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Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

Blog

To Test or Not to Test: 5 Need-To-Know Questions to choose for YOU

Posted on July 23, 2015 at 8:11 PM Comments comments ()

I saw the question come up again in a chat group:

Should I get "X" test? Should I decline "X" medication?

You could also substitute the words 
"procedure" or "intervention" in those phrases.

As childbirth educators, we make every effort to keep our opinion out of the equation whether that question comes up in a live class, or when we see it on message boards and chat groups.  The bottom line is that YOU are the only one that can make decisions about your body and your baby.

As the natural childbirth movement has grown, families are becoming aware that a lot about birth works.  After all, we have survived as a species long before birth became a medical event.  Along with raising awareness of how physiological birth proceeds without any medical intervention in most cases, the birth movement has also encouraged patients to advocate for themselves: question everything. 

To be fair, there are tests for many of the things that used to be devastating to mothers and infants: gestational diabetes, Group B Strep, Rh factor to name a few.  There are newborn screens that can be done so that any genetic diseases can be caught and treated early before they take full effect and harm the child.

The challenge is as it usually is: the blanket treatment, "If it works for one, then it works for all." Which then leads to over-treatment and over-medicalization, and sometimes more complications than if we had left Mother Nature alone to begin with.  As patient advocates, we encourage our students to insist on beineg treated as individuals - we are all unique.

Somehow, somewhere, there is a growing thread that is saying: "Deny Everything".  I find this concerning because despite some negatives, there are some positives to today's birth climate.  So I decided to share the list of questions that I share with our students.  

Ask these questions of your care provider so that you can make an informed decision about personalized care for YOU in your unique situation

1.) Why was this test/intervention/medication/procedure ("TIMP") developed in the first place?

2.) Has this TIMP been effective in affectng the problem it was designed to solve?

3.) What is the treatment plan if I say yes to the TIMP?  What is the treatment plan if I say no to the TIMP?

4.) If something happens in spite of saying yes to the TIMP, will the treatment be any different than if I didn't have the TIMP?

5.) How do my personal lifestyle/career choices affect my chances of needing this TIMP? If I want to decline it, is there anything I can do to improve my chances of not needing it?

There are usually several alternative to consider instead of a flat "no".  We have several Pros/Cons/Alternatives listed in our Info Sheets.  You can find a complete listing to them HERE, or click on the "Info Sheet" category on the left side of this blog.

I wish you all the best for a safe and healthy pregnancy.  Also remember that these 5 questions can also be applied to options for newborn care, postpartum care, and really any care you or your children may need in the future!

Disclaimer: 
Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe material included in this blog is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The 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 in this video and on our blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
 





Q&A with SPB: Healthy Pregnancy How-to

Posted on March 17, 2015 at 4:31 AM Comments comments ()
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
Today's VLOG is all about the things that you *can* control in the very unplannable process of pregnancy, labor, birth and the childbearing year.











LINKS

What can you control?
1. Pay attention to your nutrition
This is just as important for the father as it is for the mother.  A better diet creates higher quality sperm, and a well-nourished mother can feed her growing embryo-fetus-baby as it develops from zygote stage through pregnancy.  A breastfeeding mother is also growing her infant's brain - mindful nutrition is just as important after the Birth-Day.

HERE is the pregnancy nutrition program that we teach in The Bradley Method®.

2. Engage in an exercise program
Your ability to give birth does not hinge on whether or not you are an exercise fanatic before you conceive.  A mother who wants to prepare her belly, back and bottom to give birth can follow a pregnancy-specific exercise program. Even doing a few minutes a day of this low-impact, low-stress program can be a game-changer for mamas and their overall strength as they go into their labor.  


 
What can you influence?
1. Your experience
You have the responsibility to choose the right care provider and the right birth setting for you.  If you have a nagging feeling that persists, or if you see/hear/feel red flags at your prenatal appointments that your provider is not right for you, GO WITH IT.  Believe in yourself and your instinct.  Ask people you respect and who felt supported in their births who they chose and why...and then, maybe take a risk! Go on some interviews to see if maybe you want to make a switch.

2. Relaxation and Pain Coping
We do not know what kind of labor card you are going to draw.  What we do know is that all labors and births can benefit from mindfulness.  Whether you have a natural birth, a cesarean birth, or anything in between, there is a surrender.  There is a point when you will have to dig deep and say YES to the journey that you are on. 

There are many ways to prepare for your journey - HERE is an info sheet that explores the variety of classes available to birthing families.

What is part of the journey?
The rest of your story is entirely up to your baby, your body, and The Fates.  A story is about to unfold - and what a story it will be.  However you birth, that day is one day in the rest of your lives as a family.  Be open to the experience, look for the joys, and also watch for the surprises.  

It is in the unexpected and the trials that growth and transformation happen...a transformation that is necessary as we experience a rite of passage.  Before children, you are you.  After they are in your lives, you are now Mother, Father, or which ever name you choose for yourself.

I wish you a childbearing year that surprises you, grows you, and leads you to discover more about yourself than you knew when you started.



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®.




Birth Story: Marathon Labor

Posted on January 23, 2015 at 9:45 AM Comments comments ()
Christine & BJ Bollier 
Bradley Method© Birth Story

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonOur goal is to prepare families to have a natural birth by teaching a mom and her loving coach to labor together.  The reality is that even with the best preparation, birth is unique, fluid and unpredictable.  Our experience as natural childbirth educators is that even if your birth does not go according to your plan, a comprehensive education like The Bradley Method® will pave the way for you to have your best possible birth with a Healthy Mom, Healthy Baby outcome.
 
