We live in a day and age where planned cesarean sections are routine, and are even recommended for all women. However, this is not a desirable procedure for many women today. There has been a push in recent years for a return to the natural methods of childbirth. This is indicated by the growing popularity of midwives, the burgeoning relatively new field of birth and post-partum doulas, as well as an overall general shift towards being healthy and living a natural life.
There are many reasons to prevent a C-section. There are financial reasons, since the cost of a C-section coupled with the hospital stay required afterwards can cost a new mother and father out of pocket in the tens of thousands of dollars, especially if they have a not-so-great health insurance policy. When compared to the cost of a natural birth (which is more in the area of one to two thousand in deductible or out of pocket), there is a big difference.
A natural birth requires a shorter hospital stay, often only a couple of days. A C-section can cause a woman to be in the hospital for a week or more afterward, especially if there were complications to the woman or the newborn. This can create a significant increase in cost, and for some women it can become a real financial burden.
Another reason to prevent a C-section has to do with the possible long term consequences to the mother in future pregnancies. As mentioned in a previous article, improper placental implantation has been positively linked to previous C-section. A Wikipedia entry about cesarean sections (linked to here ) speaks about several complications that are higher with C-sections, and apply to later births. “Women who delivered their first child by Caesarean delivery had increased risks for malpresentation, placenta previa, antepartum hemorrhage, placenta accreta, prolonged labor, uterine rupture, preterm birth, low birth weight, and stillbirth in their second deliveries.” These same risks were echoed by GynoGab (linked to here )
Some of these risks can lead to maternal mortality, especially placenta accreta. In most cases placenta accreta will lead to hemorrhage since the placenta must detach from the uterus and be expelled after the birth. This is a fact of every birth. With placenta accreta, the placenta is essentially tied to the body through the previous C-section scar, so it cannot be expelled. The article states that women who plan to have larger families should not have elective C-sections. An elective C-section is performed for the convenience of the mother and the hospital staff, rather than in an emergency situation where the mother or baby is at risk.
It should also be noted that in Ina May‘s Guide to Childbirth, she states that these placental implantation problems have become an issue in recent years because surgeons have elected to use a single layer stitch when closing the wound in the uterus, whereas in the past the stitching was done in multiple layers. These multiple layers did not lead to such an increased risk of placental mal-implantation. Women who know they are at high risk can discuss the type of stitching they would prefer if they have a C-section with their surgeon to reduce their risk of these problems.
When placenta accreta occurs, the surgeon attending the birth will often have to perform a complete hysterectomy in order to save the mother’s life. This should indicate how serious of a problem this can become. When this happens, the mother can have no more children.
In addition to these types of complications, there is also a three times higher rate of maternal mortality with a C-section in general over having a natural birth. While natural births can sometimes result in death, the rate of death from a C-section is higher than that in a normal birth. Considering that birth is a natural part of life, and that the female body was designed to give birth, this makes sense.
So, how can the pregnant woman prevent a C-section? Possibly one of the best ways to prevent this would be to have a midwife for your prenatal care provider. A midwife is experienced in taking care of many of the problems that would otherwise lead to a C-section. For example, nuchal cord births (where the umbilical cord is wrapped around the neck), breech births, and twins, can often be naturally delivered by an experienced midwife. For this reason, having a midwife with experience is very important.
Another way to help prevent C-section is to hire a birth doula. This person is knowledgeable about childbirth and can help to calm you if you feel that the labor is lasting too long or that there is a problem. She will likely be able to tell you if there is an actual problem, or if there is actually no reason to panic.
Another way to help prevent C-section is to have frequent pre-natal massages. Multiple studies have shown that prenatal massage can help to prevent complications, interventions, prematurity, and other problems. When complications are reduced, so is the rate of C-section since emergency C-sections are performed due to complications. While the reasons massage helps in this way are not understood, it is worthwhile to try prenatal massage while you are pregnant. For more information on prenatal massage, please click here.
Prenatal chiropractic can also help in similar ways, and you can find a chiropractor trained in prenatal care by clicking here. Prenatal yoga has also been shown to have similar benefits. You can do prenatal yoga in a classroom setting, or by purchasing one of the many DVDs available. Prenatal yoga has become very popular in recent years, as many midwives and even OBs have been recommending it. Consequently, it is likely that you can find a yoga studio offering prenatal yoga in your area. Low impact exercise during pregnancy, such as walking, has also been shown to help prevent complications.
If you have a high risk pregnancy, there may be no way for you to prevent having a C-section when the time comes for your child to be born. In such a case, it is better for you to be informed about all of your options. If you have tried all of the above measures, including massage, chiropractic, yoga, etc., and you must have a C-section, you can still ask your obstetrician to stitch your uterus in multiple layers to prevent future implantation problems. That way, you may be able to have a vaginal birth after your C-section, and continue having more children naturally if that is what you choose. However, as with everything, going into this procedure informed will be the best way to have a successful outcome for you and your children.
Friday, August 15, 2014
10 Reasons to Have a Midwife-Led or Midwife-Assisted Childbirth
When you are considering your options for labor and birth, you might wish to consider having a midwife lead or assist at your birth. This article details ten reasons for having a midwife at your birth. There are certain medical conditions, described below the list, that may prevent you from having a midwife led birth, but some of the benefits below will also apply to a midwife assisted birth (where you have a midwife work with your obstetrician at your labor and birth).
So, if you are interested in having a midwife but are unsure of the benefits to you, here are the top 10 reasons to have a midwife led or assisted labor and birth.
1) Lower maternity care costs. This may not apply if your deductible is very low or waived for pregnancy. However, you are likely to still pay about $2-3,000 for your co-pay or deductible depending on your insurance if you have a natural birth in a hospital. If you have an elective or necessary C-section, your co-pay is likely to be closer to $7,000.
