Archive for the ‘prenatal’ Category

EMAB and Doulaparty Team Up

Friday, June 22nd, 2012

 

 

Join the #doulaparty on Twitter or follow along at DesirreAndrews.com, June 22nd 6pm PT/9pm ET to kick off summer birth work with something extra special!

 

I am very excited that Earth Mama Angel Baby is sponsoring this weeks live chat. EMAB has amazing products for all types of birth professionals and families.

 

A note from the EMAB Team:

 

Are you a midwife, doula, nurse or obstetrician looking for pure, safe products to comfort postpartum mamas and brand new babies? You’ve come to the right place! Earth Mama Angel Baby offers safe alternatives for your clients who are concerned with detergents, parabens, 1,4-Dioxane, artificial fragrance, dyes, preservatives, emulsifiers and other toxins. Earth Mama products are used in hospitals, even on the most fragile NICU babies, and they all rate a zero on the Skin Deep toxin database, the best rating a product can receive. Earth Mama only uses the highest-quality, certified-organic or organically grown herbs and oils for our teas, bath herbs, gentle handmade soaps, salves, lotions and massage oils.

Earth Mama now offers a Birth Pro Cart for wholesale pricing available for birth support professionals! Join Earth Mama Angel Baby on the #doulaparty chat Friday June 22 to talk about their new shopping cart plus answer any questions you may have. Earth Mama will be giving away Postpartum Bath Herbs and Monthly Comfort Tea, Mama Bottom Balm, Mama Bottom Spray, and a grand prize of their new Travel Birth & Baby Kit!

Writing Your Own Birth “Plan”

Sunday, October 16th, 2011

A birth plan has more than one purpose. It begins as a value clarification exercise, then becomes a communication tool with your care provider and ultimately a guide of needs and desires during labor, delivery and postpartum. Even if your birth location does not ask for birth plans, it is a good idea to write one for your own benefit.

Step 1

Clarifying your needs, wants and desires. Here are the  Birth Menu of Options and Assessing Your Feelings we use in class  to begin the value clarification process.  The birth menu is most helpful when you begin by crossing out what you are not interested in, highlighting the items you know you want and circling what you need to research. The AYF worksheet is for you and your husband/partner/non-doula labor support person to go over together to ensure you are on the same page and open up conversation. Doing this prior to 35 weeks of pregnancy gives you more time to coordinate with your care provider or birth location. If you have a doula or are taking a childbirth class, she/he can help you in this part of the process as well.

Step 2

Write down in order of labor, delivery, immediate postpartum and in case of cesarean needs and desires. Your plan really needs to be within one typed page for easy reading and digesting by care provider and staff. The only items that must be listed are care options that are outside of usual practices, protocols or standing orders. Here is the Sample Low Intervention Birth Plan we use to help you see a finished format and types of pertinent information that may be necessary to list.

Step 3

Take your written plan into your care provider. This is a conversation starter, a beginning, a partnering tool. As I encouraged above, early to mid 3rd trimester gives you more flexibility in communicating with your provider and setting your plan in motion. It also gives you opportunity to change providers or birth location if you cannot reach a comfortable agreement.

Step 4

Make any changes.Finalize.  Print out final copy.  Give one to care provider, have one in your bag for labor and birth, give one to doula (if you hired one). Though this is not a binding or legal agreement it can go a long way toward the type of care and birth you want.

Step 5

Gestate peacefully until labor begins!

A Guide to Finding Your Doula

Tuesday, August 2nd, 2011

Building a labor support team is part of conscious preparation during pregnancy for your labor,  birth and life with the very newborn. Hiring a labor doula continues to gain in popularity for the expecting family. Your doula comes alongside you in pregnancy through labor and delivery with some additional early postpartum follow-up.  For additional after birth support, a postpartum doula is a great addition.

Step 1: Finding a Doula

  • Inquire with friends, family, local support/informational groups (for example – ICAN, LLLI, Birth Network, Birth Circle, Cloth Diaper store), childbirth educators, care providers, prenatal massage therapists, prenatal exercise instructors, lactation experts and chiropractors for referrals.
  • Use your favorite search engine and type in your city or area name with the keyword doula
  • Search training and certifying organizations such as CAPPA, DONA, ICEA ToLabor , Birth Works and Birth Arts International
  • Search general doula sites such as All Doulas, Doulas.com, About.com, Doula Match or Doula.com

Step 2: First Contact

Once you have located local area doulas, the next step is  to make contact. You will likely find that most doulas are women though occasionally you will find a male doula in your area.  After visiting any websites; phone or email only the doulas that most interest you and fit your particular needs.  Generally there is not much need to contact more than three perspective doulas.

During your initial phone conversation or in your email be sure to include:

  • Full name
  • Contact information
  • Estimated Due Date
  • General location where you live
  • Care Provider
  • Birth Location
  • Top needs and desires for birth
  • If referred, by whom
  • Any financial considerations

Step 3:  Setting up the Interview

I encourage after the phone or email contact and response, set-up in-person interviews with the doulas you found most compatible with you.

  • Unless the doula you are meeting has her own office, interviews are usually held in a public place such as a coffee house, restaurant, library, park, or shopping center. If you meet at a place where beverages or food will be ordered you can offer to pick up the tab for everyone if you desire, but it is never expected.
  • Your partner, husband or other support who will be attending the birth needs to be at in-person interview if at all possible.
  • Expect the interview to be approximately an hour and to be free of charge.

Step 4: The Interview

The interview is to gain more detailed information from the doula, as well as, share more  about yourself and what you want.  It is customary for the doula to either email ahead of time her client packet or bring it with her to the interview. It may include her professional profile, client agreement, services, and support details, as well as, additional offerings.

Suggested Interview Questions:

  • Why are you a doula?
  • What is your philosophy of childbirth?
  • Where did you get your training?
  • Are you certified? Why or why not?
  • How long have you been a doula?
  • What is your scope of practice?
  • What types of births have you participated in?
  • What types of birth locations have you been to?
  • How many births per month on average do you attend?
  • How many clients would max you out in a month?
  • Have you ever missed a birth? Please explain why.
  • Do you specialize in working with a specific type of clientele or birth plan?
  • What has been the most challenging birth you have attended? Why?
  • How do you work with my husband/partner/other support?
  • Have you worked with my provider before? If yes, please describe the experience.
  • How many prenatal visits would there be?
  • In general, what is covered in the prenatal visits?
  • Will you help me make a birth plan?
  • Please explain how your fee is structured.
  • Do you accept barter?
  • Do you have a back-up and do I meet her ahead of time?
  • When do you go on-call?
  • Do you labor at home with me?
  • What do you do if I am induced or need to schedule a cesarean?
  • When will you see me postpartum and what does it include?
  • What are your expectations of me as a client?
  • How long do I have to decide before you would contract with someone else around my EDD?

