Sweet Pea Births

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Waiting For Baby

Posted on May 27, 2016 at 8:54 AM Comments comments (93)
 Originally posted Fall 2011 - sharing today since some of our Spring 2016 mamas are starting to approach their EDD's)

So your estimated due date is approaching...or maybe it has passed.  Those little ones we are carrying are happily ensconced in their warm, loving homes.  To us “carriers”, it feels like we have been pregnant forever!!

I remember that feeling very well.  We have always had the good fortune of having our babies before our due date.  I am mentally preparing for this baby to be the one that teaches us how to wait...and since we are not planning to have any more children after this, reminding myself to treasure every moment of the pregnancy...I’ll get back to you on that after our baby is born. (Our youngest was born at 38 weeks - got lucky again!)

As a reminder, if you are a first-time mom, there was a Harvard study published in the June 1990 edition of the medical journal Obstetrics & Gynecology that demonstrated that we are probably not allowing enough time when estimating due dates (read more).  We give a copy of this article to our students on the first evening of class.  It is a retrospective evaluation of pregnancies between April 1, 1983 and March 31, 1984.

The conclusion of that study was that the median estimated due date for primiparas (first-time mothers) should be 8 days later than Naegele’s rule (the 40 week date used to estimate due dates - it’s been around since 1830), and that multiparas should have an estimated due date that was 3 days later than Naegele’s rule.  Per their study, if you are 41 weeks as a first-time mother, your baby might just be arriving to the point when he or she is ready to be born.

For some of us, it is hard to be in the last two weeks before your due date, wondering when labor is going to start.  If you are personally tired of being pregnant, it is hard to remember that every day your baby is inside your womb is a day he or she needs to finish their preparation for “life on the outside”.  Because you are big, hot and uncomfortable, and you are ready to be done!!  I cannot even imagine what it’s like to go past your estimated due date and then have people you know constantly asking, “Is the baby here yet?”  or, “Have you had that baby yet?”  

At that point, you might as well get a t-shirt made that says “Obviously STILL Pregnant”.  If your family and friends are constantly calling to check on you, you could screen your calls.  Change your phone message to say “Still pregnant - don’t call me, I’ll call you!  Leave me a message if you are calling about something else.”

All kidding aside, here are some ideas that have been shared on our Facebook page that I hope will help you pass the time as you wait for your baby to arrive safely into your loving arms.

From a Series 2 Coach:
“[We] Reviewed Bradley® material, continued to think about our own birth plan and contingencies, continued to exercise (Kegel), and practiced relaxation techniques. Bags packed, gas tank filled, friends/family/support group info programmed into phone, phone charger? We also enjoyed the peaceful time we shared as a couple and thought about our soon to be family of 3. Slept a bunch too. Ahhhhh..... sleep.”

From a reader in Phoenix, AZ:
“My confession: I had gathered supplies to bake birth-day cupcakes during early labor. At about 10 days past ''due date,'' I caved in, baked the cupcakes, and ate them! Our son arrived two days later. Despite our Bradley® training, I was a bit impatient and I definitely learned my lesson!”

From one of our Bradley® teachers:
“The other kids kept me busy. Eating out is always a help.”

From moms in our Series 2 and Series 4:
“Retail therapy!”

I know one of our students from our Spring Series 5 is busy quilting a blanket while she waits for her labor to start - they are already “past due” their estimated due date by seven days.

To piggyback on the advice from our Series 2 Coach, it is vitally important that you keep up with your exercise and relaxation practice.  Exercise is important to keep your stamina and your energy up, as well as keep your circulation going.  Some moms experience swelling in the last weeks of pregnancy.  Doing regular cardiovascular exercise will make sure that things are circulating through your body as needed.  The pregnancy exercises will continue to keep you in good shape for your athletic event, whether you have a “sprint” or a “marathon” birth.  

It has been proven that exercise also produce endorphins.  These “good guys” will be a great asset to you if you are feeling a little cranky about being uncomfortable.  Anything you can do to stay positive will help you have a better labor.

Relaxation practice is another key for coping with an approaching or passing due date.  It helps both mom and coach increase in their confidence to manage their natural labor.  If mom knows that coach knows what they are doing, it will help her achieve deeper relaxation to manage the discomforts of labor.  If coach knows they know what they are doing, they are confident and unwavering in their support.  

Relaxation practice also helps keep mom’s blood pressure lower.  If you go past your due date, your blood pressure will be monitored every visit.  The better your reading, the less likely you are to be pressured to “do a little something to speed things along” or schedule an induction.

I spent the last two weeks of our first pregnancy preparing Puma’s pregnancy scrapbook.  The attention to detail and the loving touches made the time worthwhile.  To date, she is the only one with a real book - that was the last time I have made the time to work on one.  The rest of the kiddos have their items gathered and labeled...one of these days there will be time again.  

If you have older children, I find it’s important to spend one-on-one time with them, too, wherever you are in respect to your due date.  I do have virtual albums made for each of the kiddos - they are a great help as we prepare to welcome our fourth child.  I use our special time to look at their pictures with them, tell them their birth story, and remind them that they were once babies, too.  

