Cesareans

If you have had a cesarean in the past, or if you have been told you need a cesarean in the future, this website is for you!

http://www.ican-online.org/

There are some great chiropractors these days. If you have been told that your pelvis is too small, visit a chiropractor. It may be that you just need an adjustment. Some chiropractors specialize in pregnant women and will even come to the hospital and adjust you while you are in labor! There is a technique they do called the Webster Technique. This is a pelvic adjustment that makes more room for the baby. Interesting, eh? Our pelvic bones are made to open when we are giving birth, so if everything is aligned, things should go smoothly.

Finding a Doula

How to Find the Right Doula to Support You During Labor and Birth

Research says that having a doula (a trained labor support professional) as part of your labor
support team can keep birth safe and healthy and help you avoid unwanted interventions. But
how do you find someone who is a good fit for you? Here are some tips:

1. Get referrals.
Ask friends, childbirth educators, your doctor or midwife for recommendations. Some hospitals and birth centers provide doula services or referrals. Mothers in a local Birth Network or La Leche League (lalecheleague.org) meeting may have used doulas at their births and may be able to recommend one. Keep in mind that each woman and her birth are unique; youmust decide if this doula is a good match for you.
2. Go online.
Check the websites of the organizations that certify and train doulas, such as DONA International (dona.org). Most of these sites will let you search by location for a doula near you.
3. Interview several doulas, if possible, before choosing one.
Think about what you want your doula to do for you. How will she fit in with the rest of your labor support team? How does your partner want to support you? Does he or she want to participate in the physical support or just be there emotionally for you? Ask the doula how she sees her role at your birth.
4. If cost is a problem, look for low-cost doula support.
If your insurance doesn’t cover doulas and you can’t afford the doula’s fees, look for a doula-in-training. She may not have as much experience with birth as someone who is certified, but she may attend your birth for little or no fee in order to earn her certification. Some communities have volunteer doula services for women in need. Some doulas will write a contract for women to pay over time or even trade for another service that you can offer to her.
5. Trust your intuition.
Once you've followed the steps above, trust your gut feeling. Just as your own intuitive knowledge can guide you in birth, it can also help you decide who should be with you when you give birth.

Questions for Interviewing a Doula:
• What training and education do you have?
• How long have you been a birthing assistant, and how many births have you attended as a doula?
• What is your philosophy about childbirth and supporting women and their partners through labor?
• Will you meet with us to discuss our birth plans and the role that you will play in supporting us through childbirth?
• How many times will I see you before the birth? Will my partner be included?
• May we call you with questions or concerns before or after the birth?
• When do you try to join women in labor—at home or at the place of birth?
• Describe your role in my birthing. What exactly will you do?
• Do you work with one or more backup doulas for times when you are not available? May we meet them?
• What is your fee? What services does it include, and what are your refund policies?
• What is your policy in the event I have a cesarean?
• What other services do you offer? (such services might include breastfeeding support, postpartum for mom and dad, and new baby care.)
• Do you meet with me (us) after the birth to review the birth and answer questions?
• Are there two of your past clients whom I may call?

Free Educational Website

Check this out. This is a free website that provides a lot of great information!

www.mothersadvocate.org

Healthy Birth Practices

If you don't have time to read a book about childbirth, here is a GREAT place to start. It's also a great resource to give to your husband to read, since some husbands are not likely to read a childbirth book along with you. :) Hopefully there are some husbands out there who do.

THESE are the topics put out by Lamaze to give you a quick overview of a Healthy Birth. Check it out!

Healthy Birth Practice 1: Let labor begin on its own
Healthy Birth Practice 2: Walk, move around and change positions throughout labor
Healthy Birth Practice 3: Bring a loved one, friend or doula for continuous support
Healthy Birth Practice 4: Avoid interventions that are not medically necessary
Healthy Birth Practice 5: Avoid giving birth on your back and follow your body's urges to push
Healthy Birth Practice 6: Keep your baby with you to enable the best relationship and to promote breastfeeding

Hey, and just so everyone knows, the new version of Lamaze does not teach "patterned breathing" anymore. So no more hee hee hoo's...unless your doula is coaching you to breath that way for only a moment during pushing if your baby is coming too fast and the doctor needs to untangle the cord or something. :)

The agreement amongst all childbirth educators is that the best way to breath during a contraction is slow and deep. So there you go, easy right?

