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Published on April 12, 2014, by in Parenting.

The thing about babies is, they cry.

Sometimes it’s an easy fix: He’s hungry. She wants a fresh diaper. He’s tired. She’s overstimulated, too warm, too cold. But sometimes all these needs are met, and baby is still crying. For new parents figuring things out as they go – often on very little sleep – this can be frustrating indeed. In time you will learn your baby’s unique cues and get to be very good at determining how to respond, and in time your baby will get better at telling you. But in the meantime, I want to share with you the magic of the “5 S’s,” which got me through one newborn stage with my sanity and are now carrying me through another.

Recommended by such names as Dr. Phil and Harvey Karp, author of Happiest Baby on the Block, the 5 S’s are helpful techniques for parents to know.

My first little one, happy in his swaddle wrap!

Suck: Infants are hungry more often than not, so it’s always a good idea to offer a fussy baby the breast or bottle as a first step. But even if she’s not hungry, your baby might find great comfort in sucking, so offering a clean finger or pacifier can help her relax and calm down. What you should know about using a pacifier.

Swaddle: Swaddling can soothe your baby by providing him with the secure feeling he enjoyed in the womb before birth. His arms will be tucked in, preventing the startle reflex, which can restart the cycle of crying and fussing. (Some babies prefer not to be swaddled; in this case try substituting Skin to Skin time in which your warmth and heartbeat perform wonders to settle your baby.)

Side or Stomach: Newborns seem to feel more content on their side or tummy, and this position can also help to soothe a gassy tummy. Always hold your baby in this position (she should be placed on her back for sleeping).

Shush: Contrary to popular belief, newborns don’t need silence. In utero your baby has enjoyed constant white noise from mom’s blood flow. Simply say “shhh” into your baby’s ear at around the same volume that he is crying. As he quiets, so do you. You can also add a noise machine or cd of white noises to play as your baby falls asleep. We love our Sleep Sheep!

Swing: Before birth, your baby was often rocked and jiggled in utero. That makes this motion comforting to her now. Support your baby’s head and gently jiggle (do not shake) her, moving no more than an inch in any direction. My babies love the motion of posting (a horseback riding motion I’ve adapted to do on the ground with babe in arms)!

Harvey Karp suggests that the most success will come from employing all 5 techniques at once, but play around with them and find what works best for your baby. My son preferred to be up by my shoulder while I bounced and tapped his bum, while my daughter loves the “shh”ing noise combined with cradling her on her side in my arms and swinging… and bouncing… while walking….. Of course, the winning order/combination could change from hour to hour, but having these go-to soothing tools can make all the difference for you and your little one.

 
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So this blog was intended to be written during the last days of my second pregnancy; the last days of my first baby’s life as an only child. The words were to be products of my musing on what this child would be like, addressing my fears about dividing my motherly attentions, a way to meet all the conflicting emotions of joy and apprehension over this change head on.

But we never got to that. Sweet baby girl arrived on the very first day of what I considered my “due month,” forcing me to stop overthinking it and just dive in. And I must say, I think this little munchkin was onto something.

I’m told that it’s par for the course – “The second child is a bigger adjustment than the first.” But that didn’t stop me from feeling like a bad mama. I already felt like I was choosing sides.

One moment I’d be feeling guilty for bringing an “intruder” into the special private relationship I’d developed with my toddler. Was it too soon? Was he too young to share his mama? How could I possibly be the parent I’d been thus far when there was another child in the picture? Oh my, what had I done? Cue the floodgates.

And then in the next heartbeat a new wave of guilt would wash over me – oh this poor tiny baby developing in my womb! How unfair of me to see her in this light. She was innocent and needed me, depended on me. I should be nurturing our connection as we shared my body, feeling nothing but excitement over her pending arrival. That’s what I gave her big brother – I needed to be fair! What if I didn’t love her when she arrived? And fresh tears.

I did rein in the pregnancy hormones and find a peace with both worries…. somewhat…. before baby 2 emerged. But then here she was and – guess what? It all melted away. Just like I had known, deep down, that it would. I fell in love instantly. So did her big brother. And I’ve fallen in love with him all over again, seeing him in his new role. (Don’t get me wrong – we’ve had our low moments, all three of us crying when I couldn’t meet everybody’s needs at once. But those moments are infrequent, and we’ve survived them.)

