Filed under: birth | Tags: bonding, parenting, oxycotin, attachment parenting, hormones
Michel Odent on Mother & Baby separation:
Oxytocin is more than just the hormone responsible for uterine contractions. When it is injected into the brain of a mammal, even a male or virgin rat, it induces maternal behavior, i.e., the need to take care of pups. One of the greatest peaks of oxytocin a woman can have in her life is just after childbirth, if the birth has occurred without any intervention. It is also necessary for the “milk ejection reflex.” In fact, oxytocin is involved in any episode of sexual life, and both partners release oxytocin during intercourse. It is even involved in any aspect of love and friendship: when we share a meal with companions, we increase our levels of oxytocin.Morphine-like hormones, commonly called endorphins, also play important roles in the birth process. Up to the birth of the baby, both mother and fetus release their own endorphins, so that during the hour following birth they are still impregnated with opiates. It is well known that opiates induce a state of dependency. When mother and baby haven’t yet eliminated their endorphins and are close to each other, the beginning of a deep bond is created. In fact, when sexual partners are close to each other and impregnated with opiates, another kind of bonding may result that follows exactly the same model as the bonding between mother and baby.
It is not only the mother who is releasing hormones during labor and delivery. During the last contractions, the fetus is also releasing a high level of hormones of the adrenaline family. One of the effects of this is that the baby is alert at birth, with eyes wide open and pupils dilated. Mothers are fascinated by the gaze of their newborn babies. It seems that this eye-to-eye contact is an important feature of the beginning of the mother-baby relationship, which probably helps the release of the love hormone, oxytocin. Both mother and baby are in a complex hormonal balance that will not last long and will never happen again. Physiologists today can interpret what ethologists have known for half a century by studying the behavior of animals: where the development of the capacity to love is concerned, there is a critical, sensitive period just after the birth.
Filed under: birth, birth poem | Tags: love, womb, birthing, birth poem, birthing poem, birth dance, dreams, sanctuary, mother's power, birthing dance
Come to me, My Child
Secret longing of my inner heart
Breath of spirit
Wandering the cosmos
Choosing your next lifepath
Seeking sanctuary in my wonb
Visions of you stir my dreams
Your gentle essence drifting inward
Merging into matter
Coming into consciousness
Birthing into being
Your tender wisdom speaks
The ancient knowledge of a mother’s power
Our bodies grow together
Two as one
Turning round, in birthing dance
You lead me
Opening the circle corridor
Descending into unhindered ecstasy
Into my arms
Judie C. Rall
Picture by Carnaval King
Filed under: birth, breech (posterior baby), labour | Tags: posterior, turning baby in utero, painless childbirth, posterior baby, relaxation, painfree birht, odent, pelvic rock, occiput posterior
Two facts regarding posterior position have been authoritatively confirmed by published prospective studies.
The first fact is that worrying pregnant women about the position of their baby in the womb is useless. A large Australian randomized controlled trial involving 2547 pregnant women has eloquently demonstrated that hands and knees exercise with pelvic rocking from 37 weeks’ gestation until the onset of labor does not reduce the incidence of persistent occiput posterior position at birth.
The second fact is that fetal position changes are common during labor, with the final position established close to birth. This is the conclusion of a prospective study of 1562 women to evaluate changes in fetal position during labor by using serial ultrasound examination. Among babies who were posterior late in labor, only 20.7% appeared to be posterior at birth.
Finally, when the mother had no epidural, the overall rate of posterior position at birth was only 3.3%, although this study was conducted in conventional departments of obstetrics, where the basic needs of birthing women could not easily be met. The rate was 12.9% in the epidural group.
When taking into account these two well-documented facts, focusing on the right question becomes easy: what factors can influence the rotation process during labor?
The answer is simple: The factors that can facilitate the rotation process are those that make a typical fetus ejection reflex possible.The passage toward the fetus ejection reflex is inhibited by any interference with the state of privacy. The ejection reflex does not occur in the presence of a birth attendant who behaves like a “coach,” an observer, a helper, a guide or a “support person.”
The fetus ejection reflex can be inhibited by a vaginal exam, by an eye-to-eye contact or by the imposition of a change of environment. It does not occur if the intellect of the laboring woman is stimulated by rational language (e.g., “Now you are at complete dilation; you must push”). It does not occur if the room is not warm enough or if the lights are bright. The best situation I know for a typical fetus ejection reflex is when no one is around but an experienced, low profile, silent, motherly midwife sitting in a corner and knitting.
The image of the “knitting midwife” should not be understood in a literal sense. Instead, it symbolizes the authentic midwife as a protective mother figure whose own level of adrenaline is maintained as low as possible.
