Practice Positions

Women all over the world give birth squatting, leaning or even standing. But we in America we lie down. There is something the rest of world must know about labor positions that we do not.  If your car stalled at the bottom of a hill, you certainly wouldn’t try to push it uphill. So why does it make sense to fight gravity by lying down during labor? This is just one reason why the standard hospital labor position—semi- or fully reclining—is not ideal. For one thing, when you’re lying on your back, your uterus compresses major blood vessels, potentially depriving the baby of oxygen and making you feel dizzy or queasy. “Most women feel better when they are not lying on their back during labor,” says certified nurse-midwife Katy Dawley, Ph.D., C.N.M., director of the Institute of Midwifery at Philadelphia University in Pennsylvania. In addition, when you’re reclining, the baby’s head puts pressure on pelvic nerves in your sacrum, increasing pain during contractions. Remaining upright and leaning forward reduces this pressure while allowing the baby’s head to constantly bear down on your cervix. As a result, dilation tends to occur more quickly.

“Lying on your side, standing, sitting, walking, rocking—anything that keeps you active can help decrease pain and speed up labor,” says Dawley. Just be aware that a prenatal visit is the time to discuss with your doctor or midwife the different positions you think you’d like to try. “In the throes of labor, you’re not going to be able to advocate for yourself,” she explains.

Soothing labor positions

Here’s another reason to be open to the possibilities: Fetal heart monitoring during labor can help determine which positions you can sustain without impairing circulation to the baby, so it’s best to have a repertoire available. Some options:

1. Get on all fours This position eases back pain and helps the baby rotate into the optimal position for delivery—facedown. (When the baby is faceup, the result is the dreaded “back labor.”)

2. Lean forward This can help make uterine contractions more effective in bringing the baby down. Drape your chest over a table, bed, countertop, pillow or exercise ball (see “Get on the [Birthing] Ball,”).

3. Lie on your left side This may increase blood flow to your baby and can help reduce back pain. Support your belly and legs with pillows.

4. Lunge Place one foot on a sturdy chair or footstool and lean into that foot during contractions.

5. Rock Sit on an exercise ball, the edge of the bed or a chair and gently rock back and forth.

6. Sit and lean Sitting in a chair, prop up one foot and lean forward into it during contractions.

7. Sway Put your arms around your partner’s neck and sway back and forth; pretend you’re slow dancing.

Ready, set, push! While the position may be less convenient for hospital personnel, squatting is especially effective when you’re ready to push. In fact, squatting is sometimes called the “midwife’s forceps” because of its ability to work with, not against, gravity, enlarge the pelvic opening and speed the pushing phase of labor.

The dancing mom writes: “Trying to induce our twins at 40+ weeks after trying everything else. I went into labor two days later and had a natural, un-medicated hospital birth (with the support of my awesome husband and our amazing midwives).” Let’s get it started!

Gotta love that her partner joins in and that she has a successful NATURAL CHILDBIRTH!  

DUE DATE: November 8, 2011

BIRTH preparing for the best!!  

"Birthologie was created to help women all over the world to band together and become empowered to create the birth experience of their dreams.

Our medical system routinely deals with pregnancy like a disease requiringinterventions and treatment, rather than a natural biological process.

The aim of this course is to provide you with all the information you need to understand what is happening to your body so that you can work WITH the medical system to ensure the best possible outcome for you and your baby.

Whether you want to give birth at home, in a midwife center, or at a hospital, Birthologie Empowered Childbirth will arm you with the tools necessary to experience the birth of your dreams!"  (http://www.birthologie.com/)

I remember when my husband and I were preparing for our  first born.  We were so excited, he was thrilled to be having a natural birth. I was not as thrilled about that part.  I needed help to understand why this was important.  So we signed up for some natural childbirth classes.  I started reading books and gaining my own understanding regarding the importance of natural childbirth.  BUT the class got canceled.  I was 12 weeks away from giving birth for FIRST time, ohhhh boy!  Let's just say my birth was not spectacular nor was it natural.  I thought my doctors had my best interest at hand.  However, I heard the dreadful words, "Your baby is in distress. You gave it the good old college try, BUT you NEED a c-section."  Let me be honest, they had me at "YOUR BABY IS IN DISTRESS!!!"

It took me a long time to figure out that this was not the way my birth should have gone.  So, baby #2 = VBAC!!!  I'm gonna do it right this time and prepare until I cannot prepare anymore!!  And I did!!  So much so that at 26 weeks when my doctor turned to me and said, "I want you to let me section you if you go to 40 weeks" I ran.  And I didn't look back.  Four weeks before my due date my husband and I decided a homebirth was our best option.  It's not the best option for everyone.  But I knew it was my only way of having peace throughout my labor.  

So I say all this to say, education is soooo important.  Know what you want for your birth.  I believe in Birthologie because you can do it at home.  I had to go to class for 12 weeks and I had a two year old.  Some people don't have that time but there are options.  Birtholgie is a great one.  Take control of your birth!!

