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Sweet Pea Births

Chandler, Arizona

Sweet Pea Births

...celebrating every swee​t pea their birth

Blog

Getting Labor Started

Posted on October 21, 2016 at 12:29 PM Comments comments (0)
Among the common text questions I get, is "What can I/my friend do to get labor started?"

The answer I want to give: Wait.





My_theory is that here is nothing you can do that is going to start labor if the baby isn't ready.  And sometimes it's not the baby...it's the mother.  The mother has more factors in play that can be influenced: physical, chemical, mental, emotional...any one or all of these can delay the onset of labor.

Since we are an action-type of culture, here are the things I offer when I get this text.  All of them **do not** include "taking something".  They are all things to help the mother and baby align physically and emotionally with the oncoming labor and birth of the baby.

Along with "doing something", we also invite our students who send us this text to do some internal checks: is there anything they are worried about? That they have left to do or say before the baby arrives? Are there any unexplored conversations or feelings to face?

An extra disclaimer: for any of the body workers, do your homework and check out their certifying organizations. In addition, trust your instinct - if you do not feel comfortable with them, politely decline an appointment and call the next person on your list.

So, having said all that...here are some ideas to try if you feel like waiting is not an option...

For Mom:
Acupuncture - an ancient Chinese modality that involves inserting very fine needles along meridians of energy in the body.

Acupressure - if you are needle-averse, this uses applied pressure on the energy meridians.

Pregnancy Massage - your local childbirth educator, doula or midwife probably has at least one or two names for you to contact.  These practitioners specialize in releasing tension and opening the body.

Chiropractic Adjustment - again, your local birth workers may have some leads for you. A chiropractor trained in the Webster Protocol can do an assessment to see if the mother's body is optimally aligned for labor and birth.  
Making love - yes, really. If your partner is a man, his semen can help ripen your cervix with natural prostaglandins. If you were to be induced in the hospital, they will insert the synthetic version to get things going.  Whatever gender your partner is, as long as they can help you climax, there is a possibility that one contraction of muscles may encourage the uterine muscles to start contracting as well.  And if nothing starts, at least you (hopefully) both had an enjoyable time trying to get labor started.

Self-Reflection  - Is there anything you still want to do - say - accomplish before your Sweet Pea arrives? Any issues or fears you would like to explore or resolve? I encourage our students to do some kind of fear release exercise or an art exploration to access their right brain and see if anything new comes up or any ideas present themselves. Sometimes just naming them makes a huge difference in being emotionally ready for the birth journey.

For Baby:
Pelvic Rocking - encourages the baby into an optimal fetal position. When you are on hands and knees, it is more likely for them to put their heaviest side (spine-down) against your belly-button.

Deep Chest-Knee Position - kneeling on the floor, instead of resting on your hands, put your chest on the floor. This position helps to get a malpositioned baby that has found a comfortable spot out of that spot that isn't allowing labor to start or progress. Once the baby is out of the pelvis, you can try other things to get baby back into the pelvis with a better alignment. 

Miles Circuit - a series of three exercises to encourage optimal fetal positioning. Two doulas brainstorming over the phone gave rise to this popular labor tool.

Spinning Babies - a website that offers several ideas to encourage babies into an optimal fetal position.

Read more about how we used Webster Protocol and Deep Chest-Knee position in THIS post.

Disclaimer: 
The material included in this video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer 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 and video contain 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®.
 
Birthing From Within and Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson


Q&A with SPB: Variations and Complications

Posted on May 17, 2016 at 3:41 PM Comments comments (0)
Q: How can I tell the difference between a variation and a complication when I'm in labor?

A: It's the difference between waiting it out with a variation; and choosing interventions for a complication. What ever the birth journey, give yourself permission to do what it takes to have a Healthy Mom, Healthy Baby outcome.






Let's start with some basics:

A "variation" in labor is something that is still within the range of normal, and just needs time to resolve itself.  With watchful waiting and allowing for time, a variation usually leads to the birth of the baby without any further intervention. 
 
A "complication" is something that would require an action or an intervention.  There may be a greater urgency for intervention since it may be outside the range of normal.

