Rest!

The Undervalued Therapeutic Power of Rest

Posted on August 20, 2009 by gloria

I developed very sore nipples when my youngest daughter (now 28 years old) was about 8 months old. I was working as a midwife at the time and I was completely perplexed and dismayed to be having sore nipples for, what I thought was, no reason at all. I called the La Leche League to see if they had any ideas about cause or cure and the first response on the other end of the phone was “Have you been getting your rest?” Oh, how I hated those words. . . I wanted a much fancier diagnosis than “you’re tired, dear”. The truth was that I’d just come off a very long birth and had been up two nights in a row. I was rushing around trying to pull my own household together and do postpartum care for the new family, too. That LaLeche League Leader gave me such a gift by causing me to pause and see that I wasn’t taking care of myself and my nipples were a first alert that things were falling apart.

I notice that my clients have the same dismayed reaction when I bring up rest. Isn’t there another way? Isn’t it possible to have those 3 birthday parties I have scheduled for my 4 year old? Can’t I pick someone up at the airport, go to the library and cook dinner for six in my first week after giving birth? Whaaaaaaaaa.

We live in a culture that has no value or respect for rest. If you’re resting, you’re lazy and incorrigible. We have been raised on Tampax ads that say “Go play tennis, golf and volleyball when you’re having your moon time. An active woman is an attractive woman.” I love the Orthodox Jewish practice of giving women a bed of their own from when their period starts to 12 days later and arranging a complete day of rest from all household duties on Saturday. We would all be well advised to adopt these customs.

Some of the problems that are cured by rest in bed:
-breast problems of all kinds in nursing mothers
-heavy or prolonged vaginal bleeding in post partum or perimenopause
-general crabbiness or depression

For building up milk production, go to bed with the baby for 24 hours. Mother should wear only panties, baby only a diaper. A tray with fluids, magazines and flowers beside the bed for the mother and all diaper changing needs for the baby close at hand. Another adult woman in the house brings meals to the mother. After 24 hours of this bed rest, the milk will be abundant. (I’ve had one client who said it didn’t work. When I went through what she had done, it turned out that instead of following these instructions exactly, she went to her cousin’s place for the day and lay on her couch.) No, no, no. The naked skin and privacy are a big part of this “Babymoon” formula. Don’t modify. Probably, when you read this, you thought “This would be a luxury for a new mother.” It’s actually very basic and pays huge dividends for the family and larger community. Some cultures understand this and make sure the new mother is given a 40 day period of rest/care when she has a baby. (interesting: when I just looked on Google images for a photo to go with this post, the first 3 pages of pictures were new mothers and babies ALL sitting up.  The baby in this photo looks about 3 months old.)

I hear many dramatic stories from midwives and nurses about women who had to be operated on after giving birth because they were bleeding heavily and had “retained pieces of placenta” or “retained clots”. My personal experience is that ALL post birth bleeding is remedied by resting in bed. The lochia is red for the first two days, changes to pink and serumy around the third day, and then proceeds to being brownish and quite smelly for about two weeks. If it turns red again after going through the pink and brownish stages, it means the mother is doing too much. She needs to follow the “BabyMoon” lie-in instructions above. Remember, THIS IS NOT A LUXURY, IT’S BASIC. The family needs to be told that, if they don’t help the mother to rest in bed, they will end up visiting her in hospital.
We need to give up the notion of supermom. Do whatever it takes to get your rest time after the birth and then you will be back to your busy life sooner. When women have homebirths, they usually feel so well that they want to get up and “prove” to the world that they can do anything. Be mindful of the Zen maxim “If you have something to prove, you have nothing to discover.” The really smart women don’t even get dressed for weeks after the birth. If you’re all perky in a track suit, people will expect you to run . . . therefore, find the nastiest old nightie possible and wear that to convince family and friends that you need their assistance.

If you can’t figure out how to ask for help in the early weeks with a new baby, photocopy 20 copies of this list and hand out freely.

