Categories
Birth

Top Ways to Prepare for a Positive Birth Experience

The top ways to prepare for a positive labor and birth experience begin long before the actual labor starts. At Midwife360, we talk about our “Recipe for Success” when we are discussing a client’s birth plans. 

The core of our recommendations include self-education through reading books and online resources (see the reading and web organization list at the end of this article) and commitment to a healthy lifestyle through clean eating and regular exercise. We strongly advise eliminating processed foods, dairy, and inorganic foods. Through clean eating and regular exercise, it is likely that there will be an absence of disease processes such as diabetes and high blood pressure which can make a pregnancy cross the line into a truly high-risk status. If the pregnancy can be maintained in the low-risk status range, then recommendations such as induction of labor are more easily declined. 

Our “Recipe for Success”

Our “Recipe for Success” also includes hiring a doula and taking a deep meditation for labor course such as Blissborn or Hypnobabies. Many times the doula will be the one who teaches these courses. Doulas are invaluable as educational resources and typically have a wealth of information regarding comfort measures and labor preparation activities. They will meet with the client usually two times prenatally and will be the first to show up at the labor. They help with labor support if things are not progressing, and will let you know when to call the midwife or leave for the hospital. Meditation or hypnosis is a tool that can be used to cope with the surges of labor. It helps to keep the mind occupied with positive thoughts to allow the body to perform the work of releasing the baby unimpeded.

Positioning of the Baby 

The most common reason that labor doesn’t progress is the positioning of the baby. We recommend becoming familiar with an online resource called “Spinning Babies” that teaches postures that can be used prenatally to help ensure proper positioning of the baby in relation to the mother’s bony pelvis. This will ease the baby’s passage and create a more efficient labor process. Your doula will most likely be familiar with this resource and have the ability to guide you through the postures as well as know when to employ them in labor.

Using a Birth Tub 

The final recommendation in our “Recipe for Success” is to use a birth tub for labor and birth. The benefits of hydrotherapy have been recognized by midwives and laboring women for years. Some people call it a ‘liquid epidural’ as the sense of relief is so great when entering a warm tub of water in active labor. Sitting on a yoga ball or stool in the shower can have some of the same sense of relief, but immersion in water is better and helps lift the belly to remove the heaviness caused by gravity. Also, releasing the baby into the water helps with vaginal and perineal stretching and reduces tearing.

Visiting a Chiropractor and Acupuncturist 

In addition to the “Recipe”, we strongly recommend developing relationships with a chiropractor and acupuncturist who are skilled in caring for pregnant people. Get regular massages and take yoga classes or do yoga at home. All of these adjunctive therapies contribute to a body that is well adjusted and free from muscular and energetic blockages that can inhibit the passage of the baby when it’s time for birth. 

Preparing for a positive labor and birth experience ideally starts before pregnancy. However, with a determined mindset and a willingness to do the work, preparation for a positive experience can easily be accomplished in the 40 weeks of pregnancy. Decide where you want to give birth and hire a care provider that you trust. Check out the resources listed below and prepare to have an amazing, informed, respectful labor and birth experience!

Categories
Birth Pregnancy

What’s wrong with the Medical Model of childbirth?

Let me tell you a story…

We recently attempted to assist a client to achieve a successful home vaginal birth after 2 previous cesareans. She was a little more than one week passed her due date, and she had tried to induce her labor with castor oil. The oil didn’t seem to do much, but her water broke and she was having contractions soon after. Her labor progressed quickly, but her baby remained high in her pelvis and it took a lot of maneuvering with Spinning Babies postures (Walcher’s Brim is a great one for this problem) and the baby finally began moving down into the birth canal. 

Things take a complicated turn… 

However, after hours of pushing, seeing the head and thinking that the baby was coming any minute, she began having some bleeding. It was significant enough that the midwives elected to transfer by 911 to the hospital. All of mom’s and baby’s vital signs were good, but unexplained bleeding in a mom with 2 previous cesareans is a potentially life-threatening sign. Our job is to recognize potential emergencies and get to the hospital before the train wrecks. This momma continued to push in the ambulance, and within minutes of getting into the hospital she pushed her baby out! 

Hallelujah!!! The baby came through the door, not the window! 

But wait…The baby was a bit shocked, but instead of allowing him to get his full placental transfusion and administering PPV (Positive Pressure Ventilation)* with a bag and mask to help the baby inflate his lungs, they immediately cut the cord and rushed him over to the warmer to tortuously stimulate him into taking his first breath. I had a hard time watching the video due to the roughness and lack of respect afforded this brand new being. 

How does this impact our society?

For the nurses and midwives on duty, it is just another case, just another hour in their day. However, for that baby, it is his BIRTH. That happens to every one of us just ONCE in this life. We clearly do not appreciate the importance and significance of this event for our species. I am frightened to see the future generations coming up in the world when they have embedded in their primal memories this episode fraught with pain and fear and separation from the source of their sustenance. We are not building generations of people who will have love and trust as their core values. Else wise we must figure out how to overcome a beginning like this. Prolonged skin to skin contact with both parents initially and prolonged on-demand breastfeeding with baby-led weaning will both go a long way to repair the damage.

Hospital L&D should be a place that all women feel comfortable, respected, and supported… The other thing that really bugged me about this experience is that when the midwives showed up (they followed the ambulance), they were greeted by a seasoned L&D nurse who was shaking her head and clearly upset by the situation. She said something to the effect that the client is an RN at their facility, and that she should have known better than to attempt a home birth. Really!?!?! Excuse me, but maybe your facility should do a better job at supporting women with their choices so they wouldn’t see home birth as their only option. 

