Chandler, Arizona
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Sweet Pea ​Births
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...celebrating every swee​t pea their birth
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Birth Story: Marathon Labor
Posted on January 23, 2015 at 9:45 AM |
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Christine & BJ Bollier Bradley Method© Birth Story 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.”
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
Changing the Plan
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. 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 |
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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:
Here is my statement on the Arizona Department of Health Services Website:
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:
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 |
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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. |
Failing to Progress or Naturally Aligning
Posted on June 1, 2012 at 4:52 PM |
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One of the cornerstones of The Bradley Method® is a Healthy
Mom, Healthy Baby outcome. All of the
discussion below only applies if Mom and Baby are not showing any signs of
distress through labor. Mom is
maintaining a healthy temperature, heart rate and blood pressure, and Baby is
also showing that it is doing well as per the monitoring that is being
done. If Mom or Baby are starting to
demonstrate that their health is compromised, then parents are encouraged to
make the best choices for their particular situation. The words “Failure To Progress” are the sound of doom to
some of us (I say "us" because I heard this three times!). They very often mean that interventions are going to start being
suggested. How a couple acts upon those
suggestions is very individual. Marjie
Hathaway coined the phrase “Natural Alignment Plateau”, or “NAP” as an answer
to the dreaded “diagnosis”: “FTP”, or “Failure To Progress”. Failure To Progress is based on the Friedman’s Curve*. It looks like this: As human beings, it is in our nature to see this neat,
explainable graph and say, “It’s a rule!” This can have dire implications
whilst in labor if you really want a natural birth. There are no averages in the midst of a labor
– each labor on is unique and individual. Mathematically, it’s unfair for all labors to be expected to fit the average. That brings in another concept we teach in
The Bradley Method® classes: consumerism and informed consent. If there is time: ask questions, ask for
time, and then communicate and evaluate what you have heard with your partner
before you decide on a course of action.
When a mom does not progress in dilation from one vaginal
exam to the next, or between several vaginal exams, she may be diagnosed with
“Failure To Progress”, and along come the string of possible
interventions. They can include any or all of the following, along with other interventions: an Amniotomy (intentional rupture of the bag of waters),
augmentation of labor with Pitocin, an Epidural to take of the edge of
Pitocin-induced contractions, a Cesarean. A cesarean may also be suggested if the care team suspects that the baby may not fit through mom's pelvis. Diagnosed as "CPD", this is the subject for another post altogether. For now, check the link I listed below* for more information. Instead of accepting the words, “Failure To Progress”,
Marjie decided to suggest a new phrase to her students: “Natural Alignment
Plateau”. NAP instead of FTP. Natural Alignment Plateau is a different way
of approaching that point in labor when dilation does not change. What we teach in class and hope that our
students will remember when they face this crossroads is, "Labor is much
more than dilation." Labor can be slow to start, dilation can stop and/or
contractions can slow down for many reasons.
Here are some to consider:
If your labor has been slow to start after a spontaneous
rupture of membranes, or if you are seemingly “stuck” at a measurement of
dilation, it might be time to evaluate what could be going on and change
tactics:
If Mom and Baby are doing well, you can ask for
time. There is not a medical reason for
an intervention if Mom and Baby are doing well in labor and your care team
confirms that Mom and Baby are okay. Here
are two examples for you to consider and think about if you face a point in
labor when there is no measurable progress. We had a mom from our Winter class go from 6 cm dilated
(usually considered Active First Stage – not yet in Late First Stage) to
holding her baby in 21 minutes. Yes –
you read that correctly. She went from
what most care professionals would consider mid-range in labor to holding her
baby in 21 minutes…that meant she pushed within that time, too, folks. Hers was an emotional component. She was waiting for her mom to arrive. Once her mom arrived at the hospital and
stepped into the room where she and her husband were laboring, her baby and her
body got busy. They dilated a total of 4
cm from 6 cm to “complete” at 10 cm, then pushed, and they were holding their
baby in 21 minutes. Our other story is from our Spring Class. Mom had a slow start to labor. She had started seeing some clear fluid on
Sunday, noticed some more on Monday, and went to the hospital on Tuesday. They tested her fluid and it was amniotic
fluid. Although they were in triage and
barely 1 cm dilated, the couple was strongly encouraged to be admitted. Now they are into the hospital and the expectations
of “Friedman’s Curve.” This couple did a
great job of asking, “Is Mom okay? Is Baby Okay?” After getting their “Yes”
answers, then they followed up with, “That’s great! Then let’s wait a couple more hours and see
where we are.” And sure enough, the next
time the staff and their care provider checked in, they were a little further
along in labor. Once things got going,
this mom went from being 4 cm dilated to 8 cm dilated in one hour! Within two hours of that point, they were
holding their baby. The great news about hitting the NAP is that once the Mom’s
body and Baby “get organized”, labor seems to progress very quickly. Again, remember what I said at the beginning
– things go well when a Healthy Mom and a Healthy Baby are given the time they
need. If Mom or Baby start to indicate
that “healthy” is losing out, then a family needs to make the best choice for
their situation.
What has been your experience – have you had a NAP in your
labor? What choices did you make? For a full explanation of Friedman’s Curve click here or enter this URL into your browser: http://allaboutbirth.net/pdfs/Failure-to-progress.pdf Disclaimer: The material included on this site is for informational
purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
Let's talk about Cesareans
Posted on April 17, 2012 at 8:33 AM |
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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®,
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. (2) http://transform.childbirthconnection.org/wp-content/uploads/2011/03/factsandfiguresapril2011.pdf 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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