Rest, high protein meals, and lots of skin to skin time in bed with baby . . . these are the basics of getting motherhood off to a good start.

By: Gloria Lema

The Waiting Game

The Waiting Game: Why Baby Knows Best

October 22, 2010 By Cara Terreri 6 Comments

By Debby Amis, RN, BSN, CD(DONA), LCCE, FACCE

Patience is truly a virtue after 9 long months, especially when you’re a few weeks or days from your due date. The swollen feet, extra pounds and late-night bathroom trips can take their toll. Wouldn’t it be easier to just schedule your baby’s birth and get the show on the road?

Elective induction offers the satisfaction of knowing your baby’s birth date in advance, but it might not go as planned. Sometimes women scheduled for induction are bumped from the hospital agenda because the staff is busy. Plus, induction doubles your risk of cesarean birth. The major risk of elective induction is that your baby may not be ready to be born. Experts agree that a normal pregnancy lasts between 38 and 42 weeks, and research indicates that the baby actually initiates the labor process. Once his lungs are fully mature, he releases a protein that tells his mother’s body that it’s time. A baby born even a few weeks early is at an increased risk for breathing problems, admission to special-care nurseries and breastfeeding difficulties.

Inductions & Interventions

An induction usually requires more interventions than a naturally starting birth. You will need IV fluids and continuous electronic fetal monitoring, making you less mobile. Also, artificial contractions may peak sooner and be more intense than natural ones. You are therefore more likely to request an epidural, which increases your chances of needing forceps or vacuum assistance, developing a fever and/or requiring a cesarean section. Plus, the most common medication used for induction (Pitocin) interferes with the release of hormones that promote birth happening normally and breastfeeding.  

Because of these risks, some hospitals do not offer or limit elective inductions. “It seems that, if we are too cavalier about inducing labor for the convenience of either the mother or the provider, we are ignoring the baby’s essential contribution and asking him to participate even when he is not ready,” says Biddy Fein, CNM, who attends births at Brigham and Women’s Hospital in Boston. “We accept this as necessary when the risks of continuing pregnancy outweigh the benefits. But in all other circumstances, we should be respectful of nature’s plan for the initiation of labor and the exquisite interplay between mother and baby.”

Baby Makes the Date

If there are valid medical reasons for labor induction, your health-care provider will weigh the benefits of immediate delivery versus continuing the pregnancy for the health of your baby. But if you are like the majority of women who have a healthy pregnancy, the safest option for you and your baby is to wait for labor to begin on its own. Your baby may decide to come on his due date (although less than 10 percent of babies do), but you may want to plan for a later date in case your pregnancy does extend to 42 weeks.  

If your pregnancy lasts longer than expected, try not to worry. Continue normal activities and remember that you are giving your baby the best start by allowing him to decide when he is ready to make his grand entrance into the world.

This article was reprinted with permission from Lamaze International and is available on the Lamaze parent resource Web site along with many more helpful tips and advice for pregnancy, birth and parenting.

5 Unnecessary Hospital Procedures

Birth should be an awesome thing with as much focus on making it as easy and safe for you as possible, and of course, as safe as possible for the baby as well.

Today's labor and delivery wards are much more like an assembly line, and some typical L&D staff policies and procedures not only make birth harder and more painful, but can be the very reason for unnecessary medications and c-sections.

Here are the top five myths associated with hospital procedures that change your birth experience.

Myth 1: You need a monitor on your belly the whole time you're in labor.

Fact: You absolutely do not. Intermittent monitoring is shown to be just as effective, and actually allows the woman to focus on things other than her contractions. Consider that women are often made to lie down and stay relatively still with the monitors on as well, and you're put in a position where you have nothing to do but focus on and internalize any pain of contractions.

In fact, constant fetal monitoring often leads to unnecessary concern, and even intervention, including c-sections, so says the American Academy of Family Physicians, not some holistic home birth website, for those of you in doubt. In fact, only monitoring the baby's heartrate and your contractions every 30 minutes during early labor, and every 15 during transition and pushing is the current recommendation, but one that you almost never see actually practiced.

