In labor, continuous monitoring increases the risks of many interventions, including pitocin, epidurals, and cesarean birth, without improving birth outcomes for mother or baby. Asking a woman in labor to be still (and often in bed) so the monitor can do its job is not a benign request, since it can result in a longer labor and...
In any pregnancy, there is about a 3 per cent risk of delivering a baby with a birth defect (that's 3 out of every 100 babies born). Most of the causes of these birth defects are unknown – but medication exposures are known to cause very few. The vast majority of drugs and vaccines do NOT cause fetal harm. Pregnant women get...
There are many medical indications why a repeat c-section may be a safer option than a trial of labor after cesarean, such as a prior classical incision, prior uterine rupture or a history of three or more cesarean sections. However, there are also reasons why women may be told by their care providers that they are not “allowed...
These days there is a lot of awareness and information out there about postpartum depression and that’s great. But the name postpartum “depression” can be misleading because sometimes postpartum depression doesn’t manifest as typical feeling “down” depression. Sometimes it comes in other shapes and forms. So for anyone who has...
A pregnant woman, I’ll call her Dorie, was concerned about the effect that her asthma medication might have on her unborn baby. Dorie decided that the safest thing to do was to stop taking her asthma medication until the baby was born. Unfortunately, without her medication, Dorie experienced an acute asthma attack – both she...
This study published online in May in the Obstetrics & Gynecology journal called "A National Survey on Public Perceptions of Miscarriage" asked about perceptions about miscarriage. Not surprisingly, most who answered the questionnaire have many misconceptions about miscarriage. Respondents to the survey erroneously believed...
CNN reported on a baby that was born 8 weeks early in Hong Kong.  The mother apparently cannot pay the hospital expenses and the hospital withheld the baby's birth certificate. Her insurance won't pay for the baby either, likely because the hospital is outside the United States, so she is responsible to pay expenses herself....
Pregnancy

Pregnancy News May 14th, 2015

Drum Circle For Home birth? In this Craigslist ad, a drum circle is requested for a home birth. According to Wikipedia, "a drum circle is any group of people playing (usually) hand-drums and percussion in a circle."  Considering that home births have been associated with an increase in neonatal deaths, one wonders whether...
Hyperemesis Gravidarum is nausea and vomiting on steroids. It's awful - just ask anyone who's had it. It’s good that the condition is recognized with a day of its own. In honor of this special day, here are 15 things you can do about normal and abnormal nausea and vomiting during pregnancy. And how to tell the difference.  15...
I was surprised to learn that Hyperemesis Gravidarum had a day to call its own and pleased that this unpleasant condition has been recognized as a serious problem. In honor of that special day, here are 15 facts about hyperemesis gravidarum. (See my next post for 15 things you can do about it). 15 facts about hyperemesis...
Pregnancy

A Centered Pregnancy

“CenteringPregnancy incorporates the three components of prenatal care - education, risk assessment and supportive care - into one entity and encourages women to take responsibility for their own health...The CenteringPregnancy Model ‘centers’ the three components of prenatal care...into a whole and helps a woman ‘center...
What’s one of the first things you generally do if you smack your funny bone? Without even thinking about it, you rub your elbow. You’re using gate control to alleviate your pain - even if you don’t have any idea what that is - and gate control is an essential tool to have in your labor kit. According to Marcy White’s book,...
Study Shows Babies Born as early as 22 weeks Can Survive With Resuscitation Until now, 24 weeks of the pregnancy was considered the absolute cut-off for viability, for the potential of a premature neborn baby to survive. But now this long-time understanding of how babies survive is being challenged. A new studies shows that...
Holidays are known to be stressful times for many of us. High expectations, family tensions, forced “happiness,” and rigid traditions can cause sadness and frustration. All we can see are our perceived failures at creating a life that meets some ideal of what our lives “are supposed to be.” But let’s be real, that perfect life...
Childbirth

Ten Tips for Birth Partners

Help her stay in the moment while you plan ahead.A laboring mom’s job is to take one contraction at a time. But the partner can help by thinking ahead. Maybe you’re slow dancing together, and all is well. It’s helpful for the partner to think about what to suggest when mom is ready to move on. Maybe she’d like to try the shower...
I like to think that I went into my birth about as well educated as a first time mom could be, but if you’ve had a baby you know how that goes. I was one of those women who read everything - and I mean everything - she could get her hands on. Now, looking back with chagrin, I see how little I really knew. Sadly, most of that...
Have you thought about what you’re going to do in early labor? A friend of mine who is a midwife suggests baking cookies in early labor. I think this is excellent advice. First of all, then there will be cookies. But also, having a fun activity will help you pass the time in early labor. My friend the midwife tells her families...
So you just missed your period but the home pregnancy test is negative? You are sure that you are not pregnant? Think again. Maybe it's a false negative pregnancy test which means the test is negative when in fact you are pregnant. Studies have shown that women with a high BMI, women who are overweight, have lower hCG pregnancy...
Childbirth

What Can't Doulas Do?