Of course that is a fairly long list of overview questions. Brainstorm some of your own. The interview is not meant to be a free prenatal visit, it is simply to find out if you and the doula are a fit personality wise and in how she practices.  Most doulas do not expect to be hired on the spot. You  need time to think and process after each interview. If a doula is pressuring you to hire on the spot because she fills so quickly, that could be a red flag and cause for you to take a pause.

Step 5: Hiring the Doula

Within 1-2 weeks,  contact the doula you would like to hire and proceed and those you did not choose to let them know you have hired someone else so they will not be holding your EDD space open any longer.

Details to be clear about when initially hiring your doula:

  • Sign and return the agreement/contract she gave you at the interview (if applicable).
  • Return any intake paperwork by mail or email.
  • Payment  – First portion of fee is usually paid upon hiring a doula.
  • Ask her usual business hours and contact preference for non-emergencies or labor related needs.
  • Let her know your contact preferences and all phone numbers to reach you and your spouse/partner or other support.
  • Set the date and time for the first prenatal appointment. Give her directions if your home is not easy to find.
  • Get clarity on what routine contact she would like from you (updates after care provider appointments, etc.)

Happy doula-ing!

Picking Your Care Provider – Interview Questions

Thursday, July 28th, 2011

Being an active participant in your pregnancy and birth journey begins with choosing your provider. You can begin the search for the right provider fit prior to becoming pregnant, in early pregnancy or anytime before your baby is born. So much of how your pregnancy and birth unfold are directly related to your care provider so this is really a key element. Every provider is not the right fit for every mother and vice verse. If you already have an established provider relationship, these questions can be used as a re-interview tool.

When asking these questions, take care to really listen to the answers. If a provider will not meet with you prior to you becoming a patient, that can be a red flag.

______________________________________________________________________

Begin by expressing your overall idea of what your best pregnancy, labor and birth looks like to provider.

  • What are your core beliefs, training, experience surrounding pregnancy and birth?
  • Why did you choose this line of work?
  • What sets you apart from other maternity providers?
  • How can you help me attain my vision for pregnancy, labor and birth?
  • If I have a question, will you answer over the phone, by email or other avenue outside of prenatal appointments?
  • How much time will you spend with me during each appointment?
  • What routine tests are utilized during pregnancy? What if I decline these tests?
  • What is the average birth experience of first time mothers in your practice?
  • How do you approach the due date? What do you consider full term and when would I be considered overdue?
  • What are your patient intervention rates? (IV, AROM, continuous monitoring, episiotomy, etc.) Cesarean rate? VBAC rate? Induction rate? What induction methods are used? When are forceps/vacuum used? These numbers are tracked.
  • What positions are you comfortable catching in? Birth stool? Hand/Knees? Squatting? Standing? Water? How often do patients deliver in positions other than reclined or McRoberts positions?
  • How do you feel about me having a birth plan?
  • What if I hire a doula? Do you have an interest in who I work with or restrictions? If yes, why?
  • Do you have an opinion on the type of childbirth or breastfeeding class I take? If so, what and why?
  • Are you part of on call rotation or do you attend your own  overall? Will the back-up or on-call CP honor the requests we have agreed on?
  • Are there any protocols that are non-negotiable? If you cannot refuse – you are not consenting.
  • What if I choose to decline a recommended procedure or intervention in labor or post birth, how will that be viewed?
  • When will I see you during labor?
  • What postpartum care or support do you offer?
  • Will I be able to get questions answered or be seen before the 6 week postpartum visit?

Points to ponder afterward:

  • Did you feel immediately comfortable and respected at the interview? If already with a CP, do you feel comfortable, respected and heard at each appointment?
  • Were there red flags or white flags?
  • Was or is care provider willing to answer questions in detail without being annoyed?
  • Is choosing your care provider based on your insurance or lack of insurance?
  • What are you willing to do in order to have the birth you really desire? Birth location?
  • How much responsibility are you willing to take for the health care decisions for you and your baby?

Creating a relationship 10 minutes at a time

Sunday, February 27th, 2011

It has occurred to me through my time with doula clients and students,  that many care providers serving hospital birthing mothers do not ask any questions of their pregnant patients during the 7-10 minute prenatal visits that lead to a substantive working relationship.

I have also learned that too often the pregnant “patient” does not know to tell her provider anything about what is going on in her life or pregnancy since she is not queried first.

Thinking there must be a way to better bridge this very real separation to solid patient-provider relationship building, I am drawing from my work as a midwife assistant in the making of this tip list.

Pregnant mothers your provider needs to know so much more about you and your pregnancy than blood pressure, weight, fundal height and fetal heart tones. I encourage you to freely offer the below information at every appointment to grow personalized care, advisement and support.

1) Appetite/Diet/Supplements – tell your provider if your appetite has increased or decreased between visits. Do you have food aversions? Are you taking any supplements or want to take supplements?

2) Sleep habits – tell your provider how you are or are not sleeping.  For example, are you having trouble falling asleep, falling back to sleep or staying asleep.

3) Nausea – Do you continue to have nausea? When? How often? Does it correlate with anything in particular?

4) Hemorrhoids – if you have them or not. What you are doing for them.

5) Varicose veins -  Are there veins sticking out or causing issue anywhere in your body?

6) Bowel habits – Are you experiencing normal or abnormal bowel habits?

7) Exercise – What have you been doing? Do changes need to be made?

8) Stress – Is there anything in your life that is really stressing you? Stress can impact pregnancy health. Important to discuss.

9) Related Providers – Are you going to any pregnancy related providers (such as chiropractor, acupuncturist, yoga, etc.)?

10) General  – Are you feeling well or not. Do you need more information or referrals?

There is so much more to you than a pregnant uterus. You are a holistic person who needs to be treated as such. I would venture that something much more individualized can come out of your care with simple sharing!

Here’s to whole care!

Why Childbirth Education?

Monday, November 22nd, 2010

I sit here and ponder Why childbirth education is important?. I am an educator because I think it can be a vital piece to the preparation puzzle prior to welcoming a baby.  I use the word “can” versus “is” due to the fact that all educational offerings are not created equally.

It is known that only a percentage of expecting mothers attend a childbirth class series. Perhaps they believe the staff will explain everything when they get to the hospital, they really have a deep trust in the process and are reading up on everything, or since they are having a home birth that additional education is unneeded. Whatever the reason, women are not getting the foundational information that can be incredibly helpful toward confidence, ability, decision making and mothering far beyond the birth itself.

A good childbirth class series (or rather perinatal class) is well worth the monetary and time investment for most first time mothers and can benefit those who have already birthed.  My post on choosing a childbirth class is a good jumping off point to figuring out what type of course suits the individual expecting mother (her partner or labor support).

