tag:blogger.com,1999:blog-12371193931353245422024-03-12T18:28:46.666-07:00Natural Birth In KitsapWholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.comBlogger26125tag:blogger.com,1999:blog-1237119393135324542.post-6630728888520044842016-04-03T21:56:00.000-07:002016-04-03T21:56:07.168-07:00Why It's Important<span style="background-color: white; color: #141823; font-family: helvetica, arial, sans-serif; font-size: 14px; line-height: 19.32px;">When I was 20 years old, I was on the path toward law school. I was intent on becoming a child advocacy lawyer in order to protect all of the vulnerable children that I saw in my day to day life. I was naive and I thought this would change the world.</span><br style="background-color: white; color: #141823; font-family: helvetica, arial, sans-serif; font-size: 14px; line-height: 19.32px;" /><span style="background-color: white; color: #141823; font-family: helvetica, arial, sans-serif; font-size: 14px; line-height: 19.32px;">I married a man and we made four babies and I realized that child advocacy does not need to happen only in a courtroom, but way before that time. I became a childbirth educator and a birth doula, and did not ask for it, but fo</span><span class="text_exposed_show" style="background-color: white; color: #141823; display: inline; font-family: helvetica, arial, sans-serif; font-size: 14px; line-height: 19.32px;">und myself becoming mentors for younger mothers. And through this, I came to realize, I was doing child advocacy.<br />I stood in my kitchen last night with this man who is leaving me. Whose childhood is so full of horror, I cannot even fathom it. I break to a million pieces thinking about the little boy who endured so much, and it presses me on to continue this work. We have a great opportunity, midwives and birth workers. We may not always see it come to fruition, but every interaction we have with an expecting family and with a new mother, we are planting seeds. We are advocating for those children in how we treat their mothers, in how we honor their family, in how we speak of the baby and to the baby. </span><br />
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<span class="text_exposed_show" style="background-color: white; color: #141823; display: inline; font-family: helvetica, arial, sans-serif; font-size: 14px; line-height: 19.32px;"><br />Peace on earth begins at birth? I think it's worth a try.</span>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com18tag:blogger.com,1999:blog-1237119393135324542.post-62992863812713281892014-01-16T20:23:00.002-08:002014-01-16T20:26:11.704-08:00The Female FormOn my way home from the gym today, I was chatting with my friend about body image. Both of us being mothers of four breastfed children, we shared in the laments over our stretched out bellies and breasts. We shared with one another our own struggles against body confidence, how our mothers' words and actions had affected the ways in which we viewed ourselves and our hopes and dreams for our own daughters.<br />
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It is hard to feel comfortable with your own female form in this day and age. When we are constantly being bombarded by images of what some person somewhere decided was the "ideal" female shape, it is hard to find acceptance in a body that cannot fit that mold.<br />
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I grew up with a lot of inner confidence, but sadly lacking the outer confidence that I needed. I felt confident in my knowledge and abilities, but was scared of how I might appear to other people. It has taken many years to accept this body, this shape, these genes, this skin that cocoons the very essence of who I am.<br />
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When I started birth work, I was given the opportunity to see a wide range of female bodies, and I was blown away with how beautiful they were. No matter if a woman was short or tall, tiny or large, this pregnant mother was breath-taking in my eyes. Because pregnancy and birth were not about focusing on what was wrong, but rather on focusing on what was right with the female body.<br />
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These bodies of ours, they are amazing. These stripes of stretched skin bear the mark of our having a hand in the creation of another human being. This extra fluff on the belly belies the fat that was stored for transporting extra nutrients to a child if need be. These not-so-perky breasts mark the wisdom that has been gained through patiently nursing, nourishing, nurturing these four children now half grown. This body is an outward reminder of the inner changes that have occurred in my life.<br />
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This female form is not beautiful because it is firm and toned and polished and perfect. This female form is beautiful because it has worked hard in its feminine role of growing, bearing, nourishing, and loving these little people in my life. Why hide these accomplishments? Wear them proudly because you earned them.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-6605621517253885292013-10-21T03:40:00.002-07:002013-10-21T03:42:28.623-07:00Birth is UniversalWe sat around my living room, the three of us. We laughed about the ridiculous things we had seen and heard in hospital birth rooms. We gushed about the awe and wonder of a woman giving birth in all of her glory. We opened up to one another and shared our concerns and asked for input on how to be better - in both the hands on and business aspects of birth. We ate scones and hummus and thousand-layer cake and chocolates. We nursed babies and re-directed school-age children, and sent them upstairs to find their own entertainment. The three of us, though not knowing one another well, we clung to one another's words, experiences, souls.<br />
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Three different women, three different continents, three different cultures. Together we represented a very broad range of beliefs and ways of life. But we convened for the purpose of discussing something universal. Birth.<br />
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I have found that this profession - the profession of being with a woman through her birth - is one that is unlike any other. While bankers, mechanics, graphic designers can all gather together and talk about their lives, their work, their difficulties and successes, nothing can compare to the sisterhood that is created in sharing this work. <br />
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No matter where I go in this world, no matter what ethnicity or culture or continent I am with, I have found that birth is universal. Every child from the beginning of time has come from a woman's body, and to witness this everyday miracle is such an honor. Everywhere on earth, from the beginning of time, other women have gathered around the laboring mother to help her, love her, cherish her through the transition of motherhood. It is an amazing privilege to be able to share this experience with women all over the world and throughout time.<br />
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After the get together at my house, we all went our separate ways. Three different religions, three different lifestyles, three different households, and yet this love of birthing women connects our souls and leaves us with a feeling of unity that cannot be described.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-46320559205260498982013-05-31T17:37:00.001-07:002013-05-31T17:37:06.016-07:00Inversion - Going Upside-Down to Make Things Right!For years in my childbirth education classes I would joke with my students about how the only position worse than laboring on your back would be laboring upside down. We all laughed and thought it was hilarious to imagine a women doing handstands in labor. Funny how perspectives can change.<br />
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I was originally introduced to inversions by my chiropractor, who specializes in pregnancy and pediatric chiropractic care. I often invited her to come to my childbirth classes to talk about the importance of posture, optimal fetal positioning, and chiropractic support in pregnancy. Since many of my doula clients also saw her, we have always had an open relationship about ways in which to help laboring mothers.<br />
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The first time I went to her office with a client in early labor she had my client put her knees on the adjustment table and her hands on the ground. I thought it was a bit odd, but I have seen a lot of odd things in this job that end up working! It didn't make sense to me at first, but the more I asked, the more I pondered, the more I practiced it, it began to make perfect sense.<br />
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The Baby Entering The Pelvis</h3>
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Think about driving a car into a parking space in a crowded parking lot. You turn the wheel of your car and try to ease in to the tight fitting space when you realize, uh-oh! I don't have enough room to maneuver my way into this spot! Do you then keep driving your car forward? No way! That would result in crushing cars parked in the adjoining spaces. So, you back up, take a different angle and try again.<br />
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This can also occur in pregnancy and labor. As mentioned in my <a href="http://www.naturalbirthinkitsap.blogspot.com/2010/09/optimal-fetal-positioning-part-3.html" target="_blank">previous posts</a>, there tends to be an optimal position in which babies best fit through the mother's pelvis. Sometimes, babies start to move down into the pelvis in a manner that makes an awkward fit. This can result in a stuck baby who does not make much forward progression. In these cases, getting baby to first back up and then come in at a different angle is what will help baby best to realign and enter in a more suitable manner.</div>
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How Do You Do It?</h3>
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Inversions can seem a bit scary at first. And it's okay if it is a bit awkward. You have a large belly and it will be awkward! </div>
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<h4 style="text-align: left;">
What you'll need:</h4>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7vsC4kfpL2ZSVF3IUZLd7Eo73_HpXbcRoOSM81Jd4p3gQQPa4MXwhAbloqN8FH286hx0VBNa5MejPXsrmcP8Vhaln3_jXnL9aQLwrbYbKgIqiXwmwgZ8BdKBqWiBj2sdXmIWhqdVLie-M/s1600/What+You+Need.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="314" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi7vsC4kfpL2ZSVF3IUZLd7Eo73_HpXbcRoOSM81Jd4p3gQQPa4MXwhAbloqN8FH286hx0VBNa5MejPXsrmcP8Vhaln3_jXnL9aQLwrbYbKgIqiXwmwgZ8BdKBqWiBj2sdXmIWhqdVLie-M/s320/What+You+Need.jpg" width="320" /></a></div>
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- A support person</div>
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- Stairs, a low table, a couch, or chair</div>
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<strong>Step One</strong>. You should begin by starting on your hands and knees, facing away from the furniture that will be supporting you.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF69ZNl5r1unlwVcNTw5m7b2oiLwxJRjcPRMVr6kAZrs5UOznGx6qQzi1Tb3o45fH6pzbOyL7NN8Vi8nFIkIB5xOgFSBtEx1KYs7pOt0m6ZjilDkge7vx5qKGF9uo9bQALIV79h61iVLFm/s1600/Step1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="293" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF69ZNl5r1unlwVcNTw5m7b2oiLwxJRjcPRMVr6kAZrs5UOznGx6qQzi1Tb3o45fH6pzbOyL7NN8Vi8nFIkIB5xOgFSBtEx1KYs7pOt0m6ZjilDkge7vx5qKGF9uo9bQALIV79h61iVLFm/s320/Step1.jpg" width="320" /></a></div>
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<strong>Step Two.</strong> With your support person helping, crawl backward and lift one knee up onto the furniture.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-OnSsDlmk_Cx5QyO3aiQ7xisK4pb5cwt23DKlMniUhbSoj6UMCcS2GZyq67RqudWUaQV7s_vkIVN7RVxe8naVHkjZThIsnta5T_3bdC1B1fdV3UA4j02Gk0NwrwJH5c6Qe5-xkeYnP_AC/s1600/Step2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="231" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-OnSsDlmk_Cx5QyO3aiQ7xisK4pb5cwt23DKlMniUhbSoj6UMCcS2GZyq67RqudWUaQV7s_vkIVN7RVxe8naVHkjZThIsnta5T_3bdC1B1fdV3UA4j02Gk0NwrwJH5c6Qe5-xkeYnP_AC/s320/Step2.jpg" width="320" /></a></div>
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<strong>Step Three</strong>. Pull up your other knee onto the furniture.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSxwZLojFHzSRXc_zKUz1SsPe-DyOnHd8j331qxVEmzehIzpEio-x_WVAkUhjP_KCKu0JblJlZ6WiP33o7Hdu4NXEjKJchOcLhE5DdAbrDL3pPlgD_udkVgRAkkMwOZwFoPT9AUyimezof/s1600/Step3.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="263" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiSxwZLojFHzSRXc_zKUz1SsPe-DyOnHd8j331qxVEmzehIzpEio-x_WVAkUhjP_KCKu0JblJlZ6WiP33o7Hdu4NXEjKJchOcLhE5DdAbrDL3pPlgD_udkVgRAkkMwOZwFoPT9AUyimezof/s320/Step3.jpg" width="320" /></a></div>
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<strong>Step Four</strong>. With your support person supporting your shoulders, push off your knees, up onto your feet, lifting your bottom farther up into the air, and attempt to make your body into an angle of 90* or less. Make sure the mom releases her belly, letting it fully relax.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhFzOAahDrz1YczYFFuFKp9tB9mIxjy_-wMAk75R2SarpIZWdduMatQVosNkMiBPPR09_He_Gj5HQpMZG1n332v51xeCH6JHHV0kI7tFYUnpR51RiNS4KpAMwZbvRfec3sU9LLK0vnhvF2Q/s1600/Step4.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="284" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhFzOAahDrz1YczYFFuFKp9tB9mIxjy_-wMAk75R2SarpIZWdduMatQVosNkMiBPPR09_He_Gj5HQpMZG1n332v51xeCH6JHHV0kI7tFYUnpR51RiNS4KpAMwZbvRfec3sU9LLK0vnhvF2Q/s320/Step4.jpg" width="320" /></a></div>
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<strong>Step Five</strong>. Hold this position for a minute at a time. (Notice how the support person uses her knees/legs to support the shoulders while holding/shimmying the hips). Make sure mom is keeping her belly relaxed.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnvTqMBygqBcAagNq9964vpQz8b5W8_rT0tNEZOhNmhZ2uYA65hvwOanLqqbGl9aJykA1ngJmEFGeT5_vLeK9C0UCqi-QR9jEQDWkVdYQ5WmOlx8e2Tx5DF_5iH7sf48KJqyudKnsc4qpR/s1600/Step5.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="282" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnvTqMBygqBcAagNq9964vpQz8b5W8_rT0tNEZOhNmhZ2uYA65hvwOanLqqbGl9aJykA1ngJmEFGeT5_vLeK9C0UCqi-QR9jEQDWkVdYQ5WmOlx8e2Tx5DF_5iH7sf48KJqyudKnsc4qpR/s320/Step5.jpg" width="320" /></a></div>
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<strong>Step Six</strong>. Alternate onto elbows if needed.</div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEioZPUFG0P_uTd5RkO5YOHKKbyehWqI1BVdvYZC6r-WdsPBxTmStPgDUjMQHZ7DDM6lDGxY98ClnxGZqjaxxZ_YY_uqn0zRMogcWrzK75oW0rfRdFa0rQzhA5xYkNMMtW2LsGZbxptq47k3/s1600/Step8.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="251" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEioZPUFG0P_uTd5RkO5YOHKKbyehWqI1BVdvYZC6r-WdsPBxTmStPgDUjMQHZ7DDM6lDGxY98ClnxGZqjaxxZ_YY_uqn0zRMogcWrzK75oW0rfRdFa0rQzhA5xYkNMMtW2LsGZbxptq47k3/s320/Step8.jpg" width="320" /></a></div>
<strong>Step Seven.</strong> If desired/necessary, have the partner shimmy your hips to help disengage baby.</div>
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<strong>Step Eight</strong>. Take a break on your hands and knees/elbows and knees but do not stand upright.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF69ZNl5r1unlwVcNTw5m7b2oiLwxJRjcPRMVr6kAZrs5UOznGx6qQzi1Tb3o45fH6pzbOyL7NN8Vi8nFIkIB5xOgFSBtEx1KYs7pOt0m6ZjilDkge7vx5qKGF9uo9bQALIV79h61iVLFm/s1600/Step1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="293" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF69ZNl5r1unlwVcNTw5m7b2oiLwxJRjcPRMVr6kAZrs5UOznGx6qQzi1Tb3o45fH6pzbOyL7NN8Vi8nFIkIB5xOgFSBtEx1KYs7pOt0m6ZjilDkge7vx5qKGF9uo9bQALIV79h61iVLFm/s320/Step1.jpg" width="320" /></a></div>
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Repeat steps 1-8 twice if in late pregnancy, in between each contraction if in labor.</div>
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<strong>Now this is important!!</strong> Before the mother gets into an upright position, it is incredibly beneficial to sift the mother's belly to help baby rotate into a better position, or angle him/herself into a better position.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWwKFpIGTEyxwkQqmgyZSqsEZxg3qj-iyQBjOUup5lP4eYirNZ38zlzDoNFeSUNWm9gZOOkPUgeOZy4oe1RIEqAZ-UbN53bKZosTJzx1ClJYabYxCWTnyHeYKdIbZLL-Xi2U8Kg4JBi0BK/s1600/Step6.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWwKFpIGTEyxwkQqmgyZSqsEZxg3qj-iyQBjOUup5lP4eYirNZ38zlzDoNFeSUNWm9gZOOkPUgeOZy4oe1RIEqAZ-UbN53bKZosTJzx1ClJYabYxCWTnyHeYKdIbZLL-Xi2U8Kg4JBi0BK/s320/Step6.jpg" width="284" /></a></div>
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Why This Works</h3>
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<u>The Uterus</u> - If your uterus has any type of twist or imbalance to it due to uneven ligaments holding it to the pelvis and back, the inversion will be incredibly helpful at releasing those ligaments. We humans tend to spend all of our time in an upright position. In this position, the heavy uterus hangs down in the same manner day after day. When a pregnant woman inverts, her uterus then hangs in a completely different manner. This allow the ligaments to be gently pulled on and balanced on both sides of mom's body. This will help the uterus to become aligned, allowing more room for a baby to move around.</div>
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<u>The Baby</u> - This technique can be incredibly effective at getting a baby to find it's best position through the pelvis. Once the baby has started to engage into the pelvis in late pregnancy, it is much more difficult for baby to maneuver his way into different positions. If his hand is up by his head, his head is extended, he's come down oblique, or posterior (to name a few predicaments), getting him *out* of the pelvis will be a much more effective technique to realigning him than just trying to move him in an already tight space. Like that car in the parking space, backing up out of the pelvis before correcting the position of the baby will be much easier than trying to reposition him while he's hedged in.<br />
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In Labor</h3>
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The inversion is most effective if done prior to the onset of labor. This allows the repositioning to be done without the counter-acting forces of contractions. Since contractions forcefully push the baby into the pelvis, trying to disengage the baby from the pelvis during labor can be difficult. The contractions act as an additional force to gravity, like a bulldozer pushing that car into the parking space. But, it can be done!</div>
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In labor, assume the inversion position as often as you can in-between contractions. It can be difficult to hold the position through a contraction, but see if mom can do that as well. The contractions will feel very odd in this upside down position, and mom will need a lot of support. If mom is laboring in a hospital, you may need to work around a lot of wires and lines. Having an i.v. or hep lock in her hand will cause some difficulty in leaning forward on her hands. Helping her on to her elbows will be a better position if this is the case.<br />
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Signs That An Inversion Would Be Helpful</h3>
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In Pregnancy:</h4>
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* You are in your third trimester of pregnancy</div>
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* You have round ligament pain</div>
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* You have pressure in your back or bottom</div>
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* You have pressure in your hips</div>
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In Labor:</h4>
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* You are having prodromal labor</div>
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* Your contractions are sporadic or spaced out<br />
* You are feeling the contractions mostly in your back<br />
* Contractions are strong but baby is not moving down<br />
* Contractions are irregular - coming at varying lengths, piggy-backing, or double peaking<br />
* You are feeling a lot of pressure in your back or in your hips<br />
* You have an urge to push while only 4-6 cm dilated<br />
* You seem to be "stuck" at a certain dilation</div>
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Warnings!!</h3>
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Please reserve the inversion for women with intact waters. Once the waters are released, there is the added risk of a cord prolapse. A mom can go to knees and elbows at this point, but a full inversion may add to the risk.</div>
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Please reserve the inversion for women with normal blood pressure. Make sure mom feels okay with this position, can support herself with her arms and does not get a headache from being upside down.</div>