Birth doulas can be an extremely valuable source of support to mothers before, during and just after childbirth, as they are specially trained to provide physical, emotional and informational support. Doulas, however, are not trained medical providers, and thus, there are limits on what they can and cannot do. Unlike physicians...
Childbirth

7 Ways to get your Labor Started

The first thing you should do if you are overdue is to wait. Have patience and let your baby decide what his or her birthday will be. You’ll be making most of his/her decisions after that. When You Should You should only consider inducing labor when it is more risky for your baby to remain inside you than to be born. Conditions...
Imagine a woman giving birth. What position do you see her in? If, like most people, your views on birth have been shaped by what you see on tv and in the movies, you likely imagine her lying flat on her back in a hospital bed. Traditionally birth took place at home, and people formed their impressions by direct experience....
Yes, research and statistics are important, but sometimes the best gift we have to offer a pregnant woman is a story. We crave the I-know-about-a-woman-similar-to-you-who-did-it stories. Cut, Stapled, & Mended: When One Woman Reclaimed Her Body and Gave Birth on Her Own Terms After Cesarean, by Roanna Rosewood, is such a...

Pregnancy & Fertility News April 27, 2015

World Health Organization Publishes Folate Recommendations for Women In the United States, women consume folic acid from three sources: enriched cereal grain products (i.e., fortified foods), ready-to-eat cereals, and supplements. Neural tube defects increase with folic acid deficiency. In 1996  the U.S. Food and Drug...
In-vitro fertilization or IVF is a procedure where eggs are fertilized outside the body and implanted into the uterus.  There are many clinics that perform this procedure but success rates can be confusing because they depend on many factors including a woman's age, height, weight, prior pregnancies, reasons for infertility,...

Pregnancy & Fertility News April 23, 2015

Induction of labor after 39 weeks may have benefits The authors studied randomized controlled studies of labor inductions between 39w0d and 40w6d and found that induction of labor at full term in uncomplicated singleton gestations was not associated with increased risk of cesarean delivery and has overall similar outcomes...
Amenorrhea, meaning the absence of your period, comes from three Latin words: a (no), men (moon), rrhea (flow). No moon flow. Our periods are susceptible to the influences of many things besides the moon so missing a period now and then is not a big deal. But if you are skipping periods and you are not pregnant, you will want...
Operative vaginal delivery methods, which include forceps and vacuums, are sometimes used as an alternative to cesarean delivery during the second stage of labor. While they carry high success rates and allow mothers to avoid a c-section, they also come with risks that many parents are unwilling to take. According to the CDC,...
What is my fantasy of the perfect birth experience? Do you want to squat and effortlessly push out your baby in your bedroom? Labor in water? Get an epidural in the hospital parking lot? While no one can predict how your labor will go, thinking about your ideal will help you make decisions now and in labor. It’s important to...
Childbirth

My Feelings on Homebirth

I very much believe in a woman’s right to choose where she gives birth. I also believe that the vast majority of homebirths are uncomplicated and Certified Nurse Midwives are well-qualified to manage most complications that do occasionally occur. With informed consent and qualified care providers, homebirth may be the right...
A former CPM, Leigh Fransen, has bravely stepped forward to blow the whistle on the illegal practices of homebirth midwives in the United States. Fransen attended direct-entry midwifery school in Florida. She founded a birth center with three other midwives in South Carolina. After Fransen's departure from the birth center, ...
I know that CPMs are not real midwives from reading the MANA Statement of Values and Ethics, by which NARM recommends they practice. I have copied portions of it below, with my emphasis. “I. Woman As a Unique Individual:A. We value each woman as a strong, creative, unique individual with life-giving powers. B. We value each...
D-O-U-L-A! When I became a doula in the early nineties I frequently spelled the word to help people who had never heard it before. I often had to explain what a doula was and how we were different than midwives. Times have changed and the doula profession has grown up. I don’t spend nearly as much time as I used to explaining...
If 90% of US mothers breastfed their babies it would prevent 14,000 heart attacks in women per year, according to Dr. Bimla Schwarz, an accomplished physician, researcher and “women’s health truth-teller.”1 Heart attacks are the #1 cause of death in women. We are all very aware of the benefits that accrue to babies from being...
Cesarean Section Should Only Be Performed When Medically Necessary Cesarean section may be necessary when vaginal delivery might pose a risk to the mother or baby – for example due to prolonged labor, fetal distress, or because the baby is presenting in an abnormal position. Cesarean section is valuable in saving the lives of...
While it is often ideal for the laboring mother to be out of bed and moving around during labor, sometimes complications or her desire for an epidural prevents this. However, frequent position changes can still be done in moms who have the epidural, including various positions using a peanut ball. A peanut ball is a a peanut-...
Here are the most common misconceptions and myths I often we hear: 1. 'I am 35 years old and there is no need to worry about getting pregnant until much later on." No matter how you look at it, from a biologic point of view the best time to get pregnant and havea baby is well before the age of 35. At birth, a woman...
Childbirth

