The Power of Birth Comes from Within, The Knowledge of Birth Comes from Support.

Friday, December 2, 2011

It’s called Couvade

Couvade comes from the French verb couver, meaning ‘to hatch’.  It has come to describe expectant fathers experiencing a sympathetic pregnancy.  The symptoms are often experienced by more than 20% and in some studies, up to 80% of expectant fathers.  So, you are not going crazy dads!  These symptoms are real and often begin in the 2nd trimester of pregnancy.
Some of the symptoms that the fathers may have include: food cravings, weight gain, nausea, vomiting, changes in sleep patterns, changes in sex drive, and dreams about being a parent.   Many people attribute these symptoms to ‘nervousness’ about becoming a father though there is some evidence to support that fathers may have some hormonal fluctuations in the weeks and days leading up to the birth.  There are some studies that suggest father’s who experience these symptoms may develop a stronger attachment to the baby. 
The cure….the birth of your baby of course!  In the meantime when the cravings hit, go with them.  Get some rest.  Prepare for the changes ahead and enjoy the last weeks of pregnancy with your partner.   The symptoms will soon be replaced by the overwhelming joy of cradling your newborn in your arms.

Thursday, November 24, 2011

Going Past Your Due Date

It’s so hard to see your due date come and go with no signs of labor on the horizon.  People may comment about your date being off, being about to ‘pop’, and question you about getting induced or even comment about ‘are you sure there aren’t twins in there?’   Roughly 8% of women give birth on their due dates with many women going past their EDC.  Generally pregnancy lasts about 266 days.  This is calculated on having your cycle every 28 days and ovulating on day 14.  Thank you Dr. Naegele for this wonderful mathematical calculation born somewhere in the late 1800’s.
Perhaps your due date was off.  More likely that the baby just isn’t ready yet and they are the only ones who really know for sure.  Let’s trust them.  So what to do while you wait?
v Make a plan.  Are you ready for the first days and weeks postpartum?  Is your bag packed?  Camera’s ready?  Music for labor loaded on your IPOD?  Has your support team all reviewed your birth plan?
v Do something fun: Take in a movie.  Spend the days with the remote control and Lifetime TV.  Take a walk on the beach.   Have a romantic dinner out together.  Go out with friends.  Get a massage. Practice your relaxation.  Take naps.  Get a pedicure so your toes look pretty while you push.
v Research natural ways to induce labor.  There are several methods that have been noted to get things going.
v Talk with your care provider about any concerns you may have.
v Install your car seat in the car if you haven’t already.
v Keep monitoring fetal movements and any contractions that you may be having.
v Read over positive birth affirmations.
v Talk, read, and sing to your baby.
v Try to let go and breathe.  The baby will come when the baby is ready. 

Friday, June 24, 2011

What’s a Kangaroo got to do with it?

Kangaroo Care or Skin to Skin contact began in the late 1970’s / early 1980’s in Columbia and resulted in a decrease in Infant Mortality by about 40%.    It is termed Kangaroo Care to describe how a baby Kangaroo is carried by its mother.  Since then there have been many more studies evaluating the benefits of Skin to Skin contact predominately with infants who are premature or are in the Neonatal Intensive Care Unit (NICU).  82% of NICU’s in the United States use Kangaroo Care.  However, all infants benefit from this amazing contact with their mother (or father) and the wonderful intimacy and attachment it brings.
Mothers and infants should be together.  We know this to be true.  This contact stimulates the infants’ behavior, helps them stay calm, decreases crying, stabilizes breathing and heart rate, maintains their temperature, increases the likelihood of successful breastfeeding, maintains the infants’ blood sugar and assists with weight gain.  Skin to skin increases parental confidence and helps them get to know their infant.  Plus, it just feels wonderful.    So, get that infant down to their diaper, hold them close, kiss their head and take a breath.  There is nothing more important than what you are doing right now.

