Shorten Labor by Eating This Fruit

Did you know that you can increase your chances of a shorter and easier labor just by adding a particular fruit to your diet in the last few weeks of pregnancy? One study published in the Journal of Obstetrics and Gynecology found that women who ate dates in the last 4 weeks of pregnancy dilated faster and had faster labors compared to those that did not consume dates.

dates

The Study

The date and pregnancy study was carried out at Jordan University of Science and Technology, who studied 114 women from February 2007 to January 2008. The date consuming group (69 women) consumed at least 6 date fruits per day in the last 4 weeks of pregnancy compared to the non-date consuming group (45 women) who had none. The two groups were similar in terms of gestational age and maternal age.

The date consuming group were more dilated upon admission to the hospital, had a higher proportion of intact membranes, a greater rate of spontaneous labor, a lower rate of induction, and an average of 7 hours shorter labor compared to the non-date consuming group.

The researchers concluded that eating dates in the last month of pregnancy can reduce the need for induction and augmentation of labor and may shorten the overall duration of labor.

Researchers believe that something in the dates mimics the hormone oxytocin, a hormone involved in labor, among other things.

Dates

Date fruit (phoenix dactylifera) comes from a date palm tree which has long been cultivated for its fruits. Date fruits (which contain a hard seed inside) can be soft or dried and enjoyed in a number of ways. Dates are a terrific source of potassium and also contain sugar, protein and a number of vitamins and minerals. They can serve as a great natural sweetener. Dates can be stored in a glass jar in a cupboard or in the fridge.

Date Recipes

Date Energy Balls

These vegan and paleo energy balls are a quick and easy treat, perfect for snacking! These would also make great labor snacks.

Makes: 24

Ingredients

  • 2 cups walnuts, or other nut/seed of choice
  • 1 cup shredded, unsweetened coconut
  • 2 cups soft Medjool dates, pitted
  • 2 T coconut oil
  • 1 t sea salt
  • 1 t vanilla extract

In a large food processor, process the walnuts and coconut until crumbly. Add in remaining ingredients and mix until a sticky, uniform batter is formed. Scoop the dough by heaping tablespoons, then roll between your hands to form balls. Arrange them on a baking sheet lined with parchment paper, then place in the freezer to set for at least an hour before serving. Store the balls in a sealed container in the fridge for up to a week, or in the freezer for an even longer shelf life.

You may also roll them in shredded coconut or cocoa powder before chilling.

Date Walnut Bread

Ingredients

  • ½ cup blanched almond flour
  • 2 tablespoons coconut flour
  • ⅛ teaspoon celtic sea salt
  • ¼ teaspoon baking soda
  • 3 large Medjool dates, pitted
  • 3 large eggs
  • 1 tablespoon apple cider vinegar
  • ½ cup walnuts, chopped

In a food processor, mix together almond flour and coconut flour. Add salt and baking soda. Next add the dates until mixture resembles coarse sand. Add eggs and apple cider vinegar. Lastly, pulse in walnuts. Transfer batter to a mini loaf pan. Bake at 350° for about 28 to 32 minutes. Allow to cool in pan for 2 hours before removing.

Chocolate Cranberry Power Bars

Ingredients

  • 2 ¼ cups pecans, lightly toasted
  • ¼ cup cacao powder
  • 15 large medjool dates, pits removed
  • 1 tablespoon vanilla extract
  • 10 drops stevia
  • 2 tablespoons agave nectar or honey
  • ½ cup dried cranberries (you can add more if you like)

Blend pecans and cacao powder in food processor until combined and coarsely ground. Add in dates and process until blended into dry ingredients. Process in vanilla, stevia and agave until well combined. Stir in dried cranberries with a spoon.

Press mixture into an 8 x 8 inch baking dish. Freeze for 1 hour, or until firm, then cut into 16 squares. Enjoy!

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Newborn Male Circumcision

What is circumcision?

Male circumcision is the surgical removal of some or all of the skin covering the tip of the penis, called the foreskin or the prepuce. In the United States, this surgery is often performed within the first few days of an infant’s life, when it is considered the most “simple.” It can also be performed later in life, should a man choose, though the procedure is considered “more complex.”

Infant male circumcision is one of many decisions parents are asked to make during their pregnancy or shortly after their boy is born. Socio-culturally speaking, this issue is very controversial and carries a lot of cultural, religious, and ethical charge. We believe that informed decision-making is paramount and want to empower our families to make an educated decision about infant male circumcision. While we cannot cover all of the information about male circumcision here, we hope to offer a broad look of this issue, as a launching point for gathering more information.

How prevalent is circumcision?

Globally, it was estimated in 2006 that approximately 30% of the world’s men were circumcised. The practice is nearly universal in some parts of the world (in most of these countries the practice is done almost exclusively for religious or cultural reasons), while in other areas the numbers are quite low.

In the United States, most estimates show that between 70-90% of males are circumcised, with the numbers peaking in the 1960s and falling by 5 to 10% since then. The practice has seen a greater decline in other developed nations including Canada, England, other parts of Europe, and Australia. The rates also vary by race, region, and class in the United States today.

