Saturday, September 27, 2008

Mother-Friendly Childbirth

What is mother-friendly childbirth?

Coalition for Improving Maternity Services (CIMS) offers several excellent articles on mother-friendly care:

The Mother-Friendly Childbirth Initiative outlines the principles of mother-friendly care. I highly recommend reading the two-page pdf, but these are the principles it highlights:
Normalcy of the Birth Process;
Empowerment;
Autonomy;
Do No Harm;
Responsibility.
Highlights of the Evidence is another two-page pdf that presents the evidence in very straight-forward, easy-to-read language.

***************************************

There are so many aspects of mother-friendly care that it's hard to pick one to focus on... To me, mother friendly care is…
• care that considers mother & baby together; what’s good for mother is good for baby.

• care that honors birth as the birth of a mother & family; as an opportunity to empower mothers as they begin their parenting journey.

• care that values mothers, encouraging and supporting them as partners…
But, I think one of the most significant things about mother-friendly care is that it is PERSONALIZED care.

What is “friendly” to one mother may be confusing, overwhelming, or aggravating to another.

For example, in my childbirth classes, we practice contractions holding ice. For the first practice scenario, everyone complains and moans and giggles about how uncomfortable they are. For the second practice, everyone focuses inward and listens to their breathing. The focused breathing practice goes by much faster, and is much less uncomfortable for most people; however, for others, all the distraction of people talking moves time faster. These practice contractions help them realize something about themselves: they might benefit from a big crowd of friends and family supporting & encouraging them during labor; for others, they think about having a quiet, cave where nothing is distracting them from their coping internally.

The point is, what is friendly to one person – no talking, or lots of talking – might not work at all for someone else. Or – it might work better one way for part of labor, and another way later.

Our friends know us. They listen to us. They treat us as individuals.

They know our history & our beliefs…
They know how we are trying to live and they support us…

Mother-friendly care comes from providers who take the time to listen to mothers, to learn about each mother’s history, what she believes about birth…

Does this mother love the water?
Is she anxious about needles?

Mother-friendly care comes from providers who take the time to consider how to best support each particular mother and baby on their birth journey…

Does she need a lot of step-by-step, close support, or would that distract her, pulling her out of her mammal instinctive brain?

…and who then follow-through, basing care decision on that particular mother & baby.

Finally, mother-friendly care is about trust. Friends can trust each other. Mothers should be able to trust that their caregivers will provide personalized care that is based on the best evidence, not on legalities and convenience; that the hospitals and birth centers where they give birth are crafting policies to support and encourage mother-friendly caregiving. With homebirths, families get to make up their own rules, with the guidance of their midwife!

Do I think that’s where we’re at, now, in Central Maine? Where most women give birth in places that support mother-friendly caregivers; that the nurses, doctors, and midwives are mother-friendly?

Sometimes, yes, but (so sadly) I do not think it is the norm here, or in the USA as a whole. Like many people, I struggle with this - how to be an active agent for change? how to encourage others to request (or to insist on!) this type of care? how to show them that they, and their babies, deserve it?

I went to see Birth last night in Gardiner - it was amazing, awesome, sad, beautiful, empowering. I wish the theater had been packed - it wasn't. I wish people had brought their teenage daughters (and sons) to continue an ongoing discussion with them about birth. I wish couples thinking about trying to conceive had come, to open/continue their discussions about the birth of their family. Not that the conversation afterwards wasn't fun and interesting; it was to me - it just would have been even more wonderful if it had reacher a broader segment of the population.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Friday, September 26, 2008

Boot Camp for New Dads - Free!

The next Boot Camp for New Dads is Saturday, October 25th, from 9-12 at the Ford Grant Conference Room at Inland Hospital, in Waterville. I have heard great things about this program, taught by dads, with demos by "veteren" dads and their babies.

Flyer, with basic information.

Description of the program.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
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Maine's Biggest Baby Shower

Inland Hospital, in Waterville, ME is hosting MAINE'S BIGGEST BABY SHOWER, on Saturday, October 4th, from 9-11:30am. There are lots of informative, helpful exhibits, as well as food, gifts, and games. For more information, email inlandhospital@emh.org or call 861-3392. See the schedule.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Nursing Is Normal Media Project

This slide show of nursing mothers is beautiful - brought tears to my eyes. Babies and young children nursing in a variety of settings - some on Mama's lap, others in baby carriers; mothers of various sizes and ages, too.