We at Midwife360 would be happy to encourage our VBAC moms to birth in the hospital. We acknowledge that it is the safest place to be for someone with a complex physiologic pregnancy. We also believe that the way someone is treated during their pregnancy, labor, and birth will have far-reaching consequences for them, their baby, and their entire family. It can mean the difference between having postpartum depression or not. It can mean the difference between successful breastfeeding or not. It can mean the difference between having a vaginal or cesarean birth. On an individual level and ultimately on a societal level, these things matter!

What’s wrong with the NICU?

The next situation evolved because the baby had a ‘lesion’ on his head. It was in such a position that it was likely caused when he was trying to get under her pubic bone and the length of time that he was in the birth canal. Neither parent had a history or tested positive for herpes – which is what the hospital providers were worried about. They started the baby on an antiviral, and on an antibiotic, since mom was GBS positive and had received her antibiotics just shy of the 4 hours recommended by the protocol. The baby was not sick and had no abnormal WBC (white blood cell) nor a positive culture. They insisted on performing a spinal tap for this well-baby because they were sure he had herpes somewhere that was gonna kill him. The mom knew her baby was fine, but every time she said she was taking her baby home, the nurse practitioner would tell her that her baby could die. This baby spent 10 excruciating days in the NICU and received multiple doses of antivirals and antibiotics, with multiple IVs in his little body, and endured a spinal tap – FOR NOTHING! A huge NICU bill later for a normal baby with a skid mark on his head. I believe we can do better in our hospitals. 

What can we do? 

Expose the neonatologists who up-sell services for healthy normal newborns and get evidence-based care into standard practice. We must not stand for this any longer! This family was so relieved and ecstatic for the vaginal birth they knew was possible, only to be traumatized and beaten down by having to advocate and protect their new baby. It doesn’t have to be this way! It’s up to individual parents who have these types of experiences to write letters and submit evaluations of their experience to the hospital and local media. Also, seek out respectful maternity care and demand respectful newborn care as well. We as a society can do better for our pregnant people and newborn babies!

*This is giving the baby breaths with the bag and mask and is the first step in neonatal resuscitation. 5 long slow breaths.

Categories
Birth Pregnancy

High-tech Childbirth is Not Always Better

America excels in high-tech medicine

When it comes to healthcare and medicine, America is the greatest country in the world. If you get into a car crash or have a heart attack, or need a life-saving surgery, then you are very grateful to have that happen in the US of A. However, this statement is not true if you are pregnant and healthy. It is well known that the US scores shamefully low on the two standards used worldwide to evaluate how well a country is doing in the area of childbirth – infant mortality and maternal mortality. And it’s not a mystery as to why this is the case. We know that the standard interventions performed on pregnant women in the hospital on low-risk, healthy moms and babies are not evidence based. Withholding food and fluids by mouth.  Limiting movement and positioning in labor.  Use of continuous fetal monitoring for low risk labors.  Non-medically indicated inductions.  Immediate cord clamping.  Overuse of Pitocin for labor augmentation. All of these standard interventions can lead to perceived and real problems that trigger the cascade of events leading to an operative delivery – forceps, vacuum extraction, or cesarean (and occasionally a cesarean with forceps or vacuum delivery!).

Low-tech better for physiologic childbirth

When it comes to childbirth, high tech is not better than low tech. I have been privileged to attend many out of hospital births and many more in hospital births. Even a ‘normal’ birth in the hospital typically comes with continuous fetal monitoring and epidural. And unless it is the middle of the night and the lights are kept dimmed, the nurses use intermittent monitoring, the cord is left alone for at least 10-15 minutes, and the baby is kept on the mother AT ALL TIMES, no hospital birth worker has truly witnessed natural birth. There are many, many videos of home birth on the internet and it can be seen time and again the beauty and wonder of birth as it is meant to be.

Out-of-hospital birth should be first-line care for all low-risk childbirth

We have such great prenatal care standards, that any significant problem with the mom or the baby will most likely be detected prior to labor so that a baby that may need more high tech assistance can be born in a place where she can receive that assistance in a timely manner. It is so unlikely that a healthy mom and baby will have a major life-threatening problem during the birth process, that out of hospital birth and midwifery have been approved through legislation in most states. And statistics have proven that most transports from an out of hospital setting are done for non-emergent reasons. The American Congress of Obstetricians and Gynecologists have suggested that the out of hospital Birth Center should be the first level of care for healthy pregnant women. They recommend only moving up the chain to a hospital capable of performing a cesarean if there are risk criteria that have been demonstrated.

Low-tech interventions for childbirth

So that means in order to fix the problem, more doctors need to be trained in the low tech hand skills that are truly helpful to laboring women. These include Leopolds maneuvers (feeling the baby from the outside to determine it’s position), which, when performed properly, can assist the provider to be able to tell not only the baby’s position but if there is adequate fluid around the baby. Keeping hands out of the way other than to provide warm compresses during the actual birth. Turning a breech baby to avoid a breech delivery. Even being able to perform a breech delivery – these are skills that are slowly being lost to us because they are not being taught in medical schools. And delayed cord clamping is probably the single most important non-intervention that can be supported at a birth! We have been complacent, and have allowed an intervention – immediate clamping and cutting of the umbilical cord (that typically happens in the course of surgical birth) – to become standard of care for all births without studying the effects. It is part of the OB culture and doctors and CNMs are taught to do it without question. This is what happens when you put surgeons in charge of a physiological event.

Women’s complacency has really been the main cause of our loss of control over our bodies and our labors. It is time for us to stand up and reclaim our bodies, our labors, and our births. Support your local midwife, demand respect and evidence based care. Maintain a healthy lifestyle and prepare yourself for an out of hospital birth – it will transform your life!