This story is a great example of making your wishes known, persevering through a long labor that stalled (The Bradley Method® calls “the stall”, aka “failure to progress”, a “Natural Alignment Plateau” or "NAP"), and making decisions as the labor progressed for a Healthy Mom, Healthy Baby birth experience.  Even with an intervention they did not initially want or anticipate, they were able to have the vaginal, unmedicated birth they had prepared for.
 
One of my favorite quotes from the video is Christine’s statement, “I was tired, but I was never scared, because I knew what to expect.”
 
 Link to video: http://youtu.be/PmlPITHsFio

Here is a quick summary of their labor:  She started with contractions around 15 minutes apart on a Thursday morning.  They went to their doctor’s appointment that afternoon and decided to go home and let their labor progress. On Friday, they were timing contractions throughout the day.  When they got to five minutes apart, they decided to go to the hospital because of the impending blizzard (they live in Payson, AZ).  By the time they were all checked into their room, it was 2:30 am on Saturday.  By Saturday evening at 6:00 pm, they hit a NAP at around 8 cm dilation.  They made the decision to accept an amniotomy (breaking the bag of waters) at 10:00 pm.  Their son was born on Sunday morning at 3:30 am.
 
When the Bollier's time their labor, they call it 36 hours from the contractions that were 6 minute apart  on Friday afternoon to the time when he was born on Sunday morning.  They both stayed awake for the whole of that time, save a few cat naps that happened between contractions when they were both exhausted.  It is good to note that they did sleep on Thursday night when contractions were still in the "putsy-putsy" stage.
 
I am so glad she talks about how she experienced contractions – that’s a big question mark for first-time moms.  Christine says she felt them as rhythmic and internalized them – she says she could have painted you a picture of the contractions.  I love that perspective!
 
HIGHLIGHTS
Birth plan

  • They did their work throughout and after Class 7 when we talk about writing the Birth Plan. 
  • They got great ideas, and then took it to their care provider and asked her, “Is everything realistic on here?”  She went through it line by line and said it was all in-line with what was possible in a hospital setting. 
  • Care provider signed off on plan, put it in file, sent it to hospital to give the staff their a heads up on their desires for their birth. 
  • When it was “go time”, they arrived at hospital with several copies of plan and 3 dozen cookies.
  • Everyone who walked into the room was offered cookies and a birth plan

 
Changing the Plan

  • “Going in, we knew there might be a possibility that things were not going to go to plan.”
  • Came to terms with making an adjustment
  • Once the bag of waters was broken, contractions completely changed and things progressed quickly
  • Christine reasoned with herself, “This isn’t going to be how I planned it, but if I give up one thing, the birth can still happen unmedicated like I want it to”

 
Christine’s Insight:
Q: What did BJ do as a Coach that helped you the most?
A: He kept me from freaking out when it had gone on for so long.  
As she explains, he kept her on track through the exhaustion. BJ kept her calm with reassurance; he also pointed out the progress they had made. 

Loosely paraphrasing: [The hard part] wasn’t the pain – it was the exhaustion.  I knew the pain was purposeful because I was getting a baby.  [Contractions] came in bursts and they were not constant - it wasn’t miserable pain or constant pain from an injury that hurts all the time. Looking back a year later, [a contraction] was such a short period of time.
 
BJ’s nuggets of wisdom
Education & knowledge quell fear – having notes at my fingertips kept me from getting scatterbrained while I was watching (coaching) my wife through labor.
 
Postpartum advice for the husbands: Don’t be proud – just say yes.  Don’t be too proud to accept help – it’s a gift.
 
On the lighter side, you’ll hear the inauguration of the term “The Splash Zone” – now that we know our student’s perception of watching all the birth videos from the first row of chairs, it’s what we call that front line when we show birth videos in class - lol.
 
QUESTIONS FROM THE CLASS:
Q: Were you both awake the whole [36 hours of progressive labor]?
A: Yes…If I had it to do over again – we would rest throughout labor.  You’ll hear it in class that you should rest.  Seriously – REST.  After the baby is born, you are playing catch-up with sleep.
 
Q: What can you tell us about breastfeeding a newborn?
A: Get your hands on reading material, borrow books, have phone numbers of support people you can call, have a good structure around you to encourage, inspire, and inform you.
 
Invest in good bras – wear a tank top with shirt underneath at this age (son is about 11 months old in this video), after the infant stage the nursing cover is not staying on!
 

Did you have a long labor?  What labor management tips would you share with first-time parents?
 Please leave us a comment - it will be moderated and posted. 
 
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®.


 

The Uterus and the Fear-Tension-Pain Cycle

Posted on May 13, 2014 at 12:23 PM Comments comments ()
The woman who taught my Doulas of North America (DONA) training course was kind enough to allow me to post this to our blog.  She is an accomplished doula, doula trainer, and author. Besides her passion around childbirth, she is also a dedicated state representative for District 16 in Arizona.  She sent this message to an SPB student who she knows through her political career.
 
