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Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

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Healthy Mom, Healthy Baby

Posted on January 27, 2012 at 7:15 PM Comments comments (7)
Bradley Method® Fall 2011 Series Chandler, AZBradley Method® Fall 2011 Series Chandler, AZ





I finally got approval from all the families to post the Healthy Mom, Healthy Baby pictures.  Here is a brief synopsis of their outcomes along with a birth story from one of the moms.
 
All of these are babies from our Fall 2011 Bradley Method® series.  Angelika got to be one of these babies, too!  The families enrolled in our classes with the intention of having natural births.  However, all of them took to heart our entreaty to evaluate all their decision points with the Healthy Mom, Healthy Baby filter.  Most of them deviated from their birth plan, and definitely from what their expectation were…each birth is unique.  The beautiful element of these photographs is that these babies are all healthy, and so are their mammas.
 
I am going to number the babies from left to right.  Baby 1 is our longest labor (so far) for this class.  This family labored for 51 hours!  Mom and Dad labored at home, they went to the hospital and found out they were only 3 centimeters so they followed Berman’s law (go home if your are less than 5 cm dilated and not showing any physical or emotional signs of late labor) and went home.  Mom rested, ate, labored and the couple had the support of a wonderful doula.  They rested that night and labored at home most of the day.  When they went back to the hospital on day 2, mom had not progressed as much as they had hoped but they were past a five so they stayed in the hospital.  When they had marked the 48 hour of labor, they opted to have the bag of waters broken to see if that would speed labor.  Guess what – the on-call doctor did not want to come in to the hospital so he told the nurse to start a Pitocin drip instead.  Mom and Dad evaluated their choices and their wise doula gave them invaluable advice, “Let’s redefine our birth plan and make the adjustment we need to keep the vaginal birth.”  Knowing that mom was exhausted physically, and that she had been dilated to 8 cm with no progress for several hours, the parents evaluated their situation and opted for an epidural so that the strong Pitocin-induced contractions wouldn’t sap what was left of mom’s energy.  Three hours later they welcomed their son via vaginal birth.  He was ready to nurse – Healthy Mom, Healthy Baby.
 
Baby 2 is our Angélika.  Most of the hospital to homebirth stories we heard from families testified to the fact that their home births were significantly faster than their hospital births.  No transfer, no poking, no prodding, no weird or distracting noises.  So here we are, going into our home birth so excited that we are not going to have to move to the hospital since that had always stalled our labor in the past.  Labor starts and it is a completely different pattern than we have ever had before…the water broke at the midway point instead of at the beginning, walking slowed or stopped labor and laying on my side made things move along.  By the middle of day 2, I gave up on having the faster homebirth and resigned myself to be the mom that went to sleep and woke up ready to push.  You can read the long version here, suffice it to say Angélika was born about five hours after I surrendered and went to bed!
 
Baby number 3 was born to an experienced birth mom.  She has two older boys and this was her third child, dad’s first.  She made the decision to switch care providers at 39 weeks!  Although she had been with her OB for several years and had even followed her when she went into independent practice, she started to get red flags in her third trimester.  They couldn’t agree on her birth plan; and then the doctor wanted to strip her membranes a week before her estimated due date.  Mom made the decision to switch providers and moved to an OB recommended by another classmate that still allowed them to deliver at the same hospital.  Guess what?  This baby was ten days past his due date!  Had mom stayed with her first OB, who knows when he would have been born?  By changing providers, baby was allowed the time he needed to start labor.  This couple opted for a cesarean section to ensure a Healthy Mom, Healthy Baby outcome.  Two factors led to their decision: three hours of pushing with no change in station, plus amniotic fluid that was stained with meconium. “Trust birth” as the saying goes…this young man was born with his cord wrapped not once or twice, but several times around his neck.
 
Baby 4 was an average length labor with a painful complication.  As labor progressed, she had a ring of pain that radiated from her uterus down to her upper thighs.  The lower baby dropped and engaged in the pelvis, the more sensation mom lost in her legs!  This mom and dad endured 18 hours of posterior labor – I award them the title of “Rock Stars” for staying drug-free for so long. It is truly a testament to her commitment and his coaching.  Her midwives recommended an epidural since she was not dilating past an eight.  Their baby was born an hour later!
 
