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Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

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To Eat or Not To Eat…

Posted on November 5, 2015 at 8:07 AM Comments comments (32)
To eat or not to eat…That was the question for families planning a hospital birth.  When you are laboring at home or a birth center, you have the freedom to eat as your appetite dictates.  If you choose to have a hospital birth, you are at the mercy of your doctor’s orders and the nurse’s interpretation of the hospital protocol.  

We love it when science catches up to Dr. Bradley.  Anecdotally, we could tell students that it was safer to eat before/during labor since anesthesia has changed from the days of "knock'em out, drag 'em out" birth, as Dr. Bradley called it.  Women used to be under general anesthesia, which is administered differently than today's spinal or epidural blocks.  

We are so excited to update this post (and our class info!) with a press release from the American Society of Anesthesiologists (ASA):

"Most healthy women can skip the fasting and, in fact, would benefit from eating a light meal during labor, suggests research being presented at the ANESTHESIOLOGY® 2015 annual meeting. Improvements in anesthesia care have made pain control during labor safer, reducing risks related to eating, researchers note."
ASA Press Release, "Most healthy women would benefit from light meal during labor", October 24, 2015

For other reading,  HERE is some research I had found before this 2015 press release to make the case for eating and drinking in labor (in case you want to do more poking around the subject).

Now...how long will it take for hospital protocols to change and reflect these recommendations from ASA? As we found out the hard way, sometimes the doctor approves something but if it is not in writing and signed off on the birth plan, it probably isn't going to happen in the hospital setting. The nurse will follow the hospital protocol or they may invent their own interpretation if none exists to cover their liability.  If you are going to have a hospital birth, I have a strong opinion about getting your wish list signed so that the nursing staff has “permission” to “break the rules” if they feel that something you are requesting is out of the ordinary.  Maybe you could ask for a copy of the ASA press release to be included in your chart that goes to the hospital.

Dr. Bradley always advocated that a healthy mom should eat if she is hungry and drink if she is thirsty.  As he said, “Birthing is like playing a full game of football without any substitutions.”  He recognized that labor is an athletic event, and that a well-nourished athlete would perform better than a hungry one.

Science and the ASA catch up to Dr. Bradley:
"The research suggests that the energy and caloric demands of laboring women are similar to those of marathon runners, Harty said. Without adequate nutrition, women’s bodies will begin to use fat as an energy source, increasing acidity of the blood in the mother and infant, potentially reducing uterine contractions and leading to longer labor and lower health scores in newborns. Additionally, the studies suggest that fasting can cause emotional stress, potentially moving blood away from the uterus and placenta, lengthening labor and contributing to distress of the fetus."  

A Note About Hospitals and Nourishment
If you are having a hospital birth, you need to find out how your care provider feels about nourishment during labor, even with this announcement by the ASA. If your care provider is on board with mom eating and drinking as her body directs, great!  Get it into your birth plan, aka "wish list", that you have permission to eat and drink.  If they restrict intake, you need to think about your options.  You may question whether or not your care provider is truly supportive of your plans for a natural birth.  

You should also ask what the hospital policy is on food and drink during labor when you do your hospital tour.  It helps to know what kind of potential situations you may be facing so you can avoid stress-inducing encounters during labor.

The potential conflict between a laboring mother’s needs for nourishment and her care provider or hospital protocol comes from the days when general anesthesia was standard for hospital births.  There was a very real danger of a mom “aspirating”, meaning that food or drink the mom had consumed before labor would be regurgitated and accidently enter the trachea and lungs, creating a life-threatening condition to mother and baby.  [See reference 1]

From the press release:
"Researchers said aspiration today is almost nonexistent, especially in healthy patients. In the United States, there was only one case of aspiration associated with labor and delivery between 2005 and 2013, involving a complicated case of a woman who was obese and had pre-eclampsia (a precursor to eclampsia, or high blood pressure that can lead to seizures), according to the American Society of Anesthesiology’s Closed Claims Project database. Researchers also noted that no cases of death due to aspiration were reported in the United Kingdom between 2000 and 2005, compared to 1.5 cases per 1,000 during the 1940s. They say this is likely due to advances in anesthesia care, including increased use of epidurals and spinal blocks in place of providing anesthesia through a mask over the nose and mouth. Before these improvements, women were more likely to need a tube placed in the windpipe for breathing, which potentially increased the risk of aspiration." 

Although very few women have births under general anesthesia nowadays, the practice of restricting food and drink still persists.  You may hear it called “NPO”, which stands for the Latin, “non per os”, meaning nothing by mouth.  With the press release from the ASA, we can keep our fingers crossed that hospitals will start to change their practice protocols.

In the past, it was likely that you would only be allowed ice chips if you opted for an epidural.  The chance of needing general anesthesia was within the realm of possibility since some moms and babies “crash” after the epidural dose is dispensed.  As with all labor interventions, you don’t know how you will react until it’s administered.  Although it’s a small percentage of women that have life-threatening complications, the prospect of the drugs dropping your heart rate, blood pressure or respiration to dangerously low levels exists once they are in your bloodstream.  In the instance of a “crash”, you would need general anesthesia to perform an emergency cesarean to save your or your baby’s life, thus your nourishment options become limited to ice.

Eating and Drinking During Labor
Have your refrigerator stocked with your favorite healthful foods and/or meals as you near your estimated due date.  Labor is a funny thing – you never know what your body is going to like.  If you think you are in labor, you can go through Dr. Bradley’s list of things to do to see if you are in pre-labor (contractions slow down or stop) or actual labor (contractions continue at same pace or get closer and harder despite the change in position or activity).  To "test" for labor, he suggests that a woman should eat, drink, go for a walk, shower and nap – in that order.  

When you start with the “eat” part of the list, it will be more satisfying to eat something you really enjoy.  If you are not in labor, at least you ate something you like and you can move on with your day with a tummy-full of your particular “comfort food”.  If you are in labor, then you have eaten something that is fueling your body for the labor.  It will put you in a good frame of mind if you ate something that is a favorite and you create a positive emotional state.

The best drink during labor is water.  Water is a key to staying hydrated and avoiding the slippery slope of interventions.  A hydrated body has the energy for the work of labor.  Ample water also allows for effective hormone distribution throughout the body: the chemicals and hormones being made to stimulate and progress labor are able to circulate freely.  If you have a longer labor, consider an electrolyte replacement: trace minerals added to the water you are drinking, Emergen-C makes a powder, or coconut milk is a "natural" version of sports drinks.

Dehydration causes a spike in temperature and blood pressure, while at the same time depleting your energy by as much as 30%.  Can you see that simple dehydration can also be interpreted as the mom being “in distress”?  Your care team will not want to take a chance of making the wrong call, so they are likely to intervene or suggest drastic measures to “save” mom and baby.

Whether you are laboring at home, a hospital or birth center, small-portioned, protein rich snacks are nice to have on hand.  As your labor progresses, a laboring woman’s appetite will naturally decrease as the body shuts down other functions such as digestion to allow for full focus on the progression of labor and birth.  

Here are some foods that we and other students have found useful for quick energy boosts when mom doesn’t have the desire to eat a full meal.  These snacks are also handy for the coach to get the energy boost he needs to be a great support person for mom.  We don’t want hungry, cranky coaches during labor!!

What the ASA recommends:
"A light meal could include fruit, light soups, toast, light sandwiches (no large slices of meat), juice and water. Most women lose their appetites during very active labor, but can continue to drink fluids such as water and clear juices, researchers said." 