How will you know the difference?  {Shameless plug} Take a Bradley class, or any other good childbirth preparation course to learn the difference.  In the Bradley Method, part of our philosophy is to educate couples to be informed consumers. So in class, we talk about many of the different variations and complications not to scare you or burst your bubble of peace, but to equip you with knowledge so that if on the outside .02 percent chance that you would face some of the complications, you have a general idea of what your options are to preserve the intention of your birth journey.  

By the same token, by having a basic understanding of the different variations of labor that don't necessarily follow the flow chart your care provider is following, a couple is better able to decide whether they want to wait it out or "do something" to move labor along. 

There are two questions that will tell you the difference between a variation and a complication.
Is Mom okay?
Is Baby okay?

Once you know the answer to those questions, you will have more information to use as you navigate the course of your birth journey.

There are also some behaviors that will indicate the difference:
Variation: lights stay low, you are just having a conversation with a nurse in the hospital or maybe the student midwife in a home setting.

Concern: the nurse may bring in another nurse to look at the record from maternal/fetal monitoring. Lights may stay off or be turned on for a moment.

Complication: the room starts to fill with people. Usually the lights are switched on and you are seeing a higher level of care providers. Interventions are suggested and you will need to choose a course of action sooner rather than later.

I hope this helps you distinguish the difference between knowing you have time to "wait it out", and being in a situation where decisions need to be made along the birth journey.

Please leave me a comment if you have any questions you would like to see answered on Q&A with SPB.

Disclaimer: 
  Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonThe material included in this video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer 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 and video contain 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: Delivering the Placenta

Posted on October 6, 2015 at 9:54 AM Comments comments (0)
Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
This is a question that came up in class on Friday evening. I thought it would be great to answer it as a Q&A today:


Here is summary of the info:
Anywhere from 10 minutes to 1 hour could be considered range of normal as long as mom is doing well and not losing too much blood (<2 liters). Reference HERE

HERE is a great article to read about the delivery of the placenta and possible complicaitons. Dr. Rachel Reed, who writes the blog, Midwife Thinking, offers information and writes about a couple of scenarios that might interfere with the delivery of the placenta.

Please leave me a comment with your experience in this last phase of labor. Thankfully, all of ours were uneventful.  Also, let me know if you have a question for next week!

Bradley Method® natural childbirth classes offered in Arizona: convenient to Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, PaysonDisclaimer: 
The material included in this blog and video is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The viewer 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 and video contain 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®.
 


Info Sheet: Amniotomy

Posted on February 6, 2015 at 9:23 AM Comments comments (0)
Amniotomy, Artificial Rupture of the Membranes, AROM - Info sheet for Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
*Definition
Amniotomy, also known as Artificial Rupture of the Membranes (AROM) is the surgical rupture of fetal membranes to induce or expedite labor.

Source: 
American Heritage Medical Dictionary

 
*History
Amniotomy is used to start or speed up contractions and, as a result, shorten the length of labour.
 
Artificial rupture of the amniotic membranes during labour, sometimes called amniotomy or ’breaking of the waters’ was introduced in the mid-eighteenth century, first being described in 1756 by an English obstetrician, Thomas Denman (Calder 1999). Whilst he emphasized reliance on the natural process of labour, he acknowledged that rupture of the membranes might be necessary in order to induce or accelerate labour (Dunn 1992). Since then, the popularity of amniotomy as a procedure has varied over time (Busowski1995), more recently becoming common practice in many maternity units throughout the UK and Ireland (Downe 2001; Enkin 2000a ; O’Driscoll 1993) and in parts of the developing world (Camey 1996; Chanrachakul 2001; Rana 2003). The primary aim of amniotomy is to speed up contractions and, therefore, shorten the length of labour.
 
The first recorded use of amniotomy in the United States was in 1810; it was used to induce premature labor. Amniotomy and other mechanical methods remained the methods of labor induction most commonly employed until the 20th century. Amniotomy, or artificial rupture of the amniotic membranes, causes local synthesis and release of prostaglandins, leading to labor within 6 hours in nearly 90% of term patients. Turnbull and Anderson found that amniotomy without additional drug therapy successfully induced labor in approximately 75% of cases within 24 hours.
 