Baby 5 was born to another multipara.  This mom was induced with her first baby…and she wrote her story out to share with you:
 
"Our birth choices were all made with a Healthy Mom, Healthy Baby outcome in mind.  Our first big decision was choosing a care provider we were comfortable with.  We ended up with a wonderful group of midwives who totally supported our birth preferences and were obviously in favor of our choice to have a natural birth.  We had started with a group of midwives in Brooklyn, then went to an OB in Phoenix for a couple of months while we waited for our AZ insurance to kick in.  This OB was definitely NOT on the same page as we were (he wanted to induce before the new year so we could get a tax break...) so we switched as soon as possible.
 
When it came to our labor, we chose to hire a doula and labor at home as long as we could so we could avoid any potential pressure from the hospital for interventions.  As it turned out, my labor was so short that was pretty easy to do!  When we got to the hospital I was already 9 cm, so it was a matter of a little time, then onto pushing, and within the hour Amelia was born.  We chose to skip the Hep B vaccine in the hospital, and waived the vitamin K and eye ointment.  We know my STD status, so we knew she was at no risk, and we wanted her to be able to see the world as best she could with her newborn eyes!  As far as the Vitamin K shot was concerned, we did some research and decided it wasn’t necessary unless she experienced trauma at birth, which she didn’t.  We also chose not to bathe her so the vernix could do its job and she wouldn’t experience crazy changes in her body temperature.  We have yet to bathe her, and won’t for a while longer.  
 
We also decided to encapsulate my placenta this time around.  It was an option presented by our Bradley® instructors, and we were encouraged to do so by our midwife and our doula.  We went home from the hospital the day after our birth because Amelia and I were both doing well.  I wanted to see my 3 year old, and felt like I would be happier resting and enjoying my family in our own home.  
 
It was a different experience from our first birth.  I felt like we were much more informed and able to make more decisions that were Healthy Mom, Healthy Baby outcome-minded.  That said, I was induced with my first because of high blood pressure, and while it wasn’t my ideal birth plan, it was a Healthy Mom, Healthy Baby based decision.  I also got an epidural after nearly 12 hours of a Pitocin induced labor, and I was able to progress quickly after that and go on to have a vaginal delivery.  I truly believe that I would have been too exhausted to push had I not gotten the epidural, so again, I don’t regret that decision.  An epidural was much more favorable to me than a C section!  We did have a doula with our first as well, and she was instrumental in keeping us calm and grounded through uncharted territories!  
 
With our firstborn Max, though, we hadn’t researched the vitamin K shot or the eye ointment, so we did both of those.  We also were not informed about the benefits of placenta encapsulation, so it wasn’t even on our radar the first time around.  I stayed in the hospital with Max for two nights, and felt like I needed that amount of time!
 
I definitely liked working with midwives the second time around rather than an OBGYN like we did with Max.  I liked my OB with Max, but I was definitely more comfortable with the midwives and felt like we saw eye to eye on our birth choices.  If we do have another, we will probably consider a home birth since Amelia’s birth was so fast and relatively easy.  That will be a whole new territory to explore, but we’re definitely interested!"
 
I hope these stories demonstrate the importance of a care provider you trust and have a rapport with, as well as the importance of making the choices to have a Healthy Mom, Healthy Baby outcome.  Happy New Year to all these babies and their families – ours has been wonderful so far.  Angélika started laughing today – pure joy!
 
Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 
We are now enrolling for our Spring 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 [email protected]
 

Positive Communication

Posted on January 24, 2012 at 6:08 PM Comments comments (2)
Communicating with your Care Provider  

Tonight’s class was about Variations & Complications of Labor.  The Bradley Method® believes in teaching this topic so that parents are prepared for the outside possibility of a variation of labor.  We strive to introduce these in an informative way while leaving out the flashing sirens of fear and doubt.  

In previous posts, I have written about choosing your care provider and your rights as a patient consumer of health care in a hospital setting; both will affect your outcome when faced with critical decisions during the birth process.  Bruss suggested I write about communication since it’s tied to making a good decision if you face decision points in your pregnancy and/or labor.  So let’s expand on a related topic: talking to your care provider so you can assess the recommendations they are making at any point in your pregnancy or labor.  

