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Author Archives: Rebecca

Placenta Encapsulation and Newborn GBS Case Study: Response

On June 29, 2017, the CDC published an article about a case study in Oregon describing a situation wherein a newborn of a woman that had her placenta encapsulated, developed early and late-onset Group B Strep infection. You can read the original article here. The newborn developed early-onset GBS sepsis shortly after birth (before the mother started taking her placenta pills) and was treated for 11 days and then sent home. Several days later the baby was brought to another hospital with symptoms of irritability and later diagnosed with late-onset GBS sepsis. You can read about the difference between early vs late-onset GBS sepsis here. Early-onset sepsis is contracted during the birth process and develops within the first few days. Late-onset can be transmitted during the birth process but also through physical contact by nursing staff, doctors, family members, friends, etc., and develops after the first week.

In this case study, the article’s conclusion, regardless of the fact that baby was already diagnosed with early-onset sepsis and treated, is the late-onset GBS sepsis was contracted secondary to her placenta pills that were tested and confirmed to have been contaminated with GBS.  However, it states that transmission via physical contact with others could not be ruled out. “Although transmission from other colonized household members could not be ruled out, the final diagnosis was late-onset GBS disease attributable to high maternal colonization secondary to consumption of GBS-infected placental tissue.” The mother’s breastmilk was tested and no GBS was found, so ingestion of the pills by the mother could not be the cause of transmission to baby. It is concluded that handling of the contaminated pills increased colonization on the mother and therefore transferred to baby. “Consumption of contaminated placenta capsules might have elevated maternal GBS intestinal and skin colonization, facilitating transfer to the infant.”

The article explains that the company that processed the placenta dehydrates at temperatures ranging from 115-160 degrees F, which is a very wide range and so it is unclear how this specific placenta was processed. According to the CDC article, placental tissue needs to be dehydrated with at least 130 degrees F for 121 mins to reduce bacteria.

Unknown factors in this case study

  • How the placenta was handled/processed, and the sanitation protocol of the equipment by the encapsulation company
  • Could someone else have transmitted GBS to the baby such as a family member, friend, nurse, etc.
  • Could the late-onset sepsis be a recurrence of the original infection that wasn’t completely resolved after treatment
  • Could the mother unknowingly have contaminated the pills herself after bringing them home because she herself was still highly colonized. We know that she had previously been colonized to have transmitted it to baby initially during the birthing process because the baby already had early-onset GBS sepsis

Keep in mind, this is just ONE case study, it is unknown how the placenta pills became contaminated, or how the GBS was transmitted to baby the second time, but we do know that safety protocols, proper sanitation, and eligibility requirements in the encapsulation process is paramount.

My Standards:

  • See my sanitation protocol here
  • I give specific and detailed instructions on how to handle/store placenta after birth until I can pick up, as well as instructions for after you receive your pills. See my instructions/responsibilities of client here
  • I instruct clients they must inform me of any symptoms of infection or diagnosis, during or after birth
  • I dehydrate every placenta at 155-165 degrees F for at least 24 hours and up to 48 hours to ensure complete dehydration
  • I also offer a steaming method of encapsulation before dehydrating, should a client choose this, which is known to be even more effective (aside from proper sanitation/handling and dehydrating at 155-165 degrees F) at killing bacteria, see article here

I am always happy to answer any questions about my process. I pride myself on safe practices and I want my clients to be comfortable and confident with your decision to hire me for placenta services. The safety and health of my clients are top priority.

 

Written by Rebecca Burkett

June 30,2017

Posted in After Birth, General, Placenta Encapsulation.