The Controversy

There are a variety of views about circumcision. Generally speaking, those in favor of circumcision point to medical evidence that circumcision offers some health benefits to men. These advocates state that the benefits of the procedure greatly outweigh the potential risks. Some believe that circumcision should be performed for religious or cultural reasons (this is the more common reason, globally speaking).

Critics of the procedure believe it is entirely unnecessary, traumatic, and painful to a child.

Some people talk about the importance of choice—that parents should be able to make a choice about whether or not to circumcise their child. Others argue that the choice should be with the child because it is their body—in this view, circumcision is not considered ethical to perform on someone who is not able to make that choice.

Parents are often weighing all of these views and conflicting information in the context of cultural and familial norms. That is, many of the men in our country (and within our families) are circumcised, so there may be an additional pressure (stated or unstated) to conform to this norm.

It can be helpful to become aware of the reasons you may feel compelled toward or against the procedure as you explore this issue for yourself or your family.

The purported pros of male circumcision

In the US, the practice began in the late 1800s, prior to the germ theory of disease, when circumcision was thought to be “morally hygienic” (reducing sexual excitation) and even curative of such things as paralysis, masturbation, epilepsy, and insomnia. Those views have changed, but the health benefits of circumcision are still widely touted by the dominant medical community in our country.

For a long time, the American Academy of Pediatrics had remained neutral on the practice of circumcision. Then in 2012, it changed its policy (on which many insurance and social health care decisions are made). This new statement on circumcision stated that medical evidence shows that the health benefits of circumcision significantly outweigh the potential risks. They stopped short of actually recommending the practice, however, and instead said that families should have access to the procedure if they so desire.

The health benefits of male circumcision, as described by the AAP report include but are not limited to the following:

  • Reduced lifetime risk of urinary tract infections
  • Lowered risk of some cancers of the penis and prostate
  • Lowered risk of some, but not all, sexually transmitted diseases

They claim that the benefits outweigh the risks by 100 to 1 and that 50% of all those uncircumcised will experience some negative health effects as a result. They also claim that circumcision does not appear to have any negative effects on sexual sensitivity or function later in life.

The purported cons of male circumcision

There are many reasons given against male circumcision. The group Intact America, one of several organizations in the United States that are against circumcision, offers the following 10 arguments against circumcising, which you can read more about on theirs and other websites. 

  1. There is no medical reason for “routine” circumcision of baby boys and it is not recommended by any major organization in the nation.
  2. The foreskin is not a birth defect; it is a normal, sensitive, functional part of the body.
  3. Federal and state laws protect girls of all ages from forced genital surgery and they should protect boys as well.
  4. Circumcision exposes a child to unnecessary pain and medical risks
  5. Removing part of a baby’s penis is painful, risky, and harmful.
  6. Times and attitudes have changed and it is becoming more acceptable not to circumcise.
  7. Most medically advanced nations do not circumcise baby boys
  8. Caring for and cleaning the foreskin is easy and being intact doesn’t present hygienic concerns.
  9. Circumcision does not prevent HIV or other diseases
  10. Children should be protected from permanent bodily alteration inflicted on them without their consent in the name of culture, religion, profit, or parental preference.

Risks of circumcision

Significant complications are believed to occur in approximately one in 500 procedures.  One source states that over 100 infant males die each year as a result of circumcision complications, although this number is hotly contested by some members of the medical community and does not seem to be supported by medical data (although reports of circumcision deaths are not actually reported to the CDC, making it difficult to gather data at all).

Possible complications of circumcision can include:

  • Local Bruising
  • Bleeding
  • Scarring (always occurs)
  • Adhesions
  • Puncture and skin bridges
  • Amputation
  • Difficulty breastfeeding
  • Difficulty with urination
  • Long term aggravated response to pain
  • Infection
  • Subsequent corrective surgery
  • Permanent disability or death

Many also argue that because the foreskin is so sexually sensitive, that circumcision reduces sexual pleasure and function.

This list doesn’t include the potentially negative psychological impact of this procedure on the newborn child, which is more difficult to account for.

Bottom Line

As mentioned we encourage our families to research and talk to their pediatric care providers about circumcision. We hope this article serves as a “launching off” point for one’s own exploration of this issue and we hope that each family makes an informed decision based on their own preferences and values, as well as a clear understanding of the available information on circumcision.

Resources

http://www.mayoclinicproceedings.org/article/S0025-6196%2814%2900036-6/fulltext#tbl4fne

http://www.mayoclinic.org/tests-procedures/circumcision/basics/why-its-done/prc-20013585

http://pediatrics.aappublications.org/content/early/2012/08/22/peds.2012-1990

http://www.nytimes.com/2012/08/27/science/benefits-of-circumcision-outweigh-risks-pediatric-group-says.html?_r=0

http://www.who.int/hiv/pub/malecircumcision/infopack_en_2.pdf

http://www.jurology.com/article/S0022-5347(12)05623-6/abstract

http://www.intactamerica.org

http://www.circumcision.org/

http://www.cirp.org

www.cirp.org

Minnesota births at homes and birth centers rise more than 150 percent

Press Release by MCCPM

St. Paul, Minn.—The number of Minnesota babies born outside of a hospital setting rose by 156 percent from 2004 to 2012, according to birth certificate data from the Minnesota Department of Health.