A class series worth the time and effort will be comprehensive in nature, not just covering labor and birth. What does that look like? A class that covers midway third trimester pregnancy through 4-8 weeks postpartum. It is content that is deep and is applicable to real life.

A sample of course content:

  • Pregnancy Basics
  • Common Terminology
  • Normal Physiologic Changes and “helps”
  • Exercise
  • Nutrition
  • Prenatal Testing
  • Birth Plans
  • Informed Consent
  • Communication and Self-Advocacy Skill Building
  • Overview of spontaneous Labor and Birth
  • Labor milestones with Comfort and Positioning Strategies
  • Overview of all Options in Labor, Birth and Postpartum
  • Labor Partner Role
  • Immediate Postpartum
  • Navigating first weeks Postpartum
  • Overview of Infant Feeding and Norms
  • Bonding
  • Medications and Interventions
  • Cesarean and VBAC
  • Unexpected Events
  • Role-playing Scenarios
  • Relaxation and Visualization Practice
  • Local/Online Resources

How the educator reaches her class is fundamental to the learning process and take away of participants.  I encourage women to interview the potential educator. Finding the right fit in a class is no different that in provider, doula or birth location.

Even if a woman knows she wants an epidural, TAKING A GOOD CLASS is vital because she will be having a natural birth the epidural is on board and her Plan B could very well be a natural birth. Being prepared will only serve her well in the fluid process known as labor and delivery.

Gaining knowledge that will help a woman to partner with her provider, address her own needs fully and help her to define her own birth philosophy gives her a leg up on being responsible and in charge in her own health care and even outcomes.

The vast scope of what a solid class series can offer an expecting mother (her partner or support person) is incredibly valuable and can not be understated. A class that provides for encouragement, comfort, safety, respect, connection, structure, evidence-based information and real life application can plant seeds and prosper skills that will carry a woman well into her mothering years. These skills are for life, not just for labor and birth. I am stunned often by how birthing knowledge carries me in daily ability with my own family.

Here’s to happy and deep learning!

The Best isn’t Better. Usual is where It is at.

Thursday, September 16th, 2010

There has been much ado surrounding the language of breastfeeding being normal and usual versus the best for baby and mother in great thanks to Diane Weissinger. It is so valuable to recognize that while we all desire to be the best, we often hit the normal everyday averages in life. We are comfortable reaching a goal that seems more attainable. Best or better can feel so far out of reach where average and usual seem quite in reach most of the time. None of us generally want to be below the average or usual. Thus the language of the risks of NOT breastfeeding is so vital.

I would like to see the same type of language revolving around pregnancy and birth as well.

In the overall picture here is the usual occurrence: Ovulation leads to heightened sexual desire, which leads to sexual activity, which leads to pregnancy, which leads to labor, which leads to birth, which leads to breastfeeding…..

So how do we look at language as an important part of our social fabric and belief systems surrounding this process?

Let us look at contrasting statements of what is often heard and how a positive point of view can be adapted.

Pregnancy is: a burden, an illness, an affliction, a mistake, something to be tolerated……

Pregnancy is: a gift, wonderful, amazing, part of the design, someone to grow…..

Labor is: scary, worth fearing, the unknown, unpredictable, painful, to be avoided, to be numbed from, to be medicated, to be induced, out of control, unfeminine…..

Labor is: what happens at the end of pregnancy, hard work but worth it, manageable by our own endorphins and oxytocin, an adventure, not bigger than the woman creating it, to be worked with, worth be present for, is what baby expects……..

Pushing and Birth are: terrifying, physically too difficult, only works for women who are not too small, short, skinny, big, fat, young or old, responsible for pelvic floor problems, out of control, horrible……..

Pushing and Birth are: what happens after dilation completes, to help baby prepare for breathing, bonding and feeding, sometimes pleasurable, sometimes fast, sometimes slow, able to occur in water, standing, laying down, squatting, on hands and knees, often most effective when a woman is given the opportunity to spontaneously work with her baby and body, not always responsible for pelvic floor issues, amazing, hard work, worthwhile, sets the finals hormonal shifts in motion for mother and baby……

Is it really BETTER? I say no. It is usual and normal.

  • Spontaneous labor is not better – it is the expected usual occurrence at the end of pregnancy.
  • Unmedicated labor and birth is not better – it is what the body mechanisms and baby expect to perform at normal levels.
  • Unrestricted access to movement, support and safety in response to labor progression is not better – it is the usual expectation to facilitate a normal process.
  • Spontaneous physiologic pushing is not better – it is what a woman will just do, in her way.
  • Spontaneous birth is not better – it is what a mother and baby do.
  • Keeping mother and baby together without separation is not better – it is what both the mother and baby are expecting to facilitate bonding, breastfeeding, and normal newborn health.

Denying the norms and adding in unnecessary interventions, medications and separation is creating a risky environment for mothers and babies. Thus increasing fear, worry,and even a desire to be fixed at all costs.

Perhaps even worse, an atmosphere has been created where the abnormal has become the expected norm and the normal has become the problem to be eradicated.

Bottom line, our language matters and will help shape for the positive or negative the future of birth.

Technology and the Prenatal “Diet”

Wednesday, February 17th, 2010

In westernized countries, television and the internet have almost completely replaced the generational teaching and learning found in the “circles” of the past. Women would gather over sewing, quilting, canning, and life events including pregnancy and childbirth. They offered support, told their stories, spoke of family life, shared their everyday knowledge, wisdom and expertise while the children played at their feet.

At first glance it seems that through these technologies women are able to gain vast amounts of incredible knowledge regarding childbirth.  There are very popular websites, message boards and forums to meet and greet other women who are expecting the very same month.  Any topic is available to explore. Excellent places for a sense of community and belonging. The information is so prevalent that some women even eschew childbirth classes because they feel well enough prepared from all the exposure. Fantastic to be sure, at first glance.

Upon a deeper look  with a critical eye at the most popular shows and on-line communities, it becomes pretty obvious that overwhelmingly the messages and scenes actually have little to do with real encouragement and instilling confidence in a woman’s design and inherent ability to birth.

Let’s start with the satellite/cable television shows on the learning and health channels. Stop for a moment and think of what occurred during the last episode you viewed.  Did you see a spontaneous labor from entry to hospital to birth without augmentation, epidural, or any other intervention except for intermittent monitoring and perhaps a saline lock (IV port) placed? Was it an induction with an epidural? Was it a cesarean or a vaginal delivery? Did she have adequate support? Was her background given in any detail? Who made the decisions? What about informed consent? Was the laboring woman paid attention too or were the machines heeded more? What sort of comfort measures did she employ? Was she ever out of bed? Who delivered the baby?  What response to her baby did the mother have? Who saw her baby first? With that clear memory in mind, how did you feel after viewing it? What thoughts came to your mind? Now consider that essentially all of the births shown take place in a hospital. In fact any birth that does not, is often touted as extreme or some other like descriptive.