Myth 2: Lying on your back is a good position for pushing.

Fact: It sucks, big time. The only reason women end up on their backs is to make it easier for doctors to get in there. So, really, unless they NEED to be in there, it's a bad move. It's not only shown to reduce the size of the pelvis significantly, but it puts pressure on the vena cava, which reduces blood flow to the baby and your lower body -- why is it not okay during pregnancy, but they tell you to do it for hours on end during labor, and then are surprised at reduced blood flow to the baby?

The National Center for Biotechnology Information states that being upright, in addition to increasing blood flow also makes contractions and labor less painful, faster, easier, with a lot less trauma to the mother's birth canal, minimal to no tearing, and less trauma to the infant as well. It also makes for less postpartum complications, damage to the pelvic floor, incontinence, and in general, a much better, faster, less painful birth.

Also, if you opt for an epidural and can't feel your legs, you can't walk or kneel. So consider that you might not need that if you actually get up off the bed, and that just because you can't feel the pain with an epidural, your baby can, and you will once the drugs wear off. I wish I'd known as much about epidurals as I do now 15 months ago when I had my daughter. I was ashamed of myself for getting it then, but now I really, really wish I hadn't.

So why are 75 percent of births still done with the woman flat on her back? Back to the beginning of this point -- to make it easier for the doctor.

Myth 3: You can't eat or you'll barf it up and aspirate the vomit.

Fact: You wouldn't tell a marathon runner to skip breakfast, would you? Telling a woman about to engage in major physical work not to eat is almost as bad -- except what is at risk here isn't just a race, but two lives. Yes, there has been some concern that with intubation before anesthesia would come vomit, and then aspiration of said vomit.

MedScape discusses a study on the matter that says:

"Aspiration pneumonitis/pneumonia is significantly associated with intubation and ventilation," the study authors conclude. "In modern obstetric practice it is the use of regional anaesthesia, thereby avoiding intubation, rather [than] fasting regimens that is likely to have reduced mortality from aspiration. Although the National Institute for Health and Clinical Excellence has recommended, on the basis of consensus opinion, that women in normal labour may eat/drink in labour, our trial shows that this will not improve their obstetric and neonatal outcomes."

In other words, forcing women not to eat hasn't reduced aspiration -- not shoving tubes down their throats has. In their study, women who ate light meals showed absolutely no difference in anything -- no more vomiting, no more risk than women who were only allowed ice chips or water.

Myth 4: You need to be told when to push.

Fact: Do you need to be told when to poop? You no more need permission and direction to push out your baby than you do to push out a bowel movement. Just as your body uses contractions to move the baby towards the cervix and through it, it moves the baby down the birth canal, too. Your body will tell you what to do. You will feel when you need to push, and you will just work with it. When you feel the need to relax, do it. Push as hard as YOU are comfortable and if someone is yelling to you to push harder or longer than you feel you should, yell at them to shut up.

Pushing to the point of shaking, not breathing (called 'purple pushing' for the color your face turns) and breaking blood vessels in your face is not going to help you. In fact, it can cause the cervix to swell if you're not ready, it can make you exhausted, it can create much more severe tears, and is just a bad idea in general, even according to the World Health Organization.

Drugs can inhibit the feeling of needing to push (or the ability to know if you need to stop), though, but that's a whole 'nother topic all on it's own.

Myth 5: A break in contractions/labor stalling is a bad sign.

Fact: Women can get fully dilated and have the baby ready to go ... and then have a period that has been appropriately nicknamed the "Rest and Be Thankful" stage. It is nature's way of giving you a break after all the work to get your body ready, before the final hurrah. You can also have a break like this earlier in labor as well. Sometimes you can even be in early labor for what ends up being days, often called prodromal labor. We are mammals, first and foremost, and our bodies aren't stupid -- if a woman gets really stressed or really exhausted, often her body will sense that she doesn't have the energy for birth, or deems that it's an unsafe situation and halt labor until mom is rested or calmed. Think of a mother rabbit in labor realizing a predator is nearby -- she NEEDS to get safe before she can birth the babies.