The slideshow, by Kathy O'Brien, is currently being presented on the Mothering website, which introduces it this way:
"The NIN Project is a photographic display of nursing moms in public settings. We believe the more often something is seen, the more accepted it becomes. These mothers have posed in various public settings to help other mothers feel comfortable nursing in public. Nursing is normal."
NIN Slide Show

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Wednesday, September 24, 2008

Local Eating during Pregnancy: Part One

I'm finishing up the excellent book Animal, Vegetable, Miracle: A Year of Food Life, by Barbara Kingsolver, who is one of my favorite authors. And I'm finishing up my year of garden work: picking my winter squash and orange pumpkins, the last peppers and eggplant, and putting cold frames over the less-hardy greens. Three days of rainy weather approaching has made the task more urgent - I don't want my peppers and winter squash to get moldy! During the rain, I think we'll be inside peeling apples from our local orchard for applesauce and husking/blanching/freezing corn from a farm just up the road.

There are many advantages to buying & eating more foods locally and seasonally. Some help others most directly, but certainly affect us in the long-term: economic benefits for the local area and local farmers; less dependence on gasoline to bring the food to you; small farms often farm more sustainably and/or organically (even if they don't go through the process to be certified organic). There are other benefits that are just for the local eater her/himself: eating food that was grown for taste, not portability/storage (YUM!) as well as the additional nutrition offered by eating locally and seasonally.

For many women, pregnancy is a time when they are more motivated to learn about nutrition, and to make food choices based on what they learn. It's also a time when there is a more obvious link to other mothers - mothers past, animal mothers, our mothers, future mothers. One of my favorite books to read during pregnancy was a memoir-ish book called Having Faith: An Ecologist's Journey to Motherhood. The author, Sandra Steingraber, discusses her journey month-by-month through pregnancy, giving each chapter a moon name, from "Old Moon" to "Harvest Moon". She writes in the preface that "When I became pregnant at the age of thirty-eight, I realized, with amazement, that I myself had become a habitat. My womb was an inland ocean with a population of one" (ix).

So, in honor of the coming harvest, and for all of you mamas growing your babies in the "inland ocean", here are a few recipes I'll be using to take advantage of this beautiful (and delicious!) season...

KALE

This recipe, Dino Kale Saute, is my favorite ways to use kale - everyone I've made it for as always loved it. Kale is an excellent source of Vitamin C, Vitamin A, and Vitamin K and has calcium and protein in it (!!).

Dino Kale Saute

12 ounces dinosaur kale or regular kale, cut or torn into 1- to 2-inch pieces (about 12 cups)
2 tablespoons olive oil
1/4 cup soft sourdough or French loaf bread crumbs
1/8 teaspoon pepper
1 teaspoon white wine Worcestershire sauce
Lemon wedges (optional)

1. Rinse kale leaves thoroughly under cold running water. Drain well; set aside.

2. In a small skillet heat 2 teaspoons of the oil. Cook bread crumbs in the hot oil for 1 to 2 minutes or until browned. Season with pepper; set aside.

3. In a large, nonstick skillet heat the remaining 4 teaspoons oil. Add kale. Cook the kale, covered, for 1 minute. Uncover. Cook and stir for 1 minute more or until just wilted. Transfer kale to serving dish. Drizzle with Worcestershire sauce. Sprinkle with the browned bread crumbs. Squeeze lemon wedges over all. Makes 4 servings.

Nutrition Facts
Servings Per Recipe 4 servings
Calories 89, Total Fat (g) 5, Saturated Fat (g) 1, Cholesterol (mg) 0, Sodium (mg) 53, Carbohydrate (g) 9, Fiber (g) 4, Protein (g) 3, Vitamin C (DV%) 94, Calcium (DV%) 8, Iron (DV%) 8, Percent Daily Values are based on a 2,000 calorie diet


APPLES

Apples are delicious this time of year and there are so many kinds to choose from. Apples have some Vitamin C and are a good source of fiber.

Rustic Apple Sauce

Ingredients
4 cups cubed peeled Braeburn or Pink Lady apple
4 cups cubed peeled Granny Smith apple
1/2 cup packed brown sugar
2 teaspoons grated lemon rind
3 tablespoons fresh lemon juice
1 teaspoon ground cinnamon
1 teaspoon vanilla extract
Dash of salt
2 tablespoons crème fraîche (or full-fat yogurt or sour cream)
Preparation

Combine first 8 ingredients in a Dutch oven over medium heat. Cook 25 minutes or until apples are tender, stirring occasionally.

Remove from heat; mash to desired consistency with a fork or potato masher. Stir in crème fraîche. Serve warm or chilled.

Nutritional Information
Calories:140 (12% from fat)
Fat:1.8g (sat 1g,mono 0.5g,poly 0.2g) Protein:0.3g Carbohydrate:32.5g Fiber:2.3g
Cholesterol:3mg Iron:0.5mg Sodium:30mg Calcium:31mg

One of my favorite recipes comes from the mother of my best friend growing up. It's not really a recipe, actually: chop up an apple and a small handful of walnuts; add a couple of spoonfuls of ricotta cheese and a sprinkle of cinnamon. Yum!


PEARS

Pears are also in season in the fall. They have some Vitamin C and are a very good source of fiber.