2) Reduced mortality and morbidity rates due to a lower rate of cesaereans and other interventions.
3) Lower rate of interventions, including forceps and vacuum assisted delivery rates.
4) Fewer recovery complications
5) Flat rate pricing, which will often include gynecological exams, preconception care, labor and delivery support, newborn care, as well as birth and labor education and breastfeeding education. This flat rate is often lower than your co-pay or deductible out of pocket expenses for a hospital birth. Those co-pays do not include the cost of your hospital stay.
6) Provides hands on assistance and support during labor and birth. The midwife will also monitor the physical, emotional, and overall wellness of the mother throughout labor and birth.
7) The midwife will provide post-partum support, such as counseling and breastfeeding education.
8) The midwife can help reduce pain in the laboring mother by making suggestions for non-pharmacological interventions such as a warm bath, chaning positions, certain herbs and juices, etc.
9) A midwife led birth held out of a hospital will not be subjected to the same time limits as a hospital birth often is. In many hospitals, labors have a set time limit, after which interventions will begin. Such interventions can include induction of labor (where certain of the induction medications can cause their own complications including uterine rupture and fetal distress), forceps and vacuum extractor deliveries, as well as C-sections. As indicated above, C-sections can lead to complications in later births, and may be best avoided in situations where they are not medically necessary.
10) A midwife is also likely to suggest certain pre and post birth activities that will reduce later pain during labor as well as pregnancy itself. Such suggestions are likely to include pre-natal massage, pre-natal yoga, as well as post-natal massage. Post-natal massage has been known in other countries such as India to speed recovery time, enhance milk production, as well as enhance the bonding of the newborn with its mother. Pre-natal massage and yoga have both been shown to reduce complications and interventions.
The medical conditions that generally require obstetric assistance or intervention are the following: preeclampsia (which means high blood pressure in the mother); epilepsy, heart disease, and non-gestational diabetes are also conditions which will make your pregnancy be considered high risk; placenta accreta, percreta, and increta (where the placenta implants too deeply into the uterine wall), and placenta previa where the placenta covers the opening of the cervix.
While placenta previa is not necessarily a complication requiring a surgical delivery (as many midwives have attended these births), the former three types of placental implantation require surgical intervention and have been positively linked to one or more previous C-sections. See the page about placental problems on the American Pregnancy website here . In addition, most obstetricians will tell you that the presence of multiples (i.e. twins) is also a reason to have a cesarean section. However, the latest Summer issue of Midwifery Today is centered on the topic of twins, with many stories of twins being successfully delivered by midwives.
The decision to have a midwife or an obstetrician be responsible for your childbirth and prenatal care is a very personal one. However, there are also medical and physical reasons to consider having a midwife involved in your birth. A future article will discuss the benefits of a doula, so that if a midwife is out of your price range, you can also have a doula, who is a birth assistant there to help you.
This article referenced several websites that speak about the benefits of having a midwife for your birth. American Pregnancy’s article can be viewed here, the BabyCenter webpage can be found here, and Pregnancy Corner’s website can be found here.
So, if you are interested in having a midwife but are unsure of the benefits to you, here are the top 10 reasons to have a midwife led or assisted labor and birth.
1) Lower maternity care costs. This may not apply if your deductible is very low or waived for pregnancy. However, you are likely to still pay about $2-3,000 for your co-pay or deductible depending on your insurance if you have a natural birth in a hospital. If you have an elective or necessary C-section, your co-pay is likely to be closer to $7,000.
2) Reduced mortality and morbidity rates due to a lower rate of cesaereans and other interventions.
3) Lower rate of interventions, including forceps and vacuum assisted delivery rates.
4) Fewer recovery complications
5) Flat rate pricing, which will often include gynecological exams, preconception care, labor and delivery support, newborn care, as well as birth and labor education and breastfeeding education. This flat rate is often lower than your co-pay or deductible out of pocket expenses for a hospital birth. Those co-pays do not include the cost of your hospital stay.
6) Provides hands on assistance and support during labor and birth. The midwife will also monitor the physical, emotional, and overall wellness of the mother throughout labor and birth.
7) The midwife will provide post-partum support, such as counseling and breastfeeding education.
8) The midwife can help reduce pain in the laboring mother by making suggestions for non-pharmacological interventions such as a warm bath, chaning positions, certain herbs and juices, etc.
9) A midwife led birth held out of a hospital will not be subjected to the same time limits as a hospital birth often is. In many hospitals, labors have a set time limit, after which interventions will begin. Such interventions can include induction of labor (where certain of the induction medications can cause their own complications including uterine rupture and fetal distress), forceps and vacuum extractor deliveries, as well as C-sections. As indicated above, C-sections can lead to complications in later births, and may be best avoided in situations where they are not medically necessary.
10) A midwife is also likely to suggest certain pre and post birth activities that will reduce later pain during labor as well as pregnancy itself. Such suggestions are likely to include pre-natal massage, pre-natal yoga, as well as post-natal massage. Post-natal massage has been known in other countries such as India to speed recovery time, enhance milk production, as well as enhance the bonding of the newborn with its mother. Pre-natal massage and yoga have both been shown to reduce complications and interventions.
The medical conditions that generally require obstetric assistance or intervention are the following: preeclampsia (which means high blood pressure in the mother); epilepsy, heart disease, and non-gestational diabetes are also conditions which will make your pregnancy be considered high risk; placenta accreta, percreta, and increta (where the placenta implants too deeply into the uterine wall), and placenta previa where the placenta covers the opening of the cervix.