The albums show their birth and their first year in our family.  The pictures show them how we took care of them, and we can relate how we will be doing things for the new baby.  You can also remind them that you will always love them despite the fact it will seem like you are spending most your time with the new baby.  It may feel like the baby is going to be a baby forever - showing them the pictures of their quick progression may help demonstrate that this time will pass and soon they will have more of your attention again.  “Banking” some special time with them now may help decrease the jealousy after baby arrives.

I would also suggest making time with your spouse.  Create special date nights for just the two of you, for it will be the last time you are just the two of you, or “the parents of # children.”  This is a time you can spend talking about the plans for your birth, your hopes and dreams for your children, and reminiscing about the days you fell in love.  Although it will feel like there is less “couple time” after your baby is born, I hope that you will be as blessed as we are with the birth.  Inexplicably, we are more and more in love with each other after each birth when it seems like we just couldn’t love each other any more than the overabundance of love we felt already.

Have you documented your pregnancy yet?  Make time to have a belly-cast done, or have some pregnancy pictures taken.  You can share some laughs with the person doing your belly cast.  Find a fun place to take pregnancy photos - maybe a botanical garden, the zoo, a historical building.  Not only will you have a good day trip, but your child will have some great stories to hear some day when you tell them about the pictures.

If you are artistic, you can dedicate some time to writing, painting or drawing.  You can dedicate your art to the new baby, or explore your feelings about your pregnancy through your art.  These pieces will probably become treasured keepsakes to your children.

If you are so inclined, you can also sew, knit, or crochet a blanket or baby clothes.  Older siblings might enjoy having an item of clothing or outfit made out of the same fabric or yarn to show that they are all going to be part of the family now.  Just wear your “STILL Pregnant” t-shirt when you go to the fabric store!  It has been my experience that the ladies at the fabric counter love to chat up pregnant customers.

Best wishes to you if you are near or past your due date.  Please feel free to drop me a line at [email protected] if you would like us to pray for you.
 

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®.

Reference:
Harvard Study: Obstetrics & Gynecology, Vol. 75, No. 6, June 1990, pgs 929-932

Uterine Rupture: Assessing the Risks

Posted on April 26, 2016 at 10:18 AM Comments comments (48)
Uterine Rupture: Assessing the RisksThis was in posted April 2012 - updated April 2016
Uterine rupture is a topic that came up when I was pregnant with Otter that I was not ready to allow into my consciousness until she was safely in our arms.  After enough time had passed and we have proven to ourselves that homebirth can be a safe option when a person is healthy and low risk, I am ready to write about it.   

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

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

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

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

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

So what does the research say?   

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 For the resource list, click here

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

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



Holiday Due Dates

Posted on December 11, 2015 at 3:55 AM Comments comments (47)

You are pregnant over the holidays.

You feel like you are as big as a house, or you are barely showing.

No matter what trimester you are in – you feel it! The holidays are full of pressures…if you are working in or out of the home, you may have goals to meet and/or year-end reports to finish. If you are entertaining, there is shopping to be done and food to be prepared. If you are gifting, there are presents to buy and wrap. This is a lot of "extra" on top of an already full plate.

To that pile, add the fact that you are building another human being, in addition to everything else you are trying to accomplish this season. Here are some ideas I want to share with you to help you keep your sanity.

1.  Work the “Pregnancy Pass” for all that it is worth.
Pregnancy is a very sacred time in a woman’s life. Very few of us take the time to honor it and reflect on it – it really is amazing to have two souls living in one body! It is okay that you are tired, and if you are like me, you have aches and pains that settle in with the tiredness. If you are feeling tired, or have a day when you can’t get past the pregnancy hormones to wear a smile, that’s okay – you are still loved!!

Let this be the year that you say, “No”, to the extra activities, the invitations, maybe even pass the mantle for something you have been hosting on to someone else in your circle. What you and your baby may need more than anything else is rest.

2.  Take time for reflection and relaxation.
Again, these are the “somethings” we forget about in our Go-Go-Go mindset that sets in around the holidays. Even if you only take five deep “belly-breathing” breaths before you get out of bed in the morning, that is extra oxygen for you and the baby to use that day. If you can, allow time for a meditation or deep breathing to relaxing music. I recorded my favorite meditations on my voice recorder, and would play them back when I needed a moment to slow down before I entered the fray of daily life again. Doing a good relaxation practice is good for mama and baby, and for your blood pressure, too! Elevated blood pressure is definitely not a stress you want to add to a pregnancy, in any season.

3.  Bring snacks and stay hydrated.
Our holidays are defined by a constant rush through the days – how about yours? Go here, stop there, move on again. I encourage you to use a gallon water bottle to serve yourself water throughout the day. That way you can keep track if you are drinking enough. (Read THIS post for the ounces/day formula for your body weight, and for ideas to flavor your water for variety.)  I also carried snacks with me, wherever we went, even if we thought we were only going out for a minute. Sometimes, if everyone was doing well after the first stop, we did more, and more.

Some ideas for quick snacks: nut packs (we buy ours from Trader Joe’s), fruit bars, nut-butter+jelly sandwiches, granola, dried fruits, or fresh fruits that travel well. There was always something in the car, or in my purse. Funny, because nowadays that I am not pregnant or breastfeeding an infant nursling, there is no more stash in the car, purse or diaper bag, and the kiddos are still raiding my snack stash spots, and very upset that I no longer travel fully-equipped with food!

