Tips for Planning a Good Cesarean

Are you planning a cesarean birth, but unsure what to expect, or if it will be a satisfying, memorable experience? You can trust your doctor to take care of everything and hope for the best, or you can take steps to help ensure a good cesarean birth.

1. Know what you want. Read about cesareans, talk to moms who have had them, and write down your preferences.

2. Keeping your list of preferences in mind, interview doctors from different hospitals in your area until you find one who is experienced, has low rates of cesarean complications, supports your wishes wholeheartedly, and who gives you good vibes (they are important!).

3. Hire a birth doula. That is, one who has experience attending cesareans. This will be especially helpful if you can get permission to bring her with you into the O.R., but even if you can’t, a doula can support you prenatally in finding information and resources, give you emotional support before, during, and after birth, offer assistance with communicating yourself to the staff, take pictures or video, stay with the baby until you can be kept together (if you are separated) after birth, and assist with initial breastfeeding. They are known for increasing both mothers’ and fathers’ satisfaction of the birth experience.

4. Hire a postpartum doula. Or at least a female relative who can offer true help postpartum – dishes, laundry, childcare, meals, arrends… things you should not be doing much of, if any, soon after birth if you want to avoid unnecessary pain and risk of post-surgery complications.

5. Unless medically necessary, avoid scheduling your cesarean prior to 39 weeks to avoid prematurity. Babies like to be born on their own timeline, and many like to wait until after their due date, to help with the last bit of lung development they need. Giving them until at least 39 weeks makes their transition to life outside the womb so much easier, and reduces their risk of long term breathing problems like asthma.

6. Consider waiting until contractions begin in earnest before going to the hospital for your scheduled cesarean. Benefits of this option include nearly eliminating the risk of prematurity, a potentially lower risk of surgical hemorrhage, and an increased chance for successful breastfeeding.

7. Pack something in your bag to keep you busy. You will be asked to come in a while before the surgery is planned to ensure time to set up the O.R., get you prepped, and fill out all the paperwork. Sometimes though, an unplanned cesarean for a woman already in labor can bump back the time of a planned cesarean; another consideration you should be mentally prepared for. There can be a lot of waiting and anticipation involved!

8. Get rest before going to the hospital. This will probably be the hardest to do, because you’ll be full of mixed emotions that make sleep hard to reach – preparing to meet your new baby, and facing normal worries about the experience – but it is important to get rest so your recovery, and your initial bonding experience with baby will be more satisfying.

9. Plan to have your baby stay with you after birth. Because you are planning the cesarean you are more likely to get support from your care providers to do this. You may even be able to hold your baby skin-to-skin before you leave the O.R.! This contact with your baby will speed recovery for both you and your baby, create a more peaceful transition for both of you, and may make initial breastfeeding less of an anxious experience.

10. Know ahead of time what to expect from recovery. That way you can get prompt medical attention should anything veer from normal, and you will have a clear understanding of how to care for your body during the postpartum weeks and months.

If you have had a cesarean birth, feel free to share your thoughts! Can you think of additional steps a woman can take to have a good cesarean birth?

Are epidurals safe after acupuncture?

During the last birth I attended, my client decided to get an epidural, but when the anesthesiologist discovered the acupuncture marks on her back from the treatment she had received the day before, he immediately backed off.

“I can’t give you an epidural,” he said. “We have no way of knowing whether the acupuncturist used sterile technique or not, and we could push bacteria into your spine, causing meningitis!”

Uh, what?! How many women have received acupuncture treatments to induce labor and then received epidurals after labor started? I assumed since acupuncture was not an uncommon practice that it would not be a problem (or we would have heard about it), but this doctor seemed to think it was since he had “never seen this before”. Now what?

After a couple phone calls to the acupuncturist’s office, and conversations with hospital staff, my client felt confident that an epidural was safe in this regard and chose to have one despite the anesthesiologist’s warning. She suffered no infection, and does not regret her decision, but I still wondered – is there an additional risk of infection with epidurals following acupunture?

I did a little research, and could only find two studies which might offer insight.

