Tuesday, August 31, 2010

Physiological 3rd Stage, without the "as long as..."

I shared a link to my post A Natural Third Stage with Buscando la Luz after reading two posts on her blog, Birth Faith, called Preventing postpartum hemorrhage naturally and Preventing Postpartum Hemorrhage: a follow-up. She shared it on her facebook page and my live traffic feed has been going crazy with hits to that post. One commenter was a former L&D nurse who said her experiences backed up the theories I wrote about.

If it is true that keeping mother and baby together reduces the risk of hemorrhage, then that is a good reason not to cut the cord immediately. According to Dr. Nicholas Fogelson of AcademicOBGYN,research does not support the current standard practice of immediate clamping. (I also love this post also because of his example of routine episiotomy as a practice that is very obviously passe. I know from a first hand conversation that there are some dinosaur OBs out there who don't stay up to date on research who still use them liberally--I should post about that conversation sometime)

Someone on the Childbirth International e-mail group recently shared a link to a beautiful series of birth photos by Patti Ramos called Emergence. One of the photos shows an attached cord that is simply beautiful. I never knew they were that color.

Later timing of cord clamping may better for both mother and baby. However, after two hospital births where clamping occured earlier than I preferred both times, I have come to believe that physiological cord clamping is still quite rare in hospitals. I think this is partly because they have been conditioned to believe that routine immediate clamping is normal and may subconsiously look for a reason to cut the cord, partly because they have narrow parameters for what constitutes a "healthy" newborn and are quick to provide support, and partly because they aren't set up to provide transitional support to neonates without moving them away from their mothers. Often "delayed" cord clamping is only available at special request and "as long as the baby is doing okay."

In a post at her blog Midwife Thinking, The placenta--essential resuscitation equipment, one homebirth midwife discusses her reasoning for keeping cords intact no matter what and explains how she goes about doing that. She also talks about obstetric pracitces that contribute to the need for babies to be given support. In a response, Navelgazing Midwife shared pictures of the wooden board she brings to births so that she has a hard surface she could use without cutting the cord in case she ever needs to do chest compressions on a baby.

This just goes to show that in some things, both your choice of provider and the equipment aviailable in your chosen birth location can influence what happens in your birth.

Tuesday, August 24, 2010

I'm in!

It's official! I got the e-mail today saying I've been accepted into the Hypnobabies Instructor training program! Now I have to register, do book reviews, and do the Introduction to Hypnosis Course, as well as finish my doula training. If all goes according to my plans, in about 10 months, I will have both CD(CBI) and HCHI after my name.

2009 Washington State Cesarean Rates

The Unnecessarean posted the 2009 Washington State Cesarean Rates by Hospital today. The hospitals in my area are actually doing really well. Yakima Valley Memorial Hospital has the lowest rate on the list (not including hospitals that only had one or two births in the year because they don't have labor and delivery departments) at 16.8%, and Toppenish Community Hospital (where I had my son, even though it is farther way, for insurance reasons) is the second lowest, at 17.6%.. I mentioned a few reasons why I think the rates here are so good here in the comments. The factors that influence cesarean rates in hospitals are complex, and the cesarean rate is one measure of how well maternity care is doing in an area. Although the hospitals here are very good, this community can definitely use some improvement in options for childbirth education and birth location, since the hospitals pretty much have a monopoly on both right now. The data did not list the rates for homebirths or birth centers. It's not really fair to compare hospitals whose communities have very few out-of-hospital options to hospitals that have abundant ones--because having out-of-hospital options takes away some of the vaginal births from the hospital's stats. Higher c-section rates in hospitals were there are out-of-hospital births in the area is to be expected. If the data included out-of-hospital births in areas like Seattle, I think it is likely the overall rate for the state would have been lowerl.

Monday, August 16, 2010

"Little Lovies by Char" giveaway!