"That" Question
Lastly, I want to address that ever-asked question if your due date is around the holidays.  Those lovely people who will ask, “You’re STILL pregnant?”  In my mind, I want to say, “You’re still tactless?”

Seriously, though, it is so hard to hear that, especially if you are close to or past your estimated due date.  You can answer with a smile, and tell them the doctor/midwife guessed wrong again!  Only 4% of babies are born on their estimated due date.  Or you can be sassy – which ever fits your personality best ;)

Happy Holidays to you and yours!! 
Enjoy the sacredness - take care of you and your baby :)

Tips from other mamas:
I will be adding tips to this section as they trickle in from students and readers.

From C.J.: Do everything you would normally do, because a "due date" is relative. I've had 2 holiday babies though (Christmas Day, and New Years Eve). With the first I worked right up till I had her, went with my little sister (7 yo at the time) & cut down the Xmas tree (a week before Xmas), made Xmas dinner, and then had baby around 11pm. Second baby was "due" Xmas day, and came New Year’s Eve. Still went about things as normal, till it was time to call the midwife. Made sure there were sandwiches, cheeses, meats, grapes, and other fruits available to those that came for the birth.

From O.C.: It can be hard because it's such a time for family and also an important time to bond and keep your new little one away from germs. Don't plan too much- Do enlist your husband to help- tell everyone you love them, introduce them to the new member of the family, and then hands off- Don't be too afraid to spend time with your family but do ask them to keep a little distance if they are sick and let them know they'll get lots of snuggle time when the baby is a little bigger and stronger.

From K.R.:  I was due with my 2nd on Dec 21st but also wanted to make sure my 1st (only a year old) would still have a special Christmas time no matter what happened. I made sure I had everything done early just in case...and then just relaxed. Baby #2 came two weeks early on Dec. 9th...and everything was already done.

From F.H.: Lots of rest, it's easy to get caught in the "holiday spirit" I listened to my body and took it easy. Baby came a week early, two days before Christmas.

Do you have tips to share? 
Please leave a comment; it will be moderated and published.

Disclaimer:
The material included on this site is for informational purposes only.
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson 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®.

Redefining Pregnancy and Term Limits

Posted on October 28, 2013 at 12:06 PM Comments comments (46)

Maybe you heard the news last week that ACOG, “redefined ‘term pregnancy’ to improve newborn outcomes and expand efforts to prevent nonmedically indicated deliveries before 39 weeks of gestation.”  
Read the News Release HERE

While many people around me whooped for joy, I am reserving judgment.  I do think it is a move in the right direction to define full term as 39 weeks to prevent an elective cesarean mother from scheduling a cesarean two weeks sooner than the baby is estimated to be ready to live outside the uterus. 

However, I see a lot of challenges.  I suspect that we are going to find that term limits are better saved for politicians, and not healthy mothers and healthy babies.

























While it doesn’t define ‘early term’ as premature, I am going to wonder if, in our liability-driven society; if this won’t mean that any infants born between 37 weeks and 38 weeks, 6 days are going to be under more scrutiny.  I wonder if those parents are going to be pressured to “do” things like we have seen preemie parents of otherwise healthy babies pressured to “do” things that were against their better judgment.

I also wonder if simply renaming the time period between 41 weeks and 41 weeks, 6 days as ‘late term’ is going to be enough.  Will a name change suffice to calm down the fears of malpractice, and allow mamas and babies the time they need to get labor started on their own?

I would like to think that mothers and babies with healthy, low-risk pregnancies will be allowed to be pregnant as long as the Mother is okay and the Baby is okay.  If a family has healthy and low-risk delivery, and a Healthy Mom, Healthy Baby outcome, I can hope that no matter when that baby is born in relation to their estimated due date, that the MotherBaby pair will be left alone to meet, greet and bond without the baby being poked, jabbed, weighed, measured and otherwise.

Here’s to hope – I hope that this will mean better outcomes, evidence-based care and an increase in the number of Healthy Mom, Healthy Baby birth stories.


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®.

Warning Labels: Induction Drugs

Posted on June 7, 2013 at 4:20 PM Comments comments (0)
This is the second post in the series that looks at the small print on the drug information sheet for consumers.  In our first post, we looked at the details of drugs used in epidurals.  Here is the fine print for the drugs used by hospital practitioners to induce labor.  This may be offered for a variety of reasons.  

Whenever a drug or procedure is offered, we encourage our students to look at the benefits and the risks.  There are circumstances where the benefits clearly outweigh the risks.  It is up to each family to individually decide what works best for them and their baby.  In the spirit of informed consent, here is the fine print and FDA Pregnancy Category for Cervadil (Brand Name for a form of Dinoprostone), Dinoprostone, Cytotec (Misoprostol) and Pitocin.


To be clear – we are not anti-care provider or anti-drug.  We are grateful for modern medicine that saves lives in circumstances when Mother Nature needs help.  It exists for a reason, and we are thankful for the opportunity to meet all the Healthy Moms and Healthy Babies when we hold a class reunion.

Please read and consider this information as you prepare for the birth of your baby.  I included the link to find the complete drug label on-line.  As with last week, everything is in direct quotes because the information is pulled from the drug information made available by the Federal Drug Administration (USA).