While placenta previa is not necessarily a complication requiring a surgical delivery (as many midwives have attended these births), the former three types of placental implantation require surgical intervention and have been positively linked to one or more previous C-sections. See the page about placental problems on the American Pregnancy website here . In addition, most obstetricians will tell you that the presence of multiples (i.e. twins) is also a reason to have a cesarean section. However, the latest Summer issue of Midwifery Today is centered on the topic of twins, with many stories of twins being successfully delivered by midwives.
The decision to have a midwife or an obstetrician be responsible for your childbirth and prenatal care is a very personal one. However, there are also medical and physical reasons to consider having a midwife involved in your birth. A future article will discuss the benefits of a doula, so that if a midwife is out of your price range, you can also have a doula, who is a birth assistant there to help you.
This article referenced several websites that speak about the benefits of having a midwife for your birth. American Pregnancy’s article can be viewed here, the BabyCenter webpage can be found here, and Pregnancy Corner’s website can be found here.
Monday, August 4, 2014
Informing Yourself About the Dangers of Induction Of Labor in Pregnant Women
When you are pregnant, you have a great many decisions to make. You need to think about a birth plan for yourself, you need to find the best midwife or obstetrician for your birth, and you need to consider where you want to have your baby. You also need to think a lot about your pre- and post-natal care, for example, will you have a midwife and a doula, an obstetrician and a doula, an OB only?
Will you have prenatal massages, or will you have a series of post-natal massage sessions after the baby is born to help you recover? Or will you have both? Do you understand why these decisions are important, and are you clear as to why you have made the choices you have?
In the midst of all of these decisions, you may be neglecting informing yourself about a very important decision that can have consequences for your and your baby: the decision of whether to induce labor or to let nature take its course.
It is helpful to understand that obstetricians working in hospitals are generally quick to try to get a pregnant woman to induce labor. They have a view that the pregnant woman’s body is somehow defective and will not induce labor when it is ready, on its own. However, this view is not borne out in the research, which has shown that women will labor when the time is right. (see midwifethinking for a more holistic view of birth and labor)(Also see the article on Clinic Advisor located here )
Many times when a woman has an induced labor, there are unintended consequences. The rates of caesarean sections after an induction are twice those of non-induced women. For many women today, this type of birth is undesirable. Additionally, for conditions like gestational diabetes where the baby is assumed to be very large based on ultrasounds and other monitoring, when born the baby is often underweight or premature.
Thus, many inductions were unnecessary. The problem here seems to be one of a missing feedback loop. In other words, a feedback loop would mean that: a hospital performs a certain number of inductions, many of those inductions turned out to be unnecessary or even dangerous for the baby or mother, thus fewer inductions would be performed in the future. However, this feedback loop is actually missing in most hospitals since most of them continue to perform just as many inductions, and the number is on the rise.
All of these facts are aside from the actual dangers to mothers and babies from inductions. When a woman is induced to have labor, it is an unnatural event. Thus, there is an actual risk of rupturing or tearing the uterine wall because the contractions are unnaturally strong. This leads to a higher rate of C-sections, and can also cause long term incontinence. (See this website for more information) A higher risk of post-partum bleeding has also been observed with the use of these drugs. (Belghiti J, Kayem G, Dupont C, et al. Oxytocin during labour and risk of severe postpartum haemorrhage: a population-based cohort-nested case-control study. BMJ Open 2011;1:)
With regard to the infant, brain damage, increased fetal heart rate (leading to a C-section), permanent CNS, as well as fetal death have all been reported. The rates for these conditions in the infant are higher than in those born to mothers who are not induced. In addition to these issues with newborns, they have been generally underweight or premature when born through induction, even though their ultrasounds had indicated a larger than appropriate for gestational age baby. See the pages here and here for more information.
It should also be remembered that a due date is a guess at best, since most women do not know the exact date on which they conceived. They may know the date of their last period, from which the due date is estimated. These possibilities have actually caused the American College of Obstetricians and Gynecologists to state on their own website that caution should be used when inducing labor, as quoted in the bellybelly webpage above. However, hospitals and obstetricians continue to use these procedures regularly.
In addition to the reasons mentioned, it is also helpful to note that when a woman is admitted to a hospital as being in labor, there is a time limit for that labor, regardless of what her body believes is the time limit. When that time limit has passed, the OB will generally insist on induction. When the induction occurs, if the fetal heart rate drops, or the fetus appears to be in distress, an emergency C-section will be performed. For further reading on this topic, see Ina May’s Guide to Childbirth by Ina May Gaskin, a midwife practicing since the 1970s.
It is also useful to remember that most independent midwives do not perform labor inductions. They prefer to consider the woman’s body as wise enough to know when the baby is ready to be born. The normal labor of a pregnant woman releases small amounts of induction hormones into her blood, so spontaneous uterine rupture is rare. A midwife will generally allow a woman to labor until the baby is born. Many midwives have the experience to know when a fetus is in distress, and have a hospital birth contingency plan in place before the birth takes place. (See Ina May’s book above, as well as current and past issues of Midwifery Today for further details)
Massage therapy in the prenatal period has also been shown to reduce the incidence of prematurity, as well as the incidence of complications during labor. This is another factor to consider when creating your prenatal care team. A doula is also helpful to have with you at birth, as they are another educated care provider, who can help you to be informed about the decisions you are making with your body and your baby.
The best time to learn about labor induction, using chemical or mechanical methods (such as breaking waters, which often leads to chemical induction if ineffective), is before you are scheduled to deliver your baby. Researching the possibilities will give you the best chance of having the birth experience that is best for you and your baby.