More than 1.3 percent of births (904 babies) in Minnesota in 2012 occurred outside of a hospital—mainly in homes and freestanding birth centers—up from 0.5 percent of births (366 babies) in 2004.

press release graph

Births occur outside of hospitals more frequently in greater Minnesota than in the Twin Cities metro area. In 2012, 1.7 percent of babies born in greater Minnesota counties were born outside of hospitals, while 1 percent of babies in the seven-county metro area were born outside of hospitals, according to health department data.

Nationally births outside of hospital settings have increased since 2004. According to the Centers for Disease Control and Prevention, the percentage of births occurring outside of hospitals increased from about 0.9 percent of U.S. births in 2004 to about 1.4 percent of U.S. births in 2012, its highest level since 1975. In 2012, 53,635 births in the U.S. occurred outside of a hospital, including 35,184 home births and 15,577 births at birth centers.

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About the Minnesota Council of Certified Professional Midwives

The nonprofit Minnesota Council of Certified Professional Midwives promotes, protects, and preserves midwifery as practiced by certified professional midwives in the state of Minnesota. The council is committed to safe maternity care provided in an out-of-hospital setting. For more information, visit http://www.minnesotamidwives.org.

Birth Story: Women should be running the world!

ElenaJane

Birth Story of Elena Jane

As told by mama Emily

Elena Jane was born Sept. 7 at 12:45 a.m. She weighed 8 lbs, 1 oz and was 21.5″ long. Here’s how it went down:

T-minus 5 days until the 42- week mark. Monday, Sept. 8 was 42 weeks, this was Wednesday, Sept. 3. We met with Midwife Monica, she had me wear a belly band to make sure everything was lined up. A belly band sounds nice — oh it supports your back from your massive belly. But, actually it was kind of painful and I had to wear it over night. I kept coming up with excuses to take a shower so I could have a reprieve for 10 minutes.

T-minus 3 days until the 42-week mark — Friday, Sept. 5. We met with midwife Monica in the morning and she checked things out. She said things had progressed slightly since last time and my cervix was soft. I was dreading the herbal induction but by this point had succumbed to the fact that this is probably in my future. Monica suggested we do the Foley catheter–I would need to return that afternoon so Midwife Amy could insert the Foley. I was sent home with the herbal induction if, by Sunday morning, nothing happened I would need to start the herbal induction — which is ingesting something every 15 minutes followed by a lot of time in the bathroom (as I’ve heard).

My husband, Geoff, and I left with my bag of “goodies”. We decided to go to Mickey’s diner in St. Paul to load up on a greasy meal (figured it was similar to an herbal induction, right!?) and then went to Como zoo to walk around. Luckily, I took a 2-hour nap before going back to the birth center to get the Foley.

I know we learned about the Foley in childbirth ed class or at the Health Foundations complications class, but until I actually had to have it, I don’t think I filed it in my brain as something to recall. The Foley catheter is a thing that is inserted into your cervix and then two small balloons are filled up with saline solution on each side of the cervix. This is meant to aid dilation. It falls out on its own around 4 cm, otherwise you have to have it taken out. I was scheduled to have it removed on Saturday at 4 p.m.

As soon as midwife Amy filled the balloons, I got instant cramps all over. By the time I came home, the pain was so bad, I called the midwife line to see if there was anything I should do — I couldn’t imagine having this constant pain until 4 p.m. the next day. I will remember Monica’s words forever, “Well, Emily, it sounds like it’s doing what we want it to do, which is put you into labor…so wrap your head around that!” I laughed and thought, OMG — no kidding, I can start doing my relaxation and breathing (for some reason that didn’t occur to me until she told me that). Monica said to focus on if contractions were coming and going and to call if they got close together or especially if the catheter fell out.

Once I had that to focus on, the contractions were more manageable. I could barely eat anything for supper (rice and cream of mushroom soup) and then I went to bed. The contractions lasted all night but by the morning, they had lightened quite a bit so I could eat a solid breakfast (thank goodness or I don’t know if I would have had the energy). After breakfast we went for a walk which picked things back up quickly — we didn’t make it for a long walk and we had to stop every 5 – 7 minutes to work through a contraction.

I got back and called the midwife Amy to check in and let her know where we were at. She said she’d see me at 4pm but to rest and eat some oatmeal. Geoff went and got me some oatmeal of which I could eat half — and then in less then an hour the contractions were so bad, the oatmeal came back up. Geoff called again to let Amy know the contractions were consistently 5 minutes apart ( I was also concerned b/c I needed to get to the birth center for antibiotics b/c I tested positive for group B strep — and they said I should go in about 5 min apart). Amy said to really try to get some sleep and she’d see me still at 4pm.

I went to bed to try to get some good shut eye but within 15 minutes I had to pee and out came the catheter — those balloons were WAY bigger than I had thought…Not quite a raquet ball but I’d say maybe two ping pong balls on each side. As it was coming out I thought, what good practice for birth — HA (not the case). This was at 1:45pm on Saturday.