Sources: 
 
PROS
  • Amniotomy was associated with a reduction in labour duration of between 60 and 120 minutes in various trials
  • There was a statistically significant association of amniotomy with a decrease in the use of oxytocin: OR = 0.79; 95% CI = 0.67-0.92 in several randomized trials
  • AROM does not involve any type of medication to mom or baby and is considered by some to be the most “natural” means of induction in a hospital setting.
 
CONS
  • In several randomized trials there was a marked trend toward an increase in the risk of Cesarean delivery: OR = 1.26; 95% Confidence Interval (CI)=0.96-1. 66.
  • Trial reviewers suggest that amniotomy should be reserved for women with abnormal labour progress.
  • In 15 studies containing 5583 women there was no clear statistically significant difference between women in the amniotomy and control groups in length of the first stage of labour
  • Evidence does not support routinely breaking the waters for women in normally progressing spontaneous labour or where labours have become prolonged.
  • [Once membranes are broken} most obstetricians want the baby birthed as soon as 6 hours post-onset to reduce the risk of infection from the introduction of bacteria into the vagina due to repeated vaginal exams. Some obstetricians will wait as long as 24 hours but that is less common. In contrast, midwives, who do not routinely perform cervical checks unless specifically indicated or requested, thus limiting the chance of infection, will often allow up to 36-48 hours as long as no indications of an active infection are present.
  • A large study of 3000 women’s opinions of the intervention was conducted by the National Childbirth Trust (1989). Two thirds of the women in this study reported an increase in rate, strength and pain of contractions following membrane rupture; they found these contractions more difficult to cope with, needed more analgesia and felt that the physiology of labour was disturbed.
  • When there is concern that labour is slowing down, benign measures to intensify contractions such as positional changes and movement may prevent the need for more invasive interventions (Simkin 2010). The Cochrane review of maternal positions and mobility during first stage labour supports the positive impact mobility has in shortening labour (Lawrence et al. 2009).
  • Smyth et al. 2007 studies showed that amniotomy is not an effective method of shortening spontaneous labour and increases the risk of caesarean section and more fetal heart abnormalities
 
Sources:


 
*Link List
 For further exploration on your part


What do you think? Is this an option you would consider, or that you chose for during your birth?
 

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®.

 

I believe

Posted on June 2, 2014 at 5:27 AM Comments comments (0)
Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
The female form is beautifully made to grow a baby and birth a baby.  Birthing wisdom tells us that, in general, Sweet Peas will not grow bigger than the outlet the vessel carrying them can provide.

Another idea that is brought to mind is the analogy that our bodies know how to maintain our heart beat, breathe, digest, and do all the other autonomic functions that keep us alive.  All this, without any instruction or direction from us!  Why, then, would these miraculous bodies fail us when it comes to childbirth? Believe!!

A tenet of The Bradley Method® is for parents to attend classes and then read, read, and then read some more to be be informed and confident consumers.  This confidence begets the abtility to birth without fear of the process, possible interventions, variations or complications.  

Prepared parents can believe in the ability of the mother to birth.  This allows them to approach their labor and birth with the best intentions for an unmedicated, vaginal birth, and then see that birth through in spite of any variations or decision points they may face.

The mother has the confidence in the process and her ability to birth.  The Coach has the confidence and the motivation to be at her side and meet her needs for support and encouragement.  

NOW COMES THE BIG *HOWEVER*...

I have to admit, this affirmation gave me pause as I was preparing it. We have had students in the past who have worked so hard and so beautifully to have a vaginal birth, and it just did not go that way for them.  

So I put this out today with a caveat...believe in your ability to birth for a Healthy Mom, Healthy Baby outcome.  Sometimes, the focus may need to switch to "I will give this baby the birth that (s)he needs," which gives us the space to change from our expected path to the birth that needs to happen for a Healthy Mom, Healthy Baby outcome.

If that is the case, please talk to someone who understands that a mother can grieve her birth experience while still appreciating the fact that she has a healthy baby.  THIS article by Milli Hill articulates so beautifully the feelings a mom may have with the knowledge that she has a healthy baby AND a variation from the birth experience she may have wanted.

Here is a picture from our last birth - still the look of surprise and the "I did it!", even though it was our fourth birth!! Never cease to be amazed by the miracle of life that you grew within you...no matter how you birth, take heart from the fact that the new human being you are holding in your arms was grown within you and by you with loving intention.