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Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com14tag:blogger.com,1999:blog-1237119393135324542.post-54296062152807644992013-03-12T18:11:00.004-07:002013-03-12T18:11:59.318-07:00Trauma, unexpectedMany times as doulas we are called to support a mother through a birth that doesn't go the way she expected. Like the wedding we plan since childhood, our birth experiences are something we often dream of, plan out, idealize. And sometimes it goes <em>just so</em>. Perfectly. But more often, there are things that go awry. Sometimes in little ways, other times in large ways. <br />
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These unexpected births can be difficult for the mothers and difficult for the doulas to know how to process, to support and help the mother through. We've all had those births - the ones that encompass an unplanned epidural, a transfer from home to hospital, or an unexpected cesarean. When mothers encounter resistance at the hospital, we know to pour on the love and support. When mothers suffer through the agony of back labor, we know to keep our hands pressed firmly and endlessly in counter pressure. When labors tend to go on and on with little progress, we persevere ourselves with endless encouragement and optimism, utilizing every possible tool we can find. Those difficult hairpin turns in the labor can take a moment for our actions to support our ideas of taking everything in stride and readjusting our expectations. But we keep on supporting, loving, tending. And we know that these mothers will often need more time to process their births afterward, and that we need to be available and open for listening to the mother share her experience, her feelings, her grief.<br />
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But many of us have the idea that it is only those births that were intended to be natural births and ended up being medicalized that are the ones which mothers need longer support to process. When we see a birth go quickly and naturally, we tend to rejoice and applaud the wonders of such an efficient birth process. We often think, that was easy! She got her natural birth, she must feel great! This is not always the case, and we really need to be careful to not assume that any birth outcome is exactly what the mother intended.<br />
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My most recent client's labor started out slow and steady, easing into contractions, gradually building up in length and intensity. And then, all of a sudden things changed so quickly, we barely had time to blink before we were rushing off to the hospital. This mama's body switched gears so fast that her baby was born in the car in the hospital parking lot. At first I was so pleased for this mama, who was fearful of encountering resistance to her natural birth plan in the hospital. She didn't have to fight for a single one of her wishes! Her baby came without any interference! But I knew. I could see it on her face. That look of shock and trauma. I knew how that felt. <br />
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There is no place in another woman's birth experience for our own feelings. There is no where in her own perception that we need to place our own feelings, or the way we think she should feel. Mothers get that all the time from outsiders. "You should be happy that you have a healthy baby!" "You are fine." "Just focus on the relief of this being over with!" Why do so many press upon the mother how they need to be feeling? We do this often in the obviously traumatic births. But we also do this with those births that are unexpectedly traumatic. "Wow! That was fast! You must be so happy!" "How exciting that your baby was born in the car!" Why must we assume that a mother feels a certain way just because we would feel a certain way, or because we expect her to feel a certain way?<br />
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Those births that seem great from an outside perspective are those that we, as doulas, need to be very aware of. Never assume that a mother feels great, or <em>doesn't </em>feel great about her experience! Check in with her. Look her over, holistically. How is her emotional state? How is her mental state? What is she presenting physically? Touch her and look at her. Quietly assure her that you are there for her and that she can feel safe to tell you her story. Many times women are afraid to tell the truth of how they feel. When everyone around them expects them to feel one way, why would they feel safe in countering everyone? If even her doula expects her to be happy, then how does that impact the mother who is, in fact, not happy with her experience?<br />
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So doulas, listen up! Make sure you are not overtaken by your own feelings. Because, while they matter to you, they don't matter in the experience of the mother. Only her feelings matter there. Save your own feelings for your debriefings and reflections, but tuck them aside and open your heart to see and hear the story that the mother tells. You may find yourself quite surprised that it is a very different story from the one in which you feel you just took part.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-27461349516367635232012-07-18T00:54:00.001-07:002013-05-31T21:19:29.930-07:00Life and DeathFor the first time in 9 years of doula'ing, I had to step out and let someone else take over my roll of doula for one of my clients.<br />
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It was not due to my inability. Nor my lack of desire. In fact, I grieved over having to leave my laboring mother. But I knew that I left her in good hands, and I felt some peace with that.<br />
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In late April, as my client frantically nested, setting everything up in the nursery <i>just so</i>, cleaning bathtubs and refrigerators, and feeling the first little twinges and changes of impending labor, a dear friend of ours was on a drastically different journey. On a rescue mission to fly wounded soldiers to medical help, his helicopter was brought down, and his life with it.<br />
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While I cleared my schedule to focus on being available for my client, we heard about a helicopter crash and pilots who were KIA, and we prayed it wasn't one of our pilots. One of the ones we had travelled with through aviation school. <br />
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And after my last prenatal meeting, having talked through all of the mama's fears, her desires, sifted belly and baby to coordinate in mama's womb, we got the news. Our fears were brought to reality. It was Nick. And he was being laid to rest in five days.<br />
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The first day was spent in shock and utter disbelief. The second day in sobs of grief. We purchased plane tickets, booked hotels, and arranged for my mother to come and watch our kids. And then I remembered my client. A woman on the verge of welcoming life. Surely new life could wait while I honored a life already spent. Surely birth could hold out while we experienced death.<br />
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In the last days before our departure, I quickly coordinated a back-up plan, naively believing that my client would hold out for my return.<br />
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And on that night before we were to leave, we had our alarm clocks set to awaken us at 3 a.m., our funeral clothes pressed and hanging in travel bags, my client informed me that life could not wait. So, I went. <br />
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As this mama worked and walked and struggled and sipped, I imagined my friend, Julie, and how she labored that same evening in preparation for her husband's funeral. I rubbed and sifted and gentled and supported, and this mama praised Jesus for the new life about to unfold. And I wondered, is there someone with Julie to rub and sort and gentle and support her tonight? To praise Jesus for the life that was well spent? Is there a doula for death as there are doulas for birth?<br />
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And baby Jacob took his time. Like his name implies, he struggled to make his way out. My back up came in the wee hours of the night to take over as welcoming committee, and my husband and I flew off to make up the farewell one for our friend.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNL8NdXABI23uQyAQ-1KKW9LVWrns2ge9JCwv-DCgkScqFhdlmuzPZU2R10zATC6PGTkYjv9zbhRLo9CFHzpkzLe8Z-F18TUuauQIQXstDg6u2ILSPBVIQhaKPnOfWMJfFjGQDMx8m0N3V/s1600/Baby+Jacob.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="238" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgNL8NdXABI23uQyAQ-1KKW9LVWrns2ge9JCwv-DCgkScqFhdlmuzPZU2R10zATC6PGTkYjv9zbhRLo9CFHzpkzLe8Z-F18TUuauQIQXstDg6u2ILSPBVIQhaKPnOfWMJfFjGQDMx8m0N3V/s320/Baby+Jacob.jpg" width="320" /></a>Jacob took his time coming. He struggled his way through his mother's pelvis, slowly moving toward his exit, and his mother struggled her way with his movements. It was not an easy birth, but at last he emerged, vigorous, healthy, crying. And I, so far away now, also struggled. I was torn between two worlds. I had left a mother transitioning into a new role, and was now present to witness my friend relinquishing a role she so loved. We also struggled our way through this ceremony of exit. It was not easy. We struggled with the right movements. We cried. And as my client said, "Hello little one! How I love you!" We said, "Good bye, dear friend. We love you." <br />
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Life and death, they go hand in hand. They are events in our lives that change us forever. They help us to learn and to grow and sometimes take a lot of time to understand. Both events need to be covered in love and support, to be surrounded by strong and gentle arms, and tears that express what cannot be said through words.<br />
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And we need to remember, just as the new mother doesn't stop her journey at the birth, the bereaved do not stop their journey at the death.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-75833379170738785952012-07-13T22:16:00.001-07:002012-07-18T00:19:16.190-07:00A New Role UnfoldsI show up again today, armed with, well, my arms. And my heart. And my experience. But mostly my presence.
This new role unfolds before me - a lot less telling, a lot less movement, a lot more quiet listening, a hug, a reassurance. This pace is much slower than I'm used to, and lengthier. But the benefits are amazing. To not end with motherhood, but, instead to begin there.
When I teach childbirth classes, parents often become so focused on the childbirth aspect, they sometimes forget that the birth of their baby is not the end, but merely the beginning of their journey. Walking with women as they emerge from their own re-birth into mothers, wet around the ears, tender and vulnerable, this is an amazing blessing and honor to be here. To share.
Babies, they are amazing. We think they are helpless and clueless and must be taught so much, but watch and learn. They have more to teach us than we have to teach them. Babies are not logical creatures. They are fully right-brained, instinctually powered individuals with so much inner wisdom. Us mothers, we tend to fear our right brains, afraid that we won't sound intelligent, that we'll let things get out of control unless we keep track of the numbers and facts. We have our books and our computers and our experts, but look! Your expert is in your arms. Your expert is in your soul. Mothers and babies, they are already experts. The hardest part of becoming a mother is what should be the easiest. Trust. Trust yourself. Trust your baby. You know already! And this is just the beginning. If you can open yourself up in the beginning to learn from your wee little teacher, you will soon find that they will teach you everything along the journey of parenting.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-69422324913313397222012-01-28T00:40:00.000-08:002012-01-28T01:01:32.917-08:00It's Not Always EasyI recently had a couple from my childbirth classes go through two full straight days of back labor. Because I have spent so much time studying optimal fetal positioning, and apply it extensively in my doula work, it can be very difficult for me to stand back and not try to jump in and "help".<br /><br />The mom and dad both remained in touch with me throughout the labor via phone calls and text messages. They kept me updated with what was going on, and asked for input every now and then. I offered to come over and help them periodically, but I was not hired as their doula. They wanted to do this on their own.<br /><br />And I thought over and over, if only they'd invite me over! I could help them out so much! At a difficult moment for the mom, dad asked me to come over and lend an extra set of hands. This was on their second night of intense back pain. I did a ton of rotational techniques, getting mom in all sorts of various positions. But I could only encourage mom to do what felt right to her. I could not take control over her body or her labor. As much as I'd like to have, this was her labor, and she needed to make the choices.<br /><br />I went home after an hour of being with them. Left them relaxing in their bed, hoping that something I did had helped, but not knowing whether it had.<br />A few days later I received an email from the mom, and it really struck my heart what she said;<br /> <blockquote>I feel like our labor experience really created and set the foundation for our family. I've had so many reflections on the beauty of it all. So many times we try to run from suffering at all costs and miss out on the amazing, redemptive power of it all. That was the hardest thing we have ever experienced, but it brought us closer together than we could imagine and because of that the pain was the best gift. Michael was an excellent coach and I admire him so much more now that we have been through that, and he has seen my strength by what we were able to do together. </blockquote><br />If I had insisted on going over there earlier on in their labor, when I knew that I could make things easier for them, what would that have accomplished? It probably would have made for a faster, easier labor, yes. But did you hear how that labor has shaped these parents? A quick, easy labor was not what these parents needed. A long, difficult labor is what they were given, and they excelled with it. They learned from it. And they are wiser and stronger because of it.<br /><br />As childbirth educators and doulas, we give our clients all the information and tools ahead of time, but then it is up to the couple as to how they will use it.<br />We are not to be their guides on the journey. Even if we <em>know</em> for certain a better way, an easier way, how a different decision will create a better outcome. We are not to guide them along the pathway to parenthood. The parents are the guides, learning some of the most important things they'll need to know as parents - how to make decisions on their own.<br /><br />We are not the guides, we are the observers of this journey. A presence along the way to witness the strength and the transformation of these parents, emerging from self into self<em>less</em>.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-1622477873192859472011-04-26T18:15:00.000-07:002013-05-31T20:35:40.054-07:00Why Natural Birth Isn't Beneficial...Say, what??!! Isn't this blog titled, "Natural Birth In Kitsap"? Aren't you a propenent of natural birth?<br />
Why, yes. Yes, I am.<br />
What I want to share with you is something that has been spreading in the breastfeeding world for some time now, and I think needs to also spread to the birth world.<br />
Natural birth does not hold benefits. It holds normalities. <br />
As mammals, this is the normal way we were intended to birth babies. Moving, private, peaceful, freedom. As humans, this is the normal way we were intended to birth babies. Supported, loved, nurtured, unmedicated.<br />
Natural birth doesn't add anything to the birth experience. It is the way the birth experience was intended to be. It doesn't benefit the baby. It doesn't benefit the mother. It doesn't bring short-term, nor long-term benefits. It is where we set our human standard. Anything other than <em>this</em> is deviating from the way we were inteded to be. <em>Not</em> birthing naturally brings risks. <br />
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Just as with breastfeeding, our bodies have a specific way to work. We have a specific birthing function, a specific feeding function. It is a correlation between the mother and the baby.<br />
Any time we alter from that course, we increase risks of things going wrong, and causing harm.<br />
Often times we are told that our bodies are not good enough. That, even though we are mammals, whose very defination is one who "gives birth" and "nurses their young", our bodies cannot do. We need help from man-made products. "Supplements".<br />
We supplement with membrane sweeps, cervical ripenings, artificial oxytocin. Supplements lead to less of us, more of them, until we find ourselves unable to produce at all. Unable to produce milk, unable to produce contractions. <br />
We are told our nipples are the wrong shape, our uteri are the wrong shape, our pelvises are the wrong shape. Our bodies will harm our babies. They tell us this, and they are wrong. <br />
We are told that natural birth is dangerous, that it is impossible, that it is unrealistic, and that we are just trying to martyr ourselves. When did normal become such a big deal? When did we get so detached from ourselves that we can't fathom our bodies functioning in normal ways?<br />
We have set the standard at medicated birth, just as our society has set the standard at artificially-fed infants. We have tests and procedures that are necessary for medical births, that have become routine and "normal". We have nurses trained to help medicated mothers but unaware of what to do for a naturally birthing one. We have doctors who have been trained to interfere and do so with such regularity, that we have to specifically state over and over that for *this* birth, we want to be left alone. <br />
Shouldn't it all be the other way around?<br />
Shouldn't we be wondering at the dangers of medicated birth? Of interfering with the natural bodily functions? Shouldn't we base our studies, not on how natural birth might lower risks, but how interference may increase risks? Shouldn't the burden of proof be placed on deviating from normal, rather than deviating from medicalized?<br />
Why are we looking for studies and statistics which prove the worth of natural birth? Do we look for studies and statistics which prove the worth of natural breathing, natural urination, natural eating? Why don't we hear studies talking about the benefits of NOT catheterizing everyone? Or NOT putting everyone on a ventilator. Or NOT giving everyone a feeding tube? Wouldn't that be a ridiculous world to live in where everyone was made to believe that they could not eat, breathe or urinate without medical intervention?<br />
And yet, with birth, we find a huge discrepency. A normal bodily function that is overseen by doctors, nurses, medications and machines. We are told that we can't do it naturally. And medicalized birth becomes the norm.<br />
We need to stop setting the birth standard at medicalized birth. Any deviation from the normal way the body functions should be backed by a true medical reason. We should not be laughed at, rolled eyes at, scoffed at, annoyed at, or ridiculed for wanting to do what is normal. Normal should be supported and accepted. It should not be rare. It should not be so hard to attain. It should not be something we have to battle for!<br />
The health benefits, bonding benefits, breastfeeding benefits, etc. associated with natural birth are not benefits at all. They are what every mother and baby were intended to have. They are the standard. And, yet, how many know this? How many are choosing risk because they believe that risk is normal?<br />