My experience of becoming a new mom…… again…… is at once uniquely personal and a common shared experience among many mothers. I was lucky to have the chance to cry with another mom over the “loss” of our one to one relationships with our dear first children. It was incredibly validating and healing. And so I’m putting these words out there for all of you, in hopes that they may help shoulder you through some of the overwhelming and contradicting feelings that come with this change.

There is nothing like the feeling of becoming a mother. Except the feeling of becoming a mother again.

 
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If your practitioner is recommending induction, it is important for you to know the facts before moving ahead with anything. Always ask for the reasoning behind the suggestion – why is this being recommended?

 

WHEN SHOULD LABOR BE INDUCED?

There are situations in which induction is medically necessary, typically when either the mother or baby’s health is in danger. Sometimes in these cases getting the baby out as quickly as possible is the best way to ensure the health of both. These situations may include:

  • Preeclampsia
  • Cholestasis (liver issues)
  • Fetal distress (i.e. lack of movement, heart rate decels)
  • Other immediate concern with health of mother and/or baby

 

WHEN IS INDUCTION UNECCESSARY?

The following are common reasons cited for induction. While not medically necessary, the reasons behind these situations may be presented by providers in a way that makes not inducing sound scary, or even irresponsible. Be informed and trust your instinct.

 

Reached or Passed the Due Date

This is the most common reason given for induction, but in and of itself is not a medical reason to induce labor. To begin with, many due dates are inaccurate. Women have varying cycle lengths, which can influence a due date by up to a week. Also, some babies take longer to grow and develop than others do.  Families can feel confident waiting as long as mama is feeling well, does not have high blood pressure, does not have glucose or protein in her urine, does not have any (or minimal) swelling in her legs, and the baby is active with a strong heart rate. All of these factors can be confirmed during a simple office visit. As a woman reaches 42 weeks and beyond, non-stress tests and ultrasounds can ensure that the placenta and amount of amniotic fluid are still sufficient to support baby.

This may be a valid reason when: Mother has high blood pressure, glucose or protein in urine, or significant swelling in her legs, which may indicate a health concern such as preeclampsia, gestational diabetes, or a kidney issue; or baby is inactive or shows heart rate decelerations.

For accounts from families who birthed past 42 weeks: https://www.facebook.com/TenMonthMamas

Large Baby Suspected

Ultrasounds and other measurements of baby’s size prior to birth are accurate to about 2 pounds. Which is to say, not all that accurate. Consider a measurement predicting a 10-pound baby… which may in reality be an 8-pound baby. That said, in a healthy mother bigger babies are not necessarily harder to deliver. When labor begins naturally, a woman’s body goes through some final changes that allow her ligaments to relax more. This as well as birthing positions can enable her to stretch and open to deliver her baby. With an induction, women do not have the benefit of these extra hormones and often end up in less helpful birthing positions.

This may be a valid reason when: Mother also has gestational diabetes, which slightly increases the chances of shoulder dystocia, preeclampsia, and newborn jaundice.

For more info: http://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

 

Previous C-Section 

Sometimes women who are trying for a VBAC (Vaginal Birth After Cesearean) are told that they should be induced on the grounds that they will therefore be monitored during their labor and a problem requiring a repeat C-section can be immediately noticed.  However, the use of Pitocin in women with a previous c-section actually increases the likelihood of uterine rupture!  Induction should be skipped if at all possible to increase the likelihood of a successful VBAC.

For more info on VBACS: VBAC Resources

 

Tired of Being Pregnant

If you’ve been pregnant, you’ve been tired of being pregnant. There is often much physical discomfort in the last weeks of pregnancy, and some practitioners will offer the option of induction as relief for the mother. But as long as these discomforts are at normal levels for pregnancy, induction is not the best solution. There are countless benefits to waiting for labor to begin naturally. Instead the mother may seek relief from sources such as chiropractic care, massage, rest, warm baths, etc. The waiting can be hard on women emotionally as well; a mother can seek comfort in talking with other moms, take on a project to occupy her mind, write in a pregnancy journal, practice meditation, etc.

This may be a valid reason when: Discomfort is extreme and therefore possibly indicative of a health problem.

 Benefits of spontaneous labor: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1948087/

 

Convenience (Provider or Personal)

Impending holidays, visiting relatives, leave time from work, school schedules, etc. – all of these have been cited as reasons for elective inductions at one time or another. Parents must always weigh the risks and benefits of their choices for both themselves and their baby. In the absence of a medical reason, the risks of an induction tend to heavily outweigh the benefits.