There are many variations in labor.  Some women will labor quickly, others slowly.  Some women dilate continuously, other women dilate a centimeter or two every few hours, some women might even experience what is termed “reverse dilation”.  Women manage the pain of labor differently – some moan, some chant, some scream.  Some women have the water break early, other women have the water break as they are pushing, and rarely babies are born “en-caul”, having their bag of waters intact and then it’s broken after delivery.  

Possible complications in labor are things like placental abruption, uterine rupture, a baby in a transverse position, a baby in fetal distress that has been determined by having the doctor listen with a Doppler or fetoscope…we aim to cover the things that are true medical complications when a cesarean is medically indicated.  

I like Henci Goer’s definition of informed consent.  It means that any time an intervention is suggested, you have the legal right to know what is being recommended, and that it must be conveyed in a language that you understand.  You must also know why it’s being recommended, the potential problems and side effects, alternatives to handling the problem, the pros and cons of the alternatives, including doing nothing.  (See page 105 of Thinking Woman’s Guide To A Better Birth)  

Your frame of mind going into these situations needs to be focused on a Healthy Mom, Healthy Baby outcome.  The person in front of you is not the enemy – they are a person who is trained and is trying to do their job.  If there perception of a situation is different than yours, then it’s vital to clarify where you are in labor.  The most important questions to ask when you are faced with a “fork in the road” as Bruss calls them, are, “Is Mom okay? Is Baby okay? How much time do we have?”  

We tell our students to gauge the amount of time not only by words, but by actions.  If you have time, you will only see the nurse and maybe your main care provider, or the student midwife and maybe the main midwife in a homebirth.  If you are facing an emergency, there is markedly more activity.  There are teams of people monitoring both mom and baby, as well as maybe getting ready to move them.  

One of the reasons it is so important to take care when choosing your care providers and birth facilities is that sometimes there isn’t time to ask all these questions.  If Mother and Baby are already compromised and there is no time to ask questions, you must trust that the care providers and the birthplace will do the best for your family.  Do you have this level of trust with your care provider?  Do you have this level or trust with the birthplace?  If you answered “no” to either of these questions, it’s time to seriously consider making a change.  Although true complications are rare, if you are part of the small percentage, you want to ensure that you have the best chance for a good outcome despite any complications that may arise.  

I am going to pull from my post on Patient Rights for the rest of the conversation you can have with your care team once you establish there is time to talk and consider your options:  

If both are well enough and there is time, then you can continue with questions such as:
 - “What is the problem?”
 - “What are the symptoms or test results causing concern?”
 - “Could this be normal?”
 - “What is the most likely cause?  Are there any other possible causes?”  

If the care provider agrees that Mother and Baby are well enough to let labor proceed and let nature take her course, continue to trust that Mother and Baby are working together and that you will be meeting your baby in due course.  You can address other probable causes – is mom hydrated?  Is she emotionally ready and relaxed enough to accept her labor?  Are you using the best positions in the appropriate stage of labor to allow gravity and physiology to move things along?  

If after asking this series of questions Mother and Coach decide that further action is worth exploring, then you can continue with these questions:

“What exactly are you recommending?” – Paraphrase it back to ensure you understand what the recommendation is. 

“What are the benefits of this procedure or drug?”  - You want to listen well, and paraphrase again.  You can also ask if their opinion is based on fact or observation.  

“What are the risks and known side effects of this procedure or drug?” – Ask to see the insert if it is a drug and there is time to read it – you may be surprised at what is in the fine print and the care provider fails to mention. 

“Is this an established procedure (or drug) or is it being offered as part of a trial?” – This is very important to know, especially if it is something whose short-term or long-term effects on an unborn child or a newborn are unknown.  

“What are alternatives to this procedure or drug?” – Again, care providers have routines based on what their protocol is – sometimes there are other options that they don’t mention, not from malice, it could be simply because they are not accustomed to being asked for alternatives. 

“What are your qualifications for making this recommendation?” – Who are you talking to?  Student midwife or Professional Licensed Midwife?  Nurses come in many varieties: a student nurse, an LPN (one year of schooling), an ASN nurse (two years of schooling), a BSN (four years of schooling).  Beyond that, how long have they been working as a nurse?  If you are talking to a doctor: are they a resident (student) doctor, or an attending (more experienced) physician?  How long have they been a resident or an attending?  