Bradley Method® natural childbirth classes offered in Arizona: Chandler, Tempe, Ahwatukee, Gilbert, Mesa, Scottsdale, Payson
Image: ©2011 A Bunch of Smiles Photography
All rights reserved - we are not models - please do not copy image - thank you!

What is a birth mantra or affirmation that helped you or inspires you?
Please leave a comment - it will be moderated and posted.

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®.


Birth News: December 12, 2013

Posted on December 12, 2013 at 12:58 PM Comments comments (0)
A bigger selection of topics today...check out the news if you are "trying" to get pregnant, and more motivation to keep your pregnancy healthy, low-risk and as stress-free as possible.  Also, new study from ACOG that shows that there may be risks with the use of Pitocin.

Happy Thursday to all of you!  

P.S. I also did an early morning posting of our Wordless Wednesday from yesterday...the day got away from me!  Enjoy a peek into our home as we celebrate the season.

FERTILITY
Low folate in male diet linked to risk of offspring birth defects
“Previous research has shown that what mothers eat during pregnancy affects the health of their offspring. But now, a new study suggests that a father's diet prior to conception could also play an important role in their child's health, particularly when it comes to consumption of folate.”
Medical News Today http://bit.ly/1h3oVdw

PREGNANCY
Right amount of fat and protein, key to babies
"The early childhood diet and that of the mother during pregnancy determines the health of a child later life. This is the claim that the EU-funded research project Early Nutrition is trying to substantiate by the time it is due to be completed in 2017." 
From Medical Xpress http://bit.ly/1h3mTKr

Study shows moms may pass effects of stress to offspring via vaginal bacteria and placenta
“As a newborn passes through the birth canal, the microbiome of a mother’s vagina ends up in the offspring’s gut. In the first study, the team, led by Tracy L. Bale, PhD, Professor of Neuroscience in the Perelman School of Medicine, Department of Psychiatry and the School of Veterinary Medicine Department of Animal Biology at Penn, found that changes in the microbiome produced by stress in pregnant mice altered the microbe population in the newborn’s gut and correlated to changes in the developing brain.”
“In a parallel animal study, Bale and colleagues were looking for predictive biomarkers of maternal stress and found that a specific protein in the placenta, OGT, may have implications for brain development in offspring. The single enzyme is known as O-linked-N-acetylglucosamine transferase or “OGT,” which is important in a wide variety of regulatory functions, including development.

The researchers found that placentas associated with male mouse pups had lower levels of OGT than the placentas associated with female pups, and levels of OGT in the placenta were even lower when their moms were stressed.”
The Almagest http://bit.ly/1h3nBaI

BIRTH
Early lung infection exacerbates asthma risk in preterm birth children
"A Swedish study of children admitted to hospital within the first year of life for lung infection has found that the increased risk this poses for later development of asthma is exacerbated by low gestational age.
Early respiratory infection and preterm birth are both known to be markers of increased subsequent asthma risk, but the relationship between these two factors has been unclear."
News Medical: http://bit.ly/1cz66Og

Study Finds Adverse Effects of Pitocin in Newborns
"These results suggest that Pitocin use is associated with adverse effects on neonatal outcomes. It underscores the importance of using valid medical indications when Pitocin is used.”
 http://bit.ly/1jIzyEO

Vaginal Births Without Epidural Anesthesia Lead To Happier Moms, Point To Potential Cure For Postpartum Depression
"Maternity care may play a role in determining a mother’s overall level of satisfaction during birth and months after labor. A mother’s decision on the mode of baby delivery and whether they opt for pain relief during labor will affect her overall happiness. A recent study finds a vaginal birth without epidural anesthesia increases the odds of happiness for new moms."
From Medical Daily http://bit.ly/18FRafX

Home births are up and less expensive than hospital births
"For the third straight year the United States has fallen in rank in the World Health Organization’s international ranking for maternal mortality. The U.S. currently ranks 58, meaning in 57 nations women have a better chance of surviving childbirth than they do here. The U.S. fares a little better in infant mortality, ranking 34 in the world at keeping infants alive through the birth process. If this sounds outrageous, consider also that the U.S. spends more money on maternity health care than any other developed nation. Licensed midwife Sondra Londino, who recently opened Birthroot Midwifery, a private practice in the Fall Creek area, explains why out-of-hospital births have increased by 41 percent from 2004-2010 and how a midwifed home birth provides a safe and satisfying birth experience." 
Ithaca Times : News http://bit.ly/18FSsHX