Will you have prenatal massages, or will you have a series of post-natal massage sessions after the baby is born to help you recover? Or will you have both? Do you understand why these decisions are important, and are you clear as to why you have made the choices you have?
In the midst of all of these decisions, you may be neglecting informing yourself about a very important decision that can have consequences for your and your baby: the decision of whether to induce labor or to let nature take its course.
It is helpful to understand that obstetricians working in hospitals are generally quick to try to get a pregnant woman to induce labor. They have a view that the pregnant woman’s body is somehow defective and will not induce labor when it is ready, on its own. However, this view is not borne out in the research, which has shown that women will labor when the time is right. (see midwifethinking for a more holistic view of birth and labor)(Also see the article on Clinic Advisor located here )
Many times when a woman has an induced labor, there are unintended consequences. The rates of caesarean sections after an induction are twice those of non-induced women. For many women today, this type of birth is undesirable. Additionally, for conditions like gestational diabetes where the baby is assumed to be very large based on ultrasounds and other monitoring, when born the baby is often underweight or premature.
Thus, many inductions were unnecessary. The problem here seems to be one of a missing feedback loop. In other words, a feedback loop would mean that: a hospital performs a certain number of inductions, many of those inductions turned out to be unnecessary or even dangerous for the baby or mother, thus fewer inductions would be performed in the future. However, this feedback loop is actually missing in most hospitals since most of them continue to perform just as many inductions, and the number is on the rise.
All of these facts are aside from the actual dangers to mothers and babies from inductions. When a woman is induced to have labor, it is an unnatural event. Thus, there is an actual risk of rupturing or tearing the uterine wall because the contractions are unnaturally strong. This leads to a higher rate of C-sections, and can also cause long term incontinence. (See this website for more information) A higher risk of post-partum bleeding has also been observed with the use of these drugs. (Belghiti J, Kayem G, Dupont C, et al. Oxytocin during labour and risk of severe postpartum haemorrhage: a population-based cohort-nested case-control study. BMJ Open 2011;1:)
With regard to the infant, brain damage, increased fetal heart rate (leading to a C-section), permanent CNS, as well as fetal death have all been reported. The rates for these conditions in the infant are higher than in those born to mothers who are not induced. In addition to these issues with newborns, they have been generally underweight or premature when born through induction, even though their ultrasounds had indicated a larger than appropriate for gestational age baby. See the pages here and here for more information.
It should also be remembered that a due date is a guess at best, since most women do not know the exact date on which they conceived. They may know the date of their last period, from which the due date is estimated. These possibilities have actually caused the American College of Obstetricians and Gynecologists to state on their own website that caution should be used when inducing labor, as quoted in the bellybelly webpage above. However, hospitals and obstetricians continue to use these procedures regularly.
In addition to the reasons mentioned, it is also helpful to note that when a woman is admitted to a hospital as being in labor, there is a time limit for that labor, regardless of what her body believes is the time limit. When that time limit has passed, the OB will generally insist on induction. When the induction occurs, if the fetal heart rate drops, or the fetus appears to be in distress, an emergency C-section will be performed. For further reading on this topic, see Ina May’s Guide to Childbirth by Ina May Gaskin, a midwife practicing since the 1970s.
It is also useful to remember that most independent midwives do not perform labor inductions. They prefer to consider the woman’s body as wise enough to know when the baby is ready to be born. The normal labor of a pregnant woman releases small amounts of induction hormones into her blood, so spontaneous uterine rupture is rare. A midwife will generally allow a woman to labor until the baby is born. Many midwives have the experience to know when a fetus is in distress, and have a hospital birth contingency plan in place before the birth takes place. (See Ina May’s book above, as well as current and past issues of Midwifery Today for further details)
Massage therapy in the prenatal period has also been shown to reduce the incidence of prematurity, as well as the incidence of complications during labor. This is another factor to consider when creating your prenatal care team. A doula is also helpful to have with you at birth, as they are another educated care provider, who can help you to be informed about the decisions you are making with your body and your baby.
The best time to learn about labor induction, using chemical or mechanical methods (such as breaking waters, which often leads to chemical induction if ineffective), is before you are scheduled to deliver your baby. Researching the possibilities will give you the best chance of having the birth experience that is best for you and your baby.
Monday, July 21, 2014
Choosing A Home Birth – Your Pregnancy Can End At Home With Proper Preparation
When you are pregnant, you have many different people offering you so many suggestions that it can be confusing to know what the right choice is for you and your baby. Most of your friends and relatives have given birth in a hospital, and they argue that this is the safest way. However, more women than ever in the United States are choosing to have home births, and most of those births are uneventful in terms of complications. They also create a deeper bond and a more lasting memory for the woman giving birth.
If you read stories about home births online (such as on the forum located here), you will find that almost universally, women were extremely happy with their choice. If you think about it, it is easy to see why. A birth at home is in the most comfortable environment for you. You can shower if you would like, and you can move around your home freely. The lighting is the type of lighting that you like best (no harsh overhead fluorescent lighting), and you bed is there for you right after you have given birth. In addition, it is going to become the most familiar place for your baby once he is born, so why not start him out in the place where he will be spending most of his time and life.
So, if a home birth sounds like a good choice for you, there are some things that you can do to ensure that you are able to have one. Of course, it is not possible to prepare in advance for every eventuality, and some women are not able to have a home birth even if they want one. Conditions such as preeclampsia, gestational diabetes, and placenta Previa are certain to prevent a home birth, since they are complications that are much more likely to require the intervention of a hospital medical team.