You Can Now Drink Clear Liquids During Labor!

Okay, so my title is supposed to sound sarcastic. But I do have to say that I'm glad that things are headed this way. See this article HERE.

I remember being at the hospital and being ravenously hungry! I just wanted to nibble on a granola bar, or crackers, or SOMEthing. But no one would let me. It made me so mad, I can't even tell you. It took all I could muster to keep from losing control, I was so angry. I could not understand why they were denying me the energy I needed to have a baby! They finally told me that I could have popsicles, so you better believe that I ate the whole bag.

You can imagine how I felt when I learned that other people, such as the President of the Midwives College of Utah, felt the same way that I did. That it's ridiculous to withhold food from a laboring woman. Some of you may know the reasoning as to why they withold food. It's because, in the event that you need an emergency c-section, and if you need to be put under general anesthesia, there is a risk of aspiration if you have food in your stomache. Aspiration is when you vomit and then breath it into your lungs.

So tell me, what about all the other people being admitted to the hospital that day who are going through emergency surgery under general anesthesia? I can tell you that some probably get their stomaches pumped.

Thus, I have decided that during my next labor, I will eat if I want to. (The other thing is laboring womean are usually not too hungry, and won't eat a lot during labor. But they are encouraged to drink a lot!) Okay, so if I get in trouble for eating, I will write up a paper that says, "IF by chance you have to do an emergency c-section, and IF by chance a spinal block does not work, and you have to put me under general anesthesia, you are allowed to pump out my stomach. Thank you very much! Signed, Natalie"

Holly's Birth

SO... I got home at about 4 AM from helping with a birth, and my child started to cry. I got him out of bed and he was struggling a bit with his breathing. I gave him a dose of his inhaler, and he went to sleep for an hour. He got back up and his breathing still made me really, really nervous, so I decided to take him to the ER at Primary Children's. They gave him a breathing treatment and the higher dosage really helped him. My mom met me there to help, which I really appreciated. I also called my husband and he got the day off to come and help. I needed the help because my friend had checked into the hospital to be induced, and I was to be her doula too! So we kept in touch over text message. We were both a little frustrated at first because before they started the pitocen, her doctor came in and broke her water. Now, I'm under the opinion because I have been taught by midwives that you do not need to break someone's water to induce them. We all know that there are many risks involved when you artificially rupture the membranes: infection, cord prolapse, no more cushion, etc. Plus, this friend of mine, her labors go so fast, that she doesn't need her water broken. There are times when it may be more beneficial to have your water broken, but I believe that it is when you are way into labor Not at the get go. Now it's usually okay when your water breaks first thing on it's own, because.. it's on it's own. It's not artificial. Anyway....my child was doing okay so I decided to head to this birth. When I got to the hosptial, she was doing SO amazing! She was working through her contractions beautifully and her husband was so supportive! They were doing so well. I was so impressed that she was doing so well with no sac of waters, and hooked up to intense pitocen. She said that her Dr told her the baby was posterior. So we changed her positions, and it worked! He turned. That was so neat to see. She kept progressing very quickly. She She was so strong and so determined! Her husband and I worked together to do some counter pressure and pretty soon she felt like pushing! She was in a great position to push the baby out....and the staff came in and laid her back and put her legs up in stirrups. I wanted to yell out, "Why are we doing this to her? She's going natural!" But I couldn't, it's not my place. Instead I tried to help her feel comfortable, and the baby was coming so fast, she couldn't really do anything about their positioning her. She's a pro anyway, so she could deal with it. And she did! Her little babe was born at 2:10 and was just the cutest, most alert baby I have seen! It was such a celebration and such an accomplishment! It was so amazing to be there with her, I was so grateful. And I was so grateful that my prayers were answered and that I was able to make it to help at her birth. I am so happy for these beautiful women and that they let me be part of their special experience. I really love being a doula!

