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!

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.

labor4

 

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.

laughing

 

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.

 

labor #3

 

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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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

More Evidence About Water Birth 

Amanda5

This week Evidence Based Birth released a statement of findings on the safety data available about water birth.  As you may recall, we blogged about water birth earlier this year, shortly after the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatricians (AAP) released a joint statement warning about the possible risks of water birth.  This warning resulted in some Twin Cities area hospitals stopping their practice of water births.  Since then, many hospitals have reinstated their practice of water birth in light of overwhelming evidence that water birth is a safe option for many women.

Health Foundations did not alter their water birth practices as a result of this statement, as the evidence was not there to support any such change.  We were honored to serve many women in the Twin Cities who wished to have the option of water birth and chose to change providers to allow for this option.

Evidence Based Birth’s (EBB) recent thorough account of the evidence available on water birth echoes and extends the case for water birth set forth by the American Association of Birth Centers (AABC) and The American College of Nurse Midwives (ACNM) back in April. This EBB article focuses primarily on the safety information available for birth (that is, actual delivery) in water, as the safety of water immersion during labor has already been well established.

Kinds of Research on Water Birth

Discussed in this article are the types of studies that have been used to gather information about the safety of water birth, including but not limited to:

  • Qualitative descriptions of water birth
  • Retrospective surveys
  • Small randomized trials
  • High quality prospective studies
  • Case control studies
  • Case reports

Each of these kinds of studies has their benefits and drawbacks and varies in the quality and reliability of the information they produce. For example, case reports are considered the lowest level of research evidence available.  They only discuss a single event, which can potentially give us information about rare occurrences but cannot give us any reliable information about the overall safety and risks associated with water birth.  The ACOG/AAP statement issued earlier this year was based primarily on this kind of evidence, while it ignored other, higher quality forms of evidence available.  The EBB article also asserts that this statement relied on outdated literature review and made several significant errors of fact.

While the evidence presented in the EEB article is far too detailed (which is a good thing!) to cover in this blog, we wanted to share this resource as a great place for our clients to learn more about water birth safety research currently available.  We feel this is a prudent and thorough analysis that allows women and their families to gather the information they need to make an informed decision about water birth.

As a helpful high-level guide, available high-quality research is presented on the following topics:

 Effects of water birth on mothers:

  • Normal vaginal birth
  • Episiotomy rates
  • Perineal tear and trauma rates
  • Need for pain relief and pain scores
  • Length of labor, by stages
  • Postpartum blood loss
  • Birth positioning
  • Hands-off delivery
  • Maternal satisfaction with water birth
  • Pelvic floor function

Effects of water birth on infants

  • Perinatal mortality
  • APGAR scores
  • Respiratory complications
  • Birth injuries
  • NICU or Special Care Nursery admission
  • Umbilical cord pH
  • Shoulder dystocia
  • Newborn infections
  • Group B Strep
  • Newborn microbiome
  • Umbilical cord tears
  • Newborn resuscitation

The article goes on to cover frequently asked questions about water birth, such as:

  • “Why do women get out of the tub in labor?”
  • “What evidence is available about VBAC water birth?”
  • “What are the contraindications for water birth?”
  • “Why do some women report choosing or enjoying water birth?”
  • ‘What rare adverse events have been reported?”

The bottom line

In this article, EBB includes a section about what all this detailed information means for women as they consider this choice in pregnancy.

While new research continues to improve our understanding of water birth safety, the evidence suggests that low risk women experience a lower episiotomy rate, have higher rates of intact perineum, and use less medicine for pain relief when they choose water birth.  While the benefits to newborns are less clear, so far the evidence shows that fewer or equal rates of NICU admission are seen in babies born in water compared to on land.

This research review repeats the sentiment made in the 2014 AABC and ACNM statements that “water birth is a reasonable option for low-risk women during childbirth, provided that they understand the potential benefits and risks.”  The review further states that universal bans on water birth are not evidence based.

 

We encourage you to read this article on water birth and to ask us questions about this birth option during your prenatal visits.  It is supremely important that our families have the best evidence available to make informed and empowered decisions about their pregnancies, births and postpartum.

 

 

 

 

Breech babies

breech babyWhile it is not common, only 1 in 25 babies present this way at birth, we wanted to talk a bit about breech babies today and ways to encourage optimal fetal positioning during pregnancy.  Most babies will move to a head-down position in the weeks prior to birth, although not all.  Breech presentation is when the baby, instead of being positioned head-down, presents with his or her buttocks (and sometimes knees or feet) first, closest to the birth canal.

Though many babies have been safely delivered from the breech position throughout time, this type of birth scenario is considered out of the scope of birth center practice.  In cases of breech birth at the birth center, we transfer to the care of a hospital-based team.  However, there are many ways to encourage baby to move into a more optimal position if they are breech and ways to lower the risk of breech presentation before it occurs.