GUEST BLOG POST
by Kelly Townsend, CD (DONA)
 
There is a psychosomatic approach to childbirth that is often ignored in the United States.  Over in Sweden and other parts of Europe, Psychosomatic Obstetrics and Gynecology is pretty big, and it’s no surprise that they also have the best maternal and fetal outcomes over there.

The thing is, the uterus is affected like the heart is during stressful situations.  When you are startled, your heart beats faster, right?  Much the same, when there is any stress, fear, tension in the muscles, etc., it sends a message to the sympathetic nervous system that there is danger present (not really, but this is the response to fear during birth) and the body goes into an effort to "protect the baby." 


The myometrium is the muscle of the uterus.  It is one muscle with three distinct layers, each with its own responsibility. 
  • The outer layer contracts and opens the cervix, and pushes the baby out. 
  • The middle layer supports the blood vessels. 
  • The inner layer contracts the uterus back down after the baby is born. 
Image source: http://medical-dictionary.thefreedictionary.com/myometrium 

BUT – the inner layer also becomes rigid during times of stress.  Like the heart beating faster, the inner layer fights the outer layer and tries to stall the birth, protecting the baby from whatever is causing the mother to worry or be tense.  Thus, labor takes longer. 
 
This is the only time in the human body when there are opposing muscles working against each other.  All other muscles work in tangent, one relaxes while the other contracts (think biceps and triceps).  When opposition happens within the uterus it slows down labor, and it also causes pain. 
 
Try this example: Have someone try to extend your arm while you are making a muscle.  If they have any strength, it would start to hurt after a short while because you have resistance on your muscles. 
 
Just the same, the uterus starts to hurt quickly after this process starts.  So then contractions become painful.  And the laboring woman gets scared and tenses up because it hurts.  And that tension continues the inner layer's resistance because the "danger" is intensifying.  It’s not really danger, it's the fear+tension. Since the body doesn't know the difference, it causes the inner layer to get rigid.  And so begins the vicious fear-tension-pain cycle.

How to fix it?  Well, first: what do you do to counteract the heart beating fast?  Slow deep breaths!  Hence, this is why we breathe deep and slow from the abdomen during birth to enter a state of deep relaxation.  Childbirth classes will tell you that this is important, but during labor, if the woman doesn't know why it is so important on the inner layer of the uterus, she can be tempted to throw it out the window.  So it is a fantastic incentive to remain very relaxed and calm, with tranquility as the goal.  

Second, the positions she uses and the environment she is laboring in can influence her feeling of safety.  She can use upright positions, total relaxation, the tub, soft music, dim lights, etc., whatever it takes so that she can feel safe.
 
And let me say this now, if she doesn't feel safe where she is – whether it be on a physical, mental or emotional level, that inner layer is one heck of a fighter and will stall the birth.  My hunch is it can even prevent someone from going into labor. 
 
A woman has to be safe and secure in order for that inner layer to relax so the outer layer can be relaxed.  Something as simple as a loved one not being in town yet can keep that inner layer rigid.  And something as emotional as prior abuse, or some kind of relationship conflict with the husband or other family dynamics; really any emotional "hurdle" that has to be overcome can cause a mental hold on labor and delivery.  

If you are Christians, I can also provide you with a ton of spiritual ideas to help in this area.  There are scriptures and/or prayers during birth that help. 

Anyway, as the coach your job is to help her stay as calm and secure as possible.  Use as few words as possible during active labor/transition, because hearing and absorbing words takes effort and that distracts from her staying in a tranquil state.  Instead, tell her before hand if she tenses muscles, you will gently touch them and that is a signal to her to release the muscle.  Tense muscles = tense inner layer of the myometrium.  So a wet noodle kind of approach if at all possible.  

If you find that labor is slow to start, ask her if there is something that she is worried about or not yet ready for.  And then at the end of the day, ask her to tell you when she is ready to surrender to the process.  That word surrender - it is the one word that sums up childbirth on her part.  Many things you cannot control during birth, but that is the one thing you can control and that is surrendering.  Kind of paradoxical.

Blessings to you and happy birthing!
 

You can check out Kelly’s book on Christian Childbirth HERE.

What has been your experience with your uterus, safety and surrender in childbirth?
Please leave us a comment - it will be moderated and posted.

Disclaimer:  
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson



Birth Mantras

Posted on July 9, 2013 at 9:56 AM Comments comments ()
We have been teaching Bradley Method® classes long enough to have the privilege of having alumni students come back and take another series as they are expecting their next child.  We have one of those couples in our current class, and something came up in class that made me reflect on our births.

The class topic last week was stages of labor.  We talked about the markers of the different stages of labor, how to identify “transition” that typically happens between first stage (cervical dilation and positioning baby) and second stage (pushing to birth), and how to manage the different stages of labor.

Our alumni mom mentioned that she was never able to let go of the discomfort of feeling like she had to have a bowel movement.  She wasn’t able to dilate any further until they got to the hospital and she got an epidural.  The epidural relieved that feeling for her, and she dilated from 5cm to 10cm in one hour.  When she was able to let go of that sensation and the fear of losing control, her body got busy.  She is retaking our class because although she liked her epidural, she knows that the less drug exposure to baby, the better.

It made me reflect back on our birth experiences.  Although I never asked for drugs, I look back and wonder what would have happened if I had given up control of our births a lot sooner.  I imagine they would have been more in line with our 18-hour birth of our biggest baby.  All 11 pounds and 1 ounce of Night Owl, arrived in the early morning after being left alone to labor with the support of Coach Bruss and our doula.  We had eaten, slept, stayed hydrated, and his was our easiest birth.