Pear Clafouti

Cooking spray
1 teaspoon all-purpose flour
2 cups cubed peeled pear
3/4 cup all-purpose flour
1/4 teaspoon salt
1/8 teaspoon nutmeg
2 cups 1% low-fat milk, divided
3 large eggs, lightly beaten
1/2 cup sugar
1/2 teaspoon vanilla extract
Preparation

Preheat oven to 375°.

Coat a 10-inch deep-dish pie plate with cooking spray, and dust plate with 1 teaspoon flour. Arrange the pear cubes in the bottom of prepared dish, and set aside.

Combine 3/4 cup flour, salt, and nutmeg in a bowl. Gradually add 1 cup milk, stirring with a whisk until well-blended. Add 1 cup milk, eggs, sugar, and vanilla extract, stirring until smooth. Pour batter over pear cubes. Bake mixture at 375° for 35 minutes or until set.

Nutritional Information
Calories:230 (15% from fat)
Fat:3.9g (sat 1.3g,mono 1g,poly 0.5g) Protein:7.7g Carbohydrate:41.1g Fiber:1.8g
Cholesterol:113mg Iron:1.3mg Sodium:171mg Calcium:121mg


PEARS & APPLES

I think pears and apples are both excellent addition to spinach or lettuce salads. A salad with spinach or mixed greens, apples or pears, a sprinkle of sunflower seeds and some chopped cooked chicken or hard-boiled egg is an excellent lunch or dinner. Paul Newman's raspberry walnut salad dressing is a good one to try on this type of salad if you don't want to make your own balsamic vinaigrette. A sprinkle of (pastuerized!) blue cheese or goat cheese, or cheddar, can be nice too.

Pears and apples are also good served with this dip:

Cottage Cheese and Apple Snacks

1 cup low-fat cottage cheese
2 tablespoons peanut butter
1/4 teaspoon ground cinnamon or apple pie spice
1 to 2 teaspoons skim milk
3 medium apples or pears, cored and sliced

For dip, in blender container or food processor bowl place the cottage cheese, peanut butter, and cinnamon or apple pie spice. Cover and blend or process until smooth. If necessary, stir in enough milk to make dip of desired consistency.

Serve the dip immediately or cover and chill it for up to 24 hours. Serve dip with the apple or pear slices. Makes 6 (2-tablespoon) servings.

Nutrition Facts
Calories 106, Total Fat (g) 4, Cholesterol (mg) 3, Sodium (mg) 178, Carbohydrate (g) 13, Protein (g) 7, Percent Daily Values are based on a 2,000 calorie diet

Next week, I'll include more seasonal recipes for spinach, winter squash, pumpkin and more.

In the meantime, to learn more about eating locally, I recommend Kingsolver's book (of course) - as well as the Animal, Vegetable, Miracle website, which offers tons of online resources to learn more about the benefits of eating locally/seasonally and how to incorporate more seasonal/local food into your diet. There is also information on how to find local foods, and the recipes from her book (which I can't wait to try!).

For us Mainers, I also recommend the Get Real Get Maine website, which has searches for specific food items, listed by county; pick your own farms; farmers markets; CSAs (community sustained agriculture farms that sell "shares" of their produce) and more.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Friday, September 19, 2008

The Other Side of the Glass

I watched a very, very powerful film trailer, called The Other Side of the Glass, the other day and I want to invite you to view it too. You can also view it directly from Janel's (the film's writer/producer) blog, along with information on how to purchase the extended trailer and her story of making the film so far. I just purchased the extended trailer myself & can't wait to view it - and offer it as a resource for my clients.

This trailer is about dads and moms and babies: how babies are thinking, feeling creatures from the time of birth (and before), and as such, deserve dignity and respect during the birthing process; how dads can be guardians of the birth space, for mom and baby; how birth is now and how it could be.

I've noticed that families who are expecting their first baby sometimes have a certain attitude about experiences they see or hear that challenge the decisions they're making for their baby's birth: this _____________ won't happen to me. It happens to other people, but it won't happen to me because ___________________.
**I** won't be one of the women who have a cesarean for failure-to-progress (the reason for 40% of primary cesareans).

**MY baby** will stay with me for skin-to-skin bonding after the birth (according to the Listening to Mothers II report, 39% left their mother's arms during the first hour for "routine, non-urgent care").

**MY hospital/doctor/midwife** will treat me like an individual, offering care specific to my body, my baby and my birth.
Turns out that many caregivers and hospitals have certain routines (routine IV, routine continuous electronic fetal monitoring, routine epidural), and they have varying degrees of willingness to deviate from that routine. According to the Listening to Mothers II report, "Each of the following interventions was experienced by most mothers: continuous electronic fetal monitoring, one or more vaginal exams, intravenous drip, epidural or spinal analgesia, and urinary catheter."