Let’s move on for a moment.

Now let’s take a look at the most popular pregnancy websites, message boards and forums where women connect with one another.  The “conversations” and threads are filled with all things related to the impending birth. Chatter about baby showers, maternity leave, body changes, vaccinations, previous experiences, breastfeeding, nursery preparations and so much more. Really anything under the prenatal sun. Inspecting further though, there seems to be an inordinate amount of discussion regarding the need for scheduled inductions and cesareans and very little conversation or even support for natural or spontaneous labor and birth.

With intervention appearing to be the ruling majority within the technological communities and filling the television, how is a pregnant woman feeding her eyes, heart, and mind on this type of diet supposed to feel confident, uplifted and excited about her upcoming birth? I am uncertain that she can with the seeds of inadequacy, fear, brokenness, helplessness, and lack of options being sewn into her being at such an alarming ratio.  Sometimes yes interventions are needed, however, in practice it isn’t a need for many women and babies.

These shows and internet locales are like junk food. Like all junk food they are not to be an integral part of a healthy prenatal “diet” that will be encouraging, expand useful knowledge, grow confidence, spark self-advocacy, promote self-awareness, ignite excitement, and offer joy to the expecting mother.

How can an expecting mother improve her “diet” regardless of the type of birth she is planning? What are the better places to “shop”?

  • Turning off the TV
  • Check out and attend local groups and support meetings. Educational sessions and workshops are often free of charge. For example: Doula Groups, ICAN, Midwifery Groups, Birth Network, Birth Circles, and similar.
  • Try some different message boards, forums and sites. See Blog Roll and Resources listed on this site.
  • Seek out positive free videos to watch on You Tube.  http://prepforbirth.com/2009/07/30/birth-videos/
  • Talk to women who have birthed in the hospital, birth center and at home. Get a variety of positive stories.
  • Try some different reading on for size. http://prepforbirth.com/books-videos-and-more/
  • Rent or borrow movies from Netflix, a doula or childbirth educator, such as, Business of Being Born, Pregnant in America, or Orgasmic Birth to name a few.
  • Take the challenge to learn about and be open to the variety of birthing techniques, locations, options and provider types that women are utilizing.

Bottom line, the most prevalent “food group” in a diet is going to positively or negatively affect the parts and the whole of the journey to having a babe in arms.  No matter what the mother and baby live with the outcomes from the birth. Enriching the prenatal “diet” is not a guarantee of outcome or path to the birth. It does however give much more possibility and opportunity for both mother and baby to have a better birth and start together.

Preparing For Birth – Affirmations

Friday, October 9th, 2009

Guarding what you put into your eyes, ears, and mind is such an important part of pregnancy and birth.  As women we learn socially, from one another.  When we allow the pervasive negativity (TV, horror stories, fearful education, good patient education, unsupportive comments, etc.) to take root we lose so much inborn knowledge and wisdom of all the women who came before.  I encourage you to read the below affirmations, use them, tweak them, and then write your very own. Place affirmations everywhere that you are. Encourage others around you to also speak them to you. whenever you think of labor and birth, recite your affirmations.  Build in the positive at any opportunity. If someone gets a negative experience out to you, stop and ask what she would have or could have done differently if she was able.

  • I will take labor one contraction at a time. I can do ANYTHING for a minute or two.
  • I am able to make the best possible choices for a healthy, joyful birth.
  • I TRUST my body to labor smoothly and efficiently.
  • My design is PERFECT to birth my baby.
  • I trust my baby and body to choose when labor will begin.
  • I will receive the start of labor and I will labor well.
  • I accept the unknown of labor and birth.
  • My baby already knows how to labor and come into my arms.
  • I am well equipped to mother my baby.
  • I can make choices and decisions based out of love/evidence not fear.
  • I embrace the concept of healthy pain.
  • I am welcoming my contractions.
  • I have enough love to go around.
  • There is always enough love for me.
  • I am strong, confident, assured, and assertive and still feminine.
  • I am helping my baby feel safe so that she can be born.
  • I am a strong and capable woman.
  • I am creating a totally positive and new birth experience.
  • My pelvis is releasing and opening (as have those of countless women before me).
  • I am accepting my labor and believe that it is the right labor for me, and for my baby.
  • I now feel the love that others have for me during the birth.
  • I will treat my mate lovingly during the birth.
  • I will have exactly who I need supporting me for my birth.
  • I am birthing where I will be the safest, most peaceful, and most encouraged.
  • I have a beautiful body. My body is my friend.

If you would like to add to my list, please email me at desirre@prepforbirth.com.

Preparing For Birth – Pregnancy Nutrition

Tuesday, September 22nd, 2009

during childbirth class there is always a question of “What should I eat?”.  Pulling from the FDA pyramid plan for moms interactive website, the below information puts it into an easy perspective.  I input information based on an average sized 30 year-old pregnant woman.  On the site, you can put in your information to personalize it for age, weight, multiples, and more.   You can also get menus to print out to make it extra simple to follow a solid plan. Below the chart, there is a complete listing of proteins to eat.  I added this since women often get far too little protein (the FDA recommends a minimum of 60 grams per day though other schools of thought start at 80 grams per day).

Nutrition is the foundation of toward a healthy pregnancy and baby.  Growing a new human being is not a simple task, so giving yourself the proper building blocks can make a big difference.  I hope this helps sets you on a path of happy and healthful eating.

1st Trimester 2nd Trimester 3rd Trimester
Grains 6 ounces 8 ounces 9 ounces tips
Vegetables cups 3 cups cups tips
Fruits 2 cups 2 cups 2 cups tips
Milk 3 cups 3 cups 3 cups tips
Meat & Beans ounces ounces ounces tips
Click the food groups above to learn more.
1 Make Half Your Grains Whole
Aim for at least this amount of whole grains per day. 3 ounces 4 ounces ounces
* You will need the free Adobe Acrobat Reader plug-in to view and print the above PDF file.
2 Vary Your Veggies
Aim for this much weekly.
Dark Green Vegetables 3 cups 3 cups 3 cups
Orange Vegetables 2 cups 2 cups cups
Dry Beans & Peas 3 cups 3 cups cups
Starchy Vegetables 3 cups 6 cups 7 cups
Other Vegetables cups 7 cups cups
Oils & Discretionary Calories
Aim for this amount of oils per day. 6 teaspoons 7 teaspoons 8 teaspoons
Limit your extras (extra fats & sugars) to this amount per day. 265 calories 360 calories 410 calories
Physical Activity

Physical activity is also important for health. Adults should get at least 30 minutes of moderate level activity most days. Longer or more vigorous activity can provide greater health benefits. Click here to find out if you should talk with a health care provider before starting or increasing physical activity. Click here for more information about physical activity and health.