Noticeably, when the conditions for an ejection reflex are met, most birthing women find spontaneously complex and asymmetrical bending-forward postures that probably play an important part in facilitating the rotation of the baby’s head.
Persistent posterior position at birth will become exceptionally rare on the day when the meaning of privacy is understood and authentic midwifery has been rediscovered.
- Michel Odent, MD, excerpted from “Occiput Posterior Position Should Be Exceptionally Rare at Birth”
by Judy Edmunds midwiferytoday.comMidwives try to convey these simple truths: Birth is not a clinical exercise. It is not a medical procedure. In nearly every instance, it should not be major surgery. Nor should it even routinely include minor surgery. Rather than being a time of weakness with beds, shots, fasting, IVs and wheelchairs, it is a time of energy and strength. Raw power. Mightiness. Courage. Sometimes our victories are great: a beautiful home VBAC after doctors had convinced the woman her body was defective. Sometimes the victories are small: a routine hospital birth, yet no drugs were taken to dull the senses. Still, considering the tales of woe amassed in Nancy’s book, we see we have work to do, a long way to go. Birth abuse continues to take place. In fact, how many hospital birth horror stories have you heard? And yet, how many times have you been asked, “Just what, exactly, does a midwife do?” or “Mid-what?” Considering that only a small percentage of women choose to birth at home, we recognize that many women don’t even know what this choice could mean for them. |
Filed under: birth, birthstories | Tags: birth center, birthstory, giving birth at the birth center, homebirt, hospitalbirth, natural childbirth advantages
Martin Spielman Writes about Alex, Brandon and Grace Spielman’s Births
Our first son, Alexander, was born at a hospital and it was a horror story that fortunately my wife cannot remember a lot of to this day, which is better, since I can. It involved a disinterested staff and a doctor who had better things to do
We were sent home twice for not progressing and when Cherie finally started to progress the tiniest fraction hospital policy decreed that all and food and drink were to be withheld. It had been a long 2 days and we had had enough and so we signed ourselves out. Finally we returned and Cherie was progressing slowly, but after several hours the staff decided there was a problem being reported to them by the fetal monitor
We were told that since the baby’s heart rate was not climbing enough during contractions that an internal monitor was necessary. When we protested the doctor said, “You don’t want your baby to die do you?” So the doctor broke Cherie’s amniotic sac, attached the fetal monitor and put Cherie on Pitocin. Within 10 minutes (2 contractions) Cherie had gone from 3 cm to 10 not, I believe, because of the Pitocin but more along the lines of what her family history had going for her (Cherie was born on the way to the hospital.) The staff was shocked but said it was OK to go ahead and push, they were not prepared for the result.
Within 5 minutes of starting to push Alex’s head started to crown. The staff rushed Cherie to the delivery room, demanding she not push (as if.) I tried to take some pictures of Alex being born, but the nurses starting yelling at me for being at, The “Wrong” end of the table. The doctor was busy fiddling and did not notice Alexander emerging, and ended up lunging and catching him with one hand. As soon as Alex was born the doctor panicked and called for the pediatrician “Stat,” because Alex was not “Responding properly.” The less panic oriented pediatrician gave Alex the once over and declared, “He’s sleeping.” Obviously Doctor Dopey, had not considered that Cherie was not the only one having endured the 60 hour labor.
Our second son, Brandon, was born at the Familyborn birth center and we were very pleased. I even got to catch the baby. Cool, a must for all real fathers. I was shocked by the lack of poking and prodding this time around. The best part of Brandon Michael’s birth was when Cherie’s water broke. Cherie had not yet broken her amniotic sac by the time she was ready to push so she had to do it while pushing which was very uncomfortable for her, and a great relief once it did happen.
Cherie was in the middle of a full blown pushing contraction when her water was ready to break, and it was quite a show! The amniotic fluid sprayed 6 feet, past the end of the bed and on to the floor. Actually it looked like we were at the bottom of a log flume when the spray erupted. 10 minutes later Brandon was born with the most beautiful blond hair.
As we approached the midway point of our third pregnancy the center told us that they were closing down their on-site birth facilities and that we were out of luck. And so we decided on a home birth. Cherie’s labor actually started almost a full week before Grace was born. Cherie called me to come home at 8:30 am Saturday, 39.5 weeks into her pregnancy.
We were sure this baby was going to be special because she had stayed in so long, both her brothers had been born at 37 weeks and were 6lb 10oz and 7lb 1oz. Cherie had false labor twice before, so we were so worn down that we did not get our hopes up. By Sunday Cherie was still going steady, but not too strong so her midwife came by for a check/cheer up and found her to be 1 cm and 50% effaced. So we unfortunately prepared for the long haul since both of Cherie’s previous labor’s had lasted 60 hours. Sunday night and Monday passed without much fanfare, although Cherie’s labor began to take its toll on her sleep, so that by Tuesday, during her weekly appointment, Midwife Louise and trainee Martha were concerned, and we created a plan of action.