There are certainly doctors, midwives, and hospitals who encourage women to participate in their care, and who treat women and their babies as individuals, with respect and dignity and patience. But, unfortunately, not all do. Even if you personally like your provider, or he/she is "terrific" accoring to your friends, or if he/she is the closest, or has rights at the newly remodeled hospital birth center: none of these things guarantee that dignity, respect, patience and/or treatment as an individual. According to the Listening to Mothers Survey II, 26% of women chose a care provider on family/friend recommendation; 26% for its nearby location; 47% because of their insurance plan. Only 18% chose a care provider because (s)he was a good match with the mother's philosophy.

I encourage (implore?) moms and their partners to remove any blinders and truly investigate whether or not the provider/birth place that they've chosen truly fits their needs. Ask challenging questions! Ask yourself, each other, your care provider(s), your hospital/birth center. Assuming (hoping?) that it won't be you, or your partner, or your baby has nothing like the impact of asking questions, communicating preferences, doing the research, and making informed decisions. Nothing guarantees a perfect birth experience, but doing this kind of work ahead of time has obvious advantages for moms, dads, and babies!

Wondering where to get started? I wrote two posts that directly address these issues, both full of book and website recommendations that might help: "Pregnancy and Birth: What Are My Choices" and "Choosing a Care Provider and Birth Place".

Other resources to check out, especially for partners: book review on Don't Just Stand There, and one of the best books for moms & their partners: Penny Simkin's The Birth Partner. Pam England's book Birthing From Within also has some good suggestions specifically for dads and birth support people, as well as some thoughtful & practical information for dads on her website.

Good luck on the journey!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Wednesday, September 17, 2008

Good Breakfasts for Pregnant Women

This post is the first of a new Wednesday series about nutrition during pregnancy. I figured it'd make sense to start with breakfast!

When I was pregnant the first time, I had to be out the door by 6:40am so I could be at work (I was a high school teacher) between 7 and 7:15. I've never been a morning person. I've never enjoyed eating as soon as I get up - I'd much rather have breakfast after I've been up for an hour or so. Well, I found that when I was pregnant, sleep was very, very precious. In order to sleep a few minutes longer, I was sacrificing breakfast time. Turns out, that made me feel nauseous: morning sickness!! And, it turns out, the threat of morning sickness was very motivating to me - breakfast became the most important meal of the day because having it (or not) affected how I felt the rest of the day.

With baby #2, I knew I was pregnant way before the positive pee stick - one of the first major signs was breakfast. Without it, I chased a toddler and a puppy (whose bright idea was that combination??) all day feeling queasy & exhausted. With it, at least I was just exhausted. I would've been exhausted anyway!

I decided to check back on the weeks of food journaling I did with baby #1 (not so much with baby #2), to see just what I did have for breakfast. Here are some of the meals:
Mozzeralla cheese stick + fruit/veg muffin (x5 school mornings)
Yogurt, apple salad, 1 slice carrot bread, juice
2-egg souffle + 2 pieces of bacon; OJ and milk
Banana bread + milk
Cream of wheat with dried apricots and pecans
2 slices of whole wheat bread toasted with cheese; 1 apple; dill pickles and milk (what??? I was pregnant!)
OJ; yogurt with granola and blueberries
Cottage cheese with pineapple; OJ
Cottage cheese eggs; whole wheat toast; milk; OJ
These breakfasts were from my second trimester - first trimester breakfasts were different, mostly a can of ginger ale and those skinny pretzal sticks. By mid-morning I was usually feeling better and so could sneak in a snack before lunch. I did find that if I made a smoothie in the blender and slowly sipped it (again with the pretzals!) on my way to school, that also worked.

Here are some smoothie ideas to play around with:
Fresh or frozen fruits: banana, berries, peach slices, melon
Low-fat vanilla or plain yogurt or soy milk
Orange juice
Ice, if you want
Non-fat powdered milk (to increase protein)
Combinations I like:
yogurt + banana + small scoop of peanut butter
yogurt + frozen strawberries + banana + 1T powdered milk
soy milk + banana + frozen strawberries
yogurt + banana + OJ
yogurt + mix of frozen berries
I know some people swear that putting a few handfuls of spinach or a big kale leaf doesn't change the taste of a breakfast smoothie while adding great nutrients... I haven't personally tried this, but if you have (or if you do), I'd love to hear what you thought.

If you noticed a theme of a low-fat dairy source (skim milk, low-fat cheese stick, or low-fat yogurt) plus fruit/veggie bread or muffin for the second trimester breakfasts, that's because that's what I usually would grab on my way out the door. For my second pregnancy - when I was home, there was a lot of yogurt + fruit + homemade granola.