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Natural birth is not beneficial. Natural birth is normal.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com16tag:blogger.com,1999:blog-1237119393135324542.post-90452235746615174672011-01-25T12:14:00.000-08:002011-01-25T12:38:34.706-08:00A World of Safety Nets<em>“Differing definitions of safety also play a part. Doctors often feel unconcerned about side effects – even life-threatening side effects – provided they know what they will do to treat them and that the life-threatening ones occur reasonably rarely. So, two doctors writing for their colleagues can say reassuringly: “These [epidural] complications should not cause fatalities if trained personnel and adequate resuscitation facilities are available.” Loose translation: If a laboring woman develops a life-threatening complication from an epidural, she or her baby won’t die of it provided hospital staff are on the ball.”</em><br />From, <em>The Thinking Woman’s Guide to a Better Birth</em> by Henci Goer, page 127<br /><br /><em>“What has happened in the rich world is that, while removing the ideal food and feeding method, there has been progress in the elimination of other immediate risks. It is important to remember that it is still only a minority of the world’s population that can be artificially fed from birth without getting ill or dying.”</em><br />From, <em>The Politics of Breastfeeding </em>by Gabrielle Palmer<br /><br />While these two quotes talk about two different things – medicated birth and artificial feeding – they are essentially saying the same thing about the world we currently live in. That those of us in first world countries live in societies filled with safety nets. And while that’s great for us, the rest of the world cannot manage to live the same way and afford the same healthy outcomes.<br /><br />The switch from births happening at homes to hospitals and the rise of artificial milk for babies has followed a similar trend. They were at first disastrous. Dangerous. Doctors in hospitals and artificial baby food makers did not really know what they were doing. It was all trial and error, and many mothers and babies died as a result. With the awareness of germ theory, sanitation, and clean water sources, births in hospitals and artificial feedings improved. As the western world improved in wealth, it also began to take risks with its health. As long as they had a way of fixing the mistakes, it was okay to risk making them.<br /><br />But living in a world of safety nets is a precarious world to live in. Walking a tightrope is risky, especially if there is not a safety net below. But even with the safety net, you will need to deal with the consequences of walking in a way that our bodies were not intended to walk. The feet of tightrope walkers tend to have many broken bones. Bodies react when we force them to do something outside of what they were intended to do.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjrPpe6iQAdV62Okm-aIbwBGzg66NSbbp9S8vrYziCePcRoZnNj_DPh7yCCvmJxIVJfGZFAjU6em8lZ_Bs1k67C1VZGNmmYah-VKf6FpfCBoFB4qjAyRC-KN6QWQ-4Q7Xkok83E8dC0Ey5b/s1600/natural+birth.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjrPpe6iQAdV62Okm-aIbwBGzg66NSbbp9S8vrYziCePcRoZnNj_DPh7yCCvmJxIVJfGZFAjU6em8lZ_Bs1k67C1VZGNmmYah-VKf6FpfCBoFB4qjAyRC-KN6QWQ-4Q7Xkok83E8dC0Ey5b/s320/natural+birth.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5566223647683434162" /></a><br />When we interfere with the natural processes of labor, there will be reactions. Most doctors see these reactions as perfectly acceptable, since they tend to have plenty of safety nets set up in place – epidurals, pitocin, cesarean sections, drugs to bring blood pressure back up, resuscitation devices, and epinephrine. We believe that taking risks with our bodies while in labor is safe because we have become so accustomed to the safety nets. We have begun to forget what normal is meant to look like, and only what it’s like in a life of safety nets.<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijCYdiH88iD3DCYKAU7CRfNyg8PDLswdo_YcoWqfeJdAzes_Fg909hYCi6Eze3oYnOMS7Hnx-_VT7He9Nzl85F0TTlppbfg_wM_0FpHbm2ymKzCfUaTJsg2f4w7K2mySpzo-QSSkBaWl3W/s1600/medical+birth.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 300px; height: 193px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijCYdiH88iD3DCYKAU7CRfNyg8PDLswdo_YcoWqfeJdAzes_Fg909hYCi6Eze3oYnOMS7Hnx-_VT7He9Nzl85F0TTlppbfg_wM_0FpHbm2ymKzCfUaTJsg2f4w7K2mySpzo-QSSkBaWl3W/s320/medical+birth.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5566224008326119666" /></a><br /><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0Z644oii2Cj9EShjQc_Vb3C9UcsRGthWuLRZxCtfAUm8ZgMEzkwDoUMUH5GkMXI3UhTMAHrKfy1Ataqwx2uCNT2ZO56B1Y8FMVos9lfiRpEZJLekRl6MsBqV8232x12F4gGo-0lEhQJLM/s1600/breastfeeding.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 214px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0Z644oii2Cj9EShjQc_Vb3C9UcsRGthWuLRZxCtfAUm8ZgMEzkwDoUMUH5GkMXI3UhTMAHrKfy1Ataqwx2uCNT2ZO56B1Y8FMVos9lfiRpEZJLekRl6MsBqV8232x12F4gGo-0lEhQJLM/s320/breastfeeding.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5566224260632109746" /></a><br />The same goes with artificial baby foods. A mother’s body is meant to breastfeed her baby, and a baby’s body is meant to breastfeed from it’s mother. When we alter this normal process, there are reactions. We have come to believe that ear infections, upper respiratory infections, and digestive problems are normal for infants because they happen so often. But these are reactions to altering the normal state of being. And this is only acceptable in our society because we have so many safety nets set in place. We have clean water to mix with formula. We have unbelievably easy access to fuel with which to heat the milk. We have easy access to transportation if our child becomes ill, and many hospitals, clinics and health care providers to offer care for our sick children. All of these are safety nets. Without such easy access to these things, feeding our babies with anything other than breastmilk would be dangerous. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhq5y1kDYDnBf8iom4k1LrT4X9xQP1nUe5C3ulnBqlZRlNwhNMoyknae9hVcbvV0P_Mu4VyhOPNaj3wDCWyuLrBs_kxHzq2w3G4E3O3fFMzjkWO8k7BVzVrodinHEHhzDMIjJ8USIhRIulm/s1600/bottlefeeding.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhq5y1kDYDnBf8iom4k1LrT4X9xQP1nUe5C3ulnBqlZRlNwhNMoyknae9hVcbvV0P_Mu4VyhOPNaj3wDCWyuLrBs_kxHzq2w3G4E3O3fFMzjkWO8k7BVzVrodinHEHhzDMIjJ8USIhRIulm/s320/bottlefeeding.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5566224476309322882" /></a><br /><br /><br />But this alternate form of normal is acceptable in our society because a world of safety nets has become the new normal. And while I do not wish for these safety nets to stop existing – I am very thankful for them, actually! – I do wish that we would understand that safety nets are meant to protect us in case of emergency, not as a daily way of life. Normal labors should not routinely need to be induced or augmented. One third or our women should not need to have their babies removed from their bodies for them. Breasts should not be seen as so easily unable to provide nourishment. Ear infections and upper respiratory infections should not be common childhood ailments. <br /><br />It does not take moving to a third world country to begin to understand the effects of a life based on alternatives without safety nets. What would we do in our comfy, wealthy society if these safety nets were suddenly sparse? It sounds unlikely, but all you need to do is consider Florida after the 2004 Hurricane Charley. Or the Gulf Coast after 2005’s Hurricane Katrina. We are not a country immune to natural disasters. And these disasters could easily wipe out all of our safety nets from beneath our feet. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijexBPRvRJ8hjaVhgLCk3LsDBQw0vtNLsqfB3IKzKKRTOObieBrYe-eRAGKjZuLk9BO_RInT1IxbZ4vm1Pk472saokzznUWg-m1LCnLNQmXuROVgpIyj31fapd9VfjmaITCssfYrRe3vEy/s1600/hurricane.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 214px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEijexBPRvRJ8hjaVhgLCk3LsDBQw0vtNLsqfB3IKzKKRTOObieBrYe-eRAGKjZuLk9BO_RInT1IxbZ4vm1Pk472saokzznUWg-m1LCnLNQmXuROVgpIyj31fapd9VfjmaITCssfYrRe3vEy/s320/hurricane.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5566224813927685330" /></a><br /><br /><br />In order for a medicalized birth to be above dangerous, there are many safety nets that need to be in place. Electricity, clean water, access to medications, availability of trained physicians, anesthesiologists, and surgeons. This may seem standard to many, but when hurricanes barrel through, earthquakes topple down, tsunamis wash away, or volcanos erupt around and upset all of this, we find that those must-have inductions and must-have cesareans become less urgent. We find that women can labor without being numbed, and that babies can come out without all the gadgets and gizmos set up in a hospital. And many see it as a tragedy that, because of a natural disaster, these women had to birth in a normal way!<br /><br />In order for artificial feeding to be above dangerous, there are also many safety nets that need to be in place. How long does it take to boil water in order for it to be sterile? How many times must a mother do this in a 24 hour period for a formula-fed infant? How many gallons of water must she carry to her home? How much wood or other fuel source does it take to heat up the water for formula or for cleaning the bottles and nipples? How far is it to the nearest health care clinic, and how long would it take her to walk there with a sick child? How available is a health care provider in an emergency situation? During Hurricane Katrina, this is what formula feeding parents had to consider. In most of the world, this is what all parents have to consider.<br /><br />I hear over and over again that <a href="http://www.mayoclinic.com/health/breast-feeding/FL00133/NSECTIONGROUP=2">formula feeding is perfectly safe</a> ), and that <a href="http://www.theatlantic.com/magazine/archive/2009/04/the-case-against-breast-feeding/7311/1/">breastfeeding really is not much better than formula feeding</a>. What arrogance we have in our society! To take away the immunities and healthy digestive system our babies were intended to have, and replace it with a safety net of doctor’s trips, antibiotics, special hypoallergenic formulas, inhalers, insulin, etc. just because that is what is now normal, does not mean that it is safe. We can only claim it’s safety because we have all of the safety nets in place to catch our children when they fall. Those safety nets would not be as necessary if we followed the natural order our bodies and our babies’ bodies were intended to follow.<br /><br />In our country, we have the ability to choose whether we want to have a natural or medicalized birth. We have the ability to choose whether we want to breastfeed or formula feed. But just because these choices are available, it doesn’t mean that they hold the same level of safety. At any moment we could be in a situation where our safety nets fail.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-69229930038691119162010-12-13T14:12:00.000-08:002010-12-13T14:27:17.966-08:00ReflectionThe other day while waiting for my daughter's ballet class to finish up, I began chatting with a woman who was also waiting. During our chat, it came up that I am a doula. "A do-what?" this middle-aged Ukranian woman asked me.<br />Though the term doula is becoming more and more well-known, this is a question that I hear often. And I've noticed that older women tend to not understand the necessity of my role as do the younger women. And not knowing much about birth in the Ukraine, I was not really sure what this woman would think about the work I do.<br />"Are you more for the emotional support, then?" this woman asked me when I tried to describe my role at a birth.<br />"Yes! Exactly!" I responded.<br />This opened the door for this women to share her own experience, as often is the case when talk of my profession comes up.<br />I love that women feel that they can trust me to be a sounding board for them as they describe in great detail a part of their lives that is so intimate, and so personal. I love to listen and gain more insight into the beauty and pain of womanhood.<br />This woman told me of her first birth, thirty years ago at a Soviet hospital in what is now the Ukraine. She told me how she had no idea what was happening to her, that no one had explained how the baby would come out of her, and that no one bothered to inform her at the hospital. She told me how she was left alone to experience pain after pain, not knowing if she was dying. She asked me if I tell women what to expect before they go into labor. I assured her that this was a large part of my role as a doula, and that I teach entire class series on what to expect through my childbirth classes. "This is good," she told me. "Women need to know. And they need someone with them to help them through it. What you are doing, it is a very good thing."<br />I think that it is important for us, as birth workers, to hear not only the good stories of birth, but be reminded of the bad stories, and how our efforts must continue - that history must continue to change so that all women can experience birth in a safe and satisfying way.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-42149205074405406132010-09-20T23:53:00.000-07:002013-05-31T17:30:03.910-07:00OFP, part 4 - Putting Optimal Fetal Positioning into Practice<strong>WHAT IS “OPTIMAL”?</strong><br />
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What is Optimal Fetal Positioning? Optimal fetal positioning is the act of manipulating a mother’s body through movement in order to alter the fetus’s position into one that is favorable to moving through the mother’s pelvis.<br />
In the previous blog post, I explained why the left occipital anterior (LOA) position is the most favorable for a baby to start in during labor. While this is true for the majority of labors, I’d like to refer back to the first blog post on the various pelvis shapes among women, and explore how this may not be true in all cases. <br />
Because the gynecoid pelvis is the most common shape – one that 50% of women possess – this is the pelvis that is mainly referred to in OFP discussions. But, what if you have one of the other three types of pelvises? Optimal fetal positioning may then look different for you. While the general thought is that OFP is trying to get the baby into the LOA position, variations in the pelvic shape will change what is the optimal position for the baby.<br />
I will reiterate here: the optimal position for the baby is whichever position the baby most easily fits through the pelvis. So, in the case of the anthropoid or android pelvis, the shape of these pelvises makes it much more likely for a baby to be in the posterior position. While a labor where the occipital bone of the baby is pressing against the mother’s sacrum may not sound ideal to the mother, if it’s the place that baby best fits through, it’s the best position in which the baby should be.<br />
<strong><br />OPTIMAL FETAL POSITIONING DURING PREGNANCY</strong><br />
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<strong>*POSTURE</strong> In the last blog post, I brought up one of the best things a pregnant woman can do to encourage OFP, and that deals with her posture. <br />
I would say that the majority of “failure to progress” babies are due to malpositioning, and that the majority of the malpositioning is due to our modern lifestyles. Instead of walking for travel, we slouch in our cars. We do not sit cross-legged on the floor, nor do we squat, we lounge on sofas and in easy chairs. The majority of our work is done while seated, and the majority of us sit poorly. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO7VnWJswlmvttz040gIEfS7zJD2NAG6-BGyEbP9uisFXEsQZc1McCJ7zIRV4s2Cn7pzAc_KubQl2VyWiSBhZ4to-odFSmZ7iXLp5RsYVkO6DIaeFzaMK4Ea2T7edxPoKE4S2QbysL164d/s1600/slouch.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519264929473055986" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO7VnWJswlmvttz040gIEfS7zJD2NAG6-BGyEbP9uisFXEsQZc1McCJ7zIRV4s2Cn7pzAc_KubQl2VyWiSBhZ4to-odFSmZ7iXLp5RsYVkO6DIaeFzaMK4Ea2T7edxPoKE4S2QbysL164d/s320/slouch.jpg" style="cursor: pointer; float: right; height: 320px; margin: 0px 0px 10px 10px; width: 319px;" /></a><br />
So, watch your posture! Get a birth ball to sit on during the day. Tailor sit at home. Take breaks from sitting and do pelvic rocks. Spend a good 10 minutes when you get home from work just leaning over your kitchen countertop and moving your hipsThese positions will move the uterus forward, and help the baby to rotate into an anterior position. These postures will encourage flexibility in the pelvic joints which will enable them to open up to make more room for the baby.<br />
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<strong>*BODY WORK</strong> Some of us may need more help than just normal posturing to get our babies to move into more favorable positions. <br />
Perhaps you had a bad fall when you were a kid. Maybe you were in a car accident. Or you played soccer and made the same one-sided twisting motion over and over again. All of these things can affect the pelvis alignment and uterine ligaments.<br />
When the pelvis is bumped out of alignment, or the uterine ligaments are tighter on one side of the uterus, there’s going to be a twist in the uterus. While a slight twist or misalignment may seem like a minimal problem from the outside, everything is magnified on the inside. A slight twist outside turns into a large twist on the inside, making rotation more difficult for the baby.<br />
Chiropractic care is wonderful for dealing with these bone and ligament issues. Mayan Abdominal Massage is another form of body work that helps get the uterus into better alignment.<br />
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<strong>*MOVEMENT</strong> What happens when you sit the same way, walk the same way, move the same way over and over again? Your body becomes rigid and tight, only allowing certain movements to take place. In pregnancy and birth, we want the body to be able to open up, the pelvis to open and move, the ligaments stretch. So, to help a baby be able to move, you need to move! Certain movements are more helpful during pregnancy and for optimal fetal positioning than others. <br />
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- <em>squatting</em> – opens up the pelvis, stretches your leg muscles, gets baby into alignment.<br />
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- <em>tailor sitting</em> – this stretches out the legs, opens the pelvis, moves the uterus forward and aligns your body.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh2vHNDc8PTleLiXGea_c7V1dm8BFXkulHOHxIQspx-y8qnNkL3YxBXYa1krPWd4bikh2HAmfPYhuvQM6q5DMFlMt5OKF1bth2DnPVX4tUyp2M9eMDYXL3W2IiOkK19hoSOrnzGHsJ04AH-/s1600/tailor+sit.jpg" style="margin-left: 1em; margin-right: 1em;"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519266273853388034" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh2vHNDc8PTleLiXGea_c7V1dm8BFXkulHOHxIQspx-y8qnNkL3YxBXYa1krPWd4bikh2HAmfPYhuvQM6q5DMFlMt5OKF1bth2DnPVX4tUyp2M9eMDYXL3W2IiOkK19hoSOrnzGHsJ04AH-/s320/tailor+sit.jpg" style="float: right; height: 320px; margin: 0px 0px 10px 10px; width: 240px;" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJDlaCpbdOjuF3ntNeKvRePBTfbGbEgvJNT2niC1Pptt59EpmraSlx95Fr8lmWalS6eRFW4GoRNAyNrr-AZnu98_iBoYZPUJSPeVZja_zvAB-_6RiJDQD8e2dTgV4zQXArj8FXo4SXsCg8/s1600/pelvic+tilt.jpg" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519266099402366946" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjJDlaCpbdOjuF3ntNeKvRePBTfbGbEgvJNT2niC1Pptt59EpmraSlx95Fr8lmWalS6eRFW4GoRNAyNrr-AZnu98_iBoYZPUJSPeVZja_zvAB-_6RiJDQD8e2dTgV4zQXArj8FXo4SXsCg8/s320/pelvic+tilt.jpg" style="float: right; height: 240px; margin: 0px 0px 10px 10px; width: 320px;" /></a>- <em>pelvic rocking</em> – this helps get the baby out of the pelvis to allow it to move into a more optimal position, loosens the joints and ligaments of the pelvis and uterus and tones the abdominal and back muscles..<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0CcewpadT4uE5X8qHTIA-TZ5QBEWuSJ0vYVs8Opele8ylrqKKxHLji3rjwlIOnMaj7gDiGtKbiMSXKL3g6oxRcK8y6pOJUiSLfa1JSEYTHQly4Zz4zHyl42slFLhkuvOmLHtQDHJPYYm-/s1600/The+lean.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519266378101347730" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0CcewpadT4uE5X8qHTIA-TZ5QBEWuSJ0vYVs8Opele8ylrqKKxHLji3rjwlIOnMaj7gDiGtKbiMSXKL3g6oxRcK8y6pOJUiSLfa1JSEYTHQly4Zz4zHyl42slFLhkuvOmLHtQDHJPYYm-/s320/The+lean.jpg" style="cursor: pointer; float: right; height: 320px; margin: 0px 0px 10px 10px; width: 259px;" /></a><br />
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- <em>forward lean</em> – this helps to counter all the leaning back we do during the day. Lean against a table, a counter and while you lean move your bottom around to loosen up the hips!<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi55gG6RyXkcn514XZhoJrQChRuZLJD5ZC0sCBG5wNHsyZXggm6A9zg8mRCfYDjwVV6uU8m3QUNxGCMG1vdPExW30LD5qTFwGAYEmQb1cK5t587lK_l0STDEPOiB_5Q0IUsYPeeJUL4uNkT/s1600/hip+shake.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519265905948225090" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi55gG6RyXkcn514XZhoJrQChRuZLJD5ZC0sCBG5wNHsyZXggm6A9zg8mRCfYDjwVV6uU8m3QUNxGCMG1vdPExW30LD5qTFwGAYEmQb1cK5t587lK_l0STDEPOiB_5Q0IUsYPeeJUL4uNkT/s320/hip+shake.jpg" style="cursor: pointer; float: right; height: 320px; margin: 0px 0px 10px 10px; width: 316px;" /></a><br />
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- <em>hip shimmy</em> – this is where, as mom leans forward (over a birth ball or a table or a bed) her partner comes up behind her, grabs each side of her hips and shimmies them back and forth. This helps to loosen up the pelvis and the uterus, gets baby moving around and feels good to mom<br />