- Honey sticks.  According to honey.com, “Honey is also a rich source of carbohydrates, providing 17 grams per tablespoon, which makes it ideal for your working muscles since carbohydrates are the primary fuel the body uses for energy. Carbohydrates are necessary in the diet to help maintain muscle glycogen, also known as stored carbohydrates, which are the most important fuel source for athletes to help them keep going.” [2]

- Trail mix.  You get the nice variety of nuts, dried fruits and if you want, candy, in one bag.  I found myself picking out my favorite nuts and fruits and snacking on them – literally one or two at a time – as we got into the active phase of first stage labor.

- Protein bars or chews.  Look for bars that are low in carbs and added sugars –the key is to provide an energy boost without an energy crash afterwards. We have had students that use the “PowerBar” brand Energy Bites, as well as Gel Blasts that are bite size energy foods.

- Handful of nuts.  If you have a favorite nut (besides your coach-lol), bring some with you.  You can eat 1 or 10, whatever you are in the mood for.  I like nuts because you get the energy boost in whatever quantity you are in the mood to chew and swallow.  Trader Joe’s sells packages nuts in handy single serve packets.  I usually eat 2 or 3 pieces, and Bruss would finish off the bag for his energy boost.

- Popsicles.  While working hard in labor, a popsicle can be refreshing.  To prevent an energy crash, look for a brand that uses natural fruit as a sweetener instead of added sugars.  Added bonus: you can also push it against the top of your palate to stimulate oxytocin production.

- Applesauce cups.  Provide potassium along with a little protein.  The nice thing about applesauce is that while some people prefer them cold, they don’t need to be refrigerated.  Again, look for naturally rather than artificially sweetened sauces.

- Banana.  Another source of potassium that is portable and easy to eat.  To prevent a sugar burst, pair this with a cheese stick to balance out the carbs.



- Soup or clear broth.  Campbell’s came out with the “Soup at Hand Cups” that are single serve, portable and microwaveable.  They were a God-send during our third birth.  The nurse didn’t want me to eat “just in case”, but she was okay with me drinking – hence, I could drink my meal and stay nourished through our 34 hours at the hospital.

- Single serve smoothies or juice drinks.  I am thinking along the lines of Stonyfield Farm Smoothies or Drinkable Yogurts for a liquid protein boost, or the Odwalla line of Protein Beverages.  It’s a little sip of something sweet with carbs that still offers a protein source for energy.

As you noticed from the list, some of these foods need refrigeration or a heating source.  These are considerations if you are having a hospital birth.  It stands to reason that if you will not have access to a refrigerator or microwave, the items that won’t stay cool with an ice pack or the foods that need to be heated need to left out of the cooler.

The bottom line: eat to appetite and drink to thirst for the best labor possible!  I hope this list gives some ideas with which you can fill your refrigerator or cooler.  What did you eat during your labor?

Disclaimer:
Bradley Method classes offered in Arizona convenient to Chandler, Tempe, Gilbert, Mesa, Ahwatukee, Scottsdale, Phoenix and Payson, AZThe 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:
[1] http://en.wikipedia.org/wiki/Pulmonary_aspiration

[2] http://www.honey.com/nhb/benefits/natural-energy/

Natural Oxytocin Boosters

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

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

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

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



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


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


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



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


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


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

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

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

A Letter To You, The New Mother

Posted on April 1, 2014 at 9:19 AM Comments comments (4)
Carnival of Natural Mothering
April 2014: What You Wish You Knew

Remember when you got your first positive pregnancy test? What do you wish that woman knew? Write a letter of love and encouragement to that awesome mama just starting her journey.
 
Dear New Mama:
 
Yes, you.  I skipped over the “mother-to-be”.  You are already growing life, and you are already aware of that life and protective of that life…as I see it, there is no “to-be” in mothering.  It is a state of being since you got your BFP.  Your mother’s instinct is no joke: trust it always, even in the face of a “lack of evidence” or just “having a feeling”.  No mother has ever regretted doing the best for her child from a place of love and concern…the only regret is not listening to that voice.  Your mothering instinct will not fail you in pregnancy or parenting.
 
At times, pregnancy may feel equally miraculous and uncomfortable.  First trimester: the unquenchable excitement of being pregnant (it happened!!)…and nausea.  Second trimester: interesting sounds and smells, and maternity clothing as your waistline grows.  Third trimester: the disappearance of your feet beneath your belly, maybe nausea (again!), and the OMGosh moment: this baby has to come out of me – through *there*! 
 
Through it all, the miracle and awe of growing another human being is constant.  There are two hearts beating, two minds working, two souls living in one body.  The first time you feel your Sweet Pea stir inside of you…their hiccups, the reaction to voices and touch…and those sensations continue.  I believe they exist as a reminder that the sacred and divine is happening right now.
 
You want to do the best for your baby.  You want to have a perfect pregnancy that leads into your perfect birth story.  While those are worthy ideals, you can only control finite amounts of conception through the Birth-Day, and at some point you must surrender the rest of it to the universe.
 
I encourage you to learn as much as you can about birth, breastfeeding and parenting!  
Birth: Find a comprehensive childbirth class that prepares you and your coach for a positive birth experience.  Connect with the ICAN group in your area and learn how to avoid a primary cesarean, because an unnecessary one can be heartbreaking.  Read up on placenta encapsulation and the postpartum period.

Breastfeeding and Parenting: Find a group of women and/or families to build your village.  The best lesson I ever got was to ask questions and take advice from the parents that are already doing/have done what you want to do.  If you want to breastfeed, don’t get advice from someone who made a different choice.  Connect with breastfeeding mothers at La Leche League or a breastfeeding support group.  If you want to babywear, don’t seek out a person who is always pushing a stroller.  Connect with a babywearing group in your area, or find a group online.  If you want to practice gentle parenting, read up on attachment parenting, and in this day and age, you can connect with the experts online.  Two of my favorites are Dr. Laura Markham and L.R. Knost
 
Maternity Leave: Are you going to work outside the home after a maternity leave?  Connect with the women who have made that choice and have the breastfeeding/parenting relationship you want with your child.  As far as I know, there are no support groups for that.  I have a cadre of students who have breastfed/are breastfeeding and practice attachment parenting while working out of the home full-time.  Please feel free to contact me to connect with them – several are willing to share their stories and mentor new mothers.
 
You are never alone on this journey.  Birth and parenting have happened for eons.  There is so much wisdom available to you, and so many people to walk and learn with as a new parent.  Read, connect, be willing to say hello to the person sitting next to you in your childbirth or breastfeeding group.  Once your Sweet Pea is earthside, get out and about.  Say hello at the breastfeeding or postpartum support group, story time or playgroup.  A simple hello can lead to a beautiful friendship for you and your Sweet Pea.
 
Since this is a birth blog, here are some more details about preparing for the Birth-Day…
The decisions you can make and be in control of:
Eating a whole food, balanced diet: as much as possible, skip the processed foods.  Here’s an illustration: if your great-grandmother wouldn’t recognize it as food, do not eat it. Or, try this one: if it has more than ten ingredients, or more than one you cannot pronounce without concentrated effort, then put it back on the shelf. Check out our posts on nutrition HERE.

Exercise every day: even 10-20 minutes of cardio is better than none.  You are going to be part of an athletic event...train for it intentionally. Engage in both stamina-building and pregnancy-specific exercises to equip you for a stronger pregnancy and birth.