Inside The Pyramid

Meats

What foods are included in the meat, poultry, fish, dry beans, eggs, and nuts (meat & beans) group?
Divider

All foods made from meat, poultry, fish, dry beans or peas, eggs, nuts, and seeds are considered part of this group. Dry beans and peas are part of this group as well as the vegetable group. For more information on dry beans and peas click here.

Most meat and poultry choices should be lean or low-fat. Fish, nuts, and seeds contain healthy oils, so choose these foods frequently instead of meat or poultry. (See Why is it important to include fish, nuts, and seeds?)

Some commonly eaten choices in the Meat and Beans group, with selection tips, are:

Meats Food Gallery
Meats*

Lean cuts of:

beef
ham
lamb
pork
veal

Game meats:

bison
rabbit
venison

Lean ground meats:

beef
pork
lamb

Lean luncheon meats
Organ meats:

liver
giblets

Poultry*

chicken
duck
goose
turkey
ground chicken and turkey

Eggs*

chicken eggs
duck eggs
Dry beans and peas:

black beans
black-eyed peas
chickpeas (garbanzo beans)
falafel
kidney beans
lentils
lima beans (mature)
navy beans
pinto beans
soy beans
split peas
tofu (bean curd made from soy beans)
white beans

bean burgers:

garden burgers
veggie burgers

tempeh
texturized vegetable protein (TVP)

Nuts & seeds*

almonds
cashews
hazelnuts (filberts)
mixed nuts
peanuts
peanut butter
pecans
pistachios
pumpkin seeds
sesame seeds
sunflower seeds
walnuts
Fish*

Finfish such as:

catfish
cod
flounder
haddock
halibut
herring
mackerel
pollock
porgy
salmon
sea bass
snapper
swordfish
trout
tuna

Shellfish such as:

clams
crab
crayfish
lobster
mussels
octopus
oysters
scallops
squid (calamari)
shrimp

Canned fish such as:

anchovies
clams
tuna
sardines

*Selection Tips

Choose lean or low-fat meat and poultry. If higher fat choices are made, such as regular ground beef (75 to 80% lean) or chicken with skin, the fat in the product counts as part of the discretionary calorie allowance. Click here for more details on discretionary calories. divider
If solid fat is added in cooking, such as frying chicken in shortening or frying eggs in butter or stick margarine, this also counts as part of the discretionary calorie allowance. Click here for more details on discretionary calories. divider
Select fish rich in omega-3 fatty acids, such as salmon, trout, and herring, more often (See Why is it important to include fish, nuts, and seeds?). divider
Liver and other organ meats are high in cholesterol. Egg yolks are also high in cholesterol, but egg whites are cholesterol-free. divider
Processed meats such as ham, sausage, frankfurters, and luncheon or deli meats have added sodium. Check the ingredient and Nutrition Facts label to help limit sodium intake. Fresh chicken, turkey, and pork that have been enhanced with a salt-containing solution also have added sodium. Check the product label for statements such as “self-basting” or “contains up to __% of __”, which mean that a sodium-containing solution has been added to the product. divider
Sunflower seeds, almonds, and hazelnuts (filberts) are the richest sources of vitamin E in this food group. To help meet vitamin E recommendations, make these your nut and seed choices more often.

Preparing For Birth: 35+ and Pregnant

Wednesday, September 16th, 2009

Hourglass

The disturbing trend in treating ALL  “advanced maternal age”  mothers (over 35 at the time of impending birth) high risk continues to grow despite lack of evidence to do so.

My original post from 3.5 years ago still rings true today.

They are being subject to weekly Biophysical profiles or Fetal Non-stress tests tests that are normally reserved only for high-risk mothers and babies from as early as 32 weeks in pregnancy.  On top of the scans, these mothers are often pressured to agree to an early delivery of their babies by means of labor induction or cesarean even without other risk associations.  This is growing more and more prevalent especially for women over 35 who are first time mothers.

I have heard even from women that at their first OB appointment they are being told they will be induced at 39 weeks as a standard of practice and expectation for signing on with said provider.  The seed of fear and worry is being planted that their growing baby will die if the pregnancy goes to 40 weeks or longer.  What a way to start out a provider/mother relationship.  I would call that a red flag of immense proportion.

So what really is the big deal with “old” mothers?  This study Advanced Maternal Age Morbidity and Mortality correlates various medical issues with “AMA” mothers though the biggest hot button is an elevated yet unknown cause of perinatal death.  This statement alone has caused a huge shift in the way these mothers are viewed regardless of  overall pregnancy health and absence of any known risk associations. ACOG’s February 2009  Managing Stillbirths maintains there is a risk to older mothers with no explanation as to why there is a risk, what the percentage of  risk increase is or any prevention protocols.  Seems dodgy since the other groups noted in the bulletin have all the data included.

There are some serious problems with any practitioner taking this study and applying it across the board to “AMA” women.  The study even says so much, “It is important to note that the findings of this study may not be generalized to every advanced-maternal-age obstetric patient in the United States. Although the FASTER trial patient population was unselected, meaning that patients were not excluded based on any confounding factors such as race, parity, BMI, education, marital status, smoking, pre-existing medical conditions, previous adverse pregnancy outcomes, and use of assisted reproductive care, there may have been significant patient or provider self-selection.” So the population could have been skewed from the get go by provider or patient selection, along with the fact that it seems the only point of homogeneity is present in that most of the women were Caucasian.  Throw all these women in a pot and see what happens?  Next step is to make protocols and change practice style upon weak findings?

The study also shows an increased risk for cesarean by “AMA” mothers.  “As with prior literature, this study demonstrated that women aged 40 years and older are at increased risk for cesarean delivery. Older women may be at increased risk for abnormalities of the course of labor, perhaps secondary to the physiology of aging. It is possible that decreased myometrial efficiency occurs with aging. Nonetheless, maternal age alone may be a factor influencing physician decision making. It is uncertain whether the increased rates of cesarean delivery are due to a real increase in the prevalence of obstetric complications or whether there is a component of iatrogenic intervention secondary to both physician and patient attitudes toward pregnancy in this older patient population.” Very interesting. So “old” women are perceived as being unable or problematic so they have less successful vaginal birth outcomes. Now that is a self-fulfilling practice style with a huge dose of ageism thrown in.  I also wonder what the cesarean rate in this age grouping is going to be due to these protocols.