We ended up meeting Amy at the birth center at 3:30pm. She wasn’t quite there when we arrived so I had some lovely heaving and ho-ing out on the deck until she arrived. As soon as she opened the door, I went into the birth room (the one on the left), knelt on the ground with my head on the sofa and dealt with a few more contractions while I got my antibiotics. I heard my husband ask Amy, “Do you think we’ll need to go home or is she far enough along to stay?” Amy said based on the noises I was making, I was staying (I was relieved).

My doula, Kim, arrived shortly after. I started working through contractions in the shower on a birth ball, which was nice and then Amy had me get up and walk up and down the steps and around the studio upstairs. I don’t know what we would have done without our doula there, it was nice for Geoff to be able to take a break or stay with me when I wanted. I was so out of it, I didn’t notice any lapse in having someone there to help me. And I later found out that he had eaten dinner at some point…who knew!?!

Around 6 or 7pm, Dr. Amber (chiropractor) came to adjust me. Her three cute kids walked in and I was again heaving and ho-ing in the waiting room. They were so cute but I couldn’t say a word to Amber!  After the adjustment, Dr. Amber had me go to the bed and hang one leg over the bed ( I think we watched a video of this in class) and labor there for a bit. After several of these on each side, Amy checked to see where I was at.

With Amy’s check, my water broke because it was right there and she said I was fully dilated and ready to push! I couldn’t believe it! It didn’t even seem possible, I kind of just assumed at that point that the baby would be in me forever and I would have contractions the rest of my life. She said once I stood up, I’d probably feel a lot less pressure and an urge to push.

I did feel less pressure but never really had the urge to push — just pushed when I had a contraction as they told me. This was 9:30pm. I started pushing on the birth stool — not really a fan. I felt kind of like the gorilla I saw at the zoo that morning — just sort of sitting there with my big belly while everyone watched me from every angle. Then we did squats in the shower — these were my least favorite as they were the most painful, I think I thought the baby would accidentally fall out on the hard shower floor (I’m an idiot) and I didn’t like that I couldn’t rest in between pushes — just stand. Then we labored on the bed in the normal legs raised position — and a little with the birth ball on the bed..by far my favorite because I liked that I could rest in between. However, Geoff and our Doula sure had to be strong to basically be my make-shift stirrups!

We rotated between all of these positions maybe three times. Every time Amy suggested the shower squat thing I gave her a bit of a stink-eye (she later told me!) but complied because I knew the pain meant it was working. Throughout I thought I would not have enough energy to get through it. A few spoons of honey I think pushed me through.

Finally, we got to the point where I could feel things happen and Amy told Geoff to get ready to catch the baby. She had one of the nurses (Monica – a nurse in training and her first birth) take his place to hold my leg. That was exciting for me because I knew it was close. I asked if I could push even if there wasn’t a contraction, I was ready for the finish line. I pushed and felt her head come out. Amy told everyone to wait (while she moved the umbilical cord from around the neck). I remember just being super still and then she said, “ok” and I was still. That felt like 10 minutes of waiting for — I didnt realize she was saying ok for me to finish pushing. I just watched her and it felt like silence. Then she looked at me and said, “ok, push” and that was super easy! Elena’s slippery squirmy body went from Geoff’s hands to my stomach — It was awesome!

I remember saying something along the lines of, “Holy @#$&, I cannot believe women have done this for so long. We deserve a huge amount of money and women should be running the world!”

The rest is a blur — I had to get that darn placenta out. I had to cough a bunch which was hard because I was sore everywhere and my throat hurt from groaning for 12 hours. Ok, it wasn’t anywhere as close as hard as birth but I was just tired and wanted to cuddle my baby. Geoff was nervous because there was bleeding and clotting that the nurse was concerned about but they all calmly did what they said would happen in the complications course (super helpful). I was on cloud 9 and didn’t really have any concerns.

We packed up and headed home at 5:30 a.m. It felt a little weird to be driving home with an infant after having no sleep at all and going through that but it was nice to be home. All things said and done: Labor for 33-ish hours, active labor for 12-ish hours, pushing for 3 hours, 0 drugs (well accept for the antibiotics and ibuprofen afterwards), 0 herbal inductions :), 1 cutie pie and 1 happy family!!

I can’t say enough about how amazed I am with the nurses and midwives at Health Foundations. What an amazing profession they have been called to do. I could never do it but I am so grateful for them!

Emily, Geoff, Elena & Ella bean (the dog isn’t too jealous!)

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Estimated Due Dates

DueDateWe live in a culture where we seek to make everything measurable and predictable. Just as we might expect our favorite TV show to come on at 7pm sharp, our work day to end at 5pm on the dot, and so on, many of us want or expect our pregnancies to begin and end in a predictable way. Yet, with birth (and death), there is the element of mystery, of the unknown, to which we must humbly surrender. There is also the fallibility of the methods we have in estimating birth dates.

While the great myth that babies are supposed to be born on their due dates pervades our cultural consciousness, this expectation or assumption is at the very least misleading, often causes undue emotional burdens on birthing families, and at its most serious holds the potential to cause serious harm to a woman and her child. Focusing too much on a due date, particularly in conventional maternity care, can create a situation that increases the likelihood of unnecessary fetal testing, unnecessary induction and cesarean, and other serious risks, not to mention undue mental and emotional stress for mama and her partner.