CERVADIL: Pregnancy Category C
http://www.drugs.com/pro/cervidil.html
Cervidil is contraindicated in:
"- Patients with known hypersensitivity to prostaglandins.
- Patients in whom there is clinical suspicion or definite evidence of fetal distress where delivery is not imminent.
- Patients with unexplained vaginal bleeding during this pregnancy.
- Patients in whom there is evidence or strong suspicion of marked cephalopelvic disproportion.
- Patients in whom oxytocic drugs are contraindicated or when prolonged contraction of the uterus may be detrimental to fetal safety or uterine integrity, such as previous cesarean section or major uterine surgery (see PRECAUTIONS and ADVERSE REACTIONS).
- Patients already receiving intravenous oxytocic drugs.
- Multipara with 6 or more previous term pregnancies."

"Warnings
Women aged 30 years or older, those with complications during pregnancy and those with a gestational age over 40 weeks have been shown to have an increased risk of postpartum disseminated intravascular coagulation. In addition, these factors may further increase the risk associated with labor induction (See ADVERSE REACTIONS, Post-marketing surveillance). Therefore, in these women, use of dinoprostone should be undertaken with caution. Measures should be applied to detect as soon as possible an evolving fibrinolysis in the immediate post-partum period.
The Clinician should be alert that use of dinoprostone may result in inadvertent disruption and subsequent embolization of antigenic tissue causing in rare circumstances the development of Anaphylactoid Syndrome of Pregnancy (Amniotic Fluid Embolism)."

"Precautions
General: Since prostaglandins potentiate the effect of oxytocin, Cervidil must be removed before oxytocin administration is initiated and the patient's uterine activity carefully monitored for uterine hyperstimulation. If uterine hyperstimulation is encountered or if labor commences, the vaginal insert should be removed. Cervidil should also be removed prior to amniotomy.
Cervidil is contraindicated when prolonged contraction of the uterus may be detrimental to fetal safety and uterine integrity. Therefore, Cervidil should not be administered to patients with a history of previous cesarean section or uterine surgery given the potential risk for uterine rupture and associated obstetrical complications, including the need for hysterectomy and the occurrence of fetal or neonatal death.

2. Drug Interactions: Cervidil may augment the activity of oxytocic agents and their concomitant use is not recommended. A dosing interval of at least 30 minutes is recommended for the sequential use of oxytocin following the removal of the dinoprostone vaginal insert. No other drug interactions have been identified."

"Post-marketing surveillance:
Immune System Disorders: Hypersensitivity
Blood and lymphatic system disorders: Disseminated Intravascular Coagulation (See WarningsSection)
Reproductive system: Reports of uterine rupture have been reported in association with use of Cervidil some required a hysterectomy and some resulted in subsequent fetal or neonatal death.
Vascular Disorders: Hypotension
Pregnancy, Puerperium and Perinatal Conditions: Amniotic fluid embolism"
"Contraindications:
Hypersensitivity to dinoprostone, prostaglandins, or any components of the product; patients in whom oxytocic drugs are contraindicated or when prolonged contractions of uterus are considered inappropriate; ruptured membranes; placenta previa; unexplained vaginal bleeding during current pregnancy; when vaginal delivery is not indicated; acute pelvic inflammatory disease; active cardiac, pulmonary, renal, or hepatic disease (suppository only)."

"General advice:
Carefully examine vagina to determine degree of effacement and appropriate length of endocervical catheter to be used for application of gel (10 mm if 50% effaced, 20 mm if no effacement).
Patient should be in dorsal position for administration and remain supine for 15 to 30 min after administration of cervical gel.
Following administration of vaginal suppository, the patient should remain in the supine position for 10 min.
Following administration of the vaginal insert, the patient should remain in a recumbent position for 2 h.
Inserts do not require warming prior to administration.
Suppositories and gel must be brought to room temperature. Do not use external sources of heat (eg, hot water bath, microwave oven) to decrease warming time.
Wait at least 6 to 12 h after administration of gel before using IV oxytocin; a dosing interval of at least 30 min is recommended after removal of insert.
Do not use dinoprostone vaginal suppository for extemporaneous preparation of any other dosage forms or for cervical ripening or other indications in the patient with term pregnancy."

"May augment effect of other oxytocic agents; avoid concomitant use. For the sequential use of oxytocin following dinoprostone cervical gel administration, a dosing interval of 6 to 12 h is recommended. A dosing interval of at least 30 min is recommended for the sequential use of oxytocin following the removal of the dinoprostone vaginal insert."

"Pregnancy Category C. Contraindicated if fetus in utero has reached viability stage except when cervical ripening is indicated."

"Lactation: Undetermined."