After that, we had our two longest births, ironically, at the time when we were training to become a Bradley™ instructors, and after we were certified as instructors.  

It seems that the more I “knew”, the less able I was to let go.  I was so busy analyzing, worrying about taking pictures that we could use in class, wondering how I would be perceived by my peers and our students, that I added untold layers of emotional baggage that Bruss would have to work me through.  I had to surrender to the fact that natural birth is all about relinquishing judgment and control, and accepting that we were going to allow my body and our baby the birth that they needed.  Once I hit that point of complete release, both of those children were born within about 5 hours of that turning point.

I want to share what I now know to be my birth mantra, just in case it can help another mama have an easier birth.  As much as I would love another go at putting this into practice (and have a labor sprint instead of marathons!), it feels like our family is complete, so I hope you will benefit from it for a better birth for you and your baby. 

Side note.1:  If you have any past birth or sexual trauma, it is so important to work through those feelings during pregnancy. Come to your current birth experience with a clean of a slate as possible.  The path to surrender is more easily paved if you aren’t trying to do it all in your present labor.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson Accept:  There is no one right way to birth.  There is no one right way to feel.  The most important thing to evaluate is am I (Mom) okay?  Is our Baby okay?  If so, then accept that this is your birth and carry on.

Surrender:  Surrender to your thoughts.  Surrender to the sensations.  Surrender to the feelings.  Birth is much bigger than we are.  It is timeless.  It is the way our bodies were designed to work for childbirth.  Be okay with losing control over the process.

Give In:  Give into your thoughts.  Give into your sensations.  Give into your feelings.  Do you want to cry?  Cry.  Does moaning feel good?  Moan!  Do you want to rock, roll, walk, move, gyrate, sway, just lay still?  What are your body and your baby telling you to do?  Release all worry about judgment from outsiders, release yourself from your own judgment of what you can and can’t do.  Allow yourself to give into your birth and see where it takes you.

Let Go:  Let it all go.  Any preconceived notions of your birth.  Your timeline.  The clock.  Your plan A, plan B, and the other plans you had – let them go.  Focus on being in the moment with your partner.  Focus on being in the moment with your baby – you cannot relive or redo these sensations later.  Let everything go, and *go* for the ride. 

Let God:  Being a spiritual person, there was always an emotional component for me that involved prayer, and appealing to a higher power.  Once I gave up my control and turned it over to God, labor seemed to flow smoothly and resolutely to a birth.  The birth of another of His miracles, of which Bruss and I got to play a small part.  It is so humbling to realize that I am not in control, and I don’t have to be, in order for birth to happen.  

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

When I gave into my body, our baby and our God, all things fell into place and we ended up having beautiful birth experiences, albeit long ones.  In the midst of those long labors, the idea that got me through the time with patience and without resorting to drugs to ease the sensations of labor was “We are allowing my body and our baby the birth that they need.” 

Side note.2:  Knowing what I know now about Pitocin, I wish we hadn’t asked for it with Charger’s birth.  I know the point when I didn’t need it anymore, and I wish I had insisted as the consumer that they take the line out.  I know where that emotional release happened and there was no turning back labor with or without “the Pit”.

While there in nothing wrong with having a long labor, and we usually “win” the long labor comparison conversations (there is that judgment again!), I really do not wish long waiting times to meet your baby on anyone.  Think about these mantras if you need them, and I wish you all the best for a beautiful birth experience!!

Did you have any mantras when you were in labor?  What were they?

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®.

Rights For Homebirth - May 2013 Update

Posted on May 17, 2013 at 8:56 AM Comments comments ()

The final Midwifery Scope of Practice Meeting was held on Wednesday, May 15, 2013.  It is now time for the families of Arizona, and anyone else who believes that compassionate care is a human right’s issue for the mother and the baby to take a stand.

You can click on the links below to read a copy of the current draft rules and to see Wednesday’s proceedings:
Most Recent Draft: http://1.usa.gov/YZw4Xt
Most Recent Meeting: http://bit.ly/104ZtKT

Here is my statement on the Arizona Department of Health Services Website:
In addition to agreeing wholeheartedly with Allyson Fernstrom's statement below, I want to direct the committee to THIS brief article with references if they want to dig deeper:
 
As the article and study succinctly show, "FTP" and "CPD" in the 21st century are mostly iatrogenic.  "Watchful waiting" IS the midwifery model of care in the hospital, in the birth center and in the home setting.  Many midwives have less than a 15% cesarean rate (defined as an "acceptable" rate by the WHO) in their practices because they do not intervene until necessary.  This does not mean emergency; read: most of these are non-emergent and appropriate.
 
At this point in our history, 99% of births are still occurring in the hospital setting (read more HERE), and a vast majority of those women are still under the OB model of care: the "do something to help this along" model.  A 32.8% cesarean rate calls into question the common practices that are being forced on women.  It should not surprise us that some of these women are demanding a different model of care with subsequent pregnancies.
 
It is unreasonable to essentially punish women who are seeking compassionate care after feeling abused in the traditional care system by doctors who subscribe to a different philosophy about birth.  By including FTP and CPD in the final version of the rules and regulations, you are essentially providing a VBAC option on paper without providing a VBAC option that will be a choice for the majority of the consumers who are now faced with choosing unassisted births instead of facing the trauma they faced in a previous birth.
 