By Wednesday stress had taken its toll and the midwives rushed up to check on Cherie’s now stronger contractions early in the morning. After setting up and determining that Cherie was now 3cm 60% they stayed expecting a prompt arrival, they were to be disappointed. Cherie continued to putter along the rest of the day, but since she had progressed Louise and Martha thought it best to let nature take its course. The midwives agreed that since Cherie was tiring, an understatement, that unless something happened that, in accordance with our plan of action Friday morning she would take castor oil to stabilize and stimulate her labor. On Friday at 9:30 am Cherie took the castor oil “Milkshake” as prescribed, and boy did it ever work.
By 12:30 Cherie was into a strong, stable contraction pattern. Cherie became restless and it was nice to be able to waddle her around our own block. By 4:30pm Cherie’s water finally succumbed and things became intense. With the first push I could tell this baby was bigger than we had imagined just by how high Cherie’s belly rose. Louise and Martha gave a constant stream of direction and suggestion, including having Cherie change positions twice. Shortly before Grace was born Louise brought in Alex who sat by his mom’s head and was the official baby hat holder and coach. As the baby’s head started to crown I warned Martha and Louise to watch out in case I lost my balance since Cherie had a tendency to “blast” babies out.
Alex had to be caught with one hand by the doctor as he turned to get something and Brandon had gone from crowning directly to being exposed up to his elbows with one mighty push. I knew this had to be a big baby when it ended up taking Cherie two entire pushes to expel the head and another one to get out Grace’s body, which I happily caught without incident. Grace arrived at 5:19 pm and weighed in at 9lb 4 oz.
Filed under: birth, homebirth, midwifery, video | Tags: asynclitic, baby's head is asynclitic, easy labor, natural home birth
Beautiful Natural Home Birth of Hudson James attended by a midwife. Katie’s son was asynclitic and needed assistance coming through the birth canal
Midwifery Today published the article by Valerie a while ago that presents very clear instructions on how to turn the baby’s head. IT WORKS. She has taught me the difference between intervention and intercession. We also use visualization, relaxation, talking-to-the-baby, pulsatilla ( for assisting the turn) and gelsemium ( for lips and rings). At a hospital labor support birth this past week, when the doctor announced that it was time for the pit and epidural, to see if we could “get things rolling” - I spoke to my couple. I told them that they had hired me to assist them with a natural birth, and that I was absolutely convinced that they could do this - as long as the baby’s head was lined up well. I told them that in other cultures there is no pitocin or epidurals - women do not have these as options - and yet they have their babies!! I told them that we are mammals - and that mammals have their babies. I told them that I had unwavering faith in a woman’s body’s ability to give birth. We adjusted the baby’s head ( in private) and the baby was born soon after.
At a labor support birth this past week, the midwife who came on call had heard me speak at an MT conference in Oregon a few years ago. She was very warm and friendly, and told me that I could “do this birth” ( by the way, I do not “do” births - I attend them, or assist at them, or help to “receive” the baby with the parent’s permission). I told her that it seemed necessary to adjust the head - she said “By all means please try! I have never done that!” Within a few minutes of the adjustment, the woman began to push and birthed her baby. It had been fifteen years since she had had a baby - the last birth had been a horror show with a “stuck” baby and a resulting forceps delivery - and she was 43 years old.
One last note. One of the women whom I attended had been at 7 centimeters for about four hours when I was called to her birth. Her cervix was swollen and not very giving. She had been told to pant and blow - not to push as it would further swell her cervix. The baby’s head was asynclitic. I adjusted the head, and told her to push - much to the dismay of those around me. This did not come from new-midwife uppity-ness or arrogance - but from my intuition - ” Just push, Kate - just push and lets see what happens.” Within a few moments, she was fully dilated. In some situations, a cervix that has been at 7 for that long probably wants to “go” just as much as the mom wants it too! It just needed the baby’s head more well applied to assist it in its final act of “disappearance”!
