Tuesday, January 26, 2010

More on Eating, Drinking and Labor

This is just a quick post to highlight an article in today's New York Times Health section (by the way, I love getting this free, weekly, via email). The article is called, "In Labor, a Snack or a Sip?", and in it, an obstetrician is quoted giving the same example situation I give in my classes:
'“My own view of this has always been that you could say one shouldn’t eat or drink anything before getting into a car on the same basis, because you could be in an automobile accident and you might require general anesthesia,” said Dr. Marcie Richardson, an obstetrician and gynecologist at Harvard Vanguard Medical Associates in Boston, who was not connected to the new study.'
I wonder if more people need emergency general anesthetic after a car accident or during a Cesarean birth?

I imagine this article in the Times was prompted by the recent Cochrane review of the seven-decades-long ban on eating and drinking in labor enforced by many (but not all) hospitals. The review, Restricting Oral Fluid Intake and Food Intake During Labour is available online.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Sunday, January 24, 2010

Wow! Links.

I love reading birth blogs. And I love the fact that I can share my favorite entries written by informed, compassionate birth professionals with you. Here are some great ones that I've read lately...

Navelgazing Midwife has had some fantastic photo posts lately. "Labor: A Visual Guide" explains some of the signposts Barbara uses to assess where a woman is in her birth journey.

So many of the mamas I work with ask about eating and drinking during labor. Kathy, a fellow independent childbirth educator, offers a terrific evidence-based post on this topic, "No Justification for NPO".

She also wrote a hard-to-read but oh-so-important post on circumcision. When a family I'm working with wants to talk about their plans to circumcise their son, I always ask, "Who is going to go with him for this procedure?". The responses are often telling: no one wants to go. When that happens, I hope that gives the family room to think through putting their infant through a procedure they don't even want to watch! There are some graphic pictures in this post, but I think it's an important one, "Circumcision Guidelines". I didn't watch the linked videos and so cannot comment on those.

Finally, Gloria Lemay has had some great blog posts lately too. Even though the H1N1/swine flu has gotten much less hype lately, I think her tips on staying flu-free are excellent ones throughout a winter pregnancy. You can read them at "Gloria Lemay's Regimen for a Flu-free Pregnancy". And her post, "The Slow Birth" movement may make some women who wish for short labors reconsider...

Have you read any excellent blog posts lately that you'd like to share? Or written a really good one? Leave a link in the comments!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Thursday, January 21, 2010

"Why Choose a Midwife?" Video

I saw this video on Gloria Lemay's blog. I think it's a terrific overview of the many reasons why women choose hospital or homebirth midwives. It was put together by volunteers from Our Bodies Ourselves and the Massachusetts Friends of Midwives.



Of course it's critical to remember that there are some OBs and family docs who practice evidence-based, woman-centered care and that there are some midwives who practice as "med"wives. That's why it's so important to get to know your care provider!

But for people who are just beginning to investigate the possibilities of midwifery care, or those who are curious, this video is a great introduction.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Sunday, January 17, 2010

Status Quo: Not Good Enough

As usual, I enjoyed Peggy O'Mara's article in the most recent Mothering magazine, "The New Health Journalism: Challenging the Status Quo". What stood out to me most was this part, "Barbara Loe Fisher asked me if I have suffered for challenging the status quo. My job as a mother is to challenge the status quo . . . It is not my job to follow the current fashions, but to forge my own way, to develop my own personal ethic of parenting."

The status quo (defined by dictionary.com as "the existing state or condition") is not good enough. Just yesterday I got an email link to an msnbc news article, "C-section rates around globe at 'epidemic' levels", which makes a perfect Exhibit A.
"In the U.S., where C-sections are at an all-time high of 31 percent, the surgery is often performed on older expectant mothers, during multiple births or simply because patients request it or doctors fear malpractice lawsuits. A government panel warned against elective C-sections in 2006.

“The relative safety of the operation leads people to think it’s as safe as vaginal birth,” said Dr. A. Metin Gulmezoglu, who co-authored the Asia report. “That’s unlikely to be the case.”

Women undergoing C-sections that are not medically necessary are more likely to die or be admitted into intensive care units, require blood transfusions or encounter complications that lead to hysterectomies, the WHO study found."
This example fits Peggy O'Mara's warning perfectly. She explains that,
"As new parents, we believe that society will take care of us, has our best interests at heart, and will protect us. I want new parents to believe this, but health-care policy in the US is focused on eradicating rather than preventing disease. It is fear-based, interventionist, and compromised by economic considerations. At this time in history, assuming that society will protect you can be a dangerous belief."
Personally, I do not want new parents to believe this. I want it to be true; but until it IS true, I wish opened eyes and hearts for all of us, so we can make the best choices possible for our families' health.