"Special Risk Patients
Use with caution in patients with asthma, glaucoma, or raised IOP, hypotension or hypertension, CV or renal or hepatic impairment, anemia, jaundice, diabetes, epilepsy, compromised uterus, infected endocervical lesions, acute vaginitis, in patients with cases of non-vertex or non-singleton presentation, and in patients with a history of previous uterine hypertony.
-Anaphylactoid syndrome of pregnancy Intracervical placement of dinoprostone may result in inadvertent disruption and subsequent embolization of antigenic tissue, and rarely leads to development of anaphylactoid syndrome of pregnancy (amniotic fluid embolism).
- Incomplete pregnancy termination If dinoprostone pregnancy termination is incomplete, take other measures to ensure complete abortion.
- Postpartum disseminated intravascular coagulation An increased risk has been described in patients whose labor was induced by physiologic means. Women who are 30 y and older, those with complications during pregnancy, and those with gestational age more than 40 wk are at risk.
- Pyrexia Transient pyrexia (temperature elevations in excess of 2°F), possibly due to the dinoprostone effect on hypothalamic regulation, was observed in 50% of patients receiving suppositories at the recommended dosage. Temperature returned to normal on discontinuation of therapy.
- Ruptured membranes Exercise caution when administering dinoprostone cervical gel or vaginal insert to patients with ruptured membranes.
- Uterine hyperstimulation Placement of dinoprostone cervical gel into the extra-amniotic space has been associated with uterine hyperstimulation. When using the vaginal insert, if uterine hyperstimulation is encountered or if labor starts, the vaginal insert should be removed."

CYTOTEC/MISOPROSTOL: Pregnancy Category X
http://www.drugs.com/search.php?searchterm=Cytotec
"Generic Name: misoprostol (MYE-soe-PROST-ol) Brand Name: Cytotec Do not take Cytotec to reduce the risk of stomach ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs) if you are pregnant. Cytotec may cause abortion, premature birth, or birth defects if taken during pregnancy. Life-threatening..."
(My note: yes - this is just how it appears - with the ellipsis there)

"Misoprostol has been assigned to pregnancy category X by the FDA. Animal studies have failed to reveal evidence of fetotoxicity and teratogenicity. In studies of women undergoing elective first trimester abortion, the administration of misoprostol 400 mcg for two doses caused increased uterine contractions and bleeding in 41% of cases, and partial or complete expulsion of uterine contents in 11% of cases." 

"Breastfeeding Warnings
Misoprostol is rapidly metabolized in the mother to misoprostol acid which is biologically active and is excreted in human breast milk. There are no published reports of adverse effects of misoprostol in breast-feeding infants of mothers taking misoprostol. The manufacturer recommends that caution should be exercised when misoprostol is administered to a nursing woman."
"What should I discuss with my healthcare provider before receiving Pitocin (oxytocin)?
You should not receive this medication if you have ever had an allergic reaction to oxytocin."

"To make sure oxytocin is safe for you, tell your doctor if you have:
genital herpes;
diabetes;

    • high blood pressure;
    • a heart rhythm disorder;
    • a history of cervical cancer;
    • a history of severe infection in your uterus;
    • a history of difficult labor because you have a small pelvis;
    • if you have ever had surgery on your cervix or uterus (including a prior C-section);
    • if your pregnancy is less than 37 weeks; or
    • if you have had 5 or more pregnancies.’’

"Tell your caregivers at once if you have a serious side effect such as:
fast, slow, or uneven heart rate;
excessive bleeding long after childbirth;
headache, confusion, slurred speech, hallucinations, severe vomiting, severe weakness, muscle cramps, loss of coordination, feeling unsteady, seizure (convulsions), fainting, shallow breathing or breathing that stops; or dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure)."

"Less serious side effects may include:


    • nausea, vomiting;
    • runny nose, sinus pain or irritation;
    • memory problems; or
    • more intense or more frequent contractions (this is an expected effect of oxytocin)."

"For Health Professionals
Hepatic side effects have included neonatal jaundice."
Read more at HERE 

"Genitourinary
Genitourinary side effects have included pelvic hematoma. Excessive doses have produced pelvic fracture, uterine hypertonicity, spasm, tetanic contraction and rupture."

"Hematologic
Hematologic side effects have included postpartum hemorrhage and fatal afibrinogenemia."
Read more HERE 

"General side effects have include low Apgar scores at 5 minutes. Fetal death has been reported."
Read more HERE 


As you can see from the insert information and the pregnancy categories assigned by the FDA, these are not inherently safe just because they are commonly used.  Any parent who is being asked to use these should do so after careful consideration of the risks and the benefits.  You can use this series of questions to help you determine if the benefits outweigh the risks:
  • Is Mom okay?
  • Is Baby okay?
  • What are the benefits of using this drug?
  • What are the risks of using this drug? (You have the right to read the drug insert for yourself in the care facility)
  • What else is going to happen if we say yes? (Additional procedures, time in bed, time being monitored, position for mom, etc.)
  • What are the expected results?  What if we don’t see them? 
  • What are the alternatives if we choose not to do this?
  • What does our intuition tell us?
  • What happens if we choose to do nothing?

Any advice to offer about being induced?
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.

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


10 Good Things

Posted on November 16, 2012 at 10:09 AM Comments comments (3)

I got a desperate text this week from an alumni mom.  A mama in her circle heard these words from her OB, “Nothing good happens after 40 weeks,” as a reason for her to schedule an induction.

All I could think, was, "WOW!" and how grateful I was that our care providers did not have that belief.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
 I want to preface this post by 
clearly stating that this is not medical information, nor am I medical professional.  What follows are consideration and discussion points for a couple who is thoughtfully weighing their options.