Filed under: baby care, birth | Tags: apgar scoring system, baby care, birthing, natural birth, newborn assessment
Immediately after the baby is born, the baby will be tested using the APGAR scoring system if it is born in the hospital. If the baby is born at home, it is a good idea to perform this assessment yourself to see help you evaluate how the baby is doing. The APGAR test is performed at 1 minute and 5 minutes after birth. Ideally, the scores should improve during the four minutes that elapse between the two tests. A score of 10 is considered a perfect score. The infant is tested on five different indicators of the well-being, and receives a score of 0, 1 or 2. The items tested are:
| Sign | 0 | 1 | 2 |
| Heart Rate | Absent | Slow | Over 100 |
| Respiratory Effect | Absent | Slow, Irregular | Good, Strong |
| Muscle Tone | Limp | Some Flexion of Extremities | Active Motion |
| Reflex Irritability (response to bulb syringe or lips being touched) |
No Response | Grimace | Cough or sneeze (or strong grimace) |
| Color | Blue, Pale | Body Pink, Exremeties Blue |
Completely Pink |
A score of 8-10 is excellent, 4-7 is guarded, 0-3 is critical. This lets you know how the baby is doing and if he/she is going to need extra assistance.
The baby should be offered the breast immediately because the sucking stimulates the uterus to contract, expel the placenta, and clamp down to reduce blood flow. If the infant does not want to nurse right away, there is no rush to do anything else unless there is hemorrhaging taking place.
Under no circumstances should the umbilical cord be cut until it has stopped pulsing. Babies whose cords are cut immediately have a tendency to become jaundiced or anemic because they did not receive all the blood from the cord and placenta that they needed.
Judie C. Rall and The Center for Unhindered Living
Photo by Barb
Filed under: birth, labour | Tags: contractions, empowered birthing, how to push, labour, natural childbirth blog, natural delivery, pushing the baby out, when to push
Releasing Your Baby From Your Body
Once you are dilated to ten centimeters, and perhaps even before ten centimeters, your body may begin involuntary pushing efforts. Some women never get this urge to push at all. Whether you do or don’t, it is NOT necessary to add your own pushing efforts to that of your body. By staying totally relaxed and upright, the combination of gravity and the contractions of your uterus can birth the baby.
Women who have heart conditions are not allowed to push to birth their babies because of the strain this puts on their hearts. Yet, their bodies still birth their babies without help.
As the baby makes its way down the birth canal, this is a very intense time. Many women find that they have very primal feelings. They feel the need to make vocalizations, and some even report feeling like wild animals trying to get free. At this point, the intensity of the contractions is calling the shots. The intensity dictates your position, your breathing, everything.
As the baby’s head nears the opening of the birth canal, the perineal tissues will start to bulge. If you have remained upright and allowed gravity to bring the baby down and fan the tissues out naturally, there is very little chance you will tear. However, some women prefer to massage the tissues with oil and warm the tissues with warm, wet washcloths. A good way to keep these hand is to have two crock pots - a small potpourri size pot for the oil and a large one for water and washcloths so they can be ready any time needed. Both should be set on low.
The perineal area is the area below the vaginal opening and above the anus. As this tissue starts to bulge, the birth partner can, at the request of the woman, support the tissue with firm pressure from a hand covered with a warm washcloth. The warmth usually feels very comforting. Pressure against those tissues as the head is emerging can often prevent tearing and can guide the head gently out. However, if you have remained upright, and are giving birth in an upright position, you will probably not have a need for support and there is little chance you will tear. Birthing in the squatting position gives the baby the maximum amount of room available. The position also maximizes the pressure of the diaphragm on the top of the uterus so that the baby is literally propelled down the birth canal without extra pushing. The position pulls the tailbone out of the way so that there is no obstruction of the birth canal. The position normally provides 2 to 3 extra centimeters, which is more than enough room to birth any baby. A standing supported squat also will allow the baby’s head to fan out the birthing tissues so that there is no tearing.
As the head emerges, the perineal tissues will be stretched around the largest diameter of the baby’s head. At this point, some women experience a burning sensation that has been termed the “Ring of Fire.” This burning sensation is only momentary and passes as soon as the baby’s head moves past this point and the vaginal opening closes around the baby’s neck. Once the head is out, the body should be born within the next couple of contractions.
Once the head is out, the baby’s body must rotate so that the shoulder is released from under the pubic bone. Once the shoulder is released, the whole body is immediately born.
I encourage the birthing woman to be the one to catch her own baby. Once the head is out, the woman can reach down and guide the baby out as the body is release from the birth canal. If she does not feel able, the birth partner can be the one to “catch” the baby. As soon as the baby is out, he/she should be handed directly to the mother. If the baby does not take a breath immediately, the mother should stroke the baby, rub his/her back, speak softly and gently to him/her, and soon the baby should begin to breath and his/her color should pink up.
Babies born to mothers who have remained upright throughout their labors rarely need to have nose or mouth suctioned because the fact that they have been head down the whole time means mucous has been draining from the nose and mouth throughout the entire delivery. As the baby descends through the birth canal, his chest and lungs are tightly squeezed so that any fluid or mucous is naturally expelled.