Getting Past the Ick Factor: Placenta Encapsulation for the Every-Woman

Lions do it. Bears do it. Even some Kardashians do it. Placenta encapsulation has generated much hype in recent years and celebrities, mommy bloggers, and maybe even some of your friends have touted the benefits of placental consumption left and right: energy producer! mood booster! milk supply enhancer! You might be thinking, “could there really be a magic pill to address all difficulties of new motherhood?” Or perhaps you’re caught up on the contents of the little brown pill, asking, “is it safe?” or, “can I really stomach it? It grew IN my body!” Fear not, every-woman. I’m here to tell you that you don’t have to be a wild animal, nor a millionairess to consume your placenta. I’m here to give you some tools to get past the ick factor.

Placenta Encapsulation

If in the end you think it’s right for you, (this is YOUR choice, after all!), or if you find you have more questions, give me a call. We might all be mammals, but I want you to have the information you need before deciding to take this primal step.

Here are some tools to get you started:

1. Understand that placenta encapsulation is not regulated, but it CAN be safe! Ask your encapsulator (yes, metoo!) what their sanitation protocol involves. I make sure mine is public because I want to be transparent with my clients and I want them to have all the information they need. Without mandated regulations (and I would argue, even with!), you must take responsibility for your own peace of mind when consuming products – internally or otherwise. Feel free to view my sanitation protocol here.

If it’s important to you to feel safe with my services (beyond just reading about them), or to feel safe with my character (beyond what you can find in my bio), perhaps it’s best we meet inperson or talk on the phone about how, exactly, I will treat your placenta. I promise that it will always be safe and sanitary, but if you have concerns, let me meet you where you’re at.

Regardless of who you choose to encapsulate your placenta, make sure you ask questions and make sure your questions are answered! Some of my frequently asked questions include:

• When will you pick up my placenta?
• How do I need to store it before you arrive?
• What if there is meconium staining on the placenta?
• What if I test positive for Group B Strep?
• How do I talk to the hospital about having you take my placenta?
• Where do you encapsulate my placenta?
• How long will it take?
• What is the recommended dosage?
• How should I store my capsules?

Feel free to visit my FAQ page for answers to these questions and more, or email, text, or call me for more information.

2. Take heart: you can outsource the “gross” part. Look, I’m a self-described placenta nerd. I’d love to show you all the parts of the magnificent, you-grown organ that sustained your child’s life inside the womb. I understand that isn’t for everyone. It kind of looks like blood-soaked beef covered in membranes. No part of that sounds beautiful or appetizing. The great part is, you don’t have to deal with the raw materials because I will do it for you!

By the time your placenta gets back to you, it’ll be in the form of 80-300 brown little pills that look like multivitamins, stored in an amber glass bottle. Your capsules may smell a little earthy and they may taste slightly of blood-rich meat, but if you take and swallow the capsules quickly without letting them sit in your mouth, you probably won’t be bothered by the taste. Take them with juice or flavored water to mask the metallic taste even more. It goes without saying that sometimes what’s good for us isn’t entirely appetizing. Think fish oil, or green vegetables for kids.

If you absolutely cannot get over the thought of consuming your own body’s material, let’s talk. Maybe a healing salve infused with placenta is right for you, maybe you can have the capsules prepared and decide later if you want to take them, or maybe you could just bury your placenta and plant a tree with it. There are several ways you can give yourself this gift and I’m here to help you find which way is best for you.

3. Do your research and do so creatively. I’ll be frank: you won’t find much in the way of academic research on the benefits/hazards of placenta encapsulation. And if it’s important to you to have the AMA’s stamp of approval on placental consumption, maybe my services aren’t right for you. Though mammals and humans have been consuming their placentas for millennia, and though more modern women are choosing to consume these precious organs, the medical and academic communities haven’t quite been able to get past the ick either and they don’t want to spend much money on the research, and thus we lack studies that show hard evidence of the benefits of placental consumption.

This doesn’t mean you can’t make an informed decision. Become the investigator. Uncover the answer yourself. To date, most of what you will find regarding the benefits of placental consumption is anecdotal — so use it! Ask your friends or friends of friends what their experience was like. Ask them how taking placenta capsules made them feel, if they experienced negative side-effects, if it tasted super gross, if their encapsulator seemed informed, if they experienced some or all of the touted benefits, and if they would do it again! If you’re nervous, start by reading my testimonials. And if you’re struggling to find someone in your own circle who has consumed their placenta, let me know. I might be able to put you in contact with a few women who have.