I'll be posting more recipes each week - here are a few to get you started:

Morning Glory Muffins - from Cooking Light

1 1/4 C Flour
1/2 C Packed Brown Sugar
1 Tsp Baking Soda
1 Tsp Cinnamon
1/4 Tsp Salt
1 C Carrot -- Shredded
1 Small Cooking Apple (Rome) – Shredded
1/3 C Raisins
1/4 C Pecans – Chopped
1/8 C Flaked Coconut
4 Oz Crushed Pineapple In Juice – Drained
1/3 C Vegetable Oil
1/3 C Apple Butter
1 Tsp Vanilla
1 Egg
1 Egg White

Preheat oven to 350 degrees.

Lightly spoon flour into dry measuring cups. Combine flour and next four ingredients (flour, brown sugar, soda, cinnamon, salt) in a large bowl.

Shred or chop apples and carrots and pecans (in food processor is easiest). Add to flour ingredients with raisins, coconut, and pineapple.

In separate bowl, combine oil, apple butter, vanilla and eggs. Stir well with a whisk. Add oil mixture to flour mixture; stirring just until moist.

Spoon the batter into a 12 muffin cup pan coated with cooking spray.

Bake at 350 degrees for 25 minutes. Remove muffins from pans immediately to cool on a wire rack.

Pregnancy modification: all whole-wheat flour or half and half whole wheat & white; and/or a few tablespoons of wheat germ mixed in with the flour to add protein. Cooking Light lists the muffins as having 2.6 grams of protein each with just white flour.

These muffins keep very well in the refrigerator. My kids also really like them.


Sweet Potato Bread - from Cooking Light

1/3 cup flaxseed
2 cups all-purpose flour
1 teaspoon baking powder
1/2 teaspoon baking soda
1/4 teaspoon salt
1/4 cup (2 ounces) 1/3-less-fat cream cheese, softened
3 tablespoons butter, softened
1/2 cup packed brown sugar
1/4 cup honey
1 large egg
1 large egg white
1 cup mashed cooked sweet potato
Cooking spray
Preparation

Preheat oven to 350°.

Place flaxseed in a clean coffee grinder or blender; process until coarsely ground. Lightly spoon flour into dry measuring cups; level with a knife. Combine flaxseed, flour, baking powder, baking soda, and salt in a large bowl; make a well in center of mixture. Beat cream cheese and the next 5 ingredients (cream cheese through egg white); stir in sweet potato. Add to the flour mixture, stirring just until moist.

Spoon batter into an 8 x 4-inch loaf pan coated with cooking spray. Bake at 350° for 50 minutes or until a wooden pick inserted in center comes out clean. Cool 10 minutes in pan on a wire rack; remove from pan. Cool completely on wire rack.

Note: To freeze bread for up to 1 month, place in an airtight container, or wrap in heavy-duty plastic wrap or foil. Thaw at room temperature.

Pregnancy modification: Again, I used half & half whole wheat & white flours. I also used sweet potatoes from a can - mashed what I needed and put the rest in the freezer for the next time I made this. With just white flour, Cooking Light lists the protein grams per slice as 3.6.

This is really good with low-fat cream cheese spread on it.

And last, my favorite yummy, yummy granola:

Maple Pecan Granola - from Cooking Light

2 cups regular oats
1/2 cup pecan pieces
1/2 cup maple syrup
1/4 cup packed brown sugar
2 tablespoons canola oil
1/8 teaspoon salt
Cooking spray
Preparation

Preheat oven to 300°.

Combine oats and next 5 ingredients (through salt); spread on a large jelly-roll pan coated with cooking spray. Bake at 300° for 1 hour, stirring every 15 minutes. Cool completely.

Note: Store in an airtight container for up to one week.

My note: it can also be frozen. I love it with fresh berries and/or banana and plain low-fat yogurt. Also good with pumpkin butter swirled in during the winter when fresh berries are harder to find (or afford!).

Cooking Light lists the protein grams as 2.2/serving.

If you're looking for more ideas about the specifics and benefits of healthy eating during pregnancy, click on the nutrition label below, or here. Enjoy!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Saturday, September 13, 2008

Bonding after Cesarean Birth in the News

I read Tara Parker-Pope's most recent blog entry in the Health section of the New York Times, "Delivery Method Affects Brain Response to Baby's Cry" last week and I've been thinking about it ever since.

Pope opens with some personal experience, explaining that her feelings of "being numb" and "uninvolved" with her daughter's Cesarean birth surprised her, and that "When I finally heard a baby cry, it took a minute for me to realize that the sound belonged to my own baby."

