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Birth Story – Hospital VBAC

by Krista Haggerty

My first birth was a cesarean after a long labor.  It was hugely disappointing, and I struggled with feelings of failure.  When I became pregnant again, I knew I wanted to have a vaginal birth with no interventions.  I switched providers two times and met the OB who delivered my son at my 37 week appointment.  I went into labor 5 days later.

My water broke early in the morning with a slow leak without contractions.  At my morning appointment my OB told me to go right away to the hospital even though I wasn’t ready to go.  He also told me he didn’t think I could have a VBAC because I was so small (I am 4’11”) but he would let me try anyway.  I was furious!  I spent so much time researching VBACs this pregnancy, and knew that his reasons were not evidence based.

I didn’t want to be put on a clock, so we went home from the appointment.  My husband and I packed a bag and tidied up the house.  We went to a late lunch and voted in the presidential election.  Finally, around 5pm, the OB called my husband and told him to bring me in.  By this time my contractions had started in earnest so even though I still felt hesitant because of the OB’s attitude, I knew it was time.

We arrived at triage where a midwife from the hospital met us.  She told me she would have to take a sample of the fluids to make sure it was my waters and that she would check me.  I told her I didn’t want to be checked until I was ready to push, but she insisted it was hospital policy.  A moment later I had a contraction, and she checked me.  I told her “No, get out!” but she ignored me, and just said “You’re 7 cm”.  She left and about 15 minutes later I told my husband I felt like pushing.  He ran out to find someone and there was a whirl of activity as nurses came in, put me onto a bed, and wheeled me upstairs to the maternity floor.  My headphones were removed from my ears without anyone asking, and during the trip up I was checked another two or three while I yelled “No!  Stop, Get out!”  Not once was I asked or even warned that someone was checking.  I felt violated, like all they saw of me was my uterus, and not me as a person.

Once we were in the room, the OB checked me (without asking or acknowledging me at all), declared I was at 10 cm but had a lip, and left the room.  The nurses told me to stop pushing, which was what happened with my first baby.  I couldn’t stop, it felt impossible to fight the urge.  I began to panic; my doula wasn’t there yet (we had just called her) and no one would tell me what a lip meant or what I could expect.  I told the nurse that if they wanted me to stop pushing they would have to give me an epidural.  My husband asked—mid contraction—if I wanted to just have a C-section.  I managed not to punch him.

While I was waiting, a tech came in and told me she was going to draw blood for my STD test.  I had already been tested early on in pregnancy and it was negative, so I declined.  She left for a moment, and when she came back she said if I didn’t allow her to take blood now, my baby would be taken and tested as soon as he came out.  I was shocked; I felt threatened and angry, but I also didn’t want to be separated from my newborn for an unnecessary blood test, so I reluctantly agreed.

Soon the anesthesiologist came in and prepped me for the epidural.  He had me sit up, and as I sat I felt the baby move down into my pelvis.  I almost said something to the nurse, but at that point I felt so out of control of the situation I just rode it out.  After the epidural was in, they had me lie on my back, which was extremely uncomfortable.  I started to shake badly and was freezing.  As the anesthesiologist walked out, my doula walked in.  She saw what was going on and asked if anyone had checked me for the lip before the epidural was put in.  I almost started to cry when I realized they hadn’t. She went to work soothing me and making me comfortable.  She sat with my husband and helped calm him a bit, and things got quiet.

A little while passed, and I was checked again.  I was ready to push!  They sat me up in the bed and the nurse had me practice pushing before the OB came in.  I took a moment to talk to my baby, telling him we were going to do this together and that I couldn’t wait to meet him.  I pushed once and was immediately told to stop; he was right there and ready to come out!  The OB came in and I pushed twice more, and my son was born.  He was placed on my chest but there were too many other sheets to really hold him, with all the fussing from the nurses.  They took him aside because he wasn’t breathing well, but after I insisted I hold him, he perked up.  He was perfect, and the whole labor lasted about 4 hours.

In many ways I felt like a warrior; it felt like a battle to birth the way I wanted, and though I felt wounded by the care I received, it could not diminish the triumph of what I accomplished once I held my son for the first time.  I felt invincible!  Despite the struggle to have my voice heard and to be treated respectfully, I was able to do what no-one in the room (except my doula) thought I could.  As I held my son for the first time, all I could think was “WE DID IT!”

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The Nocebo Effect

By Cathy Daub, PT, CCE and CD(BWI)
I remember once talking with a pregnant woman in the hospital who had just been tested for gestational diabetes. She looked up at me confused saying, “I eat healthfully and there is no history of diabetes in my family.” She had a look of despair in her eyes and I could tell any confidence she had had in her body to give birth had suddenly been diminished. I saw her later and found out that the test was a false positive and that she didn’t have gestational diabetes after all, but the lingering effect that something could go wrong in her body remained and affected her deeply. A woman giving birth needs to have a lot of confidence in her body for the work of labor for it may be one of the hardest but most rewarding things she has ever done.
The word Nocebo comes from the Latin word “noceo” which means “to harm” whereas the word “placebo” means “to please.” More simply put, nocebo means words that are said that cause harm. The nocebo effect is basically the effects of the power of suggestion. For example if a doctor tells a woman that she has a small uterus, and then as her belly grows, if she believes what he said is true, she may not believe she can birth her baby and a cesarean may be the outcome.