We love the saying “babies are born on their birth dates not their due dates.” Babies are born when they are ready to be born and when all those factors that influence birth timing converge on a specific given day. We’ll talk below a great deal about the scientific understanding (and lack thereof) of birth timing, but even without these details, it is important to remember that babies are born on their birth dates not their due dates! and that there is a great range of what is considered normal gestational duration for the human being.

Naegele’s Rule: the not-so-gold standard in due date estimation

Due dates are most widely calculated based on something called Naegele’s Rule. Trouble is, use of this rule is considered outdated and inaccurate for many women.

This rule was developed by an early 1800s German doctor named Franz Karl Naegele who concluded, based on his personal observations (not any methodical research), that pregnancy lasted 10 lunar months, or 40 weeks. His calculation assumes that pregnancy lasts 280 days from the first date of the last menstrual period, the LMP, or 266 days from ovulation, which he deemed always occurs on day 14 of a woman’s 28 day cycle.

Naegele’s Rule follows this formula: (LMP + 7 days) – 3 months = Due Date

This antiquated method is the standard in determining due date, yet only 3 to 5% of babies are actually due on their due dates. There are some major flaws with this nearly universal way of determining due dates:

  1. It assumes that pregnancy lasts the same duration for all women.

The duration of pregnancy varies based on many factors including:

  • Whether a women is having a first or subsequent baby (some estimates suggest pregnancy is an average of 5-10 days longer for first time birthing women)
  • The race of the mother. For example, one researcher noted that black women tend to have pregnancies shorter by 8.5 days compared to white women of similar socioeconomic status.
  • Number of babies. Women carrying twins, for example, have a shorter pregnancy on average, than women carrying a single fetus.
  • Nutrition
  • Substance abuse
  • Mother’s age
  • Mother’s size
  • Mother and baby’s health

Experts also submit that additional factors, which we don’t fully understand, may also be at play.

  1. It assumes that reports of one’s last menstrual period are 100% accurate

Naegele’s rule depends on the accurate recall of the first day of a woman’s last menstrual cycle. While many women are good at such recall, there is room for error here. Inaccurate memory, the possibility of interpreting post-conception spotting as a period, and unrecognized pregnancy loss can all alter what might be reported as one’s last menstrual period.

  1. It assumes all women have 28-day cycles and ovulate on day 14.

This method of calculation assumes that all women have a 28-day cycle and all ovulate on day 14 of this cycle. But we are not machines. Many women have cycles that do not match this 28-day trend. Recent discontinued use of oral contraceptives, current use of other medications, stress, travel, as well as other physical and lifestyle factors can all impact the length of a woman’s cycle and when she ovulates.

This method of due date calculation assumes a woman ovulates on day 14. This too is not often the case. Ovulation can take place as early as the 7th day and as late as the 20-30th day of a woman’s cycle.

Many women are unaware of when they ovulate, but some women are attuned to/understand how to determine ovulation based on regular charting of their waking basal body temperature, cervical fluid changes, and other indicators. (Learn more about the fertility awareness method/FAM online or in the book Taking Charge of your Fertility by Toni Weschler). Ovulation dates may help inform a due date calculation, as can known dates of intercourse. However, many practitioners prefer to rely on LMP, as reported ovulation dates and intercourse dates carry a margin of error in many provider’s minds.

  1. It assumes conception takes place during ovulation.

While ovulation is the time of heightened fertility, conception does not necessarily take place on the day of ovulation (or even the days just before or after). Healthy sperm can survive in fertile quality cervical fluid for up to 5 days, which can change the date of conception and alter a due date by several days.

Mittendorf’s Rule

In the late 1980s, a doctor named Robert Mittendorf reviewed the records of 17,000 births (his practice was composed primarily of second generation Irish-Americans). He found that most healthy, white, private-care, first time birthing women with regular menstrual histories experienced pregnancies lasting an average of 288 days from LMP to birth, (or 274 days from ovulation to birth) a full 8 days longer than Naegele’s Rule postulates.

Thus, Mittendorf’s rule follows this formula: (LMP – 3 months) + 15* days = Due date

*use 10 days if a women is not white and/or if she has given birth before

Again, this supposes that a woman knows her LMP and that her cycle is 28 days with ovulation on day 14. It also doesn’t seem to suggest any definitive information on women not belonging to the same population as was studied by Mittendorf.

Early ultrasound measurements

Early ultrasound (in the first trimester) can also be used to determine gestational age of a fetus. Early cell generation occurs at the same pace in all human fetuses until about 6 to 8 weeks of gestation. Beyond that, individual genetics set in and the rate of growth is unique to that individual.

While ultrasound before week 8 can be used with some accuracy (some say

greater accuracy than with Naegele’s rule), one researcher estimates that ultrasound dating accurately predicts the date of birth in less than 5% of all pregnancies, with delivery within 7 days of this estimated due date occurring in only 55% of pregnancies. Not a particularly reliable alternative, some would argue. (And ultrasound exposure may pose additional risks to a fetus.)

It should also be noted that second and third trimester ultrasounds are not accurate in determining length of gestation and can also be inaccurate in determining fetal size.