Reasons for breech presentation

Many believe that babies will get into the best position possible given the space they occupy in the womb.  This space can be affected by mom’s pelvic alignment and ligament length.  For example a twist, or torsion, of the pelvic joints can throw the uterine ligaments out of balance.  Broad ligaments may also be too tight and can hold a baby in a breech position.  Uterine tone can affect fetal positioning, as can the amount of amniotic fluid present.  Mom’s physical and emotional experiences can also affect baby’s position in the uterus (such as a car ride, or emotions such a fear, grief, or a sense of safety).

Fortunately, many babies that are presenting breech late in pregnancy flip before labor begins.  In these cases, they are often aided by the increased relaxin hormone levels made by mom’s body at the very end of pregnancy, which can relax her ligaments and uterus enough to allow baby room to shift.

In some cases, the natural shape of mom’s uterus, which may have a center membrane (septum) or a heart shape (bicornate) may contribute to breech presentation.

Evidence also indicates that women with a history of breech presentation in their personal or family history may have a greater chance of breech.

The location of the placenta, such as with placenta previa (placenta covers part or all of mom’s cervix), can also increase the likelihood of a breech presentation.

A short or wrapped cord may also be preventing a baby from getting into optimal position.  (This scenario is rare and doesn’t necessarily indicate an impending danger during birth.)

Lastly, premature birth also increases the risk that a baby will be born breech.  However, only 3 to 4 % of babies born between 37 and 42 weeks present in the breech position.

Types of Breech Positions

There are four ways a baby can present breech:

  • Frank breech: the buttocks presents first with legs extended towards baby’s trunk
  • Complete breech: the buttocks presents first with the legs folded so feet are close to the buttocks
  • Footling: one or both feet present first
  • Kneeling: when both knees present first, with the feet folded up behind baby’s thighs.

Oblique (diagonal) and transverse (lying sideways) positions are not considered breech presentations, although these positions carry their own risks.

Natural ways to help a breech baby turn

Before 30 weeks many babies are breech and it is generally not a concern at this time, as most of these babies will get into position in plenty of time before birth.  Midwives are trained and experienced at feeling for fetal position at every visit in the later months of pregnancy.  Breeches are often addressed between 32 and 37 weeks of pregnancy.

It is important to manage situations of breech presentation with the guidance of an experienced care provider.  Together, mom and care provider can talk about the options and what actions might be most appropriate, safe and beneficial to you.  Many factors, such as gestational age, known or suspected cause of breech, mom’s physiological health, and positioning may affect the course of action with a breech baby.

Homeopathy, chiropractic, craniosacral therapy, and Traditional Chinese Medicine (including acupuncture and moxibustion) can all assist in cases of breech.  In fact, many of these treatments utilized throughout pregnancy can help prevent any of the pelvic conditions that may contribute to breech.  A particular technique of chiropractic care known as the Webster technique has high success rates in turning breech babies.

Mayan abdominal therapy is another modality in which women have experienced success in turning a breech baby.  Massage, particularly myofascial release, can also be helpful in preventing or addressing breech.

Mothers can use certain positions to help turn a breech baby or prevent a baby from becoming breech in the first place.  This includes what is called the forward-leaning inversion.  Spinning babies is a great resource for more information about this.

In cases where low amniotic fluid is the case, women can increase their fluid intake and modify their diet (again with support from an experienced care provider) in addition to receiving bodywork.

You may also been seen by an OB for an External Cephalic Version (ECV) in which a doctor manually turns the baby head down through the abdominal wall.  This may be a good choice for some women after other options have been explored.

If you have questions about breech babies, please feel free to speak with us at an upcoming appointment.

Water Birth

maiabirth_0027Health Foundations Birth Center ~ Water Birth Delivery

With the recent release of an opinion statement on immersion in water during labor and delivery (water birth) by the American Congress of Obstetricians and Gynecologist (ACOG) and the closure of water birth programs at several Twin Cities hospitals, we wanted to explore this issue in greater detail.

The use of water during labor and birth, known as hydrotherapy, has been growing ever more popular in the United States both inside and outside of the hospital setting.  We offer the option of water birth at Health Foundations Birth Center because the best available evidence demonstrates that hydrotherapy offers physiological and psychological benefits in labor and birth. 

What the experts say

According to The American College of Nurse Midwives, “labor and birth in water can be safely offered to women with uncomplicated pregnancies and should be made available by qualified maternity care providers. Labor and birth in water may be particularly useful for women who prefer physiological childbirth and wish to avoid use of pharmacological pain relief methods.”

They further state: “Warm water immersion hydrotherapy during labor provides comfort, supports relaxation, and is a safe and effective non-pharmacologic pain relief strategy that promotes physiologic childbirth.”

The American Association of Birth Centers posits that, “water birth, with careful selection criteria and experienced providers, does not negatively affect mothers or newborns.”