The nocebo can also have the effect of taking an inert harmless substance that ends up causing a harmful effect, simply because someone believes or expects it will harm him/her.  The power of suggestion and our beliefs are very strong and can actually alter and control physiology by simply changing a thought.  Therefore, results of the placebo or nocebo are actually a mind plus body effect. “Changing thoughts can actually create a brand-new reality.”1 “Considering that the latest scientific research in psychology estimates that about 70% of our thoughts are negative and redundant, the number of unconsciously created nocebo-like illnesses might be much higher than we realize.”2

Joe Dispenza in his book “You Are the Placebo” writes:  In other words, in exactly the same environment, those with a positive mind-set tend to create positive situations, while those with a negative mind-set tend to create negative situations.  This is the miracle of our own free-willed, individual, biological engineering.”3  These are the reasons that in BirthWorks certification programs, we focus a great deal on identifying beliefs related to birth and work to change those not perceived to be helpful.

At a recent BirthWorks Childbirth Education Workshop, Krista shared the following story of her birth, one full of the nocebo effect, but also of her power as a woman to rise above it.  This, itself, takes much courage and determination to make the best out of any situation.  But just imagine after reading it how different her experience would have been had she received the respect she deserved during her labor.

References:

  1. Dispenza, Joe, You Are the Placebo: Making Your Mind Matter, published and distributed in the United Kingdom by Hay House Hay House Inc., 2014. p.31.
  2. p.45.
  3. p.45.

 

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The Truth About Lips

 

 

 

 

 

elliptical

When you see these diagrams of an opening cervix, you can see how a posterior lip would be unlikely        because in actuality, the cervix opens in an elliptical fashion and not concentrically.  The baby’s head dilates the cervix more with each contraction pulling the anterior part of the cervix with it.  When the head is not centered evenly on the cervix, one side may dilate more than the other resulting in an anterior lip.

Wikipedia defines an anterior lip as:  “The anterior section of the cervix is nearly always the last part of the woman’s cervix to be finally taken up into the lower segment of the uterus.  An anterior lip occurs when the top of the cervix swells, but the rest of the cervix has completely dilated. An anterior lip can slow the woman’s progress from the 1st to 2nd stage of labor, because the swelling will usually take time to reduce, before enabling the woman’s cervix to be pulled up, and around, the baby’s head.”                                                                                                                                                                                                                                                                    concentric

 

Women are frequently told they may have a swollen anterior lip that is impeding progress in labor.  What can a woman in labor do?

  • Try to push through the cervix but only if she feels an urge to push. When the cervix simply isn’t ready it can just become more swollen.
  • Changing positions a lot throughout labor will help to avoid malpositions. Position changes will help keep the baby moving and rotating into optimal positions so the baby’s head will be presented evenly on the cervix.  Upright positions or hands and knees are best. Try lunges, trunk rotation, walking up and down steps or marching in place, rocking the pelvis, or hanging from a rope. Using a rebozo can give even more sway to the hips when used to make a figure eight in a standing position.
  • Some midwives will place an ice cube on the lip and leave it there for a few minutes. They say this works every time for them.

The woman who was told she had a posterior lip – well, it just shows we have to be informed consumers.

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Labor Pain – Part II

by Haley Macklin

Pain in labour and childbirth is not a ‘bad’ thing requiring fixing or flat out avoidance. On the contrary, it is the pain of labour that helps contract the uterus and open a mother ready to bring her child into the world. This collection of sensations should be encouraged because it is these sensations that help to welcome new life. And without the sensations of birth, none of us would be here. The pain in childbirth has been around for as long as childbirth itself; it is natural, safe and completely normal to have this experience. So, instead of trying to change or remove the pain, perhaps we need to change us; a change in our beliefs and expectations of birth, from a place of fear of pain to one of acceptance and even welcoming any experience during labour, would allow birth to proceed exactly as its meant to. It may also reduce the rates of intervention we are seeing across the world – namely, forceps, vacuum extraction and cesarean section – and the risks associated with these medical interventions (remember – some of these risks live on in the lives of mothers for years after birth). Mothers deserve the very best in their care during pregnancy and birth, and I believe strongly that one of the best ways we as carers can support women is to inform them of the truth around birth. And that truth is this;

 

Birth and all that comes with it is simply an organic unfolding of a event that has endured since time began. In any moment during labour and birth when the pain feels too big or too strong, just remember, your body was made to endure this power, and you have this and even more power within you. It is nothing compared to the joy you will experience when you hold your baby for the first time, and the love that will come flooding into your life. 

 

References:

Alehagen, S., Wijma, B., Lundberg, U. (2005). Fear, pain and stress hormones during childbirth. Journal of Psychosomatic Obstetrics Gynaecology, 26(3), p153-165

Beigi, N., Broumandfar, K., Bahadoran, P., Abedi, H. (2010). Women’s experience of pain during childbirth. Iranian Journal of Nursing and Midwifery Research. 15(2): 77 – 82.

