In Case of Emergency, Bear Down and Push!

So what on earth am I talking about with that title? Well, pretty much exactly what I said.

There have been many times I've heard a woman talk about her "emergency" birth story. Labor progressed quickly (she may be home or she may already be in the hospital) and she feels pushy. Let's say she's at home and on the phone with a 911 dispatcher (or her spouse/friend/kid/dog/etc is) and she feels an overwhelming urge to push. But alas, she is told to FIGHT against her body's natural desire and force to prevent the baby from being born until help arrives. Let's say the woman was in the hospital and the doctor isn't there, but of course he will be soon, so she's told by her nurses to resist the urge to push.

Now, I've felt that urge to push, in fact, I've been that woman at home in full blown labor ready to have a baby and I can tell you if you don't know for yourself, there is NO way you're going to fight that urge. It doesn't do you any good, anyway. If the urge to push has come, your body will literally birth the baby without your help. So you can push to help it or let it happen on it's own...either way, you're havin' a baby!

So for the rest of this blog I am not speaking as a homebirth or out of hospital birth advocate. I am speaking solely for the purpose of educating on "emergency birth", that is birth outside of how it was planned to take place.

I'm not naive, so I know that 3% of US women are choosing to birth with midwives and only 1% are choosing to birth at home. That being said, EVERY woman should be prepared for an unassisted home birth. I repeat: EVERY WOMAN SHOULD BE PREPARED FOR AN UNASSISTED HOME BIRTH.

Why?

Well, because you NEVER know what's going to happen. You need to trust that birth truly IS normal and that it is very rare that complications arrive especially when the process is left to happen naturally. It may be your second or third baby and labor just progresses quicker than expected or perhaps you handle your contractions very well and don't realize you're truly that close to birthing. Whatever the reason, you're now at home and about to have a baby. Quick, what do you do?

First, you RELAX and calm down and trust in this process.

Second, you let your support person and doctor/midwife/witch doctor know that you are in full blown labor and baby will be coming where you're at.

Third, get COMFORTABLE. Listen to your body, what does it want? Should you be squatting with support? Or is laying on your side more comfortable? Listen and do that.

Next, breathe through your contractions and push when your body tells you to push. If you have a partner there, have them get you some sheets or towels for the birth mess. Don't be afraid if your water hasn't broken, most bags of water don't break until the pushing phase. The towels will help to keep this mess under control. If fluid is clear: awesome. If meconium is present, that's ok. If the baby happens to aspirate the meconium, they can be suctioned. Many hospitals/midwives/birth centers are no longer suctioning for meconium unless they know the baby has swallowed some. So, you're still good to go.

*Do not have your support at any time check you for dilation*

As you and your body are pushing together, have your partner prepare to catch the baby. If you don't have someone there, try to get in a position so that you can gently welcome baby to this world. Don't pull the baby out, continue to push with your body. It may help to take a little rest after the head is birthed before you push the baby the rest of the way out. If you notice the cord around the baby's neck, don't be alarmed. Nuchal cords are present in 1 in every 3-4 births, wrapped at least once. This is not an emergency but rather another variation of normal. If you're able, simply loosen the cord and slip it off the baby's neck, then push to deliver the body.

You may notice that when your baby is first born, they are gray or bluish in color. Don't be alarmed. When your baby passes through the birth canal, up to half of their blood volume is pushed back up in to the placenta. As long as the cord is thick and pulsating, they are receiving nutrients and oxygen from the placenta. There is no need to clamp or tie off the cord. Many people let the cord finish pulsing on it's own so the baby gets vital blood that was lost back to the placenta, this helps reduce jaundice and other complications in newborn babies. As your baby's blood begins to circulate, they will "pink up", you can rub them to help get the blood moving, and skin to skin contact is vital to keep them warm.

If able, bring the baby skin to skin and begin nursing. Nursing immediately after birth will help with any post partum bleeding and can reduce hemorrhaging. If you notice that your baby's umbilical cord is short and they cannot reach your chest, hold them lower on your abdomen, DO NOT tug on the cord. The placenta can stay attached to the uterine lining for 30-60 minutes, so let the after contractions do their work and release the placenta. You may push it out when you feel the need, if help hasn't arrived yet.

