Sunday, May 29, 2011

10 Common Questions about Water Births

Courtesy of The Birthing Site.

1. How long is the baby under water after birth?
The amount of time the baby is under water will not harm or help the baby. Many practitioners usually bring the baby up within 10 seconds or mom or dad can lift baby out of the water themselves. There is no physiological reason to leave the baby under the water for any length of time. There are several water birth videos that depict leaving the baby under the water for several moments after birth and the babies are just fine, because babies can breathe under water as long as they haven't taken their first breath of oxygen.
Physiologically, the placenta is supporting the baby with oxygen during this time though it can never be predicted when the placenta will begin to separate causing the flow of oxygen to baby to stop. The umbilical cord pulsating is not a guarantee that the baby is receiving enough oxygen. The safe approach is to remove the baby, without hurrying, and gently place him into his mother's arms.
2. What is the cost of a water birth?
The cost of a water birth is significantly less than that of a hospital birth and some provinces and states are now insuring them as standard coverage. The rental of the pool can be anywhere from $0 if you use your own home tub or a pool (or your midwives have them to borrow), if you rent or purchase it can be a few hundred dollars.
3. What should the water temperature be in the pool?
Water should be monitored at a temperature that is comfortable for the mother, usually between 95-100 degrees Fahrenheit. Water temperature should not exceed 101 degrees Fahrenheit as it could lead to an increase in the mother's body temperature which could cause the baby's heart rate to increase. It is a good idea to have plenty of water to drink and cold cloths for the mother's face and neck. A cool facial mist from a spray bottle is a welcome relief for some mothers as well.
4. When should I get into the water?
You should get into the water whenever you feel you are ready. When you begin to feel strong contractions, you brain will desire comfort, this is usually a good indicator. However, test the water prior to immersing. When you enter the water, your brain sends relaxation hormones to your body within 20 minutes of entering the pool and peak around 90 minutes. It is recommended to get out and walk around as a change of scenery and reimmerse to re-engage the relaxation chemicals in your body.
5. Who should I have with me?
It is recommended to have a midwife or doula at all times to monitor the baby and you. You may have any other support people around to encourage and relax you as this is the most important goal. You can even have a spouse or partner in the tub with you for periods of time.
6. What should I wear in the pool?
You can wear anything that feels comfortable that will not impede the delivery of the baby or many women wear nothing at all.
7. How long does a typical water birth take?
A water birth takes as long as any natural birth. The water is a means of relaxing. There is no evidence that it speeds up or slows delivery.
8. What if something goes wrong?
Have a backup plan and be flexible. A birth does not go always as planned and may move faster or slower than expected. There are many things that can be remedied by itself through birth and listening to your support staff and doula or midwife for their guidance. If a medical intervention is required, ensure you have items packed prior to the birth and any other support measures needed on call.
9. What can prevent the baby from breathing under water?
There are four main factors that prevent the baby from inhaling water at the time of birth:
- Prostaglandin E2 levels from the placenta which cause a slowing down or stopping of the fetal breathing movements. When the baby is born and the Prostaglandin level is still high, the baby's muscles for breathing simply don't work, thus engaging the first inhibitory response.
- Babies are born experiencing mild hypoxia or lack of oxygen. Hypoxia causes apnea and swallowing, not breathing or gasping.
- Water is a hypotonic solution and lung fluids present in the fetus are hypertonic. So, even if water were to travel in past the larynx, they could not pass into the lungs based on the fact that hypertonic solutions are denser and prevent hypotonic solutions from merging or coming into their presence.
- The last important inhibitory factor is the Dive Reflex and revolves around the larynx. The larynx is covered all over with chemoreceptors or taste buds. The larynx has five times as many as taste buds as the whole surface of the tongue. So, when a solution hits the back of the throat, passing the larynx, the taste buds interprets what substance it is and the glottis automatically closes and the solution is then swallowed, not inhaled.
10. What types of pools can I use?
There are many types of pools women choose to use or rent. There are designated water birthing tubs you can rent for about $300-$500. Many women suggest using a deep kiddie pool, a trough or your own tub if it is large enough as these are often the same benefit and a smaller price.
Further Reads and Resources Sources
Last modified on Saturday, 28 May 2011 11:07

Friday, May 27, 2011

Promising News for Homebirthers!

ATLANTA – Home births rose 20 percent over four years, government figures show, reflecting what experts say is a small subculture among white women toward natural birth.
Fewer than 1 percent of U.S. births occur at home. But the proportion is clearly going up, study by researchers at the Centers for Disease Control and Prevention found. The new figures are for 2004 to 2008. Home births had been declining from 1990 to 2004.
The increase was driven by white women — 1 in 98 had their babies at home in 2008, the most recent year for which the statistics were available.
Only about 1 in 357 black women give birth at home, and just 1 in 500 Hispanic women do.
"I think there's more of a natural birth subculture going on with white women — an interest in a low-intervention birth in a familiar setting," said the lead author, Marian MacDorman of the CDC's National Center for Health Statistics.
For all races combined, about 1 in 143 births were at home in 2008, up from 1 in 179 in 2004.
Geographically, 27 states had significant increases during those four years. Montana, Vermont and Oregon had the most home births — about 1 in 50 births were at home in those states.
Alaska's rate was nearly as high, and it's clear that some home births occur because women are in remote locations and are not able to get to hospitals in time for delivery.
The increase is notable because doctors groups have been increasingly vocal about opposing home births, The American College of Obstetricians and Gynecologists has for years warned against home births, arguing they can be unsafe, especially if the mother has high-risk medical conditions, if the attendant is inadequately trained or if there's no quick way to get mother and child to a hospital if something goes awry.
Doctor participation in home births declined by 38 percent from 2004 to 2008. The percentage of home births attended by certified midwives and nurse-midwives grew, meanwhile.
Home births increasing? "From our perspective, that's not the best thing for the overall health of babies and women," said Dr. George Macones, an obstetrician at Washington University in St. Louis who chairs ACOG's Committee on Obstetric Practice.
Exactly how unsafe home births are is a matter of medical controversy, with studies offering conflicting conclusions. And some argue that hospitals present their own dangers of infection and sometimes unnecessary medical interventions.
The CDC researchers did find that home births involving medical risks became less common from 2004 to 2008. Home births of infants born prematurely fell by 16 percent, so that by 2008 only 6 percent of all home births involved preterm births. That's less than half the percentage in hospitals.
The study was done by two CDC researchers and a Boston university professor. It was electronically published Friday by a medical journal called Birth: Issues in Perinatal Care.