Filed under: birth | Tags: baby, birth, labour, natural birth, natural childbirth blog, what birth is like
1. Cervix softens and ripens.
2. Light contractions cause the cervix to open up and thin out.
3. Baby’s head exerts pressure on cervix, speeding up dilation.
4. When cervix is fully dilated, there may be a resting period.
5. When contractions begin again, baby starts down the birth canal.
6. Baby rotates as it navigates through the bony structure of the pelvis.
7. With each contraction, the baby will advance down the birth canal, and slide back up a little after the end of the contraction.
8. The head crowns. As it emerges, the vaginal opening will be stretched around the largest diameter of the baby’s head. This sensation has been called by some the “ring of fire.”
9. After the head is born, the shoulders must rotate and slip from underneath the pelvic bone. After this occurs, the rest of the body is born immediately.
10. The baby should be then handed to Mom and allowed to nurse if he or she desires. Nursing helps the uterus to clamp down and stop bleeding, and expels the placenta
11. The umbilical cord should not be cut until it stops pulsating, as the baby needs all the extra blood he or she can get. There is no need to cut the cord all until the placenta arrives.
12. The baby should stay in skin-to-skin contact with Mom to help regulate his or her body temperature. This works better than putting them in a warmer.
Judie C. Rall The Center for Unhindered Living
Photo by Justin Henry
Filed under: birth, breech (posterior baby) | Tags: back labor, breech, breech birth, breech delivery, communicating with the baby, kicking baby, posterior baby, transverse baby, trust in birth, yurning posterior baby
from the women whose children are “rescued” from her womb by a surgeon? OK, there are two things…
P.S. If you feel your baby is crying for help, get help. Being empowered isn’t about doing it yourself, it’s about making the best choices we can with the information we have.
Filed under: baby care, birth | Tags: eye antibiotics, heelstick, Hepatitis B Vaccine injection, hospital birth, meconium, mercury poisoning, mothering, newborn assessment, placenta, postpartum hemorrhage, pumping baby's stomach, umbilical cord, vitamin k injection
There are a number of routine newborn procedures that will be offered or recommended at the time of your baby’s birth. It is helpful to learn about these procedures beforehand so that you can gather as much information as you need to make educated choices for your baby. Remember that in your home you have the freedom to create your birth like you want it.
In the hospital, your midwife or obstetrician almost certainly will not provide care for your newborn baby; care will be provided by hospital staff according to the standard protocols of the hospital unless you request otherwise. In some very rare cases, your pediatrician may be present to provide this care. In most cases, there will be an attempt to obtain “informed consent”, but busy hospital staff may simply announce that they are about to perform a procedure and take your silence as consent.
If you choose to decline some of these procedures, you may be asked to sign waivers to satisfy a state requirement. In most cases, you do not have to give a reason for declining any particular treatment. However, in California, you will be asked to sign a religious waiver if you choose not to have a heelstick done on your baby for the newborn screen (aka PKU) within six days after the birth.
This handout contains some introductory information; be sure to ask your pediatrician if you have any questions about these procedures.
Cutting the Umbilical Cord
Premature cutting of the umbilical cord deprives your baby of about 30% of your baby’s blood volume that nature intended to flow from the placenta and cord after birth. Although this “extra” blood usually isn’t necessary for survival, the iron in this blood is meant to help meet the baby’s iron needs during the first six months, since breastmilk is low in iron. In the days immediately after birth, your baby’s body breaks down this surplus blood and stores the iron in the liver. One of the byproducts of the breaking down of the surplus blood is bilirubin, which may cause a mild case of benign jaundice. Because many parents and health care professionals do not understand that this jaundice is normal and harmless, practices have evolved to cut the umbilical cord as soon as possible after the birth to prevent your baby from receiving the normal amount of blood and potentially experiencing jaundice, even though normal.
There is also some thinking that allowing your baby’s blood to flow back from the placenta reduces the size of the placenta, facilitates quicker and easier placental delivery and reduces postpartum hemorrhage.
In addition, cutting the umbilical cord before your baby’s breathing is well established may deprive your baby of life-sustaining oxygen that continues to flow from the placenta for several minutes after birth. Some people suggest waiting until after the umbilical cord has stopped pulsing before cutting the cord. In fact, this may still be too early. As part of the normal adaptation to breathing outside the womb, your baby’s body stops sending blood back to the placenta (which is what causes the pulse) some minutes before it stops receiving oxygenated blood from the placenta and umbilical cord, which doesn’t pulse.
Unfortunately, many institutions do not have personnel trained in resuscitating your baby while still receiving oxygen through the umbilical cord – their training is limited to working at the baby warming station across the room. This means that babies that most need to continue receiving oxygen through the umbilical cord (because they’re having trouble breathing or are in some other kind of distress) are the babies who are most likely to have their oxygen source – the placenta and umbilical cord – disconnected prematurely so they can be moved to the baby warming station.