Other informants of gestational age

Other sources of information, while less precise, can help us learn about gestational age including physical estimation of baby’s size by a qualified care provider, quickening (or the onset of fetal movement felt by the mother), and detection of fetal heart tones.

Wide range in normal development

Even if one were to know with total accuracy the first date of LMP, the date of conception, and early fetal age, they still may not be able to predict with accuracy the date on which baby will be born. This is because there is a normal range of gestational age in humans that spans several weeks (generally considered 37 to 42 weeks). Just as every baby doesn’t sit up, sprout their first tooth, or walk at the exact same age, babies don’t all require the exact same amount of time in the womb. Some take more and some take less, and science hasn’t figured out all the reasons for this.

Problems with inaccurate due dating

Medically speaking, due dates are used to determine when prenatal tests should best be performed, what ranges of results are considered normal, whether baby is growing at a healthy rate, and whether a baby is premature or postmature. While pregnancy dating may help us gain insight into the health of baby, inaccurate dating can cause a number of problems.

Certain prenatal tests must be done during a certain window of time during pregnancy. Inaccurate pregnancy dating can result in inaccurate prenatal tests. For example, fetal heart rates become measureable at a certain week. If a fetus is thought to be older than is it, and fetal heart rate does not register as expected, a problem may be suspected in a case where there is no problem. This can lead to unnecessary testing and concern about a healthy fetus. The AFP test/triple screen test is another test that must be done within a certain window of gestational time. With this test too, inaccurate dating can yield unreliable and misleading test results.

Inaccurate dating can lead to unnecessary induction and/or cesarean, especially in cases where a care provider relies too heavily on a due date calculation to make medical decisions. Labor is induced in over 13% of all US births, with post-date pregnancy (after 40 weeks) being the number one reason given. According to ACOG, 95% of all babies born between 41 and 42 weeks of estimated gestation are born safely without complications. Even after the 42nd week, only a very small percentage of babies have complications due to postmaturity.

Babies can be born premature due to unnecessary interventions, which carries many risks to the health of baby. It is estimated that up to 10% of neonatal intensive care unit admissions are due to iatrogenic prematurity (that is, caused by unnecessary medical interventions to bring labor on before baby is mature). There are ways to reduce the risk of unnecessary interventions, such as amniocentesis and allowing a woman to go into spontaneous labor before intervention. The risk of iatrogenic prematurity and newborn lung disease in infants delivered by elective cesarean before labor begins is 30% compared to 11 percent for those whose mothers go into labor first.

Inaccurate due date calculation or over reliance on this date as THE date baby should ideally be born causes undue psychological burdens on women and their families. So many women feel this tremendous pressure to deliver their babies on or before that magical due date day. Women are often told that baby is mature at 38 weeks and to expect their arrival any time in the next two weeks. When that due date comes and goes, many women feel like something is wrong or they are somehow to blame for not having yet birthed. Many people make so many work or family plans around that magical due date that women can feel additional pressure and a lot of guilt for “inconveniencing” people when birth doesn’t happen exactly when they expect it should.

While we tell our mamas, especially first time mamas, to expect to go over their due date by 7 to 10 days, we know that the overwhelming social pressure (and often physical readiness on mom’s part!) still makes it difficult to relax in those days past the due date. It can help to better understand due date calculation and the truth that there is a wide range of normal. At Health Foundations we are very proactive in watching mamas and babies who go beyond 40 weeks, but that is prudence and not pressure to birth or worry that something is amiss.

Postmaturity risks

While the risk of postmaturity complications is relatively low, it can be helpful to know what these risks are. Postmaturity syndrome is characterized by:

  • Diminished functioning of the placenta
  • Reduced amniotic fluid
  • Large size of baby (or, conversely, sudden fetal weight loss)
  • Increased risk of meconium aspiration (when baby inhales amniotic fluid containing its first stool)
  • Hypoglycemia in baby

There are a number of tests care providers offer to monitor mamas and babies in the 40-42 weeks of pregnancy to diagnose postmaturity syndrome.

While our estimations of due dates are far from perfect, this practice doesn’t seem to be going anywhere and does offer us some value. We think it is most helpful to find a care team that doesn’t regard the due date as this fixed time before which babies should be born. After all, it’s not a deadline (we have plenty enough of those in our lives, don’t we?) it’s a guess date. It may serve many families to think about the due window. It certainly would better reflect the reality that birth presents us.

And remember 100% of babies are born on their birth dates, but only a very small percentage are born on their estimated due dates.

Flower essences

SAMSUNG DIGITAL CAMERAFlower essences are an amazing and lesser-known healing resource that can be quite amazing for expectant and new mamas, and, really, anyone.  We offer a line of flower essences by Santosha Birth and Wellness that are specifically for conception, pregnancy, birth and motherhood.  We also have a new acupuncturist that is trained in the use of flower essences.  With all the buzz about flower essences, we wanted to share a bit more about what flower essences are and why they are so wonderful for the childbearing cycle.  

What are flower essences?

Flower essences are type of botanical medicine that works on the energetic level (like acupuncture does) to positively affect the emotions, energy, and deeper soul levels. Flower essences are especially suited to helping people overcome obstacles, heal the past, reduce negative thoughts, actions and perspectives, cope with changes and challenges, and achieve greater joy and peace. Put simply, flower essences are energy medicine—they safely and effectively address root causes of emotional and physical issues to bring healing and growth on all levels (physical, emotional, mental and soul).