Let’s get to the perinatal and neonatal death risks.  The study says: “Studies regarding an increased risk for perinatal mortality in women of advanced maternal age have been controversial. In this study, the increased risk of perinatal mortality was not statistically significant for patients aged 35–39 years (adjOR 1.1). Age 40 years and older was associated with a statistically significant increased risk of perinatal loss (adjOR 2.2). There were only 119 stillbirths and 37 neonatal demises in total. As a result, we could not draw any meaningful conclusions about the etiology or timing of perinatal mortality in women of advancing maternal age. The reason that advanced-maternal-age patients may be at increased risk of perinatal mortality is unknown. The failure of uterine vasculature to adapt to the increased hemodynamic demands of pregnancy as women age is a proposed explanation. So in conclusion, we have no idea why this might occur and have no way of counseling “AMA” mothers to lower the risk especially those over 40. Another noteworthy thought is that this study had 79% under 34 year old women, 17% 35-39 year old women, and only 4% women over aged 40.  So with such a small grouping ALL women considered “AMA” are being put under very heavy handed protocols to delivery their babies in the 39th week of gestation.

In closing, I find it difficult to believe that anyone who reads this study would change practice style because of it and move pregnant patients who are otherwise maintaining a healthy pregnancy without risk associations to a high risk model of care. Amazingly the study itself says the same thing, “In summary, the majority of women of advanced maternal age deliver at term without maternal or perinatal adverse outcomes.” And, “The role of routine antenatal surveillance in women aged 40 years and older requires further investigation because these women seem to be at increased risk for perinatal mortality, including stillbirth. Although the likelihood of adverse outcomes increases along with maternal age, patients and obstetric care providers can be reassured that overall maternal and fetal outcomes are favorable in this patient population.”

Couldn’t have said it better myself.

Since the original posting – - – instead of women being told they must be induced in the 39th week they are now being “offered” non-medical, cesareans as a first course of action.  This sort of pressure is not evidence-based or even medically ethical in my opinion.

Preparing For Birth – Common Pregnancy and Childbirth Terms

Tuesday, August 25th, 2009

Below is a compilation of common terms and acronyms that women often will come across during pregnancy, labor, and delivery.  Check back as more will be added from time to time.

  • AROM – Artificial Rupture of Membranes – using a finger or tool to open the amniotic sac to to allow the fluid to release.
  • PROM – Premature Rupture of Membranes – when the amniotic fluids releases before labor starts.
  • SROM – Spontaneous Rupture of Membranes during labor.
  • ROM – Rupture of Membranes
  • Miso – Misoprostol is the pharmacological name for Cytotec a drug used for cervical ripening and induction though a controversial, off and against label used ulcer Medication
  • VBAC – Vaginal Birth After Cesarean
  • HBAC – Home Birth After Cesarean
  • WBAC – Water Birth After Cesarean
  • UBAC – Unattended Birth After Cesarean
  • CBAC – Cesarean Birth After Cesarean – This is a repeat cesarean after a woman desires and tries to have a vaginal birth after cesarean.
  • ERCS – Elective Repeat Cesarean
  • RCS – Repeat Cesarean
  • Natural Birth – Labor and vaginal delivery free from intervention except for intermittent fetal monitoring. In the hospital only a saline lock and intermittent monitoring.
  • Vaginal Birth – Baby born vaginally with or without medication and intervention.
  • First Stage – Early, Active, and Transition. This encompasses the effacement to 100%, dilation to 10 centimeters/complete, position movement of cervix from posterior to forward as contractions begin while staying longer, strong and closer together prior to pushing and delivery.
  • Second Stage – Pushing phase after cervix is completely dilated to delivery of baby.
  • Third Stage – Delivery of baby to delivery of placenta.
  • Fourth Stage – First hours after placenta is delivered.
  • Oxytocin – A hormone made in the brain that plays a role in childbirth and lactation by causing muscles to contract in the uterus (womb) and the mammary glands in the breast. It also plays a role in bonding with mate, child, and socially.
  • Pitocin (oxytocin injection, USP) is a sterile, clear, colorless aqueous solution of synthetic oxytocin, for intravenous infusion or intramuscular injection.
  • Prostaglandin – Any of a group of hormone like fatty acids found throughout the body, esp. in semen, that affect blood pressure, metabolism, body temperature, and other important body processes such as cervical ripening.
  • Uterus -The muscular organ in which a fertilized egg implants and matures through pregnancy. During menstruation, the uterus sheds the inner lining.
  • Cervix -The lower portion of the uterus that provides an opening between the uterus and the vagina. Also known as the neck of the uterus that softens, effaces, dilates and changes position during labor.
  • Vagina – A muscular canal between the uterus and the outside of the body. Also known as the birth canal.
  • Perineum – The area between the anus and the vulva (the labial opening to the vagina).
  • Pelvis -The basin like cavity formed by the ring of bones of the pelvic girdle in the posterior part of the trunk in many vertebrates: in humans, it is formed by the ilium, ischium, pubis, coccyx, and sacrum, supporting the spinal column and resting upon the legs.
  • Pelvic Floor Muscles -The sphincter mechanism of the lower urinary tract, the upper and lower vaginal supports, and the internal and external anal sphincters. It is a network of muscles, ligaments, and other tissues that hold up the pelvic organs.  Includes bladder, rectum, vagina and uterus.
  • Fundus -  Top of the uterus. During labor contractions the fundus thickens and gets more firm as the strength of contractions increase and dilation increases.
  • Placenta -The organ that develops during pregnancy that transports nutrients to the fetus and waste away from the fetus. The placenta is attached to the uterus and is connected to the fetus by the umbilical cord.
  • Umbilical cord – The cord that transports blood, oxygen and nutrients to the baby from the placenta.
  • Bloody Show – Mucous and blood mixed together as dilation and effacement occurs.  Starts off as blood tinged mucous and becomes heavier as labor progresses.
  • Stripping membranes -  Pressing the amniotic sac away from the inside of the cervix.
  • Mucous plug - The mucous that blocks off the non-dilated and non-ripened cervix for protection.
  • Lochia – Post birth bleeding that though a wound site from the placenta detaching from the uterine wall, it mimics a heavy and long menstrual period.
  • Cesarean – Baby born via a surgical incision made through the abdomen into the uterus.
  • Obstetrician – Is the surgical specialty dealing with the care of women and their children during pregnancy, childbirth and the immediate post birth time.
  • Midwife – Is a person usually a woman who is trained to assist women during pregnancy,  during childbirth, and postpartum as well as the newborn post birth.  There are many types of midwives – some work in the home, at birth centers or in the hospital.
  • Doula – Is an assistant who provides various forms of non-medical and non-midwifery support (physical and emotional) in the childbirth process. Based on a particular doula’s training and background, the doula may offer support during prenatal care, during childbirth and/or during the postpartum period. A birth doula provides support during labor. A labor doula may attend a home birth or might attend the laboring at home and continue while in transport and then complete supporting the birth at a hospital or a birth center. A postpartum doula typically begins providing care in the home after the birth. Such care might include cooking for the mother, breastfeeding support, newborn care assistance, errands, light housekeeping, etc. Such care is provided from the day after the birth, providing services through the first six weeks postpartum. In some cases, doula care can last several months or even to a year postpartum – especially in cases when mothers are suffering from postpartum depression, children with special needs require longer care, or there are multiple infants.
  • Birth Center – Free standing location usually run by one or more certified nurse midwife. True birth centers are almost always independently run. They are not overseen by a hospital or in a hospital. May be near a hospital. Often set-up like a home birth space and epidurals or other pain medications are not available.   Hospital “birth centers” are labor and delivery floors not birth centers in the true sense of the term.
  • Intervention – Anything that does not exist in a naturally occuring labor and delivery that is done.
  • Saline Lock/Buffalo Cap/ Hep Lock – Is the apparatus that the IV line hooks into.  It is silicone tubing that is lightweight with a plastic needle that stays under the skin to allow easy vein access.
  • Foley – A foley catheter is used to release the bladder if a woman unable to urinate due to an epidural, post surgery, or with a swollen urethra post birth.  It can also be used for successful cervical ripening in lieu of cytotec.
  • Induction – To attempt to artificially start labor usually by pitocin, artificial rupture of membranes with or without cervical ripening (Cytotec or Foley Catheter).
  • Epidural - A medical method of giving pain relief during labor. A catheter is inserted through the lower back into a space near the spinal cord. Anesthesia is given through this catheter, and results in decreased sensation from the abdomen to the feet.
  • Contraction – Tightening and loosening of your uterus. Productive contractions are often felt at the bottom of the uterus, start out like period cramps and progressively grow stronger, longer in length, and closer together.
  • Braxton-Hicks – Practice contractions that do not dilate or efface the cervix often felt at the top of the uterus versus the bottom.
  • Episiotomy – A surgical procedure to widen the outlet of the birth canal to facilitate delivery of the baby and avoid a jagged rip of the perineum. (Natural abrading or tearing is preferred and episiotomies are not evidence-based to be used except under specific circumstances).
  • Ina May’s Sphincter Law -Tapping into the concept that if one sphincter is open and relaxed, the others will also open, relax and be able to handle, quite adequately, the task at hand. This also includes the aspect of birth requiring privacy, sacredness, and honor as well so a woman feels safe, unwatched and supported.
  • Kegel Exercises – Named after Dr. Arnold Kegel, consists of contracting and relaxing the muscles that form part of the pelvic floor (sometimes called the “Kegel muscles”).