Following are some commonly held beliefs about the benefits of placental consumption. Feel free to test these against the anecdotes you gather:

• Balances hormones
• Increases energy
• Increases and enriches milk supply
• Decreases postpartum bleeding
• Helps increase iron levels
• Helps with sleeping problems
• Helps tone your uterus back to normal size

The placenta is rich in nutrients and filled with natural hormones you quickly lose after childbirth. Ingesting the placenta helps balance that immediate loss and allows your body to slowly adapt to such a change. Read more about the “ingredients” that give the placenta its healing properties here.

4. Prepare to tell your family. Or not. If you have a partner on your parenting journey, you’ll probably discuss your placenta encapsulation decision with them. And if you’re super close with some relatives, it may seem natural to tell them too. Be prepared for backlash. Our parents grew up and grew us in a time of hyper-sterilization, and the decision to consume your placenta may seem ridiculously new-age to your loved ones. Remember, this is your decision to make and if negativity from others will do nothing but put stress on you as a new mom, you don’t have to tell!

The benefits may be so great for you that you want to shout it to the world! If you’re anything like me, you’ll even bring it up at the dinner table (warning: not for the faint of heart). If that’s the case, and I hope it is, be sure to go prepared. Bring with you the anecdotes you’ve gathered and the research you’ve done. Let them know you were once wary, too, and show them why you changed your mind.

5. Remember that placenta pills are not a cure-all. Many of my clients endearingly refer to their placenta capsules as “mama’s happy pills.” I love hearing this! I believe in the benefits of placenta capsules because I’ve seen them work. But a note of caution: though the nutrients and hormones in your placenta may help stave off the baby blues and though the pills may help establish and enrich your milk supply, your pills are not a cure-all!

Before you have your baby, make a postpartum plan. That you’re reading this blog is an indication you already are! But beyond answering the questions, “what will I do with my placenta,” and “can I really consume that?” be sure to set up your support network. Think about who will help you initiate breastfeeding. Arrange for childcare if you have younger children. Fill your freezer with ready-to-go meals. When allowing visitors over (everyone loves a new baby!) kindly ask if they can complete a chore for you or throw a meal in the oven. Your job is to love and feed and nurture yourself and the new life you’ve birthed. Don’t play host. Let others care for you in the way you want to be cared for. Make specific asks. What do YOU need to mother the way that you envision? I’d be so happy if placenta encapsulation is part of that vision for you, but remember that other acts of self-care are just as important.

Placenta encapsulation is for the every-woman because every woman is a mammal. But we have the unique ability as humans to choose which primal behaviors to allow and which seem icky and animalistic. If you think you can move past the ick factor, or if you need further information to be convinced, call me, read through my website, email me or text. Allow me to meet you where you are.

 

By: Rebecca Burkett, Originally posted on Gold Coast Doula‘s Blog

Posted in After Birth, Natural Remedies, Placenta Encapsulation.

Research Checklist Ideas for Pregnancy, Labor, Birth and the Postpartum Period

Looking for ideas on things to know about pregnancy, labor, birth and the postpartum period but don’t really know where to start? Here is a great research checklist to give you a starting point for the things you should research for your pregnancy, labor, birth and postpartum care. Just click on the link below:

Research Checklist

 

Research Checklist

Posted in After Birth, Home Birth, Hospital Birth, Labor, Pregnancy.