In the event that the cord was short and your baby appears hungry or you feel the need to nurse immediately, try to push. It's not in your best interest to cut the cord without sterile scissors, as you don't want to risk an infection to the baby. If your placenta is not coming out, just be patient and wait for help. Don't attempt to tug on the cord and manually remove the placenta. Bend down/over to nurse if you need to.

If the cord was long enough for baby to be brought to breast, keep nursing until your help arrives or you're able to birth the placenta. Keep baby, cord and placenta intact without properly sterilized scissors.

That's pretty much it, you've had a baby. Congratulations.

Regardless of where you plan to birth or who you plan to attend you during that momentous occasion, it is wise to be prepared for anything and to know what is truly required, and what else is not. The easiest thing to remember in an emergency birth situation like this, is that less is more. Hopefully all of you get the births you're planning, but for those who end up in a situation that's, to them, less than ideal, be well informed.

Homebirth Babble

Most recentlyGisele Bundchen's home birth of her son in December has been a topic of discussion. But there have been many other celebrities who've birthed at home. This is of course good for the homebirth awareness cause, but myself and some others wonder if this makes the anti-homebirth group cry "Trend!" in regards to women choosing to birth at home. Obviously, there's hardly anything trendy about the way women have been birthing since the dawn of time. However, since the big push to move birth from home to hospital and replace midwives with OBs it seems that anyone who has a natural birth even in the hospital is "primal and crazy".

If you've ever been around a group of women discussing birth, you've probably noticed a similar trend. Stories told with a life threatening complication and drama, how they had to endure this and the doctor had to do that and it was an awful horrible experience...but it was all worth it to have a healthy baby. You may have been one of these women, I know I was. I told my first birth story with excitement and enthusiasm but it wasn't that of a happy or calm birth, it was that of peril and fear; of internal monitoring and the "need" for an episiotomy that's left me forever scarred (literally and figuratively).

Now, if you've been lucky enough to talk to a group of homebirth (or even natural birthing) women, the stories are much different. They have that same excited tone and dramatic arm movements, but yet, there's a calm and tranquil quality to the woman who experienced birth in her own home. Even if a "complication" arose, they usually include how their midwife simply did X, Y or Z and the rest went smoothly.

I would love to hear these celebrity accounts of homebirth, straight from their mouths. After all, drama is their JOB, so I can only imagine how intriguing these stories are. I do hope to continue to see many more celebrities choose homebirth, and I'd love to hear more public speeches on their experiences. I also hope that the anti-homebirth movement stops claiming that homebirthing is a "trendy, new-age" idea simply because in the last CENTURY birth was taken from home.

I'd also love to hear YOUR thoughts on celebrities, homebirth and the idea of the supposed trend. What are your thoughts on it all?

The Importance of Nutrition in Pregnancy

I wanted to share an article on Nutrition in Pregnancy. We all have cravings during pregnancy and it's certainly not harmful to indulge occasionally, but it seems many care providers really aren't giving women the real deal on just how important eating healthy in pregnancy is. Enjoy the article below from an older issue of Midwifery Today.

Nutrition during Pregnancy
by Amy V. Haas

© 1995 Midwifery Today, Inc. All rights reserved.

[Editor's Note: This article first appeared in Having a Baby Today Issue 5, Spring 1995.]
Photos by Jennifer Rosenberg

The single most important thing that you can do for your baby is to eat a healthy, well-balanced diet. A well-balanced diet is one that includes foods from all food groups in appropriate amounts, so as to ensure proper nutrition. Proper nutrition ensures that all essential nutrients (carbohydrates, fats, protein, vitamins, minerals and water) are supplied to the body to maintain optimal health and well-being. Good nutrition is essential for normal organ development and functioning; normal reproduction, growth and maintenance; for optimum activity level and working efficiency; for resistance to infection and disease; and for the ability to repair bodily damage or injury. While pregnancy is a normal alternative condition for the female body, it is stressful, and all nutritional needs are increased in order to meet the needs of the pregnancy.

Dr. Tom Brewer found through more than 30 years of research that each day, pregnant women need a well-balanced, high-quality diet that includes 80 to 100 grams of protein, adequate salt (to taste), and water (to thirst), as well as calories from all of the food groups. The World Health Organization recommends that a pregnant woman eat a minimum of 75 grams of protein per day, but protein is just a marker for a nutritious diet. It must be obtained from a wide variety of whole food sources in order to get all of the important nutrients a woman needs during pregnancy. While the government's food pyramid is a good example of a well-balanced diet, pregnant women need more protein and calories in general.