Avoid harmful substances: back to all those things you cannot pronounce.  Pregnancy is a great time to go green…one change at a time.  Start by looking at your personal care products…then your kitchen…then your cleaners (both at home and in your school and/or workplace).  Commit to yourself and to your baby that once a month, you will make a change that will make just one more thing in your life non-toxic.  By the time you are holding your Sweet Pea, there are at least 7-8 changes that are now healthy habits.

Choose the right care provider and birth space: if you know you want a natural birth, do your homework now. Find a care provider that supports your choice. The other thing to evaluate is whether your birth space and your birth vision are aligned.  If either of these is a NO, you can change providers and/or birth spaces – no permission slip necessary.

Pain is not normal: your body can do pregnancy pain-free. Are you uncomfortable? Look into chiropractic care, acupuncture, pregnancy massage, aromatherapy...decide what you will do to eliminate any physical pain or anxiety so you can prepare for a positive birth experience.

Pamper yourself: Say YES when it comes to being kind to yourself.  Get the pedicure, go out to dinner, eat your favorite foods that are safe in pregnancy.  You won't know when you are ready, willing or able to afford those things after your Sweet Pea arrives.  Do it now while you still only have your schedule to manage.
 
About the things you cannot possibly know or control...
How long you will be pregnant: you were given an estimated due date…it’s a guess at best.  It is definitely NOT an expiration date.  Each day inside you is a day your Sweet Pea is growing and preparing to live earthside.  As long as you are okay, and they are okay, inside is a great place to be.  Find ways to enjoy being pregnant, even if your due date comes and goes.

How long your labor will be: if only there was a magic wand for this!  I love Dr. Bradley’s “formula” for labor…whether you have a “sprint”, a “marathon” or something in between, your energy and your rest determine how you manage the duration of your labor.  It is intense work, it is athletic work…so eat if you are hungry and definitely sleep, even in the excitement of “I think I’m in labor!” Eat something, drink something, go for a walk, take a bath or shower to relax you…and then go to bed!  I promise you that you cannot sleep through an unmedicated labor.  Your body will wake you up when it’s time to start that cycle again…until you can’t sleep anymore because you are working.  If you slept as suggested, you will have all the energy you need to have the birth you prepared for.  If you do not sleep, then you will have to dig down even deeper to see your birth through the way you want to – totally possible as well.  If you can, just trust me and sleep – it makes for a better birth!

When you surrender control: let go, give in, and let your baby come out.  At some point, we must let go of the present and give into the primal timelessness of birth.  I know! It sounds completely hippie-hoodoo right now.  Take it from me – I am Miss Priss and Miss Always-in-control…it makes for a LONG birth.  Your body can only get down to the real work of birth when we are willing to be vulnerable, to feel, to surrender all of the control to the bigness that is birth.  Let go – even though you are not in the driver’s seat, it does happen…without you.  It is the one time in your life when you can connect to all the birthers that have gone before you.  When I would finally surrender, I would feel all the energy in the Universe around me.  That energy sustained me, it pushed through the fear of no control, to the absolute bliss of working with our baby and my body to just Be.  A little secret: you can control your breath.  Focus on making it as deep as possible…then just feel.
 
Thank you for taking the time to read this letter.  You are already an amazing parent – you have chosen to carry this life, and by doing that, you have undertaken the essence of mothering: living outside of yourself and considering the needs of another.  Best wishes to you as you continue to grow in love.
 
Blessings,
Krystyna
 

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  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®.

5 Step Plan for Labor

Posted on December 10, 2013 at 4:28 PM Comments comments (27)
Here are Dr. Bradley’s "Keys to Labor", as per his book, Husband-Coached Childbirth.  I love these simple steps – they could almost be considered a “recipe” for labor.  

If you follow these steps, you can figure out if you are in “real” labor.  If you are not, somewhere along these steps, your contractions will fizzle out.  And if they do, mama has eaten well, slept, and hopefully had a good nap so that you are rested for the next round of contractions when they begin again.  If you are in labor, you will go through these five steps and discover that despite the change in activity and positions, your contractions are progressing.  Now you can get excited because you will be meeting your baby sooner than later.  And then, settle down to "work", because labor is definitely an athletic event, albeit one of the most rewarding ones ever!
 
Eat
  • Mom should eat the kind of food she is hungry for: a meal, a snack, or a nibble, depending on where she has progressed in labor. 

A laboring mother should eat to her appetite.  Early in labor, she may be ready for a full meal.  We have students who go out to breakfast after they know they are in labor just to pass the time away.  If she is hungry, feed her accordingly.  As labor progresses and the body starts to divert bodily functions exclusively to labor and birth, you will see her appetite wane.  Later in labor, maybe she will want a bite of something – and definitely not the full meal she was requesting before.  If labor has been on the longer side and she is refusing food, or if she is being denied food and she is still hungry, you may consider clear broths for the dual purpose of an energy boost and hydration.

Drink
  • Mom needs to be drinking every hour.  Whether she wants a full glass, a few sips, or ice chips – keep her hydrated.
 
Dr. Bradley wrote in his book that a mother should “drink to thirst”.  We now know that thirst is a late sign of dehydration.  It is best to keep mom hydrated by offering her a glass of water every hour in the early stages of labor.  Again, as labor progresses, she may not want that full glass of water.  You can offer her a sip of water after every contraction, or maybe ice chips will be better.  Some mothers may even prefer sucking on a damp cloth.

Walk
  • At a good pace to rock baby down and encourage labor to progress.
 
Walking is a great way to speed up labor.  It is always a great way to work yourself into exhaustion.  You need to gauge how it’s working for your particular labor.  When you walk, are the contractions getting harder, longer and stronger?  If walking is not having that effect on your labor, then maybe you should just go for a 20-30 minute walk to labor baby down into the pelvis and exert some pressure on the cervix to encourage it to dialate, and then move on to the next step.  If walking is clearly making your labor progress, go for it.  You could walk until mom needs more help with relaxation besides reassuring words and counter-pressure.

Shower
  • Water has been called the “midwife’s epidural”. A warm shower or bath can do wonders to ease the intensity of labor.
 
Water has an incredibly relaxing effect.  It can literally wash the tension away.  Some mothers may like the full submersion and weightlessness in a birth tub.  Other mothers may prefer the soothing sound and the sensation of water flowing down her body.  If your birth place has the equipment, try both and see what works for her.  You may want to consider limiting your use of water to an hour at a time if mom is in the tub.  See THIS article from Penny Simkin for more information about how to use water in labor.

Nap
  • Now that Mom has fueled, hydrated, moved baby, and eased tension, do a relaxation exercise to ease her into a rest period.  An unmedicated mother *will not* sleep through the birth of her baby.
 
Mom has done everything she can to ensure a healthy, low-risk labor. She has nourished and hydrated her body as it prepares for the athletic event of birth.  She has walked to move baby and help dilate the cervix.  She has used water to dissipate any tension she may have been holding onto.  Now it’s time to encourage her into a side relaxation position, or which ever other position is comfortable enough for her to enter a state of deep relaxation.  Optimally, you want the mother to get a good sleep.  If it’s nighttime, then maybe she can sleep through the night, or until her contractions wake her up again.  If it’s during the day, hopefully she can get a decent nap.

You can definitely follow this labor pattern over and over, until the mother is unable to sleep anymore because she is going through transition, and/or having the urge to push.  It is definitely a way to manage labor without additional pain relief.  The love and support of an invested coach, replenishing energy, and rest can go a long way for a family to have a natural birth.

If you liked the way you labored, what was your recipe for success?