1. A journal called Medical Acupuncture, in volume 17 #3, May 2006, reported a study called “Acupuncture for Prebirth Treatment” in which the benefits of acupuncture on pregnant women were considered. Among the results, epidurals were used 31% less frequently compared to women without acupuncture treatments. This tells me that 69% of the women who would have chosen an epidural still had one after recently receiving acupuncture. Meaning, women do get epidurals after acupuncture treatments.
2. The American Society of Anesthesiologists, in their journal, Anesthesiology 2001; 95: 349-56, reported a study called, “Preoperative Intradermal Acupuncture Reduces Postoperative Pain, Nausea, and Vomiting, Analgesic Requirement, and Sympathoadrenal Rsponses.” In this study, patients were given acupuncture treatment along the spine the day before planned abdominal surgeries with epidural anesthesia. Not only did they not mention safety issues, but the authors said, “intradermal acupuncture is easy to use and requires no special training.”

It seems to me that receiving acupuncture treatments to jumpstart labor is not a problem for women who may want, or need, an epidural during birth, but it isn’t a bad idea to consider a few safety tips just in case.

• Interview the acupuncturist before treatment to ensure sterile technique is used and no infections have resulted from his/her treatments.
• After treatment, get a written note with contact information from the acupuncturist stating their practice methods, safety precautions, and experience. Include this note in your hospital bag to show to your anesthesiologist if needed.
• Bathe well before and after acupuncture treatment and birth to help minimize introduction of bacteria under your skin. Not necessary, but may help.
• Understand the signs and symptoms of infection, including meningitis, so you can receive treatment as quickly as possible should it occur.

Have you received an acupuncture treatment shortly before epidural anesthesia? Tell us about your experience!

If you have thought of dying while giving birth…

You’re not alone. It’s that moment, near the very end, when the baby is just about to emerge, when women reach that point of balance between life and death; when it feels as though you are no longer part of his world, but hovering somewhere over it.

Many will say, “I just want to die!” It hurts, they’re tired, and they have very little concern remaining for earthly things.

Pam England, in her famous book, Birthing From Within, captured this timeless moment so well when she wrote:

“Why does this thought of dying come up in a healthy labor, often just before giving birth? The mounting intensity of labor forces complete surrender of our body and will, dissolving our egos, ideas, and familiar sense of self. We’re not afraid of dying because there is no “self” left to resist and fear. At that transcendent moment we have become birth itself. This is the spiritual birth of woman into mother.”

I have given birth three times, and have been revisiting Pam England’s book recently because my fourth baby is due in just a couple of months. I don’t remember wishing I could die in labor, but I do recall feeling as though I did not exist anymore, that there was no going back to the person I once was. That last bit of resistance was gone and birth consumed me. Motherhood transformed my body and spirit.

As a birth doula, other women have given me the sacred gift of witnessing their motherhood transformation. Each time, when their baby is upon their perineum, their eyes open wide, their expression is one of unbelief and then suddenly, the baby emerges and that brief moment of intense, other-worldly birthing is gone in an instant, its purpose fulfilled.

The fear of dying in birth is a common fear. One that, for some women, is overpowering prior to birth. That kind of fear is one that a woman should have support to address, but there is also the thought of death which occurs in birthing and seems not to be harmful, but to be a normal process of moving from one phase of womanhood to the next.

Have you experienced this?

Kelly’s Closet, a cloth diaper resource

Are you interested in cloth-diapering your babe, but not sure where to start? At the local health fair I attended last fall I met a couple of women who run Kelly’s Closet.

Kelly’s closet is an excellent resource for parents looking for information on what they really need to start using cloth diapers, how to use them, and information on all the different types of diapers out there. They even showed me the latest style of potty training absorbant undies, in pretty rad colors of course!

 

 

 

 

 

 

 

Not only can you get 10% off your entire order of cloth diaper supplies by entering CHECKLIST at the checkout (and no, I’m not paid to say that), but they also have a blog and a Facebook page you can visit to connect with other parents and find additional resources.

I used cloth diapers and wipes with all three of my kids. It saved us a ton of money (and dump runs), and they were so cute!

For more info, visit www.kellyscloset.com.

Something to think about #33 ~ A Midwifery Today Collection

Normally when I publish a STTA post, I include a single quote with reference and let it speak for itself, but because I don’t do them very often, my binder of thoughts to publish has been sitting on my shelf, growing older and older. So to start off the year I’m going to give you some of the quotes I have found most interesting from Midwifery Today from the past few years; things I don’t want to forget and that I think may benefit you. All of these quotes have come from the Midwifery Today free e-newsletter, which you can sign up for on their website here.