Before a final draft is approved, I implore Dir. Humble to attend a home birth.  See what it is we are talking about.  Really understand why we are so passionate about this cause, and why we believe that birth is a fundamental human right and a woman's rights issue.  We are not asking for the sun, the moon and the stars.  We simply want you to understand the power of birth, and why we want our care providers to have all the tools they need at their disposal if we choose a home birth setting. 
 
Midwives have the ability, the training, and the knowledge to bring babies safely into the world without compromising the health of the mother.  They believe that mothers care about the life they carry within them, and will do their research when it comes time to choose or decline procedures.  Midwives also know how to recognize non-reassuring patterns and when it is time to safely transfer to a different birth setting in the rare cases that complications do arise.
 
I advocate for midwives to be free to choose the clients that they feel they have the training to care for, be that VBAC, breech, or mothers of multiples.  As an informed consumer, I ask for the state to certify that the women who offer this care are educated in the care and management of those labors.  Along with this, I trust that midwives will have the opportunity to continue their education so that they can assist at VBAC, breech and multiples births once they have completed training in those areas.  I am glad to see that there is a review process to keep midwives accountable for their decisions, none of which will be made lightly because at midwives care deeply about the women and the children that they serve. 
 
Dir. Humble, you have the opportunity to lead here and set a new standard for the great state of Arizona.  Please take it.
 
Respectfully,
Krystyna Robles-Bowman
Mother of 4
Chandler, AZ
 
Statement from Allyson Fernstrom:
"I am extremely grateful to see that VBAC is still included in the drafts. I believe this is a huge step in the right direction. It shows that the department is listening to the concerns of the consumers. I appreciate that more options are being opened up to the growing number of women who desire to achieve a VBAC. However, I have GREAT concern with some of the conditions suggested. It currently reads that a midwife can not attend a VBAC if their was a diagnosis of "failure to dilate" or cephalopelvic insufficiency". I heard in the last meeting that it is supposed to read "failure to progress". That does not make the problem better. Failure to progress, failure to dilate and cephalopelvic insufficiency/disproportion are ALL unacceptable. There is NO literature to support this rule. Listen to the members of the committee, including those from the medical community, who have mentioned may times that FTP is over diagnosed. FTP only tells you that a mother did not progress. It did not tell you WHY she did not progress. What if there was failed induction? What if it is an emotional issue that stalled labor? What if the baby was in a poor positioning? Maybe the care provider followed the Friedman's Curve, which does NOT allow the typical mother enough time to labor to full dilation? There are too many variables in play. A woman should not be excluded from attempting a VBAC because she had a failed induction, an emotional block, a baby in a poor position, an impatient care provider, etc. Because the diagnosis of FTP does NOT explain WHY the woman had a cesarean section, it should NOT be used to determine whether or not she is capable of vaginal delivery. CPD is also highly disputed in the literature. It is difficult to ever give a TRUE diagnosis of CPD. The testing is unreliable. FTP and CPD are subjective, over diagnosed and would be completely inappropriate in the rules. Director Humble mentioned that if he allows VBAC, he does not want to make it so restrictive that no one can do it. Leaving in FTP and CPD would essentially make it impossible for most VBAC clients to qualify for a homebirth VBAC. Consumers and members of the committee have been asking from the beginning that this be removed from the rules. Listen to these important stakeholders!"

Do you want to get involved?  Please do!!

There is a peaceful Rights For Birth rally being planned for today and Monday in the Phoenix area – click HERE for all the details.

Do you want to submit your own comment?
Click HERE for to make a direct public comment.

Let me be clear that I do not believe that OB's are bad people.  I simply disagree with the birth paradigm under which many of them practice.  I am forever grateful for their skill set as surgeons when it is an appropriate and needed use of their considerable skill in the operating theater.

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


 

Labor Is More Than Dilation

Posted on April 30, 2013 at 5:50 PM Comments comments ()

As we close out Cesarean Awareness Month, I want to share this link to a post that I wrote about "Failing To Progress".  So often, these are the words of doom to a couple that is working towards a natural labor.  

There are other things that are going on when a woman is in labor.  The more birth stories I hear, the more convinced I am that labor is about surrender.  That concept is not measurable, nor is it graphed anywhere.

Please take a minute to revisit the post about "Failing To Progress or Naturally Aligning" before you go into labor.  You may be glad you have another point of reference for the dreaded FTP!!

I hope to bring you a CBAC story later today, maybe tomorrow.  I look forward to sharing these words from a mama as she goes through her healing process.  

10 Good Things

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

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®. 

Failing to Progress or Naturally Aligning

Posted on June 1, 2012 at 4:52 PM Comments comments ()
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson  We have had a couple of students have had textbook “NAPS” in the last two classes…and since we still have several couples waiting for their babies, I thought this might be a reminder and an inspiration to them for their labors.  NAP – no, they didn’t take epic naps in labor (although I am a big advocate for sleeping in labor)…what it means is that they were very patient in their labors.   

One of the cornerstones of The Bradley Method® is a Healthy Mom, Healthy Baby outcome.  All of the discussion below only applies if Mom and Baby are not showing any signs of distress through labor.  Mom is maintaining a healthy temperature, heart rate and blood pressure, and Baby is also showing that it is doing well as per the monitoring that is being done.  If Mom or Baby are starting to demonstrate that their health is compromised, then parents are encouraged to make the best choices for their particular situation.   