Doctors often start up pictocin here, when the recommended things are anything but that -- squatting, moving around, getting in a bath all are proven safe methods to help the mother relax and get her contractions going in a normal pattern again. In fact, my midwife told me that studies show nipple stimulation and relaxing in water had been shown to be as effective, if not moreso, than pictocin. Considering that pictocin is an artificial chemical designed to mock those from things like nipple contraction, it's not exactly a far leap in logic.

If your labor stalls, don't rush for the meds -- relax, move around, have a light meal for energy, try to take a nap. In and of it's own, it is NOT an emergency

For Fun

PREGNANCY Q20& A & more!

Q: Should I have a baby after 35?
A: No, 35 children is enough.
 
Q : I'm two months pregnant now. When will my baby move?
A: With any luck, right after he finishes college.

Q : What is the most reliable method to determine a baby's sex?
A: Childbirth.

Q: My wife is five months pregnant and so moody that sometimes she's borderline irrational.
A: So what's your question?

Q?: Is there any reason I have to be in the delivery room while my wife is in labor?
A: Not unless the word 'alimony' means anything to you.

Q: Is there anything I should avoid while recovering from childbirth? 
A: Yes, pregnancy.

Q?: Do I have to have a baby shower?
A: Not if you change the baby's diaper very quickly.

Q?: Our baby was born last week. When will my wife begin to feel and act normal again?
A: When the kids are in college.

'ESTROGEN ISSUES'
10 WAYS TO KNOW IF YOU HAVE 'ESTROGEN ISSUES'
1. Everyone around you has an attitude problem.
 2. You're adding chocolate chips to your cheese omelet.
 3. The dryer has shrunk every last pair of your jeans.
 4. Your husband is suddenly agreeing to everything you say.
 5. You 're using your cellular phone to dial up every bumper sticker that says: 'How's my driving-call 1- 800-'.
 6. Everyone's head looks like an invitation to batting practice.
 7. Everyone seems to have just landed here from 'outer space.'
 9. You're sure that everyone is scheming to drive you crazy.
 10. The ibuprofen bottle is empty and you bought it yesterday.

TOP TEN THINGS ONLY WOMEN UNDERSTAND
10. Cats' facial expressions.
 9. The need for the same style of shoes in different colors.
 8. Why bean sprouts aren't just weeds.
 7. Fat clothes.
 6.. Taking a car trip without trying to beat your best time.
 5. The difference between beige, ecru, cream, off-white, and eggshell.
 4. Cutting your hair to make it grow.
 3. Eyelash curlers.
 2. The inaccuracy of every bathroom scale ever made.
AND, the Number One thing only women understand:
1. OTHER WOMEN

Eating During Labor

What are the facts??/

You may already know that eating in labor is a big no-no here in the United States - as it is in most industrialized countries. However, you may not know why...

What you do know is to expect an IV in labor...no drinks and certainly no food. So let's discuss the facts and the myths of this practice.

Eating and Drinking in Labor

Historically, women have always been advised to eat and drink during labor as long as they could and were able to do so.

So what is the thought behind not eating in labor?

Well, simply put the concern was in case you had to be put under general anesthesia. The fear was that if you vomited you could maybe potentially aspirate food into your lungs.

The facts are:

1) This level of risk is minimal and even more so since - even if you need a c-section - general anesthesia are no longer favored. Most women would receive an epidural instead.
2) Anesthesiologists are well trained and know how to avoid such an incident from occurring.
3) This line of thinking is faulty from the start since your stomach is never truly empty as it always contains gastric juices.
4) Prolonged fasting increases the amount of hydrochloric acid in your stomach which can in turn increase the complications with aspiration.
5) We would not call "good science" to make recommendations on only one study done 60 years ago.

Eating in Labor: Why is it Good for You?