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

Information Sheet: Non Per Os

Posted on September 24, 2013 at 1:51 AM Comments comments (0)
Info Sheet: NPO non per os nil by mouthRestricting food and drink is still a common practice in many hospital settings.  Here is our presentation of the information so you can make an informed decision for your labor:

Definition:  Non Per Os or Nil By Mouth
From Wikipedia [1]:
Nil per os (alternatively nihil/non/nulla per os) (NPO) is a medical instruction meaning to withhold oral food and fluids from a patient for various reasons. It is a Latin phrase which translates as "nothing through the mouth". In the United Kingdom, it is translated as nil by mouth (NBM).

Typical reasons for NPO instructions are the prevention of aspiration pneumonia, e.g. in those who will undergo general anesthetic, or those with weak swallowing musculature, or in case of gastrointestinal bleeding, gastrointestinal blockage, or acute pancreatitis. Alcohol overdoses that result in vomiting or severe external bleeding also warrants NPO instructions for a period.

When patients are placed on NPO orders prior to surgical general anesthesia, physicians would usually add the exception that patients are allowed a very small drink of water to take with their usual medication. This is the only exception to a patient's pre-surgery NPO status. Otherwise, if a patient accidentally ingested some food or water, the surgery would usually be canceled or postponed for at least 8 hours.”

*History
Why was it adopted in labor?  What was it supposed to treat? 
Restricting food and drink was supposed to prevent Mendelson’s Syndrome.  It is a condition…it is a theory that there is an increased risk of the stomach contents entering the lungs…here is a little history from About.com [2]:
“In 1946 Dr. Curtis Mendelson hypothesized that the cause of pneumonia following general anesthesia was aspiration of the stomach contents, due to delayed gastric emptying in labor. He noted that food could be vomited 24-48 hours after being eaten. Dr. Mendelson experimented on rabbits to examine the effects of content in their lungs. Aspiration (taking the particles into your lungs) of undigested food could cause obstruction, but not aspiration pneumonia, and no deaths were due to aspiration of fluids with a neutral pH. The rabbits only died when they aspirated materials containing hydrochloric acid. He said by forbidding food and drink in labor you could reduce stomach volume, thereby decreasing the risk of maternal problems from acid aspiration while under general anesthesia. We also found that there were two factors that increased the risk of maternal problems:


    • A volume of an aspirate of 25+ mm
    • A pH of 2.5 higher (biggest problem)

However, in the 40's and 50's general anesthesia was used much more often for labor and delivery. For example, most forceps were done under general anesthesia. Gases were given with a face mask, often opaque, which hampered the anesthesiologist's view of the airway. Dr. Robert Parker, in 1950, largely blamed aspiration on poor anesthetic technique and poor quality of the practitioners.


Has it been effective: as in, has the incidence decreased or has a problem been solved as a result of the intervention/procedure/test?
From About.com [2]
“The risks of aspiration are only a problem when general anesthesia is used (3.5-13% of cesareans), and the technique has improved. Anesthesiologists now have more quality control.

So the two solutions that have been the most popular have been the IV and antacids before a cesarean surgery.

IV fluids are not always reasonable solution to hydration problems, as they have problems of their own: over load, closer monitoring of intake and output, hyperinsulinism in infants after 25 g of glucose, and the salt free solutions can result in serious hyponatraemia in mom and baby. And the antacids are usually given in the quantity of 30 mm, a volume known to increase the risks of aspiration pneumonia.

We also know that restricting food in labor can cause problems of its own. Besides the stress factors, restricting intake during labor can cause dehydration and ketosis.”

*Pros and Cons
Pros:
Theoretically: if you have an empty stomach, you are easier to treat.  In reality: very hard to justify one.  The idea of an “empty stomach” is a fallacy, and anesthetic techniques and training are vastly improved since the initial hypothesis about the link between aspiration and pneumonia in the 1950’s.  You have to evaluate how you feel about this statement:  “Labor is not an illness to be treated – it is a natural event that needs to be supported.”

Cons:
  • Stress factors caused by denial of food and water
  • Dehydration
  • Ketosis
  • Longer labor: women who are allowed to eat and drink to comfort in labor have shorter labor (by an average of 90 minutes)
  • May need augmentation with Pitocin
  • May require more pain medications
  • In one study, babies had lower apgar scores than of those in the control group. [2]

Most telling is this practice guideline published by the anesthesiologist in 2007.  The folks doing the anesthesia are saying it is safe for low-risk mothers to eat and drink in labor, even with anesthesia, and go so far as to make recommendations about the type of foods that can be eater:

From the Practice Guidelines from An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia [3]
II. Aspiration Prevention
Clear Liquids.
There is insufficient published evidence to draw conclusions about the relationship between fasting times for clear liquids and the risk of emesis/reflux or pulmonary aspiration during labor. The consultants and ASA members both agree that oral intake of clear liquids during labor improves maternal comfort and satisfaction. Although the ASA members are equivocal, the consultants agree that oral intake of clear liquids during labor does not increase maternal complications.

Recommendations.
The oral intake of modest amounts of clear liquids may be allowed for uncomplicated laboring patients. The uncomplicated patient undergoing elective cesarean delivery may have modest amounts of clear liquids up to 2 h before induction of anesthesia. Examples of clear liquids include, but are not limited to, water, fruit juices without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. The volume of liquid ingested is less important than the presence of particulate matter in the liquid ingested. However, patients with additional risk factors for aspiration (e.g., morbid obesity, diabetes, difficult airway) or patients at increased risk for operative delivery (e.g., nonreassuring fetal heart rate pattern) may have further restrictions of oral intake, determined on a case-by-case basis.

*Links 
Resources with other options to explore if you want to negotiate for unrestricted eating and drinking in labor – maybe you will “compromise” and get “clear fluids”.  These are more studies and articles that demonstrates that eating and drinking in labor is a sound evidence-based practice:

1.) Singata M, Tranmer J, Gyte GML. Restricting oral fluid and food intake during labour. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD003930. DOI: 10.1002/14651858.CD003930.pub3.
http://summaries.cochrane.org/CD003930/eating-and-drinking-in-labour

2.) Health Behavior News Service, part of the Center for Advancing Health (2013, August 22). Restricting food and fluids during labor is unwarranted, study suggests. ScienceDaily. Retrieved September 10, 2013, from http://www.sciencedaily.com/releases/2013/08/130822141954.htm

3.) Wiley-Blackwell (2010, January 22). Eating and drinking during labor: Let women decide, review suggests. ScienceDaily. Retrieved September 10, 2013, from http://www.sciencedaily.com/releases/2010/01/100119213043.htm

4.) Summary of these three articles in our blog post “Can I Eat and Drink in Labor?”

Did you eat and/or drink during your labor?  Did you worry about it?  What was your thought process? 

References:
[1] http://en.wikipedia.org/wiki/Nil_per_os

[2] http://pregnancy.about.com/cs/laborbasics/a/eatinginlabor.htm

[3] http://journals.lww.com/anesthesiology/toc/2007/04000
Anesthesiology:
April 2007 - Volume 106 - Issue 4 - pp 843-863
doi: 10.1097/01.anes.0000264744.63275.10

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








Can I eat and drink in labor?

Posted on September 10, 2013 at 7:48 AM Comments comments (0)

We had a great question come up in class on Friday, one that bears writing about because at least one student every session plans to give birth at a hospital where they are told to have a good meal before they come in, because their food will be restricted or prohibited once they check into the labor and delivery department. 