Do you believe it is a mother's (or parent's) job to challenge the status quo? How have you challenged the status quo? What sources do you use to make your best informed choices for your families' health?

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Friday, January 15, 2010

Mamas & Muffins Group Coming Up: Monday, 1/18

We're meeting in Winthrop (15 min from Augusta; around ~30 min from Waterville and Lewiston/Auburn) this Monday, January 18th. Free, fun, with food!

This group's topic is baby-wearing, with demos of a Maya Wrap (ring sling), a Moby Wrap, and a fleece snap sling. Come visit & try them out.

Pregnant moms welcome too!

For time, directions and more information, go to http://www.birthingyourbaby.com/postpartum.html.

We'll be meeting regularly, first and third Mondays of the month. Hope to see you there!

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Wednesday, January 13, 2010

More on Coping Skills

Thanks for the comment on my last blog, Morgan. Reminds me that it might be helpful to post more specifics about the relaxation strategies I use! Here's the one I used the most during labor; it's also what I do if I'm in bed and worries or stressed about something, or if I'm having a hard time going back to sleep. Though I can't go through the whole "loose and limp" thing in situations like flying or driving, I do try to pay attention to and loosen up muscles that are tight due to tension, like raised shoulders or a clenched jaw.

This is the handout I give to all the moms/families I work with. Feel free to download it in word here, for personal use only, or link to it as you wish!

RELAXATION: BY YOURSELF
Lie on your side with a cushion under your head and another under the bent knee of your top let so that you are completely comfortable. Close your eyes, and allow all your body weight to drop comfortably onto the floor. Breathe deeply, relaxing each part of your body in turn with each exhalation. Keeping your awareness focused on your breath, find your center as you relax more and more deeply. Remain this way for 5-20 minutes. Before you come up, focus your awareness on your baby inside you, and spend a few minutes in peaceful relaxation together.

When you are finished, take your time to open your eyes, letting the light come in slowly instead of hurrying to look outwards. Keep the sense of inner peace and relaxation as you stretch out slowly and come up in your own time.

RELAXATION SCRIPT: WITH A PARTNER

Read quietly, slowly, and in a calm voice. Practice reading the script a few times to yourself. Eventually you won’t need it at all. Feel free to make it your own. Mom, let your reader know what works best for you! Practice at least 3 time/week.
Breathe with a steady, even rhythm. Not in the middle of your belly, but way down low. Listen to the quiet ease of your abdominal breathing. Use each outbreath to relax a little more deeply. Let the breath fill your entire body, surrounding and relaxing each muscle; wherever you feel tension, use the outbreath to send it away.

Concentrate on relaxing your belly extremely. Think of it just floating outward and away from you as you breathe in. Drop your head into the pillow. Don’t hold your head up with your neck muscles. Just let it drop into the pillow.

Smooth your eyelids, and concentrate on all those facial muscles being loose and slack. smooth your brow. Let your eyes rest. Let all the tension go from your face. Loosen your jaw and let it float open. Have a relaxed, open throat.

Drop your shoulders. Have no tension in them at all. Relax your back and let your belly relax completely, floating out and away from you. You can always relax your belly a little more. Each time you exhale, you let go a little more. Let your whole body sag and relax.

Locate any tension that is left in your shoulders and your arms and let go of it so it eases out through your hands. Let your hands be limp and let your fingers be loose and limp. Everything just sinks down into the pillows and mattress.

Let go of any strain or tension in your chest. Drop your whole body into that bed. Let go. Release everywhere. Relax your belly extremely. Concentrate on letting go and letting it float out and away from you. Keep your breathing very calm and quiet and steady and way down low in the bottom of your belly. Use each outbreath to relax a little more deeply. Let the breath fill your entire body, surrounding and relaxing each muscle; wherever you feel tension, use the outbreath to send it away.

Really let go. Don’t just hold yourself still. Keep loose and limp. Let your bottom relax completely.

Let your hips be slack and sink down into the bed. Let go of any tension in your thighs. Let it all go out through your legs and feet. Your legs are loose and easy now. Your feet are loose and limp.

That’s it. Go loose and limp. Breathe with a nice, quiet, steady rhythm. Listen to the sound of it, way down low in the bottom of your belly. You can always relax a little more and a bit more. Breathe and float.

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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Saturday, January 9, 2010

Re-Using Coping Skills: Here is Your Life

Back when I attended Bradley Method classes to prepare for my daughter's birth, I learned about the effect deep, calm breathing can have on my physical and emotional state. I practiced these new coping skills in hopes of using them to help me relax during birth. I'm happy to report that they were incredibly useful during Madelyn's birth back in 2002 and for Owen's in 2005.