Buckley, S. (2009). Gentle Birth, Gentle Mothering. Celestial Arts. Brisbane.

Coad, J & Dunstall, M. (2001). Anatomy and Physiology for Midwives, C.V Mosby

Gaskin, I. (2003). Ina May’s Guide to Childbirth. Bantam Books Trade Paperbacks. New York.

Jansen, L., Gibson, M., Bowles, B., Leach, J. (2013). First Do No Harm: Interventions

During Childbirth. Journal of Perinatal Education. 22(2): 83 – 92.

Van der Gucht, N., Lewis, K. (2015). Women’s experiences of coping with pain during childbirth: A critical review of qualitative research. Midwifery Journal, 31(3), p341-394.

 

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Over Night Oats

Oats are among the healthiest grains on earth.
They’re a gluten-free whole grain and a great source of important vitamins, minerals, fiber and antioxidants.
Studies show that oats and oatmeal have many health benefits.
These include weight , lower blood sugar levels and a reduced risk of heart disease.
The nutrient composition of oats is well-balanced.
They are a good source of carbs and fiber, including the powerful fiber beta-glucan
They also contain more protein and fat than most grains
Oats are loaded with important vitamins, minerals and antioxidant plant compounds. Half a cup (78 grams) of dry oats contains:
• Manganese: 191% of the RDI
• Phosphorus: 41% of the RDI
• Magnesium: 34% of the RDI
• Copper: 24% of the RDI
• Iron: 20% of the RDI
• Zinc: 20% of the RDI
• Folate: 11% of the RDI
• Vitamin B1 (thiamin): 39% of the RDI
• Vitamin B5 (pantothenic acid): 10% of the RDI
• Smaller amounts of calcium, potassium, vitamin B6 (pyridoxine) and vitamin B3 (niacin)
oats are among the most nutrient-dense foods you can eat.
Both flax and chia seeds are healthy additions to your diet. They’re both good sources of plant-based omega-3 fatty acids, fibre and minerals.
Karen Burzichelli RN,
HealthCoach
Karen’s Healing Kitchen
856-803-9910
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Viagra Given To Pregnant Women

Viagra Given To Pregnant Women

By Cathy Daub PT, CCE and CD(BWI)

I am saddened as I read the new headline in today’s news.

Eleven babies die after Dutch women given Viagra in drug trial.  Research halted as 10 to 15 other participants wait to see if their children affected,”

My mind immediately goes back to the drug thalidomide in the 1960’s given to women to help relieve morning sickness in pregnancy.  Thalidomide was found to be safe when tested on animals, but in humans the side effect of phocomelia, a shortening or absence of limbs was the result.  Now, even though Sildenafil, also known as Viagra (commonly prescribed for erectile dysfunction), was found to be safe in rats, we have human babies dying.  The experiment on humans in the Netherlands was terminated when an independent committee overseeing the research, realized that “more babies than expected were being born with lung problems.”

The intent of these “experiments” on pregnant women are carried out with good intention, to help relieve the suffering of morning sickness in the case of thalidomide, and in the case of Viagra, to help increase blood supply to the placenta of babies already very compromised.  But what is not realized is that we still do not know or understand much of the workings of the human body to be meddling with it especially in the presence of a developing fetus.  When we try out a new drug on small fetuses and babies growing in the womb, believing that what is safe for animals is safe for humans, it is bound to be met with serious consequences.  I am saddened that we have not yet learned our lessons.

We can be forever grateful to FDA inspector Frances Kelsey who in July of 1962, resisted pressure from the pharmaceutical company and FDA supervisors to market the Thalidomide in the USA, as she was concerned about the lack of research on whether or not the drug could cross the placenta and affect nourishment to the developing fetus.  Thankfully, again, the USA may be saved as the study was conducted in the Netherlands unless there was some unofficial and illegal use here in the USA.

In this day and age, it is healthy for consumers and especially pregnant women to be skeptical about accepting a drug that is not always new on the market but newly used for other purposes, in this case Viagra on pregnant woman. How a drug responds in an animal and human adult can be completely different from how it affects the intricate workings of a developing baby.  To this day, we don’t understand how the fetus knows to make folds in its proteins to store more knowledge and develop organs.  We cannot see most of the vessels in the human body with the naked eye.  We don’t completely understand how the brain works and develops.  Extreme caution needs to be used along with educating the public, especially women of childbearing age, not to accept something they don’t know or understand.  People and especially pregnant women need to question medical treatment and prescriptions.

There are other ways to improve fetal development:

  • Take consumer oriented childbirth preparation classes that are designed to educate women about these issues.
  • Educate pregnant women about more healthy nutrition. The food a pregnant woman eats grows her baby.
  • Find ways to lower stress in their lives through meditation and yoga that also encourage slow deep breathing.
  • Encouraging them to keep physically active.
  • Educating pregnant women about the dangers of smoking, drinking, and high caffeine intake.
  • Impress on pregnant women the need to read labels. If they don’t understand what the ingredients are, they need to find out so they can make informed decisions.