To begin with, even having to ask that title question begs another question: why are we asking permission?  The female body, left to it’s own devices, will naturally shut down appetite as the serious work of labor progresses.  Dr. Bradley teaches to eat to appetite if you are hungry, drink if you are thirsty.  Even after mom is no longer asking for water, Dr. Bradley admonishes coaches to keep mamas hydrated so that the labor progresses with ample hydration to circulate all the hormones that keep labor on track.

As students of natural birth, we know that as labor gets harder and moves closer to birth, the body shuts down appetite because it needs to focus on the work of labor, not digestion.  If labor is prolonged, maybe mom will want literally “a bite” of something: a bite of banana, a bite of cheese, a bite of fruit, a couple of nuts, etc.; definitely not a full meal.  Since we had long labors, we found that clear broths or simple soups (thin tomato soup in my case) were a great compromise.  Although I wasn’t hungry, the liquids gave me a few calories to lend some energy to continue to labor, while also meeting my hydration needs.

Science confirms that hospital policies need to catch up with evidence-based care.  Here are excerpts from the Cochrane Review, plus two other articles for you to consider as you decide what is best for your family.

From the review, “Restricting oral fluid and food intake during labour” [1]
In some cultures, food and drinks are consumed during labour for nourishment and comfort to help meet the demands of labour. However, in many birth settings, oral intake is restricted in response to work by Mendelson in the 1940s. Mendelson reported that during general anaesthesia, there was an increased risk of the stomach contents entering the lungs. The acid nature of the stomach liquid and the presence of food particles were particularly dangerous, and potentially could lead to severe lung disease or death. Since the 1940s, obstetrical anaesthesia has changed considerably, with better general anaesthetic techniques and a greater use of regional anaesthesia. These advances, and the reports by women that they found the restrictions unpleasant, have led to research looking at these restrictions. In addition, poor nutritional balance may be associated with longer and more painful labours, and fasting does not guarantee an empty stomach or less acidity. This review looked at any restriction of fluids and food in labour compared with women able to eat and drink. The review identified five studies involving 3130 women. Most studies had looked at specific foods being recommended, though one study let women choose what they wished to eat and drink. The review identified no benefits or harms of restricting foods and fluids during labour in women at low risk of needing anaesthesia. There were no studies identified on women at increased risk of needing anaesthesia. None of the studies looked at women's views of restricting fluids and foods during labour. Thus, given these findings, women should be free to eat and drink in labour, or not, as they wish.

From the Science Daily article, “Restricting Food and Fluids During Labor Is Unwarranted, Study Suggests” [2]
"There should be no hospital policies which restrict fluids and foods in labor; nor should formal guidelines tell women to take specific foods, such as energy drinks," states one of the study's authors, Gillian ML Gyte, M.Phil, of the department of women and children's health at the University of Liverpool in the U.K.

She and her co-authors point out that prior research has shown that many women in labor do not feel like eating, but for others the notion of long hours without any food or drink can be anxiety provoking.” …

"Our study found no difference in the outcomes measured, in terms of the babies' wellbeing or the likelihood of a woman needing a C-section," said Gyte. "There is no evidence of any benefit to restricting what women eat and drink in labor." The researchers also emphasize the value of allowing women to make choices regarding these matters. 

From the Science Daily article, “Eating and Drinking During Labor: Let Women Decide, Review Suggests” [3]
Throughout much of the last century, eating and drinking during labour was considered dangerous and many maternity units operated "nil by mouth" policies or restricted what women in labour were allowed to eat and drink, regardless of women's preferences. This was largely due to concerns about possibly fatal damage to the lungs caused by "Mendelson's syndrome," where particles of regurgitated food are inhaled under general anaesthetic during Caesarean sections. Recently, however, attitudes have begun to change and in many maternity wards, particularly in the UK, women are now allowed to eat and drink what they want during labour…

"Since the evidence shows no benefits or harms, there is no justification for nil by mouth policies during labour, provided women are at low risk of complications," said lead researcher Mandisa Singata, who is based at the East London Hospital Complex in East London, South Africa. "Women should be able to make their own decisions about whether they want to eat or drink during labour, or not."…

"While it is important to try to prevent Mendelson's syndrome, it is very rare and not the best way to assess whether eating and drinking during labour is beneficial for the majority of patients. It might be better to look at ways of preventing regurgitation during anaesthesia for those patients who do require it," she said. 

So what is a couple to do when the hospital has a policy that restricts food and drink during labor?  Do you feel confident in your choice to eat and drink?  Do you want to circumvent the system by bringing in “Coach’s Food”?

That is a very individual choice.  You can labor at home as long as possible and follow your own cues if you want to prolong going to the hospital where your intake is going to be restricted.  You can pack some “Coach’s Food” and circumvent the system by snacking out of the coach’s cooler.  You can do neither and go with the system.  You can also talk to your care provider, bring in the scientific literature, and see if they will sign off on a birth plan that allows you to eat and drink in the hospital in spite of the policy.  Their hands may be tied, and it may not be a possibility, however as the saying goes, you won’t know unless you try.

Did your birth place have a policy that restricted food and drink?  What did you do; how did you handle it?
Please leave us a comment – it will be moderated and posted.

[1] Singata M, Tranmer J, Gyte GML. Restricting oral fluid and food intake during labour. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD003930. DOI: 10.1002/14651858.CD003930.pub3.

[2] Health Behavior News Service, part of the Center for Advancing Health (2013, August 22). Restricting food and fluids during labor is unwarranted, study suggests. ScienceDaily. Retrieved September 10, 2013, from http://www.sciencedaily.com/releases/2013/08/130822141954.htm

[3] Wiley-Blackwell (2010, January 22). Eating and drinking during labor: Let women decide, review suggests. ScienceDaily. Retrieved September 10, 2013, from http://www.sciencedaily.com/releases/2010/01/100119213043.htm

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


Natural Labor Coping Techniques

Posted on June 8, 2012 at 10:27 PM Comments comments (43)
Here are some of the ways we recommend our students manage their labor without analgesics or anesthetics.  Even when they are used in labor, we are so happy that our couples use them as tools to manage a long labor and their children are born nursing vigorously and with high APGAR scores.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson  Mom and Coach are informed. 
Through the course of The Bradley Method® class series, parents are taught about what to expect as “normal” in labor, what the variations on normal might be, the different options and interventions in labor, and how to recognize a complication that warrants a change in the plan for a Healthy Mom, Healthy Baby outcome.    

We also teach positive communication, something intended to strengthen the parental bond, as well as serve for positive interactions in the birth space with care providers and support personnel.  Our goal is that parents have the tools they need to evaluate labor, communicate their needs to care providers, and ask the questions they need to make informed decisions about the choices they may have to make in labor.   

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson  Mom and Coach are athletes. 
An athlete with an eye on crossing the finish line does four things:  They train, they rest, they nourish and they hydrate.  Dr. Bradley called his patients “obstetrical athletes”.    

His nurse, Rhonda Hartman, designed a training program just for moms to prepare them for labor.  We are still teaching our couples this training program, starting with week one of class and continuing until the time of birth.  We also “train” relaxation.  Each couple is encouraged to take the weekly technique and practice at least 15 minutes per day so that there is muscle memory for relaxation when it is needed in labor.   

We continually harp on the importance of sleep in the weeks leading up to labor and once labor starts.  We learned this lesson the hard way, and as excited as we know our students are going to get as they anticipate the birth of their child, we want them to try to rest.  Getting to the magic number of “10 cm” is only the first part of labor – once they reach 10 cm, they also need energy for the second stage of labor to welcome their child into this world.   

