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Archive for May, 2008
I have never been one to closely follow celebrity gossip. In fact, I am embarrassingly behind the times - stuck somewhere in the late 90’s when Julia Roberts, Meg Ryan and Friends were big. But I can’t deny the influence celebrities have on society. They are the American equivalent of the British Royal Family. Recently, the biggest Hollywood trend is pregnancy and babies. (I have even been called up by VH1 looking for the scoop on “hot Hollywood mamas” only to disappoint the producer when I told him the mega stars have not passed our threshold.)
With this uprise in celebrity births there is a bit more scrutiny on how the precious little off-spring of the Hollywood elite come into the world. And, it stands to reason that like everything else, how Tinseltown gives birth will have an impact on Jane Q. Public. There seem to be two emerging camps of thought: A return to the home for birth or an early trip to the ER for a planned cesarean birth.
On one hand we have people like Ricki Lake, who has used her celebrity status to open the eyes of many to the possibility and safety of a home birth with her film The Business of Being Born. I recently spoke with one midwife who said she has never been this busy. That movie really boosted business! After a little digging, I was thrilled to find out that many well-known celebs have recently opted for a home birth with a midwife. Demi Moore, Cindy Crawford, and Davina McCall have all given birth at home three times. Nelly Furtado, Lucy Lawless, Ani DiFranco, and Pamela Anderson are also amongst those who chose a home birth. Pamela Anderson is quoted as saying “I gave birth at home both times, naturally, with a midwife, in water, with nothing.’
Then there is the other side - the planned cesarean births - that seem to get a bit more media attention. I guess what I find most horrifying is the reasoning behind this choice, and I am ghastly afraid that the American public will follow suit. Many of the Hollywood mamas are “too posh to push”. Christina Aguilera has been quoted in Hello Magazine as saying “I didn’t want any surprises. Honestly, I didn’t want any [vaginal] tearing. I had heard horror stories of women going in and having to have an emergency C-section [anyway]. The hardest part was deciding on his birthday. I wanted to leave it up to fate, but at the same time I was ready to be done early!” I strongly encourage readers to research the full spectrum of evidence on the risks of non-emergency C-sections.
A related scary trend is the idea of “near term” births. These are babies that are delivered 4 or 5 weeks before the given due date. (Note that full term is considered between 37-42 weeks.) It’s rumored that some celebrity moms have asked to deliver their babies via C-section a month before their due dates to get a head-start on slimming down, says Wang, co-director of the newborn nursery at Massachusetts General Hospital.
There is significant risk to a child delivered before full gestation. A study published last year in the medical journal Pediatrics,compared 90 near-term infants with 95 full-term infants. Near-term babies were more likely to be evaluated for infections and to have low blood sugar, unstable temperatures, breathing problems and jaundice. As a result, 27% of the near-term babies required treatment with intravenous fluids, while only 5% of the full-term babies did. And 50 of the near-term infants didn’t get to leave the hospital with their mothers, compared with only 7 of the full-term babies. Infant mortality in our country is at a surprisingly high rate for a developed country. Does this “near term” birthing trend shed some light on why U.S infants die too often? Marian MacDorman, a statistician at the U.S. National Center for Health Statistics (NCHS), was recently quoted as saying The single most important thing we can do to lower the rate of infant mortality is to reduce the rate of preterm birth. But in fact the trend is going in the opposite direction — that rate [in the U.S.] is increasing.
We live in a society where our heroes are actors and rock stars - fame is valued, many would argue, more highly than education. I’m not prepared to debunk the importance of the cool factor in our role models. But I do think it’s important to bear in mind that when it comes to life and death decisions, jumping on any bandwagon being driven by pop culture is ill-advised. Who will empower you? What will inspire you? And what is informing your decisions?
Watch the red carpet for the latest in evening gown fashion and read the tabloids to see who looks best in a bikini. But when it comes to how you bring life into the world, look not to the A-list, but to your very own inner goddess.
*Check out the article from iyogalife.com about Angela Kinsey from The Office, as she talks about how prenatal yoga practice prepared her for birth!
May 27th, 2008
Very few occasions in life have the expectations and anticipation that compare to those of pregnancy - the whole pregnancy is called ‘expecting’! So of course, the onset of labor is going to be a big deal - but maybe it shouldn’t. I am not saying that you shouldn’t be excited about finally meeting your baby and starting this new phase in your life, but at times over -excitement can lead to downright exhaustion.
