Wednesday, May 30, 2007

Due date?

"My baby will be born on its birthday, not its due date. I am not in a
hurry. I am not on a schedule. I am patient. When I am in labor, I
will not rely on the clock to tell me how fast to go. I am not a
factory. I am a powerful woman, birthing a new person into the world." --Doula Daniella

Helping with the birth of twins

I was thrilled to be invited to help out two of my friend midwives with a family expecting twins. I'd only been to one homebirth twin birth and that was early on when even squeezing the bulb syringe deserved a review. After meeting me, the parents agreed to include me as one of their midwives.

A couple nights before these girls were born the lead midwife and I were chatting. She said in her early years, 26 years ago, her faith in birth got her through where experience was thin. She trusted the Lord and birth itself. But now, after many years, the things shes learned through experience can sometimes be a burden.

I knew what she was describing. Learning birth at home builds the trust first. There are fewer complications and less fear. But as we grow older we learn about the unexpected firsthand, not just in a book. We've found that something often comes up that wasn't in the books.

My friend said when she reflects on that, that she goes back to the faith she had in the beginning when birth seemed so simple. We have a choice. We can breath fast, let our heart rate race and get tense. Or we can breath deep into the trust.

We still know what we know. We bring together nutrition, rest, trust and a good fetal position. Yes, there is the unknown, but it can be allowed, not feared.
We have a plan, we have a plan B, and we have a plan for going in to the hospital if needed-- Within these "plans," we take into account the unique qualities of the birthing mother, the baby or babies, in this case, and yes, the spirit of the birth. Communication is expressed through all these sources from one Source. And we must communicate our own thoughts, too. First by being receptive, then by speaking the truth, not the wish, of the moment. This is what I feel, see, touch, smell or hear. Not, this is what I hope to be or what I wish were true.

If it is given to you to know, you will know. Some things we can change, some things we are not given to know and then we must experience the course that unfolds. When we are receptive we can trust this mechanism to be protective. We move forward. When we fear, a lack of receptivity hides us in denial. We seek stability and stop hearing.

When control is an expectation, trusting birth seems ridiculous. But what can keep birth within the bounds of the known world? Monitoring every body function? Surgery without birth? Warnings and doubts expressed? There is no magic there, only an exchange. The unknown risk is traded for a known side effect. As if the frequency of induction makes the higher death rate of late prematurity acceptable. Believe it or not it is more medically acceptable than, say, the rate of death due to shoulder dystocia, which is lower than that the deaths in the first year due to complications of late prematurity.
First of all, preparation for a natural twin birth is quite different. Prenatal care for twins includes a woman's self care, 100-150 grams of protein daily, a gallon of fluids, salt to taste, chlorophyll liquid and Floradex with Iron, etc. etc.
Are women under medical care hearing this sort of nutritional counseling? No, they are given weekly ultrasounds and bed rest. Then once past 36 weeks, surgery. Are babies faring better?
Well, we have to look at twins born with after emotionally and physically nourishing prenatal care compared to the usual medical care. The food and supplementation we suggest has led to full term twins for my friend's other twins experiences and many other midwives, too.
As a doula for twin moms, The Brewer Diet, natural supplementation and Chiropractic care helped women get to 38 weeks and beyond. Much good can come of technical birth interventions when it is needed. I'm not naive. One family wanted their twins born at home, but one twin wasn't doing excellently at term and a cesarean helped them have a safe delivery, one that wouldn't have been safe at home.

I was the first midwife to arrive the other night. Thoughts went through my head as I drove closer to the home. Will I be prepared to handle the unexpected? Will my brain freeze? I stopped myself. Taking a deep breath I let trust in. The preparations were made, the prayers were said. Just take a step and walk in the door. The birth will be waiting for you there.

Two healthy babies were born a few hours later. And mom did great during and after. So that I'm not telling the family's story, let me just say that together the babies weighed just one ounce less than 15 1/2 pounds.
Every thing turned out so well at home that night. Everything went just about as expected. Everything went according to plan "B." So well in fact, the little ones' Apgar scores were 8-9 and 9-10 respectively. Praise God.