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- <em>dancing</em> – dancing is one of the most fun ways of helping to get a baby positioned correctly! Last year when I attended a Zumba class with a friend, one of the dance instructors leading the class was 8 months pregnant. While her movements may have not been as mobile or precise as the other instructors, I couldn’t take my eyes off of her! The whole time I watched her I was thinking how great these movements were for her pelvis and uterus, and what a wonderful gift she was giving her baby through movement and flexibility!<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-duB6ao2-ZdIq-KIbrrYazyzqkT7T0dEfiZgV2fbL9Z9KKTXIQ-52gB_5X1wXnzr82nzAsfD7_vBQEpJY7yAH6IsBsxqgAvHW1xwRzTv4St8eSuBl3QUvpro05BWmAgGSaBaha9pbpzRJ/s1600/forward+sift+setup.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519265320701645186" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-duB6ao2-ZdIq-KIbrrYazyzqkT7T0dEfiZgV2fbL9Z9KKTXIQ-52gB_5X1wXnzr82nzAsfD7_vBQEpJY7yAH6IsBsxqgAvHW1xwRzTv4St8eSuBl3QUvpro05BWmAgGSaBaha9pbpzRJ/s320/forward+sift+setup.jpg" style="float: right; height: 320px; margin: 0px 0px 10px 10px; width: 284px;" /></a><strong>* SIFTING</strong> Sifting is a technique that has been used by Mexican midwives for centuries. It involves wrapping a rebozo (“shawl”) under the bottom or belly of a pregnant mother, and shifting the shawl back and forth while raising the mother’s body slightly off the floor. This takes some arm strength, so have someone strong apply this technique! If you do not have a traditional shawl, a towel or sheet, or any longer piece of material, will work. This technique is similar to the hip shimmy in that it helps to loosen up the pelvis and uterus. It loosens ligaments and muscles, gets the baby moving, and can really help to rotate a baby. Whether or not sifting should be done on the woman’s belly or bottom depends on the position of her baby.<br />
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It is a wonderful technique to use on most pregnant women, as it often helps to ease any lower back discomfort that is common in pregnancy.<br />
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<strong>* DUMPING</strong> Dumping is a technique that was brought to my attention by my friend and chiropractic care provider, Dr. Joella Pettigrew. When a pregnant mama comes into her practice and she determines that baby is lodged into a bad position, before she performs an adjustment on the mother, she will have her get up on her table, and bend down – feet on the raised platform, bottom in the air, and hands on the floor. This is something that should not be done by oneself, but with supporters on both sides. What happens with this position is that it allows gravity to work on getting the baby out of the mom’s pelvis, in order to then get the baby to rotate into a better position through the chiropractic adjustments. Dumping prior to the other movement techniques helps to increase the likelihood of getting a posterior baby into a more optimal position.<br />
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<strong>GETTING BABY TO FLEX ITS HEAD</strong><br />
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Referring back to the second part of the OFP posts, whether or not a baby’s head is flexed can make a huge difference on the ease with which the baby will fit through the mother’s pelvis. How to get a baby to flex its head may be a question that arose while reading through that post. While it’s not as simple as the rotational techniques, there are still some things that can help get a baby to have a well flexed head.<br />
First off, before a baby has engaged deep into the mother’s pelvis, a skilled midwife can feel, through palpation, whether or not the baby’s head is flexed. And, if the baby’s head seems to be extended, she can help the baby to flex its head all from the outside of the mother. <br />
Another way to encourage a baby to have good flexion, is to have toned abdominal muscles. Women with multiple pregnancies, which tend to stretch out both the uterus and the abdominal muscles, seem to present more babies with extended, or asynclitic heads. Keeping the abdominal muscles toned in between pregnancies, and through pregnancy with pelvic rocks, will greatly help with getting the baby to flex his head.<br />
Along with well-toned abdominal muscles, sifting can be very helpful in getting a baby to flex his head. The shifting movement of the mother’s body can help to shimmy the baby down in the most accommodating place of the pelvis and encourage the baby to tuck his chin.<br />
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<strong>OPTIMAL FETAL POSITIONING DURING LABOR</strong><br />
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Many of the techniques for optimal fetal positioning during pregnancy can also be applied during labor. While it’s best to have baby in an optimal position prior to labor starting, sometimes it cannot be helped!<br />
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<strong>*MOVEMENT</strong> Key to any labor, but especially one in which the mother is trying to get a baby to change position, movement allows gravity and momentum to work together to get a baby to rotate. Walking is simple to do and a wonderful way to encourage rotation! The back and forth shifting of the pelvis as the mother takes her steps helps to get baby moving too. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkaWR-jg8lNGMkgnZfCHM2lsdi_N-Q8ss5rt_j7JfhrtPWwAzTwiXXQqZQ3RtzPCEXz5JK7ykUKc1o-45i_kwyNXOe_zFEwJZt5Jb2pzBRa5_jImG3St3kpODh0Rfw_bxpGekvBwNkjRgG/s1600/birth+ball.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519265247971810754" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkaWR-jg8lNGMkgnZfCHM2lsdi_N-Q8ss5rt_j7JfhrtPWwAzTwiXXQqZQ3RtzPCEXz5JK7ykUKc1o-45i_kwyNXOe_zFEwJZt5Jb2pzBRa5_jImG3St3kpODh0Rfw_bxpGekvBwNkjRgG/s320/birth+ball.jpg" style="cursor: pointer; float: right; height: 320px; margin: 0px 0px 10px 10px; width: 282px;" /></a><br />
Rotating the hips while sitting on a birth ball is another movement which encourages baby to move and find the best fit through mom’s pelvis. Dancing with a partner, or just moving side to side, swaying your hips, these primal, unconscious movements that many mothers make during labor are all ways that the body works to get a baby to move around and down.<br />
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<strong>*UPRIGHT</strong> Unless you are trying to get the baby out of the pelvis, or to move more specifically, upright positions will allow the most opportunity for babies to rotate and find their good fit. It also tends to be most comfortable for moms, allowing them to freely move.<br />
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<strong>*TURNING A BABY FROM RIGHT TO LEFT</strong> If the baby is starting with its occipital bone facing the mother’s right side, it is important to remember that babies tend to move dextrorotationally. Meaning that they move clockwise and will therefore have to move into a posterior position before swinging around to the left. How will you know if the baby is in a right position? One way is belly mapping, which can be discovered at the spinning babies website. Another way you can see a baby’s position is by looking at the mother’s hips from behind her. If a baby’s occipital bone is pressing down into the pelvis, you will most likely see that side of the mother’s pelvis bulge out. This is only visible if the baby is in a more posterior position. If the baby is starting in an ROA position, you will probably not see any difference in the hips.<br />
If baby is starting out in an RO position, the best way to get it moving in the right direction is to purposely rotate the baby first into a posterior position. That may not sound pleasant, but if a baby is turning clockwise, it will need to move around the back before coming back over to the left! Depending on which position baby starts in – ROA , ROT or ROP, you may need to start with right side-lying to get baby to move farther back. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4wFBxgBAKcQNIsW4ZhR9WDZ3F2N58kT4zq9S88yxnXzbJORmGx-IdSJP6QRpzf70oIu-qyh-DNRbrdNYu3VFQH32fjaCZhlQnlf4K3E1IdxdmbgJV3Py-wxupdpfIz7SDlroXIsRbMxkM/s1600/right+lay.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519266172368015362" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg4wFBxgBAKcQNIsW4ZhR9WDZ3F2N58kT4zq9S88yxnXzbJORmGx-IdSJP6QRpzf70oIu-qyh-DNRbrdNYu3VFQH32fjaCZhlQnlf4K3E1IdxdmbgJV3Py-wxupdpfIz7SDlroXIsRbMxkM/s320/right+lay.jpg" style="cursor: pointer; float: right; height: 195px; margin: 0px 0px 10px 10px; width: 320px;" /></a><br />
If the baby is engaged into the pelvis, and especially if the bag of waters has broken already, it might be necessary to first get the baby out of the pelvis. Dumping was one option already mentioned, though it might be scary to do during labor. Another technique for lifting babies out of the pelvis is called the belly lift and tuck (described below). I discovered this technique on the spinning babies website and have used it very successfully! Once baby is brought back up out of the pelvis, sifting while mom is on her back is what I’ve found to be best. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxeZi2zlNKsYW4ibOwHoyVIdm0ZO0vTJtTzqKOxMIBUibvUGSq_R-1KWZq9_x7aQdHvlWRlATGRUERGt6G0FkX1B7vaZqR9hla6q7SsPn7732qHmpm4nBCH3I3w6Lmz6WIV2vLMgWfNRI_/s1600/back+sift.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519265109539055394" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhxeZi2zlNKsYW4ibOwHoyVIdm0ZO0vTJtTzqKOxMIBUibvUGSq_R-1KWZq9_x7aQdHvlWRlATGRUERGt6G0FkX1B7vaZqR9hla6q7SsPn7732qHmpm4nBCH3I3w6Lmz6WIV2vLMgWfNRI_/s320/back+sift.jpg" style="cursor: pointer; float: right; height: 320px; margin: 0px 0px 10px 10px; width: 240px;" /></a><br />
This shimmies the baby to rotate into a posterior position. Sift only between contractions. Babies rotate between contractions, move down during.<br />
Once baby is established in the posterior position, moving mom onto her left side will help get the baby rotated into an LO position. Just side-lying can do the trick. A little hip shaking while mom is side lying isn’t bad, either. <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgx1Idtx6fZ-IP0_HFTEt4jJX9FDNOKqy4MUnmVXIAktUShaKqYUM_azG43uVNowoO_A-9AL44dmdGwruOSHfZp3Wofh5Wdtboa1WVX_azO5GmfGAPzvL8Rr211OUAleXZqwc_OQ5nsy-9m/s1600/left+lay.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519265994930594658" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgx1Idtx6fZ-IP0_HFTEt4jJX9FDNOKqy4MUnmVXIAktUShaKqYUM_azG43uVNowoO_A-9AL44dmdGwruOSHfZp3Wofh5Wdtboa1WVX_azO5GmfGAPzvL8Rr211OUAleXZqwc_OQ5nsy-9m/s320/left+lay.jpg" style="cursor: pointer; float: right; height: 172px; margin: 0px 0px 10px 10px; width: 320px;" /></a><br />
When you feel certain that baby has moved to the left side (again, look for the hip bulge), have mom get up and walk around to get baby to engage in this position. Hopefully, once this is done, progress will be seen soon after!<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVLzLCNwhdfX1be5fx1T18trOhzwB-KXCkcd2CpNon8D81Kgdjf6L2MMu6K5Ekmopawo4Ei8JvoclBDSyMP73f4nCmVhUBzW2HlF-cXVOdsndZDR6FAlQ9jisuvMDO_2hc-NFf0VSrT-il/s1600/forward+sift.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519265619869430578" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVLzLCNwhdfX1be5fx1T18trOhzwB-KXCkcd2CpNon8D81Kgdjf6L2MMu6K5Ekmopawo4Ei8JvoclBDSyMP73f4nCmVhUBzW2HlF-cXVOdsndZDR6FAlQ9jisuvMDO_2hc-NFf0VSrT-il/s320/forward+sift.jpg" style="cursor: pointer; float: right; height: 320px; margin: 0px 0px 10px 10px; width: 246px;" /></a><br />
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<strong>*SIFTING</strong> This was brought up as part of the rotational process above, but it can be helpful no matter what position you either think, or know, the baby is in. Sifting is also the best technique to use if a mother has one of the “other” types of pelvises in which the baby best descends in a posterior position, or with an asynclitic attitude. Sifting is like jiggling a key in a lock to make it fit. It will help to get the baby into the pelvis because it is moving the baby around until it finds the best fit!<br />
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<strong>*BELLY LIFT AND TUCK</strong> This is a technique I learned from the spinning babies website and have used successfully in getting stalled labors going again. What I discovered with labors that progress with contractions but not with dilation, is that it often has to do with either the attitude of the baby’s head, or the position of the baby. If a baby cannot fit down into a pelvis, it will not be putting pressure on the cervix to dilate it. In Bradley® classes, we talk about the NAP – the Natural Alignment Plateau – that occurs in over one-third of all births. While there are many reasons for an NAP (emotions, hormone production, head molding), one of the most common is what the name infers. Alignment. <br />
When you help the baby get into a better alignment, the labor will progress with dilation and descent. <br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5yWLnnH_WVeyQ4UPK6PeutqiASIbVxl3A92uftL7UxZNSUJLi7zSpABRBu95-mSslxP11gycMxYsL1Y6gY12cGB3wpiXGDkPPjIgnx1EoHM6TlcYsgvEg9Q4EmkD2ZLM-5pFgqCMYIKdp/s1600/Tummy+lift,+pelvic+tilt.jpg"><img alt="" border="0" id="BLOGGER_PHOTO_ID_5519266475732207282" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi5yWLnnH_WVeyQ4UPK6PeutqiASIbVxl3A92uftL7UxZNSUJLi7zSpABRBu95-mSslxP11gycMxYsL1Y6gY12cGB3wpiXGDkPPjIgnx1EoHM6TlcYsgvEg9Q4EmkD2ZLM-5pFgqCMYIKdp/s320/Tummy+lift,+pelvic+tilt.jpg" style="cursor: pointer; float: right; height: 320px; margin: 0px 0px 10px 10px; width: 238px;" /></a><br />
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What the belly lift and tuck does is lift the baby out of the pelvis where it is assumed he has tried to descend, either with a wonky head, or in a suboptimal position. Once he got there, he couldn’t go any further. So, when the mother lifts her belly up during a contraction, it helps to lift the baby out of the pelvis. While mom lifts her belly, she also tucks her pelvis under as she would do during a pelvic rock. This helps the baby find a better entry point into the mother’s pelvis. If the stall in the labor is due to the baby’s need to flex or straighten his head, this may be all that is needed to finish labor rapidly. If baby still needs to rotate, this technique in combination with some of the others will be best in getting labor to progress further.<br />
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<strong>*HIP SHAKING</strong> Like dancing, moving, and sifting, the hip shake technique described in the pregnancy portion can help to rotate a baby into a better position. This is a useful technique if a mother does not want to lie down to be sifted, or does not want her belly touched with sifting. The partner can stand behind her, ask her to lean over the bed, counter, chair, etc., grab her hips firmly and move them in the same fashion as the sifting would.<br />
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Optimal fetal positioning is a wonderful skill to know, whether you are the pregnant mother, a doula, a nurse, midwife or doctor! Knowing how to utilize these techniques may mean the difference in a vaginal or a cesarean birth. It may mean the difference in a 12 hour labor and a 48 hour labor. It may mean the difference in an extremely intense back labor, or a labor that is more manageable. Knowing how to make the difference is an invaluable skill to have!<br />
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While all of these techniques can help get a baby rotated and into an optimal fetal position, it is important to remember that pelvises and babies’ heads are still amazing at adapting. Babies can still be born in posterior positions, with brow and face presentations, and in other “non-optimal” positions. It may take a little more time, and a lot more effort, but the human body is amazing at making birth work.<br />
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<strong>WHERE I LEARNED THIS STUFF (a.k.a References and Resources)</strong><br />
* <a href="http://www.childbirthinternational.com/">Childbirth International Physiology in Birth Course Manual</a> <br />
* <a href="http://www.childbirthinternational.com/">Childbirth International Birth Doula Skills Course Manual</a><br />
* <a href="http://www.midwiferytoday.com/reviews/optimalfp.asp"><em>Understanding and Teaching Optimal Foetal Positioning</em> by Jean Sutton and Pauline Scott</a><br />
* <a href="http://www.icpa4kids.org/">The International Chiropractic Pediatric Association</a><br />
* <a href="http://jp-chiropractic.com/index.html">Joella Pettigrew, D.C.</a> <br />
* <a href="http://www.spinningbabies.com/">Spinning Babies</a><br />
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* <a href="http://www.spinningbabies.com/buy-the-belly-mapping-workbook">The Belly Mapping Workbook</a><br />
* <a href="http://www.amyhoyt.com/">Personal Experience</a>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com9tag:blogger.com,1999:blog-1237119393135324542.post-34082832274966185352010-09-10T17:25:00.000-07:002010-09-10T18:52:02.457-07:00Optimal Fetal Positioning, Part 3 - Putting the Pieces TogetherIn my first blog post on Optimal Fetal Positioning I focused on the dimensions of the human pelvis. With my second post, I explored the shape and angles of the fetal head. This next post on OFP will be bringing these two parts together, showing how well they can fit when things are done right.<br /><br /><strong>CARDINAL MOVEMENTS</strong><br /><br />The way a baby moves through the mother’s pelvis on its exit from the womb is described as the “cardinal movements.” The cardinal movements always begin with the fetal head in the LOA position, though sometimes babies do not go that route. The reason why LOA is the most described starting position is as follows.<br />As the baby enters the inlet of the pelvis, the widest diameter is transverse – from side to side. The baby’s head, when flexed well (or even when not), will be wider front to back. So, the best way for the baby’s head to enter the pelvis is in a sideways, or OT position.<br /><br />INTERNAL ROTATION<br /><br />As the baby is pushed further into the pelvis by the power of the contractions, and enters the pelvic cavity, the dimensions change. The cavity is more equally rounded, and since body movements tend to move in a clockwise direction (I’ll explain this more below), the baby is rotated from LOT to LOA.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsu5DqwLurdtr8USbABPFFuK9aOhiaiF8PEIjyieFSZEmfwEMHTMRJoQ0oZbfW5162nG7VhRjh5W7L3seO0m10TYG4WBIkc-x2IC50sTkW6OuQ58Twkikt_71gyhALHQ-VKx-tyBpYZI0E/s1600/entry.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 283px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhsu5DqwLurdtr8USbABPFFuK9aOhiaiF8PEIjyieFSZEmfwEMHTMRJoQ0oZbfW5162nG7VhRjh5W7L3seO0m10TYG4WBIkc-x2IC50sTkW6OuQ58Twkikt_71gyhALHQ-VKx-tyBpYZI0E/s320/entry.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515459423216569010" /></a><br /><br /><br />EXTENSION<br /><br />The pelvic cavity is where head flexion really has a big impact. With an equal diameter of 12 cm, a well-flexed head will have a much more successful journey past the ischial spines than an extended head with an 11-13.5 cm diameter. As the baby moves through the cavity, it will continue its rotation from LOA to OA.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiT7baMLwPkbonpx13Z0aY9Gg178Vm13aXBN-aCXotY4kCoS2I6c3BeTy_hC9KIv2-fNtHaqA1cW3yVbyEyCmveSX4bFItdw-FHi9PkqVx-Y2mWtIVOhkNFpnEDc0Nc6t4WdCeJBPCrMOTg/s1600/OA.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 243px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiT7baMLwPkbonpx13Z0aY9Gg178Vm13aXBN-aCXotY4kCoS2I6c3BeTy_hC9KIv2-fNtHaqA1cW3yVbyEyCmveSX4bFItdw-FHi9PkqVx-Y2mWtIVOhkNFpnEDc0Nc6t4WdCeJBPCrMOTg/s320/OA.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515460794302224242" /></a><br /><br /><br />EMERGING<br /><br />Once the baby has moved through the pelvic cavity, the front part of the pelvis basically disappears with the pubic arch. But the sacrum and coccyx at the back are still creating a posterior resistance. The pelvic outlet is absolutely wider from front to back than to side to side. But, if mom is in a position that allows free movement of the sacrum and coccyx (side-lying, hands and knees, upright/squat), the front to back opening will be even greater as the baby pushes the sacrum and coccyx back. This anteroposterior opening creates a space that favors an OA position for the baby’s head. <br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEirRSliY1noWl6Zb-m0vK9xCqJqEe-kUQcvw32Syls-vi9FOAhPzUMVx0Xm-IErie7Enkt3agHFSgGSggaQ21J2TWN3-jXdsAJMVCpPIY-B2Hy7cWx4mBAWNscVoYXp9kfklPTteTrBCV7T/s1600/emergence2.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 213px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEirRSliY1noWl6Zb-m0vK9xCqJqEe-kUQcvw32Syls-vi9FOAhPzUMVx0Xm-IErie7Enkt3agHFSgGSggaQ21J2TWN3-jXdsAJMVCpPIY-B2Hy7cWx4mBAWNscVoYXp9kfklPTteTrBCV7T/s320/emergence2.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515463665171191970" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaCSgz8RcKC9rbpdeNJtQ-aHSDaZFLphNsSWM8RascaZrlGWA731GuvzXi_QPyLH5ZlMb9RoaKVwU5Sac16lHMKK2Yp5CIOEu1xqGIotT706i0dh0Aoo4_zrJHXpBWeEjEFjwikEtkMEgW/s1600/emergence.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 222px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgaCSgz8RcKC9rbpdeNJtQ-aHSDaZFLphNsSWM8RascaZrlGWA731GuvzXi_QPyLH5ZlMb9RoaKVwU5Sac16lHMKK2Yp5CIOEu1xqGIotT706i0dh0Aoo4_zrJHXpBWeEjEFjwikEtkMEgW/s320/emergence.