Retrospective cohort study: Timely Progestin Lowers Risk for  Preterm Birth
“Our report suggests that progestin prophylaxis can reduce the rate of recurrent spontaneous preterm birth when barriers to care and treatment are aggressively removed and that the gestational age at initiation may affect the success of progestin prophylaxis," the authors write.”
Medscape: http://bit.ly/1jSYpGg

BABIES
Safe Baby Wearing: Facing in or Facing Out?
“When people find out that I'm an at-home Dad, there's often an image that comes to mind that is not quite accurate, and is largely fueled by the "TV depiction" of stay-at-home and work-at-home Dads: A group of four or five guys standing around a park with outward-facing babies dangling from their chests. If this happens anywhere, I have not witnessed it, nor been a part of such a gathering in the past 4+ years of my career as a parent. When I have seen babies worn by other parents (and sometimes myself), the big question has always been "which way is the right way - inward or outward." It's been the subject of vigorous debate among parents, but the folks at Boba Family just might have the answer, and that answer is inward.”
From The Rock Father http://bit.ly/1jT1lT5

BREASTFEEDING
Malnutrition Decreased With Breastfeeding
“Professor Christophe Lacroix at the Institute for Food, Nutrition and Health, ETH-Zurich, led a study which found  the important good bacteria that babies receive from breast milk comes from their mothers gut. This is part of the innate support that assists babies with acquiring strong immune systems. It is also part of building colonic health and the babies gut.”
Las Vegas Guardian Express http://bit.ly/18FOWNH


Just for fun: 
maybe we should have therapy dogs for labor!
Therapy Dogs Help Students De-Stress During Finals
"Whether it's taking a break from the books, the workplace, or even the crowds at some of the country's busiest airports, four-legged friends are being used to help people feel good.

Scientifically, that's exactly what they're doing. Dr. Katherine Zupancic is a professor at SCC and says when people play with animals during stressful times, a hormone called Oxytocin is released that makes people happy."
From 1011HD http://bit.ly/1h3m6cs


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

5 Step Plan for Labor

Posted on December 10, 2013 at 4:28 PM Comments comments (0)
Here are Dr. Bradley’s "Keys to Labor", as per his book, Husband-Coached Childbirth.  I love these simple steps – they could almost be considered a “recipe” for labor.  

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

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

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

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

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

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

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

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

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


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

Dr. Bradley's Keys to Labor

Posted on December 9, 2013 at 8:00 PM Comments comments (0)
We saw that one of our mamas from our Fall class is in labor...so exciting!  I thought today would be a great day to share these instructions Dr. Bradley left for laboring mothers in his book, Husband-Coached Childbirth.

Here is a written version:


Here is a visual version:

I hope that one of them will be a great reminder for what you can do to have the energy you need to see your labor through from beginning to end when it's your turn.  I will write more about the principles behind these bullet points tomorrow :)


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

Warning Labels: Drugs Used for Augmentation

Posted on June 21, 2013 at 11:07 AM Comments comments (0)
When looking up the drugs used that stimulate uterine contractions, Oxytocics, I also noticed that this post needs to include the drugs that are used to reverse the effect of those drugs, a group called Tocolytics.  As with the two previous posts in this series, I have listed the FDA Pregnancy category, included links to the complete drug profiles, and then pulled out the warning, adverse reaction, and contraindication sections for you to read right here and right now.

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

We are passionate about helping families have their Best Possible Birth.  By that we mean the path that leads each individual family to a Healthy Mom, Healthy Baby outcome.  We want families to have a toolbox full of tips and techniques that help them manage the ebb and flow of labor.  We want them to be comfortable with the path of a normal, low-risk labor.  We want them to have true informed consent by having an open line of communication with their care providers.