1. Eating small amounts of easily digested foods during labor can give you the energy you need to keep going. We would not think of starving an athlete before a performance now would we? Labor is equivalent to a 50 mile hike!
2. In 1989, a National Birth Center study including 11,814 women 22% of whom had a c-section, none of them aspirated even though they were allowed to eat and drink at willduring labor.
3. Being able to eat and drink during labor gives you a sense of control which is very important to your emotional well being.
4. Midwives and doulas know that if your labor is not progressing, often eating and drinking during labor helps to get things moving.

Eating in Labor: Latest Research

Professor Andrew Shennan at King's College in London felt that five previous trials on "eating in labor" were inconclusive...so he decided to do his own research.

He concluded that eating in labor did not affect delivery rates, but let's look at this research more closely.

Dr. Shennan's study took place at Guy's and St Thomas' Hospital in London between June 2001 and April 2006 and it involved 2,426 healthy women, having their first baby.

The mothers were randomly split into an "eating in labor" group or a "water only" group. The eating group was advised to eat small regular amounts of food, such as bread, biscuits, fruits, low fat yogurt, isotonic drinks, and fruit juice.

The mothers in the water only group were advised to have ice chips and water only.

Note: In most American hospitals, you do not even have a choice of water or food since you will be hooked to an IV. Keep on reading to see that IVs cause more harm than good and that given a choice, water - or even ice chips - is a much safer choice!

Age, ethnicity, food intake for six hours before and during labor, vomiting and the need for intravenous fluids were recorded.

The results:

The spontaneous vaginal delivery rate was the same in both groups and was 44%.

The duration of labor was 597 minutes for the eating group and 612 minutes for the water group which the researchers did not determine to be significant. HOWEVER, any woman who has gone through labor will take a shorter labor even if it is "only" by 15 minutes!

The c-section rate was about the same for both groups 29 and 30 respectively.

There were no differences in the condition of the babies at birth or in admission to NICU.

The researchers felt that according to their results eating was not detrimental.

Eating in Labor: IV use in Labor

If you give birth in a hospital, you should expect to be hooked to and IV in labor. The fluid you receive from an IV is supposed to compensate for the lack of food and water...it is also used to facilitate the administration of various drugs including pitocin. If you want an epidural...an IV is mandatory.

What fluids go into your IV? Well, to put it simply: water and sugar.

This is such a mixture which presents a hazard for you as well as for your baby.

Usually the sugar that is used in an IV is called Dextrose. So what is Dextrose? It is often used to replace glucose and it is a refined sugar which has been known to have nasty side effects:

Dextrose is known to rapidly elevate your blood sugar. As with any refined sugars, at first, it will cause an energy boost followed by a rapid drop in blood sugar as your body tries to go back in balance. To compound this problem, you do not receive Dextrose just once but continually during the courseof your labor which according to Drs. Abrahamson and Pezet and their research creates havoc on your body.

My IV will contain sugar in the form of glucose...so it's okay...right?

We'd love to say yes and put your mind at easy but this is not the case.

Studies comparing laboring mothers who were allowed to drink versus mothers who received an IV in labor showed that IV use in labor causes a fluid overload. This is not a good situation as it can lead to:

Electrolyte imbalance

Cardiac arrhythmia - irregular heartbeat

Pulmonary edema - fluid in the lungs

There is more...since IV fluids are just sugar with no protein...a laboring mom can experience a"negative nitrogen balance" which is a condition of starvation and therefore not a good thing.

Yes, there is still more: in a study 11.4% of the IVs were colonized with bacteria ...so receiving an IV in labor increases your chances of infection. This is very scary because little germs that can survive in a hospital environment are known to be very very bad and in some cases deadly.

If this was not bad enough, studies have shown that these "sugar cocktails" reduce a mother's pain tolerance levels!!! And who wants that?

IV use in labor also affects your ability to move which in turn affects the speed and the quality of your labor. 

Eating in Labor: The Risk of an IV to your Baby

These are the risks to you...but that is not all. Your baby is also at risk:

Hypoglycemia after birth - low blood sugar

Increased chance of jaundice at birth

Increased weight loss after birth