She goes on to summarize the study:
"That’s why I was particularly interested to read of new research showing that the method of delivery seems to influence how a mother’s brain responds to the cries of her own baby. The brains of women who have natural childbirth appear to be more responsive to the cries of their own babies, compared to the brains of women who have C-section births . . . The study, published in The Journal of Child Psychology and Psychiatry, found that the cry of a woman’s own baby triggered significant responses in several parts of the brain related to sensory processing, empathy, arousal, motivation, reward and habit-regulation"
(I'm going to interrupt myself here to say that I hate it when people euphemize "vaginal birth" with "natural birth" - is the word vagina that threatening? because to me, and to lots of other people, natural birth is not the same as, or interchangeable with, vaginal birth. A vaginal birth could have been induced with cytotec (to soften the cervix) and pitocin (to stimulate contractions); the amniotic membranes could have been artificially ruptured; the mother could have been hooked up to an IV (with the Pitocin drip) and an epidural and a catheter; baby could be removed with a vacuum extractor. Does all this result in a vaginal birth? Yes, certainly! But is that a "natural" birth?? I'm not sure how all those medications and procedures equal "natural", even in the loosest sense of the word. And when doctors and/or scientists, and those who report their findings, start choosing not to distinguish between the two, that's when we're in real trouble - see VBAC link below...).

Anyway! Here are two links to a summary of the study: "Maternal brain response to own baby-cry is affected by cesarean section delivery". I like this summary because it reports that this study was done on a sample size of (only!!) TWELVE women - six who "delivered vaginally" and six who elected for a Cesarean birth; and "Natural childbirth makes mothers more responsive to own baby-cry", which I think summarizes the study in easier to understand language, though they do make that pesky trick of making "vaginal" into "natural" in their title (!!).

Another blogger, who writes about oxytocin (the "hormone of luuuuuvv" is what I call it in class), has this blog entry about the study.

Reading that study made me think back to something that I read (or heard?) about monkeys who reject their babies born by Cesarean. After a little searching, I found out that the reknowned French obstetrician has a very interesting website called WombEcology. In one terrific article, "In-labor Physiolocial Reference", he reminds us that humans are mammals, and that we give birth as mammals. He describes the handicaps that are special to human mothers giving birth, and how we can help minimize them. It's really a terrific article - much better than the title makes it sound - go read it!

One thing he highlights in the article is that:
"Physiologists constantly refer to what they learn from non-human mammals. This leads to keep in mind the main differences between human beings and other species. One of the main differences is that the effects of a disturbed birth process on maternal behaviour are much more evident at an individual level among non-human mammals . . .

Today caesareans are common in veterinary medicine, particularly among dogs. This is possible as long as human beings compensate for a frequently inadequate maternal behaviour, assist the process of nursing and provide, if necessary, commercial canine milk replacers. The effects of a caesarean on the maternal behaviour of primates are well documented, because several species of monkeys are used as laboratory animals. This is the case of the ‘crab-eating macaques’ and the rhesus monkeys.(3) In these species the mothers do not take care of their baby after a caesarean; laboratory personnel must spread vaginal secretions on the baby’s body in order to try to induce the mother’s interest for her newborn.

We don’t need to multiply the examples of animal experiments and observations by veterinarians and primate-using scientists to convince anyone that a caesarean – or just the anaesthesia that is necessary for the operation – can dramatically alter the maternal behaviour of mammals in general. In this regard humans are special. Millions of women all over the world have taken care of their baby after a caesarean birth or simply an epidural birth or a ‘twilight sleep birth’.

We know why the behaviour of humans is more complex and more difficult to interpret than the behaviour of other mammals, including primates.(4) Human beings have developed sophisticated ways to communicate. They speak. They create cultures. Their behaviour is less directly influenced by their hormonal balance and more directly by the cultural milieu. When a woman knows that she is expecting a baby, she can anticipate displaying some maternal behaviour. This does not mean that we cannot learn from non-human mammals. The spectacular and immediate behavioural responses of animals indicate the questions we should raise about ourselves."
The reason I include this excerpt is because I think that for some women, feelings of distance, or not feeling immediately "bonded" to her baby, become one more thing that she feels guilt or shame about. I think it's critical to realize that bonding happens over time, and that we as humans can overcome a less-than-optimal beginning. I think the truth - that feelings of distance can be a part of some women's postpartum experience - gets covered up, which can make women feel alone and also make it very hard to find resources for help.

If we realized, accepted, and publicized as part of informed consent that epidural anesthesia and/or Cesarean birth can have a physiological impact on bonding and post-partum blues/depression, women could make more informed decisions about their care and could prepare in one of the many ways (extra support, more skin-to-skin contact with baby, and massage come immediately to mind) that are shown to promote bonding and lessen post-partum blues.

If any of this gets you wondering about choices for VBAC (vaginal birth after cesarean), or the safety of VBAC, I came across a great article on the Midwifery Today website, Homebirth after Cesarean: The Myth and the Reality (see also if you're interested in how equating vaginal birth with natural birth as affected hospital policies on VBACs).

You can also visit the Online Resources section of my site for links to VBAC.com and ICAN (International Cesarean Awareness Network), as well as lots of links to postpartum depression and support sites.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Blog Format

I'm going to try something new! In addition to various entries about pregnancy/birth/postpartum issues, I've chosen two topics to return to on a weekly basis:
Since so many of my searches are nutrition-related, on Wednesdays I'll highlight nutrition during pregnancy & postpartum, including at least a recipe or two.