However, for those women who are having a normal pregnancy, with no complications, who are at low risk, there are a number of things that you can do so that your wishes can be honored. First, be sure you are getting adequate nutrition. Following the basic food groups, having good portion sizes, and eating whole grains and healthy fruits and vegetables can help ensure you are having good nutrition. The baby’s weight is also a good indicator, so be sure your doctor agrees that your weight gain and the baby’s are appropriately progressing.
Second, you should ensure that you are taking the proper pre-natal vitamins. For the most part, doctors and midwives today have been recommending pre-natal vitamins based on the favorable results of many studies, including those performed by the March Of Dimes. Certain vitamins have been definitively shown to prevent birth defects, and increase fetal health.
Third, you may wish to consider having a pre-natal massage session or a series of sessions before you give birth, and then continuing after you have given birth, preferably in your home. Due to limitations to mobility, getting yourself to a spa may become impossible, and massage therapy can be crucial for your pregnancy. Rather than allowing the lack of mobility to stop you from having one, it is best to have one in your home. Evidence is mounting with each passing month and year on the incredible benefits to both mother and baby of prenatal massage therapy.
Fourth, it is advisable to sign up for a pre-natal yoga class, or to obtain a prenatal yoga video, such as can be found on amazon by clicking here. Pre-natal yoga has demonstrated beneficial effects for every stage of pregnancy, and many physicians and midwives heartily recommend the practice. Like massage, it can help your body be prepared for labor by loosening and relaxing the pelvic floor muscles, making pushing during labor easier.
Fifth, it is strongly advised that you hire a doula, in addition to a skilled and experienced midwife. The doula will help the laboring woman with emotional support, as well as helping to calm the laboring woman and her partner. Having a doula is almost certainly a must if one wants to have a natural childbirth at home. You can check the links here and here to help you find a certified doula in the New Jersey area.
While there are risks of a home birth, the risks are generally small. Usually, the risks involve complications during the birth that were not foreseen, leading to the need to be transferred to a hospital. Prior to the 1900s, nearly all births were home births. Advances in modern medical treatment have made even home births safer, with midwives generally bringing fetal monitoring equipment with them, along with oxygen for the mother or baby. With proper preparation, it has been found that home births are nearly as safe as those in a hospital or birthing center, and their popularity is on the rise. Research for this article was performed on The Mayo Clinic's home birth page, the American Pregnancy Association’s page, and a recent Huffington Post article detailing the results of a study of home births in America.
Since more and more modern women are choosing to insist on a natural childbirth, feeling that their decision matters and that they have a say, it is only natural that home births are following in the footsteps of this growing trend. Just as C-sections come with many risks, but are performed routinely, perhaps there will come a time when births are routinely performed at home even though there are some risks to this. If you are considering a home birth, then you are paving the way for future women just like yourself to make the same decision. You are treating pregnancy and birth as a natural process rather than a medical condition, and this is to be applauded. We can only hope that more women in the future will follow in these footsteps toward a more integrated approach to their own labor and birth.
Friday, July 18, 2014
Why Every Pregnant Woman Should Educate Herself About Pregnancy
Every pregnant woman should read at least one book about her pregnancy. I would state, actually, that every pregnant woman should read every book and internet article about pregnancy that she can. It is very important to be informed. In the introduction to the book Pregnancy, Childbirth, and the Newborn, by Simkin et al., the author states that “…expectant parents [should] have a portable, comprehensive, and unbiased source of factual information and sound advice…” about their pregnancy, as well as how to care for the new baby once it is born.
While this is an excellent book, and every pregnant woman should obtain a copy, there are many other books, websites, scientific studies, and scholarly articles that one should research upon becoming pregnant. Since the evolution of the e-reading device, as well as magazines available on Google’s newsstand app for smart devices, it is not difficult to get most of the information you need right on your smartphone or tablet device, thus making it easier than ever to make informed decisions about your birth plan, your medical care, and the desired outcome of your labor.
Some of the decisions to make involve medications such as epidurals, whether you want a natural birth or C-section (this desire cannot always be honored, although it is best to know what each option entails beforehand), and whether you want a hospital birth, home birth, birthing center birth, or a water birth. Each of these decisions required careful research on the risks and benefits, the statistics regarding success rates, and possible side effects or harmful effects on you and the baby for each decision.
While pregnancy is a completely natural event, there have been advances in medical science that every woman should know about. There is also a lot of knowledge among the general public about certain advances and interventions, but some are not fully understood. There are procedures that bring with them a certain level of higher risk, but many women may not be aware of these risks.
For example, an epidural and an amniocentesis are both rather routine in this day and age. However, there are some women who would not want either of them if they were aware of the risks and possible damage that can occur to mother or fetus. In the case of an epidural, there is a 1 in 1,000 risk of temporary nerve damage, and a 1 in 13,000 risk of permanent nerve damage in the leg, foot, or stomach. This nerve damage can result in numb patches on these body parts. Permanent urinary incontinence can rarely result from this procedure as well.
The overall complication risk, including all complications both minor and major, is 23% This is according to the website listed in the next paragraph. The rate of caesarian section increases among women who have had epidurals, by 7 percentage points. Other complications have included a drop in blood pressure, the need for assistance in delivery with forceps or vacuum, as well as fetal distress, blood vessel trauma, and punctured Dura.
Infections, high fever, and backache were also common. This list is only a brief discussion about some of the problems associated with epidurals. Every woman who is considering having one should know all of the risks. The website located here is well-referenced, with many studies about epidurals listed in the footnotes. While the pain of labor is intense, and is obviously what has prompted the popularity of this procedure, it is still best to know as much as possible before accepting it. Also, while the risks of major problems are rather small, especially compared to other medical procedures, it is still best to make such a decision with both eyes open.