Here are two sites that do offer reputable information:
  1. PubMed offers an ABSTRACT of a Harvard Study that questions the current method of establishing due dates.  Their study found that white, low-risk women delivered after their due date.  The median for first time moms (primipara) was found to be 8 days past the estimated due date.  Moms in their 2+ pregnancy (multipara) were 3 days past.
  2. Childbirth Connection offers an evidence-based analysis of the concerns, methods and options available to birthing families when faced with the choice of induction.

As we say in class, your due date is not an expiration date.  So what might be going on with your baby and your body when your due date comes and there is still no sign of labor?  If you are having a healthy, low-risk pregnancy, there could be a variety of things happening that are still within the “range of normal”.  If you believe that your body and your baby have their own timeline, here are some points to ponder as you decide whether or not to have an induction at 40 weeks, or realistically, whenever it is offered in a healthy, low-risk pregnancy.

  • Keep in mind that this list may also apply during labor, when you may be “failing to progress” per the expected dilation measurements.  The Bradley Method® offers the possibility that your body might have a Natural Alignment Plateau while mama and baby make their last adjustments.  This period with no measurable dilation is often followed by an acceleration of labor and the birth – more about that HERE.

#1.  Physical alignment of the baby within the pelvis and in relation to the birth canal.  Babies like to move.  The time before labor starts can be used to encourage baby to get into an optimal position and possibly save you some work whilst in labor.  If you are in labor already, then the proper alignment is even more important for an uncomplicated second stage.

#2.  Softening of the cartilage in the mother’s pelvis.
  It is a moving part that can stretch to allow the passage for the baby inside of you.

#3.  Increasing the flexibility of the ligaments and tendons around the pelvis.
  They can also stretch to help ease baby through the birth canal.

#4.  Cartilage is softening and/or molding of the baby’s head to allow for passage through the birth canal.
  The baby may also be undergoing some adjustments for their passage into the world.

#5.  Colostrum is being made just for your baby.
  The time is being used for the breasts to form all the immunities necessary to protect the baby after they are born.

#6.  Baby may need more contractions to massage and stimulate the baby’s systems on-line. 
In pre-labor, Braxton-Hicks contractions are the “test drive” as mom and baby prepare for labor.  During labor, one of benefits of contractions is to help “wake up” all the baby’s systems in preparation for life outside the womb.

#7.  Lungs are preparing for breath of air by being coated in surfactant.
  Without enough surfactant, the baby cannot breath.  HERE is a study that found a link between lung readiness and stimulating factors for labor to start naturally.

#8.  Psychological changes for the mom.
  Has mom accepted the responsibility and dependence of this new life?  Is she in her safe place for labor to start and/or progress?

#9.  Psychological changes for the baby.
  Has the baby accepted that they will be an independent being outside of their mother’s body?  Do they feel like they are a part of your family?

#10.  Baby is growing.
  This one does not apply so much in labor.  However, Dr. Bradley gives a great reminder in his book, Husband-Coached Childbirth.  He reminds us that baby’s do not know about hard and fast rules.  He uses the analogy of an apple tree.  A few apples are going to ripen early and fall off early.  The majority of the apples will ripen together at the expected time during the harvest.  Finally, there will be several apples that for whatever unknown reason, ripen at the end of the harvest season, the bumper crop.

As in nature, babies arrive in a range.  Remember that the numbers, averages, are a collection of data that is analyzed to arrive at one “easy” number for planning purposes.  There is a real danger of "harvesting our apples" to soon, to the detriment of the baby’s health.  The March of Dimes has focused an entire campaign to discourage elective induction before 39 weeks since there were so many complications from inducing labor before babies were ready.  Get more information HERE

If your ovulation or conception dates are off, you might be inducing a baby to come who is before their gestational 39 weeks.  Then that child has been forced to arrive before they are ready, adding a host of complications to what might have been an uncomplicated process if it had been allowed to happen in nature’s time. 

I will end this post by asking you to consider two things:
  1. Take the time to read the information offered by Childbirth Connection on induction – and read ALL of it.  HERE is that link again.
  2. LISTEN to your care provider, which is why it is so super important to choose a provider you trust implicitly.  They are the expert in pregnancy and labor.  They have prior experience and training that leads them to make the recommendations they are making to you today.  If you know your care provider is using evidence-based practice, then you know that they are asking you to consider actions supported by research and probably not asking you to do something for their convenience.

You have an instinct to help guide you to a Healthy Mom, Healthy Baby outcome.  That is what your care provider wants for you, too.  Whatever your path, making an informed decision and choosing a Healthy Mom, Healthy Baby outcome is a win-win every time.

When was your child(ren) born? 

If you want to have fun and participate in a VERY INFORMAL poll, please put your baby’s gestational arrival dates in the comments section.

Here are our babies:
Puma ~ 39 weeks, 4 days
Night Owl ~ 40 weeks – yes, right on his date!
Charger ~ 38 weeks
Otter ~ 38 weeks


LINK LIST:
Harvard Study Abstract:
  • http://www.ncbi.nlm.nih.gov/pubmed/2342739

Childbirth Connection Induction Pages
  • http://childbirthconnection.org/article.asp?ck=10651

Lung Protein as Labor Signal

  • http://www.utsouthwestern.edu/newsroom/news-releases/year-2004/fetal-lungs-provide-a-signal-initiating-labor-ut-southwestern-researchers-find.html

March of Dimes 39 Weeks Campaign
  • http://www.marchofdimes.com/pregnancy/getready_atleast39weeks.html 

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®. 