“Who would be performing this procedure?” – This is an especially important question to ask if you are in a teaching hospital or at home with the professional + student midwife.  Every family needs to make a decision regarding their comfort level with students literally practicing on you based on their individual preferences.  On a personal note, while I am all for students learning, when it come to my body and our child, I want a trained and experienced professional to work on us.  I am okay if a student wants to observe, however, only someone with extensive experience and knowledge is going “to do” something or administer something to us.  

“What else can we expect to happen, or which other interventions typically follow as a result of this drug or procedure?” – In the interest of full disclosure, this is a very important question.  1.) You want to know how they will measure the efficacy of the intervention.  2.) When you accept one intervention, it is likely that other interventions or compromises will follow.  If there is time, you want to hear all of the other interventions or protocol they will have to follow that may be a result of the first intervention you agree to have.  

“What happens if we choose to do nothing at this time?” – Back to full disclosure – there are ways to phrase things that force you to make an immediate decision.  If you ask this question, it tells you the other side of the story, or the whole story in regards to their recommendations.   

You have a couple of options in the event that you want to choose differently than your care providers are recommending and/or if you feel like your concerns are not being heard by your care provider. 
1.  If you have done your research and you have heard the benefits and the risks of a procedure or drug, and you are confident in your decision and want to refuse, hospitals have documents called “Against Medical Advice” that you can sign.  You accept the risks inherent in your decision and relieve the hospital of liability.  I have no idea if midwives have a  similar document…I will have to ask!
2.  In the hospital setting, you can ask for an Independent Patient Advocate.  This person acts as a liaison between the patient and the care providers.  It puts someone in between you and the care provider, and it is implied that they would convey information in a neutral way.  Sometimes taking away the “authority” of the person conveying the information relieves the pressure and lets a patient make a decision without feeling the pressure of “The Doctor” or “The Nurse”.  

Whether you are experiencing a variation of labor or a true complication, effective communication with your birth partner, with your doula, with your midwife, with the nurses and doctors will directly affect your outcome.  If you are knowledgeable about what normal variations of labor are, then you can have conversations about your care to determine the best positive outcome for your situation.  If you are not confident or trained in what to expect during the labor process, you may wish you had known a little more.   

Do you have any communication tips to share?  What are they?

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


We are now enrolling for our
Spring Series
March 5, 2012 to
May 21, 2012  

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

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 

Preparation for a Positive Postpartum

Posted on November 15, 2011 at 12:19 PM Comments comments (0)
Baby arrives - now what?  We all spend time planning and preparing the nursery and for the birth-day - and we may forget that there life after the big day, and that your new normal is going to include caring for a newborn child.
 
What can you do to prepare for the best postpartum possible?  The mom who can rest and feels capable in feeding and caring for her baby is less likely to experience postpartum depression.  Avoiding birth trauma, mental anguish and physical distress are factors that lead to a more positive postpartum experience. 
 
Today’s post will talk about the things you can do during labor, birth and breastfeeding to set yourself up for a positive mental and physical experience.  On Friday I will share some practical tips for making the transition to life after baby a little smoother.
 
1.  Have a birth experience that you are happy with.
     The start to a healthy postpartum period is to have a birth experience you feel good about.  Positive mental health is always a plus!  Begin by choosing a care provider and a birth setting that support the birth you and your coach want for your baby.  If you cannot physically, mentally and/or emotionally relax in your birthplace, you will end up with more interventions and a less than optimal birth experience.     
     You may also need to be flexible.  In each of our three hospital births, we prepared for natural, intervention-free births.  Each birth, we reached times when we had to deviate from our birth plan.  Although our births weren’t “perfect”, we felt proud of our births because we made choices together, and we felt confident about the decisions we made along the path of labor.  The teamwork we learned and the information we gained as students of The Bradley Method® helped us to achieve what we wanted: epidural-free births for our children.
 