Tami's Birth

I got to the hospital at 5:30 PM. I pushed the call button. The nurse that answered told me, "Sorry, you cannot come in. She already has her two visitors." I explained that I had called earlier, and they told me that she could have two doulas." She said, "Nope, I'm sorry." I told her that I understood. So I was ready to just go home. I texted the doula already in there to tell her that I was not allowed in. Pretty soon the director came out to the lobby and told me that they were going to make an exception and let me in. I told her it was okay if they needed to follow policy - I didn't have to go in, but she said it was fine. So she let me to her room.

It was really neat to work in a team. And it ended up being a really good thing because I was there for 10 hrs! The other doula had already been with her for a previous 6 hours. The dad also was grateful for the help from both doulas. I could not believe the huge hug he gave to me afterwards, and we had never met previously. This couple did absolutely amazing. It was her first baby and she went completely natural. Completely! And she did not lose control nor did she scream even once. She used self hypnosis (Hypnobabies) and it was amazing. It took her through her 26 hour labor all the way to the very end. I was so impressed. She had the baby at 2:30 am. It was such a neat experience!

Lee's Birth

What an incredible day. I was supposed to be to an early morning meeting today, but I slept right through my alarm. I woke up at 7:20 to my phone turning off because the battery was dead. I thought to myself that I better plug it in and charge it up, in case I get a call. I then thought, "What are the chances of that happening in the next 15 minutes." But I plugged it in anyway. Two second s later, my phone rang. It was Lee, she said she was heading to the hospital because she was having contractions and she knows she progresses very quickly. So I got ready and headed to the hospital to meet her.

I met her in triage and she was being monitored. Her contractions were irregular and she was dialated to a two. They told her she could walk around for a while, or go home. Since she was 5 days late, she said she was determined to have this baby today, so she was going to walk around. We went and got some breakfast and then rode the elevator to the 6th flor and walked down the stairs. We then repeated and went up the elevator and walked down the stairs. We did this for an hour and it was giving her some good waves. We also sat down for a mintue and I did some accupressure points to help induce labor, soften the cervix, and bring the baby down. On our way back to labor and delivery we stopped at the chapel and attended a bit of church.

Back in labor and delivery, the checked her and she really hadn't progressed, so they said she could go home and set an inducation time for the next day. She told them she would be back that night instead.

So I went home and had a normal day until 5:30 when I locked myself out of my house. I had to call for help and waited for it to come. When I finally got my keys out of my house and put my kids in the car to go to family dinner, I got a call from Lee. She said that she was headed to the hospital again because her contractions were regular, about 6-9 minutes apart. So instead, I headed to the hospital. On my way I decided to stop for some food to keep me going. I thought it might be a long night since her contractions were so far apart. I got to the hospital about 50 mintues after she called me. They had admitted her. I walked into her room and could tell she was close. 10 minutes later, she had her baby! I was just there to remind her of what she wanted to do while pushing. It was incredibly fast. And she did amazing and all natural too! She had a beautiful, beautiful baby who was alert and healthy. I stayed for a few hours afterwards while they monitored her, and then headed home on a happy high.