We also echo Dr. Bradley’s advice to eat if you’re hungry, drink if you’re thirsty.  He makes the analogy that going through labor without eating or drinking is like playing a full game of football without any substitutions.  The body is working and burning energy to birth your baby, it makes sense to follow mom’s physical cues.  As long as mom is okay and baby is okay, we have found that mom’s appetite will naturally decrease as labor intensifies; and as with an actual marathon, that the need to hydrate is as important in early labor as it is when mom is close to crossing the finish line.   

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson Water is your friend.
As stated above, a hydrated mother makes for an optimal obstetrical athlete.  She is hydrated for energy and optimal hormone distribution throughout labor.   

 Water is also a excellent relaxation tool.  It works magic in labor: the warmth and the sensation move tension away from the body and adding a layer of relaxation as it works to soothe the mother’s body.  I have heard it called, “The Midwives Epidural”.    

Many hospital moms now have access to the birth tubs that are used very effectively at birth centers or at home births.  If  using a birthing tub or home bathtub is not an option, then the shower can also be an effective tool.  The sensation of water will still massage and soothe the body.  With a shower hose attachment, the water can also be directed at the body where it is the most soothing for the laboring mother. 
  

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson  Use abdominal breathing.
Abdominal breathing is taught in many settings to deepen relaxation – yoga, hypnosis, meditation, stress relief, and in The Bradley Method® of natural childbirth classes!  Abdominal breathing is also known as diaphragmatic breathing.  Basically, you are allowing your belly to rise and fall as you breath instead of your chest.  If you watch children breathe, or if you remember what it was like to breathe before someone told you that you needed to suck in your stomach, you will know what it means to breath with your abdomen.   

Abdominal breath is an important foundation for relaxation.  It slows down our mind and it allows or bodies to release tension.  We teach abdominal breathing in class 2 so we can build on it through the rest of the series.   

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson  Coach is a relaxation expert. 
Coach needs to know what relaxes their partner.  Does mom respond to physical touch?  What kind of touch?  Does she like a strong counter-pressure or gentle effleurage?  Does she like a relaxation script, a prayer or a story read to her?  Does she feel safe in her birth space?     

By the end of The Bradley Method® class series, we have covered these, and many more questions, to help the Coach be a relaxation expert on their partner.  We also teach 11 different relaxation techniques for coaches to put into their “toolbox” to use as needed as labor progresses.   

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson  Have a trusted assistant coach. 
Champion sports teams have a stellar assistant coaching staff.  The head coach doesn’t try to do it all – he delegates and finds the best person to train his team so that he can keep his eye on the big picture and continue leading and motivating his team.   

We have noticed that couples with an assistant coach generally end up with births that are closer to the birth wishes they made in preparation for their labor.  The extra set of hands, the extra energy in labor make a difference.  The couples that hire doulas also have an experienced birth professional to help them manage the map of labor.  A good birth doula doesn’t take over the birth, she will help the couple to recognize the signs of progress and make suggestions for coach to support the mom.   

Even if you feel like you want to be just Mom and Coach, you can benefit from an assistant coach coming in for a period in labor.  When we labored with Angelika, a dear friend of ours came in and labored with me when Bruss needed rest.  I had been laying down the first day, resting and napping since we know we have long labors.  Bruss had been checking in on me, taking care of our older children while we waited for family to arrive to tend to them, and he took care of feeding all of us.  He REALLY needed to sleep after dinner that night.  Andrea came, labored with me as long as she could, and when it was time for her to get back to her own family, Bruss was rested and ready to be head coach again.  I am forever grateful for her time that night – it allowed for Bruss to rest and restore for the long work we still had ahead of us.   

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson  Break the Fear-Tension-Pain cycle. 
We break the Fear by teaching couples what to expect in a normal labor, along with the many variations on “normal”.  We also break the Fear by discussing the complications and sharing strategies and options for them to consider if they are among the small percentage of people that face complications in labor.   

We break the Tension by teaching Mom and Coach to be relaxation experts.  We break the Tension by teaching couples to communicate together, and how to communicate with their care team for effective and positive interactions.   

We break the Pain by reminding mothers that labor is an athletic event.  It isn’t always easy, however it is doable.  We invite couples from the previous class come share their stories with our current class.  I have seen the “light bulbs” click for both Moms and Coach when the other “first-timers” share their stories.  It makes it more realistic to hear that other newbies had Healthy Mom, Healthy Baby outcomes by using the information they learned in class.  It reassures them that the intensity is brief compared to the joy of holding their children.  The new parents confirm that the work is worth the effort, and that staying the course and/or making Healthy Mom, Healthy Baby choices are rewarded with a happy family outcome.    

We also encourage couples to find affirmations, prayers, scripts and/or music to draw energy from in labor.  Labor is an exercise in intensity that ebbs and flows.  Having something to focus on besides the intensity that is growing helps to focus mom on the work that she is doing.  They can also restore and encourage her when she wants to give into the pain.    

By having knowledge, training and tools, couples are well on their way to a Healthy Mom, Healthy Baby outcome.   

What was a natural labor coping technique that worked for you during your labor?   

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 comments (0)
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:
  • They have learned several strategies for positive communication. 
  • There are several places in their class materials to find the questions for informed consent.  If they remember nothing else, the first questions to ask are, “Is Mom okay?  Is Baby okay?  Then they can ask for the benefits, risks, expected results, alternatives to the suggested procedure, and a timeframe to think about it before making a decision.
  • If there is time, it is always okay to ask for the privacy to talk things through before making a decision.
  • Always evaluate any decisions that need to be made with the Healthy Mom, Healthy Baby filter on.  As long as they remember the ultimate goal, they will be able to make peace with the decisions they make in labor.
 
On managing labor:
  • The amount of sleep a couple gets can positively or negatively effect their outcome.  Against the odds, try to sleep in spite of the excitement.
  • Eat if you are hungry, drink if you are thirsty.
  • Fast labors are indicated by a rapid progression of duration, intensity and frequency of the contractions.  If you notice that things are getting longer, harder, stronger and closer together over the course of a couple of hours, you need to get to your birthplace sooner than later.
  • Long labors are indicated by little or no change in the duration, intensity and frequency of contractions over the course of several hours.  If your contractions start ten+ minutes apart, and they are still ten+ minutes apart two hours later,  you are in for a marathon – stop timing, eat something, hydrate, shower and go to bed!  Although we do not wish this labor on anyone, if it is your birth story, you will be happy you rested early on, because you will definitely have energy when you need it later.
  • It is possible to sleep between contractions or even through contractions.  Surrender to the process and allow Mom to rest.
  • Relaxation is on physical, mental and emotional levels.  There are several summary pages we cover so that they can find and refer to what they need at different points in their labor.

  (To read in more detail about evaluating your labor, click here.)
 