22 Questions to ask while touring the maternity ward

Here are some questions to ask while touring the maternity ward:

1. What is the Cesarean Rate?
2. What is the Episiotomy Rate?
3. Do you have time limits on how long I can labor before intervention is suggested?
4. Do you automatically administer pitocin after birth? What if I don’t want it?
5. What birthing tools do you provide or allow? (birthing balls, birth stool, shower, tub, birth bars, etc.
6. What is the procedure for IVs when admitted? (Automatically start heplock vs wait until needed)
7. Do you allow women to eat and drink during labor?
8. What is your policy on cord clamping? If I want to delay, will you respect my wishes?
9. Do you allow immediate skin-to-skin before you do your routine checks on baby?
10. What does your routine checks of baby consist of?
11. Do you provide breastfeeding support? Is there a lactation consultant on staff?
12. How many visitors can I have at one time after birth?
13. How many people can I have in the room during the birth?
14. Do you allow women to move around the room freely during labor to help relieve pain?
15. Do you allow different positions for birth other than on my back in the bed? ( Standing up, hands and knees, squatting, etc)
16. Can my baby stay in the room with me at all times?
17. What are your policies on fetal monitoring? (intermittent or continuous) If continuous, is it wireless so I can still move around during labor?
18. What are the maternal and infant mortality rates?
19. If I need a C-Section, can my partner be in the room?
20. If I have a C-Section, do you allow immediate skin-to-skin?
21. Do you have students or residents? If so, how involved are they/could they be in my birth experience? What procedures do you allow them to do?
22. How often do you do vaginal exams?

Posted in General, Hospital Birth, Labor, Pregnancy.

My reflections on reading Born in the USA by Mardsen Wagner

Reading Born in the USA by Mardsen Wagner was very overwhelming and I was surprised by most of his points including the fact that the American Congress of Obstetricians and Gynecologists (ACOG) is not regulated or given responsibility to set the standards it does, the fact that off-label and against-label drug use by doctors is tolerated, why the US does not have regulations or required standards on recording and investigating maternal mortality, and the fact that doctors are surprised and complain about the “litigation crisis” while continuing to put into practice the things that result in litigation.

I have heard of ACOG several times before reading Born in the USA. It has been mentioned in other books and articles I have read as well as brought up in conversations when talking about home birth and specifically water birth. I was under the impression that ACOG was a very important organization that had the responsibility of setting standards for care providers. Much to my surprise, thanks to this book, I know the truth about ACOG. While they are a very important group (to doctors) no government agency has given them the responsibility and right to see such standards and have care providers be reprimanded if they practice against these standards and statements. How did they get so much power? I know there are several care providers out there that don’t agree with the way ACOG does things but they fear speaking out because they do have so much power and fear it would have negative effects on their careers. We need more people like Wagner to speak out with confidence against ACOG in order to overcome this organization that claims to care about the health of our country.

The tolerance of off-label and against-label drug use by doctors such as using Cytotec to induce labor, absolutely blows my mind! How is this even legal? Wagner mentions several studies that have been done that suggest Cytotec is not safe to use for labor induction and it says right on the bottle that this drug should NOT be used on pregnant women. Doctors have been using this drug for years against label and there have been so many cases with negative outcomes, and yet they continue with this practice. We need to make this illegal! I work in real estate doing appraisals for bank loans and for realtors when a house goes up for sale. I was discussing with my boyfriend the other day how ridiculously regulated the real estate market is compared to our health care system, specifically our maternal health care system. There are so many rules, standards, and regulations on how to put together an appraisal on a house and to make sure your appraisal is not misleading and contains 100% accurate information, but yet our doctors and nurses have a very relaxed system and very little accountability.  It’s insane to me that more effort is put into making sure a house sale is legit and fair but yet obstetricians don’t have to or are not being reprimanded for not ensuring women are making informed choices about their health and are giving them drugs without their knowledge that are known to be dangerous and cause adverse effects.