To that end, I am sharing the information below in the interest of furthering our goal that all our students have true informed consent: knowing all the benefits and risks of a drug or procedure.  It is very rare for anyone to read the drug information insert that comes in all drug packages.  To save you time and squinting, we are already researched Epidural Drugs and Induction Drugs.  To conclude the “Warning Label” Series, here are the drugs used for Augmentation and to counteract the strong contractions they have the potential to stimulate.


PITOCIN: Pregnancy Category X
http://www.drugs.com/pro/pitocin.html
Contraindications:
“Antepartum [before delivery] use of Pitocin is contraindicated in any of the following circumstances:
Where there is significant cephalopelvic disproportion;
In unfavorable fetal positions or presentations, such as transverse lies, which are undeliverable without conversion prior to delivery;
In obstetrical emergencies where the benefit-to-risk ratio for either the fetus or the mother favors surgical intervention;
In fetal distress where delivery is not imminent;
Where adequate uterine activity fails to achieve satisfactory progress;
Where the uterus is already hyperactive or hypertonic;
In cases where vaginal delivery is contraindicated, such as invasive cervical carcinoma, active herpes genitalis, total placenta previa, vasa previa, and cord presentation or prolapse of the cord;
In patients with hypersensitivity to the drug.”

Precautions
“When properly administered, oxytocin should stimulate uterine contractions comparable to those seen in normal labor. Overstimulation of the uterus by improper administration can be hazardous to both mother and fetus. Even with proper administration and adequate supervision, hypertonic contractions can occur in patients whose uteri are hypersensitive to oxytocin. This fact must be considered by the physician in exercising his judgment regarding patient selection.”

“Except in unusual circumstances, oxytocin should not be administered in the following conditions: fetal distress, hydramnios, partial placenta previa, prematurity, borderline cephalopelvic disproportion, and any condition in which there is a predisposition for uterine rupture, such as previous major surgery on the cervix or uterus including cesarean section, overdistention of the uterus, grand multiparity, or past history of uterine sepsis or of traumatic delivery. Because of the variability of the combinations of factors which may be present in the conditions listed above, the definition of "unusual circumstances" must be left to the judgment of the physician. The decision can be made only by carefully weighing the potential benefits which oxytocin can provide in a given case against rare but definite potential for the drug to produce hypertonicity or tetanic spasm.
Maternal deaths due to hypertensive episodes, subarachnoid hemorrhage, rupture of the uterus, and fetal deaths due to various causes have been reported associated with the use of parenteral oxytocic drugs for induction of labor or for augmentation in the first and second stages of labor.”

“Oxytocin has been shown to have an intrinsic antidiuretic effect, acting to increase water reabsorption from the glomerular filtrate. Consideration should, therefore, be given to the possibility of water intoxication, particularly when oxytocin is administered continuously by infusion and the patient is receiving fluids by mouth.
When oxytocin is used for induction or reinforcement of already existent labor, patients should be carefully selected. Pelvic adequacy must be considered and maternal and fetal conditions evaluated before use of the drug.”

Adverse Reactions
“The following adverse reactions have been reported in the mother:

  • Anaphylactic reaction
  • Premature ventricular contractions
  • Postpartum hemorrhage
  • Pelvic hematoma
  • Cardiac arrhythmia
  • Subarachnoid hemorrhage
  • Fatal afibrinogenemia
  • Hypertensive episodes
  • Nausea
  • Rupture of the uterus
  • Vomiting
  • Excessive dosage or hypersensitivity to the drug may result in uterine hypertonicity, spasm, tetanic contraction, or rupture of the uterus.”


“The possibility of increased blood loss and afibrinogenemia should be kept in mind when administering the drug.”

“Severe water intoxication with convulsions and coma has occurred, associated with a slow oxytocin infusion over a 24-hour period. Maternal death due to oxytocin-induced water intoxication has been reported.”

“The following adverse reactions have been reported in the fetus or neonate:
Due to induced uterine motility:

  •   Bradycardia
  •   Premature ventricular contractions and other arrhythmias
  •   Permanent CNS or brain damage
  •   Fetal death
  •   Neonatal seizures have been reported with the use of Pitocin.
Due to use of oxytocin in the mother:
  • Low Apgar scores at five minutes
  • Neonatal jaundice
  • Neonatal retinal hemorrhage



Related drug SYNTOCINON® - most of the information is identical
http://www.drugs.com/pro/syntocinon.html

ERGOTRATE (ERGONOVINE) – Pregnancy: Should not be administered prior to delivery or delivery of the placenta
http://www.drugs.com/mmx/ergotrate.html
Pregnancy—
“Use of ergonovine is contraindicated during pregnancy…Tetanic contractions may result in decreased uterine blood flow and fetal distress.”