 

Stay tuned for the next blog post, coming soon:

MEDICAL INDUCTION METHODS: How each one works, its risks, and what kind of experience to expect

 
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Have you done your math? Moms nearing their due dates sure have.

 

An extra 25 pounds on the scale.

5 pillows propping various body parts in bed.

Having to pee every 10 minutes.

Adding 1 cup size. Make that 2.

 

But fitting 40 weeks into 9 months of pregnancy… it just doesn’t add up. Not to mention about 80% of first-time mamas deliver post date. If only someone told us to expect a 10 month commitment, that last stretch might feel a little more manageable.

 

So here are our moms, bumping into everything with their protruding bellies, waddling around on swollen feet, sleep interrupted despite all those pillows. Not to mention, just dying to meet their little ones at last!

 

“I don’t want to be pregnant anymore! Come out already, baby!”

 

Well, we don’t expect you to just sit on your hands, mamas. (Sit on your yoga ball instead!) Here are some of the ways that you can encourage things to get started as you heave and ho through that endless tenth month.

 

Keep in mind that natural induction is gentle and will only bring on labor if your body and your baby are ready. You should wait until at least 39-40 weeks to try these methods. And remember, you are not overdue until 42 weeks. Now go for it!

 

  1. Move It – Take daily walks. Dance and swing those hips. Squat. Climb stairs. Go for a swim. Bounce on your birth ball. Practice prenatal yoga. You can even try a bumpy car ride or a swing. Basically, let gravity help you move that baby down.
  2. Eat Your Baby Out – Certain foods may help encourage labor. Try bananas (potassium helps muscle contractions), balsamic vinegar, basil and oregano, dates (6 a day help with dilation), Chinese food, spicy food (stimulates digestive system therefore releasing prostaglandins), eggplant, pineapple (it would take about 7) and licorice (can cause bowel cramping which can cause contractions). Bonus points if you can work them all into one [palatable] meal!
  3. Get It On – Oxytocin, the “love hormone,” is key in birth. So start with some sweet talking, heat things up with nipple stimulation (you can also use your breast pump), and move on to as much sex as you feel up to – semen contains prostaglandins, which soften the cervix. Works best if mom also orgasms.
  4. Wining Allowed – While alcohol is generally not recommended during pregnancy, a glass of wine can help an anxious mom relax, which may help as stress or fear can stall labor.
  5. Accupressure and Accupuncture – There are pressure points which can trigger labor. Make an appointment with a trained professional.
  6. Herbal Remedies – Ask an herbalist about how to benefit from black/blue cohosh, evening primrose oil, motherwort, thyme, borage seed oil, and goldenseal.

(I’m going to skip the recommendation to try castor oil. Though it can be helpful, only about 57% of women have success with it and it can cause side effects such as cramping, diarrhea, and vomiting. Please do your research if you choose to try this method.)

 

Good luck and take heart in knowing that no pregnancy lasts forever!

 

Stay tuned for Part II: Medical Inductions….

 
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Published on March 10, 2013, by in Events.

Free Workshop:

WELLNESS FOR PREGNANCY AND BIRTH

Saturday, March 23, 2pm

 Cakettes Coffee Shop

14 Milton O Fountain Way, Warren MA 01083

 

*How a Doula can Make Your Birth Better

Learn what a doula does and why you don’t want to go without.

Led by Lauren Noone, Labor Doula, of Full Moon Mama Birth Services.

*Prenatal Massage

Find out how massage can help make you comfortable and prepare you for labor.

Kari Flowers, LMT Therapeutic Massage and Reiki, certified in Prenatal Massage.

*Nutrition for Pregnancy and Nursing

What should you eat? What should you avoid? Why?

All the answers and more from nutritionist Jesse Mushenko.

Complimentary chair massage for pregnant mamas!

Enjoy a coffee, tea, or decadent dessert from Cakettes while you’re there.

 
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“The lights are bright and I’m surrounded by uniformed strangers. I lay on my back on an operating table, unable to see my body below my chest. I am numb and nauseous. I feel and do nothing as my baby is lifted from my belly. I cannot lift my arms to embrace my child, who is checked, warmed, and washed across the room, and finally brought to me swaddled up tight.”