The words “Failure To Progress” are the sound of doom to some of us (I say "us" because I heard this three times!).  They very often mean that interventions are going to start being suggested.  How a couple acts upon those suggestions is very individual.  Marjie Hathaway coined the phrase “Natural Alignment Plateau”, or “NAP” as an answer to the dreaded “diagnosis”: “FTP”, or “Failure To Progress”.    

Failure To Progress is based on the Friedman’s Curve*.  It looks like this: 
 As human beings, it is in our nature to see this neat, explainable graph and say, “It’s a rule!” This can have dire implications whilst in labor if you really want a natural birth.  There are no averages in the midst of a labor – each labor on is unique and individual.  

Mathematically, it’s unfair for all labors to be expected to fit the average.  That brings in another concept we teach in The Bradley Method® classes: consumerism and informed consent.  If there is time: ask questions, ask for time, and then communicate and evaluate what you have heard with your partner before you decide on a course of action.   

  • It is important to remember that the graph is AN AVERAGE representation of labor.  It indicates that a mom should dilate 1 cm per hour, and push an average of 3 hours – for an average length of labor that is between 12-14 hours long.    
  • Math class reminder:  The average number is the number you get when you add all of the data in a set of information, and then divide that total number by the number of units that provided the data.  Applied to laboring mothers: That means that there will be some people that have labors much shorter than 14 hours, and other people that have labors much longer than 14 hours, more will be around that number…and then a few will be right on with the average.  


When a mom does not progress in dilation from one vaginal exam to the next, or between several vaginal exams, she may be diagnosed with “Failure To Progress”, and along come the string of possible interventions.  They can include any or all of the following, along with other interventions: an Amniotomy (intentional rupture of the bag of waters), augmentation of labor with Pitocin, an Epidural to take of the edge of Pitocin-induced contractions, a Cesarean.  

A cesarean may also be suggested if the care team suspects that the baby may not fit through mom's pelvis.  Diagnosed as "CPD", this is the subject for another post altogether.  For now, check the link I listed below* for more information.

Instead of accepting the words, “Failure To Progress”, Marjie decided to suggest a new phrase to her students: “Natural Alignment Plateau”.  NAP instead of FTP.  Natural Alignment Plateau is a different way of approaching that point in labor when dilation does not change.  What we teach in class and hope that our students will remember when they face this crossroads is, "Labor is much more than dilation."   

Labor can be slow to start, dilation can stop and/or contractions can slow down for many reasons.  Here are some to consider: 

  •  Did you change locations where Mom is laboring? 
  •  Is Baby posterior? (Click here for ideas to move baby)
  •  Is Baby trying to figure out how to line up in the birth canal? 
  •  Is there an emotional component that hasn’t been dealt with? 
  •  Is Mom tired and does she need a nap? 
  •  Is Mom making more hormones for labor? 
  •  Is Mom's pelvis still stretching (and using the extra hormones) for baby to fit?
  •  Is the Baby's head still molding for the passage through the birth canal?
  •  Is Mom making more colostrum for baby? 
  •  Has Mom surrendered to the birth? 
  •  Has Baby accepted the birth process?  


If your labor has been slow to start after a spontaneous rupture of membranes, or if you are seemingly “stuck” at a measurement of dilation, it might be time to evaluate what could be going on and change tactics: 

  •  Try a new labor position. 
  •  Go for a walk to clear your heads. 
  •  Take a nap to conserve your energy (It’s hard for a care provider to argue with a dad or doula who is protective of a sleeping mom.)  
  •  "Talk" to your baby and encourage them that you are ready to meet him/her. 


If Mom and Baby are doing well, you can ask for time.  There is not a medical reason for an intervention if Mom and Baby are doing well in labor and your care team confirms that Mom and Baby are okay.  Here are two examples for you to consider and think about if you face a point in labor when there is no measurable progress.   

We had a mom from our Winter class go from 6 cm dilated (usually considered Active First Stage – not yet in Late First Stage) to holding her baby in 21 minutes.  Yes – you read that correctly.  She went from what most care professionals would consider mid-range in labor to holding her baby in 21 minutes…that meant she pushed within that time, too, folks.  Hers was an emotional component.  She was waiting for her mom to arrive.  Once her mom arrived at the hospital and stepped into the room where she and her husband were laboring, her baby and her body got busy.  They dilated a total of 4 cm from 6 cm to “complete” at 10 cm, then pushed, and they were holding their baby in 21 minutes.   

Our other story is from our Spring Class.  Mom had a slow start to labor.  She had started seeing some clear fluid on Sunday, noticed some more on Monday, and went to the hospital on Tuesday.  They tested her fluid and it was amniotic fluid.  Although they were in triage and barely 1 cm dilated, the couple was strongly encouraged to be admitted.  Now they are into the hospital and the expectations of “Friedman’s Curve.”  

This couple did a great job of asking, “Is Mom okay? Is Baby Okay?” After getting their “Yes” answers, then they followed up with, “That’s great!  Then let’s wait a couple more hours and see where we are.”  And sure enough, the next time the staff and their care provider checked in, they were a little further along in labor.  Once things got going, this mom went from being 4 cm dilated to 8 cm dilated in one hour!  Within two hours of that point, they were holding their baby.   