Because this procedure is usually carried out without receiving parental permission, it is wise to discuss this with your care provider if the issue is important to you.
About cord blood collection - “Cord blood” is blood that would flow into your baby’s body if the cord weren’t cut to collect it. If you wouldn’t allow your baby’s blood to be drawn and 30% of the baby’s blood volume removed, then you probably don’t want to allow “cord blood collection”.
Suctioning the Baby’s Stomach
Many hospitals routinely suction or “pump” the baby’s stomach after birth, even if there was no evidence of meconium at birth. This procedure has no benefits - it can cause a sudden drop in the heart rate and can cause throat irritation that will interfere with breathing and breastfeeding.
Eye Antibiotics
The purpose of routine administration of antibiotic medication (erythromycin ointment) to your baby’s eyes about an hour after birth is to prevent infection from any germs that your baby may have been exposed to in passing through the birth canal. Some people object to this procedure on principle because of their objections to the routine use of antibiotics without proven benefit. Discomfort to the baby is minimal, and there is little disruption of the bonding procedure if the procedure is delayed until after the baby has fallen into the post-birth stupor. However, the benefits of routine administration are also minimal; if the baby does develop an eye infection, it will be very obvious to observant parents, and then there is plenty of time to administer antibiotics to prevent serious consequences.
Vitamin K Injection
Routine injection of vitamin K is controversial. It is generally accepted that administering vitamin K will increase clotting factors and reduce the incidence of Newborn Hemorrhagic Disease (NHD), a very rare situation in which a baby bleeds internally. NHD is seen much more commonly in babies who have experienced a traumatic birth, such as by forceps or vacuum extraction, or who are visibly bruised at birth. Although giving vitamin K to increase clotting factors does reduce the incidence of NHD, it also appears to increase the likelihood of death from bacterial meningitis. Nature obviously intended for newborns to have lowered clotting factors at birth, although science does not yet understand why.
Opposition to routine vitamin K administration centers around the injection itself, and many people who oppose the injection will accept an oral administration of the same formulation. (A study conducted at Children’s Hospital, University of Missouri, Columbia, found administration of oral vitamin K to be effective. [Journal of Pediatrics, vol. 127 #2, Aug., 1995, page 301, "Twenty-seven years of experience with oral vitamin K1 therapy in neonates" by Clark and James.] Oral doses of vitamin K should be twice the injected dose, and there are suggestions to repeat the dose at two, four and six weeks of age.
Colostrum contains high levels of vitamin K, and if your baby experiences a gentle birth and nurses readily at birth, your baby will probably receive exactly the dose intended by nature. If you choose to have your baby receive supplementary vitamin K, it might be worth discussing oral administration with your pediatrician in advance. Even if they don’t have a special oral preparation, they can use the preparation meant for injection.
Whether or not your baby receives vitamin K supplementation, it is best to contact your baby’s care provider if you notice that your baby seems to have a lot of bruises or an unusual amount of bleeding from the umbilical cord stump. This is a common precursor to more serious bleeding problems.
Hepatitis B Vaccine Injection
For the last few years, it has been the standard of care to vaccinate all newborns with a Hepatitis B Vaccine before they left the hospital. However, on July 7, 1999, it was reported that the American Academy of Pediatrics is now recommending that newborns not be vaccinated because the mercury used as a preservative in the vaccines has been implicated in mercury poisoning occurring in babies. Some hospitals may still be vaccinating newborns as they use up their store of vaccines. If you do not want your baby to receive the Hepatitis B vaccine, it is important that you be very clear about this with the neonatal team, the nursery staff and your pediatrician.
Photo by Sean Dreillinger
Filed under: baby care, birth | Tags: birth trauma, bonding, healing birth trauma, siblings, VBAC
Ronnie Falcao, homebirth midwife, CA:
I’m often struck by how much VBAC moms insist on having their older siblings present at the birth, especially the ones born by cesarean. It finally struck me that this is yet another example of a mother’s wonderfully strong instinct about providing the best possible care for her children.
In my studies of the hormones of birth, I’ve learned that the stress of labor causes a woman’s body to release endorphins to ease the pain and to facilitate a primal bonding with her baby. In a natural labor, the levels of these hormones are significant, and they are passed through to the baby also to ease the stress on the baby. As a fun side effect, the endorphins seem to fill the air around the laboring woman so that her birth attendants also get to enjoy them. There’s a reason why birth attendants sometimes call themselves “natural birth junkies”. 