Labor and delivery—
“High doses of ergonovine administered prior to delivery may cause uterine tetany and problems in the infant (hypoxia, intracranial hemorrhage) {03}. Ergonovine should not be administered prior to delivery of the placenta…Administration prior to delivery of the placenta may cause captivation of the placenta…or missed diagnosis of a second infant, due to excessive uterine contraction.”

Breast-feeding
“Problems in humans have not been documented. However, ergot alkaloids are excreted in breast milk…Although inhibition of lactation has not been reported for ergonovine, other ergot alkaloids inhibit lactation. Also, studies have shown that ergonovine interferes with the secretion of prolactin (to a lesser degree than bromocriptine) in the immediate postpartum period…This could result in delayed or diminished lactation with prolonged use.”

“Ergot alkaloids have the potential to cause chronic ergot poisoning in the infant if used in higher-than-recommended doses or if used for a longer period of time than is generally recommended.”

Pediatrics
"Elimination of ergonovine may be prolonged in newborns...Neonates inadvertently administered ergonovine in overdose amounts have developed respiratory depression, cyanosis, seizures, decreased urine output, and severe peripheral vasoconstriction."

METHERGINE: Category C
http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=94c9b1cf-ae12-45f3-8fcb-708a922cbc10
INDICATIONS AND USAGE
“For routine management after delivery of the placenta; postpartum atony and hemorrhage; subinvolution. Under full obstetric supervision, it may be given in the second stage of labor following delivery of the anterior shoulder.”

CONTRAINDICATIONS
"Hypertension; toxemia; pregnancy; and hypersensitivity."

TOCOLYTICS
MAGNESIUM SULFATE: Pregnancy Category A
http://www.drugs.com/pregnancy/magnesium-sulfate.html
“Studies in pregnant women have not shown evidence of fetal risk if magnesium sulfate is administered during any trimesters of pregnancy. However, because studies cannot completely rule out the possibility of harm, magnesium sulfate injection is only recommended for use during pregnancy when benefit outweighs risk.”

“Newborns may show signs of magnesium toxicity (i.e. respiratory and/or neuromuscular depression) if the mother has received intravenous magnesium sulfate prior to delivery (especially if for a period of longer than 24 hours). Equipment for assisted ventilation as well as intravenous calcium should be immediately available for the first 24 to 48 hours after delivery. One study has reported that maternal magnesium sulfate treatment is associated with reduced brain blood flow perfusion in preterm infants. However, intravenous magnesium sulfate did not lead to lower neonate Apgar scores in a study of women treated for preeclampsia even though the newborns cord level indicated hypermagnesemia.”

TERBUTALINE (BRETHINE): Pregnancy Category B
http://www.drugs.com/sfx/brethine-side-effects.html
“Terbutaline has been shown to cross the placenta, and the fetus may experience the general adverse effects reported in the mother. Pulmonary edema has been associated with the intravenous use of terbutaline in pregnant women. Myocardial necrosis in one infant was thought to be associated with terbutaline given at a rate of 0.5 mg/hr for 12 weeks by subcutaneous infusion. In one retrospective review of 8,709 patients receiving continuous low-dose subcutaneous infusion of terbutaline to arrest preterm labor, only 47 (0.54%) had one or more cardiopulmonary problems. Pulmonary edema was reported in 28 patients (0.32%), 17 of whom had been treated concurrently with large amounts of IV fluids or one to three tocolytic agents and four of whom had been diagnosed with pregnancy-induced hypertension and/or multiple gestation. Other cardiovascular effects occurred in 19 patients (0.22%), including electrocardiogram changes, irregular heart rate, chest pain, or shortness of breath. However, 7 of these patients had a history of cardiac problems. Use of terbutaline in pregnant women for the relief of bronchospasm may interfere with uterine contractility. For the treatment of asthma, administration by metered dose inhaler results in lower plasma concentrations and consequently fewer adverse effects for the mother and fetus. Hepatitis has been reported in at least two patients receiving terbutaline to control premature labor.”