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515463566471980962" /></a><br /><br /><br />CROWNING<br /><br />As the baby’s head moves through the pelvic cavity, and under the pubic arch, on the outside of mom’s body we see the baby start to crown. Through the pelvis the baby has rotated from LOT to OA, and when the baby’s head is born, the baby is usually looking toward mom’s back<br /><br />EXTERNAL ROTATION/RESTITUTION<br /><br />The baby’s head has already gone on its internal rotational journey. As the head emerges, the shoulders follow with their own rotations. The shoulders enter the pelvis side to side, because they are widest that way, which puts the baby’s head in the OA position. As the shoulders move through the tight pelvic cavity, the body spins clockwise, and on the outside you’ll see the baby’s head turn toward its mother’s right leg. <br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjT2NOSX9UfRIqd8oqlYtOTqiRKj8N-ygTdEiLa4ZNqwZuZlnEz7LSSD75UXH1S5J06riwBRZlCqMk3tTBmvbkUymAGpjnQ_CVAYSfdE7gjEiKOjFte9k9722tIOZ1o6A-xQmrffcvFx8q3/s1600/restitution.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 276px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjT2NOSX9UfRIqd8oqlYtOTqiRKj8N-ygTdEiLa4ZNqwZuZlnEz7LSSD75UXH1S5J06riwBRZlCqMk3tTBmvbkUymAGpjnQ_CVAYSfdE7gjEiKOjFte9k9722tIOZ1o6A-xQmrffcvFx8q3/s320/restitution.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515463928670301298" /></a><br />As the shoulders move through the pelvic cavity, the rotation continues until the shoulders are front to back, this being the widest diameter of the pelvic outlet. Because of the pubic arch, the anterior shoulder will emerge first, followed by the posterior shoulder. The baby usually continues rotating until its facing up as the rest of the body is born.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgN_oNSvVHgK4JsX7lj9ECzd-MqbVPKs6PxgppGDAbY9UZ_T59g8FSXPcvJyTTKFZ5Xo12bG5YTryY02x4T88bMnQ9C2hVyzuZ6TGEQGPLfaeQtO3M6z05ck8sGLMGBElP815WTJyOW7CB/s1600/anterior+shoulder.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 213px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgN_oNSvVHgK4JsX7lj9ECzd-MqbVPKs6PxgppGDAbY9UZ_T59g8FSXPcvJyTTKFZ5Xo12bG5YTryY02x4T88bMnQ9C2hVyzuZ6TGEQGPLfaeQtO3M6z05ck8sGLMGBElP815WTJyOW7CB/s320/anterior+shoulder.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515464169733101890" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><strong>BACKING UP</strong><br /><br />What I’ve just described is the best way that a baby fits through the twists and turns of the maternal pelvis. The two were designed to work together in this manner and allow the baby and the mother to remain intact. Getting a baby to this starting point is what optimal fetal positioning is all about.<br /><br />DEXTROROTATION<br /><br />Why does it matter if the baby starts in a left position or a right position? Inside the body, there’s a certain phenomenon that takes place called dextrorotation. This describes the body’s tendency to have its processes move in a clockwise direction. Our uteri move the same way. As the uterus contracts and releases, babies are turned in a clockwise manner. If a baby were to start out in an ROA position, this would mean that the baby would need to rotate all the way from ROA to ROT to ROP to OP to LOP to LOT to LOA. That’s quite a long journey and includes a nice length of time moving through the posterior position, which can be extra painful for many mothers. Starting out in the LOA position means that the uterus can focus on pulling open the cervix and moving the baby down, instead of also working on getting a baby into a good position.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA4eeWJ-stmPbsU9RRDgJUDqNb6KSofgNBNT4ujSDycqkzHLK4wW31K-znTAR28wRd3WCF0J-Vr3z84gboJk6i7O4blPxOK6tI_SfDp6XoU0du2VRLkUGFTIyeq0upLS_WScy_hgs4PpWp/s1600/pelvis-female.gif"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 233px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA4eeWJ-stmPbsU9RRDgJUDqNb6KSofgNBNT4ujSDycqkzHLK4wW31K-znTAR28wRd3WCF0J-Vr3z84gboJk6i7O4blPxOK6tI_SfDp6XoU0du2VRLkUGFTIyeq0upLS_WScy_hgs4PpWp/s320/pelvis-female.gif" border="0" alt=""id="BLOGGER_PHOTO_ID_5515467157286696498" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />GETTING A GREAT START<br /><br />One of the best ways you can help start labor off right is by paying attention to your body movements in pregnancy.<br />Consider the way your spine curves. Most of us are lazy when we sit, especially if we like to sit in comfy seats such as couches and overstuffed chairs. In these places, we tend to tilt our pelvis back and curve out our lower spine, rolling our shoulders forward. Because the back of the baby’s head is heavier than the front of its head, sitting in slouched or reclined positions allows gravity to turn your baby to a posterior position, and the baby’s back is curved nicely along your curved back. If you were to sit with the pelvis tilted forward instead, your lower spine would have a nice curve inward, and your body would be more upright. This would allow the uterus to move forward, the baby to fit itself along the curvature of your spine, and the heaviest part of the baby’s head would then be toward your front.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgeN8Yx8KOyfYEiGcNZZJuefeZJ165CxyI9pRlHr4lq8lLlK7cdxCVUluZC7W7mopA4MB1Inw_FZWvGZlrrJcEOlFz8DMemiSPJRo513zgu_EEbA-QT5AXpfagJFk_Y6dB2BrEKek2wHmVH/s1600/posterior.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 308px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgeN8Yx8KOyfYEiGcNZZJuefeZJ165CxyI9pRlHr4lq8lLlK7cdxCVUluZC7W7mopA4MB1Inw_FZWvGZlrrJcEOlFz8DMemiSPJRo513zgu_EEbA-QT5AXpfagJFk_Y6dB2BrEKek2wHmVH/s320/posterior.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515458489638773746" /></a><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMOh60tKs5IkafDX6oeaC82M-tCDXca6I2ofOm56ORWzmNE5D7Z0CDFiqsV8qrfV9lxW-bz2QADJeBQL-2jos3KM4ap1qnhrRmWqkJTAHu5aXoJYf9X65YsH7IO1da-SOuZfO2w7U_1bKs/s1600/anterior.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 315px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMOh60tKs5IkafDX6oeaC82M-tCDXca6I2ofOm56ORWzmNE5D7Z0CDFiqsV8qrfV9lxW-bz2QADJeBQL-2jos3KM4ap1qnhrRmWqkJTAHu5aXoJYf9X65YsH7IO1da-SOuZfO2w7U_1bKs/s320/anterior.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5515464713887283298" /></a>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-76555110523160368122010-08-06T13:07:00.001-07:002010-09-02T16:17:31.809-07:00Optimal Fetal Positioning, Part 2 - The Fetal HeadIn the first blog entry on Optimal Fetal Positioning, I discussed the shape and variations of the first participating body part of OFP – the maternal pelvis. Before we discuss how Optimal Fetal Positioning really works, I need to explain the next participating body part – the fetal head.<br /><br />As with the maternal pelvis, the fetal head is made up of various mobile bones that form a variety of shapes and sizes. Because babies’ heads move in different directions, both on their bodies, and in relation to the mother’s pelvis, I’m going to break down the different ways we describe the fetal head.<br /><strong><br />“Attitude”</strong><br /><br />The first part of the baby’s head position to consider deals with “attitude”. This describes the amount of flexion or extension of the baby’s head, or how tucked the baby’s chin is. Why is flexion important? The amount of flexion going on will alter the diameter of the baby’s head as it moves through the pelvis, the cervix, and through the vagina. A cervix opens only as far as it needs to fit around the baby’s head. If the diameter is small, it will only need to dilate that amount. If the diameter is larger, then more dilation will need to occur. . A well-flexed head is a baby whose chin is tucked well into its chest, with the occipital (or back of the head) bone as the presenting part. From here there are varying degrees of flexion and extension.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7jiAjugqs14uBj91zi5zb6INgGs9kQ3KnezLAEVpdnuQnbJEnUJ-TJ4LMyEsTz5pl0zJsmENY_6AZb8gOsJ8dSLv6edtKTY1OUzt6km-TxAr7C_uJfvvW7HtWwWTl89XHr1lDLbRCteks/s1600/fully+flexed.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh7jiAjugqs14uBj91zi5zb6INgGs9kQ3KnezLAEVpdnuQnbJEnUJ-TJ4LMyEsTz5pl0zJsmENY_6AZb8gOsJ8dSLv6edtKTY1OUzt6km-TxAr7C_uJfvvW7HtWwWTl89XHr1lDLbRCteks/s320/fully+flexed.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512454472507275282" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZZAAAyPn0wlfcBghqmpVwwJrkjEH1AUShhLsXCaeEhnt_ybM3wRxrXXlKxRtvr0x6aCSwydK6qfjwrKBXIWqve8DrJm3A-V-AXVnQ1ez2R96J8v3Sg9BuinZ6tMVHG8fU_U1mULDoIQyo/s1600/fully+flexeddiameter.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZZAAAyPn0wlfcBghqmpVwwJrkjEH1AUShhLsXCaeEhnt_ybM3wRxrXXlKxRtvr0x6aCSwydK6qfjwrKBXIWqve8DrJm3A-V-AXVnQ1ez2R96J8v3Sg9BuinZ6tMVHG8fU_U1mULDoIQyo/s320/fully+flexeddiameter.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512454648697865202" /></a>Complete Flexion: this is the optimal position for a baby’s head to be in. The angle of the head and neck are less than 90 degrees, baby’s chin is tucked well into it’s chest, and the very back of the head presents first. The diameter of a completely flexed head, the suboccipitobregmatic diameter, is measured from just below where the occiput starts out to the center of the front fontanel. This diameter is about 9.5 cm<br /><br /><br /><br /><br /><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO8eVEQqQQRgnABQnVPqjXfYRDXpFIU3tvJctFtgvCLa-LMZNXxf9Vvq21vPRUBpBeXPMvE1JiPuJ1IXG65sUrdPyctCU21fNsi4lwrP0f8bXTt70o4JyDpnkTwGBvA-mqnTgnJxrOk0qB/s1600/military+presentation.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhO8eVEQqQQRgnABQnVPqjXfYRDXpFIU3tvJctFtgvCLa-LMZNXxf9Vvq21vPRUBpBeXPMvE1JiPuJ1IXG65sUrdPyctCU21fNsi4lwrP0f8bXTt70o4JyDpnkTwGBvA-mqnTgnJxrOk0qB/s320/military+presentation.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512454847801404530" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1Y1WnjRnr_Adq8nZxIkFZqEjCGHvksAKEaFF98QvQUJkwJyHKNysuz4RH9Np4y7tVre8EXhU6lmRyXOLpbqxiCOeHLjoKrGgi9Dblew8sYf6ldSVJWX1zE_wUSCEy5zHO_V6TF2Wxautb/s1600/military+presentation+diameter.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1Y1WnjRnr_Adq8nZxIkFZqEjCGHvksAKEaFF98QvQUJkwJyHKNysuz4RH9Np4y7tVre8EXhU6lmRyXOLpbqxiCOeHLjoKrGgi9Dblew8sYf6ldSVJWX1zE_wUSCEy5zHO_V6TF2Wxautb/s320/military+presentation+diameter.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512455037824755890" /></a><br />Moderate Flexion, or Military Attitude: with the military attitude, the baby’s head and neck are at a 90 degree angle, as if the baby is looking straight forward. The diameter of a military attitude, the suboccipitofrontal diameter, is measured from just below where the occiput starts to about the center of the forehead. This diameter is about 10 cm<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHvkeFPaVoDtE2TPdooOLfs1E0Es_6la3-RmKmfx7zukbKXci2MAyXugqBv7NmfTeNtQe69HSPH2jxFrqlpj_d3bwKwltkw5bs8QM67EEIRpgstJukSgzRtkJLJfwIo9atib0IE26mgu0K/s1600/brow+presentation.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHvkeFPaVoDtE2TPdooOLfs1E0Es_6la3-RmKmfx7zukbKXci2MAyXugqBv7NmfTeNtQe69HSPH2jxFrqlpj_d3bwKwltkw5bs8QM67EEIRpgstJukSgzRtkJLJfwIo9atib0IE26mgu0K/s320/brow+presentation.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512453547962342306" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRtNEe6nRG_dQfTfDFw-yn3NU7McCawWKUm1WaTMOoJuizrSige2wniTNgKZvRpvtJakOYv9Am-7UuPJ-Cb3Anx8cD9QGu7Vr8D0V-hpcZ4pfzgex-ebYtMVMbNunqzbCStx7BqeyUX4L_/s1600/brow+presentationdiameter.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRtNEe6nRG_dQfTfDFw-yn3NU7McCawWKUm1WaTMOoJuizrSige2wniTNgKZvRpvtJakOYv9Am-7UuPJ-Cb3Anx8cD9QGu7Vr8D0V-hpcZ4pfzgex-ebYtMVMbNunqzbCStx7BqeyUX4L_/s320/brow+presentationdiameter.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512453762428701746" /></a><br /><br /><br /><br /><br />Extended or Brow Presentation: this attitude has the baby’s head tilted back a bit, the angle of the head to the neck greater than 90 degrees. The diameter of brow presentation, the occipitofrontal diameter, is measured from the occiput start at the back of the head to about the eyes or the brow. The diameter is about 11.5 cm.<br /><br /><br /><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOysNK-zy8t2NmYt47R3kZT4q-1QV8xjboqWqtCglxUh_f2stQzgvLRY1l4eROoPUR46ycLzM2ciZ8xJCO1CyRwD2x1oFeL9od5Np1x1VkBiz4wIGMxEIrxXpHX2Kye4PtjfW5cMKNyb93/s1600/face+presentation.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiOysNK-zy8t2NmYt47R3kZT4q-1QV8xjboqWqtCglxUh_f2stQzgvLRY1l4eROoPUR46ycLzM2ciZ8xJCO1CyRwD2x1oFeL9od5Np1x1VkBiz4wIGMxEIrxXpHX2Kye4PtjfW5cMKNyb93/s320/face+presentation.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512454089606097714" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiriXNWp1U4ElbQwY6hKTUcn2s3597StNQqE-Kdumk_Ee-9qbLbmXUgVSeWyq6uacKWQYfGEHb4MwPYdH1tgJpUpq8hmy2UVTkCaN_Ne2HrATxcsAIA0DmhJuoGFt5fRlCZ2Uix5eHDOeBx/s1600/face+presentation+diameter.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiriXNWp1U4ElbQwY6hKTUcn2s3597StNQqE-Kdumk_Ee-9qbLbmXUgVSeWyq6uacKWQYfGEHb4MwPYdH1tgJpUpq8hmy2UVTkCaN_Ne2HrATxcsAIA0DmhJuoGFt5fRlCZ2Uix5eHDOeBx/s320/face+presentation+diameter.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512457634877411746" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />Hyperextended, or Face/Chin Presentation: this attitude has the baby’s head tilted way back and can be referred to as “star gazing”. The diameter of a hyperextended attitude, the mentovertical diameter, is measured from the tip of the chin to the highest point on the back of the head on the vertex. The diameter is about 13.5 cm.<br /><br /><br /><br /><br /><br /><br /><br />As you can see, the variation in diameter of the fetal head is great in relation to how well flexed is the baby’s head.<br /><br /><strong>Fetal Head Bones/Molding</strong><br /><br />So, can an unflexed head still fit through the pelvis and birth canal? Though it often takes more time and effort, yes, an unflexed head can still fit through! <br />Many pregnant women cringe when they think about pushing out a newborn baby’s head through their vaginas. How could something so large come out of something usually so small, they may wonder. While the majority of that topic can be turned into a blog post all on it’s own, for the sake of this blog post on OFP, we will discuss how the baby’s head can change size in order to fit through the mother’s pelvis.<br />We’ve already talked about how the attitude of the baby’s head alters the diameter of the presenting part. But, what if the baby comes down in one of those suboptimal positions, or what if the baby really does have a large head? The wonderful thing is, we were designed to deal with this as well. Just as the maternal pelvis can expand to allow more room, the fetal head can contract to take up less room.<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiq4POVdzUOjsYDwseZ0-h1cmum_BtSsilxKnTBYVBJUiDXXx8zVmxpZ-X4NVa6LFbrMpcFVOZFXI3CEIN9S76LcIZHuE-0InfHV39ggs5Z5Pvs7a2t7hhE6p_5KpW2dEHvYhlyYCbpyoMS/s1600/frontskull+bones.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiq4POVdzUOjsYDwseZ0-h1cmum_BtSsilxKnTBYVBJUiDXXx8zVmxpZ-X4NVa6LFbrMpcFVOZFXI3CEIN9S76LcIZHuE-0InfHV39ggs5Z5Pvs7a2t7hhE6p_5KpW2dEHvYhlyYCbpyoMS/s320/frontskull+bones.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512455142526234322" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7XlUsJYWF-6c0OyjNoi4Yx7axQjN4FI1nVSVv2d0m53MFQVTXMPlJ3NukClR2T5tlm08BhZBlCqM7YPMyn1e1WchK8PDCtSwKUUJNTht8e0vBtijz0bhT4rgNAT4V8WhdJlke1sHG_S-x/s1600/back+skull+bones.jpg"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg7XlUsJYWF-6c0OyjNoi4Yx7axQjN4FI1nVSVv2d0m53MFQVTXMPlJ3NukClR2T5tlm08BhZBlCqM7YPMyn1e1WchK8PDCtSwKUUJNTht8e0vBtijz0bhT4rgNAT4V8WhdJlke1sHG_S-x/s320/back+skull+bones.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512455228284360850" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />The fetal skull is formed from five main bones – two frontal bones, which make up the forehead area; two parietal bones, which make up the majority o fthe skull; and the occipital bones, which makes up the very back of the skull, protecting the spinal cord.<br /><br />The adult human skull has a static shape – it is not going to change unless the bones are broken. But from fetus up until eight years of age, the sutures between these bones have not yet fused. These unfused bones and the fontanels, or small gaps, between the bones, create a skull with the ability to shift, bones overlapping bones, reducing the diameter of the skull. This ability can even allow a malpositioned baby to fit through his mother’s pelvis. I’ve seen some pretty amazing coneheads in my practice! The ones that are always so amazing to me are those that cone at an angle, or off to the side of the baby’s head. It amazes me that we are able to adapt so well; that vaginal birth really is very accommodating!<br /><br /><strong>Fetal Head Position</strong><br /><br />Fetal head position is different than the attitude of the head. The attitude deals with moving the head up and down from the neck. Position deals with the direction in which the head (and the body that follows) is facing.<br /><br />When discussing fetal head position, the occipital bone – the one at the very back of the head – is always what is used as the point of reference. We describe the fetal head position as which direction of the mother is the fetal occipital bone pointed toward.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhk3Ad3BM3MVsmeXUwh90P54EBCG2W32q98lkamP-ZmwtljvUetnw2hcYPxwqudHzykVIPoPEWHmWN2tLsDXQaUb2DtwF-kpU242xw7Fp9-jNYtJtOh66ObTkybwZEx5zVNGGGnk6tBeOak/s1600/pregnant%2520belly.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 213px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhk3Ad3BM3MVsmeXUwh90P54EBCG2W32q98lkamP-ZmwtljvUetnw2hcYPxwqudHzykVIPoPEWHmWN2tLsDXQaUb2DtwF-kpU242xw7Fp9-jNYtJtOh66ObTkybwZEx5zVNGGGnk6tBeOak/s320/pregnant%2520belly.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5512421462751532706" /></a>The front portion of the mother is called the anterior. The sides are called transverse. And the back portion of the mother is called the posterior. So, if the back of the baby’s head is pointed toward the front of the mother, the baby would be in an occiput anterior position<br /><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRt-b_M4zLlIts0Q7C7-jn02bbOCPJZWM5ljgugy8BuWdHOBpXQQdVIg4oIB7PoP-Ch8FnDESB8rQOzQiBZiuvbKRkBnrm5tdZxNoaSIffv4wEXvkzIs0z9TOdu6IqZ9wbySvcAII84lAN/s1600/occiput+anterior.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgRt-b_M4zLlIts0Q7C7-jn02bbOCPJZWM5ljgugy8BuWdHOBpXQQdVIg4oIB7PoP-Ch8FnDESB8rQOzQiBZiuvbKRkBnrm5tdZxNoaSIffv4wEXvkzIs0z9TOdu6IqZ9wbySvcAII84lAN/s320/occiput+anterior.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5498847438182508818" /></a><br /><br /><br /><br /><br /><br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFBhWoTzkGAt7MHWkurvhupIoovTwPo66K5q_DgnIZrOnxCchudE9eTmcPo1yQlGrbT4khhQWH1sjL-2c3HGCzrNM4DDaN6unLIrn2NOIURIWMzFanV01123r00SLxrxZZdGRnFZBE4pwc/s1600/pelvis-female.gif"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 233px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFBhWoTzkGAt7MHWkurvhupIoovTwPo66K5q_DgnIZrOnxCchudE9eTmcPo1yQlGrbT4khhQWH1sjL-2c3HGCzrNM4DDaN6unLIrn2NOIURIWMzFanV01123r00SLxrxZZdGRnFZBE4pwc/s320/pelvis-female.gif" border="0" alt=""id="BLOGGER_PHOTO_ID_5512423672228362754" /></a><br /><br /><br /><br /><br /><br /><br />The various fetal head positions are as follows:<br /><br />ROA (Right Occiput Anterior)<br />ROT (Right Occiput Transverse)<br />ROP (Right Occipital Posterior)<br />OP (Occiput Posterior)<br />LOP (Left Occiput Posterior)<br />LOT (Left Occiput Transverse)<br />LOA (Left Occiput Anterior)<br />OA (Occiput Anterior)Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com5tag:blogger.com,1999:blog-1237119393135324542.post-3973090412936654362010-07-27T19:53:00.000-07:002010-08-31T15:07:50.287-07:00Optimal Fetal Positioning - How Baby's Position Can Alter Your LaborThe words "Optimal Fetal Positioning" may sound like technical jargon to many, but to my ears they are the sound of hope and relief. While my beliefs about birth are mostly rooted around the ideas of keeping hands off of the pregnant mama, and letting the laboring mama and the baby inside do the work they were made to do, understanding the way our bodies were designed can lend an enormous amount of insight into what makes labor work, and what doesn't.<br /><br />When dealing with optimal fetal positioning, we mainly focus on two parts of the participating bodies. The mother's pelvis, and the baby's head. Now, of course, these body parts do not function on their own, and are intricately connected to the entire rest of the body; but for now, we're going to break it down into these two parts so that we can have a better understanding for how this works.<br /><br /><strong>Part 1: The Pelvis</strong><br /><br />Most scientists will concur that the human birth process has evolved into a series of compromises. As humans became bi-peds, our pelves narrowed. In order to walk upright, we gave up the ability to birth with the ease of a wide pelvis; a pelvis that would essentially allow us to release our babies without any pushing. Whether you are of a scientific mindset, agreeing with the degrees of evolution that have brought humans to this point in history, or more of a faith-based mindset, agreeing that a Creator had a perfect plan for how a baby would come out of it's mother, the fact remains that this process works - when done right.<br /><br />The pelvis is a complex and dynamic set of bones. It cannot be defined by one shape or size. It is both wide and narrow, short and long. And it has the ability to alter its shape! What is so wonderful about all of this, is that babies heads and bodies are still able to maneuver their ways through the various turns and twists of the pelvis, and still find their way out!