Empowering Birth Blog

I'm Off to the Farm!

I won't be blogging for the next week or so.  Every waking moment the next seven days will be spent learning new midwifery skills or hiking with the family on The Farm in Summertown,TN.  I am sure I will have much to share upon my return.  Until then, be well!

Birth Center Births Good for Baby

Thanks to Israel Doula for linking to this article on Australian baby's born in birth centers.

Take a deep breath and relax

Maternal anxiety can lead to fetal distress.  Today, while making a yummy veggie lasagna with local farm veggies, I listened to my Midwifery today tapes on fetal monitoring.  Marion Toepke McLean, CNM (Certified Nurse Midwife), speaking on Fetal Monitoring at the June 1995 Midwifery Today Conference in Eugene Oregon discussed the effect of maternal anxiety on fetal heart tones.  As the mother's anxiety increases, adrenalin is released, constricting blood vessels.  This constriction increases blood pressure and therefore blood flow to the placenta decreases and the supply of nutrients and oxygen to baby is reduced (the blood is moving too forcefully for proper exchange).  The result  can be a decrease in fetal heart rate and fetal distress.  Moms, please choose a birth place where you will be able to relax and a caregiver who will do his/her best to provide a calm, nurturing, safe, comfortable environment for birth. 

This Isn't a home birth debate blog

After reading the article on "normal birth" from ICAN's latest newsletter, I just couldn't help but marvel over how completely some people miss the point of my blog.  This blog is about empowering birth, and unfortunately hospital birth has become less and less empowering.  In the article, "The New Normal," Elizabeth Payne discusses the new book written by American journalist Jennifer Block,"Pushed: The Painful Truth About Childbirth and Modern Maternity Care.  The book argues that the "increasing intervention in birth is not only unnecessary but dangerous."1  Payne shares with us a particularly telling story from the book, which I feel obliged to share with my readers:

One of the most telling anecdotes in her book takes place at Florida Hospital Heartland Medical Centre in Sebring, Florida. When Hurricane Charley hit in 1994, it knocked the power out. The hospital had an emergency generator, but its capacity was limited. So the hospital sent most women home and asked them to come back when they were in active labour.

During the few days following the hurricane, nurses noticed a change in the way babies were being born: most babies made it into the outside world without medical intervention and within hours of their mothers arriving at the hospital; nurses saw no cases of fetal distress or respiratory distress in newborns; and the hospital's C-section rate dropped dramatically -- from more than 29 per cent to 17 per cent (six per cent if several scheduled repeat C-sections were excluded from the stats).

Prior to the storm, most mothers were induced so that their babies would be born during the day, and labours were electronically and chemically managed. Once life returned to normal, a number of nurses quit the hospital, convinced its management of labour was doing more harm than good.2

As the nurses in the above story discovered, hospital birth is becoming less and less safe and not at all empowering.  Birth becomes a series of dictated medical events that are done to the mother.  Birth can be beautiful, powerful and passionate but unless something changes, there will be fewer and fewer women who experience it as such. 

1 Elizabeth Payne, The Ottawa Citizen, "The new normal."  Published Saturday, August, 18, 2007.  Accessed on-line, http://www.canada.com/ottawacitizen/news/arts/story.html?id=428f0c90-dc95-4ecc-b95f-89e962a5a9e8, September 18, 2007.

2 Ibid.

Go ahead, toast the bride!

In the U.S. we are not supposed to drink during pregnancy.  Heck, I don't think we are even supposed to nurse during pregnancy.  I remember many a raised eyebrow while nursing Khady and enjoying a beer at a sidewalk table on a summer evening.  This weekend I was off to serve as Matron of Honor at my sister's wedding.  Did I enjoy that champagne toast?  Certainly!  Myles Textbook for Midwives recommends that women should not exceed one to two units once or twice a week.  Don't worry, I did not exceed my units!

Bon Appetit!

Check out this article for some good reading on nutrition in pregnancy.
You also might want to check out this book:

What Every Pregnant Woman Should Know: The Truth about Diets and Drugs in Pregnancy.

Pre-eclampsia is linked to poor diet

Science continues to catch up with what midwives have always known.  Many conditions in pregnancy, including pre-eclampsia, are strongly affected by diet.  Two articles in the past week explore the possible link between increased risk for pre-eclampsia and diet.  One article, "Maternal vitamin D deficiency increases pre-eclampsia risk" noted that "vitamin D deficiency at less than 22 weeks gestation was a strong, independent risk factor for pre-eclampsia."1  In the second article "Diet, gestational hypertension and pre-eclampsia" researchers found that higher intakes of fish appeared to lower the risk of pre-eclampsia.2  To date science claims no known cause of pre-eclampsia while midwives (and some physicians) have seen clear links between pre-eclampsia and diet.