2.  Do your best to avoid pain medication during labor.
     Did you know that a laboring woman produces 40 times the endorphins found in a non-laboring person, and that these endorphins help you cope with the sensations of labor?  The surge of endorphins makes the sensations of labor manageable with the support of a loving coach.  They also help you fall in love and bond with your baby (and your Coach) when the work of labor is over.  It is a bona-fide love fest!     
     Further, did you know that those endorphins are not produced when pain medication inhibits the pain-response cycle?  This can cause a harder recovery if or when the epidural wears off: the discomfort would seem much more intense without the endorphins to help you enjoy your accomplishment.
      Avoiding pain medication also ensures that the natural processes remain as intact as possible: you and your baby work together during and after labor.  Your pain-medication free baby is a more responsive baby.  You can tune-in to your baby and your body and use this knowledge for adjusting labor positions.  Effective use of labor positions might speed up your labor.  At the very least, you can ensure that you are doing what your baby needs you to do so that they arrive safely into the world. 
     The biofeedback mechanism built into immediate nursing can also help you avoid the Pitocin (a labor augmentation drug) that is standard procedure after labor to shrink the uterus.  A pain-medication free baby will nurse readily, helping your body to expel the placenta by continuing to stimulate the production of oxytocin to contract and shrink the uterus.  We were always able to negotiate to “wait and see” if the Pitocin bolus needed to be administered after the baby was born.  Since all of our babies nursed readily, it was never necessary – one more area in which we were able to safely say “no thanks”.
     Speaking of Pitocin…this is purely anecdotal:  we had two labors augmented by Pitocin when we “failed to progress”, and two labors without it.  The postpartum emotional rollercoaster was much more pronounced when Pitocin was used during labor – more tears, depression and moments of anger.  We had much calmer and happier postpartum periods when Pitocin didn’t mix into our birth story. 
 
3.  Prepare ahead of time to avoid an episiotomy or tearing.
     All pregnant moms reach the point when it hits you – this baby is coming out, one way or another.  Even with our fourth baby, I had this “oh my…” moment.  The good news is that babies know where they need to get out – and the majority of them don’t grow larger than the vessel they grow in can handle.
     Good nutrition with plenty of Vitamin C and healthy fats and oils will help your muscles to stay healthy and flexible.  Your perineum is a muscle – and it follows that a healthy and flexible perineum can stretch around the head that has to pass through it. 
     You can also practice perineal massage – ask your care provider what they suggest.  Some encourage you to practice stretching the perineum as you approach your estimated due date, some will have you do nothing since they massage your perineum as the baby is crowning to ease the passage of the head.  Some care providers will want you to practice and they will do a perineal massage during the pushing phase.  The point is that between good nutrition and perineal massage, you can avoid tearing or an episiotomy altogether.
 
4.  Breathe your baby out.
     Another way to avoid tearing or an episiotomy is to tune-in during the pushing phase of labor.  Wait until you have an undeniable urge to push to start pushing.  If you are asked to push and you could take it or leave it, you are not ready to push.  You are only wasting your energy and possibly stressing out your baby and your body.  Believe me when I say you will know – the only thing you will want to focus on is getting the baby out of your body!
     Your contractions tend to space out in frequency again during the pushing phase.  Use this time to recover your energy by practicing relaxation and doing your deep abdominal breathing. 
~ When it is time to push, push only to the point of comfort.  Ease your baby out and the skin stretches comfortably; if you push too hard or too fast, you can tear from the extra stress on the skin. 
~ Do not hold your breath any prescribed amount.  Hold it only as long as your body wants to – the last thing you want to do is deprive your baby of oxygen when they are already constricted by the tight squeeze.
 
5.  There is pain after labor is over and you are holding your baby.
The three major sources of pain are contractions (!), the perineal area, and breasts.  Side note: If you have a fever after labor, it's time to call your doctor.  Do not ignore any redness or swelling or pain that is accompanied by a fever.  Dizziness and fainting are also indicators of something more serious.  This is not the time to "tough it out".  If you end up in the hospital it will compromise your ability to take care of your baby and breastfeed.
 
CONTRACTIONS
     This was the most surprising to me.  I wasn’t told that you keep experiencing uncomfortable contractions every time you nurse, and well after labor is over.  The discomfort during nursing lasted anywhere from 3 to 7 days in my experience.  Since your body makes oxytocin every time you nurse, you will feel the contractions until your uterus has shrunk down to its approximate pre-pregnancy size.  They are the most uncomfortable in the two days after labor; they get less and less noticeable with time.  You can use a heating pad to dissipate the pain during and after nursing.  My placenta pills helped ease the discomfort my last postpartum period – they made a big difference.
 