Doula Support: Before, During, and After Labor

This was originally written by my friend, April, over at Birthing Beautiful Ideas, but the way that she writes it is in so much better terms than I ever could.

If you ever have any REAL doubt as to what the actual ROLE of a doula is, then here is the best explanation I have seen so far! Go April!

Doula Support: Before, During, and after Labor

Posted on May 27, 2011 by BirthingBeautifulIdeas

For those who still view doula support as something mysterious and strange (do they say incantations?  strike up fist-fights with hospital staff?  sprinkle a magic potion over laboring women?), the reality of just what doulas do can seem quite unclear.
But for the most part, what doulas do is not all that mysterious and strange.  And what a doula does varies from each individual pregnancy and birth to the next.  What’s more, a doula’s work is often not limited to labor itself but generally extends from pregnancy to the postpartum period.
What does this work look like?
Doulas often schedule one to four prenatal visits with their clients, both to get to know them and their desires for their births and to help their them prepare for their births.  During these meetings, doulas might:
  • help their clients prepare a birth plan or birth preference list
  • refer their clients to community resources, such as chiropractors, massage therapists, and pediatricians
  • offer a safe space for their clients to discuss past birth experiences
  • attend a prenatal OB/GYN or midwife appointment with their clients
  • prepare handouts, books, or website referrals that address their clients’ particular needs or circumstances
  • help their clients to prepare for both their “ideal” birth and any unexpected circumstances (such as breech position, induction, long labor, cesarean section, etc.) that may arise before or during labor
  • discuss and work through emotional preparation for birth and parenthood
During Labor
Because each birth is different, a doula’s work inevitably varies from birth to birth.  Among the varied and unique births they attend, doulas might:
  • help to reassure their clients and their support team about the normalcy of their labors
  • foster communication between their clients and the hospital staff when labor strays from the norm (or even when it is a normal, “text book” labor)
  • offer massage, counterpressure, and other types of touch techniques to help their clients cope with the intensity of labor
  • use acupressure, aromatherapy, rebozo work, and/or guided relaxation to help comfort their clients
  • suggest position changes to encourage fetal rotation and descent, to enhance labor progress, and/or to provide comfort
  • work to maintain a calm and peaceful atmosphere for the laboring woman
  • create emotionally safe spaces for their clients–for like any mammals, such spaces are all but necessary for good labor progress
A doula’s work is not done after their clients birth their babies.  The vast majority of birth doulas offer some postpartum support, both immediately after the baby is born in the weeks following the birth.  Doulas can offer this postpartum support by:
  • guiding their clients during  early breastfeeding
  • helping the new family to get “settled in” after the birth
  • making referrals to community resources (such as lactation consultants, pediatricians, parenting support groups, and postpartum doulas) where appropriate
  • discussing common concerns about postpartum healing and baby care
  • helping their clients process their birth experiences
  • talking about ways to be mindful of and respond to postpartum mood disorders
Thus, rather than being strange or mysterious, doula support valuable, unique, and fairly “normal” work–and work that has consistently shown to have “clinically meaningful benefits for women and infants“!
In what other ways did your doula help you prenatally, during labor, and after your baby was born?  What other types of support do you incorporate into your own doula work?
This post is a part of my “Different Types of Doula Support” series honoring International Doula Month.  I’m also giving away a copy of YOUR CHOICE of a fabulous birth book in honor of International Doula Month. Please see my original postin this series to find out how you can win!

Preparing for the big day

A lot of things are changing around here, and very quickly at that. My guess date is coming up very quickly and I know very soon I will be holding my new baby girl in my arms. I have to admit, though, that I am scared of this new transition. Scared because of my toddler.... I adore her to death but realistically, I am more scared that she will think that mommy doesn't love her anymore because of all of the attention lavished on her new sister. It is definitely tough to face this with her being so young... I will miss these little moments with her as an only child.

As for the business, I am currently getting close to starting a curriculum to add a certification as a HypnoDoula through Hypnobabies to my CBI certification coming soon. As a mom working with Hypnobabies myself, I feel as though I already offer a slight advantage to mothers wanting to use this program, as I am familiar with the cues and the tracks. I am excited to be able to offer the full certification experience to mothers in the future.

Well, that's my update for today :) Hopefully one of my next ones will be my birth story of my precious little one.

Blessed to be(coming) a doula!