Similarly, an amniocentesis is a routinely administered procedure, where doctors may minimize the risks of the procedure when discussing the procedure with a possible candidate for it. Since many miscarriages occur in the second trimester, when this test is performed, it is very hard to accurately estimate the miscarriage risk. The accepted risk for miscarriage because of an amniocentesis is between 1 in 200 and 1 in 400.
To some, that may not seem a small number. This test, however, is the best way to test for a genetic abnormality. This test is performed in the second trimester to allow a woman the option of aborting the pregnancy if a genetic abnormality which will create a significant burden to the family is discovered. The burdens of having a genetically abnormal child include financial burdens, as well as social burdens with regard to when the child is in school, as well as in normal social situations with friends and family.
There are other risks of this procedure as well, including causing uterine infections, the needle coming into contact with the baby possibly causing damage, and causing the water to break (i.e. creating a leak in the amniotic fluid). This would cause labor to be induced prematurely, since the amniotic fluid is what keeps the baby alive and nourished in the womb. Click on the website names that follow for links to discussions of the risks and benefits of an amniocentesis at Babycenter and the American Pregnancy Association.
In the case that a baby will have a genetic abnormality, if the woman is not planning to have an abortion (whether for religious, moral, or other personal reasons), then the performance of the test is questionable. At the URL located here, the doctor speaks about the increasing risk of having a baby with Down’s syndrome for people who are older adults.
The benefits of this test are significantly mitigated if they lose the baby due to the test itself. And again, if they are not planning to abort the fetus, then the advantage of having the test may be quite small since there is nothing that can be done. Amniocentesis has very accurate results with regard to predicting Down’s syndrome. However, many women feel that a 1 in 200 potential risk for miscarriage from this procedure is too high and have chosen to not have one done.
There are hundreds of other reasons to become as informed as possible about pregnancy, especially with regard to your birthing choices. Whether to have your birth in a hospital, birthing center, or at home, are each choices that come with certain potential risks as well as certain potential outcomes. For example, if you choose to give birth in a hospital, you have a greater chance of having a cesarean section. Giving birth at home is nearly as safe as giving birth in a hospital or birthing center, according to recent research. An article at The Huffington Post, and another at the American Pregnancy Association go into greater details, and can be accessed by clicking on the website's name in the preceding sentence.
Home births are usually only allowed or normal pregnancies with low risk of complications. The disadvantage to a home birth is that there is no way to do a C-section if something goes wrong, and only a midwife would be willing to perform the delivery. This is probably the most important choice to make during your pregnancy, before the time of labor comes.
There are many other compelling reasons why every pregnant woman should be as informed as possible. With the evolution of smartphones and tablets, it is no longer even necessary to carry around a bunch of books to read about pregnancy and the birth experience. Kindles and e-readers, as well as other apps are available to read all about pregnancy right on your smartphone. Scientific studies and other information are available through social media sites and other apps. Every pregnant woman should learn about the procedures she will be having before undergoing them, and her birth partner should take an active role in learning to be better able to help her during the birth experience.
Such foreknowledge will make the pregnant woman feel more empowered and in control of her own pregnancy. Since much of pregnancy belongs to another (the fetus), having the most information can serve to make a woman feel that she is more of an active participant in the process, rather than just a vessel for the entrance of another being into this world. While it is certainly the case that the process is focused on the birth of a new person, it will help the pregnant woman to know that she, too, is an active participant in her own life and the creation of the life of another, since both lives will be forever changed by this experience.
While this is an excellent book, and every pregnant woman should obtain a copy, there are many other books, websites, scientific studies, and scholarly articles that one should research upon becoming pregnant. Since the evolution of the e-reading device, as well as magazines available on Google’s newsstand app for smart devices, it is not difficult to get most of the information you need right on your smartphone or tablet device, thus making it easier than ever to make informed decisions about your birth plan, your medical care, and the desired outcome of your labor.
Some of the decisions to make involve medications such as epidurals, whether you want a natural birth or C-section (this desire cannot always be honored, although it is best to know what each option entails beforehand), and whether you want a hospital birth, home birth, birthing center birth, or a water birth. Each of these decisions required careful research on the risks and benefits, the statistics regarding success rates, and possible side effects or harmful effects on you and the baby for each decision.
While pregnancy is a completely natural event, there have been advances in medical science that every woman should know about. There is also a lot of knowledge among the general public about certain advances and interventions, but some are not fully understood. There are procedures that bring with them a certain level of higher risk, but many women may not be aware of these risks.
For example, an epidural and an amniocentesis are both rather routine in this day and age. However, there are some women who would not want either of them if they were aware of the risks and possible damage that can occur to mother or fetus. In the case of an epidural, there is a 1 in 1,000 risk of temporary nerve damage, and a 1 in 13,000 risk of permanent nerve damage in the leg, foot, or stomach. This nerve damage can result in numb patches on these body parts. Permanent urinary incontinence can rarely result from this procedure as well.
The overall complication risk, including all complications both minor and major, is 23% This is according to the website listed in the next paragraph. The rate of caesarian section increases among women who have had epidurals, by 7 percentage points. Other complications have included a drop in blood pressure, the need for assistance in delivery with forceps or vacuum, as well as fetal distress, blood vessel trauma, and punctured Dura.
Infections, high fever, and backache were also common. This list is only a brief discussion about some of the problems associated with epidurals. Every woman who is considering having one should know all of the risks. The website located here is well-referenced, with many studies about epidurals listed in the footnotes. While the pain of labor is intense, and is obviously what has prompted the popularity of this procedure, it is still best to know as much as possible before accepting it. Also, while the risks of major problems are rather small, especially compared to other medical procedures, it is still best to make such a decision with both eyes open.