 

I’d be willing to bet money that when most mothers envision their birthing experiences, the one above doesn’t fit the description. Unfortunately, delivering by c-section is a reality for many women in the US. You may have a medical condition that requires a scheduled C-section. You may be induced, which doubles your risk of needing a C-section. You may want a backup plan if you are hoping for a VBAC. Or you may be a low-risk mom hoping for a natural birth who just wants to be prepared for the chance that things go differently than planned. While many of the cesareans performed in our country are likely avoidable, some of them are not. Sometimes, a C-section is truly medically necessary.

 

But it doesn’t have to be scary. It doesn’t have to be impersonal. It doesn’t have to rob you of the important first momentsof bonding with your baby, or take away all of the health benefits of a vaginal birth. It doesn’t have to mean your chances of postpartum depression or breastfeeding difficulties will be increased. It doesn’t have to be a negative experience.

 

Enter the Natural Cesarean.

 

“The lights are dim, soft soothing music is playing, and I’m accompanied by my partner, my doula, and our trusted care providers. I am wearing my own comfortable clothing. After the incision is made, the drape is dropped so that we can watch our baby’s head lifted from my belly. A pause allows my uterine muscles to expel any lung liquid, and my partner and I can look into our baby’s eyes. Then baby is eased from my body by my contractions, with a little help from the OB. The anesthesiologist clears my clothing from my free arm and my baby is brought to my chest, where we can be skin to skin and baby can start suckling right away.”

 

photo courtesy of scienceandsensibility.org

The bottom line, mamas, is that you always (unless it’s an emergency surgery) have options. First of all, make sure a cesarean is absolutely necessary for you. If it is, inform yourself of your choices, stand up for your wishes, and make your birth experience as positive as you can.

 

Try these things to achieve a more natural cesarean:

  1. See if it’s possible to book the procedure on the due date and/or allow mom to go into labor. Baby will likely be more mature and ready to be born, and endorphins released in labor can stimulate baby’s immune system.
  2. Ask if the operating room can be warmed up so the temperature is not a shock to baby coming from a warm womb.
  3. Dim the lights before baby emerges if possible, for a gentle and welcoming environment.
  4. Play familiar music at the time of birth.
  5. Deliver baby slowly in view of mom and dad.
  6. Once baby is breathing and doctors have established that suctioning is not required, place baby immediately onto mom’s exposed chest. Keep baby warm with towels/blankets.
  7. Examine baby on mom’s chest rather than examination table. (Monitoring electrodes can be attached to the mother’s side so the baby doesn’t get tangled in the wires).
  8. Have dad hold and talk to baby while mom is moved from the operating table to her bed.
  9. Omit medical interventions such as washing off the vernix, vitamin K injection and antibiotic eye drops unless there is a problem with the baby.
  10. Encourage breastfeeding as soon as possible after birth.

 

To learn more about natural cesareans, visit the links below.

The natural caesarean: a woman-centred technique– article and video — National Institutes of Health (NIH)

Family-Centered Cesarean–ICAN (International Cesarean Awareness Network) White Papers

Ideas for the best cesarean possible–by Penny Simkin. Free PDF printable.

“Natural” cesarean mimics vaginal birth experience–Reuters UK

Delivered safely by caesarean with his mother’s hands (“assisted cesarean”)–The Age (Australia)

 

 
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Published on November 9, 2012, by in Pregnancy.

How do you know if you should work with a doctor or a midwife?  Unfortunately there is no simple answer. But hopefully by considering the questions below, it will become clear to you which is the best match for your family.

 

(Start by deciding where you want to give birth – in a hospital, a birth center, or at home. Also, establish whether your pregnancy is considered low, moderate, or high risk. These factors may determine the choice of care providers for you.)

 

How much guidance do I want during labor and delivery?

An obstetrician follows a “medical management” model of care, in which he or she has more control and often directs the mother through the stages of labor and delivery. Some mothers may feel more comfortable letting someone with medical training tell them what they should do.

A midwife follows a “wait and see” model of care, in which she will only intervene if help is asked for or required. The midwife will follow the mother’s lead. Some mothers may like the feeling of empowerment this fosters, as well as the treatment of birth as a normal (non-medical) event.

During your labor and delivery, a doctor will come in a few times to measure your cervix and check you, and typically is present for the pushing and delivery stage. In between, nurses will manage your care. A nurse may have more than one woman to attend to, and her shift may end during your labor. A midwife stays with you throughout your entire labor and delivery.