“I have helped quite a few patients, both male and female, through staph infections with a few drops of tea tree oil three times a day by mouth. It is the only thing I have found to be completely reliable.” ~ G.P.

“During horrible morning sickness extending into the seventh month of my last pregnancy, my wise midwife suggested an old folk remedy: add about 1tsp of apple cider vinegar to every 8oz of water and sip it throughout the day and night. The effects were miraculous!” ~ Anon

“The effects of pumping breastmilk following cesarean birth to increase milk supply when babies are not nursing well were studied in a randomized clinical trial at a Baby-Friendly hospital. The conclusion was that pumping before the onset of lactation does not appear to improve breastfeeding outcomes and may even interfere with outcomes.” ~ Pediatrics 2001; 107:e94

“I had very bad heartburn the eighth month of pregnancy, so bad I couldn’t sleep… Then I discovered fennel seed tea. A glass of fennel seed tea before bed would completely cure the heartburn.” ~ Anon

“To assess the role of diet in reducing the risk of premature delivery, a Norwegian study assigned 290 nonsmoking pregnant women… to either a cholesterol-lowering diet… or to their usual diet. Only one of the 141 women on the cholesterol-lowering diet delivered before 37 weeks gestation, compared with 11 of 149 on their usual diet.” ~ Amer J Obstet Gyn 194(4), October 2005

“A study ruled out breastfeeding as a means for mother-infant transmission of hepatitis C virus (HCV). Breastmilk samples and serum samples from 73 breastfeeding mothers with HCV were taken… All maternal serum was found positive for HCV antibodies; none of the breastmilk samples were confirmed positive for HCV RNA. Seventy-five of the infants tested negative with each test, and one tested positive for HCV RNA at 27 days old. It took three to 28 months for the infants to lose maternal antibodies.” ~ AFP, March 1, 2000.

“It seems more important, where the initiation of lactation is concerned, to contrast “cesarean during labor” with “scheduled cesarean”. Non labor cesareans seem to be associated with more breastfeeding difficulties… Researchers found that the beginning of lactation occurred earlier and the amount of milk produced was higher among owmen whose second cesarean was performed during labor, compared with women whose second cesarean was scheduled.” ~ Michel Odent, referencing Dogany, M., and F. Avsar (2002). Effects of labor time on secretion time and quantity of breastmilk. Int J Gynaecol Obstet 76 (2): 207-11.

“I found that when a woman has back labor, sitting on the toilet backward works wonders, especially in late first stage.” ~ Linda Thorpe, CNM

“A University ofNorth Carolina Chapel Hill study… found that pregnant women who worked a night shift at any time during their pregnancy had an increased risk of preterm birth compared with those who worked the same number of hours during the day… The study also concluded that women who spend more than 30 hours a week standing or those who perform heavy lifting at least 13 times per week are at no increased risk for preterm labor or small-for-gestational-age babies.” ~ Obstetrics & Gynecology, December 1, 2005

“Following are some factors associated with preterm birth… In a study of 3,000 primiparas, those who worked in “high-fatigue” jobs had a risk of preterm premature rupture of membranes of 7% compared with 2% for those who didn’t work outside the home… A woman with a low prepregnancy weight and/or a low rate of gain before 20 weeks is at high risk for preterm birth. Low levels of vitamin C [under 300mg daily] have been implicated for several decades as contributors to prematurity and preterm rupture of membranes… Low levels of vitamin C may also be implicated in the risk of preeclampsia, which leads to preterm  birth.” ~ Gail Hart

“You can confirm that a baby has a short umbilical cord by observing the abdomen. During contractions, and sometimes without them, the baby appears engaged, even though a vaginal exam reveals that she is floating. It is important to avoid interventions that force the mother’s body to enter the birth process before the placenta and uterus are ready. The fundus has to descend with the baby. The process takes time. Contractions that cease despite dilation of 2 to 5cm in a mother with previous fast births and no other complications indicate the possible existence of a short cord. Observation without intervention is important in these cases.” ~ Unknown