On Fridays, I'll highlight and/or review a book, movie, website, online video.

I'm also going continue doing a general "Resource Round-up" post every week or two.

Any other suggestions?

Oh - and since you are reading... want to leave a comment? Are you pregnant? Just had a baby? Fellow educator? Interested in the politics of birth? A care provider? My sister? (haha! you know who you are!) I was a total lurker until just recently; it turns out leaving comments is easy and fun!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Tuesday, September 9, 2008

Be BOLD: Birth Performances in Gardiner, ME

Karen Brody's play, Birth, will be performed at the Johnson Hall Performing Arts Center (280 Water Street) in Gardiner, Maine on Friday, September 26th at 7pm and Sunday, September 28th at 2pm. The Friday performance will feature a "talk back" discussion with area healthcare providers and birth experts. Tickets are $10, and are available at the door or by emailing BOLDinMaine@yahoo.com.

All profits are to benefit Birthroots of Maine.

About the play, from the BOLD website, www.boldaction.org
"Birth is a play based on over one hundred interviews Karen Brody conducted with mothers across America who gave birth between 2000-2004. It tells the true stories of 8 women painting a portrait of how low-risk, educated women are giving birth in America today . . . Moving between first-person monologues, some dialogue, and the voices these women heard on the day they gave birth, Birth confronts, what City Lights Theater Company has called, "The naked truth about childbirth in America."

"BOLD is an exciting, uplifting, and empowering answer to our nation's childbirth crisis. I support this movement with every fiber of my being" Christine Northrup, MD, author of Mother-Daughter Wisdom, The Wisdom of Menopause and Women's Bodies, Women's Wisdom
Playwright Karen Brody's blog.

More about BOLD, from the BOLD website, www.boldaction.org, below. The website has a great list of links and books, lots more about BOLD and Birth, as well as information on how you can contribute by organizing an event or through a financial donation.
"What is BOLD’s approach?"

"BOLD's approach to our mission is based on similar "theatre for social change" models (V-Day, The Innocence Project). Every September (and during the month of other Labour Day around the world) we support communities to organize a BOLD production of Karen Brody's critically acclaimed play, Birth, and a BOLD Talkback, take the play to a college campus to educate students about maternity care, or organize a BOLD Red Tent. The goal of each event is to engage communities in a discussion about how to improve their local maternity care issues. BOLD puts mothers at the center of solving their maternity care problems. At BOLD we ask mothers: what kind of childbirth conditions do you want? What do you deserve?"

"What does the BOLD acronym stand for?"

"Our acronym stands for Birth On Labor Day (BOLD). In 2006, BOLD's first year, over forty performances of Karen Brody's critically acclaimed play, Birth, were performed throughout the world over four days during the American Labor Day weekend. Since then BOLD has expanded to include events at other times beyond Labor Day weekend."

"Why BOLD?"

"Playwright Karen Brody wanted to find a way to honor mothers’ birth experiences, get communities talking about their local birthing issues, and raise money for organizations and small groups who are working to make maternity care mother-friendly. “One woman dies every minute throughout the world from a pregnancy or childbirth-related cause,” says Brody, “As a writer I wondered, why are we not telling this story? And as an activist I wondered, how can we tell this story in a way that will make a difference, that will shift the model of maternity care for women to the mother’s needs?”
I plan to go to the Friday performance - it's been on my "to do" list for a couple of years, but the dates have never worked out. I'm really, really excited to go!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Thursday, September 4, 2008

Diddos for Kiddos - Consignment Sale in Central Maine

Diddos for Kiddos is coming up! Diddos is an awesome consignment sale (clothes, baby supplies, toys) in Augusta, Maine. There are new dates - Saturday, October 11th, from 8am to 6pm and Sunday, October 12th, from 8am to 4pm. Here's a pdf with all the information you'll need if you want to come to buy, or find out how to sell.

I've been doing this for years (buying and selling), and while it can get a little crazy, it's a lot of fun. The timing is great too - one sale in the fall (winter clothing, and holiday presents) and one in the spring (summer clothes, and presents for my kids' May & June birthdays).

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine

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Wednesday, September 3, 2008

Resource Round-up

We camped up at Cobscook Bay State Park, visited the Windsor Fair, went apple picking and started school in the past ten days - whew! So, finally, here's a list of resources from my reading in the past two weeks:

The Lamaze weekly newsletter
Excellent, as usual, with information on how to handle unsolicited advice (my personal favorite response: "I'll keep that in mind..." prefaced with "oh..." or "thank you!" depending on the brand of advice & its delivery). Their breastfeeding expert had some very helpful tips in her answer to this common question: "Is there anything I can do to make sure I will have a good experience breastfeeding?"