 

How important is a natural birth to me?

It is possible to have a natural birth with either a doctor or a midwife. It is also possible to receive pain medications from either one (although in some states there are limitations on what midwives can prescribe). A midwife may encourage or offer natural forms of pain management before moving to medical interventions, whereas a doctor is more likely to offer pain medications. Also, obstetricians are able to perform cesareans, and they tend to offer these more often. A midwife will be more likely to view a C-section as an absolute last resort.

 

What will give me confidence in my provider?

EDUCATION/CREDENTIALS: An obstetrician will have 4 years of medical school, 3 years of internship/residency, and training in surgery. He or she will need to pass the board exams and obtain a license. There are several kinds of midwives; each differs slightly in the required education. Certified midwives (CM) and certified professional midwives (CPM) do not attend nursing school but are trained in midwifery and certified by one of two American organizations. CPMs are required to have knowledge and experience with out of hospital births. Certified nurse-midwives (CNM) are trained and certified as above and also attend nursing school. A lay midwife, or direct entry midwife, is trained through various educational programs and apprenticeships. She is not certified by an organization, though this does not mean that she is incompetent; on the contrary she may have many years of experience and training that parallels that of a CPM.

FAMILIARITY: Some families gain confidence in a provider through getting to know each other well. The number of prenatal visits is the same regardless of whether you’re seeing a doctor or a midwife; it’s the content of these visits that differs. With an OB, the appointments tend to be brief with a focus on the medical aspects of your care. You may spend part of your appointment with a nurse, and only see your doctor for a short time. With a midwife, the appointments tend to be longer, lending themselves to more conversation.  A midwife will ask about your emotional well-being as well as the physical aspects of your pregnancy. She may involve you in your care; for example having you weigh yourself or take fundal measurements.

 

It is important to note that there are always exceptions to the guidelines above. You may come across an OB who offers very personalized care and focuses on preventive measures, or a midwife who takes a less natural approach and does not get to know you well. Regardless of the type of care you choose, your provider should be someone with experience, competency, and compassion with whom you feel comfortable. Don’t hesitate to “shop around” – your care provider plays a large part in how satisfying your prenatal care and birth experience will be.

 

 
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My mom was over today, and as she sat with me while I nursed my son our conversation naturally turned to the subject at hand. How long I will nurse him. (Until he decides he’s done.) How long my mother nursed me. (Around a year.) How my grandmother didn’t nurse my mother. (Wait – what??)

 

The information registers with me. “At all?!” I gasp. I guess I just assumed that all of my ancestors fed their babies the same way. But my mother has explained that no one nursed at that time. It just wasn’t done. It was a different time. And my shock comes from realizing that I have a whole generation – at least – to edit in my understanding of American mothers.

 

My grandfather’s mother delivered him at home. She gave birth to three more babies over the years, each one in her home. She nursed them all.

 

My grandmother had to leave her job before she started “showing.” My grandpa was at home cooking dinner while she labored and delivered my mom in a hospital across town. In the 1940s it was common for women to be routinely sedated and for babies to be delivered from their unconscious mothers with forceps. It is likely that this was her experience. My grandma and her new baby spent their 10-day recovery period at her sister’s house.

 

My parents went to childbirth classes at the hospital together. My mother was offered the option of tests to see if there were any genetic defects and determine the baby’s sex (which she turned down due to the risk to the baby – and the fact that she was sure I was a boy!) She worked until the day before my birth. My father took her to the hospital, but went to work when the doctors said she wasn’t in active labor yet. He came back, and was in the room as I was born, holding up a picture for my mother to use as a focal point. I nursed until I was 13 months old.

 

I think back over the history of the births in my family, and in our society, and finally in that larger context, realize how lucky mothers today are.

 

You have a choice! You have support! You get to pick where you will deliver your baby, who will be there, what kind of experience it will be. You can say “yes” or “no” to every option presented to you during your pregnancy and birth. Your partner can accompany you in every part of your journey. You will be surrounded by information and by people who will support your choices.

 

And how lucky I am, too, because I get to witness your birth as a mother, see you empowered by your own informed decision-making, feel you swell with love as you are nurtured by the same. The American birth experience is still changing, being refined. But you and I occupy a pretty nice spot on the timeline.

 

I suppose it will be more personal, then, when our granddaughters someday say, “Grandma did what?” ;)