The frustration about the use of Cytotec and the fact that doctors are giving women drugs without informed consent, including Pitocin among others, brings me to my awe that doctors are surprised with this “litigation crisis” and the raises in cost for malpractice insurance. Litigation isn’t just from the use of drugs but from all of the interventions that women feel they have no control over whether it be the doctors and nursing staff don’t tell the woman what they are doing or they impose an intervention on them against their will or without true informed consent. To this day, these care providers are still allowing and suing these practices. They blame their patients for having such high malpractice insurance and need to use some intervention to avoid litigation but it’s those very interventions that the care providers are getting sued for using. If care providers took the time to create a trusting relationship with their patients (clients) and truly gave them informed consent, their patients would not be taking them to court, or at least much less often. They need to allow for better communication and explain all of the benefits and risks of every option, and when there is a negative outcome, they need to be accountable to it and keep open communication with the families about what the possible cause was instead of making it so hard for them to figure out what happened.

When a poor outcome does arise and a mother dies, which sometimes you just can’t avoid, what are the chances that it would accurately reported or recorded at all? According to Ina May Gaskin, the CDC has admitted that maternal deaths are severely underreported. I do not understand why making sure maternal deaths are investigate and accurately reported is not a priority. We have one of the worst maternal mortality rates in the industrialized world and there seems to be no real effort in changing that, at least not from the medical model of care standpoint. They just keep focusing on how the latest technology should prevent negative outcomes but continue to be blind to the fact that using those technologies and continuing to intervene in one of the most natural processes of life, is actually what is causing those outcomes and insane mortality rates. We know that these rates can be much better by just looking at other countries and researching their systems. It makes me so sad that women and families are not respected enough to be worthy of investigation if they die during the childbearing cycle but yet the justice system can spend weeks, months, or even years on other death related events such as murders or even accidental deaths while on the job. Without these deserving investigations on maternal mortality, that should be a no brainer, the maternal health care system will be extremely difficult to improve because we won’t have the data to show where exactly needs improving and how we can make change. Putting in place regulations on reporting and investigation maternal death should be at the top of our health care system’s priority list.

It is ever so clear the need for change in our maternal health care system. Midwives are definitely a necessity in bring about the right change but without concern and dedication from other care providers such as OB/GYNs, the change will be very difficult. We won’t give up though. The need for midwives is growing and the number of midwives is growing. The health care system will be forced to work with us and they will eventually come to realize the need for change. Midwives can and do change the world!

Posted in General, Home Birth, Hospital Birth.

Safety of Home Birth and Midwives Model of Care

Home birth, is it safe? This is the million dollar question. The topic of home birth has been quite popular in the recent years and more specifically about whether home birth is safe for mothers and their babies. Less than 1% of mothers are choosing to deliver at home in the United States (Cheyney et al., 2014). It wasn’t too long ago that the majority of births took place at home, until the 1940s when it fell to 44%. (MacDorman, Mathews & Declercq, 2012). Birth became medicalized and it was the norm to give birth in a hospital. Between 2004 and 2009, however, the rate of home birth increased by 29% (MacDorman et al., 2012), and is most likely still on the rise. This significant increase has created more attention to the safety issue of midwifery care and home birth. The Midwives Model of Care, trademarked by Citizens for Midwifery, provides a great backbone when discussing how and why home birth is safe when attended by a qualified midwife because it is based on the certitude that pregnancy and birth is one of the most natural processes of life.

Midwives believe it is very important to monitor women’s physical, psychological, and social well-being during the childbearing cycle, and are very thorough in doing so. This is the first tenet of the Midwives Model of Care. Midwives pay close attention to a woman as a whole and know that several factors contribute to their overall health and wellness. During prenatal care as well as postpartum care, midwives spend anywhere from a half hour to an hour and a half discussing things that contribute to the health of their clients, from diet and exercise, to mental contributors such as stress and fears, and so much more. These long visits allow midwives to really know the health of their clients and discuss their options for better health if needed. Because their prenatal care is so thorough, this allows midwives to constantly be screening to make sure their clients are low-risk and good candidates for home birth, and they respond appropriately when things may fall out of normal range. Not only do they monitor the well-being of mother and baby during the prenatal period, they continue to monitor during labor, birth and the postpartum period. According to the North American Registry of Midwives (NARM) Certified Professional Midwives (CPMs) must be certified in CPR and neonatal resuscitation, have extensive training in natural pregnancy and birth, are educated on monitoring and decision making using Evidence-Based practices and insuring informed consent from their clients, and must take continuing education credits to recertify every 3 years (NARM, 2014). CPMs are qualified to insure that women are safe to deliver at home.