“Women who have prodromal labor may have a “cold” body type. The application of heat can be very beneficial to the progress of their contractions. Warm water is always the best, or hot towels/blankets. Apply them to the laboring woman’s belly, hips, and soles of her feet. Soaking in a very warm tub (101-105 F) after dilation begins can bring on an amazing change. Also, the cottonroot bark tincture helps remedy a pokey labor.” ~ J

“[In] a University of Washington study… women who had maintained “very strenuous” usual exertion were 81% less likely to develop gestational diabetes compared with women who reported having minimal exercise. Women with moderate prenatal exercise habits reduced their risk of gestational diabetes by 59%. Reduced risk was found even in women who had exercised less than recommended levels.” ~ Epidemiology, Jan 2006

“Regarding posterior position, some babies turn, others don’t. The Pink Kit Method for birthing better (www.birthingbetter.com) gives us, pregnant women and our partners, the ways to relax our internal soft tissue and keep our pelvis mobile, particularly the sacrum.” ~ Alicia Hannen

“Uterine contractions produced by IV (oxytocin) are very different from natural contractions – possibly because it is administered continuously rather than in a pulsatile manner – and can cause detrimental effects to the baby in utero… Such effects can produce abnormal fetal heart rate (FHR) patterns, fetal distress (leading to cesarean section) and even uterine rupture. As well, oxytocin augmentation stimulates uterine contractions out of proportion to cervical dilation, compared to a natural labor: this increases the possibility of a “failed induction”, where  a woman’s cervix fails to dilate and a cesarean becomes necessary.” ~ Sarah Buckley

Happy New Year everyone!

Greeting 2012

A big thank you to all of my readers for coming back again and again and sharing your own thoughts! You are the ones who keep me writing, sharing about birthing options and all things baby-related.

It’s been a wild year for my family, and Birth a Miracle Services at the same time. I met my goal for this year of attending six births, bringing my total to 25. That might not seem like much, but with three kids ages five and under and another on the way, six births (and 25!) is a big accomplishment for me!

Among those births, two took place at a new hospital for me, and I am very excited to be attending births there. I never imagined myself saying this about a hospital, but if you are in the area, Mercy Hospital in Portland, Maine is an excellent place to give birth! It’s a bit of a travel for me, but I absolutely love the staff; they have been very supportive of my clients, including preferences that are hardly ever supported by hospitals, like skin-to-skin bonding with baby during a cesarean birth. I do hope to be back at Mercy this coming year!

Now that I have finished my unpaid advertising, I’ll also mention that 2011 has been an important year for me because I finally published my book, Inspired Birth through Amazon.com. Please support this blog by purchasing your copy here. Thank you!

Two sad things that happened this year were my realization that my midwifery studies needed to be put on hold when I discovered my fourth pregnancy (due in March 2012!) and Haley Grant leaving BAMS. If you remember, Haley Grant was the childbirth educator-in-training who joined me at Birth a Miracle Services, but due to health restrictions, we decided that it wasn’t the right timing for her to be committing herself to teaching classes. I hope that in time she will return because her values and experiences are really what I’m looking for in a team here.

Stats for 2002 through 2011 are now as follows:

• Total births attended: 25
• Vaginal: 16, Cesarean: 9
• Planned VBACs: 4, 2 successful
• Home births: 9, Hospital: 16
• Unmedicated: 13, Medicated: 12
• Water births: 3
• HypnoBabies: 2

I have received zero negative reviews, instead I usually hear something like, “thank you! thank you! thank you!” when I leave a new family after their birth. The moms do all the laboring of course, but a doula is such a tremendous blessing to a new family.

So what does 2012 look like for Birth a Miracle Services, keeping in mind I’m expecting my fourth baby? I hope to attend 2-4 births, but I’m going to have to figure something else out for on-call babysitting for my four kids! I also have hopes to host a booth at a local fair and develop my photography skills to offer as an additional service to my clients.

Now, I need your help! I do not anticipate being able to blog on a regular basis around and during my babymoon in March and April, so I am looking for moms and dads willing to write a guest post featuring one or more of their birth stories to be scheduled for publishing at that time. Would you consider sharing your story? Written posts, videos, and pictures are all welcome. If interested, please email me at kilbrethfamily@yahoo.com. Thank you!