Similarly, an amniocentesis is a routinely administered procedure, where doctors may minimize the risks of the procedure when discussing the procedure with a possible candidate for it. Since many miscarriages occur in the second trimester, when this test is performed, it is very hard to accurately estimate the miscarriage risk. The accepted risk for miscarriage because of an amniocentesis is between 1 in 200 and 1 in 400.
To some, that may not seem a small number. This test, however, is the best way to test for a genetic abnormality. This test is performed in the second trimester to allow a woman the option of aborting the pregnancy if a genetic abnormality which will create a significant burden to the family is discovered. The burdens of having a genetically abnormal child include financial burdens, as well as social burdens with regard to when the child is in school, as well as in normal social situations with friends and family.
There are other risks of this procedure as well, including causing uterine infections, the needle coming into contact with the baby possibly causing damage, and causing the water to break (i.e. creating a leak in the amniotic fluid). This would cause labor to be induced prematurely, since the amniotic fluid is what keeps the baby alive and nourished in the womb. Click on the website names that follow for links to discussions of the risks and benefits of an amniocentesis at Babycenter and the American Pregnancy Association.
In the case that a baby will have a genetic abnormality, if the woman is not planning to have an abortion (whether for religious, moral, or other personal reasons), then the performance of the test is questionable. At the URL located here, the doctor speaks about the increasing risk of having a baby with Down’s syndrome for people who are older adults.
The benefits of this test are significantly mitigated if they lose the baby due to the test itself. And again, if they are not planning to abort the fetus, then the advantage of having the test may be quite small since there is nothing that can be done. Amniocentesis has very accurate results with regard to predicting Down’s syndrome. However, many women feel that a 1 in 200 potential risk for miscarriage from this procedure is too high and have chosen to not have one done.
There are hundreds of other reasons to become as informed as possible about pregnancy, especially with regard to your birthing choices. Whether to have your birth in a hospital, birthing center, or at home, are each choices that come with certain potential risks as well as certain potential outcomes. For example, if you choose to give birth in a hospital, you have a greater chance of having a cesarean section. Giving birth at home is nearly as safe as giving birth in a hospital or birthing center, according to recent research. An article at The Huffington Post, and another at the American Pregnancy Association go into greater details, and can be accessed by clicking on the website's name in the preceding sentence.
Home births are usually only allowed or normal pregnancies with low risk of complications. The disadvantage to a home birth is that there is no way to do a C-section if something goes wrong, and only a midwife would be willing to perform the delivery. This is probably the most important choice to make during your pregnancy, before the time of labor comes.
There are many other compelling reasons why every pregnant woman should be as informed as possible. With the evolution of smartphones and tablets, it is no longer even necessary to carry around a bunch of books to read about pregnancy and the birth experience. Kindles and e-readers, as well as other apps are available to read all about pregnancy right on your smartphone. Scientific studies and other information are available through social media sites and other apps. Every pregnant woman should learn about the procedures she will be having before undergoing them, and her birth partner should take an active role in learning to be better able to help her during the birth experience.
Such foreknowledge will make the pregnant woman feel more empowered and in control of her own pregnancy. Since much of pregnancy belongs to another (the fetus), having the most information can serve to make a woman feel that she is more of an active participant in the process, rather than just a vessel for the entrance of another being into this world. While it is certainly the case that the process is focused on the birth of a new person, it will help the pregnant woman to know that she, too, is an active participant in her own life and the creation of the life of another, since both lives will be forever changed by this experience.
Tuesday, July 8, 2014
Reducing Pain and Duration of Labor During Pregnancy: Acupressure Point
A study conducted in 2004 has some very interesting and useful information for pregnant women, as well as their caregivers. This study describes how a very simple technique, which can be applied by anyone, can reduce the pain of labor. More importantly, this technique was found to significantly reduce the time of the first stage of labor, between 3cm cervical dilation and full dilation.
While the duration of the second stage of labor did not differ significantly, the effect on the first stage of labor is clinically significant. Due to the pregnancy, there are fewer medications that can be prescribed to assist with the duration of the first stage of labor. Additionally, even medications that are deemed safe for pregnancy can have unpredictable consequences, as each person and each pregnancy can react differently. For this reason, non-pharmacological interventions (such as pre-natal massage and acupuncture) are always preferable to pharmacological ones.
I have spoken to a number of obstetricians and gynecologists, who have stated that the results of this study would be useful to them. With regard to actually performing this technique, it is simple enough to teach to the spouse or other loved one who is present, so that they can administer the technique during all of the stages of labor. Even though the first phase of labor is the only one that showed an effective shortening, this technique was still shown to reduce pain and lessen the need for pharmacological pain-killers. (A certified pre-natal massage therapist or certified acupuncturist can also demonstrate the technique to expectant parents sometime before labor)
The most popular and effective pain-killer used during labor is an epidural. However, pregnant women are not often advised that this method can actually prolong the second phase of labor, which is the pushing stage. Click here to view the study
There are also other effects that can occur from an epidural, including the risk of temporary or permanent nerve damage, many women need to have a catheter inserted in order to eliminate, and it can make you feel itchy, shivery, or fevered. Most importantly, epidurals increase the risk of your blood pressure falling, which can increase the risk for the baby needing assistance due to improper positioning for birth. Epidurals also wear off after a certain amount of time and require the services of a specialized doctor, known as an anesthetist. When the medication wears off, the anesthetist must be called again, and they may not be readily available. This is according to the website babycentre.co.uk - click here . A number of these risks may not be discussed with you by your doctor, so it is important to find out about your pain relieving options well before your labor starts.