Prevalence of Water Birth

Overall, approximately 6% of women in the United States experience the pain relieving benefit of hydrotherapy during labor and/or birth.  This rate is higher among midwifery and midwife-led collaborative practices.  Among midwives, water birth rates are between 15 and 64% during labor and 9 to 31% during birth.

Evidence on hydrotherapy during the first stage of labor

The first stage of labor includes early labor, active labor, and the transition into pushing and involves the thinning and full dilation of the cervix, among other things. 

Evidence for the safety and effectiveness of laboring in water during this first phase are well established.

Pain relief is the most clearly established benefit of laboring in water.  Evidence also suggests the possibility that first stage hydrotherapy can also:

  • Hasten the process of cervical dilation/shorten the duration of this stage of labor
  • Resolve labor dystocia (difficult labor or abnormally slow labor progress)
  • Increase postpartum maternal satisfaction with childbirth

There is no evidence of a positive or negative correlation between hydrotherapy during this stage and any of the following:

For mom~

  • maternal infection during or after labor and delivery
  • the length of second or third stage labor
  • type of delivery
  • perineal laceration (incidence or severity)
  • postpartum blood loss
  • rate of hemorrhage
  • postpartum depression

For baby~

  • abnormal fetal heart rate patterns
  • meconium stained amniotic fluid
  • umbilical cord blood pH values
  • newborn Apgar scores
  • infections
  • admissions to special care nurseries
  • or rate of breastfeeding at 6 weeks postpartum

Evidence on hydrotherapy during the second & third stages of labor

The second stage of labor involves pushing and delivery of the baby.  The third stage involves the delivery of the placenta. 

At present, evidence is not as conclusive as experts would like with regards to hydrotherapy during the second stage of labor.  Additional research is needed.

It can be hard to weave through the language of medical research.  Most professionals agree that Randomized Control Trials (RCTs) will produce the most reliable evidence.  However, to date, most evidence about birth in water has been gathered from clinical audits and observational studies rather than these randomized controlled trials.  Some case studies are also being examined but they produce a very limited picture of water birth and should not be used as the basis for recommendations or practice decisions, cautions the American College of Nurse-Midwives.

Observational studies are considered more reliable and offer some of the best evidence about water birth at the present time. This evidence suggests that women who experience uncomplicated pregnancies and labors with limited risk factors and evidence-based management have comparable outcomes whether they choose to birth in water or not.

When it comes to the best available evidence, data generated by midwifery care provides the most accurate view of the safety of water birth because midwives practicing in birth centers are trained water birth providers.

The American Association of Birth Centers has gathered data on over 15,500 births among low-risk women birthing at a birth center from 2007 to 2010.  Of these births, nearly 4,000 were water births in birth tubs (57.6%), Jacuzzis (34.6%), and standard bathtubs (7.8%).

This data revealed the following:

  • Rates of postpartum and neonatal transfer from the birth center, and neonatal procedures were low in general, and were slightly lower for births in water when compared to non-water births.  This has been reported elsewhere.
  • If labor was not progressing smoothly, women were unlikely to give birth in water
  • Rates of newborn transfer to a hospital were lower after water birth (1.5%) than non-water birth (2.8%)
  • Rates of adverse newborn outcomes were below 1.0% in the water birth population.  The total rate of any respiratory issues was 1.6% in the babies born in water and 2.0% in those not born in water.
  • There were no cases of pneumonia, sepsis or other respiratory infection following water birth and there were no reports of ruptured umbilical cords or newborns breathing water into their lungs associated with birth underwater.

Safe Water Birth at Health Foundations Birth Center

At Health Foundations Birth Center, we follow the best evidence available in every aspect of care we offer to our families, including water birth.  Each of our midwives is highly trained and experienced in offering water birth safely and when appropriate to low risk mothers.

Along with the American College of Nurse-Midwives and the American Association of Birth Centers, we believe women should be given the opportunity to remain immersed during labor and birth if they wish to do so within the context of a shared decision-making process with their care providers. We also believe women have the right to make informed choices regarding water birth and are happy to discuss the best evidence available regarding hydrotherapy in childbirth with all interested clients.

We strictly follow the best practice guidelines we’ve learned in our rigorous educations, and as set forth by The American Association of Birth Centers and The American College of Nurse Midwives.  All of our midwives are qualified to provide education, risk assessment, and care to women who desire water immersion for labor or birth.

If you are a current client and have questions about water birth, please do not hesitate to call us or speak with us during an upcoming visit.  We want you to feel empowered to make informed decisions about all aspects of your care.

Sources:

The American Association of Birth Centers Position Paper on Water Birth

The American College of Nurse Midwives Position Paper on Water Birth

Collective Wisdom: Describing our Ideal Birth

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While it is impossible to know all the elements that influence our perception of birth, our thoughts and intentions can be powerful shapers of our birth experience.  Imagining the conditions under which we wish to birth is an empowering experience in pregnancy.  While many aspects of our birth and delivery are beyond our control, we can manage our own minds and expectations: herein lies tremendous power.  How we envision our birth matters even if it doesn’t go exactly as we imagine it.