Wednesday, May 23, 2007

The hazards of induction may be worse than you thought


Induction of labor is a phrase meaning that labor contractions are encouraged by external means. Drug induced labor can be brought on with Pitocin in an IV drip, prostaglandin gels or a pill, cytotec (misoprostol). Dr. Michel Odent (www.birthworks.org/primalhealth) writes of the concerns about Induction and autism in Midwifery Today Online Magazine. Please read the entire article and support Midwifery Today. The following are exerpts from that article:

"We have many reasons to suspect a link between "autism epidemic" and "labour induction epidemic." The first reason is that in all studies that took into account independently the variable "labour induction," it appeared as a risk factor. Labour induction should be explicitly taken into consideration by epidemiologists, because it can be associated either with birth by the vaginal route (with or without intervention such as forceps), or with cesarean birth...

...the results of recent studies suggest that children with autistic disorder show alterations in their oxytocin system. The first clues came from a study of mid-day blood samples from 29 autistic and 30 age-matched normal children, all prepubertal.(Modahl, C., et al. Plasma oxytocin levels in autistic children. 1998. Biol Psychiatry (4): 270–77) The autistic group appeared to have significantly lower blood oxytocin levels than the normal group...

... Artificial induction of labour creates situations that undoubtedly interfere with the development and the reorganization of the oxytocin system in such a critical period. This fact alone is a reason for further epidemiological studies focusing on labour induction as a possible risk factor. It would be useful to know also how autistic children release oxytocin. Oxytocin is more effective when released rhythmically, in a succession of fast pulsations. Today it is possible to measure the rhythmicity "the pulsatility" of oxytocin release. In other words, the time has come to study autism as an "impaired capacity to love."'

Midwifery Today's Editor Jan Triton notes: Oxytocin is a hormone released by the posterior pituitary gland. Its mechanical effects, particularly its stimulating effects on uterine contractions during labour, have been known for a long time. Recently we learned that oxytocin also has important behavioral effects. Today we are in a position to summarize the results of dozens of studies by claiming that oxytocin is the typical hormone of love: Whichever facet of love one considers, oxytocin is involved. Read more in the free MT Online Issue.

To learn other problems with inducing labor, read the CIMS statement.

Rotating a posterior baby in pregnancy

Meanwhile, the woman in the previous post (from earlier today) realized her baby had been left occiput posterior (LOP). "His" back had been on her left and his fingers busy in front. The baby rode high and she couldn't lean forward without discomfort for herself and, she suspected, for her baby. I then felt her baby and agreed the baby was LOP.
I explained the 3 Principles: 1.) Relax what the mother can't herself relax. 2.) Use gravity to encourage the baby to settle into the front of the abdominal wall. 3.) Use movement to move the pelvis and soft tissues around the baby.

So we began:
1.) Abdominal release, also called a diaphragmatic release.
2.) Sacral release, also called a buckled sacrum release.
3.) She laid down and I stroked the sides of the abdomen, lifting the weight of her womb and wiggling my hands upward, jiggling the broad ligaments. She liked this.
4.) Rebozo "sifting" of the abdomen while she knelt and leaned her arms and head on the bed. Her husband tried this, too, surprised it was such an upper body workout. She smiled and said it was awesome.
By now she had no or little pain, remember she had taken the kali carb. See previous post.
5. ) We ended with a pelvic floor release. That put a stretch in her lower back where the pelvic floor attaches to the back side of the hip bone and sacrum. She did both sides so she didn't add to the asymmetrical pull of her body.

Her baby was now left occiput transverse (LOT), an excellent start position. Yet there was much amniotic fluid and the baby wasn't engaging into the pelvic brim yet. So unless her tissues were relaxed more completely so they could become symmetrical, the baby is likely to go back to posterior.

Her plan is to return to the Chiropractor and see what soft tissue work the Chiropractor can do. They can also continue with this list at home. I suggested she wait at least a week before trying another pelvic floor release. She planned to get on an inversion table for 30-60 seconds for a few times to help her lower uterine segment relax and in so doing, become more symmetrical.
Then the baby should be able to stay out of the posterior position.

Can this help hip and lower back pain?