PERINEAL AREA
     If you have an episiotomy, it may feel like the pain is worse than labor because it is hurting, “ouchy” pain that persists, versus the productive pain that helps you meet your baby and then stops.  Between the trauma of the cut and the stitching for repair, the skin swells and the receptor nerves are screaming at you.  It is likely you will want to take something to ease the pain. 
     A tear that needs to be repaired with stitches may also be uncomfortable.  There is a direct relationship between the number of stitches you need and the amount of pain you feel.
     I never saw the sense in having a pain-med free birth only to introduce drugs when the baby was nursing.  There are things you can do to cope with the pain and keep from introducing drugs to the baby through your breast milk.
~ Use cold compress on your perineum to numb the pain: you can make one by cutting open a newborn diaper and stuffing it with ice, or you can buy perineal compresses.
~ Use healing herbs in the peri-bottle: Did you know that even without a tear, wiping after you use the toilet is a no?  A peri-bottle is used to rinse the vaginal area after eliminating when you have a vaginal birth.  We learned about the herbs from our midwives.  Considering that hospital births tend to be more traumatic on the perineum, it’s hard to believe that our homebirth was the first time we used them.  Again, BIG difference in recovery time – I felt better within 24 hours!
~ Do a sitz bath: You can sit on an inflatable donut pillow in the bathtub, or you can use a basin designed to sit in your toilet.  Salty, warm water helps to heal the perineal area and the warmth will feel good, too.
 
BREASTS
     There is a learning curve in each breastfeeding relationship.  The biggest one is probably going to happen with your first breastfed baby.  Your nipples have to be “broken in” with the first baby – it takes a little time.  And although there is discomfort as your breasts swell (engorge) when your milk comes in, nursing should not hurt.  Many breastfeeding stories include pain, and although pain is common, it is not normal.  If you are having pain when your baby latches on, when baby is nursing, or both, get help!  La Leche League leaders, a certified breastfeeding counselor, or an IBCLC certified lactation consultant can help you identify the issue(s) and teach you how to nurse comfortably. 
     The first three weeks after birth are critical in establishing your milk supply, and effectively, the rest of your breastfeeding relationship.  If you get off to a good start, you and your baby can have a nursing relationship until you have a mutual weaning.  If you have a less favorable start, you will affect your milk supply, which then dictates the length of the breastfeeding relationship and possibly include the use of formula.
     You get what you pay for when it comes to help – LLL is knowledgeable, albeit free, peer-to-peer help.  A certified breastfeeding counselor has taken at least one professional class to receive their certification.  An IBCLC lactation consultant has the most professional training and experience from which to draw. 
     Spend the money you need spend in order to have the breastfeeding relationship you want. Some things, such as latching, are easily remedied with the help of a LLL leader.  Other things require professional help.  Among all the things on which you can spend money during the postpartum period, getting help in order to give your baby the best food possible falls high on many priority lists.
 
Preparing yourself before your baby arrives with knowledge, good nutrition, and exercise for strength and stamina will help you have fewer interventions during labor and hopefully avoid birth trauma.  A positive birth experience, being well rested and feeling competent in feeding baby is part of the equation for a happy new mother.  Check in again on Friday to read helpful tips about transitioning from pregnancy to new family.

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 still enrolling for our Winter Series
December 5, 2011 to
February 20, 2012  

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

Touring Your BIrthplace

Posted on September 20, 2011 at 11:07 AM Comments comments (0)
Typical hospital roomBirthing suite at a birth centerBedroom with all the comforts of your familiar environment








As part of our Bradley Method® class, we encourage all of our students to take a tour of their birthplace.  In the event that a couple is planning a birth center or home birth, we encourage them to tour the hospital that their care provider would transport to “just-in-case”. 
 
There are many reasons why taking a hospital tour are important:

1.  You know how to get there and can plan alternate routes in the event of traffic.
If your care provider offers you a choice of hospitals, then this could be a deciding factor in which facility you choose.  It is also important to plan a couple of alternate routes to your birthplace in the event of road closures or traffic jams.
 
2.  You get to a chance to familiarize yourself with your birth setting.
It is good to know information such as: where you can drop off mom, where you can park, where registration is, where triage and the labor & delivery rooms are, where can you receive visitors, where can you find food and beverages, what happens if you arrive “after hours” and you need to use a different entrance.
 