Early Cord Clamping

Cutting your newborn's umbilical cord is a highly significant event and the job is considered a high honor in many places. There's a sense of pride in the words, "I cut the baby's cord." But far too many Americans who utter these words don't realize that there is an event far more significant than severing the cord, it’s the clamping of it.
Why is clamping significant? Because, in the majority of medically managed births, the umbilical cord clamp violently separates a newborn infant from a portion of their vital blood supply, possibly causing damage to the brain, heart and or lungs of the child before it even takes its first breath. Many Western OBs routinely clamp the umbilical cord before the child has been fully birthed. "So what? They're doctors, they know what they're doing." According to the majority of the research they don't. Here are several reasons why you might want to tell your doctor to delay clamping the cord and some of the research available to back you up when you do.
"The placental blood normally belongs to the infant, and his/her failure to get this blood is equivalent to submitting the newborn to a severe hemorrhage at birth." (from study 1, cited below)
When a human baby is born it needs to begin breathing air into its lungs in order to survive. However, it would be a mistake to imagine that a baby's first breath contains their body’s first experience of life-giving oxygen. Oxygen is provided for the fetus throughout the entire pregnancy by the mother, through the placenta. Following birth the placenta continues to provide oxygen for approximately 5 minutes while blood pumps, to and fro, through the umbilical cord. This is part of an ingenious plan of God’s (or nature’s) to allow the newborn time to "unfold" his/her lungs and to gently make the switch from living underwater to breathing air through the lungs. Remember, the infant is not receiving "placental" blood or even the mother's blood through the umbilical cord. The baby is retrieving its own blood supply from one of its own functioning organs that just happens to be inside its mother's body.
When the transfer of blood is given time to complete itself, the placenta and umbilical cord shut down, essentially dying. The blood vessels in the baby's cord close, the placenta separates from the uterine wall and is soon expelled, its function completed. With a simple cord tie and sterile cutting tools, the umbilical cord can be safely severed at this point. The baby is typically breathing well, pinked up and perhaps even nursing away contentedly in a reasonably calm mood. Of course, baby’s first surgical procedure doesn’t really need to be done immediately following birth or, even, at all. In times past when infections were more common and sterile tools were less common, our ancestors would frequently wrap the placenta in a diaper and swaddle it in with the baby until the cord dried out and the placenta fell off by itself, a few days after the birth.
But that’s probably not what happened to your baby, if s/he was born at a typical Westernized hospital. Most OBs and even CNMs are trained to clamp the cord during or immediately following birth. If you suggest the idea of waiting until the cord has stopped pulsing you will probably be confronted with at least one of two prevailing medical attitudes:
#1 ~ It's far too dangerous for me to allow the cord to pulse. You would be putting your baby at risk of : (pick one or more of the following choices) jaundice, plethora, hyperviscosity, or polycythemia.
and/or
#2 ~ What is all this touchy-feely stuff about the umbilical cord? Early clamping does no harm.
Let's look at the research and see if either of these statements hold water, shall we?
In 1993, a study by "Kinmond et al...found no increased jaundice, plethora, hyperviscosity, or polycythemia using this method. Yet fear of late clamping persists because physicians have been conditioned to believe that these complications are caused by placental over-transfusion. Cord stripping (allowing the baby to retrieve its own blood supply) has become tantamount to malpractice."
I found the above quote in an article (cited below, note 2) but haven't yet tracked down the Kinmond study itself. It truly makes sense to me though, nature's plan to ensure our survival of birth would not, by and of itself, cause such dire consequences. I would need to see an extremely convincing study proving that such things were happening to otherwise healthy infants of healthy mothers before I would believe it.
Mothering Magazine has this to say about jaundice. "Among other drugs, Pitocin inductions and epidurals have been conclusively linked with nonphysiological neonatal jaundice (this is not normal, breastfed jaundice). Any drug administered to mother or baby must be viewed with a 'jaundiced' eye, for it is likely to compete with bilirubin sites on blood protein, causing more bilirubin to be free to contribute to jaundice.
"In an all-out effort to prevent the possibility of jaundice, obstetric practitioners have reasoned against delayed cord clamping, since it increases the volume of red blood cells , which, in breaking down, will produce increased levels of bilirubin. True, hyperbilirubinemia may be prevented in premature and "medicated" infants by early clamping; however, in a normal delivery of a full-term, unmedicated infant, there are untold advantages to delaying cord clamping until after the placenta has delivered itself." (emphasis mine)