Happy New Year everyone!

The winner of Always Within

Thank you to each woman who commented on the post Always Within ~ An interview and giveaway. Each of your stories are unique and important. I wish I had a copy of Always Within for each one of you, because I really believe this book would be such a great blessing to anyone who has lost a baby. Thank you Melissa for sharing your story and offering a free copy of your book!

The winner of the drawing is….

Erica

For those of you who did not win, please consider supporting Melissa’s mission to support parents through infant loss and purchase your own copy of Always Within: Grieving the Loss of Your Infant here.

Blessings!

My oops, your gain!

Tonight I was planning to announce the winner of the drawing I opened a couple of weeks ago for the book, Always Within.

However, in my Christmas gift-making frenzy, I completely forgot to visit my WiFi spot tonight! This means that I won’t be able to post what I had planned until next Friday, but it also means you have an additional week to comment on that post and enter in the drawing!

Skim down the page a couple posts and you’ll find it. Please enter if you or someone you know has experienced the loss of a baby. This is an excellent resource that you should take advantage of!

See you next Friday!

Introducing, Crystal Clear Photography

When I was pregnant with my third baby, I knew I wanted to do something special to celebrate this new life. I asked a photographer-friend to do pregnancy and newborn photo sessions for me to help memorialize what I thought would be my last pregnancy, and I was so happy with the results!

That’s why, when a former doula introduced me to her photographer-daughter I quickly asked for an interview to post here as a resource for local families.

Crystal Reynolds keeps her studio at her home in Otisfield, Maine where she lives with her husband and three sons. While she has been involved in photography professionally for eight years, her flexible hours allow her the gift of staying home with her youngest child, while her older boys are in school.

Crystal, owner of Crystal Clear Photography, offers all sorts of packages: wedding collections; family, senior, and children’s portraits; invitations and announcements; wall portraits with beautiful frames; photo albums and DVD slideshows to music. Yet her favorite projects continue to be maternity and newborn photography.

Because Crystal has only sons, she gets excited when she can dress up baby girls for photos in pretty ribbons and feathery wings, and playing with babies during the sessions is a special treat now that she is done having children of her own.

To see more examples of Crystal’s work, see pricing information, and find contact info, please visit Crystal at www.crystalclearphotos.com, or find her on Facebook!

Have you had maternity or newborn photos taken? Tell us about your experience, or share a link to your photos!

Always Within: Grieving the Loss of Your Infant ~ An interview and giveaway

A few weeks ago I shared the story of my lost twin, and promised that I would be sharing some resources for those who had suffered a loss as well. Today I have a very special resource to talk about, and the author of the book I had in mind is here to tell you about it herself! Please welcome Melissa Eschleman, author of Always Within: Grieving the Loss of Your Infant. If you comment on this post in the next two weeks, you will be entered in a drawing for a free copy of her book!

Naomi: Where to begin? First of all, thank you, Melissa, for taking the time to let me interview you. I was sorry to hear about the loss of your four day old son, and I can’t imagine how terrible an experience that must have been for you. And yet, you invested yourself into helping others heal from their losses by joining infant loss groups, and now writing a book, Always Within: Grieving the Loss of Your Infant. Would you mind sharing with us about the circumstances of your little boy’s death? Did you have time to grieve before you lost him or was it a shock to you and your family?

Melissa: Thank you for your kind words Naomi, and it is my pleasure to be interviewed by you. During my pregnancy we were told everything was normal, therefore it was a complete shock and we were not prepared for any of the difficulties Lucas was faced with. He was born with several complications, one being Apert syndrome, a congentical condition which causes abnormal growth of the bones in the body, particularly in the skull, face, hands, and feet. Because he was born with a cleft palate he had to be fed through a tube. He also had a serious heart defect and although he was born with several problems I was still hopeful, and believed he would be okay and that we would bring him home to the nursery that was awaiting him, but that wasn’t to be.

Naomi: Tragedies are often avoided by those who experience them, in order to prevent unnecessary pain, yet looking them in the face, while it takes incredible courage, is just what a person needs in order to grieve and heal. After reading the piece in our local newspaper about your story, it sounded to me like you did just that. Could you describe what helped you to grieve and heal from the death of your son?