The second tenet of the Midwives Model of Care describes how midwives provide individualized care to every woman. This is so important in discussing the safety of home birth. Every woman is different and what one woman may need to have a safe delivery at home may not necessarily by something another woman needs. CPMs providing care determine baseline and normal health ranges for each client and when things fall out of normal range for that specific client, options are discussed between midwife and client and the client decides what option is best suited for their safety and their needs. “The focus stays on the birthing woman, it is her unique needs and rhythms that will be paramount in the unfolding of her birth” (Davis-Floyd, 2001, p. 14). Home birth midwives also provide continuous support throughout labor and delivery. Studies show that continuous support during childbirth result in better outcomes for mother with less medical interventions and more satisfaction for her birth experience (Hodnett, Gates, Hofmeyr, Sakala & Weston, 2013). Another very important aspect of home birth with qualified midwives is the quality of postpartum care and support. Evidence suggests that during the postpartum period, several stressors can arise that increase the risk of physical and mental illness (Fahey & Shenassa, 2013). Because of this increased risk during the postpartum period, midwives find it very important to provide extensive support and include in their services several visits between birth and at least 6 weeks postpartum to avoid and catch any issues that may arise. The support provided by midwives during the postpartum period contributes to women’s psychological well-being (Lavender & Walkinshaw, 1998).

Minimalizing medical and technological interventions is the third tenet of the Midwives Model of Care and is a main factor in insuring the safety of home birth when attended by a qualified midwife. Obstetric interventions have the potential to increase adverse effects, so low intervention rates are very important implications of good, quality care (A de Jonge et al., 2009). According to a study done by Kenneth Johnson and Betty-Anne Daviss on all home births in 2000 with Certified Professional Midwives in the United States and Canada, intended home births resulted in lower rates of intervention including electronic fetal monitoring, cesarean section, episiotomy, and vacuum extraction, when compared to low risk hospital births (2005). In a study done by Cheyney et al. on 16,924 planned home births in the United States between 2004 and 2009, the majority of women and newborns experienced very low rates of intervention with exemplary outcomes (2014). There were very low rates of oxytocin augmentation, epidural analgesia, operative vaginal birth, and cesarean section when compared to hospital births (Cheyney et al., 2014). The risks of all maternal adverse outcomes including perineal tears, postpartum hemorrhage, and infection were significantly lower in women who planned to have a home birth attended by a registered midwife in Canada compared to a physician attended hospital birth (Janssen et al., 2009). Not only is home birth safe for mothers, but it also supports favorable outcomes for newborns as well. Newborns of planned home birth resulted in low or similar risk of fetal and neonatal morbidity compared with hospital births (Janssen et al., 2009).