This week, we asked our mamas-to-be…

“What words would you use to describe your ideal birth?”

These were the answers we received:

 

Calm

Peaceful

Encouraging

Empowering

Uneventful

Fully Present

Easy

Beautiful

Strength

Safe

Normal

Uncomplicated

Quiet

Confident

Supported

Serene

Sacred

Trust

 

 

 

What words would you use to describe your ideal birth experience?

Collective Wisdom: Birth Affirmations

 

 

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Birth MantrasA birth mantra or affirmation is a positive statement and intention for the pregnancy or birth experience. A mama may select her own affirmation or affirmations and repeat it/them to herself or out loud during times of relaxation, upon waking and going to sleep, during the birth experience, or any time she needs encouragement during pregnancy or labor.

Positive birth affirmations can profoundly affect our outlook and our experiences—the thoughts we choose about our birth can seep into the unconscious and powerfully influence our actual experiences.  They can calm, relax, encourage and support us as we move through our journeys of pregnancy, childbirth, and motherhood.

Birth affirmations tend to be the most powerful when they are set in the present tense (as if they are happening to us right now).  Writing them down in a journal or something you hang in your space and repeating them often also make affirmations more potent.  During labor, you may even want your support team to repeat your chosen mantras to you.

We asked a few of our mamas-to-be to share their current or favorite birth affirmation.  Here’s what they shared:

I was made to do this – Leah

I get to make all the decisions about my birth – Cassie

I am strong.  I can do this! – Hanni

I trust my body – Angie

I am strong enough – Michaela

Here is a list of other birth affirmations expectant mamas can browse to find something that perfectly resonates with them.

What is your favorite birth mantra?  How have birth affirmations helped you through pregnancy and birth?

Benefits of probiotics in pregnancy, postpartum and for baby

probiotics

Probiotics (which roughly translates to “for life”) are beneficial forms of bacteria/microbiota that can assist the human body in preventing and treating many types of illness and disease—from cancer to diarrhea.  We have these beneficial bacteria in our body naturally, but supplementation can greatly support the body in health and healing.

While nearly everyone can benefit from consuming probiotics, using probiotics is especially important and advantageous during pregnancy and once baby is born.  Read on to learn all about the amazing benefits of probiotics for mom and baby.

What are probiotics?

Probiotics are the beneficial bacteria living in your body that help protect against illness.  We can take supplements of these beneficial bacterial or obtain them from some food sources.  There are hundreds of different strains of probiotic, which are all important to overall health.  Certain strains are particularly good for pregnant women and others best for new mamas and babies.

While we typically think of probiotics as being good for digestive health, they do more to promote health in the body.  Probiotics are found lining the mucous membranes of your digestive, urinary, and vaginal tracts.  This last one is particularly important in pregnancy, because we want to foster healthy vaginal tissues before and during delivery (more about why below).

Additionally, probiotics are key to a healthy immune system.  These beneficial bacteria make up approximately 70% of your immune system, making them an important part of your daily defense mechanisms.  Ensuring a healthy balance of good bacteria in the body can foster overall wellness.

 Probiotics in pregnancy

Regular use of probiotics in pregnancy can offer women many benefits.  These benefits include lower risk of:

  • illness (colds and flu)
  • constipation
  • gestational diabetes
  • preeclampsia
  • urinary tract infections
  • yeast infections
  • premature labor

Use of probiotics in pregnancy has also been found to keep levels of Group B Streptococcus (Group B Strep) low.  Group B Strep is a common bacterium of the vaginal lining, but if levels of these bacteria get too high at the end of pregnancy it can pose some risks to baby.  When this issue presents itself, it is often managed during labor/delivery with antibiotics.  However, steps in pregnancy, including probiotic use, can reduce the risk of this condition.

Healthy vaginal flora is crucial to baby’s health.  Babies are born with a sterile gastrointestinal system and exposure to mom’s vaginal flora is their first exposure to the bacteria their systems will be colonized by.  Healthy vaginal flora helps give baby’s immune system a good start.  Babies also continue to receive beneficial bacteria through breastfeeding, being held skin to skin, and via saliva exchange (think pacifier “cleanings,” shared spoons, and the like) in the first year.

Postnatal Probiotics Benefits 

Recent studies have found that consuming probiotic supplements beginning in the first trimester of pregnancy and continuing their use through at least the first six months of exclusive breastfeeding can help women lose weight after the birth of their baby.  Supplements with Lactobacillus and Bifidobacterium were linked to less central obesity (defined as a body mass index (BMI) of 30 or more or a waist circumference over 80 centimeters).

Probiotic use can be especially important if you need to take antibiotics for any reason in the postpartum period (really any time you take antibiotics, you can benefit from use of probiotics).

When mamas consume probiotics, the health benefits also find their way into breast milk and are passed on to baby. Breast milk is actually the source of our first immune-building “good” bacteria.  Since baby’s gut bacteria continues to culture throughout the nursing time, it is great for mama to continue taking probiotics in the postpartum and as long as she breastfeeds.