In Their Own Words: Hanson Birth Story

Posted on February 13, 2012 at 11:21 PM Comments comments (2)
I am grateful to Jennifer and Devin Hanson for giving me permission to add their birth story to our Birth Story Archive.  Their generosity is premiering our first twin story.  They have an inspiring story that is a testament to faith and belief in your body, your coach and your birth team.
 
Jennifer was also kind enough to share some thoughts about Bradley Method® classes, care providers and life as a momma of twins.  Read our “virtual interview” below the links to her birth story.
 
The story of the Hanson twins begins with a momma of twins who wanted a natural birth and was ready to do whatever it took to avoid an induction.  Although their due date was October 10, 2011, since she was carrying twins, she was told they would be considered term on September 20, 2011.  I have great respect for her midwives at Valley Women for Women who allowed her to go “past due"...twice.
 
What would you do if you were 40 weeks plus four days pregnant?  You may have seen this already…if not, try this if you can…I know I would have a hard time accomplishing this not pregnant!

Momma went into labor naturally two days after their labor dance, and here are links to her birth story. 

Link to Part 1 The story of their twin sons' birth starts with the account of her labor at home and then at the hospital…
"After many months of preparing and learning (using mainly the Bradley Method®), we were able to achieve the natural, unmediated childbirth that we had hoped for. We had a beautiful, peaceful labor and a delivery that can only be described as "dramatic" but one which God's hand of protection was completely involved in every step of the way. We also have to thank our incredible team of nurse-midwifes who took such wonderful care of us during the pregnancy and allowed us to let the twins come when they were ready (which happened to be 6 days past their estimated due date) and encouraged us to still go for a natural birth, even though Isaac was breech until around 38 weeks (when he turned on his own). Truly, I can not say enough positive things about midwife care - personal, encouraging, sensitive, relaxed and fun. I've honestly missed those ladies since we've had the twins - something I would never say about any other health care provider I've ever had. "
 
Link to Part 2 Their birth story continues with the account of her natural delivery despite a trying second stage:
"While my labor was calm and peaceful, with me being completely in-tune with my body and in-control of what was happening to me, the delivery was chaotic and stressful, with me being so distracted that I couldn't even tell when contractions were happening. I felt out-of-control to the point of panic at times. It was not at all what I had envisioned when I pictured the delivery of my sons, however I believe it would have been far worse had our midwife Belinda not stepped in to fight for us amidst the chaos of doctors and hospital politics. (I should mention here that the OB practice we went with offered something called "collaborative care" with twins. We were to be cared for and delivered by midwives, but a doctor would be available should an emergency arise.)"
 
SPB: What did you take away from The Bradley Method® classes that helped you in your birth?
JH: I think what I took away from the Bradley® classes was confidence that what I believed (that my body was designed to birth children) could line up with reality, even in a hospital birth. And that I had the right to advocate for the kind of birth I felt was best for me, my husband and our twins.
 
SPB: What did your husband-coach feel was the most important lesson he learned?
JH: Devin read a number of chapters in Ina May's Guide to Childbirth, which he felt was very helpful. The Bradley® classes reiterated what he had learned from the book. However, I felt going to the classes together helped me feel more confident in him as a coach and helped bring up some good conversations about "How will we handle ______ during the labor/birth/recovery."
 
SPB: Based on your experience, what advice would you give to pregnant women who are looking for a care provider?
JH: I would encourage women to find a midwife or a care provider that has CNMs working for them. We were so encouraged and supported by our midwives. They helped to build our confidence and helped us navigate the "politics" we dealt with because we were expecting twins and wanted a 100% natural birth. Now that the medical bills are rolling in from the hospital, I would also recommend hiring a midwife out-of-pocket and birthing at home or at a birthing center, it is very likely to be cheaper (and less stressful than the hospital!!) This is what we plan to do next time around.
 
SPB: How is life with the twins?
JH: Life with twins is... a lot of work, but also a lot of fun. Weston and Isaac are adorable and I love being their mom. We get lots of attention when we go out, which took some getting used to. But now I've learned to be gracious, patient and polite to all their admirers and can enjoy it when people stop us. What's funny is that when I'm out with just one of the twins I get zero attention and now that feels weird. They are such sweet babies. In fact, as I'm typing this I can hear Weston waking up and laughing/cooing to himself - he is a big time morning person and it brightens my day so much to start the morning with his cooing and smiling. Isaac kinda hates waking up, but once he's awake he showers me with morning smiles too.

Many thanks to the Hanson family for making their inspiring story available to breech mommas, twin mommas and natural birth mommas across the world wide web and for allowing is to link to it.  We wish the Hansons all the best as they continue their journey together as a family.  Weston and Isaac, you are very blessed young men.

To read more of Jennifer's writing, you can visit her blog:

Do you have a birth story you would like to share? 
Please contact me at [email protected] if you would like to share your recollections for our Birth Story Archive.
 