When a situation does fall outside of normal range for a specific client, qualified midwives are trained to recognize this and will refer women who require obstetrical intervention when needed, whether it be during prenatal care, labor, birth, or the postpartum period. This is the fourth tenet of the Midwives Model of Care. The availability of the hospital and its technologies is very important when it is needed, but most of the time, birth is a normal physiological process that works perfectly on its own. When a situation presents itself with red flags that something is just not right, midwives will discuss the options with their clients and they will choose what they want to do based on all of the information needed to make an informed decision. Sometimes going to the hospital is necessary, and because midwives are trained and experienced in the normalcy of birth, they know when that time comes. Of 16,924 women who planned a home birth, only 10.9% transferred to the hospital intrapartum with the most common reason being failure to progress (Cheyney et al., 2014). Only 1.7% of women who gave birth at home transferred postpartum and the most common reason were related to hemorrhage and/or retained placenta and laceration repair (Cheyney et al., 2014). Only 149 of the 15,134 newborns born at home transferred to the hospital most commonly for respiratory distress and/or low APGAR scores and congenital anomalies (Cheyney et al., 2014). CPMs are trained to deal with all of these outcomes and they carry with them to every birth the necessary equipment to do so, making home birth safe for women and babies even when adverse outcomes may arise. In the study by Johnson and Daviss done on all women who intended to have home births with Certified Profession Midwives in the United States and Canada, only 3.4% of the home births were considered urgent transfers by the midwife (2005).

In a sample of 160 women who completed an online survey about their home birth, the most common response for why they wanted a home birth was because they felt it was the safest place for them to give birth (Boucher, Bennett, McFarlin & Freeze, 2009). Several studies are out there that suggest the safety of home birth. Home birth with a qualified midwife can be very beneficial for women and babies because of the expertise and the quality of care that midwives provide. Home birth is becoming more popular because women are getting more educated about birth and evidence-based practices. Ultimately, the choice is up to the women where they want to give birth and whom they want their care provider to be. Home birth with a midwife is definitely a safe option.

 

 

References

Boucher, D., Bennett, C., McFarlin, B., & Freeze, R. (2009). Staying Home to Give Birth: Why Women in the United States Choose Home Birth. The Journal of Midwifery & Women’s Health, 54(2), 119–126. doi:10.1016/j.jmwh.2008.09.006

Cheyney, M., Bovbjerg, M., Everson, C., Gordon, W., Hannibal, D., & Vedam, S. (2014). Outcomes of Care for 16,924 Planned Home Births in the United States: The Midwives Alliance of North America Statistics Project, 2004 to 2009. Journal of Midwifery & Women’s Health, 59(1), 17–27. doi:10.1111/jmwh.12172

Davis-Floyd, R. (2001). The Technocratic, Humanistic, and Holistic Paradigms of Childbirth. International Journal of Gynecology and Obstetrics, 75(1), S5–S23.

De Jonge, A., van der Goes, B. Y., Ravelli, A. C. J., Amelink-Verburg, M. P., Mol, B. W., Nijhuis, J. G., … Buitendijk, S. E. (2009). Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births. BJOG: An International Journal of Obstetrics & Gynaecology, 116(9), 1177–1184. doi:10.1111/j.1471-0528.2009.02175.x

Ed, H., Gates, S., Gj, H., & Sakala, C. (2013). Continuous support for women during childbirth (Review). The Cochrane Library, (7).

Fahey, J. O., & Shenassa, E. (2013). Understanding and Meeting the Needs of Women in the Postpartum Period: The Perinatal Maternal Health Promotion Model. Journal of Midwifery & Women’s Health, 58(6), 613–621. doi:10.1111/jmwh.12139

Janssen, P. a, Saxell, L., Page, L. a, Klein, M. C., Liston, R. M., & Lee, S. K. (2009). Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician. CMAJ : Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 181(6-7), 377–83. doi:10.1503/cmaj.081869

Johnson, K. C., & Daviss, B. (2005). Outcomes of planned home births with certified professional midwives: large prospective study in North America. BMJ (Clinical Research Ed.), 330(7505), 1416. doi:10.1136/bmj.330.7505.1416

Lavender, T., Walkinshaw, S. A., (1998). Can Midwives Reduce Postpartum Psychological Morbidity? A Randomized Trial. Birth, 25(4), 215–219. doi:10.1046/j.1523-536X.1998.00215.x

 

MacDorman, M. F., Mathews, T. J., Declercq, E. Home Birth in the United States, 1990-2009. NCHS Data Brief, 84. Hyattsville, MD: National Center for Health Statistics. 2012.