<br /><br /><strong>Pelvic Diameters</strong><br /><br />There are four main types, or shapes, of pelvises among humans, but they all have the same basic structure of the inlet, the cavity and the outlet. The diameters of each of these parts of the pelvis differ significantly.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVrLN_sMtCKPvIwBxEsTD-xH-WGqS9EP8fBlkBZBBW2rxGsQmWpNso2h5c_P_lbbl__iNCkKfBLk38hA05Ok6Um5puYYGq4712WLpXV_OA6YJmGwLnyYwEZkdC9y22PWanx68NsV6DcEgX/s1600/pelvic+inlet.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVrLN_sMtCKPvIwBxEsTD-xH-WGqS9EP8fBlkBZBBW2rxGsQmWpNso2h5c_P_lbbl__iNCkKfBLk38hA05Ok6Um5puYYGq4712WLpXV_OA6YJmGwLnyYwEZkdC9y22PWanx68NsV6DcEgX/s320/pelvic+inlet.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5502451122996958514" /></a><br /><br />The inlet of the pelvis is about 11-12 cm from front to back, and 13-13.5 cm from side to side. When I get to discussing the baby's head, you'll see why this is significant. For right now, I'm just talking about the structure of the pelvis.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhp2BKk5NFF0l_WOPRGtEx2gePahgVKyFdEDRs8ZtjqvPbg3mka_dBUsDL-khAC3TsH-2F2f5KrjZHrdixj5c3U043mUME0Yxv_4mUce1I2fGzPXM5h_bYESHczJV9zaMNhosnGCXgXTq5U/s1600/pelvic+cavity.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhp2BKk5NFF0l_WOPRGtEx2gePahgVKyFdEDRs8ZtjqvPbg3mka_dBUsDL-khAC3TsH-2F2f5KrjZHrdixj5c3U043mUME0Yxv_4mUce1I2fGzPXM5h_bYESHczJV9zaMNhosnGCXgXTq5U/s320/pelvic+cavity.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5502452847019673298" /></a><br /><br /><br /><br />The pelvic cavity is the narrower part of the pelvis. It has a more equally rounded diameter, each direction being about 12 cm wide. The ischial spines, the boney prominences that make up the narrowest part of the pelvis, are typically 11 cm apart.<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj29jYK856aBF4uqbeUn0eulHuD-KjCzTtODiUrcSYmiKbLprjQLQUF0Seaoag2KvpD1HUW_x_0p2lTedepWkMdOex5j0vNOVu4mMwaFUdk7UHIB6-f4jE4RdCiGpWP96aVMWPk0ZjBuEeu/s1600/pelvic+outlet.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 237px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj29jYK856aBF4uqbeUn0eulHuD-KjCzTtODiUrcSYmiKbLprjQLQUF0Seaoag2KvpD1HUW_x_0p2lTedepWkMdOex5j0vNOVu4mMwaFUdk7UHIB6-f4jE4RdCiGpWP96aVMWPk0ZjBuEeu/s320/pelvic+outlet.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5502454110658733650" /></a><br /><br /><br />The pelvic outlet is narrower side to side than it is front to back. The transverse diameter is about 11 cm. The anteroposterior diameter on an immobilized pelvis is about 11.5 cm. The amazing thing about the pelvic outlet is that the joints that hold the lower pelvic bones together are quite flexible. If a mama is allowed to be upright, and baby is able to press it's way through, the sacrum and the coccyx are able to move freely and will open up as the baby's head comes through the pelvis, creating an additional 3.5 cm of space!<br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUVncRwyYq9d3fS7k5w5A14Ba9az1FHphSI5eX4JiUz0AQFvIU0FLqc8kggsTVekZnbGcxYjcQzds-O8UqWMOip8TWQCpQOacpiqt6jSF0Gp2vRdF23Rtmq8bfIMl3cl1MhLHJNzZ4gL3Q/s1600/DSCN0658.JPG"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUVncRwyYq9d3fS7k5w5A14Ba9az1FHphSI5eX4JiUz0AQFvIU0FLqc8kggsTVekZnbGcxYjcQzds-O8UqWMOip8TWQCpQOacpiqt6jSF0Gp2vRdF23Rtmq8bfIMl3cl1MhLHJNzZ4gL3Q/s320/DSCN0658.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5502456086830676546" /></a><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicmTuEnc1Mx277T5jRLWguxWLQPZrnfpywSltRChoHmJK0BTzSlP0xZIsOWGv6ZWVTzMD1USUrRo6JabvC5VGYRIb48PntB8ZyIYD4fChJZnPX9mNn3naiiMZ7D6pAuA5_mpsnKan8KD_D/s1600/DSCN0659.JPG"><img style="float:right; margin:0 0 10px 10px;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicmTuEnc1Mx277T5jRLWguxWLQPZrnfpywSltRChoHmJK0BTzSlP0xZIsOWGv6ZWVTzMD1USUrRo6JabvC5VGYRIb48PntB8ZyIYD4fChJZnPX9mNn3naiiMZ7D6pAuA5_mpsnKan8KD_D/s320/DSCN0659.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5502456324274523986" /></a><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><strong>Different Pelvic Types</strong><br /><br />With about 50% occurance, the most common pelvic type among women is the <em>gynecoid pelvis</em>. This pelvis type is the ideal shape for childbirth, with a rounded pelvic brim, blunt ischial spines, round sciatic notch and a pubic arch of about 90 degrees.<br /><br />The next common pelvic type, occuring in about 25% of women, is the <em>anthropoid pelvis</em>. The pelvic brim on this pelvis is wider front to back than it is side to side, the ischial spines are blunt, sciatic notch is wide and the pubic arch is greater than 90 degrees. This type of pelvis is common among women who are tall and have narrow shoulders. Because of the shape of this pelvis, it is common to have posterior positioned babies.<br /><br />About 20% of women have the next type of pelvis, the <em>android pelvis</em>. This pelvis is similar in shape to the male pelvis and tends to be more common in women who are short and stockily build. The pelvis is heart shaped, making it more likely to have a posterior positioned baby. Because the ischial spines are prominent and close together, the baby's descent may be slow late in labor.<br /><br />And the final type of pelvis, occurring in only about 5% of women, is the <em>platypelloid pelvis</em>. This type of pelvis is kidney shaped, being much wider side to side than front to back. The ischial spines are blunt, and the sciatic notch is wide. Because of the width of this pelvis type, the baby may need to tilt its head in an asynclitic position in order to engage into the pelvis.<br /><br />No matter which type of pelvis you have, each of these pelvis types are able to give birth to a baby! Why? In the next section you'll learn how amazing the fetal head is in relation to fitting in tight places.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com9tag:blogger.com,1999:blog-1237119393135324542.post-4579526899378027512010-01-21T14:42:00.000-08:002010-01-21T15:04:19.882-08:00How Healthy Are We?This year marks the end of the second “Healthy People” decade. Healthy People is a program that puts together an extensive set of 10-year health goals for our nation with the intention of promoting health for America. Various government agencies, along with outside organizations, have worked together to come up with goals that are of the highest priority for our nations’ health.<br /><br />Being in the field that I am in, I am always eager to see the goals they set for maternal and infant health, along with how we do in meeting those goals. Of specific concern to me is how they view the rate of cesarean sections.<br /><br />In the Healthy People 2000 set of goals, a target of a 15% total cesarean rate was set for our nation, with a 12% rate for first time, low risk (full-term, singleton, vertex presentation) moms, and 65% target for repeat cesareans. The actual numbers were an improvement from what they had started at, down to 21.8% for total, 15.7% for first time moms and 66.4% for repeats, but did not meet the intended goals.<br />For Healthy People 2010, you may notice that the target rate went up. The goal for first time cesarean section was set at 15%, and target repeat cesarean was for 63%. A few points difference, but when you take into account how many thousands of women those points account for, that’s a lot of cesareans. We do not have any comprehensive data on these statistics any more current than 2007, but if we are continuing along the trend we see from that year’s rates, we are far, far, FAR from our goal! Last I heard, our overall cesarean section rate was around 31.8 %. <br />That’s more than twice the intended rate. <br /><br />So, what’s going on here? Our health agencies and organizations believe that reducing the rate of cesarean sections is imperative for improving the health of our nation, but we are moving away from our goals in this area.<br /><br />Why is a low cesarean rate an indication of a healthier nation? Isn’t cesarean a life-saving technique? Yes, it is. Having access to technology that can be used in emergencies is an indication that our country is advanced, but the use of these procedures does not mean that we are healthier because of our advancements. My belief is that we are too quick to use our advanced techniques when low-tech approaches could work just as well, if not better. If our high cesarean rates are a reflection of the number of emergency births that take place, there is something seriously wrong happening. Our women are becoming very unhealthy if one-third are unable to birth their babies. Our babies are becoming very unhealthy if one-third are too distressed to be birthed. Not only is our high cesarean section rate an indication of poor health prior to birth, but it increases health risks following birth, creating a new epidemic of young women with fertility problems, uterine problems and needing hysterectomies. If it is true that one-third of our nation’s births are emergency situations, we need to back WAY up and figure out how we can help women become healthy prior to, and throughout their pregnancies. We need to figure out how to grow healthy babies and promote that.<br /><br />My question for Healthy People is how they intend for these goals to materialize into action? It’s one thing to set a goal, it’s quite another to make a plan of action and follow it. What is the point in setting these rates when there is no plan also set in place in how to achieve them?<br /><br />Healthy People states that they are “grounded in the notion that establishing objectives and providing benchmarks to track and monitor progress over time can motivate, guide and focus action” but this is clearly not the case in obstetrical care. Though the “Mother-Friendly” and “Baby-Friendly” stamps of approval were established as an incentive to practice evidence-based, goal-meeting, care in hospitals, in the 14 years that these guidelines have been established, I can only find 86 hospitals in the entire United States that can claim being Baby-Friendly, and have yet to find one Mother-Friendly award. <br /><br />Do we just not care? On the one hand, we see it important enough to list in our health priorities, but on the other hand, the shows we watch, the organizations that are respected, and the numbers themselves all show us that we really don’t care enough to do anything about it. Instead of it being seen as a medical emergency, cesareans are beginning to be seen as the norm.<br /><br />Setting a goal without a plan of action is like saying you want to lose ten pounds and then continuing your life as you always have. If you want to lose weight, you need to make an effort and have a plan of what you are and are not going to do. The same goes with the Healthy People goals. Just setting a goal is not inspiring enough to the obstetricians in our nation. They need steps to guide them.<br />So, let’s look into the cesarean epidemic. Why are our rates so high? Why do they continue to climb when our goal is set for something much lower?<br /><br /><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI-YpQsiPwVqsOm6UBCUoK5Kc0wagFUV-A_Va7YNIVevDkK7-pRgOzsT_FoxmqGj2EQW5PiXJH3_NIU80zkdAlheUFwsw0DbCkCmwPq6sgd1PwOPXJrW1IoTf_d06LhZ6Bz_OZZVHEecU3/s1600-h/c.del..jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 135px; height: 76px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI-YpQsiPwVqsOm6UBCUoK5Kc0wagFUV-A_Va7YNIVevDkK7-pRgOzsT_FoxmqGj2EQW5PiXJH3_NIU80zkdAlheUFwsw0DbCkCmwPq6sgd1PwOPXJrW1IoTf_d06LhZ6Bz_OZZVHEecU3/s320/c.del..jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5429329967811951810" /></a><br /><br /><br />The first thing we need to do is address the top reasons for medically necessary cesarean sections.<br /><br /><strong>1. A Previous Cesarean</strong><br />Well, the easiest way to avoid this is to avoid the first cesarean! But, since that’s not always an option, we need to look into the reasons why a primary cesarean necessitates a repeat cesarean. Research shows that the risks of a vaginal birth after cesarean are much less than the risks of having another cesarean section. <br />A previous cesarean should not automatically place a woman in need for a repeat cesarean. The opportunity for women to have a vaginal birth after cesarean (VBAC) needs to be supported and encouraged.<br /><br /><strong>2. The Baby is Too Big</strong><br />This is a commonly given reason for a truly rare problem. American women, with their access to plenty of nutrition, should not be suffering from debilitating bone growth conditions, such as rickets, which would inhibit their ability to birth a baby. American women, in general, have pelvises that are perfectly suitable for passing a baby. <br />The problem lies in a misunderstanding of a pregnant woman’s anatomy, physiology, hormone production, and the baby’s role in his exiting.<br /> A woman’s production of relaxin and hyaluronidase during the last part of <br />pregnancy and throughout labor loosens up the ligaments of the pelvis, enabling it to stretch and move a lot more than a typical non-pregnant pelvis. As a side note, dehydration can decrease hormone production, so do not restrict access to fluids.<br /> A woman needs to be able to move in labor in order to allow the baby to navigate its way through the twists and turns of the pelvis. This is best done if a woman is upright and has the use of her legs.<br /> Squatting during pushing can open the outlet of the pelvis by more than 10% to allow more room for a descending baby. <br /> Physiological pushing ensures that mom is not wasting energy and only pushing when she and baby are truly ready.<br /> A well-toned pelvic floor can encourage a proper head flexion of the baby to allow for the smallest diameter of the head to lead the way out.<br /> Allowing enough time in labor and encouraging movement with the mom will help baby get into a good exit position, rather than rushing a baby down into a more difficult position.<br /> Not rushing a labor, and letting it progress on its own time will help with the baby’s head molding into a shape that fits through a mother’s pelvis.<br /><br /><strong>3. Breech Baby</strong><br />Delivering breech babies vaginally has been taboo for so long now, that it has come to the point where there are very, very few doctors who even know how to deliver a breech baby. Preventing breech babies should be the first consideration, followed by more attempts at delivering breech babies vaginally. The best ways to discourage a breech presentation are through the following:<br /> Have an extensive knowledge of optimal fetal positioning, and practice it throughout the end of pregnancy and in labor.<br /> Make time for body work such as chiropractic adjustments, craniosacral therapies, myofascial release, massage therapy, acupressure, acupuncture, and physical therapy.<br /> Have a practitioner who is good at palpating to have an understanding of how the baby lies, or do it yourself through belly mapping.<br /> If baby is not moving through home techniques and body work, try an external version.<br /> Allow mom to go into labor and utilize the wide range of movements to allow for baby to turn in labor.<br /><br /><strong>4. Transverse Baby</strong><br />A transverse baby is a problem indeed. A baby truly cannot come out of his mother shoulder-first. To reduce the likelihood of this position, the guidelines for preventing a breech presentation apply to transverse presentation as well.<br /><br /><strong>5. Placental Problems</strong><br />We cannot prevent all, but a healthy lifestyle and good nutrition prior to conception and throughout pregnancy, will greatly reduce these issues. Mothers with previous cesareans are at greater risk for placental problems due to the scar tissue acquired from the cesarean.<br /><br /><strong>6. Slow or Arrested Labor</strong><br />Failure to progress is one of the most common reasons for cesarean sections. The reasons why labors slow down or stop are so various it’s hard to address the issue unless you know all the little details surrounding each woman’s circumstances. But here are some basic things to consider.<br /> Starting a labor with artificial means increases the chance of a labor stalling out, because sometimes, a body just isn’t ready! Letting moms go into labor on their own will increase the chances of labors happening at a time when both mom and baby are ready.<br /> Women in labor are incredibly sensitive to what’s going on in their surroundings. Privacy is vital in order for a woman’s body to follow the natural course of labor. If she does not feel safe or respected, her body will shut down the labor process. Being respectful, quiet, and calm around a laboring woman will help to support her through the process.<br /> Encouraging movement and walking throughout labor can help a labor along. Studies show that it can shorten the length of labor by 25 %. Walking opens the inlet of the pelvis, allowing room for the baby to descend and move into a good position.<br /> Epidurals are known to slow down labors when given too early, or just as a reaction in some women. Using natural pain coping techniques can be effective in managing labor pain, as well as helping labor progress at a steady rate.<br /> A body that is well nourished and has the strength and stamina to endure hours of labor will be less likely to wear out and give up. Encouraging good nutrition and exercise throughout pregnancy can give women a better chance of a healthy labor.<br /> The presence of a supportive birth partner has been shown to shorten labors by 25%. Encourage participation by husbands, partners, and the use of doulas.<br /> If a woman is not in good active labor, she should not be wasting her time in the hospital! Being admitted at an early stage of labor can cause boredom, stress, excessive use of medication and fear, all of which can slow and stall a labor. <br /> In about 1/3 of labors there is a phenomenon that occurs called the Natural Alignment Plateau. During this time, contractions may continue but dilation does not happen, or contractions may stop all together. While dilation is not occurring, progress may still be occurring. Muscle revitalization, hormone production, a baby changing position, head molding, the release of fears, colostrum production – these are all ways in which progress can be made while dilation is not occurring. Staying patient while this occurs can lead to a labor which ends in rapid dilation (once all of the unseens are taken care of, things tend to move quickly). To force a labor forward that is experiencing a natural alignment plateau may be interfering with processes that are vital to the mom, baby, or both.<br /><br /><strong>7. Umbilical Cord Prolapse</strong><br />A cord prolapse is a true emergency situation. The umbilical cord is the baby’s lifeline while it is in utero. If the cord slips down past the baby’s head and gets pinched or compressed, the baby’s oxygen source is cut off. <br />> One of the ways to avoid a cord prolapse is to not artificially rupture membranes, especially early on in labor. Early ruptures are at a higher risk of cord prolapse because the baby tends to still be high in the mother’s pelvis, allowing more room for the umbilical cord to slip past.<br />> Avoiding internal exams during pregnancy and excessive exams during labor can help prevent early rupture of membranes. Each time an exam is done, bacteria from the birth canal is pushed up toward the bag of waters. This bacterium can eat away at the membranes and increase the likelihood of an early rupture.<br />> Healthy diet throughout pregnancy helps to create a strong membrane that is less likely to rupture early on.<br /><strong><br />8. HIV or Genital Herpes</strong><br />In this instance, preventing the diseases prior to pregnancy is a must. Continued education on abstinence and safe sex practices needs to be encouraged. Women with genital herpes may still be able to have a vaginal birth if they are able to suppress a herpes outbreak at the time of birth.<br /><br /><strong>9. Multiple Births</strong><br />Multiple births seem to be on the rise now that infertility treatments have become so readily available. In order to grow healthy multiples, a healthy diet and lifestyle is absolutely necessary. Just because there’s more than one baby growing in the uterus this should not automatically put mom in the cesarean category. Vaginal birth of multiples is possible and should be attempted. Because of the increased likelihood of a breech presentation with multiples, vaginal breech deliveries need to be revived and doctors should relearn this practice.<br /><br /><strong>10. Fetal Distress</strong><br />The majority of cesarean sections I know of are a result of fetal distress. This is a scary situation. Why are so many babies unable to handle the rigors of labor? If this was the intended way for babies to come out, shouldn’t they be able to endure contractions and birth? While contractions and exiting through the vagina is the way that our bodies and babies are intended to work together, the rest of the labor story tends to stray from the intended course.<br />While distress can occur even during a completely natural and hands-off labor, it is important to note that any time you interfere with the natural process of labor, you are inviting repercussions. That’s why every single intervention should be weighed in a risks vs. benefits analysis.