In fact, it seems that the practice of early cord clamping began during the days of heavily medicated births. Doctors deliberately stopped the blood flow to keep the newborns from retaining too much of the anesthesia their mothers were under. It's enough to make me think that being able to dole out drugs to laboring women is more important to doctors than preventing the various problems related to early cord clamping in newborn babies. A rather scary modern sign of the times, I fear.
When I published the first draft of this article, I got a comment from a mama who was told her doctor needed to clamp the cord early because she was diabetic and her baby was at risk of developing polycythemia (a thick blood disease) if the cord was not clamped early enough. I poked around and decided this was another obstetric myth. There are babies who do develop polycythemia and some of them are born to diabetic mothers. Late cord clamping does not appear to be a deciding factor for transmission of this condition.
On to argument #2, cord preservation is “touchy-feely, pseudo-science.” Early cord clamping has been shown to cause: newborn anemia, respiratory distress leading to brain damage and/or death (rare, yes, but it happens), inadequate blood supply resulting in a need for transfusion, possible heart defects resulting from problems closing off the hole in the heart valves following birth. There are a few doctors now theorizing that the rise in autism is due to brain damage caused by early cord clamping. The mother may suffer an increase in the length of the 3rd stage as well as increasing her blood loss following birth when her baby’s umbilical cord is clamped early.
More medical studies are needed with large control groups of babies who are not separated from their blood flow prematurely, but there is already ample evidence that early clamping is a violent, uncontrolled experiment that’s failing families.
Some more medical quotes:
"Deprivation of placental blood results in a relatively large loss of iron to the infant." (1)"The time of cord clamping may be involved in the pathogenesis of idiopathic respiratory distress syndrome (the earlier clamped, the more respiratory distress)." (3)
"Placental blood acts as a source of nourishment that protects infants against the breakdown of body protein." (1)
"Studies have shown that immediate cord clamping prolongs the average duration of the third stage and greatly increases maternal blood loss." (4)
"In order to give the newborn the blood that it need(s), physiologically cord clamping should be performed not immediately after birth. One should wait ... until the umbilical vein has been empty and is collapsed." (5)
"Normal blood volume is not produced by a cord clamp ... Many neonatal morbidities such as the hyperviscosity syndrome, infant respiratory distress syndrome, anemia, and hypovolemia correlate with early clamping. To avoid injury in all deliveries, especially those of neonates at risk, the cord should not be clamped until placental transfusion is complete." (2)
Early cord clamping may also be at least partly responsible for many of the cases of blood sensitization in Rh factor negative mothers, considering the blood is clamped off with enough force to create a brief “backflow” of the infant’s blood into the mother’s placental “wound.” Dr. Robert S Mendelsohn, M.D., in his book "How to Raise a Healthy Child. . . In Spite of Your Doctor" blames the entire Rh negative issue on early clamping of the cord. (This book is high on my recommended reading list for anyone with kids)
Recently, it has become widely known that umbilical cord blood is rich in stem cells and that they can be harvested and used to restore bone marrow in deficient children. It’s a lot cheaper and easier to just slow down birth and allow the child to absorb those rich, healthy stem cells while they’re fresh and available, immediately after birth. Any healthy mother and child should be encouraged to remain attached to each other for as long as it is comfortable, following a low risk birth.
Of course, there are some cases where the newborn is severely compromised at birth. In most of these cases, the cord is instantly severed so the birth attendants can whisk the baby off to the warmer. These are the very babies who need their blood the most! The premature, the distressed and those babies born by Cesarean sections may suffer needless interventions due to the practice of early cord clamping. Make sure that your birth attendant is made aware that you do not authorize early cord clamping long before you give birth. It isn’t time to argue the point once you are already in labor.
If your attendant does not indicate willingness to wait for the cord to stop pulsing, especially in an emergency, it may be time to consider firing them and having your baby in a safer environment. The first rule of medicine is supposed to be, "Do no harm." I, and many others, including many doctors and midwives of every stripe, believe that routine early cord clamping violates that oath. If your birth attendant doesn’t recognize this, find one who does. Delaying cord clamping is not nonsense. It is the very serious matter of your baby's health and well being.
1) De Marsh, QB, et al "The Effect of Depriving the Infant of its Placental Blood", JOUR AMA ? 7 June 1941
2) George M. Morley, MB., CH. B "Cord Closure: Can Hasty Clamping Injure the Newborn?", OBG Management - July 1998
3) Saigat, Saroj, et al. "Placental Transfusion and Hyperbilirubinemia in the Premature" PEDS 49:3 – March 1972
4) Walsh, S. Zoe "Maternal Effects of Early and Late Clamping of the Umbilical Cord" LANCET – 11 May 1968
5) Z Geburtshilfe "Cord clamping at birth - considerations for choosing the right time" Perinatol 1982 Apr-May;186(2):59-64