My cute cousin (who had her first baby a year ago via pitocin induction for PROM with no pain meds) just started her Etsy shop, Little Lovies by Char. She is having a giveaway to promote it. She currently has some adorable applique onesies for girls on her shop, and she will be adding matching headbands as well as some boy onesies that I'm sure will be just as cute as what she has so far. If you would like to enter the giveaway, visit her blog, The 3 O's. I love mama-grown businesses!

Saturday, August 14, 2010

Introducing my new doula services website

Peaceful Waves Birth Services: Birth Doula Services in Yakima, WA.

It's a free website with Weebly right now, but I hope to upgrade to my own domain in the future. I will also add more services (childbirth education, in particular) when I am ready to offer them. Check it out and pass the link on if you know anyone in my area.

Updated 9/2/10: I realized the link was incorrect! It's fixed now!

Friday, August 13, 2010

Hypnobabies Instructor Training Info & FAQ Webinar Today!

The Hypnobabies Instructor Trainign Info & FAQ Webinar is today from 11:00 a.m-12:00 pm Pacific Time. There is still time to sign up, if you are interested in becoming an instructor. If you can't make it, you'll be able to listen to a recording of it afterwards.

I will be listening live. I am so excited to start this process!

Tuesday, August 10, 2010

Hypno-anesthesiology 101, with Dr. Seuss

Now the news has arrived
From the Valley of Vail
That a Chippendale Mupp has just bitten his tail,
Which he does every night before shutting his eyes
Such nipping sounds silly, but, really, it's wise.
He has no alarm clock. So this is the way
He make sure that he'll wake at the right time of day.
His tail is so long, he won't feel any pain
'Till the nip makes the trip and gets up to his brain.
In exactly eight hours, the Chippendale Mupp
Will, at last, feel the bite, and yell "Ouch!" and wake up.
This passage is from Dr. Seuss's Sleep Book, which I read to my two year old daughter to help her fall asleep. Although the Chippendale Mupp's eight hour lag in pain perception is an exaggeration, the passage illustrates an important fact about pain. Pain signals from the body have to travel along the nervous system to the brain before we actually recognize pain. Therefore, it could be said that pain happens in the brain. The following quote from the article Replacing Painkillers With Hypnosis explains how a pain test performed under hypnosis looks on an fMRI:
New imaging techniques have recently started to reveal what occurs under hypnosis, and why pain that would otherwise lead to severe discomfort becomes bearable. Using functional magnetic resonance imaging (fMRI) scans, Sebastian Schulz-Stubner and his team at Aachen University in Germany measured the brain activity of 12 healthy volunteers who received repeated heat stimulation to their skin. The researchers found that hypnosis interrupted the pain signals that normally travel from the nerve cells to the primary somatosensory cortex, where the sensation of pain is elicited. Instead, the signals fizzled out in the subcortical region, failing to produce the normal ouch effect.
The article also goes into detail describing a dental procedure using hypnosis for pain relief, using a "Special Place" like the one taught in Hypnobabies. One thing I love about the Hypnobabies method is that is uses medical hypnoanesthesia techniques, just like the ones this article is talking about.

What is Hypnoanesthesia?

Hypnoanesthesia is simply the body's own endorphins, which are released by the brain. Endorphins are said to be ten times stronger than morphine. We experience rushes of endorphins in response to pain, but also during exercise and after good sex. Hypnosis allows us to control the release of endorphins with our thoughts. One of my friends was telling me recently about Candace Pert's Molecules Of Emotion, which explains the scientific basis of how our thoughts have physical effects on our bodies. I haven't read it yet, but it's on my list.

But wait, if birth isn't inherently painful, why do I need anesthesia for it?

Birth is not inherently painful, though that may depend on your definition of pain. However, birth can become painful when other factors are introduced. Things like stress, fear, distraction, and not being able to follow to your instincts can create pain.