Odorless and virtually tasteless, a flower essence is an infusion of flowers stabilized in water and a small amount of brandy to preserve. 

What is the history of flower essences?

Flower essence therapy has been used by indigenous people for centuries and have been thoroughly studied and developed in the West for over a century. Dr. Bach, a British physician and homeopathic doctor, was the first to develop a robust system of flower essence therapy in the early 1900s. His system included 38 flower essences and his blend, Rescue Remedy® is the most famous of all flower essences. Dr. Bach’s early death left room for further development and refinement of this system and additional flower essences have been added to this healing system.

Master herbalists such a German healer Julia Graves (creator of the Lily Circle) and Flower Essence Service, among others, have continued Dr. Bach’s legacy, producing high quality flower essences that yield profound results. The Lily Circle (used in Santosha’s blends) is exceptionally well suited for female archetypal issues and those surrounding birth and motherhood, but are equally powerful and healing for all people.  

Why flower essences?

There are so many reasons why flower essences are an incredible healing tool, especially in the childbearing cycle.  

They are safe: Because flower essences work on the energetic rather than biochemical level, they don’t pose the same risks that some pharmaceuticals, herbal tinctures, and essential oils may pose. This makes flower essences particularly attractive for treating issues that may arise in the childbearing cycle, when other treatments may not be advised. Flower essences are completely safe for use in pregnant women, birthing women, nursing women, newborns, infants, and children (and even pets and plants, evidence shows!). There are NO known contraindications.

They are gentle: Flower essences are gentle, they don’t work by force, nor do they overwhelm the body or mind. Flower essences are subtle, yet powerful and profound in the positive change they produce.

They address root causes of physical ailments and emotional/spiritual conditions. Flower essences often get to the source of one’s physical or other ailments. By addressing underlying emotional/mental/energetic/spiritual factors contributing to dis-ease or challenges, flower essences heal the deeper levels of one’s being and when they are healed, the body follows. What better time than pregnancy to clear out what doesn’t serve us and make room for greater wellbeing in parenthood? The healthier and happy we are going into parenting, the better we can be for ourselves and our children!

How do you use a flower essence?

Flower essences are commonly taken by mouth, with 4 drops taken orally 4 times a day. This is a general guideline—a person in an acute situation (e.g. labor) may take an essence as frequently as every 10 minutes as needed. Taking an essence frequently is the path to desired change. Because there is a small amount of brandy in the essence, some pregnant women or sensitive individuals may prefer not to take the essence directly under the tongue. You can add an essence to beverage—covered water is best (but tea or juice can also be used). For those that wish to avoid ingestion entirely, flower essences can be sprayed or applied on to the skin, clothing, bedding or air. One can also take a flower essence bath.

How long should one use a flower essence?

Many flower essence practitioners note a definite cycle period in taking a flower essence, typically two to four weeks though this can be longer or shorter for some and depending on the reason for use.

Can flower essences be used together with other healing modalities?

Flower essences can be used alone or in conjunction with other therapies to enhance a healing process. They have been used with great success by flower essence practitioners, naturopathic doctors, massage therapists, psychologists, medical doctors, veterinarians, and other health care practitioners.

How do I learn more?  

If you want to learn more about flower essences, you can speak with us at an upcoming appointment or contact Santosha Birth and Wellness directly at http://www.santoshamama.com.  

We’re having a good time– a birth story

Baby Jacob’s Birth Story as told by Rochelle Matos

birth6As a birth doula, childbirth educator and mother of 4, I know that birth rarely goes exactly as you hoped or imagined it to be. However, in the birth of my fifth baby I experienced what I would call, “my ideal birth”. It was absolutely amazing and I’m so thrilled and thankful for the experience!

In the weeks leading up to Jacobs birth, I would have contractions from about 4pm-9pm every 15 minutes or so, nothing too strong, but it was comforting to know my body was getting ready. The day before his birth, these same easy sort of contractions started in the morning and kept going – all day. I wasn’t in labor, but this was different, so I texted my friends who were going to attend the birth that I was experiencing something new – just a heads-up. We had a wonderful evening as a family going on a picnic and swimming at a local beach. Got home and went to bed as normal.

That night, at 2:00am, on July 4th, 2014, I woke up with a real, strong contraction. Afterward I went to the bathroom and noticed some bloody show. “Is this for real? A 4th of July baby?” I kept thinking. I went back to bed and had another contraction at 2:30 – again, super strong – definitely different from the weeks leading up to this point. After lying in bed for another 15 minutes, I was feeling restless with lots of adrenaline. I got up and brushed my teeth and did my hair. Yup, I wanted to look pretty for the birth, so I straightened my hair at 2:45am. After that I felt calmer, and went back to bed at 3:00am. I contracted 2-3 more times and at 4:00am told Luis that I was in labor, he promptly encouraged more sleep, so we rested until 5:00am when the contractions were coming every 20 minutes. At 5:30, I called the birth center, Amy told me to eat breakfast and see what would happen as the sun came up. I did as she suggested, eating breakfast with my husband, but had a hard time determining if labor was going to continue or fade. At this point, the contractions were anywhere from 10-20 minutes apart and not getting closer… however they were so, so strong that after each one I would think, “I should be at the Birth Center by now”. At 7:15am I asked if I could come in, we made a plan to meet at the Birth Center by 7:45am.