This means including:

• 2 to 3 servings of meat, fish, nuts or legumes, and tofu
• 2 to 3 servings of dairy (milk, eggs, yogurt, cheese)
• 2 servings of green vegetables; 1 serving of a yellow vegetable
• 3 servings of fruit
• 3 servings of whole grain breads, cereals, or other high-complex carbohydrates
• salt to taste
• 6 to 8 glasses of clean, filtered water each day.

While this may seem like a lot of food, it will supply the 2000 to 3000 calories needed per day to make a healthy baby.

A study conducted at Harvard University found that by eating at least 75 grams of protein per day, pregnant women could prevent diseases of pregnancy such as preeclampsia (metabolic toxemia of late pregnancy). During pregnancy a woman's blood volume increases as much as 40 to 60 percent, and in order to reach this necessary level and maintain it, a woman's body needs adequate protein, salt, calcium, potassium and water from her diet. In April of 1996 the Journal of the American Medical Association published an article indicating that calcium may also help reduce the incidence of preeclampsia. Other recent research indicates that pregnant women need adequate folic acid (a B vitamin) to prevent neural tube birth defects such as spina bifida. The Food and Drug Administration now recommends that breads and pastas be fortified with folic acid to ensure that all women of childbearing age get enough of it. Four hundred micrograms of folic acid a day is recommended. This can be obtained by eating whole grain breads, citrus fruits and dark green leafy vegetables.

As long as junk food and excessive sweets (sugar) are avoided, or kept to a minimum, weight gain should not be an issue. The diet listed above (or something similar) should provide all of the necessary nutrients, and a woman should have little problem obtaining everything she needs. A "whole food" is one that is unprocessed and is as close to its natural state as possible. While vitamin supplements are very popular these days, there are risks to taking supplements of certain vitamins while pregnant (i.e., vitamin A), and others are simply poorly assimilated (i.e., calcium or iron). The B vitamins, for example, must be taken in congress (B complex supplement), as absences, insufficiencies or excesses of one or another can cause problems. Check with your care provider before taking anything while pregnant. Vitamins and minerals should be obtained from natural, whole sources whenever possible, to ensure quality and proper assimilation by the body. A qualified nutritional expert should assess special dietary needs.

Cravings for foods are common in pregnancy and, in theory, can indicate a need or deficit in a diet. Cravings for healthy foods can be indulged, but cravings for non-food substances such as clay or laundry starch, a condition known as "pica," can be harmful and should be reported to your care provider.

Milk, eggs and other dairy products are inexpensive sources of calcium and protein. For those who are vegetarian, or simply to provide variety in an omnivorous diet, soy products, beans and nuts can be substituted. Dark green vegetables provide carbohydrates, water, bulk fiber, vitamins A, C, and B, calcium, iron, and magnesium; the darker green, the better. It is best to eat these vegetables raw whenever possible, but steaming or baking will also retain most of the nutrients. Citrus and berry fruits provide a great deal of vitamin C, and yellow fruits and vegetables such as cantaloupe, sweet potato, carrots and mango are good sources of vitamin A. Both of these vitamins are important for fighting infection, boosting the immune system, cell structure development and preventing placental detachment (abruption). Zinc is another important mineral for pregnant women, as it aids in supporting the immune system. According to the Journal of the American Medical Association, zinc also helps to improve birth weight and certain aspects of fetal development.

While a vegetarian diet is a good, healthy choice when well balanced, vegetarians do have to work harder to obtain all the protein needed to increase their blood supply. If a woman follows a strict vegan diet, it may be even more difficult to get the necessary protein, but it is possible with diligence. See the supplemental reading list for sources of information on this subject.

Good Sources

Protein: chicken, fish, beef, pork, turkey, tofu, nuts, legumes (beans), milk, eggs, cottage cheese, whole grains, wheat gluten, soy cheese

Whole grains: brown rice, kasha (buckwheat groats), whole oats, whole wheat bread, whole grain cereals, quinoa, wild rice, wheat gluten, wheat germ, whole wheat pastas

Fruits: strawberries, kiwi fruit, apples, oranges, bananas, mangos, cantaloupe, pears, grapefruit, plums, nectarines, and peaches

Green vegetables: spinach, broccoli, zucchini, dark green lettuces, kale, Swiss chard, green beans, asparagus, arugula, lambs lettuce

Dairy: milk, yogurt, hard cheese, cottage cheese, egg

Other good whole foods: baked potatoes, sweet potatoes, carrots, squash, green peas, soy products, corn

Iron: red meats, organ meats, eggs, fish poultry, blackstrap molasses, cherry juice, green leafy vegetables, dried fruits (raisins, apricots, etc.)