During natural labor, a woman will usually instinctively disconnect from her surroundings and her conscious thoughts and enter a state of deep focus. This state triggers her brain to bathe her body with endorphins and continues the flow of oxytocin. These hormones promote relaxation in the woman, which allows her body to birth her baby without her resistance.

The problem is that if a woman is unable to enter this state, or is distracted from it and can't get back to it, her birthing will become painful and she may fight her body. Knowing hypnoanesthesia techniques allows women to remove pain that is created by forces outside the birthing process. These forces can stop the flow of endorphins from her brain, resulting in pain caused by a level of endorphins lower than should naturally be present during birth. Hypnosis is a way to enter a state of deep relaxation and calmness quickly, which can get a woman back on track if she is thrown off. Hypnoanesthesia allows women to release endorphins on demand to get them back to the state they should be in during birthing. They are also able to get to this state faster when labor begins.

Distractions are a part of modern birth, even if it is just a quick check on the baby's heart rate. Women who use hypnosis have the advantage of being able to refocus quickly when distractions occur. It is natural for a woman to give birth in a place she feels safe, since giving birth makes her vulnerable to attack (several natural childbirth books discuss this concept, including Ina May's Guide to Childbirth and Birthing from Within). In antiquity, women could give birth in privacy, like animals do. Hypnosis actually allows modern birth, regardless of setting or attendant, to be more natural and instinctive, because it allows women to go within and be in a safe place in their minds. So, whether it's on a train, in the rain, in a house, with a mouse, here or there, or anywhere, you can give birth in comfort and peace.

Sunday, August 8, 2010

ABC's Rookie Blue spreads stereotypes of doulas and homebirth

Last night, my husband and I caught a re-run of Episode 7 of ABC's summer series Rookie Blue. This was our first time seeing the show. It follows the lives of five fresh out of The Academy cops.

Episode 7 featured a power outage during a heat wave. One of the story lines involved Officers Gail Peck (Charlotte Sullivan) and Dov Epstein (Gregory Smith) stumbling upon a pregnant woman in her apartment who appears to be in labor, characterized by her grabbing her belly and screaming bloody murder every few minutes. She says she is not due for another month. Her water breaks, and after she is shown on the phone, she tells the cops that she is planning a homebirth and has just spoken to her midwife and is calling her doula next. Gail turns to Dov and asks him "What is a doula?" to which he responds, "A birth coach for hippies." Peck replies "I thought a birth coach was a birth coach for hippies." I was so offended by this characterization of doulas, I almost demanded my husband change the channel right then. Doulas are for everybody, and it is not only hippies who desire natural birth or homebirth. I wanted to see how this scenario played out, so I kept watching.

Dov eventually realizes that the woman is agoraphobic and she tells them she has not left her house since she went off her meds when she started trying to get pregnant. While a woman going off her meds for the sake of her baby is highly commendable, this show seems to suggest that women who choose homebirth must be psychologically unstable or at least have irrational fears. So, now the message I'm getting is that women would have to either be a hippie or psychotic to want a homebirth, and this is far from the truth.

Despite Gail's insistence that the woman's baby is in danger and that they should just arrest the woman and take her to the hospital (really?), Dov sees that the baby is coming fast (as is typical of television births) and he is going to have to "deliver" it himself. Dov catches a very large baby for being "preterm" and which has no vernix on it, and Gail cuts the cord the second the baby emerges, with no mention of clamps (the myth that it is necessary to cut the cord immediately has GOT to stop!) Dov convinces the woman to go with her baby to the hospital to get it checked out (a good example of a woman willing to do anything for her baby), and Dov and Gail grin at each other over the experience.

Gail even later tells her boyfriend that how great she did (what did she do besides bring negativity to the room and prematurely cut an unclamped cord?) On the other hand, perhaps Dov should leave the Force in favor of becoming a male midwife?

If you want to watch the episode yourself, you can view it here.