Make Home Birth Safer

I am a part of a new group called the Coalition for Safer Home Birth. Though our group name is new, it is made up of people who desperately want change and have been fighting to increase awareness of issues we face with out-of-hospital births – and they’ve been doing so for years. As stated on the Facebook page: “We are a...
How did the Dutch Get So Tall? The Dutch are the teallest in the world. This study proposes that natural selection in addition to good environmental conditions may help explain why the Dutch are so tall. Read more HERE.... Breast Milk Purchased Over The Internet includes Cow Milk This study found that 10% of supposedly human...
Defensive medicine, which is the practice of recommending tests or treatments mainly to protect a care provider from litigation instead of for the patient’s benefit, is a term that has been widely used in the field of obstetrics lately. It is impossible to have a conversation about the rising c-section rate without discussing...
As a culture we believe that pain is unacceptable. But when we numb out sensation in labor, we diminish our endorphin levels and the endorphin levels of our babies. The pain is dulled, but so is the exuberance we are meant to experience afterwards, when contractions are over and mother and baby bathe in the highest endorphin...
Pregnancy

What is HELLP Syndrome?

What is HELLP Syndrome? HELLP Syndrome is a serious, life-threatening complication of pregnancy that occurs in less than 1 per cent of all pregnancies in the US. Pregnant women who have high blood pressure and develop severe preeclampsia or eclampsia, however, have a higher risk. Signs (test results) and Symptoms (things that...
I have written previously that safer homebirth requires educated, regulated midwives. Anyone who has looked into state midwifery laws in the U.S. has come to the same alarming conclusion: in many states, homebirth midwives are virtually unregulated. If you support uniform midwifery regulations in the U.S. that will make...
What do you think? After teaching natural childbirth classes for twenty-three years, I’ve learned that natural birth means different things to different people. Was my four hour Pitocin induced labor a natural birth, because I had no pain medications? Or only my two hour homebirth which my midwives barely made? I once asked my...
“Just because there are a few bad CPMs out there doesn’t mean that all CPMs should be vilified,” is a statement I have often read/heard when getting into discussions about home birth midwifery. I wholly disagree with that statement. Here’s why: I don’t doubt that there are some incredibly intelligent, highly educated Certified...
Labor & Delivery offers no shortage of moments that run the full spectrum of emotions. But sometimes, things that occur in the process of bringing babies into the world that just make you take a step back and laugh. Here are some of the funniest moments I’ve ever encountered in the delivery room. It’s sometimes said that...
Did you know that when your baby is born, 30% of his or her cord blood will still be in the placenta? Waiting to clamp and cut the cord will allow your baby to receive this vital blood. Babies who get delayed cord clamping, or as it is now being called, appropriately timed cord clamping, have higher iron levels even a year...
How many of us have performed more than one pregnancy test, just to be sure? Or bought a three-pack of tests, knowing we wouldn’t be satisfied with taking just one? Are we crazy – or should we not trust the results of our home pregnancy tests? Although ads claim that home pregnancy tests are 99% accurate, a recent study found...
Lebanon seizes 550 kilogram of radioactive sanitary napkins This is from the "I can't believe it's true" news. And it's not an early April fools joke. Read more HERE.... Why are more baby boys born than baby girls? At the time of conception the ratio between girls:boys is about equal but over the pregnancy, more girls die than...
Ask for what you need. This is often difficult for new parents, but if friends and family offer to help, ask them for specific favors. Do you need someone to vacuum, pick up items at the grocery store, or fold laundry? Can a different person bring you dinner for a week or two? Tell visitors ahead of time that they will only be...
The midwifery bills under consideration in Maryland and North Carolina would make it legal for direct-entry midwives to attend homebirths. In Maryland, HB9 and SB105 are house and senate versions of the same bill, and in North Carolina, S542 decriminalizes direct-entry midwifery, and S543, the Home Birth Freedom Act, licenses...

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