Endorphins are the “love hormones” released during childbirth and breastfeeding, and they really are like an aphrodisiac, causing people “under the influence” to fall in love with each other without any rational filtering. I try not to usurp the power of these hormones, and I work hard to keep the family focused on each other in that first hour after birth, because I want them bonding with each other instead of with me.
I have previously understood how these endorphins can have a wonderful healing effect for couples who have had a past traumatic birth, as the mom is under the influence of nature’s finest “narcotic”, and the dad absorbs them from the air around her. But it was this most recent discussion about siblings at VBAC that helped me realize that this also pertains to the older children who were born through a traumatic birth process. If they are present at the VBAC, these older children get to enjoy and absorb the endorphins and bond with their families in a way that they missed completely at their own birth. Nature heals.
Ronnie Falcao’s Midwifery Archives
Photo By Jennifer Schwalm
Filed under: birth, empowered childbirth, homebirth, unassisted birth | Tags: birth, birth kit, bith blog, motherworth, natural chilbirth, unassisted birth
- Small bottle of almond, olive or other natural massage-type oil. (For lubrication of any body part, if desired)
- Underpaddings. Large plastic drop cloths, shower curtains or even trash bags to protect surfaces, covered in old towels, sheets or blankets that can be washed (or thrown away). Some women prefer disposable “chux” pads, they can be purchased in the adult diapering section of your local shop.
- A copy of the book Emergency Childbirth: A Manual by Dr.Gregory White
- Some people like to have a stethoscope
- A camera or video recorder (with film)
- A pen and paper to jot down times and anything of interest
- Foods, drinks, teas or tonics for the laboring mama and her support team
- Videos, toys, art supplies, puzzles, etc. for anxious siblings to discover
An “emergence” kit can be constructed with items that could be grabbed in a hurry or not at all.
- A pair of scissors, rubbing alcohol or hydrogen peroxide and gauze swabs (or alcohol prep pads) for cleansing them.
- 2 industrial strength cord clamps (for emergency use only) and a set of gentler cord ties for normal cord procedures. Umbilical tape or dental tape (not floss, the ribbon-like stuff) works well. Braided embroidery floss is a popular choice too.
- Any bleed stopping remedy the mother has chosen. (Mango Mama posted: Shepherd’s Purse and/or Motherwort tinctures and Bayberry Bark, Cayenne, Shepherd’s Purse and Mistletoe herbs for teas as options)
- Natural fiber hat for a newborn head (remembering that hir tiny head could be very sore from the molding, those tightly knit “hospital caps” made two of my babies scream in pain). Patterns for creating your own baby hat are here for knitting and crocheting and here for sewing
- I would be remiss if I didn’t mention the rubber ball suction device as an “emergency item” but I think they are a bad idea for birth, personally. I’d probably stick one in a drawer so no one would think I was negligent for not having it. I can’t imagine ever using it though…
- Warm towels, blankets, receiving blankets or robes. Some families put towels in a dryer, on a heater, folded around a warm heating pad or in a barely warm oven during labor so they’ll be cozy after birth.
- A large pan, bowl or bucket for catching the placenta (those ice cream buckets work well).
- Maxi pads (cloth ones or even towels can work well)
- Arnica 30x for bruising or pain (mama and perhaps even baby)
- Pain reliever for after-pains (herbal tinctures, teas or commercial)
- Eldon card, vaccutainers and syringe for testing baby’s cord blood (once baby is done with it)
- Calendula tincture, honey for tears or skid marks
- Diapers and baby clothes
- A tape measure
- A scale (if desired. Some families rig up fish scales with a baby blanket or towel and subtract the towel’s weight, some subtract their weight from the reading on the bathroom scale while they hold their infant)
- Celebratory foods, drinks or items for baby’s very first Birth-day party
Filed under: birth, labour | Tags: birth positions, birthing positions, cervical dilation, dancing during labour, free birthing position pictures, massage, moving during labour, reducung the length of labour, relieve back pain, rocking motion
Positions for Labor, for Back Pain, and for Pushing
Why are different positions important?
Changing positions, and moving around during labor and birth, offers several benefits. Some are obvious to the mother in labor: increased comfort / reduced pain, distraction, and an enhanced sense of control: merely having something active to do can relieve the sense of being overwhelmed and out of control.
Beyond these advantages, there are equally important effects on the baby and on the progress of labor. Changing positions during labor can change the shape and size of the pelvis, which can help the baby’s head move to the optimal position during first stage labor, and helps the baby with rotation and descent during the second stage. Swaying motions such as walking, climbing stairs, lunging, and swaying back and forth are especially helpful with this.