Last week's newsletter had a chart that provided a summary of nutritional information - specific nutrients, why they're important, and what foods are good sources.


Hilarious Blog
Jeremy Adam Smith wrote a blog entry for the Mothering website that just cracked me up, called "I am a Porn Star".


New Products at Target!
I just read that Target has started carrying Bum Genius 3.0. I called to request information on stores here in Maine - it sounds like Topsham and Augusta have them on their computer but none in the store or ordered; Bangor might be having a shipment come in soon. To get information about locations near you, call the corporate customer service at 1-800-440-0680 and ask for stores in your area carrying these specific DPI (item #s):
wetbag (found by searching for “wet bag”): 030 00 2235
reuseable diapers: 030 00 2126
I also read somewhere (the new Mothering magazine?) that Target is carrying California Baby products - my local Target has them in stock, which I'm very excited about. We love the bubble bath, especially!


Homebirth Dads Video
The most recent Mothering magazine also included information about a film called Homebirth Dads. That's definitely going to make it into my birth class lending library, the next time I buy videos.


Long-term Effects of Pitocin Study
A really interesting study on Pitocin, on The True Face of Birth blog.
The Relationship between Artificial Oxytocin (Pitocin) Use at Birth for Labor Induction or Augmentation and the Psychosocial Functioning of Three-year-olds

The focus of my dissertation research study was, as you can see by the above title, an exploration of whether there is any relationship between the use of Pitocin (artificial oxytocin) to start or speed up labor, and the way children born with its use function individually and in their relationships when they are three years old...

The following is a summary of the findings that were statistically significant.

1. Receiving Pitocin resulted in more negative recollections of labor and delivery, suggesting that mothers who received it had a more challenging experience than those who didn’t. However, there was a similar finding for the use of epidural anesthesia and for pain medication, both of which tend either to precede or follow the use of Pitocin.

2. Mothers who received Pitocin spent less time with their babies in the first hour after delivery, and were less likely to feed their babies exclusively at the breast in the first six months. In other words, babies who were born without Pitocin were more likely to be fed exclusively at the breast in the first six months than those born with Pitocin

3. Two factors distinguished children born with Pitocin from those born without Pitocin.

The first was called “Assertiveness”, which describes a socially appropriate way that babies and children communicate their need for help and comfort when they are feeling uncomfortable or unsafe. Typically, crying, using facial expressions and physical gestures, and later, verbalizing their thoughts and feelings, elicits helpful responses from parents, who try to identify and meet the need the baby or child is expressing. However, babies born with Pitocin, whose mothers reported having had a more challenging time during labor and delivery, appear to have a higher need to be assertive because they seem to experience more discomfort, but are apparently less effective in asserting their needs and getting them met when they feel unsafe or uncomfortable.

The second factor was called “Need to Control Environment” and this summarizes what seems to be a higher level of discomfort or insecurity, particularly in response to “outside-in” influences (e.g., reacting to food with digestive problems or being picky eaters; problems coping with other people’s timing and structure, refusing help from others) and increased or exaggerated efforts to control their environment, resulting in behaviors that may be more challenging to their mothers/family. There appears to be some continuity of effects between infancy and age three: for example, children who were described as picky eaters, or as having digestive problems at three, were likely to have been colicky, fussy babies. Interestingly, the hormone oxytocin is very involved in the digestive process: it plays a role in the production of digestive enzymes and as we enjoy our meal, in a positive feedback loop, we produce more oxytocin.

It may be that a process described as “hormonal imprinting,” identified in a considerable number of animal studies since the 1970s, is the mechanism that accounts for these differences between children exposed to Pitocin and those who were not. Using Pitocin to initiate labor may “flood” the available oxytocin receptors in mother and baby, apparently affecting children’s internal comfort levels and how they interact with others, although how this takes place in the babies has not yet been studied. Since both mother and baby receive Pitocin during labor and delivery, it is as yet unclear to what degree each contributes to challenges in their mutual relationship.

Claire L. Winstone, Ph.D.
Santa Barbara Graduate Institute July 2008

Protecting Infants and Children from Toxic Exposure: Cribs
"Friends of the Earth has found that commonly used baby and children’s products, and upholstered household furniture contain dangerous levels of toxic chemicals called halogenated fire retardants.

56% of all infant carriers, 44% of all car seats, 40% of all strollers and 19% of all portable cribs were found to have high levels of halogenated fire retardants."

There is also a link to "Safe Baby Products" - ones without halogenated fire retardents - at the bottom of the page.


Who Co-Sleeps?
Turns out, lots of people! Take this co-sleeping survey to add your voice, or view the results. Over 8,000 people have taken this survey!


Body & Soul Soothers - Links to articles on Mothering.com.


Is there lead in your prenatal vitamin?
I was shocked at the number of children's vitamins and prenatal vitamins that contain lead... Here's a website with additional information, including particular vitamins and how much lead they contain.

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