More thoughts on pre-eclampsia and diet follow from Dr. Michel Odent.  Please click on the link to read Dr. Odent's full comment on prenatal nutrition in Midwifery Today's E-News.

Where preeclampsia and eclampsia are concerned, we are able to establish links with several controlled trials of the effects of fish oil supplementation during pregnancy (although eating fish should not be confused with taking capsules). Our research also reflects statistics associated with the comparatively low rate of preeclampsia in countries where the diet is rich in sea fish. My theoretical vision of human preeclampsia also takes into consideration studies of fatty acid profiles of red blood cells, which mirrors the dietary fat intake over a two to three week period. According to a study conducted in Seattle, women with the lowest levels of omega 3 are 7.6 times more likely to be preeclamptic than those with the highest levels. I propose a hierarchy between the numerous biological imbalances associated with preeclampsia. The central imbalance, in my view, is the enormous discrepancy between the blood levels of DHA (the molecule essential for brain development) and the other polyunsaturates. In preeclampsia, the level of DHA remains stable. It does not drop dramatically like the level of other polyunsaturates. The price is an imbalance inside the family of omega 3 fatty acids and finally in the whole system of prostaglandins (I would need pages to enter into all the details). Such data suggest that brain development is a priority among humans: whatever the circumstances, the levels of one of the most important molecules for brain development remain stable. In order to simplify very complex phenomena, I propose to distinguish two critical phases in the genesis of preeclampsia. The first phase is in relation to the response of the maternal immune system at the time of placental implantation (this is confirmed by the fact that a previous miscarriage, a previous blood transfusion, or a long sexual cohabitation before conception reduces the risks of preclampsia). The second phase--the one that is influenced by nutrition--occurs later in pregnancy, when the fetal brain development is the most rapid and the demand in specific nutrients, and in particular long chain fatty acids, is maximum. Then the onset of a vicious cycle is possible, that is to say the disease preeclampsia. Preeclampsia appears as the price some human beings must pay for having a large brain while the nutritional supplies are not appropriate. 3

If I were a researcher, I would follow midwives around and document their work.

(Please note, you do have to sign up for www.ORGYN.com's article's but it is free and WELL worth it.)

1 Diet, gestational hypertension and pre-eclampsia, Issue 18: 3 September 2007, Source: Annals of Epidemiology 2007;17:663-8, from ORGYN Online Magazine, http://www.orgyn.com/en/webzine/2007/Issue_18/Diet__gestational_hy.asp, accessed Sept. 14, 2007.

2 Maternal vitamin D deficiency increases pre-eclampsia risk. Source:Journal of Clinical Endocrinology and Metabolism 2007;92:3517-3522, from ORGYN Online Magazine, http://www.orgyn.com/en/news/2007/Week_37/Day_1/Maternal_vitamin_D_d.asp?C=71129393396790162037, accessed Sept. 14, 2007.

3 Midwifery Today E-News, January 9, 1999 Volume 1, Issue 2, http://midwiferytoday.com/enews/enews0102.asp, accessed Sept. 14, 2007.

Home birth is safe, REALLY

Don't just take my word for it, read Judy Norsigian's recent op-ed.  Thanks to Women in Charge blogspot for posting this great op-ed on her site.  Judy Norsigian is the Executive Director of Our Bodies Ourselves.  Check out their website for some good information, particularly the Health Resource Center.

Pregnant? Take it easy!

My first pregnancy I had spotting, my second pregnancy I had hemorrhaging.  The cause of bleeding was never discovered but during both first trimesters I was working very hard and with the second pregnancy, I had a very stressful first-trimester.  This pregnancy I am taking it easy, getting lots of good rest, and I am sure all will go well.  You CANNOT overestimate the importance of good diet, adequate rest, and low/no stress when you are pregnant.  I am not sure if it was at a conference or on one of my tapes purchased from Midwifery Today but I've heard Anne Frye say, if mom is well-nourished you can handle almost anything.  So moms, if you are pregnant, please please take excellent care of yourself.  Let me tell you, it isn't easy to get me to slow down, but after the scare I had during my second pregnancy, you can bet I am taking it easy.  If you are having a stressful day, don't add to your stress by worrying about the effects of stress on baby, take a fetal love break!  Tell baby throughout the day, mom is having a rough day but everything is going to be ok and I love you and when you get the chance, relax and take care of you!

The Labor Progress Handbook

There are some great resources out there on the web and I just discovered that one of my favorite labor books is available in its entirety on the web!  I LOVE The Labor Progress Handbook by Penny Simkin and Ruth Ancheta.  If you are a doula, buy a copy and stick it in your birth bag.  If you are a pregnant mama or a partner of a pregnant mama, you should read this too!  If you are birthing in a hospital and your provider seems to think your labor is slowing down and would like to try pitocin, pull out this handy little book, turn to the chapter "Prolonged Second Stage of Labor," for example, and say innocently, "Do you think one of the ideas in here could help?"