Melissa: I agree with you Naomi. Although I believe everyone grieves differently and in their own time, ultimately if we don’t face what is, the pain and healing can be prolonged. For me, having faith and trusting in God’s plan was and is a huge comfort for me. Although my heart was breaking and I couldn’t understand why my son had to die in my arms I felt blessed for the love and experience I was, and continue, to gain from it.

Naomi: Melissa, you lost your son ten years ago, but I imagine the pain of his loss is just as present with you now as it was then. Is it true that time heals all pain? Or is grieving still a part of the healing process for you?

Melissa: It is often said that time heals all pain, and I don’t completely agree with that, but I do think with time it gets easier. The loss is always there, but as time goes on, I find that less and less tears are shed and I feel more and more thankful for the short time I had with Lucas. I have learned that feeling the emotions as they come is the easiest way to deal with the grief; if I feel like crying I will cry until it passes. Feeling the feeling and releasing it instead of igrnoring it or burying it has helped me move forward.

Naomi: There is no way you could have avoided facing your personal experience when you decided to write a book. What inspired you to share yours and other’s loss experiences in your new book, Always Within? How does your book support a family through infant loss?

Melissa: I was inspired to share not only my experience but those of others because that helped me the most, along with Bible verses, quotes, and poems. When we lost Lucas I felt very alone, I didn’t think that anyone could possibly understand the pain and emptiness I was feeling. I finally joined a couple of infant loss groups and realized that others had endured similiar losses. I felt compelled to reach out to other grieving parents with words of compassion and understanding, and learned that I was healing in the process.

Naomi: As a birth doula, I have yet to support a client through the loss of their newborn, but as a mother who has miscarried, I know how much good support means. I was especially interested in hearing that you have a chapter in your book which offers specific ideas on how grieving parents can help keep their baby’s memories alive. Would
 you mind sharing an example or two that may be helpful should I have a client in the future who loses their baby?

Melissa: I’m truly sorry for your loss, Naomi. The one thing I have learned is that no matter how far along one is in pregnancy or how old an infant is, the death of a baby is a deep and profound loss because bonding begins before birth of the child. And no matter how much time passes, a loss of this nature doesn’t go away. Therefore, I felt it was important for each of the parents who bravely shared their experience to also share how they keep their baby’s memory alive. A few of the things grieving parents can do to honor their child’s life are birthday parties (some collect gifts and donate to charities), websites, tattoos, stuffed animals, jewelry, the lighting of candles, planting trees, balloon releases, fundraisers, and simply toasting the child’s memory on special occasions.

Naomi: While this book seems to be an excellent resource for parents, what about friends and family of the grieving parents? Could your book help them to understand the healing their loved ones need, and how they can be supportive?

Melissa: I definitely had friends and family in mind while putting the book together. Each person that shared their story wrote a section about the most helpful things others did to share their love and support. The simplest things can mean so much. I recently received an email from a woman who had a coworker lose a pregnancy. She purchased two copies of Always Within, gave one to her coworker and passed the other copy around the office to help people understand. It was very touching and brings me great joy to know the book is helping others in their grief.

Naomi: For people who may have questions about Always Within, or your personal story, would you be willing to provide contact information? And how do readers purchase a copy of your book?

Melissa: I love it when people contact me! I have received some wonderful emails from people sharing their stories and expressing their gratitude for the book and I’m so thankful. One mother who received the book from a friend said it was exactly what she needed, she just didn’t know it. Another emailed about the loss of her stillborn son that happened more than 20 years ago. My son Lucas, who would be 10 years old, touched so many lives in the four days he was on this earth with us. Four short days, but he changed lives and made a difference. It makes me wonder if people realize just how many lives they have impacted and touched in a positive way during their time here.

Melissa can be reached at melissa@findingyourwaypublishing.com. She also has a neat video about the book which you can see here, but we have a special offer just for you! If you have suffered the loss of a baby, or know someone who has, please comment below, and you will be entered in a drawing for a free copy of Always Within: Grieving the Loss of Your Infant. Melissa will personally send a copy of the book to the winner, who will be randomly chosen on the 10th of December. You have until then to comment and earn a chance to receive your free copy. If you do not win a copy, please support Melissa’s work and purchase a copy here. Thank you!