Probiotics for baby 

In addition to receiving probiotics via breast milk, probiotics can also be given to baby directly.  Supplementation to baby can take a few forms: you can add a bit of probiotic to a bottle of milk, you can take a little probiotic on your finger to give to baby orally, or you may even put a little on your nipple and baby will ingest it during a feed.

Probiotics have numerous potential benefits for babies including the prevention and treatment of:

  • allergies
  • asthma
  • eczema
  • food sensitivities, especially in infants with a family history of allergy
  • colic, one study found decreased crying times by up to 75% (look for product containing Lactobacillus reuteri)
  • diarrhea
  • ear infection
  • illness (colds and flu)

Research shows that good probiotic exposure in infancy can actually help optimize baby’s weight later in life.  Early probiotic exposure may modify the growth pattern of the child by restraining excessive weight gain during the first years of life.

Probiotics: Sources and Guidelines

Different blends of different strains of probiotic may be optimal depending on whether you are pregnant or taking them in the postpartum (or giving to baby).  We have a few excellent supplements at the clinic and we can talk to you further about what to look for in a probiotic.

Generally speaking, recommendations tend toward 1 to 10 billion Colony Forming Units for infants, and 10 to 20 billion CFU for older children and adults. To achieve and maintain a therapeutic effect, probiotics must be used consistently to ensure a sufficient and consistent population levels over time.  It can be difficult to say exactly what dose is ideal, as products vary.  Different probiotics have been shown to be effective at different levels.  Products containing a higher number of live probiotics may not be better than one with fewer.  It’s best to go with a reputable high-quality brand, ideally one that has been vetted by your health care professionals (such as us!).

There have been no reports of adverse reactions to supplementation of probiotics in moms or babies.

Food sources of probiotics

While supplementation is great, there are also many foods rich in probiotics.  Fermented foods are particularly rich in probiotics.

Food sources of probiotics include:

  • Yogurt
  • Kefir
  • Sauerkraut
  • Spirulina (with other great benefits in pregnancy and in general)
  • Miso soup
  • Pickles
  • Tempeh
  • Kimchi
  • Kombucha tea

If you have questions about probiotics, be sure to discuss them with your midwife at your next appointment, give us a call, or stop in.  We’d be happy to talk with you further about what to look for in a probiotic or connect you with a great supplement we carry.

Sources:

http://www.nutraingredients.com/Research/Probiotics-may-help-women-regain-their-figures-after-pregnancy

http://www.ncbi.nlm.nih.gov/pubmed/20231842

http://www.ncbi.nlm.nih.gov/pubmed/24164813

http://cdrf.org/home/checkoff-investments/usprobiotics/probiotics-basics/

http://www.ncbi.nlm.nih.gov/pubmed?Db=pubmed&Cmd=ShowDetailView&TermToSearch=11172991&ordinalpos=36&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Ten Tips for Partners at Birth

dad at birth 2While we tend to focus on preparing mama for birth, it is also essential that papas, partners or any other labor supporters to feel prepared.  While it would take the length of a book (or more) to fully prepare papas and partners for the birth experience, here are ten quick and easy essentials to keep in mind.

1.  Be responsive to your partner’s cues and protect her space.  Follow her lead.  Do what you can to ensure she is feeling safe and supported.  Keep the lights dim, the room quiet and the atmosphere calm.

2.  Minimize questions, distractions, and instructions (from yourself and others) especially during contractions.  Don’t take silence personally, it is probably a sign that she is going inside and focusing on the monumental task she is undertaking.  Silence is often a really good sign.

3.  Help her to be comfortable.  Suggest position changes regularly.  Observe her alignment and support her head, torso, low back, arms, hips, knees, and feet as needed.  Keep her warm, but offer ice packs or a cool cloth if she gets too warm.  Use comfort techniques you’ve learned together before the birth.

4.  Maintain your center and your stability.  Find your own breath.  Tend to yourself so that you can tend to her.  Do so discreetly so it doesn’t serve as a distraction.

5.  Take her to the bathroom hourly.

6.  Help her keep the pitch of her voice low and monitor her facial and physical tension.  Help her relax.

7.  Give her encouragement and tell her you love her.  You might even kiss if it feels right.  Feelings of love from mama help her release oxytocin, which can help with labor.

8.  If her breathing gets rapid, shallow and panicked, model a slow, even, deeper breath for her.  Maybe try to make eye contact with her as you do this, it can help to ground her.

9.  Keep her hydrated and nourished.  Offer regular sips of water (you can do so without words).  Offer labor snacks in early and active labor.

10. Help her maintain her rhythm.  Let her find what works best for her and find ways to support her there until its time for her rhythm to change again.

What other advice would you give to papas and partners for labor & birth?