Why is homebirth on the rise?

Recently Ricki Lake went on Good Morning America to talk about the benefits of homebirth.  Recognizing that homebirth is not for everyone just like c-sections are not for everyone.  Birth is a personal choice and homebirth is definitely one of those options.

Homebirth Advantages¹

At home a woman can labor and birth in the privacy and comfort of the familiar surroundings of her own home, surrounded by loved-ones. in whatever positions and attire she finds most comfortable.

Studies show that the risk of infection is reduced for both the mother and the baby.

During labor the woman is encouraged to eat, drink, walk, change positions, make noise, shower, bathe, etc.

Continuous one-on-one care is given by the midwife, providing ongoing assessment of the baby's and mother's condition throughout the birth process and postpartum period. Her care provider knows her well and she knows her care provider. They have established a trust relationship.

Women are supported through the hard work of labor, and encouraged to realize the insights, and experience the personal growth as a human being to be derived from such a powerful, life-changing event.

Bonding is enhanced and includes everyone who has contact with the baby including neighbors and relatives. Breast feeding is facilitated by the baby remaining with the mother.

Cesarean Section and forceps deliveries are unavailable – transportation to the hospital is necessary if these interventions are required. However, rates of both, as well as episiotomy, are very low.

The cost of a home birth may be less than a hospital birth, and is often covered by insurance if a CNM is utilized.

Pregnancy and birth are viewed as normal, natural body functions and not as an illness or disease.

Homebirth Disadvantages¹

Client's must assume a greater level of responsibility for their own health: physical, mental and spiritual. This requires active ongoing participation in decision making in all aspects of their care, and a willingness to accept the consequences of those choices and decisions.

Cesarean Sections, forceps deliveries and a nconaialogist arc not available at home, transport is necessary for these and other medical interventions.

Personal arrangements must be made for postpartum care, such as meals, housekeeping, child care etc.

The cost of a home birth may not be covered by the client's insurance.

Analgesics are not readily available with a home birth.

¹taken from http://www.houstonnaturalbirth.com/adv_homebirth.shtml

In my last post we talked about breastfeeding and some of the most common questions surrounding it. Now what about your newborns other needs? And just as important what about your needs?

Caring for Your Newborn

1. Describe some of the ways your baby would communicate to you that he is hungry? Full? Tired? Hot? Cold?  In Pain?

Hungry: rooting, sucking, tongue thrusts 

Full: Falls asleep, pulls away, pauses more than he sucks. (NOTE: your baby may need to be burped then feed again)

Tired: yawning, rubbing eyes, turning head side to side.

Hot: clammy skin, breathes rapidly.

Cold: splotchy skin.

Pain: a sudden, high-pitched cry.

2. What are some important parts of sleep safety for your newborn? 

Babies should sleep on their backs, on a firm surface, without pillows, stuffed animals, or fluffy blankets. The room they are in should not be heated to more than approximately 70 degrees. For more info: www.cpsc.gov/cpscpub/pubs/209.pdf

3. What are some newborn warning signs (if you see any of these signs in a baby under one month old, you should call baby’s doctor?

• Dehydration: less than 6 wet diapers in 24 hours (after day 5), papery skin; dry mouth; dark yellow urine

• Fever higher than 99.5° F, under the arm

• Jaundice: whites of the eyes turning yellow; skin below nipple line turning yellow

• Thrush: White patches on the tongue or inside the mouth that don’t wipe off easily.

• Umbilical cord or circumcision site: bright red bleeding, foul odor or pus, redness or swelling.

• Vomiting: forcefully or more frequently than usual (more than just spitting up).

• excessively or uncharacteristically fussy or irritable; unusually lethargic or sleepy

• Problems with breathing: signs such as blue lips, struggling to breathe, flaring nostrils, or deep indentations of the chest when breathing.

4. What are some ways to calm a crying newborn? 

First, make sure baby’s needs are met, especially check if she is hungry. To calm a crying newborn, replicate the womb environment: swaddle the baby and hold her close where she can hear your heartbeat and regulate her temperature to match yours.

Motion, such as swaying and rocking can help. Some babies like to be held so there is pressure on their bellies (as if you were burping them).

Giving the baby something to suck on, like your finger, or a pacifier (after breastfeeding is well-established) can help. Talk soothingly, or sing lullabies. Stay as calm as possible yourself, as your newborn will respond to your mood.

The 5 S’es: Swaddle, Side/Stomach, Swing, Shh, Suck.

Caring for Yourself (not just your newborn)

1. What are some resources you can use if you need support?

Your baby’s doctor is your primary source for health information. Have this phone number with you all the time.

Breastfeeding Info: www.breastfeeding.com; www.lalecheleague.org;

Parent crisis lines: 1-800-4-ACHILD. 1-800-448-3000. 