But their usefulness did not end there! Remember Guy Smiley on Sesame Street hosting the "Here is Your Life" segments - the one with the shoe? the one with the loaf of bread?

Well let's play "Here is Your Life" today so I can show you how the coping skills I learned continue to be a very helpful resource, 3 times even, in just the past week!

January 6th, 2010... I'm checking on my son after I put him to bed half an hour earlier, only to find that instead of being in bed, he is squatted down on the floor covering himself with his pillow. This is how he hides when he knows he's done something terribly naughty. I remove the pillow and ask him what the problem is... and he shows me that he bit the top off of a Christmas light, part of a strand that was decorating his room. Undoubtedly deep breathing on my part helped me to be calm, ask him if he had spit out the plastic and where was it etc... He was fine, I took down the lights, and I didn't yell (because really? who does that???) or laugh (because also: it was funny).

January 4th, 2010... First cross-country skiing of the year, on our local high school trails. Usually great conditions, but this time if was very, very icy. We'd gotten about 3/4 of the way around when we stopped to rest, and somehow my ski slipped and I totally rolled my ankle and crashed into the snow. It hurt, and I had heard an ominous crunching noise as I fell. My body wanted to panic - my heart started racing, and I got that light-headed, blurry vision feeling that precedes passing out. But deep breathing got me through. I calmed my body, realized the crunch was probably the ski against the icy snow, and that my ankle was not actually broken and that I was, in fact, going to live! Even to ski out and finish the day's errands, though my ankle did end up swelling from a slight sprain that's already better...

January 3rd, 2010... I'm returning from a visit to PA for the holidays, driving the normally nine-hour trip, just the kids and me. I get off to a good start, through NJ and up into NY. Close to Albany though, the wind is joined by snow (not "showers" as had been predicted by the weather.com) and the driving conditions deteriorate. It's terrible the last part of 87 and the beginning of 90 in NY, and really bad in the Berkshire Mts in Massachusetts. The other cars are also going slow, mostly, and I get behind someone going about 40mph, perfect for the conditions. Thankfully the children were very quiet & well-behaved, though they did wonder why I was going so slowly... just as they asked, a red car tried to pass me and we all watched as the car lost control, spun around, and ended up (I think) in the median. It was scary and added just that touch more of stress and panic to the already challenging driving conditions. You better believe that I was doing my deep breathing then. And listening to music (just like in labor) to help myself stay calm. The weather got better after the Berkshires, but by the time I got to NH and up into Maine, many hours later, I was exhausted, it was dark, and it was raining/sleeting/snowing again. As I drove, concentrating on keeping us safe and moving homeward, I kept reminding myself - that's another mile down: I don't have to do this mile again. Just like contractions - each one brings the baby closer, and each one down is one less to go. We ended up safe at home, where I fell into my husband's waiting arms and cried a few tears of relief & exhaustion, 11 hours from when we started in PA.

So those are my examples in the past week, how deep breathing helped me keep my brain and body calm. I've used it many other times in the past too...

Flying on Airplanes... I flew many times with my infant daughter, and later with my toddler daughter and infant son, by myself, on the way to PA. They were (thankfully!) short flights, but I am terrified of flying and I knew I had to do my best to remain calm so I could effectively parent, as well as to reduce the chance that I would freak out my kids. Because that would be so helpful - all of us crying in panic at the same time! The breathing helped incredibly, and those times I traveled with the children were some of the calmest trips I've had on airplanes, even though I had the additional stress of solo parenting while flying.

Watching my Kids do Scary Things... Like the time my kids were climbing some very scary stairs to a local lookout tower. Safe enough in theory, but absolutely terrifying for me to watch. Someone else helped them, of course, while I walked away and did my calming breathing.

Kids & Medical Problems... The time my son's finger got slammed in the door and looked terrible... the time I put him down for his nap fine and got him up to find his entire body covered in huge, puffy hives, including his neck. Deep breathing helped me stay calm and make effective decisions, while comforting him.

Anger Management... Two kids, a husband, life. Anger happens. Deep breathing helps me avoid losing it (at least some of the time!) and saying or doing things I would regret later.

In addition to using these techniques myself, I am teaching them to my children... when they are feeling angry or overwhelmed, or have been hurt, it's amazing to watch how well simple breathing in through the nose and out through the mouths, big belly breaths, helps them settle back down. It's a simple and extremely effective parenting technique.

Anyone care to join me in sharing a "Here is Your Life" with coping skills story? Which were your favorite for birth? Which do you use now? How?

Christina @ Birthing Your Baby
Independent Childbirth Classes for Central Maine
Mamas & Muffins: New Moms Group

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