Sunday, May 8, 2011

Transitions: The Postpartum Period

Shortly after the birth of a baby a family is faced with many adjustments.    Some of these are most certainly physical and some are quite emotional.  The changes involve all members of the family:  significant others, siblings, even pets.  Patience is needed as the adjustment period cannot be rushed and each person will adjust in their own time and in their own way.
The types of adjustments that a family is faced with can be broken down into separate categories:
v Physical
Immediately postpartum the body starts restoring itself.  The uterus begins restoring itself to its non-pregnant state.  After birth contractions occur and assist in the process.  The breasts begin the process of supplying milk to the baby.  The woman’s body begins to relieve itself of excess fluid by sweating and urinating.  Then there is the physical healing from the actual birth experience and working with any soreness that may occur.  The full physical healing may take anywhere between 4-6 weeks.  Time, self care, good nutrition, and rest are needed for the body to heal.
v Emotional
So many emotions flood the family right after birth ranging from exhaustion to excitement to even disappointment and anxiety based on the birth experience.  Many women experience the ‘Baby Blues’ which can occur in the first two weeks postpartum.  A new family needs rest, help at home and encouragement as they transition in the new role as parent.   Community resources must be available to all families so that they can feel safe to reach out if needed at any time. 
v Attachment
Falling in love is not a single magical moment in time in any relationship.  There are some families that take time to fall in love with their baby as they get to know who this baby is as a person.  Caring for the baby gives the new families the time to fall in love as the baby’s personality begins to emerge.  The time it takes may be different for each person in the home.
v Taking Care of the Baby
Taking care of yourself while you are pregnant takes care of the baby while the care a newborn requires is quite intensive.  Feeding, diapering, and bathing are all new skills that the new family needs to learn all while they are quite sleep deprived and healing physically.  It’s important that everyone who cares for the baby knows the basic safety factors regarding signs of illness, sleep positioning, and car seats.  The new family should contact the Pediatrician for any questions whenever they arise without feeling guilty for making that call.  It’s important that a new parent trust their instincts.  They are the experts of their baby. 
v Relationships
The effect on all relationships changes with the arrival a new baby.   It’s important to support all family members and provide time to talk about feelings and concerns in the safety of the home.   There may be times when a new parent feels vulnerable or frustrated and may  tend to take it out on the person closest to them at home.  Communication and rest are vital in getting through these times.   Each person needs a certain amount of sleep to function.  It’s important that each family member try to get that amount within every 24 hour period.  Extra time should also be taken for siblings as they adjust to their role as a big brother or sister as there may be some issues of jealousy. 
All of these types of adjustments occur simultaneously in the hours, days, and weeks postpartum.  They can present some challenging moments but with time, rest, love, open communication and feeling safe to seek help when needed, it will get easier.

Sunday, April 3, 2011

Breastfeeding ~ the gift that lasts a lifetime

It’s so important that a pregnant woman and her family are educated prenatally about the importance of breastfeeding.  There is so much evidence that is available regarding the wonderful benefits of giving a newborn and infant breast milk.  The WHO (World Health Organization) recommends exclusive breastfeeding for the first 6 months of a baby’s life because it is the best food for a baby.  Breast milk contains all the nutrients, calories and fluids that a baby need to grow.  It’s recommended that pregnant women take a breastfeeding class, find supportive friends and family and have access to evidence based information about breastfeeding.  Here is some of the evidence:
v A breastfed baby’s health is dramatically affected in the most positive ways.
Baby’s that are breastfed are protected from childhood obesity, diabetes, ear infections, asthma, eczema, digestive problems, SIDS, and some forms of cancer when compared with baby’s that are fed with artificial milk.  In addition, children that were breastfed have higher IQ’s and perform better on cognitive testing in school.
v The health benefits for the breastfeeding mother are enormous.
Women who breastfeed their baby are more likely to return to their pre-pregnancy weight faster.  They experience less postpartum bleeding and decreased risk of hemorrhage.  Breast and Ovarian Cancer risk is lower as is the risk of Osteoporosis.  During breastfeeding the hormone Oxytocin is released and helps with the bonding and attachment process with the baby.
v Once you get the hang of it breastfeeding is faster and easier and requires less time and effort. 
Breastfeeding is a learned skill.  It takes time and practice.  Breast milk is ready to go.  It’s at the right temperature and there are no bottles to mess around with and no storage to worry about.  It’s important that the baby is observed for hunger cues and signs that it’s time for a feeding and then to offer a feeding.   It’s also essential that the partner and family of the breastfeeding woman are educated about breastfeeding and the time and energy required in the beginning as breastfeeding and milk supply is established.
v The good stuff in breast milk cannot be replicated.
There are wonderful immunities in breast milk.  The first milk the baby receives is colostrum (‘liquid gold’) and is the best food for the baby in the first hours and days after birth.  Breast milk also changes over time (even the day) to meet the nutritional needs of the baby.  The milk is easily digested and provides everything that the baby needs to grow healthy and strong.
v Breastfeeding saves money.
By breastfeeding a family can save over $1,200 a year in not purchasing artificial milk.  When a baby is healthier there will be less time missed from work and less sick days used.   The environment is also saved from harmful packaging that is discarded.
v Only you can do it.
A mother’s breast milk is specific to the needs of her baby.   The physical contact a mother has with the baby while breastfeeding helps promote that special bond between a mother and a child.  Breastfeeding is truly the gift that lasts a lifetime.

Monday, March 28, 2011

Why Plan for Birth?