Zinc: pumpkin seeds, squash seeds, sunflower seeds, seafood, organ meats, mushrooms, brewer's yeast, soybeans, eggs, wheat germ, meats, turkey

Folic acid: spinach, asparagus, turnip greens, Brussels sprouts, lima beans, soybeans, organ meats, brewer's yeast, root vegetables, whole grains, wheat germ, bulger wheat, kidney beans, white beans, salmon, orange juice, avocado, milk

Trained and certified as a Bradley® Method Childbirth Educator in 1995, Amy Haas' educational history includes a Bachelor of Arts in Sociology from Plattsburgh State University of New York. For the past six years she has taught Bradley® classes to pregnant families, empowering them to make healthful decisions. Amy's article, "How to Stay Healthy and Low Risk during Pregnancy and Birth" appeared in the Winter 2001 issue of Having a Baby Today. The original version of this article was shared through The Rochester Birth Network.

Sources:

• Dunne, Lavon J., ed. 1990. The Nutrition Almanac. 3rd ed. New York: Nutrition Search, Inc., McGraw-Hill Publishing.
• Brewer, Gail Sforza and Tom Brewer. 1985. What Every Pregnant Woman Should Know: The Truth about Diet and Drugs in Pregnancy. New York: Penguin Books.
• Frye, Anne. 1993. Understanding Diagnostic Testing in the Childbearing Year. 5th ed. Portland, OR: Labrys Press.
• Frye, Anne. 1995 Summer. Unraveling Toxemia. Midwifery Today 34: 22–24.
• Frye, Anne. 1995. Holistic Midwifery, Vol. 1. Portland, OR: Labrys Press.
• American Medical Association. 1996 Apr 10. JAMA. 275(14).
• American Medical Association. 1995 Aug 9. JAMA. 274(6).

Other Recommended Reading:

• The Brewer Pregnancy Hotline by Gail Sforza Krebs and Dr. Tom Brewer (http://ebooks.kalico.net/)
• Pregnancy, Children, and the Vegan Diet, by Michael Klaper, MD
• Diet for a Small Planet, by Frances Moore Lappé
• The Birth Book, by William Sears, MD, and Martha Sears, RN
• The Pregnancy Book, by William Sears, MD, Martha Sears, RN, and Linda Holt, MD

http://www.midwiferytoday.com/articles/nutritionpreg.asp

ttp://www.blueribbonbaby.org/

http://www.blueribbonbaby.org/mainindex.shtml

2 pending homebirths

I haven't posted in a log time and I was planning, at one point, to blog about why but I've decided to just let it go.

So to bring everyone up to speed I have recently started a new adventure in the world of pregnancy and post birth working at a very popular Maternity clothing store part time. It's been very fun and fulfilling to help these women, some only weeks along in their first pregnancy.

Some clients are such regulars that I know them on a first name basis, others are one time shoppers getting a few basic things but I try to make the most out of each interaction. I've shared much breastfeeding advice and had to bite my tongue other times at things I've heard (or seen!). But all in all, I am so happy to work there, it's very good for me.

In other news, my best friend is pregnant with a baby boy and planning a homebirth. She had twin girls her first pregnancy 4 and a half years ago and had the typical hospital experience: helped along with pit, epidural, purple pushing, etc. She *did* have them vaginally which I think she's always felt was a blessing. So obviously, this is a whole new territory for her and I get to be there with her to experience it. I have yet to meet her midwife but she seems like a very sweet and smart woman. I cannot wait for this birth sometime between mid march and mid april.

There's another woman I know planning a homebirth with her second baby, a surprise package due at the end of February. She was looking for birth support through an online forum we both frequent and after meeting, we both clicked. I plan on photographing her birth as well as offering any support she may need. She's also in the care of an excellent and kind midwife.

I'm so looking forward to these experiences and feel giddy as a school girl! It seems like it's been so long since I've been around fresh new babies and even longer since I've gotten to experience this miracle with another mother.

I will continue to update on the these two births as time draws near!