On Motherhood:
  • They are about to embark on one of life’s greatest gifts.
  • It’s called “mother’s instinct” for a reason – it is unexplainable and a mystery how we are all connected, however, if they have any feelings or sense anything as it applies to their baby or their family, go with it – they are invariably proven to be the right decisions to make.
  • They are not alone – reach out for help if they are feeling overwhelmed, tired or just need another adult to talk to when Coach goes back to work and they are home alone with baby.
  • Nursing should not hurt, and it is also a learned behavior.  Each breastfeeding relationship is unique with subsequent children.  If they experience any pain, difficulty, or as questions arise, there are several free options from which to find answers: La Leche League, hospital support groups, community support groups.  If they experience any fever or lingering pain, get professional help from a medical care provider: it is best to be told how to find a solution early on, than to let things go and get into a situation where the breastfeeding relationship is compromised.
  • They cannot spoil or hold their baby too much.  It is okay to ignore people who tell you otherwise!  Your baby is designed to be with you and a part of you – they are cute, sweet and cuddly for a reason!  The time in our lives when they need us is so short compared to the time they are independent, so savor every moment of their infancy and hold them as much as you want to!
  • The sound of your child's crying makes your heart hurt for a reason – you are supposed to respond to them and meet their needs.  If the basics of wet, hungry and tired are satisfied and they are still crying, there may be other reasons why they cry: lonely, scared, in pain, over-stimulated…all of them good reasons to hold them and reassure them that it is okay and you will find a path together.
 
On Fatherhood:
  • Mom and Baby will continue to be an exclusive unit for a little while longer.  Until Coaches are allowed into the “Inner Circle”, there are many ways to support that MotherBaby unit so that they thrive and succeed: support the mother’s decision to breastfeed by bringing her food and water every time she nurses, hold the baby so she can sleep and build her milk supply and stay rested to avoid postpartum issues, change the baby’s diaper so mom can take care of her personal needs, keep telling her that she is doing a great job and you appreciate everything she is doing to take care of your child.
  • Even if you feel you are outside of the circle, there are special things that only Coaches can do.  You can soothe the baby when mom needs a break.  Coaches have a different energy that babies respond do.  One mom shared a tip they learned in breastfeeding class:  Moms always smell like milk.  If there is fussiness at the breast, Dad can take baby and calm him/her since he doesn’t stimulate their sense of smell for food…and when everyone is in a better place, they can try nursing again.
  • The time will come when you become part of that “Inner Circle”.  Your baby will recognize you and crave your attention – enjoy it!  You can sing to them, read to them, snuggle with them even before you feel completely “in”, and by the time you are “in”, baby will be confident and comfortable with you; the rewards of taking a vested interest in your child are immeasurable.
 
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®.

Energy for Pregnancy and Labor

Posted on January 10, 2012 at 9:37 AM Comments comments (0)

Energy in pregnancy and energy for labor I made the mistake of serving sweet gooey treats for snack in class tonight.  It got really quiet after we did our labor rehearsal – oops.

So what are ways of increasing your energy during pregnancy, or additionally, your labor, if you are feeling low energy?   

Abdominal Breathing 
 We talk about it often in class – deep abdominal breathing is one of the best ways to increase oxygen in your body while still maintaining a deep level of relaxation.   

 Chest breathing wastes a tremendous amount of energy.  
 “Chest breathing is inefficient because the greatest amount of blood flow occurs in the lower lobes of the lungs, areas that have limited air expansion in chest breathers. Rapid, shallow, chest breathing results in less oxygen transfer to the blood and subsequent poor delivery of nutrients to the tissues.”  
  - From http://www.amsa.org/healingthehealer/breathing.cfm  

 Abdominal breathing can also eliminate the vicious circle of the fear-tension-pain cycle.  By relaxing, you can stop the chest breathing that causes tension that causes pain; the pain causes fear; fear causes more chest breathing that winds up until mom and/or baby are showing signs of distress that leads to more intervention.   

Trace Minerals 
 Birth is an athletic event, whether you have a sprint, marathon or something in between.  The more vigorous your labor is, the more important it is to restore your body’s supply of minerals. Exercise and stress, both of which may be present during labor, can drain the body of electrolytes and trace minerals, elements needed to maintain proper fluid balance and recharge energy levels.   

 In addition, energy is passed through the body via electrical charges.  In order to work well, properly functioning electrical cellular communication is essential.  Minerals act as catalysts for the biological processes in the body, including muscle response, the transmission of messages through the nervous system, and the utilization of nutrients in food.  All of these are essential if you want the most efficient labor possible.   

 Strive to find a trace mineral supplement with a flavor you can tolerate.  At the very least look for an electrolyte drink that will help replenish the minerals you need and might be using up through the course of late pregnancy and delivery.   

Take a Nap 
 Whether you are tired during the day when you are pregnant, or feeling exhaustion set in during labor, a nap is a great solution to help mom and dad face their labor with renewed energy and confidence.  A twenty-minute nap is a very effective tool for increasing alertness.  If you can get a 30-60 minute nap it helps with decision-making skills.  Both of those would be beneficial in labor.   

 I wonder what students picture as the length of nap when we encourage them to sleep during their labor. I think most of them must imagine a 2-3 hour nap, think it is impossible and cross it off the list since so few of them have been able to nap in their labor.  We know from experience that sleeping can be incredibly restorative during labor.  If Coach can convince Mom that just twenty minutes will do her well, remind Mom she doesn’t have to hunker down for a long time.  Mom will not miss out on anything by sleeping just twenty minutes; in fact, you can drastically change your outcome by being rested.   

 So turn off the lights, wrap her in a comforting blanket and stroke or talk her to sleep with your soothing voice.  If Mom responds to music, find some relaxation tunes to play for her.  Maybe use an eye mask to block out light – it seems to be easier to fall asleep when it is dark.  

Go for a Walk 
 We encourage all our students to be walking at least twenty minutes per day from the first day of class until the day they have their baby.  Regular physical exercise not only increases stamina, it also helps energize the body.  During the day or during a low-energy point in labor, a walk might be in order.   

 A change in pace or scenery can help restore energy.  I am not talking about constant walking to speed labor, especially if you start with contractions that are more than ten minutes apart.  If your contractions start that far apart, a good meal and rest are in order to conserve energy.   

 My first question to a tired couple is, “Can you get mom to sleep?”  If that doesn’t work, it is possible that a walk around the building or around the block doing abdominal breathing will oxygenate and wake up your body when you need to restore energy.   

Eat protein-rich snacks 
 Click here to read my list of good choices for labor snacks.  They are high in protein and complex carbs.  I try to avoid processed sugars or starches that rapidly convert to sugar – no need to repeat the effects of a quick sugar up and down that we saw in class tonight!   

Drink water 
 If you are thirsty, you are already dehydrated and it’s time to get mom some plain water to get her fluid level back up.  In labor, the body is working in ways that you cannot measure.  Water is crucial to get the hormones that stimulate and regulate labor circulating effectively throughout the body.   

 Early signs of dehydration include thirst, loss of appetite, dry mouth and head rushes.  If Mom has a desire to eat, she needs to be eating to store energy for the point in labor when she is no longer hungry.  If this suppressed due to dehydration, she will miss out on her opportunity to store energy.  Head rushes can lead to an untimely fall, which could potentially change the course of your labor depending on the severity of the fall.   

 Continued dehydration can lead to increased heart rate, increased temperature, fatigue and headaches…which could also be construed as the mother going into distress.  You can absolutely head off a false distress warning in labor by making sure Mom is drinking eight ounces of water per hour, or chewing on ice if that is what she prefers.  If Mom is hydrated and this happens, then you know it’s time to pay attention and alert your care provider.   

 A side note on hydration: if Coach is good about getting Mom the necessary water, Coach also needs to be good about getting her to the bathroom.  A full bladder can lead to unnecessary pain in labor if the baby’s head is pushing against a full bladder.  It might also impede the progress of labor if the baby’s head is blocked from entering the vaginal canal by a full bladder.   