Nitrous Oxide for Labor – No Laughing Matter

A simple technique to help manage labor pain is used commonly in the United Kingdom, Scandinavia, and Canada, but is offered to few U.S. women—nitrous oxide, or often known as “laughing gas.”

What is Nitrous Oxide?  New-Nitronox-System-Retouch

Nitrous oxide, commonly called “laughing gas”, reduces pain and anxiety. It is an odorless, tasteless gas that you breathe in through a mask. Nitrous Oxide is commonly used in labor by women in many other countries. For example, nitrous oxide is the most commonly used form of analgesia in the United Kingdom, where midwives use it in hospitals and carry it with them to home births, and three of every five women use it at some time during labor.

Labor pain is different for all mothers. Some women manage labor well with birth techniques such as position changes, water, hypnobirthing or techniques they have learned from their childbirth classes and others would like the option of “a little something to take the edge off.” Nitrous oxide is able to offer “that little something”.  There are women who want to have a birth that is as natural as possible, but also would like “just a little” pain relief to help them achieve their goal. This is the strength of nitrous oxide.

Most U.S. hospitals offer only the extremes of epidurals and narcotics for pain management. Many women would prefer options that are “good enough” pain relief measures without being completely numb and avoid the risks associated with more intensive anesthesia.

Is Nitrous Oxide safe?

Administration of nitrous oxide is not associated with increased risk of complications to either moms or babies and does not require more intensive or invasive monitoring. There has been widespread and extensive use of nitrous oxide for labor in many countries since the early 1900s with no studies or published observations identifying any significant adverse effects on the baby. There is no increased requirement for resuscitation, and newborn alertness and responsiveness during the important early period of maternal‐infant bonding and early effective breastfeeding are unaffected.

Why are mothers choosing Nitrous Oxide?

Doesn’t lead to further intervention. Mothers like nitrous oxide because, in contrast to the epidural, it does not lead to a possible “chain of interventions” that can end in a cesarean section, which has become the birth method for almost one in every three American mothers delivering in hospitals.

Doesn’t affect the natural progress of labor. When used under standard conditions, side effects are minimal (such as dizziness or euphoria).  Using nitrous oxide in labor does not interrupt or stall labor progression.

 A woman administers it herself.  Self- administration allows the woman to control management of her pain. The laboring woman must hold the mask or tube herself and not let another person hold it for them. If you breathe too much of the gas, you become drowsy, your hand will relax, and the mask or tube will fall away from your face, so that you breathe normal room air.

What are the advantages to using Nitrous Oxide?

Nitrous oxide can be administered quickly, easily and safely and has a very rapid onset of action and it can be discontinued as quickly and easily as it is started. The effects begin to dissipate immediately after the woman stops breathing nitrous oxide and are completely gone within minutes. Nitrous oxide has no adverse effects on the progress of labor.   After a brief period of explanation and supervision, nitrous oxide is self-administered through a mask that the woman holds to her own face. Self-administration allows the woman to determine when and how much nitrous oxide she uses. If a woman doesn’t like or tires of using nitrous oxide, she can stop using it without residual effects from the nitrous oxide.

What are the disadvantages to using Nitrous Oxide?

The mouthpiece is connected to a gas tank and can limit the area the mother can move around. However, the equipment used at the birth center allows a women to have a wide range or mobility so she can be on the bed, in the birth tub or in the bathroom.  To avoid over sedation it cannot be used within 6 hours of narcotic pain medication (which does not apply if you are at the birth center…we do not use narcotics). Some women report dizziness and mild nausea. Women with a history of Vit B12 deficiency, Crohn’s disease, chronic malnutrition, pernicious anemia, strict vegans, or who have middle ear disease or recent ear infection are not candidate for using Nitrous Oxide.

How is Nitrous Oxide administered?

Nitrous oxide is administered in combination with oxygen through a face mask that you hold. The gas only flows when you inhale into the mask or mouthpiece. Because it is self-administered the mother controls how much or how little she receives. The Nitrous Oxide machine blends the concentration to 50% Nitrous Oxide and 50% Oxygen and is set at a specific level so the mother cannot over medicate herself.

Can I use Nitrous Oxide while in the birth tub? pain_relief_during_labour_18ev8vr-18ev91l

Yes, Nitrous Oxide and warm water immersion work well together to provide relaxation and pain management for labor.

Does insurance cover the use of Nitrous Oxide?

Insurance companies do not cover the use of Nitrous Oxide in labor.  It is an out-of-pocket expense.

As with everything, nitrous oxide is not right for every woman during labor, but it is wonderful for some.

Here is a video that talks about the use of Nitrous Oxide for labor pain management and it’s reemergence into the United States as an option for women.

15 Reasons to do Yoga in Pregnancy

yogaMany of us know that it is important to be active in pregnancy—it’s good for mom and it’s good for baby.  Yoga is one of the best forms of exercise for mamas-to-be.

