” Answer: This is a question that comes up a lot as we get towards the
end of a class series. There is no right
or wrong answer to this question – we tell our couples that they need to
discuss this with their care provider and come to a mutual understanding as to
when they are expected to arrive at their birthplace. In the instance of a homebirth, they need to
know about when the care provider will want to arrive at their home. I will address hospital births first, since that is what I
am most familiar with. Most care
providers that deliver in hospitals have some kind of 5-1-1 rule: this means the frequency of mom’s
contractions is five minutes apart, they are one minute in duration, and this
pattern has been established for an hour. Once a couple meets these or similar parameters, most care providers
will want you to head to the hospital for the birth. Different care providers have different
parameters for frequency of the contractions – check with them to know when
they will want to see you at the hospital. I need to add that if your labor starts with contractions
that are less than five minutes apart, do not wait for them to get to five
minutes apart. Chances are that if you
start with contractions that are closer than five minutes between contractions,
and lasting 45-60 seconds, you are having a sprint-to-the-finish birth and you
need to get to your birthplace if you are not planning a homebirth. If you are going to a hospital, the other part of the
equation is deciding whether or not you are going to stay once you arrive
depending on the information you get from their initial evaluation. We try to convey to our couples that when
they go to the hospital, they go with the understanding or the intention of
going home it they arrive too soon. Dr.
Victor Berman would tell his patients to follow “Berman’s Law” – if you get to
your birthplace and you are less than 5 cm dilated and you are not showing any
signs of being in late first stage labor, then go home and do the rest of the
hard work at home. The reason he adds the caveat of “not showing signs of being
in late first stage labor” is because we need to remember that labor is much
more than dilation. If the mom is five
centimeters dilated, she losing modesty and says she feels like she is going to
have a bowel movement, then chances are she is going to be dilating to
completion soon. This is not a team that
should not head home. You can find a
more complete picture of what late first stage labor looks like in The Bradley
Method® Student Workbook, page 38-39. On the other hand, if mom is less than five cm dilated, she
is still talkative between the contractions and she is still modest and upbeat,
then despite the fact the contractions are five minutes apart, that team should
go home until the hard work starts in earnest. As long as the mom and baby are doing well, it is the coaches place to
remind mom of the choices they made about their natural birth, and that those
choices have a better chance of being honored the farther away they are from
the time constrictions and the medical interventions at the hospital. If you are planning to give birth at a birth center, then
you will need to discuss arriving with your care provider at the center. Most midwives and alternative birthplaces are
careful not to take too many clients with similar due dates to ensure that they
can accommodate the moms and provide them with the intimate experience they
expect from the birth center. The benefit of a birth center is that even if you arrive
before you are five centimeters dilated, you can probably stay safely knowing
that you are not on a 24-hour clock. You
can also be assured that the “standard procedure” medical interventions at a
hospital are not available and you will be allowed to labor unencumbered as
long as mother and baby stay healthy and low-risk throughout the course of
labor. For a homebirth there is the added benefit of the comfort of
familiar surroundings. If you are having
a homebirth, you need to clarify with your midwife when they will arrive at
your home after the initial call notifying them that you are in labor. When you are nearing the point when they want
to attend your birth, you make the next call for them to come to your home. The important thing to consider with a homebirth is the traffic
and the weather at time of the day when the midwife will be making her way to
your home. One of my friends had an
unintentional unassisted birth because the midwife was caught in a
snowstorm. We know another couple that had
an unassisted water birth because they didn’t judge the mom’s progress
correctly – she was progressing much more quickly and the midwife simply did
not arrive in time. The good news is
that midwives are generally available by phone around your due date, and they
both got coaching over the phone as needed. If you are traveling to a hospital or birth center, the
final decision lies with your comfort level and feelings about your
birthplace. We have had students that
are comfortable in the hospital and want to go as soon as they hit the 5-1-1
rule. We have had students that went to
the hospital, got the word that they were at 3 cm dilation and went home until
mom’s physical signs showed that labor was progressing. We have had another student that did not like
hospitals and they barely made it to their birthplace: their baby was born 15
minutes after they arrived – they didn’t even get checked in at triage – they
went straight to their labor and delivery room. Whatever you decide to do, make sure you make the decision
together as a team and that you work as a team when you get to your birthplace
(if you are not already there) to have the birth you have been planning and practicing for. Disclaimer: The
material included on this site and 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. This site and this blog 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 site and this blog do not necessarily reflect those of The Bradley Method® or the American Academy
of Husband-Coached Childbirth®. |