Article on Home Birth

By: Jennifer Block
Click HERE to read the article.

The randomized controlled trial provides the evidence base for "evidence-based medicine," the movement toward employing only those treatments that have passed rigorous clinical study. Considered to be the gold standard, the highest quality research evidence obtainable, the RCT is basically the classic high school science experiment: divide two groups of subjects with the same characteristics, assign one to treatment A and one to placebo, and observe the outcomes. ACOG's response is doubly ironic because obstetrics has arguably been the slowest specialty to adopt the philosophy of evidence-based care — indeed, most labor interventions became routine without any study whatsoever, and several, like continuous electronic fetal monitoring and episiotomy, continue to be used even though copious evidence has proved them unnecessary and potentially harmful.

They do have a point about there being no RCTs on home birth, which is often the same point Tuteur makes when she criticizes a study for not comparing apples to apples. But there's a good reason for it: how many women would agree to be randomly assigned to where they will give birth? Not many, researchers have found. "It has been shown that conducting a randomized controlled trial is not possible," write the authors of the Dutch home birth study. "Good quality observational studies are therefore the only source of evidence on this subject." In evidence-based medicine, observational studies are second-tier (because the characteristics of groups A and B are not tightly controlled), but with home birth — and breastfeeding, and other large questions about childbirth for which women will not be subjected to random assignation to answer — they are best evidence possible.
Which brings the debate over safety to a bit of an impasse: if the only research that will satisfy those with authority and power is research that is unfeasible, the controversy will never be resolved. There could be 20 more large, observational studies that come to the same conclusion as those that already exist, but they still wouldn't be randomized controlled trials. The home birth advocates would continue to say "The research proves it's safe!" and the American medical establishment would continue to say "The research isn't good enough!"
The physicians are of course entitled to their opinion, but this opinion is often presented as fact, with the weight of medical authority. An American Medical Association resolution passed last year states without qualification that " . . . the safest setting for labor, delivery, and the immediate post-partum period is in the hospital" or accredited birth center, and promises legislative action to discourage birth outside it. Again, there is no research cited to back up this claim — because there isn't any. "We don't have evidence that home is safer than hospital, or that hospital is safer than home," says Soo Downe, a researcher with the Cochrane Collaboration, the international authority on evidence-based medicine. "There's absolutely no evidence either way at the level of randomized controlled trials."
One of the reasons the medical side has a hard time accepting home birth is that they forget that there are risks to being in the hospital. "It appears that being in a big and busy place with the attitude that birth is dangerous until proven otherwise may bring risks to women," says Downe, like higher rates of unnecessary surgery and invasive procedures, separation of mother and baby, and emotional trauma. Melissa Cheney calls this phenomenon "multiple interpretations of risk." "The physicians are talking about dangers to baby, while the mother might be talking about the dangers to her own body, or the danger of feeling victimized by an unnecessary cesarean, and having to go on and parent from a position of victimization. Her definition of risk tends to be much broader."
These policies may increase the risk to women and babies. Cheney would like medical staff to see the home birth population as a cultural group, with its own language and value system, and for the staff to have a degree of cultural competency. The lack of cross-cultural understanding breeds hostility in the community and in the delivery room during a transport. "There can be a lot of mother blaming or midwife blaming," says Cheney. "This can produce a very very hostile environment, just at a time when it is crucial that the doctor and midwife communicate across that divide. The outcome is very dependent upon that communication."
Meanwhile, more and more American women want to give birth outside the hospital setting — and economists have shown huge potential cost savings in terms of health reform — yet physicians' groups are fighting to keep certified professional midwives marginalized, and in some states, criminalized. The ACOG and the AMA policies prohibit physicians from collaborating with CPMs, which contributes to the hostility, and which may in fact contribute to a birth outcome that's worse than if a woman's choice had been supported and the midwife and physician had been encouraged to collaborate. In other words, these policies may increase the risk to women and babies.
Many physicians do support home birth midwives, and they are furious that their professional organization would not only try to dictate what women should do, but also how they should practice. In an open letter castigating ACOG and AMA, Canadian obstetrician Andrew Kostaska, MD, urged the American obstetric establishment to "join the 21st century." "Informed choice is the gold standard in decision making, and it trumps even the largest, cleanest, randomized controlled trial," he wrote. "Science supports home birth as a reasonably safe option. Even if it didn't, it still would be a woman's choice . . . As scientific evidence supporting its safety mounts, however, [ACOG and AMA] will be forced to accede or get left behind."