In a nutshell:

Physically, yoga helps make muscles more supple, increase joint mobility, and improve posture, all crucial given the colossal changes that happen to the body in pregnancy. With improved posture comes better breathing and circulation.

Yoga and labor have many things in common, which makes yoga excellent practice for labor.  Yoga has many psycho-spiritual benefits, which can help a woman navigate the tremendous transformations of pregnancy and motherhood.  Being in a yoga class also offers community, which can be just as important as the actual practice of yoga.

Here are 15 specific reasons to do yoga in pregnancy.

Ways that yoga helps in pregnancy:

1.  Helps you carry your baby optimally.

2.  Helps to prevent backache

3.  Facilitates unrestricted breathing, resulting in good blood oxygenation for mom and baby

4.  Helps mom discover movements that alleviate pregnancy discomforts such as heartburn, leg cramps, or headaches.

5.  Better blood circulation, lowering risk of problems such as varicose veins, hemorrhoids, and fluid retention

6.  Helps combat fatigue

7.  Physical pain can be diminished through regular practice

8.  Increased self awareness and awareness of baby.  Becoming more body aware and aware of your baby and its energy can help you foster a bond with baby even before birth.

Ways that yoga helps a woman prepare for labor:

9.  Many yoga poses also happen to be ideal birthing positions, practicing before hand offers strength, comfort and familiarity with these positions.

10. Yoga helps you move to your edge and sometimes beyond, finding grace and ease in physical difficulty.  This is a beneficial skill in labor.

11. Yoga helps connect you to your body, giving you confidence and courage in its abilities and helping you develop a deeper awareness of what’s happening in your body

12. The focused breath work of yoga can help you find a breathing rhythm that works for you in labor.  Breath is SO key in yoga and in labor!  In yoga, you can also practice moving breath in your body—for example, moving breath down, which can also be vital in labor as you breathe your baby down.

13.  Yoga brings a shift in consciousness out of your thinking mind and into your more embodied, instinctive mind.  This, too, will be a benefit in labor, as it requires that you release thoughts and let your body express its wisdom (a wisdom that knows how to birth your baby!)

14. Yoga offers practice in releasing stress, tension and fear.  It encourages feelings of peace, safety, and presence.  All of this is good for labor.

15. Yoga makes the body strong, helping it through labor and helping create optimal conditions for healing after labor, regardless of what labor and birth brings.

What benefits of yoga have you discovered in your pregnancy and birth?

Did you know we offer prenatal yoga at Health Foundations?  The first Friday of every month our lovely yoga instructor leads a candlelight prenatal yoga class from 7pm to 8:15pm.  Join us next month!

Pregnancy-yoga

Stay tuned for an upcoming post with some of the best yoga poses for pregnancy and their benefits.

***As with all forms of exercise in pregnancy, it is imperative to listen to your body and honor your needs and abilities at this time.

Labor nourishment

trailmix

Evidence shows that, in most cases, the benefits of eating and drinking throughout labor far exceed any potential or perceived drawbacks.  Women need calories and hydration throughout the hard work of labor in order to birth optimally and avoid risks such as exhaustion (and consequential ineffective contractions), electrolyte imbalance, low blood sugar, and other problems.  Furthermore, perceptions of pain can also be exacerbated when a mama is hungry and/or thirsty in labor.

We’ve written before on the importance of hydration during labor.  Today, we are going to talk about some possible snacks you may consider having on hand for mama during labor (and possibly the birth team—partner, doula, family—too).  If you are birthing at the birth center, you are responsible for bringing your own snacks and fluids for labor.  You’ll also want to bring or have a plan to order delivery of a post-birth meal that is more substantial than your snacks.

Recommendations on choosing labor snacks

You won’t know ahead of time what is going to sound good to you in the throes of labor.  However, you can make some wise choices ahead of time to have food on hand you think you might like to have on hand for the big event.  Having a few different options is a good idea, too, to increase the chances that what you have will sound good when you’re needing nourishment during labor.

  • Choose foods that you like and tolerate well
  • Consider foods that are comforting to you
  • Some suggest selecting the same kinds of food you might choose if you were getting over a cold or flu
  • Consider easy-to-eat, ready-to-eat (or easy-to-prepare) foods
  • Consider packing small quantities of the food you want to bring
  • Many suggest avoiding greasy, heavy, or really rich foods

 Possible foods for labor

Feel free to consider whatever on this list sounds good to you and ignore the rest!

1. Oatmeal

Warm, nourishing, gentle on the tummy and easy to make, oatmeal is a great choice for many mamas in labor.  Add fruit and honey if desired.

2. Fruit

Many women love bananas (a good source of potassium) during labor.  Some swear by frozen grapes.  Many do not care for citrus/acidic fruits in labor, though some do.  Choose whatever fruits you prefer and get them ready to go (cut into bite size pieces if possible) before labor or in early labor.  Dried fruit, such as raisins, cranberries and apricots are also good choices.  Applesauce is also a labor favorite for many mamas.