“Terbutaline has been assigned to pregnancy category B by the FDA. Animal studies have failed to reveal evidence of teratogenicity. Terbutaline is only recommended for use during pregnancy when benefit outweighs risk.”

INDOMETHACIN (NSAID): Pregnancy Category C
http://www.drugs.com/pregnancy/indomethacin.html
“Animal studies have failed to reveal evidence of teratogenicity or fetal harm except at doses which result in significant maternal toxicity. There are no controlled data in early human pregnancy. Indomethacin has been used in the management of premature labor. However, fetal hemodynamic changes, premature closure of the ductus arteriosus resulting in neonatal primary pulmonary hypertension, and neonatal oliguric renal failure, oligohydramnios, hemorrhage, and intestinal perforation have been reported as a result of this tocolytic therapy. Indomethacin is only recommended for use during pregnancy when benefit outweighs risk.”

“Indomethacin crosses the placenta. In one study, 26 pregnant patients were administered indomethacin 50 mg orally one time approximately six hours prior to scheduled cordocentesis, at a gestational age of 23.6 to 36.6 weeks. At the time of the procedure, maternal serum indomethacin concentrations ranged from 42 to 690 ng/mL (mean 218 ng/mL) while fetal concentrations ranged from 87 to 496 ng/mL (mean 219 ng/mL). The mean maternal to fetal serum concentration ratio was 0.97. There was no correlation between gestational age and maternal/fetal ratio. Amniotic fluid concentrations averaged 21 ng/mL. Indomethacin has been used successfully in the treatment of premature labor as well as polyhydramnios. In several studies, indomethacin was as effective and better tolerated than beta-agonists for premature labor. However, while earlier reports and studies suggested indomethacin was safe for the fetus or neonate, especially when use was confined to pregnancies of 34 weeks gestation or less, more recent data suggest a substantial increase in the risk of serious fetal or neonatal side effects. Eronen (1993) studied the effects of indomethacin or nylidrin on the fetal and neonatal ductus arteriosus and tricuspid valve function. A total of 84 pregnancies (94 fetuses) with premature labor between 22.9 and 34.0 weeks gestation were evaluated. Ductal constriction occurred in 46/49 (86%) of fetuses (gestational age 24.0 to 34.0 weeks) treated with indomethacin. The gestational age of the fetuses without ductal constriction ranged from 24.3 to 28.6 weeks. Eleven fetuses with ductal constriction also had tricuspid regurgitation. Data from this study suggest increasing reactivity of the ductus with increasing gestational age; although, ductal constriction occurred in one fetus at 22.9 weeks gestation. In addition to hemodynamic changes, other serious sequelae of maternal indomethacin use have been documented. One study compared 57 infants delivered at or before 30 weeks gestation whose mothers received indomethacin for the treatment of premature labor with 57 infants whose mothers had not received indomethacin. The total dose of indomethacin ranged from 50 to 6000 mg (median 425 mg) and the duration of therapy ranged from 1 to 79 days (median 3 days). Necrotizing enterocolitis occurred in 29% of infants exposed to indomethacin compared with an 8% incidence in the control group (p=0.005). Intracranial hemorrhage occurred in 28% of infants in the indomethacin group compared with only 9% in the control group (p=0.02). Maternal use of indomethacin has resulted in reduced fetal urine output and subsequent oligohydramnios, neonatal renal failure, fetal pleural effusion, and ileal perforation. In addition, at least two cases of neonatal lower limb ischemia have been reported following prolonged intrauterine exposure to indomethacin. Fetal echocardiograms after 24 hours of maternal indomethacin therapy and then weekly, thereafter, if long-term therapy is necessary, have been recommended. In addition, assessment of amniotic fluid volume is also recommended.”

RITODRINE (YUPOTAR): Pregnancy Category B
http://www.drugs.com/pregnancy/ritodrine.html
“There are no controlled data in human pregnancy. Neonatal hypoglycemia, tachycardia, and ileus have been reported. Rarely, ketoacidosis resulting in fetal death has been reported. Ritodrine is only recommended for use during pregnancy when benefit outweighs risk.”

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