2. What nutrients are especially important for pregnant / breastfeeding moms?

Continue taking prenatal vitamins!!  You’ll need each day: 30 mg of iron, 300 extra calories, 60 grams of protein, 1200 mg of calcium, and 2 quarts (64 ounces) of fluids. 

Use all the support you have.  You will need a break so take it.  Listen to your body and ask for help!!

Taking care of yourself is equally as important as taking care of your newborn!!  

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Here are a few possible questions you may be having:

Breastfeeding:

When do I feed a newborn baby?
– Watch for your baby’s hunger signs, feed on demand: anytime the baby is hungry.

What is the minimum number of feedings per day?
– Minimum: 8 to– 12 feedings per day but could be much more.

What is the longest time a newborn should go in between feedings?
– No more than 3 hours between feedings in daytime.
– No more than 4 hrs at night. (this is not a hard and fast rule: from day 1 my daughter slept 8hrs she was also over 9lbs at birth)

How long should you nurse the baby during each feeding?
– Nurse on the 1 side until baby falls asleep or pulls away (every baby differs in length of time, the average is 8 to 10 minutes) Then, give him a chance to burp, switch sides, nurse until baby is full.

How long can you store breastmilk that has been pumped?
– Generally you can refrigerate breast milk for 3 to 5 days and freeze it for 3 to 6 months.

***Don’t freeze milk you plan to use within 3 to 5 days because freezing destroys some of the antibodies. (However, frozen breast milk is still healthier than formula.) You can keep milk that’s been frozen and thawed in the refrigerator for up to 24 hours, but don’t refreeze it.

What are some things you can do which may help prevent sore nipples?
– Wash nipples with warm water, but do not use soap. Keep nipples dry,
change nursing pads whenever wet. Nurse often, for shorter periods. After each feeding,
express breast milk, rub it in to nipples, and expose breasts to fresh air for a short while.

What can you do to relieve the discomfort of engorgement?
– Warm washcloths and massage (deep and all around your breast), shower (spray directly onto your breast), hand expressing a little milk.
– Something else I have seen is dunking a diaper into water and microwaving it for 5 seconds. Then wrap the diaper around your breast, worked wonders for a friend of mine.

Here is a great product to try as well:

How do I know if I have a good position?
**This is from LaLeche an amazing support system. (http://www.llli.org)

– Basic Steps for Optimal Positioning
Position yourself comfortably with back support, pillows supporting your arms and in your lap and your feet supported by a footrest or a telephone book.
Position baby close to you, with his hips flexed, so that he does not have to turn his head to reach your breast. His mouth and nose should be facing your nipple. If possible, ask your helper to hand you the baby once you are comfortable.
Support your breast so it is not pressing on your baby’s chin. Your baby’s chin should drive into your breast.
Attach or latch baby onto your breast. Encourage him to open his mouth wide and pull him close by supporting his back (rather than the back of his head) so that his chin drives into your breast. His nose will be touching your breast. Your hand forms a “second neck” for your baby.
Enjoy! If you are feeling pain, detach baby gently and try again.

These steps may need to be repeated frequently during the early weeks. You and your baby will find a technique that works for you after some practice.

How do I know if my baby has a good latch?
**This is from LaLeche an amazing support system. (http://www.llli.org)

– When latching on your baby, use your nipple to tickle the center of your baby’s bottom lip. This will encourage him to open his mouth wide (like he is yawning). Aim your nipple slightly towards the roof of his mouth, bringing baby to you, chin first.

Good latch-on checkpoints for your baby include:

his nose is nearly touching your breast, that is, no further away than a credit card edge
his lips are flanged
at least ½ inch of your breast around the base of your nipple is in his mouth.
If the latch is uncomfortable or painful, gently place your finger in the baby’s mouth, between his gums, to detach him and try again.

Stay tuned for part 2 about taking care of your newborn and taking care of yourself.

I knew as soon as I decided to have a homebirth I wanted to give birth in the water.  My husband and I prepared for it and I was ready.  When my contractions started early in the morning I started to run a bath.  When I got completely uncomfortable I got in the bathtub to relax.  The water made it WORSE!! I could not believe it.  All this time I thought, “No matter what I am having a water birth!” I never thought it wouldn’t happen.  As labor progressed I was no where near the water.  We didn’t even set up the birthing pool.

Once my water broke I knew pushing was not far off.  My midwife and doula immediately set up the birthing pool.  At this point I was very unsure about getting into the pool.  But once I got in I was so much more relaxed it was amazing.  The rest of my labor was so easy and wonderful.  I highly recommend water birthing to anyone who is thinking about it. 

I wanted to give you some information about it.  Below is a video to help explain the benefits.  Enjoy!!

Why choose a water birth?

If you want more information please go to www.waterbirth.org. They are filled with information, possible doctors, and places where classes are offered. Feel free to leave a comment if you have questions or are interested but not sure where to get more information in your area.

Also click here for a general overview of choosing the best birth option for you.