3. Honey

Honey is a great source of instant energy (carbs) during labor.  It is also not something that requires chewing, which mama may prefer if she is having trouble keeping food down but needs energy.  Honey sticks are easiest for mom to suck on without changing her position.  You can find these in some stores.  We’ve also found them at the St. Paul Farmer’s Market (and perhaps they can be found at other farmer’s markets).

4. Yogurt

A great source of protein and carbohydrates, yogurt is also easy on the tummy.

5. Cheese

In cubes or slices, this snack has calcium and protein for lasting energy.

6. Protein, nut-fruit, or granola bars

Pure Bars and Lara Bars have fewer and whole, quality ingredients compared to other bars.

7. Miso soup or a light soup broth

8. Graham crackers, saltine crackers, other crackers

9. Eggs

Scrambled or hardboiled, eggs are light and contain protein for long lasting energy.

10. Nuts or seeds.

An excellent source of protein packed in tiny bite-sized bits. Try almonds, cashews, pumpkin or sunflower seeds.  You may want to make a trail mix, combining nuts and seeds with dried fruits.

11. Whole grain bagel or toast

12. Popsicles

Opt for a healthy option if possible.  You can also make red raspberry tea, cool it, sweeten, and make into popsicles for labor

What did you enjoy during your labor?

Oxytocin in Childbirth: A Labor of Love

Last week, we talked about the role of endorphins in natural childbirth and today we turn our focus to oxytocin, another crucial hormone in the symphony of chemicals created naturally in the body to help mom and baby through childbirth.

There are four major hormonal systems active during labor: endorphins, oxytocin, adrenaline and noradrenaline, and prolactin.

What is oxytocin?

pregnancy oxytocin

Oxytocin, known as the “love hormone,” is a hormone and neuropeptide that causes both physiological and behavioral effects when produced in the body.  It is produced in the hypothalamus of the brain and is released into the bloodstream via the pituitary gland.

Our bodies produce oxytocin when we are attracted to a mate, during lovemaking (it assists with arousal, fosters bonding and may facilitate sperm and egg transport), following positive social interactions (it can even potentially improve wound healing following such positive interactions, say experts), and with other positive experiences.  It is thought to enhance our capacity to love ourselves and others.

Oxytocin is produced in pregnancy, levels increase significantly during active labor and childbirth, and both mom and baby produce oxytocin after birth and as long as baby breastfeeds.

Oxytocin evokes feelings of contentment, trust, empathy, calmness and security and reduces anxiety and fear. Under certain circumstances, oxytocin can hinder the release of cortisol, or stress hormones.

What are the functions and roles of oxytocin in childbirth?

Oxytocin plays a major role in the following:

  • Uterine contractions that help facilitate dilation in labor
  • Facilitating the milk let-down reflex
  • Fostering the mother-baby bond
  • Encouraging maternal behavior in the first hour after birth
  • Released during breastfeeding, oxytocin causes mild uterine contractions after birth to expel the placenta and close of many blood vessels to prevent bleeding
  • Assisting the uterus in clotting the placental attachment point postpartum

What helps to facilitate the production of oxytocin naturally during labor?

Unhindered production of oxytocin is important in labor because oxytocin is responsible in large part for uterine contractions.  Oxytocin initiates labor and helps it keep going strong.

Because the production of oxytocin is so connected to our emotions, it is paramount that a laboring mama feel calm, secure, and uninhibited in her environment and that she trust those around her.  A dim room without too much excitement or distraction is an environment conducive to the unhindered production of oxytocin.

happy birth

Natural ways to stimulate oxytocin production in labor include:

  • Caring, non-medical touch
  • Nipple stimulation (this can be helpful in getting labor started in some cases, or to increase strength and frequency of contractions)
  • Laughter and humor
  • Kissing (Ina May, a famous midwife, touts “smooching” as a great way to keep labor going)
  • Gentle exercise, dancing and rhythmic movement
  • Feeling grateful and loving (a partner’s words and actions can be so instrumental in helping mama create oxytocin and so help her labor along)
  • The repetitive use of mantras, prayer or sounds
  • Meditation, positive visualization and hypnosis
  • Relaxation
  • Warm bath

What can diminish oxytocin levels in labor?

Again, because of the emotional connection, any experience of fear, anxiety, stress, tension, discomfort, or distrust can negatively effect oxytocin production during labor.  A feeling of being watched can also hinder oxytocin release.  The use of synthetic oxytocin (Pitocin)—which also stimulates contractions and is used to induce labor—can also slow the body’s own production of oxytocin.

Oxytocin in Breastfeeding

oxytocin breastfeedingOxytocin, also called the cuddle hormone, is released by both mama and baby during breastfeeding.  It can cause slight sleepiness, mild euphoria, a higher pain threshold, and increased love for one another.  It also helps build the attraction and strengthen the bond between mama and baby.

As you can see, oxytocin is an amazing gift and tool our bodies make to help us through childbirth and postpartum.