A woman and her family spend 40 weeks being pregnant and anticipating the day that the baby is born.  Planning for what they would like to happen is how they share it with everyone who may be involved in that special day.  It allows the woman and her family time to discuss with others their hopes and dreams and what, if any, interventions matter the most.  It also gives the family the opportunity to learn about birth, potential medical procedures which may occur, and the purpose and value of labor support.  In addition, it permits the family to address any potential areas that may cause anxiety prior to being in the middle of labor when decision making may not be based on informed choices.   Medical professionals value the input of the woman and her family so letting them know the woman’s preferences will help care for her in labor.
Birth plans should be simple and most importantly they should be flexible.  Like any other part of life, some things go easier than expected; other things become more challenging once in the midst of them.   The Birth Plan should ideally be kept to one page.  It should include information about some of the most common things a woman in labor will experience:  managing pain or discomfort, monitoring of the labor progress and the baby, and how a woman would like to be supported and cared for in labor.  The Birth Plan is not a binding contract.  It should be the preferences the woman and her family desire but it should be a fluid document that is able to adapt to things that may change during the course of the labor and birth.
It is also important for the woman and her family to understand the policies / procedures of the place where they plan to give birth.  Taking Childbirth Education Classes, doing Tours of the facility all help in learning about the possibilities that would be available and adapt the Birth Plan accordingly. 
Once the Birth Plan is written it should be shared prenatally with everyone who will be involved at the Birth.  A copy should be brought with the woman upon admission to the Hospital or Birth Center so other staff who may never have met the woman and her family will have a chance to review and discuss it with them.  This can assist the personnel in working to ensure the family that their hopes for the baby’s birthday are acknowledged. 

Saturday, December 18, 2010

The 'P's' of Birth

There are so many factors that effect the labor and birth process.  For those of us who like being in 'control' (or at least the illusion of being in control) there are quite a number of things that a laboring woman and her partner(s) can do to help in the process.  There will come a time however, when all women need to let go and let birth happen.  When we discuss this in childbirth eduction class, we generally refer to the 'P's' of Birth.  Many believe there are 4 of them: the passage, the passenger, the powers and the psyche.  I actually believe that there are 5.  The last one being the people who are there to support the laboring woman and welcome the baby.

The Passage:
We are born with the pelvis that we have.  No getting around that one.  But the pelvis, cervical opening, and birth canal are more than capable of letting a baby out.   As the end of pregnancy nears, a hormone helps to soften the cartilage in the pelvis to allow the pelvis to open more and give the baby more room.  The passage can be a tight one but allowing a women to move about freely and work with her body, changing positions at least every 30 minutes, assists with the baby finding the right position to pass through the passage to loving arms.

The Passenger: 
This is the baby.  This is about their size and their position especially as labor progresses.  During labor the baby will need to make some twists and turns.  These are called the Cardinal Movements.  During the hugs of contractions the mother is supplying oxygen for the baby as she breaths at a level that is comfortable to her.   The baby will move through the passage as the mother moves, at least - that's the plan and there need not be a hurry.  Labor is good for babies. 

The Powers:
These are the uterine contractions.  The uterine contractions are caused from the release of oxytocin, the 'love hormone' from the posterior pituitary.  It acts like a neurotransmitter in the brain.  As labor progresses (without any help from artificial means) the woman's body also starts to produce endorphins, natural pain relief.  As the contractions become longer, stronger, and closer together, oxytocin flows, endorphins are available, and the laboring woman is working with her body and her baby - together.  As Penny Simkin, one of the founders of DONA International states, 'The contractions cannot be stronger than you, because they are you'.  Oh, how I love that affirmation. 

The Psyche:
I never understood why there are so many people who like to scare pregnant women talking about the pain in labor.  Yes, there will be pain and the pain is from a variety of sources:  contractions, dilation, bones spreading to give the baby more room, etc.  We all need to empower women as they anticipate labor and birth.   Women must prepare mentally for the journey.  Contractions need to be taken one at a time as each one brings the woman closer to the baby in arms.  She needs support and a welcoming environment where she feels safe and loved.

The People:
The support team that is there for the labor and birth are essential. The support team needs to be loving, kind, encouraging and occasionally, even firm.  I have seen many labors stall if there is someone in a room that may be causing the laboring mother anxiety or telling her what to do when it is going against what her brain and her body are telling her to do.   As we talk about people we also need to talk about the birth environment:  the lighting in the room, does the woman feel too exposed, is the temperature comfortable for her, is there music playing that is helping her let go?  A woman in labor should not be left alone.  There are times when she may not want hands on massage or care but just the presence of a loving heart and soul.

All of these are interconnected.  One will effect another.   Even doing everything that a woman can do in labor, the process can be long.  One of the most important things to keep in mind is that she will always remember how she was treated in labor.