<br />One of the most noted side effects of pitocin is fetal distress. Pitocin, which causes unnatural contraction patterns, affect babies differently than normal contractions. Because they are stronger and last longer, they are adding stress to the baby in utero.<br />Add the epidural. Again, one of the most noted side effects of an epidural is a drop in mother’s blood pressure and decelerated heart rates in babies. And when an epidural is used in conjunction with pitocin, the pitocin is much more likely to be abused. If the mother cannot feel the intensity of the contractions, the medication can be administered in higher doses, without thinking that the baby still is feeling the intensity.<br />So, to counter the cesarean due to fetal distress, we need to:<br /> Lower the induction rates! Starting a labor chemically can stress out a baby who isn’t ready for labor, and it can cause stress to a baby due to the intensity of the pitocin-powered contractions.<br /> Utilize movement in labor! Movement in labor helps a labor to progress, which means less likelihood of having it augmented by pitocin or artificial rupture of membranes. Rupturing the membranes can also increase stress on a baby, as the cushion of water is no longer present and the strength of the uterus squeezing directly on the baby’s head can become harmful after time. Movement also helps to move baby into good positions. Many times women are asked to lie down on the bed and not move in order for the baby’s heart rate to be picked up on the fetal monitor (to ensure that baby is not in distress). The funny thing is, laying down and being still can put baby in a compromising position and cause distress in and of itself! Fetal heart tones can be picked up on a woman upright and moving by holding the monitor to the belly in conjunction to where the baby is during that time.<br /> Avoid pitocin. Avoid it for induction, avoid it for augmentation. It’s just better to stay away from the stuff.<br /> Avoid epidural. Having an epidural can slow down contractions which can then lead to augmentation with pitocin. Epidurals in and of themselves can cause fetal heart rate deceleration. Epidurals also prevent a mom from being able to move and when mom lays in one position, babies can get stuck in compromising positions.<br /> If fetal distress is suspected, fetal scalp sampling can be done to test for true distress in a baby.<br /><br /><strong>11. Maternal Medical Conditions</strong><br />There are many different medical conditions that cause concern for mothers who are carrying a baby. Some are truly incompatible with labor, some can handle labor if mom is <br />If there’s a chance for a mom with a medical condition to give birth vaginally, it’s important to keep these in mind:<br /> healthy eating and a healthy lifestyle prior to conception can make a huge difference in your options once you are pregnant.<br /> Controlling your medical condition through nutrition, exercise and medications throughout pregnancy can help increase your chances of a normal labor and birth.<br /> Try labor. See how the mom’s body reacts. Don’t just rule out labor.<br /><br /><strong>12. Baby’s Birth Defects</strong><br />Some birth defects are incompatible with labor, so cesarean is the best option for these babies. But often times, labor is beneficial for the health and well-being of a baby who has problems, so this is something that a parent needs to really research.<br />The March of Dimes has gone through a huge effort to help prevent birth defects through education. Good nutrition and a healthy lifestyle prior to conception and throughout pregnancy cuts down on the chances of birth defects, as well as a mother taking the right supplements (i.e. folic acid).<br /><br /><br />Now that we’ve addressed the top reasons for medically necessary cesareans, we need to figure out the steps to take prior to the cesarean becoming necessary.<br /><br /><strong>1. Nutrition and lifestyle counseling</strong>. This should not start *in* pregnancy, this needs to start in infancy! This is a lifelong goal, and not one that should be brought to action only after a woman is pregnant. If a woman is unhealthy when she enters a state of pregnancy, encouraging good health and nutrition still can make a difference, and should occur, but the earlier, the better.<br /><strong>2. Utilize midwifery care.</strong> We are seriously lacking in balancing out the specialized practice of obstetrics with practice of caring for normal pregnancy with midwives. The midwifery model of care goes a long way in preventing many of the reasons for cesarean sections, and our nation needs to look seriously at this.<br /><strong>3. Utilize doulas. </strong> Because doctors and nurses are kept so busy, doulas are wonderful additions to the labor room. They provide continuous labor support for the mother, father and family. They help the mom with the emotional side of labor and help her through finding her own way. They drastically cut down the medicalized part of labors and help moms get up and moving. Insurance companies would be very, very wise to reimburse families who use doulas. They can greatly reduce the cost of a hospital stay.<br /><strong>4. Train nurses in taking care of laboring women.</strong> Because of the high percentage of medicalized births, many nurses do not know the needs of a naturally laboring woman. If cesarean rates are to go down, those who work with laboring mothers need to know how to help them in ways that protect, rather than interfere, with the natural process.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-20178104442581844052010-01-20T17:11:00.000-08:002010-01-20T17:15:55.634-08:00BirthWatching birth videos always makes me cry. Not because of fear, or thoughts of pain, or sympathy. I cry because watching women bring forth life fills me with an overwhelming feeling of awe. Because women are so beautiful, so strong, so amazing.<br /><object width="425" height="344"><param name="movie" value="http://www.youtube.com/v/BuM8dzDcraI&hl=en_US&fs=1&"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/BuM8dzDcraI&hl=en_US&fs=1&" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-38655987209517543062009-12-15T17:49:00.000-08:002009-12-27T10:44:05.556-08:00Epidurals at the Door<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhB2-3hN6y3KUbHfXTWFXzLQzFjG5ANKOvjRHkdrAYZsnRPnEUPNlXrdO2hLmCS7lrkLE1NPfOD0X4LGoI2Myf9uomLv_CqqXwhgjvcJLP7Il8BLNZ9LNaxAZt6HDjyEs_s-_OfxmPBq4k_/s1600-h/OB_Epidural.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhB2-3hN6y3KUbHfXTWFXzLQzFjG5ANKOvjRHkdrAYZsnRPnEUPNlXrdO2hLmCS7lrkLE1NPfOD0X4LGoI2Myf9uomLv_CqqXwhgjvcJLP7Il8BLNZ9LNaxAZt6HDjyEs_s-_OfxmPBq4k_/s320/OB_Epidural.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5415649894305860002" /></a><br /><br />With an over 95% epidural rate in the area I'm currently living in, most people seem shocked at the idea of taking natural childbirth classes. Obviously, childbirth is about pain, and you want to do everything you can to get rid of that pain!<br /><br />But here's the cold, hard truth, ladies. An epidural is not a guaranteed thing! Sometimes you have a quick labor. Sometimes something holds you up from getting to the hospital early enough on in labor. Sometimes the anesthesiologist is being utlized for someone else's emergency situation. Just because you sign up for an epidural birth does not mean that you will get one!<br /><br />So, what happens to a woman who is in labor and finds out that the one basket she has put all her eggs in has crashed to the floor? Every labor has to start sometime, somewhere, and I'm pretty sure most will not be in a hospital room with a catheter already in the back. You will have to cope with contractions at some point. <br /><br />A woman who knows how the body works and how to work with it is a woman who will experience a lot less anxiety, a lot less panic, and a lot less fear about getting to the hospital in time. <br /><br />Attending childbirth classes that go over plenty of useful pain coping techniques is essential to every pregnant woman. I've had women who have taken my natural childbirth classes who have ended up on pitocin, had an epidural, gone through a cesarean birth, and every single one has come back to tell me that relaxation techniques were vital to their labor, no matter how it turned out. <br /><br />Learning how to relax, how to calm down the mind, how to create a setting of safety, how to deal with pain - these are all techniques that are useful in various birthing situations as well as situations outside of the labor room! These are life skills!Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-40758010893141636072009-05-20T08:15:00.000-07:002009-05-20T08:40:16.942-07:00Working Hard For NormalWhy is it that we must fight so hard for what is normal in birth? <br /><br />Normal is not what you would find if you took a glimpse into an L&D ward at any hospital around the U.S. Normal is what you'd find if you took a look at birth through history and various cultures around the world.<br /><br />What is Normal?<br /><br />Normal is women up and moving in labor.<br /><br />Normal is women wearing what is comfortable for them in labor.<br /><br />Normal is women eating when they are hungry and drinking when they are thirsty.<br /><br />Normal is women being free from wires, lines, pokes, prods, straps, and needles.<br /><br />Normal is a laboring woman being at the center of the childbearing drama while a group of supporting women surrounds her.<br /><br />Normal is a woman having instincts and trusting them.<br /><br />Normal is a familiar room full of peace and love.<br /><br />Normal is knowing those who are with you in labor.<br /><br />Normal is a woman knowing that she was made to give birth.<br /><br />Normal is women rushing with a power that their own bodies provide.<br /><br />Normal is trusting that birth has a ton of fail-safes set in place.<br /><br />Normal is understanding that there is a reason for what happens.<br /><br />Normal is a woman surrendering in labor -- not to others, but to her self.<br /><br />Normal is knowing that most variances of labor can be handled in a calm and competent manner.<br /><br />Normal is trusting that mothers are responsible for making decisions for themselves and their babies.<br /><br />Normal is being touched by loving and caring hands.<br /><br />Why is this not normal for our country? Because we are all wearing glasses tinted with a film of medical superiority. Instead of normal, we have handed birth over to an atmosphere steeped in danger, fear and pain, where women are martyrs and doctors are saviors.<br /><br />We need to put on a different set of glasses. We need a shift in paradigm. When viewed in a light that our bodies were made to give birth. That this is something women have done for all time and the human race still exists. That our bodies are capable of growing and delivering a baby into the world. That it is a normal human function. It seems a little ridiculous to create such chaos around every single birth when it is obviously unnecessary.Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-2283273983730217432008-12-01T21:57:00.001-08:002008-12-03T14:48:58.491-08:00Fathers at BirthBecause there has been such a long struggle to allow fathers to participate in the birth experience with their partners, it sometimes surprises me when I read or hear someone talking negatively about fathers at birth.<p><br />When Dr. Bradley began teaching women how to give birth naturally, fathers’ only participation was pacing in the waiting room, smoking a cigar. It wasn’t until Dr Bradley continued receiving lavish affection from these mothers after their births that he realized what an intimate and bonding experience birth was, and maybe he should invite the fathers to take part in it. I love what Dr. Bradley has to say about the fathers’ role, that it’s not just his job to plant the seed, but to nourish it and remove any weeds of doubts and anxieties.<p><br />There is an idea in most Americans’ heads of what labor looks like. Generally, it’s of a woman in pain, screaming at/hitting/or pulling on the man that put them in that situation. In all the Bradley births I’ve attended and heard feedback from, this has never been the case. When a mother is nurtured by a loving husband throughout her pregnancy, when he takes the time to understand what is taking place inside her, when he devotes his time and energy to working with her through the whole process, then birth is not a blaming or hurtful event. It is a bonding and loving event.<p><br />I strongly believe that women should be supported by women in labor. But I also believe that there is a crucial role for the father as well. A woman in labor needs to be cared for by other women <em>and</em> her husband. Each of them brings something to the laboring woman that the other can’t, which makes for a more fulfilling experience. While a husband may see his wife in pain and only think of ways he could take away the pain, another woman can look at the difficulty of labor and know that the mom will be okay. At the same time, this husband is also the only one who knows this woman intimately, all her deepest desires, her loves, her passions, is the only one who loves her deeply, and is the only one who makes up part of the baby being born. While a father can never truly understand what a laboring woman is going through, understanding the process, learning tools that help, and being an emotionally strong presence will truly lead to an experience that exceeds all others.<p><br />Is this too much pressure on the father? Some (a lot?) think so. While I don’t think fathers should be made to suffer through the laboring experience because their wives are experiencing pain, I do think it’s important for a father to see the process. When he sees the hard work that labor is, when he puts himself to use to help her through, he’s able to see a strength in his wife that he may not have previously seen before. He’s also able to see what great lengths one goes through to bring a child into the world, and experience the sacrifice of parenting from the start – an important concept to learn in the parenting journey.<p><br />When a father has an understanding of what’s happening, and is willing to be there with his love and support, birth, no matter what the outcome, becomes an experience of love and relationship. You see the two become three before your eyes. You watch as a family emerges, and you can SEE the love. The father’s love for the mother, the mother’s love for the father, the parents’ love for the baby, and the baby’s love for it’s parents. And it’s astounding.<p><br /><br /><br /><br /><img id="BLOGGER_PHOTO_ID_5275690962946086818" style="DISPLAY: block; MARGIN: 0px auto 10px; WIDTH: 266px; CURSOR: hand; HEIGHT: 320px; TEXT-ALIGN: center" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhPrbe2D-X6aEO9eJylBDxP8S84MuZrQHyXNkaSSNlDTnk7A4_eTSVQz3x6_xczcZuV-OS3UhypfPZQSeH19agMh2osW2os0uLldAzCE1kFgWog7UOmpsHo9dNWkUtvjlogYiDeXiW6noZ/s320/Proud+daddy+copy.jpg" border="0" />Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-9979070086344136422008-11-09T09:58:00.000-08:002008-12-03T14:31:58.235-08:00Got To Go Through It!<blockquote><p>We're going on a bear hunt. We're going to catch a big one. What a beautiful day! We're not scared.<br />Oh-oh! A forest! A big, dark forest. We can't go over it, we can't go under it. Oh, no! We've got to go THROUGH it!<br /></p></blockquote><br /><br />Why am I quoting a children's book on a birthing blog? Well, I was reading the book <a href="http://www.amazon.com/Baby-Catcher-Chronicles-Modern-Midwife/dp/0743219341/ref=sr_1_1?ie=UTF8&s=books&qid=1226254292&sr=1-1"><em>Baby Catcher</em> </a>by midwife Peggy Vincent this past week and I came across a birth story that brought this children's book to mind. It was Peggy's own birth story, the birth of her third baby.<br /><br /><br /><blockquote><br /><p>"I struggled to find a path around the pain. If not around it, then<br />under it, or over it. I ground my knuckles so deeply into my hip that<br />bruises remained for a week afterwards. Nothing helped, and I fought the forces of my body...</p><br /><p>The next contraction came grinding down on me, but it felt different. A white-hot hole of knowledge opened in my pain. I saw<br />that in my effort to get around or under the pain, I'd been avoiding that central point of intensity, staying on the brink of the primitive surrender that's required to get a stubborn baby out...</p><br /><p>With sudden clarity, I knew it would have to hurt more before it got better. I wouldn't be able to circumvent the pain. I had to go through it, enter willingly into the void, hoding nothing back. I had to jump off the diving board."</p></blockquote><br /><p>The bear hunt book is a great way to visualize the different stages of labor. We start with some long grass. We need to go through it, but it's not too bad. Next, we come to a river. A little more apprehension because we need to get cold and wet, and maybe the force of the river pulling us is a little frightening, but we can make it through. Now, we get to the mud. It sucks at our feet and makes us very dirty. This is getting to be harder. Then the forest, a big, dark forest. Entering into the unknown, tripping and stumbling along, we see how going *through* labor can be scary. Then, a snowstorm! It's whipping us, howling at us, we can't see where we're at, we're lost in the forces around us! And then, we're almost there. The cave. A narrow, gloomy cave. At the other end of the cave is...</p><p>In the book, it's a scary bear. But for the laboring mom, the nose, eyes and ears belong to their baby! Their sweet, precious babe that emerges from the cave.</p><p>If the mom had not traversed all the different terrain, she would not be at the final place where her baby emerges, ready to meet her.</p><p>So, you can't go under labor, over labor, or even around labor. You can't escape and get around the pain. You've got to go THROUGH it, and you'll get to the end much quicker, and be able to relish in the beautiful results of your hard work.<br /></p><p><br />Books used for this post</p><br /><p><i>Baby-Catcher</i> by Peggy Vincent</p><br /><p><i>We're Going on a Bear Hunt</i> by Michael Rosen and Helen Oxenbury</p>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com0tag:blogger.com,1999:blog-1237119393135324542.post-14777606308661174162008-11-01T19:40:00.000-07:002008-12-03T14:54:04.755-08:00The Law of the 3 P's vs. Sphincter LawThis weekend, I had the privilege of attending a workshop on Pain vs. Suffering presented by Penny Simkin, noted author, doula and one of the founders of DONA (<a href="http://www.dona.org/">Doulas of North America</a>). During her talk, I kept thinking back to Ina May Gaskin’s discussion of the physical workings of labor, and how emotions and how a woman feels plays even more important a role in how her labor progresses than the strength of contractions, position of baby, and size of a mother’s pelvis. Ms. Simkin brought up how a woman’s past can have a huge affect on her labor. Abuse, trauma, and shame can lead to fear and suffering during an event that should be celebrated. This makes perfect sense, and physicians normally take past history into account when working with a patient. But when it comes to a woman who does not have a past history, physicians rely heavily on the Law of the Three P’s for understanding progress and time of labor.<br /><br />I first read about the Law of the Three P’s along with Sphincter Law a few years back in the book, <em>Ina May’s Guide to Childbirth</em>. It sparked an interest in me, but not until this year have I really dug deeper into understanding the differences between the two and how they really play out in childbirth.<br /><br /><strong>What is the Law of the Three P’s?<br /></strong>The basics of the law say that:<br />• A woman’s body, if it is capable of giving birth, should produce a baby in a reasonable amount of time.<br />• If progress is not apparent, one of the three P’s is dysfunctional, and intervention becomes necessary.<br />• Strength of uterine contractions (Powers), size and position of baby (Passenger), and/or type and dimension of pelvis (Passage) are the main components in a labor’s progress or dysfunction.<br /><br /><br />First, let’s look into what a “reasonable amount of time” really amounts to. In the 1950’s an OB resident at Columbia-Presbyterian’s Sloane Hospital for Women in New York took on a project of plotting the progress of labor in each of the laboring women in his ward. With the initial intent of seeing if caudal anesthesia had any impact of the speed of labor, Emanuel Friedman unknowingly changed the course of obstetrics by presenting for the first time an average length of time of the three stages of labor. While he considered the information to be used to help doctors determine if their patient’s progress was well outside of normal, Friedman became frustrated when he saw that doctors used the averages as absolutes, not taking into consideration how many women fall on either side of his asymmetrical bell curve.