Morning Sickness and Nausea Tips

Friday, August 14th, 2009

Nausea is such a common complaint among pregnant women.  Usually the extreme nausea passes by the time a woman enters the second to mid-second trimester, however, some women experience it throughout pregnancy.

Though no solution is full proof, there are some things that can be done to aide in a calmer digestive system.  Remember that food aversions or smell aversions are normal.

  • Eat regularly and frequently though smaller meals
  • Use peppermint in the form of tea, essential oil, or candy such as Altoids
  • Use ginger in the form of ale, tea, raw pieces, candy, or essential oil
  • Have a honey stick or other quick sugar (a few jelly beans) prior to getting out of bed in the morning to abate low blood sugar from not eating for many hours
  • Stay hydrated with non-caffeinated beverages
  • Take prenatal vitamins with food or in the evening. Another options is to switch to a liquid or whole food vitamin which absorbs more readily and less likely to be irritating.
  • Limit coffee intake
  • Drink herbal tea (read labels some are not encouraged during pregnancy
  • Eat yogurt and take probiotics to ensure a healthy digestive system
  • Take digestive enzymes
  • Wear a sea sickness acupressure band
  • Seek out an acupuncturist for treatment
  • Seek out an herbalist or naturopath for treatment
  • If nausea or vomiting is severe or extreme, consult with your care provider as you may have a more serious form of morning sickness (hyperemesis gravidium) which requires a special course of treatment.

Here is to gestating in peace and digestive harmony.

What is a labor doula? What does she (or he) do?

Sunday, August 9th, 2009

Women have supported women throughout the ages.  In our very busy and ever transient culture, the woman to woman education and support of yesteryear is sorely lacking.  It is very common for an expecting woman not have family nearby or to have support women who know the ways of natural, normal pregnancy, labor, delivery and immediate postpartum. The labor doula was born out of this need.  Essentially this is a woman of knowledge and skill in pregnancy, birth, and immediate postpartum (yes there are a few men in who are labor doulas as well) who comes alongside a pregnant woman (family) offering education, physical support and emotional support to both the mother and partner/husband/other support.

Below is a detailed description of what a doula is and does according to CAPPA a wonderful organization that trains a variety of doulas and other birth professionals.

What is a Labor Doula?

A doula is a person who attends the birthing family before, during, and just after the birth of the baby. The certified doula is trained to deliver emotional support from home to hospital, ease the transition into the hospital environment, and be there through changing hospital shifts and alternating provider schedules. The doula serves as an advocate, labor coach, and information source to give the mother and her partner the added comfort of additional support throughout the entire labor. There are a variety of titles used by women offering these kinds of services such as “birth assistant,” “labor support specialist” and “doula”.

What Does a Doula Do?

The following is a general description of what you might expect from a CAPPA certified labor doula. Typically, doulas meet with the parents in the second or third trimester of the pregnancy to get acquainted and to learn about prior birth experiences and the history of this pregnancy. She may help you develop a birth plan, teach relaxation, visualization, and breathing skills useful for labor. Most importantly, the doula will provide comfort, support, and information about birth options.

A doula can help the woman to determine prelabor from true labor and early labor from active labor. At a point determined by the woman in labor, the doula will come to her and assist her by:

  • Helping her to rest and relax
  • Providing support for the woman’s partner
  • Encouraging nutrition and fluids in early labor
  • Assisting her in using a variety of helpful positions and comfort measures
  • Constantly focus on the comfort of both the woman and her partner
  • Helping the environment to be one in which the woman feels secure and confident
  • Providing her with information on birth options

A doula works cooperatively with the health care team. In the event of a complication, a doula can be a great help in understanding what is happening and what options the family may have. The doula may also help with the initial breastfeeding and in preserving the privacy of the new family during the first hour after birth.

What does a doula cost? This can be a huge spectrum and is defined by where you live.  A labor doula may volunteer, work for barter, or basics like gas reimbursement, childcare coverage, snacks, etc.  I have heard of fees from $100 to $1800 (mind you this is in NYC).  On average I would say a labor doula costs $250-$600 in many areas.   Call around or visit websites in your area to get a firm idea.

What about insurance? Private doulas usually do not bill insurance though many will give a super bill to be submitted for reimbursement by insurance.  many insurance companies after some effort will pay a portion of the fee as an out of network provider.