3.  You can prepare for the hospital or birth center experience.
Once you have answers to the items in #2, you can better plan for your trip.  If you hare having a planned hospital or birth center experience, once you know what’s available, you can write a better packing list.  If you are planning a home birth, you can have an idea of what to expect in the event of a transport.
 
4.  You can fill out pre-registration forms and save time on baby’s “birth-day”.
Anything you can do to save time and have Coach stay with Mom is a benefit to your birth experience.
 
5.  You get to hear “the rules” from one of the staff members.
This is your opportunity to ask all the questions you have about your birth setting.  The more medical the setting, the more “rules” you can expect them to have in place.  If there is anything that causes you concern, be sure and discuss it with your care provider.
 
6.  Knowing “the rules” can help you write a better birth plan.
If you and your care provider have agreed on one thing, and your birthplace is telling you something different, you will probably want reconcile the difference(s) before you go into labor.  We have found that having our care provider sign off on our birth plan increased the likelihood that the things we wanted were respected during our labor.
 
I want to share two of our student’s insights as this topic came up throughout the class.  One of our first time moms’s shared an “a-ha” moment they had on their hospital tour.  Their impression of their chosen hospital is that it is very natural-birth friendly.  Their tour guide told them the hospital welcomes doulas, that laboring moms are free to move about, enjoy the labor garden, try different positions…their first impression was that they can do whatever they need to have a positive birth experience. 
 
This mom was stunned to hear that if a couple decides to have an epidural, all those options are thrown out.  As someone who has been around natural birth for a while and since I have seen moms on epidurals, I forget that this is a news flash to most first-time moms.  Once a woman decides to have an epidural, she is now officially on the “medical track” and the bed in her room is the only option she has.  Why?? You cannot target a medicine to only one part of the body.  Because you are being administered an analgesic, it doesn’t just suppress pain.  It also has the potential to affect your and/or your baby's heart rate, blood pressure and your breathing among other things – it all depends on the reaction(s) to the “cocktail” you are administered. 
 
Given the fact that the drugs can have an adverse effect on the mother and/or the baby, once you have been administered the epidural you and baby must be continuously monitored so you will have two monitors (one for mom, one for baby) strapped to your abdomen and connected to the machine.  The tube delivering the medication is inserted in your back, and it’s taped all the way up to your shoulder.  You will have a continuous IV drip, so there is a needle and a tube to the IV.  You will have a blood pressure cuff.  They put a pulse oximeter on one of your fingers.  As you can imagine, you are not allowed to get off the bed – there is no way to maneuver or try different standing or moving positions with so many tubes and wires.  Since you can’t get to the bathroom, you are catheterized.  In the event that you had been eating and drinking freely before the epidural, you will probably be restricted to ice chips for the duration of your labor.  Hence, all the “butterflies and flowers” you have written down on your birth wish list are exchanged for the hard and fast rules that accompany the medical delivery of your baby.
 
The second insight that was shared came from one of our moms that has already had two hospital births.  She suggested that taking the hospital tour is a good way to gauge how comfortable you really are in a hospital setting.  I think her point was that if you have any issues with being in the hospital, they have the potential to be amplified when you are dealing with the “what ifs” or the unknowns of your birth experience.
 
Take the time to evaluate: Do you have any triggers that might send you into a negative spiral when you get to the hospital?  Negative past experiences, bad memories, maybe the smell.  Does anything send you over the edge when you go to a hospital?
 
If you discover that the idea of being in a hospital is challenging, then you need to think about your options.  Can you do some mental preparation; maybe write some affirmations that will help you better manage your hospital experience?  Are you practicing your relaxation diligently so that you will be able to relax in spite of your setting?  Are you and your Coach willing to look at other alternatives, maybe consider a birth center or a home birth?  If you choose an alternate birthplace, how will you cope in the event of a transport?
 
Bruss has a saying, “You will be the birth experience you bring with you” to your birthplace.  So far, we have had three positive hospital experiences because we prepared our birth plan with our care provider, we were comfortable with the hospitals we went to, and we communicated our desires well as a team to the staff during our labor and delivery.
 
Which questions did you ask and find helpful when you toured your birthplace?
 
 
 
 
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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