The great news about hitting the NAP is that once the Mom’s body and Baby “get organized”, labor seems to progress very quickly.  Again, remember what I said at the beginning – things go well when a Healthy Mom and a Healthy Baby are given the time they need.  If Mom or Baby start to indicate that “healthy” is losing out, then a family needs to make the best choice for their situation.   

What has been your experience – have you had a NAP in your labor?  What choices did you make?   

For a full explanation of Friedman’s Curve click here or enter this URL into your browser: http://allaboutbirth.net/pdfs/Failure-to-progress.pdf    

Disclaimer:  
 The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. 

Let's talk about Cesareans

Posted on April 17, 2012 at 8:33 AM Comments comments ()

In honor of Cesarean Awareness Month, I am going to devote the next two Tuesday posts with some information on cesareans.  I am not going to write a lot on how to avoid one in the first place or the specifics of a Vaginal Birth After Cesarean (“VBAC”) since there is already a wealth of information at the International Cesarean Awareness Network (“ICAN”) and Childbirth Connection websites. Instead I will offer an introduction to the topic for people who are not aware that cesareans are performed at an alarming high rate, and offer a quick look at causes and precautions.  At the end of the post you will find several links for more detailed information.
 
Here is a brief introduction:
In this country, the cesarean rate in 2009 was 32.9%.  It means that over 1.4 million women and families welcomed their children into the world via a surgical procedure.  It marked the 13 consecutive year of a rise in cesarean rates in the United States.  For a look at cesarean rates by the numbers, click here.
 
The good news is that for the first time in 14 years, the preliminary data in the statistical year 2010 shows that the cesarean rate went down by 0.1% (from 32.9% to 32.8% - still means over 1.3 million cesareans).  It doesn’t sound like very much, yet by the numbers, that means approximately 405,700 more women had vaginal births instead of a surgical procedure to birth their babies.  There are lots of different factors that contributed to the decline; my Pollyanna is hopeful that all the good work of ICAN, and other educators, is providing information to help mothers avoid what is termed the “unnecesarean”.  For those moms in whom a true emergency situation warrants a cesarean birth, I continue to be grateful for the medical knowledge that allows for a Healthy Mom, Healthy Baby outcome.
 
The World Health Organization recommends that the cesarean rate should be around 15% (See Reference 1 below).  This is what it estimates to be the more accurate percentage of instances when performing an operation instead of allowing for a vaginal birth saves a mother and/or child’s life.
 
So are all the cesareans performed in the United States life saving?  Here is a look at how we rank internationally: the "World Health Statistics 2010 identified 33 countries with lower maternity mortality ratios than the United States, while 37 countries had lower neonatal mortality rates, 40 had lower infant mortality rates...” (2)
 
So working strictly off the numbers, our predominantly medically managed and intervention based hospital model (which includes a high incidence of cesareans) does not equate to a better outcome for mothers and babies.  It is quite shocking to realize that some third-world countries have much better outcomes with their approach to labor and birth in comparison to ours.
 
Dr. Berman, who sits on the board of the American Academy of Husband-Coached Childbirth®, taught me a healthy respect for what a cesarean really is as opposed to how it is perceived in today’s society.  We had the privilege of hearing him speak at our Bradley Method® training in Anaheim.  According to him, if you were to sustain the injuries and the trauma associated with a cesarean surgery outside of the operating room, you would have a fatal injury that very few people could survive.  Cesareans are a surgical procedure and carry all the risks associated with surgery (see link list below).
 
Causes and Precautions:
Here are six leading causes of cesareans identified by The Academy of Husband-Coached Childbirth®,
  • Inability to relax
  • CPD: Cephalo-Pelvic-Disproportion ~ the baby’s head is too big to fit through the mother’s pelvis
  • FTP: Failure To Progress ~ the mother’s dilation doesn’t match the care provider and/or hospitals expectations, protocol or practice
  • Fetal distress
  • Prolonged labor
  • Pain
 
How do you prepare yourself and avoid facing these in your labor?

Inability to relax: attend a childbirth preparation class, like The Bradley Method® series, that teaches you about the process of labor so that you are educated.  Knowledge eases fear and has the potential to break the Fear-Tension-Pain cycle that stops relaxation.  The Bradley Method® also prepares couples with twelve different relaxation techniques – if a couple attends classes and does their homework, they will have several tools to use until they find the one that best relaxes the mother and allows her body to work with her labor.
 
CPD:  True CPD is a real medical complication.  It is usually found when a woman has experienced severe malnutrition.  However, it cannot be accurately diagnosed until a mother has had a trial of labor, which has a very ambiguous definition (3).  Know how long your care provider will let you labor before coming to this conclusion. 
 
In addition, we need to remember and trust that our pelvis is a comprised of moving parts, and that there are hormones made by our bodies that relax the tendons so that those parts can stretch and mold with our babies, and then return back to the proper alignment and shape after we give birth.  We also need to remember that labor works best with gravity.  If a mother has been lying on her back and fighting gravity, she will be more tired and her body will be less likely to function as it was designed to do.
 
If you hear this term in relation to your labor, ask for the time (as long as mom and baby are not at risk) to try different positions and see what your body is capable of.   Chances are good of a vaginal birth if you get a mother off of her back and into positions that open the pelvis and work with gravity, i.e. walking, upright and squatting positions.  With these, her pelvis will be more likely to open and expand to welcome her child vaginally.
 