Figure out what works for you. 
 Conserving energy is extremely important because you don’t know how long you will be in labor.  There isn’t much we can control about labor if you follow the course for a natural birth.  You can influence how rested you feel.  It would be unfortunate to end up with medication, an episiotomy or a cesarean if the only factor for that choice is being too tired to make it through with the energy you needed to meet your baby.   

What are the energy saving or energy restoring methods that you use?  

 Would you like to read more about today’s suggestions?   

 For information on the minerals you need and how your body uses them: 

 Start a Walking Program While you are pregnant, focus on walking for energy and stamina.  After your baby is born you can consider the suggestions on walking for weight loss. 


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 

The Importance of Water

Posted on October 18, 2011 at 11:40 AM Comments comments (1)
We are officially on our babymoon.  Thank you to my fellow Bradley® teacher, Lisa Pearson, AAHCC for contributing today's post that addresses the function of water in pregnancy.

We all know it is important to stay hydrated, especially when we live in the desert.  Why is it so important?  Does it matter what we drink to hydrate our bodies?  What is the best way to hydrate our bodies?  How much do we need to drink in order to properly hydrate our bodies?
 
Ok, let’s start at, “why is it so important?”.  Our bodies are hydroelectric machines that need water in order to function.  Feeling thirsty is actually a LAST DITCH EFFORT for our bodies to get our attention to our severely dehydrated state, it is not the first step. 
 
Our entire bodies are made entirely of cells. Picture cells this way…cells are like little shower heads in reverse.  Meaning they are covered with little perforations that allow moisture in for hydration.  Moisture gets inside the cell and hydrates it, the remaining moisture then coats the outside of the cell to hydrate the outside where it stays sort of like a bubble until needed.  Cells travel throughout our bodies hydrating organs, muscles, etc as they move along their journey allowing our bodies to work at their optimum.
 
Does it matter what we drink to hydrate our bodies? What is the best way to hydrate our bodies? 
These two questions are sort of one in the same.  Yes, what we drink matters very much; which leads us to the best way to hydrate our bodies.  Water is the ONLY way to truly hydrate your body. 
 
Why?  Let’s continue…water is the only moisture that can get inside those little perforations.  Every other liquid just cannot break down small enough to get inside.  When liquid cannot get inside and hydrate the cell from the inside out, the cell starts to dry up and shrivel like a raisin. (This is one of the reasons we get wrinkles!)  Now, it gets more insidious from here…the liquid other than water that we have put into our bodies is sticky and sticks to the outside of the cell.  As it travels throughout the body, it is not a hydrated cell so it cannot feed moisture to the organs like is needed and we start to get dehydrated.  As these cells go through the urinary system and the moisture is now eliminated, the insidiousness starts to get worse.  The sticky liquid is now leaving the cell and takes with it any moisture from the inside, leaving the cell completely dried up.
 
How much do we need to drink in order to properly hydrate our bodies? 
Most of us think of the 6-8 tall glasses of water per day rule, right?  Well this is not true.  Think about it…if Person A weighs 100 pounds and Person B weighs 350 pounds, how can 6-8 glasses of water a day be right for both of them?  How about people who gain or lose large amounts of weight (for example, being pregnant and getting appropriately larger quickly and then giving birth)?  How can the same amount be enough at both our lighter weight moments and our heavier weight moments?  This just makes no sense. 
 
A better rule of thumb is this:  take your weight in pounds, divide by 2, and that is the number of ounces of water you should be drinking every single day.  If you are drinking other liquids, for example, you just cannot live without your morning cup of coffee, you need to increase your water intake accordingly to cover that coffee that is so dehydrating.  Also, if it is very warm or you are exercising and you are perspiring, you will need to add more water to make up for that as well.
 
Now that you have learned all this lets go back a moment to why it is so important.  Remember those little dehydrated cells moving throughout our bodies?  Let’s continue on their insidiousness.   The cells move to our organs in their dehydrated state but they have no moisture to give to our organs to make the organs run smoothly at their optimum levels.  All the cells are dehydrated so what do you think happens next?  Our organs get dehydrated.   When our organs are dehydrated, our bodies start to go into power saver mode kind of like a city doing purposeful brown outs in summer to avoid a complete blackout.  Our bodies start to shut down the least important functions to save the moisture for the most important, the heart and the brain.  Without the heart and brain working properly, the body cannot continue, so other organs that are less important start to power down.  At first they go into a less active mode.  They are still working, still doing their jobs, just not as quickly or as efficiently.  The power down means our bodies are running sluggishly: digestion is not as good, we are tired, toxins are not being flushed out of the body.  The toxins show up on our skin as age spots, etc. 
 
As the drought in our bodies continues, more organs power down.  Eventually the organs begin to completely shut down.  Now we have major problems.  The pancreas stops processing sugar and we become diabetic.  Abnormal cells are not flushed out of our bodies but instead gather together with other abnormal cells somewhere in our bodies.  A cluster of abnormal cells is cancer.  The list goes on, but you start to get the idea. 
 
Does the type of water make a difference? 
Oh yes, very much.  First of all, distilled water is not for drinking, it is for cleaning.  The process that removes all the bad things in the water, also removes all the good things in the water as well.  It does not differentiate.  You cannot use distilled water in a freshwater fish tank, your fish will die.  Distilled water is “dead” water.  Our bodies cannot function with dead water; our bodies need good, healthy water. 
 
Also, make sure you know what is in your water: know how it is processed and where the water comes from.  Most bottled water is just city water put into a bottle for your convenience.  City water is full of chlorine.  “So?”, you ask, and think, “I swim in chlorine.”  That may be true but…a study conducted in 1998 by the California Department of Health issued a warning to pregnant women in regards to drinking water processed with chlorine.  A pregnant woman who drinks water processed with chlorine increases her risk of miscarriage!  Although a 2005 study of the same issue concluded that there might be less of a risk than implied by the 1998 study, a risk still remains.

There is another ingredient that you want to try to avoid in your drinking water: magnesium sulfate.  Magnesium sulfate is used in hospitals to slow labor.  Certainly not a good water to use when you are in labor! 
 
One last thought…water alone does not make the hydroelectric machine function properly.  In order to be used to its fullest potential, water needs salt.  No, you don’t have to salt your water, but you do need to add a little salt into your diet.  If you are concerned about adding salt because of high blood pressure or other reasons, try sea salt.  It is the healthiest salt because the way it is processed leaves all the minerals needed in the salt, whereas iodized salt and kosher salt remove the minerals.  This however, is a whole other blog post conversation.
 
Moral of the story…drink plenty of water and know where it has been before it arrived in your drinking glass!  Now, I am going to go get a refill on my ice water.

For more reading about Chlorine & Tap Water:
Water Quality - 1998 Study

Water Quality - 2002 Report

Water Quality - 2005 Study

Risk of Chlorinated Pools & Pregnancy
 
About the author:
My name is Lisa Pearson and I have been married for 20 years to a wonderful man.  We have 2 children, both girls, ages 16 and 4.  Our first birth was a traumatic one using a different method and the second was a fairy tale birth using the Bradley Method®.  We have been Bradley® teachers for 3 years because of that birth.  I am also a doula and soon to be student midwife; as well as just finishing up with my certificate in holistic nutrition.  We teach in North Phoenix just off the 51 highway.  Our classes are on Thursdays at 5:00 pm and Saturdays at 4:00 pm.  Our next class series will begin on Thursday, December 1, 2011 and Saturday, January 7, 2012.  You can find me on the Bradley® Birth website in the teacher information section, or call me at 602-494-3554 or email me at [email protected]


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


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