<br /><br /><br /><br />In Norwitz and Schorge’s book, <em>Obstetrics and Gynecology at a Glance,</em> a “dysfunctional labor” is diagnosed if, during the active phase of labor, a first time mom is dilating less than 1.2 centimeters per hour and/or baby is descending less than 1 centimeter an hour. In a mom who is having a second (third, fourth, etc.) baby, dysfunction is diagnosed if she is dilating less than 1.5 centimeters an hour, and/or baby is descending less than 2 centimeters an hour. An “arrested” labor is diagnosed if a mother has not progressed in dilation for more than two hours, or progressed in baby’s descent for more than one hour in multiparas and two hours for first time moms.<br /><br />How limiting! Within only these very narrow margins, a “normal” labor is considered. If a woman falls outside these margins, then the first step is to augment the Powers, the first thought being that the uterus is dysfunctional in being able to produce strong enough contractions to get the baby out. If mom doesn’t get on track with augmentation, then baby or pelvis must be to blame, and cesarean is considered the only way for baby to get out.<br /><br />Since uterine contractions, baby and pelvis seem to be the main parts of laboring, this law may seem reasonable. But it definitely puts limits on a woman’s abilities and does not take into account that the uterus does not work apart from a woman’s brain.<br /><br /><br /><br /><br /><br /><strong>Understanding the Laboring Brain<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnygdqVQQfbEhtSFXVPMVHgMquU6biXqg4CkC2EcPcmn8-LZ-6rZi6HMYOTBtwd4UJ1Fvi7ewnUOkAbDReLNT0_Sl-5dHBAo7XGjcmRqySBAykx-D66uCeVk4bkV7ozcM30FXsmVqJx-ur/s1600-h/brain+copy.jpg"><img id="BLOGGER_PHOTO_ID_5264584796863460002" style="FLOAT: left; MARGIN: 0px 10px 10px 0px; WIDTH: 301px; CURSOR: hand; HEIGHT: 320px" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnygdqVQQfbEhtSFXVPMVHgMquU6biXqg4CkC2EcPcmn8-LZ-6rZi6HMYOTBtwd4UJ1Fvi7ewnUOkAbDReLNT0_Sl-5dHBAo7XGjcmRqySBAykx-D66uCeVk4bkV7ozcM30FXsmVqJx-ur/s320/brain+copy.jpg" border="0" /></a><br /></strong><br />From the works of Michel Odent, we are able to see how much the brain is involved in labor. The brain is made of two layers – the primitive brain, and the neocortex. The Neocortex is the newer, rational part of the brain, which plays a role in abstract thought. The Primitive part of the brain, also called the brain stem, governs instinct and is considered to be a gland that releases hormones.<br /><br />Labor is all about hormones! Oxytocin, endorphins, prolactin, etc. are all released by the primitive part of the brain. Dr. Odent likes to call it a “labor hormone cocktail”. No amount of thought or rationalizing will be able to make more hormones to produce the proper workings of labor. In order for these hormones to be produced, a laboring woman must allow her primitive brain to take over. In natural births, you see this in women who are laboring. You can tell when a woman has gone deep into “laborland”, and is no longer aware of what’s going on around her.<br /><br />But what happens when we force that woman out of her primitive brain? Stimulating the neocortex by asking a laboring woman to answer questions that require thought, being near her in a way that makes her feel self-conscious, subjecting her to bright light, or failing to protect her privacy can actually inhibit the action of the primitive brain in hormone release. So, in reality, much of what goes on in a hospital room is working against the entire labor process.<br /><br /><strong>How Sphincter Law differs from the Law of the Three P’s<br /></strong>While the Law of the Three P’s takes only three physical parts of the body into account for labor progress, Sphincter Law takes a look at the woman as a whole being, and considers that the cervix and vagina, being sphincter muscles, are highly responsive to fluctuation of maternal emotions.<br /><br /><br /><br /><strong>The basics of Sphincter Law say that:</strong><br />• excretory, cervical, and vaginal sphincters function best in an atmosphere of intimacy and privacy.<br />• these sphincters cannot be opened at will and do not respond well to commands<br />• when a person’s sphincter is in the process of opening, it may suddenly close down if that person becomes upset, frightened, humiliated, or self-concious<br />• the state of relaxation of the mouth and jaw is directly correlated to the ability of the cervix, the vagina, and the anus to open to full capacity.<br /><br />Consider what your needs are when having a bowel movement. In order for that sphincter muscle to relax and open fully, most desire a moment of privacy. If, in the midst of a bowel movement, the bathroom door was suddenly thrown open, what would happen? The sphincter muscle would probably tighten back up. It is also necessary to be comfortable and relaxed in order to have a bowel movement. I know people who have a hard time with bowel movements if they can’t take off their shoes. If you are stressed and rushed, bowel movements may not occur. When you consider that the cervix is a sphincter muscle as well, it makes perfect sense that the needs for bowel movements would be similar to the needs of having a baby.<br /><p>If the Law of the Three P's were truly a law, then it would have to be true in every circumstance. And when we scan the entire U.S., we see many variations in the amount of intervention deemed "necessary" in womens' labors. Cesarean section rates vary from doctor to doctor, hospital to hospital. There is more prevelence of pitocin use in certain areas than others. Women at The Farm, Ina May's village in Tennessee, have consistently had a cesarean rate of less than 2%, while the rest of the country sees more and more cesareans each year, with a national rate of nearly 33%. How can this be if there was truth in the Law of the Three P's?</p><p>Even in Lawrence Impey’s textbook, <em>Obstetrics and Gynaecology</em>, right in the middle of discussing the Three P’s, he deviates away from his own writings by saying this:</p><p><blockquote><strong>"General Measures to Maintain Progress<br /></strong> Continuous support during labour is associated with a reduction in operative delivery and length of labor. This should be from the midwife, as well as partner, or from non-medical supporters or “doulas”. The impact of support is seldom remembered, but reflects the importance of psychological well being on obstetric outcomes. Mobility should also be encouraged."</blockquote></p><p>It's very interesting to me to read in the middle of the formula for diagnosing dysfunctional labor, and how to correct them (artificial rupture of membranes, pitocin, then cesarean section), something so simple and so far removed from the medical/pharmacutical mindset. It also seems to counter what the Law of the Three P's deems to be true. That labors don't progress due to insufficient strength of the uterus, too large or malposition of baby, or too small inlet of the pelvis. How is the presence of a partner or doula making a uterus stronger, a baby smaller or better positioned, or the pelvis outlet bigger? While there are certainly things that a doula can do to help with these things, "psychological well being" is what is being pinpointed here. Isn't this what Sphincter Law concludes as well? That feeling loved, supported, protected and safe will help with labor progress? </p><p>So why are emotions so discounted in the obstetrical world? Or perhaps its not the emotions, but how to help a woman's emotions in labor that is being brushed aside. When administering pitocin is something that can be done quickly and checked on from time to time, staying with a laboring woman and supporting her seems like a big waste of time.</p><p>It just seems to me that obstetrics and hospitals function in a way that sets up a laboring woman to fail.</p><p> </p><p>Information for this article came from</p><p><em>Birth</em>, by Tina Cassidy</p><p><em>Ina May's Guide to Childbirth</em>, by Ina May Gaskin</p><p><a href="http://books.google.com/books?id=3brbV7jdcacC&pg=PA122&lpg=PA122&dq=obstetrics,+passenger,+passage,+powers&source=web&ots=GPjDF3N1ax&sig=U9popNxx9yQxMxsNG69PRhu6PLk&hl=en&sa=X&oi=book_result&resnum=1&ct=result"><em>Obstetrics and Gynecology at a Glance</em>, by Errol R. Norwitz and John O. Schorge</a></p><p><a href="http://books.google.com/books?id=U2YTC8A2aUcC&pg=PA194&lpg=PA194&dq=obstetrics,+passenger,+passage,+powers&source=web&ots=gYPiRyKVXF&sig=9ELR-A_eYg3dL4UPsMQ-lCFctb0&hl=en&sa=X&oi=book_result&resnum=4&ct=result"><em>Obstetrics and Gynaecology</em>, by Lawrence Impey</a></p>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com2tag:blogger.com,1999:blog-1237119393135324542.post-30333296537504824792008-10-20T16:35:00.001-07:002008-10-20T16:50:43.524-07:00Natural? Are You Crazy?!The topic of natural birth can be a difficult one to discuss. Those who've had one are typically very passionate about their experiences. Those who've not had one are usually just as passionate about how crazy we are to go natural!<br />Having a natural birth does not mean that a woman is better than one who had a medicated birth, or surgical birth. Having a natural birth is not a goal to attain in order to join the rank of "super-woman"hood. Having a natural birth is not something to be had in order to make others feel guilty, sad, defensive, or less of a mother. Having a natural birth is a personal decision that a woman must make for herself for her own personal reasons. It's just that there are so many good reasons, it's hard to keep them to ourselves!<br />My reasons for having natural births were my own, but I'd like to share them here with you:<br /><br />My body was made to give birth. If all of the women before me could give birth this way, why would I need to do it differently? God made my body to do this work. He does not make mistakes.<br /><br />No drug is proven safe for the unborn. Why would I shy away from any medications throughout my entire pregnancy in order to flood my body and my baby's with drugs just before they enter this new world?<br /><br />There's a reason for everything. There's a reason for labor. There's a reason why our bodies surge with hormones, and why we work so hard to bring our babies into our arms. To brush away those things would be messing with an inner-working that is much larger than our ideas.<br /><br />I am strong and capable. I did not want anyone telling me what I could and could not do. My body was strong enough to grow this baby in my womb, and it would be strong enough to work it out! There's no reason to force a woman to do things that make no sense when she's the only one who knows her body and her baby.<br /><br />Everyone has a personal reason for their decisions. I just ask that you make an informed decision. Ask questions, look into the safety of each procedure. Think about the effects on your baby, and on yourself. Take care and do no harm!Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com1tag:blogger.com,1999:blog-1237119393135324542.post-43655572187054563052008-10-12T23:58:00.000-07:002008-10-13T00:02:32.704-07:00How Labor Prepared Me for Motherhood<p>In my childbirth classes, we mainly focus on labor, birth and the first few hours post-partum. Because this single event is so life-changing, many times parents focus so much on the birth that the actual parenting part is forgotten until you actually have to parent! <br />Even though we don’t’ go into great detail on parenting in my classes, I do feel that what I teach, and what these parents learn from coming to classes and going through labor, has life-long effects. What they learn about pregnancy, labor, and birth can greatly be carried over into parenthood.<br />Each of my own labors, just like each of my children, was unique. Each brought something new to experience, new challenges to face, and new victories to relish. This is how my labors prepared me for motherhood…<br /></p><p><strong>Labor is hard work</strong>,<strong> and so is mothering</strong>. Sometimes it can be painful, but mostly it takes a lot of time, effort, and patience.<br /></p><p><strong>Learning to work with your body makes things easier.</strong> Learning to work with your child instead of against him/her makes for easier parenting. Sometimes you want to cringe and grit and say, NO! It’s going to be MY way! But taking a deep breath, understanding the workings of their little mind and body, and helping them advance in their own natural way, rather than pulling against it makes for a smoother process.<br /></p><p><strong>Build up a toolbox.</strong> In labor, knowing that different stages call for different needs, you want to have a bunch of techniques, visual aids, physical aids, etc., to help a mom get through. In motherhood, the same applies. Sometimes children are at the easy, excited-to-be-here early first stage where all they need is your smile and hug. Other times they go through the difficult nothing-can-help-me-now transition stage where they need bigger, better, different, nothing, all of you. Having plenty of resources at your fingertips can help you all make it through.<br /></p><p><strong>Don’t interfere with “Mother Nature”.</strong> Your body knows what to do to give birth. When you start interfering, things start going wrong, and we get way far away from what childbirth is supposed to be. Your baby knows what it needs. It was born with the ability to let you know. Listen, and don’t try to change a baby’s intuition. Messing with a child’s nature will only cause further problems down the road. Children learn without us even having to try to teach them. Go with what their nature already is. Work with it, not against it.<br /></p><p><strong>The safer, more effective way usually takes dedication, hard work, and sacrifice.</strong> Dealing *with* contractions rather than escaping them usually yields greater rewards. It may be harder to experience all the sensations of labor and birth, but it is safer for the mother and baby, and usually allows the body to work the way it was meant to. Working daily with a child, being consistent in re-directing rather than relying on some “quick-fix” method, making nutritious, healthy meals rather than quick, nutritiously-void ones takes a little extra time, a bit more effort, but it safer, and allows a child’s body to work and grow in the way it was meant to. The easy way is not usually the best way.<br /></p><p><strong>Surround yourself with good support. </strong> It’s so much harder to do this on your own! Having the support of a loving husband and generous friend is what carries us through labor! It’s also what carries us through motherhood. Having someone you can release your emotions to, and knowing they can handle it can be a real life-saver. Having the support of someone who knows your true heart in spite of the words you may be uttering gives us freedom to feel loved despite our weaknesses. Mothering with community is good for moms, and good for children!<br /></p><p><strong>You can’t really understand it until you’re in it.</strong> As much as you learn about the physiological functioning of labor, as much as you practice relaxation, as much as you practice labor rehearsals, until you truly experience it, you really don’t know what it’s like. Mothering cannot be explained. It needs to be experienced. And unless someone else is mothering your child, they cannot really understand what it’s like to be you, no matter how much education they may or may not have.<br /></p><p><strong>Fear causes pain.</strong> This is the very basic of childbirth. Thanks to Dr. Dick-Read, our modern methods of pain-coping and childbirth philosophies rest on this principle. Our child-rearing practices should as well. So many mothers parent their children based on fear. What will so-and-so think? What will they say if I do this-or-that? My doctor said if I don’t do this, than that could happen. This only ends up causing pain to both mother and child. Do not mother based on what anyone else thinks or says. You are the sole mother of your child. You know what is best. Have confidence that you know what your child needs, and it doesn’t matter what others think because your job is not to meet their needs, but to meet that of your child! Fear-based parenting is just plain painful to live, and painful to watch.<br /></p><p><strong>It usually doesn’t go exactly as planned.</strong> You cannot predict how your labor will go. I held lofty goals for each of my labors, and none of them went according to *my* plan. They went according to how they were supposed to go! Children don’t understand your goals for them. They don’t understand the future you may have mapped out. They understand what they need to do to be themselves. And we as parents, while holding lofty goals, need to be open enough to accept changes along the way. It might be that you are blessed with a high-needs child who doesn’t follow your nap schedule and feeding plans. It might be that you are blessed with a child that wants to wait until he’s REALLY sure he’s ready to use a potty. Sometimes children don’t have the same athletic skills, or social desires that a parent has, and we parents need to be okay with that. <br /></p><p>Motherhood is a roller coaster ride, that’s for sure. And just as soon as you think you understand what’s going on, you are thrown into a different direction, and get to learn all over again!</p>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com0tag:blogger.com,1999:blog-1237119393135324542.post-79661588951231622792008-10-02T19:32:00.000-07:002008-10-02T19:44:25.525-07:00How I Got sucked Into “Birth”<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhETL9MNWMZ2zrGDs4q9ssp-b4zbQVZW5AxjTw08TPEq3j6I2q0ACV_vMg9CcJOJLTf5MzKEJPYsxEcqyRGquNSKWeD18YjE92TQFMBgiMbuDP-Te8pt8w_lrsCPwp8eu1ckIH7mOCprard/s1600-h/100_0126_014.jpg"><img id="BLOGGER_PHOTO_ID_5252752410368748018" style="DISPLAY: block; MARGIN: 0px auto 10px; CURSOR: hand; TEXT-ALIGN: center" alt="" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhETL9MNWMZ2zrGDs4q9ssp-b4zbQVZW5AxjTw08TPEq3j6I2q0ACV_vMg9CcJOJLTf5MzKEJPYsxEcqyRGquNSKWeD18YjE92TQFMBgiMbuDP-Te8pt8w_lrsCPwp8eu1ckIH7mOCprard/s320/100_0126_014.jpg" border="0" /></a> <div>My first birth experience felt okay to me at the time. I had wanted a natural birth, but didn’t realize how important it was to have dedicated support when going naturally in a hospital setting. Laboring in the hospital bed, I caved in to the repeated offers of pain medication the nurse kept presenting. When my baby was placed on my chest, I didn’t realize it was the drugs, having messed with that natural workings of labor, that caused me to feel so disconnected from this baby that had just come out of me. I didn’t even realize I was *supposed* to feel ecstatic. I just felt exhausted, and said to myself, “oh, so that’s a baby”. We bonded over the next few days, but this baby was a lot of work, and I often questioned my abilities to mother him.<br />The second day after he was born, while I lay on the couch, bottom too sore from the episiotomy to sit upright, I remember thinking, “Alright, now that I know what it takes, I want to do it again – but this time I *will* do it naturally.”<br />And I did.<br />During my second pregnancy, I sought out Bradley® Natural Childbirth classes, which hadn’t been available in our area during our first pregnancy. I was so excited to get face-to-face instruction, and have my husband learn everything I was learning! I asked my Bradley® teacher to be my doula, something I hadn’t heard of before taking classes, because I wanted my husband to also have support. The birth was amazing. And so healing of all that didn’t go well in my first. I was lovingly, strongly supported by my doula and a husband who knew what was going on, what he could do, and what I needed. I cried with joy when my baby came out, and lavished him with love, saying, “Oh, baby! Baby, baby, my love!” I hadn’t torn and felt so good after the birth, we were discharged within twelve hours. The pictures of me after my fist birth and after my second are drastically different. In the pictures of the first, I’m puffy, tired and lethargic looking. In pictures of the second, I am bright-eyed, energetic, and radiating with joy.<br />And that’s what changed me.<br />Why would anyone want that first experience when they could have the second?! Why not offer everyone the chance at having a joyful birth?<br />When my second baby was a year old, I started going to Bradley classes, just to sit in on them, and glean all this wisdom from my teacher. I wanted to go to the Teacher’s Training to become a Bradley teacher myself, but felt I needed to wait a bit. In the meantime, the opportunity to attend doula training fell into my lap, and I just could not pass it up! The ALACE training was put on by a local licensed midwife, and gave me so much more to work with. I wanted to do this! I wanted to support women through one of the most life-altering experiences they could go through! And so I started attending births right away.<br />And, I got pregnant again.<br />I attended my Bradley® teacher training while 8 months pregnant with my third baby. After the training, and after a beautiful, gentle birth, I started teaching classes right away, so thankful for the year and a half of observing *my* former Bradley® teacher.<br />I love meeting with couples for 12 weeks before their births. I see their apprehensions turn to excitement, and their fears turn to conviction. When they call me to tell me about their births, I hear their joy beaming through the phone lines. I love sharing in their birth highs!<br />And that’s how this whole thing started. </div>Wholly Mamahttp://www.blogger.com/profile/08009610668742172969noreply@blogger.com0