Pregnant women and their care-givers can easily administer this technique to laboring women, and it is something that more midwives and obstetricians should be using. The SP6 acupressure point is located on the inner calf of the lower leg, four finger widths above this inner ankle, at the back border of the leg bone. A diagram or photograph could be provided to the spouse or caregiver providing the acupressure, and the acupressure is applied during each contraction for 30 seconds. Although this was the model used in the experiment, it is also possible that continued application of pressure to SP6 during labor would have a similar effect on the duration of labor and intensity of pain.
As a simple intervention that nearly anyone can apply, this acupressure massage technique can be useful for most pregnant women, whether in hospitals, birthing centers, or at home. Midwives and obstetricians may find the study useful in their own practices as well.
While the duration of the second stage of labor did not differ significantly, the effect on the first stage of labor is clinically significant. Due to the pregnancy, there are fewer medications that can be prescribed to assist with the duration of the first stage of labor. Additionally, even medications that are deemed safe for pregnancy can have unpredictable consequences, as each person and each pregnancy can react differently. For this reason, non-pharmacological interventions (such as pre-natal massage and acupuncture) are always preferable to pharmacological ones.
I have spoken to a number of obstetricians and gynecologists, who have stated that the results of this study would be useful to them. With regard to actually performing this technique, it is simple enough to teach to the spouse or other loved one who is present, so that they can administer the technique during all of the stages of labor. Even though the first phase of labor is the only one that showed an effective shortening, this technique was still shown to reduce pain and lessen the need for pharmacological pain-killers. (A certified pre-natal massage therapist or certified acupuncturist can also demonstrate the technique to expectant parents sometime before labor)
The most popular and effective pain-killer used during labor is an epidural. However, pregnant women are not often advised that this method can actually prolong the second phase of labor, which is the pushing stage. Click here to view the study
There are also other effects that can occur from an epidural, including the risk of temporary or permanent nerve damage, many women need to have a catheter inserted in order to eliminate, and it can make you feel itchy, shivery, or fevered. Most importantly, epidurals increase the risk of your blood pressure falling, which can increase the risk for the baby needing assistance due to improper positioning for birth. Epidurals also wear off after a certain amount of time and require the services of a specialized doctor, known as an anesthetist. When the medication wears off, the anesthetist must be called again, and they may not be readily available. This is according to the website babycentre.co.uk - click here . A number of these risks may not be discussed with you by your doctor, so it is important to find out about your pain relieving options well before your labor starts.
Pregnant women and their care-givers can easily administer this technique to laboring women, and it is something that more midwives and obstetricians should be using. The SP6 acupressure point is located on the inner calf of the lower leg, four finger widths above this inner ankle, at the back border of the leg bone. A diagram or photograph could be provided to the spouse or caregiver providing the acupressure, and the acupressure is applied during each contraction for 30 seconds. Although this was the model used in the experiment, it is also possible that continued application of pressure to SP6 during labor would have a similar effect on the duration of labor and intensity of pain.
As a simple intervention that nearly anyone can apply, this acupressure massage technique can be useful for most pregnant women, whether in hospitals, birthing centers, or at home. Midwives and obstetricians may find the study useful in their own practices as well.
Thursday, May 22, 2014
Tactile Massage During Pregnancy To Ease Symptoms of Morning Sickness
A study conducted by Annelle Agren and Marie Berg, which can be viewed by clicking here, both registered nurses, in a clinical setting, found that there were positive benefits received by women who had tactile massage during their pregnancy. The women were suffering from nausea, vomiting, and other morning sickness symptoms. The morning sickness symptoms were severe enough to be classified as a condition in themselves, called Severe Nausea and Vomiting During Pregnancy (SSNVP).
The study was conducted on women who were suffering from SNVP, who had come to feel that the condition was ruling their life. The study findings were in the form of a post-treatment interview, and the results were subjective. The results of this study indicated that tactile massage is a useful therapy for women experiencing morning sickness. As a non-pharmacological alternative, it helped the women feel more in touch with their bodies, as well as more relaxed and less enslaved to the nausea they had been experiencing.
The results of this study are very encouraging, considering that many women do not necessarily want a pharmacologic alternative because of their pregnancy. Pregnancy is a time of caution always, as the fetus is in a delicate state during the first trimester, when most women experience morning sickness. Many alternative treatments that have given good results for this condition would be welcomed for women suffering from SNVP.
Certified pre-natal massage therapists could be called upon in the medical setting to provide this type of massage to women suffering from SNVP, with good results. The knowledge of this study would likely be very useful to both obstetricians and midwives, to assist them with patients suffering from this condition. In short, massage therapy could easily be recommended and integrated into the alternative health care practices of women with SNVP to help alleviate some of their suffering.
The study was conducted on women who were suffering from SNVP, who had come to feel that the condition was ruling their life. The study findings were in the form of a post-treatment interview, and the results were subjective. The results of this study indicated that tactile massage is a useful therapy for women experiencing morning sickness. As a non-pharmacological alternative, it helped the women feel more in touch with their bodies, as well as more relaxed and less enslaved to the nausea they had been experiencing.
The results of this study are very encouraging, considering that many women do not necessarily want a pharmacologic alternative because of their pregnancy. Pregnancy is a time of caution always, as the fetus is in a delicate state during the first trimester, when most women experience morning sickness. Many alternative treatments that have given good results for this condition would be welcomed for women suffering from SNVP.
Certified pre-natal massage therapists could be called upon in the medical setting to provide this type of massage to women suffering from SNVP, with good results. The knowledge of this study would likely be very useful to both obstetricians and midwives, to assist them with patients suffering from this condition. In short, massage therapy could easily be recommended and integrated into the alternative health care practices of women with SNVP to help alleviate some of their suffering.
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