Will a doula provide my complete childbirth education? Sometimes.  Often not.  Some doulas are educators. I provide classes separately from doula services. The labor doula will often fill in the blanks and personalize the education the client already has.  Many doulas have lending libraries or recommended reading and watching lists.

If I am going to a birth center or having a homebirth will a doula still benefit me? Yes in both cases.  When going to a birth center a doula would labor at home then arrive at the birth center at the same time as the laboring mother just as with a hospital birth.  In a homebirth scenario the doula who is not a midwife and does no medical tasks is often a welcome extra set of hands and does the same emotional and physical support as she would do in any other location.

Does evidence support that having a doula in attendance has benefits? YES. Here are some of the benefits. Lowered epidural, narcotic, induction, cesarean, and instrumental delivery rates. Increased satisfaction, breastfeeding, and bonding.  Also shorter labors!

For more information, email me at desirre@prepforbirth.com.

Rise and Shine Birth Thoughts

Sunday, July 12th, 2009

Normal, natural birth is spoken of all the time in the birth world.  It is discussed on many levels from the evidence of being overwhelmingly the safest and healthiest way to birth, to the emotional aspects of privacy, safety and support,  to following the money trail of interventive birth versus natural birth and so much more in between.

I ponder and sometimes struggle with what to share with expecting families and  how to share it.  Why the struggle?  This normal, natural birth viewpoint is counter-cultural.  I, along with many peers believe in the inherent design of women and babies to work as intended.  There is lack of belief in routine intervention, non-evidence based protocols or practice style that is created around pregnancy and birth being a tragedy in waiting.

Even in trepidation, the truths must be shared and not hidden simply because most of what is seen and heard in our culture is the opposite (think as an example of the media and the dramatic voice over person on those birthing shows).  The longer I am in this field and calling of work, I believe that protecting women from the truth for whatever reason is harmful.  I participated in a Henci Goer session several years ago at a conference that set this ideal permanently within me.  She asked many questions for the participants to answer.  One question was regarding telling options to expecting families even if they are not available locally – should you or shouldn’t you?  I stood for quite a time in front of the large paper on the wall while holding the marker in my hand.  There were many NO’s on the paper in front of me and it took some courage for me to write a commanding YES! next to their responses. I had bucked the trend.  Not easy, not a bit. When all the sheets were gathered and Henci peered at them to discuss all of the responses, she overwhelmingly said we have an ethical obligation to tell it all.  Phew I was not wrong in my group of peers, but sadly most of them said no probably out of the same fear as I had in answering the questions.  That moment gave me great strength and clarity not because Henci said so, rather because I stood in my conviction and faced the fear of being apart from others in the truth.

Why is it of the utmost importance to share all?  Because no one else goes home or remains home with that baby.  The care provider, staff, doula, educator….they all go home to their own lives.  Each expecting family must be able to live with the decisions made during pregnancy, labor, and birth.  Natural birth has many benefits but it isn’t consequence or risk free, so that too must be spoken of.  Each woman must decide what she needs and can best live with as a mother, wife, partner, even as a woman in her community who will go out and share her experiences with others.

I will often tell expecting families who contact me about childbirth education classes that they will receive much more than the anatomy, physiology, comfort measures, etc. from my course.  That very likely it will challenge to the core their beliefs and value systems surrounding what they know in their own birth culture of family, friends and personal history.

I love this work.  I hope someday to be replaced by the community based education women ought get back to. If not, I along with many others will be here to keep the conversation and education moving forward.

Childbirth Preparation: Prenatal Ponderings

Thursday, April 17th, 2008

Today pregnant women need to be consumers and self-advocates. Many childbirth classes are teaching strategies to better these skills. This is not by chance, but rather by the often one-size-fits all packaging and management from pregnancy onset to labor through immediate postpartum in the care provider offices and hospitals of today.

Many routine tests are done prenatally. Though prenatal care and these tests can help further healthy outcomes for moms and babies, too often women can be funnelled into a cycle of unnecessary fear, stress and choice limitation while in reality still healthy and maintaining normal pregnancy.

Below is a listing of common prenatal tests and practices for you to question (what is it for, what does it improve upon, what can it lead to in other tests or interventions, is it for low-risk moms and babies, what will I do with the information), research and decide on are:

  • pregnancy test by urine dip or blood work
  • ultrasound to date the pregnancy
  • blood pressure reading each visit
  • weight measure each visit
  • urine test – check for protein in the urine
  • fundal height measurement as pregnancy furthers
  • gestational diabetes testing
  • triple screen testing (AFP)
  • just because ultrasounds
  • ultrasound for fetal size
  • routine ultrasound for fluid level as “due date” approaches
  • biophysical profile(s) as “due date” approaches or passes
  • membrane sweeping

It is vitally important that you are equipped and aware of your care provider’s philosophy and usual practices.

What are you willing to do? What are you willing to bypass? How responsible for your pregnancy and birth are you willing to assume? At the end of the day you are ultimately the one who has to live with the choices you or your provider make.

Be a driver – you are more likely to arrive at the destination you desire.

Upcoming Childbirth Classes, Trainings, and Childbirth Tips

Thursday, April 17th, 2008

Visit http://www.birthingtouch.com/ for upcoming childbirth classes serving the Colorado Springs area and for CAPPA childbirth educator trainings in Colorado, Missouri, and Utah.

  • Proper support is important for childbirth – builds confidence in mom, builds safety in mom, lowers complications, interventions, medications and cesareans.
  • Induction is only for medical reasons – big baby, past “due date”, tired of being pregnant, care provider preference, upcoming holidays… all put mom and baby at risk for complications, interventions and cesarean.
  • Cesarean only for medical reasons – cord prolapse, placenta previa, pre-eclampsia or HELLP syndrome where induction fails, true fetal distress, some breech positions, placental abruption, uterine rupture (there are other less common reasons as well – notice previous cesarean, non-medical reason, large baby, gestational diabetes, obesity, convenience are not on the list)
  • Unrestricted movement in labor –
  • Pushing in gravity prone positions – only use reclined or lithotomy of mom desires it.
  • No separation of mom and baby unless there is a complication.
  • Drinking and eating in labor – the uterus is a muscle it needs to be watered and fed.
  • Intermittent monitoring of mom and baby – only high risk moms and babies need continuous monitoring.
  • No routine medications or interventions – pain management should not be pushed on a mother, episiotomies should not be routine, augmentation of labor should only be done AFTER non-medical methods are tried and patience is used, naturally occurring rupture of membranes, etc.
  • Unrestricted breastfeeding access.
  • Informed consent and refusal need to be utilized.

Check out http://www.cappa.net/, http://www.independentchildbirth.com/, http://www.lamaze.org/ for resources outside of Colorado Springs, CO (classes, doulas, other related professionals).



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