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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In Their Own Words - Chelsey and Bryce

Posted on August 19, 2011 at 5:54 AM Comments comments (337)
We had the pleasure of hosting a class reunion at the beginning of August for the families that we taught in the Spring of 2011.

Here is first installment of one of the birth stories we heard that day.  Chelsey and Bryce share their experience in today’s video segments.

Below you will find an explanation from Chelsey about what they liked about the classes and the class information that they found useful during their labor and delivery.

We were so happy to meet their healthy young man, Brody!  They made the best of their scheduled induction and ended up with the goal we emphasize throughout the class series: Healthy Mom, Healthy Baby.

Our Bradley Method® Class Experience
~ By Chelsey Bloomfield

The Bradley® classes really laid the foundation for a positive birth experience for us!

We started out not knowing the slightest thing about the whole birthing process... In fact I tried to avoid thinking about what would inevitably come so that I wouldn't be scared or freaked out by it. We were looking into getting a doula because I was terrified of the whole doctor and medical aspect of it, and I was scared that I would get pushed into doing something that I REALLY didn't want. I started looking into which birthing classes I wanted to take because I am a very education oriented person and we figured that it would help put some of my fears to rest. When we were comparing prices we realized we could only afford one thing, a doula vs childbirth classes... and when we signed up for the Bradley Method® classes I knew we had made the right choice for us!

The Bradley Method® outlines from the very beginning how to prepare your body for natural childbirth. I loved that the nutrition and exercises were a central aspect of the classes. Other classes merely focus on teaching you breathing techniques or ways to relax during labor, rather than preparing your body and mind for the entire process ahead of you.

I also loved the background information on what is happening to your body throughout pregnancy and the different stages of labor!!! By understanding what to expect, and how the entire process worked; that information really put my mind at ease.  I felt calm and prepared when I was in the hospital because I knew how the natural process worked and everything my body was going through.

During Labor we really used all of the relaxation techniques.  I specifically found massage, deep breathing, and mental relaxation the most helpful.
The abdominal breathing was the most useful because it gave me something else to focus on instead of the pain or pressure, and it really put me in this state of total relaxation that is quintessential for natural labor.

Also during labor, we relied heavily on the things we covered in Class 8 when we discussed variations and complications.  Since we ended up being induced and having other complications due to my high blood pressure, it was nice to have the tools and understanding to make the right decisions for us, so that we could end up with a healthy mom and a healthy baby.

In the end it all turned out well! The Bradley Method® gave us all the tools we needed to be able to communicate and work together as a team to bring our baby into the world.

My notes on Chelsey & Bryce's Birth Story
I want to thank Chelsey & Bryce for agreeing to share their birth story out on the internet.  I was especially touched by her praise of her husband when she talked about how she couldn't have done it without him.  That is the true testament to their teamwork and we are overjoyed when we see a couple bond over such a moving life experience.

A comment about inductions...and I will state, as per the disclaimer below:  I am not a medical professional, this is NOT medical advice.  What follows below is simply my anecdotal observation about inductions after teaching several couples.

As I have written in a previous post, there are many factors that go into determining your estimated due date.  So far, three of our couples have been induced.  Of those three, one ended up in a cesarean birth, while the other two did have a vaginal birth.  In listening to their birth stories, I am starting to think that inductions only progress to a vaginal birth when the body is already SO close to starting labor, that the medical intervention serves to "push" mom into a process that was almost ready to start. 

In reading other internet sources on the subject, it seems that other natural childbirth bloggers and/or websites have come to the same conclusion.  As we teach our students: research, research, research and ask questions when your care provider suggests that you interfere with the natural process.  There are no guarantees that what they are asking you to do will work, so if you do decide to go forward with an intervention or procedure, make sure you do so with true informed consent.  Your care provider is not a "mean" or "evil" person - they want a healthy baby for you, too.  It is understandable that their practice history or medical malpractice insurance may skew their approach, however, give them the benefit of the doubt and work together to have the outcome everyone wants: Healthy Mom, Healthy Baby.

Onto another part of their story, this couple did a couple of things that were key to their mostly-natural labor...First of all, Chelsey slept!  Never underestimate the power of sleep in aiding you to physically, mentally and emotionally navigate your labor.  The first thing she did after they induced her was get a good night's sleep - they didn't pay attention too soon.  Yeah!!

The second thing they did well:  they handled the "failure to progress diagnosis" brilliantly.  As you will hear in part two of the video, Chelsey's cervix held steady at a "4" for most of the time after their induction although her contractions kept increasing in intensity.  Once she passed the "5" mark (cervix is half-way to the point of being open enough to push), she progressed from a "7" to a "10" in less than two hours, and they were happily holding their baby in their arms 25 hours and 44 minutes after their induction started.

I was very impressed with this couple's ability to communicate with each other.  Their knowledge and confidence in the natural process allowed them to progress to their epidural-free birth because they were successful in getting their birth team behind their choices and supportive of minimal interventions and vaginal exams.  They also invited Chelsey's mom to be their assistant coach, and she was able to reassure them that based on her own birth experiences, Chelsey's body was working and that they would be meeting their baby sooner than later despite the staff's concern that Chelsey was not progressing.

Great job, team!!


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®.