Friday, August 6, 2010

It's a Blog Party! (No-Go BlogHer Blog Hop)

I found out about the No-Go BlogHer Blog Hop from Semi Crunchy Mama's blog. I'm not going to BlogHer, so I thought I'd join in!
  • When did you start blogging?
I'm pretty new to blogging. I just started this year*, soon after the birth of my second child, my little boy who was born in March.
  • Why did you start blogging?
I wanted to share all of my insights about natural birth and hypnosis and document my journey in pursuing a childbirth career. I had been a member of an online natural birth forum for over two years at that point, and I felt that sometimes things I posted there were more suited to a blog format (I'm still involved there, though!)
  • What is one thing you are going to do this week that is WAY cooler than going to BlogHer?
Right now I'm snuggling a sleeping baby, which is always cool. And waiting for the guy to come back and fix our fridge. And doing laundry. And telling my two-year-old "No, you can NOT watch Mickey Mouse Clubhouse right now!" Don't know if that stuff is cool or not...
  • Share a post that you think says a lot about you or is your favorite.
The posts in my sidebar are my favorites and/or ones that seem to be reader favorites. But, I'd like to share one different from those five, so here is "Let them to this and not fear" which is about childbirth traditions in my husband's family heritage.

*I later realized that this is actually not my first blog. I had a xanga site which nobody read when I was in my second year at BYU. I just found it. I was really embarrassed by how immature I was.

Thursday, August 5, 2010

Latter-day Saint perspectives on Nursing in Public

As an LDS woman, I believe very much in dressing modestly. I also believe that breastfeeding is the way God designed for babies to be fed, and that the only way to make breastfeeding normal in our society is for people to see it. I believe that the negative view of American society of public nursing is a big factor in why women in America don't breastfeed longer. I have experienced firsthand the crushing isolation that results from trying to breastfeed in private as much as possible, as well as the frustration from trying to nurse a baby under a cover who didn't want her head covered up. So now I nurse in public. Without a cover. I do however, usually wear nursing tank tops (I buy them at Target) under my shirts, which allows for minimal exposure of my body while nursing publically. This is what I am comfortable with and what works for me, which may be different for different people.

I have put together this collection of blog posts from LDS women, sharing their own opinions of the issue of modesty and breastfeeding:

Tuesday, August 3, 2010

How to Teach a Baby Not to Bite While Nursing

I was talking to a friend recently and mentioned that I think my son is teething. She mentioned that she would like to wean her 10 month old soon because she bites. I told her that I had nursed my daughter for an entire year after she got her first tooth, and she rarely bit me. Part of that is just her, and part of it is that if she ever did bite, I would take her off the breast long enough that I felt she understood that she can't do that. I did sometimes yell because I couldn't help it, but that seemed to work for my daughter to discourage biting (but I hear that doesn't work for some babies) My friend realized that her baby probably thinks that her reaction to biting is funny or a game. This experience made we want to help other moms know that it is possible to breastfeed babies with teeth and teach them not to bite. I will see how things go with my son, since he seems to be a bit more inclined to chomp down than my daughter, but hopefully teeth won't get in the way of our nursing relationship. Here are some more tips from kellymom about nursing babies with teeth: Kellymom.com :: When Baby Bites

Monday, August 2, 2010

August 1-7 is World Breastfeeding Week


It's World Breastfeeding week! To learn more about this year's theme, visit http://worldbreastfeedingweek.org.

I don't normally post a lot about breastfeeding, since the main focus of this blog is birth, but I am planning a post or two more, in addition to last week's post from the Breastfeeding Cafe Carnival, about breastfeeding, to honor the occasion.

By the way, I changed my blog design again. I went back to a basic blogger template, with a slightly different layout (wider, different header). I hope this one is a little softer on the eye. I also designed the new "Birth Unplugged" badge in my sidebar. I needed a graphic so that when people post links to my post on facebook, they can select it as the thumbprint. It may need different colors, but it is what it is for now.