Movement and upright positions can help with the frequency, length, and efficiency of contractions. The effects of gravity can help the baby move down more quickly. Changing positions helps to ensure a continuous oxygen supply to the fetus, rather than causing supine hypotension (low maternal blood pressure) by lying on your back or even semi-sitting.
Changing position can reduce the length of labor. Mendez-Bauer and Newton (1986) state: “duration of labor from 3 to 10 cm cervical dilation was about 50% shorter in patients who alternated supine and standing, standing and sitting positions.”
Positions for First Stage Labor
For Resting:
|
|
|
|
|
Side-lying. Try placing pillows between your knees for comfort. |
Semi-sitting, in bed, on a couch, or leaning against your partner with his arms around you. |
Sitting with one foot up. Asymmetrical positions help enlarge the pelvis on one side, and change the shape of the pelvis, which helps the baby find the best position. |
Rocking, Rhythmic Motion: In labor, it just feels better when mom rocks and sways in rhythm to her breathing. Partners sway with her, or do massage in rhythm with her breathing, or sing in rhythm.
|
|
|
|
|
|
Rocking Chair |
Sway on ball |
Slow Dancing |
Dance with Belly Lift |
Activity: Walking, climbing stairs, lunging. Activity helps baby to descend, helps baby to rotate into position for birth. In early labor, be active occasionally, but don’t exhaust yourself by walking all through early labor. Walking is more effective in active labor and transition when baby has descended far enough to put pressure on mom’s cervix and encourage the cervix to open.
|
|
|
|
|
Lunge. |
Stair Climbing |
Tailor Stretching |
Positions for Back Labor (when mom has back pain, irregular contractions, or is progressing slowly)
Leaning Forward: Many women, especially those with back labor, find it most relaxing to lean forward during contractions.
|
|
|
|
|
Straddle a chair (or the toilet), and rest your arms and head on the back |
Leaning against a wall, or your partner, or leaning over a table. Can sway. |
Raise the head of a hospital bed, then kneel on bed with arms resting on top of bed. |
Hands and knees / kneeling. Can relieve back pain, help a posterior baby rotate, allows easy access for backrubs / counterpressure massage; makes it possible to sway side to side, rock back and forth, or do pelvic tilts to aid rotation and increase comfort. Having knee pads or kneeling on something soft will help knees. Can rest upper body on pillows, chair, or birth ball.
|
|
|
|
|
|
Hands and knees |
By a chair |
Over birth ball |
Knee-Chest |
For second stage, an ideal position would: open the pelvic outlet as widely as possible, provide a smooth path for the baby to descend through the birth canal, use the advantages of gravity to help the baby move down, and give the mother a sense of being safe and in control of the process.
Try out a position for a few contractions. If it works, stay with it. If not, switch to a new position in between contractions. Depending on the caregiver, they may ask you to move to a specific position just prior to the birth.
“Standard” positions. These can be done by anyone. These are the positions that most OB’s are used to delivering babies in.
|
Semi-sitting. With pillows underneath knees, arms, and back. During contractions, can wrap hands around knees and pull knees up toward shoulders (as in squatting). Most common in hospital setting. For mom and baby: some help from gravity moving the baby down; mom feels more in control than in lithotomy position. Benefits for caregivers: good view of perineum, easy access to perineum. |
|
|
Lateral / Side-Lying. Back curved, upper leg supported by partner. Gravity neutral, good for fast second stage. May be a comfort position for mom. |
|
**
Kneeling positions. These work fine if you have no pain medication, or narcotics only. [If you have epidural anesthetic: These may be possible with a light epidural. You can ask your caregiver if it would be possible to try these positions, but you will need help getting into these positions (moving the IV tubing, catheter tube, monitor wires and so on so they’re not tangled around you is a production in and of itself!). Once you are in these positions, you would need to be “spotted” (have one person on each side of you, making sure you stay balanced and stable.)]
|
Kneeling. Hands on the bed, and knees comfortably apart. Or one knee up. Good for reducing tears and episiotomies. May be restful for mom. |
|
|
Hands and knees. Arch your back occasionally for increased comfort. Great for back labor, big babies, posterior babies. Many find it most comfortable. |
|
**
Upright positions / Squatting. These will not be possible if you have had an epidural, because with an epidural, you typically can not get up out of bed.
|
Sitting: On the toilet, on thighs of support person, on birthing stool/chair, on partner’s lap. Opens pelvis, gravity enhancing, natural pushing position. |
|
|
Squatting / Supported Squat. Opens pelvis, gravity enhancing, sense of control for mom. During squatting, the average pelvic outlet is 28% greater than in the supine position. Stand, or sit back to relax in between contractions. |
|
|
Dangle. Gravity, no external pressure on perineum / pelvis. Feeling of being well-supported. May be difficult for mom to see or touch baby during birth. |
**