I was asked by a second-time mother if she and her husband could come over and see what we could do about her hip pain. The pain went from the hip across the lower back at that level. She had it in the first pregnancy and this one, and was due in a month and was weary from such pain when ever she got up or down.
I warned her that I was not a body worker but they could come on over.
Watching her sit and move for a minute helped me to realize she had sciatica. I learned about a wonderful remedy for sciatica from my sister who suffered terribly, almost loosing her job and ending up in the ER before she tried homeopathic kali carbonicum 30 c. I carry "kali carb" in my midwifery bag. Ronnie Falcao has a list of homeopathy resources on her midwifery site.

Wednesday, May 16, 2007

Will doing an inversion turn a head down baby breech?

Q: "I have been doing several things to get my baby flipped. I am now 32.5 weeks pregnant. At my 32 week appointment my doctor said the baby is breech. Since then I have started seeing a Chiro for the webster technique, and have been doing moxibustion. My problem is that this baby moves ALL THE TIME. They are big movements ALL THE TIME. So, I never really know if it has flipped or not. I am just not good at being able to tell. If I begin trying the inversion will I risk undoing a head-down positional flip that might have already taken place?"

A: "I can't say it isn't possible. But it is likely to help you turn your breech and isn't likely to flip a head down baby if you do the short form of the inversion.
You are right on time with your attempts to help the baby head down and I expect you to be successful. The movement you feel can be two forms, One, the limbs. Two, less likely, the whole body. It isn't that likely that the baby is going breech to head down to breech to head down to breech. Add transverse in there for each turn.

There are two ways to do the inversion:
One is for 10-20 minutes in the breech tilt or Open Knee Chest.
The other form of inversion is in the inversion as shown on the movie in my blog, You hold the inversion for about 1-2 minutes. Then you crawl forward and kneel before you stand up.
This second inversion style is less likely to flip a baby who is head down into a breech. You do it once a day to first stretch and then, in standing again, relax your lower uterine ligaments/cervical ligaments so they come out of a twist. Then the baby can turn head down more likely. Chiropractors can help in addition with the sacrum, pubic bone alignment and your neck to increase the chance of a head down baby. The Webster is important, too.

For a mom with a suspected breech baby at 35-40 weeks, there is less chance of accidentally flipping a head down baby to breech. I did hear of it happening once with a mom who had 2 children and was in her third pregnancy. She did the Open Knee Chest position (to rotate a posterior baby) for 20-30 minutes. I didn't talk to her, but heard about it. I wonder how much amniotic fluid she had, but we can guess that her womb was more relaxed than the average first time mom. The longer use of an inversion position, such as Open Knee Chest or the Breech Tilt is good for when either the hips or the head are dropped into the pelvis (engaged).

I wouldn't think that at 33 weeks your baby is engaged yet. I hope not. So a short term inversion may be the better choice. Ask your midwife or doctor if there is any reason not to do an inversion in your case. Please let me know how these techniques work for you." -Gail Tully

Thursday, May 10, 2007

After 3 cesareans, a home birth

Here is a woman's truly inspirational story. Watch Aidan's birth. Shown on onetruemedia.com As a midwife, I have been blessed to share several such journeys. Theresa's comments depict her emotional feelings. She had a transforming experience before her VBAC -- a common element to success. The chiropractic work was also likely to be crucial.

One baby's song to his Obstetrician

This Dad, singing for the baby boys and girls out there ("in there?") has got something to say to all of us about induction, bonding and more! Ready to smile? Click here to hear the Obstetrician Song. Its on the Compleat Mother web site.

Wednesday, May 9, 2007

Why does the position of the head matter?

A teapot will show us why it matters that things fit. The lid won't come off crooked, but will come off after rotating to the proper position.


Its the same thing with some of our babies. They may not be able to slip through the pelvis -until they rotate to a better angle.

Tuesday, May 8, 2007

Empowering (Movie) Birth

I don't follow the Hollywood stars but I have heard the name Rikki Lake. She's put together a movie about birth in America. Her birth, her friend's birth. She calls it The Business of Birth.
Its reaching the tv generation and ends with a warning from Dr. Michel Odent on the importance of labor hormones.

Changing the Earth by supporting Birth

Mothers bring forth life; medical corporations do not. Birth can be simple, powerful and loving. Fetal positioning, natural birthing and practical help for normal birth.