When I teach a childbirth education class or am working with a couple as their doula, I advise them that when they suspect labor is starting they should notify the important people that are involved: Their doula, doctor, babysitter, etc. - just to give them the heads-up. And then ignore the situation. Put the watch away- don’t time the contractions. Early labor can take many hours or even days. I guarantee you will know when things have shifted to where they need more attention. If it is nighttime, try to sleep. If it is daytime, alternate between rest and doing a ‘birth project’. (A birth project is anything that is distracting that you like to do. Some women I know have started baking projects or crossword puzzles or just gone for a walk.) A good indication that labor is shifting is that the mother can no longer focus on her birth project, and the cookies she started earlier are burning in the oven!
The reason I give this is advice is that if she doesn’t rest, a woman will focus solely on the early contractions and will start to pull out all the tricks she has to deal with labor - and not have any energy for later in labor. I was having an in-depth conversation with a friend who is currently pregnant with her second child about the length and exhaustion of her first labor. (Granted, her baby was posterior which explains the lengthiness of the experience.) But one thing she recognizes is that she jumped the gun a bit on ‘dealing with her labor’, and by the time it got really difficult she had already exhausted herself.
For a woman giving birth for the first time, it’s hard to know how to pace herself for an experience she has not yet had. Over the years as a doula, I’ve had the benefit of seeing many births - and now I’m better at knowing when it’s really time for mom to gear up for labor. But I remember several years back, when I was just starting out as a doula, when I too was drawn into the excitement of early labor. I was called into my client’s birth, and she explained that her contractions were rather intense and she felt she was ready for me. I thought it was pretty early on for her to be so far along in her labor, but being a novice I didn’t really question the situation, and I didn’t know the emotional signposts to look for to indicate where in labor she was really at. When I arrived, she was bouncing on her birth ball with a big smile across her face and doing her “breathing”. Needless to say, we were miles away from the more active part of labor. But we breathed, we walked and we rocked - and ultimately by the time she really needed her energy reserves, she was pretty tired. (Just to give you the ending to this client’s birth story, she went on to have a beautiful baby girl and all was well.) Had we ignored her labor for a bit longer, she might have had a bit more energy, hydration and stamina for her marathon labor.
So I guess what I am trying to say is do less. Let your body and baby give you the signals - you’ll know when you need to put a little more energy into your labor. Until then, continue to nourish, hydrate and rest until you just can’t ignore your new arrival.
May 20th, 2008
I was talking to one of the students yesterday about freedom of movement during labor. She was concerned that as soon as she arrived at the hospital she would be hooked up to the EFM and would not have the freedom to move about as she would like. She asked what I thought about that.
Well, if you are on full-time EFM, it is true that your movement options will be limited. This is because in certain positions, like on all-fours or sitting/leaning on the birth ball, the fetal heart rate isn’t as easily picked up by the monitor. As an alternative to full-time EFM, you can ask your doctor to do intermittent monitoring, which will allow you to walk the halls, take a shower or bath or what ever else you want to do, monitoring at times between these activities.
So why is it so important to be able to move around? First of all, it will be A LOT more comfortable to work through the contractions if you are not lying down and can move organically. Many of the laboring mothers whom I have assisted did NOT prefer a supine position. Most of them agreed that the contractions were a lot more intense and difficult to get through lying down. Secondly: “When you walk or move around in labor, your uterus, a muscle, works more efficiently. Changing position frequently moves the bones of the pelvis to help the baby find the best fit through your birth canal, while upright positions use gravity to help bring the baby down.”
A few years ago, I attended Monica’s first birth. Her baby was slightly posterior and her labor was not progressing very well. So, knowing that we needed to shift her baby in her pelvis, we turned on the salsa music and got her booty shaking! It was actually a lot of fun - her mom even joined us in dancing around the room! (The hospital staff didn’t quite know what to make of this spontaneous dance party.) And, the dancing and movement was quite effective. After many songs and different moves, her baby did shift into a better position and she was able to have a vaginal birth.
When I was at The Farm Midwifery Center this past fall, I remember Joanna, one of the legendary midwives, saying that moving during labor reduces the length of labor by 25%. What woman would not want those results? Ina May Gaskin, one of the founding members of The Farm, encourages women to “find their inner monkey” while birthing. A primate would not labor on her back in stillness. She would move. She would rock. She would sway. She would create mobility to allow her baby to descend and rotate deeper into her pelvis and work its way out of her body. So why not follow her example? Birth is birth!
There is so much evidence in support of open movement during labor. I encourage all pregnant women and those thinking about becoming pregnant to investigate this option with their care providers. If mom is ok and baby is ok, why not move and groove as your body and baby wants to?
May 13th, 2008