Health Foundations birth centerLuis loaded the car, I texted my friends and called our doula. I told everyone that we were heading in, but since I wasn’t sure if this was really going to happen, I told them to wait on standby. The drive to the birth center was fun, Luis and I really enjoyed the morning together – I kept saying, “we should get up before the kids every morning and hang out together”. It was awesome to have a morning, just the two of us, it felt sort-of like a mini date morning together. We arrived at the birth center at 8:00am. Amy was still setting up so we wandered about upstairs… it was nice to have the birth center to ourselves and relax.

Initially, in my birth plan I requested no vaginal exams, however I was uncertain if I was really in labor, the contractions at this point were still 10-20 minutes apart. I asked Amy to check me, so I could decide if the team should come on in. She did, and found I was a 7-8cm. I was so relieved and that little bit of knowledge helped me to relax, I was in labor and going to have a baby – today!

labor #1At this point, I was experiencing a quite a bit of back labor. Amy suggested the TENS unit and I was eager to try it out for myself. It was really helpful – it didn’t take the pain completely away, and I still needed Luis to put pressure on my back, but it felt like a little massage to help ease the pain during and between contractions.

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At 8:30am, we asked our team to come on in to the birth center. As the birth team started arriving, I welcomed them – we chatted and laughed. Everyone was surprised by the joking and smiling of the morning. I kept saying “we are having a good time” in reference to the birth stories I read in Spiritual Midwifery by Ina May Gaskin. And I really was having a good time, it was so fun to have my friends and family come and be with me on this special day.

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By 9:00am, Sibyl our doula, Anna my sister-in-law and photographer, Laura my friend and videographer, and Liz, with 2-week-old Maeve, all arrived at the birth center. Having everyone come was a wave of joy. When the last person drove up front of the birth center, I looked out the window and said, “Now that everyone is here we can go have a baby”. I had hoped everyone would be able to come, but with kids and busy lives it was all uncertain – I am amazed that they could all be there. Quickly, the labor picked up – with the frequency of contractions increasing.

 

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I made my way back to the birthing suite, knowing I’d want to get into the water soon. I looked around the room, it was so beautiful and everything was ready. I had set up my birth altar from the Sacred Pregnancy journal & class, I was wearing my birth necklace, Luis was with me every step of the way, rubbing my back and kissing me. Amy, my midwife, whom I truly trust, was ready. After a few really strong contractions I was ready for the tub.

 

Birth Altar

 

At 9:30am, I climbed into the tub and again looked around the room, everyone was here; it was perfect. I made a joke about everyone watching me enjoy my hot tub and where is my margarita and we all laughed. Did I mention we were having a good time?

 

Tub w: Birth TeamI rolled on to my knees away from everyone, facing Luis to get ready for baby to come. We quietly talked for a few moments, sharing this little break together. It was a private and intimate moment. Then I had the beginnings of wanting to push. I reached inside to see if baby was close – nope, he was about three inches inside. 10 minutes passed.

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tubamy1tubamy2Next contraction, I felt an overwhelming downward pressure, I couldn’t decide if I should relax or push, so I panicked, I can’t do this. I started shaking my head, I couldn’t breathe and my midwife, husband and doula were all talking to me and encouraging me. “Just Amy,” I said, “Just Amy”. She reminded me to slow my breathing, she told me I was strong, and that I could do this. I repeated her words and calmed down.

After a few little pushes, Luis got in the tub and I felt again where baby was at (hoping he was about to crown), nope, still an inch inside. With the next contraction, I felt like a bowling ball was moving through my body, it was so intense, I pushed short easy pushes as Amy encouraged, I reached down tubwithbackpressureand felt the head slowly coming, I stopped pushing wanting everything to stretch, and his head slowly eased out. I said “head”. I could feel the bag of waters around his head, like a soft helmet. Then the bag released and I said “bag broke”.

At this point I knew I was going to survive – one more push and I’d be done. With the next contraction, I gave a good strong push and his body slid out of mine. I opened my eyes to see my baby under the water, and slowly brought him up to my chest. The bag was still on his face and Amy pulled it off. As soon as I heard his first little whimper, I breathed a big sigh of relief and laid my head back on the tub. It was 9:51am.

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birth8After a bit of holding and laughing and rejoicing we climbed out of the tub to the bed. In bed we delivered the placenta and started nursing. While nursing in bed, I discovered a knot in his umbilical cord, which I thought was really cool. We had some food, continued to nurse, and enjoy baby Jacob. Slowly the birth team took off and soon it was just Luis and I and Jacob resting in bed together. Bliss!

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knot

 

After four and a half hours at the birth center we were ready to make our way home. That night, we could hear the 4th of July fireworks as we lay in bed with our fifth baby – we even saw some from our window! It was a celebration of his birth, a beautiful day and new beginning for our family.

 

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Photos by Anna Botz