I recently learned that a possible indicator for CPD might also be a swollen cervix.  You can read a conversation between midwives here .  I thank my lucky stars that I am not a medical professional when I read their dialogue.  I am always open to sharing information – so please take the time to read this so you can consider possible options you want to ask for if you face CPD in your labor.
 
FTP: This is a clear instance where knowing what your care provider and birthplace consider “normal” is of utmost importance.  If one or both of them expect all moms to deliver by a certain timeline, find another care provider or birthplace.  All bodies are unique and all babies are unique.  Each labor will be exactly as long as it needs to be – and if you are expected to fit into a particular timeframe or else face the knife, trust your instinct that is telling you that this is an unrealistic expectation.
 
Fetal Distress:  This is another situation that could be a real medical complication.  Fetal monitors were designed to be used intermittently, and specifically in instances when distress was suspected.  Instead, monitors are used as a continuous procedure unless you make a specific request in your birth plan to have it otherwise.
 
The word “labor” applies to both the mother and the baby – and as we all know, hard work causes stress.  Most babies will handle the stress of labor beautifully when the mom has stayed low-risk and eaten a well-balanced diet throughout her pregnancy. It is important to read and educate yourself on what true fetal distress is and what the causes are so you can make an informed decision if you start to hear that term during your labor.
 
If fetal distress is indicated solely due to the tape the machine is spitting out, the first thing to do is ask if you have time.  If the clear and urgent answer is no, then you decide what you want to do for a Healthy Mom, Healthy Baby outcome.  If there is time, then you can ask for a second opinion, and/or ask for them to listen to the baby by other means, such as a fetoscope or a Doppler.  The monitors can give false readings by the simple fact that they are just a machine interpreting the signs from the baby instead of a trained set of hands and a human ear that feels and listens to the baby.
 
Prolonged Labor: This is a situation when knowing what your care provider or birthplace considers “prolonged”, and also when having a supportive coach and a support team makes a huge difference.  The mother and coaches attitude about having a prolonged labor will affect how a choice for or against a cesarean.  The questions to consider here are: Is the mother okay? Is the baby okay? Do we believe that our labor is what our baby needs?  Are we willing to give baby the time he or she needs to be born? What else could we do/try before we agree to a cesarean?
 
Every couple will make their own choice under these circumstances.  Their list of things to do or try before they accept a cesarean will depend on their training and the experience of coach or any assistant coaches the couple has with them.  If the mom and baby are not in distress after a prolonged labor, there is no right or wrong answer in this case – it is entirely up to the parents to decide which path they want to choose.  If either the mom or baby is showing signs of distress, the path forward is clearer when you are central goals are a Healthy Mom, Healthy Baby outcome.
 
Pain: I would be lying to you if I told you that childbirth is painless.  However, the pain is bearable and welcomed when you focus on the result of the work you are doing and when you are surrounded by the love and care of your coach and any assistant coaches.  There are times when the pain changes, and an excruciating pain that doesn’t break and/or that is accompanied by bright red blood and/or large blood clots is a true complication. It could be a life-threatening complication like placental abruption or a uterine rupture.  These clearly indicate a cesarean to attempt to save the life of the mother and the child.
 
If the pain increases in intensity, but it continues to ebb and flow with the strength of the contractions, then the team needs to evaluate if maybe the baby is malpositioned and needs to be encouraged to move again.  The other cause of intense yet manageable pain could indicate an emotional component of labor that the mom needs to address before labor can resume its normal course.
 
The bottom line is that you, as a consumer of medical services, need to educate yourself, ask questions of your care provider, and advocate for the choices you want.  If your requests are reasonable, chances are high that you will be able to find a care provider who supports your choices and only uses cesarean surgery in the emergency situations for which it was intended.
 
ANNOUNCEMENT FROM ICAN: ICAN of Phoenix will be offering a Cesarean Prevention Class on Saturday May 19th from 2-4pm. Location is TBA but will be in the East Valley this time. Cost will be $25 per couple, your other half is strongly encouraged to attend (your doula may attend too, no cost for bringing her). There will be a sign up form on the website as soon as the location is set, but you may rsvp if you already know you will attend. If you need more details please email Stephanie Stanley at [email protected] 
 
Link List
Things you can do to avoid an unnecessary cesarean:
 
Risks associated with cesarean:
 
More information on cesareans and related topics:
 
 
ICAN Facebook page:
 
ICAN Phoenix Facebook page
 
References
(1)  World Health Organization. Appropriate technology for birth. Lancet 1985; 2: 436-7.
 
I used the provisional 2010 number and multiplied it by 0.01%
 
For the number geeks:
Number of births in the US
Preliminary Data (11/17/11) 2010 was 4,000,279

Feb 2012 update: 4,057,000 for the 12-month period ending June 2010  4,057,000 - 32.8% = 1,330,696 cesareans

Final 2009 Data (11/03/11): Number of births: 4,130,665
4,130,665 – 32.9% = 1,358,989 cesareans
 
Comparing 2010 to 2009 
2010 Birth rate: 2% lower
2010 Cesarean rate: 0.1% lower
 
 
Disclaimer: 
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation.  Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided.  This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale
 
 

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