North American Registry of Midwives. (2014).

Posted in Home Birth.

Delayed Cord Clamping

Immediate or early cord clamping after birth is considered a common practice in today’s obstetric care. I question these practices because studies have shown delayed cord clamping can be of benefit for newborns. Delayed cord clamping can allow between twenty and fifty percent of the baby’s blood volume to return from the placenta after birth (Enkin et al., 2000). A study published in the Cochrane Pregnancy and Childbirth Group found that early cord clamping compared to late cord clamping resulted in no significant difference in postpartum hemorrhage of the mother and that babies with delayed cord clamping had a higher birth weight, higher hemoglobin levels, and had a decreased risk of anemia later in life (McDonald, Middleton, Dowswell, & Morris, 2013). Another obvious benefit of delayed cord clamping is that because the baby is still attached to the mother, through the cord to the placenta, before the end of the third stage, it allows immediate and longer skin-to-skin contact just after birth if the baby is placed on the mother. Granted, there may be an emergency requiring an immediate cutting of the cord so the newborn can be attended to, based on the evidence, in a normal, safe, non-emergency birth, I believe delayed cord clamping is in the best interest of the baby and mother.

 

 

References

Enkin, M., Keirse, M. J. N. C., Neilson, J., Crowther, C., Duley, L., Hodnett, E., & Hofmeyr, J. (2000). The Third Stage of Labor. In A guide to effective care in pregnancy and childbirth (Third., pp. 300–309). Oxford: Oxford University Press.

McDonald, S. J., Middleton, P., Dowswell, T., & Morris, P. S. (2013). Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes. The Cochrane Database of Systematic Reviews, 7, CD004074. doi:10.1002/14651858.CD004074.pub3

Paddock, C. (2013). Delayed Cord Clamping After Birth Better for Baby’s Health. Retrieved from www.medicalnewstoday.com/articles/263181.php

Posted in After Birth.

Essential Oils Safe for Pregnancy

essential oils safe for pregnancyThere is a lot of wonder and questions about essential oils safe for pregnancy and unsafe to use during pregnancy. Below is a list of essential oils specific to doTERRA essential oils and their blends.

Essential Oils Safe for Pregnancy

Single Oils: Bergamot, Cilantro, Coriander, Eucalyptus, Frankincense, Geranium, Ginger, Grapefruit, Hawaiian Sandalwood, Helichrysum, Juniper Berry, Lavender, Lemon, Lemongrass, Lime, Melaleuca, Melissa, Patchouli, Roman Chamomile, Rose, Sandalwood, White Fir, Wild Orange, Ylang Ylang

Oil Blends: AromaTouch, Balance, Breath, Citrus Bliss, Deep Blue, Elevation, In Tune, Purify, Serenity, TerraShield, Whisper

 

Essential Oils to be Used With Extreme Caution and Heavy Dilution

Single Oils: Black Pepper, Cedarwood, Clary Sage, Clove, Cypress, Fennel, Marjoram, Myrrh, Oregano, Peppermint, Vetiver

Oil Blends: ClaryCalm, Clear Skin Topical, DDR Prime, DigestZen, Immortelle, OnGuard, PastTense, Slim & Sassy, Zendocine

 

Essential Oils to Avoid During Pregnancy

Single Oils: Basil, Birch, Cassia, Cinnamon, Rosemary, Thyme, Wintergreen

 

Resources: Modern Essential Fifth Edition

 

 

 

Posted in Pregnancy.

What is a Doula?

doula baby

 

 

Definition: a woman who is trained to assist another woman during childbirth and who may provide support to the family after the baby is born.

The word “doula” comes from the Greek meaning “a woman who serves”.

Studies show that in doula attended births:

*Labors are shorter

*Babies are healthier

*There are fewer complications

*Breastfeeding is more successful

*Spontaneous vaginal birth is more likely

*Less likely to need or ask for pain medications

*Less likely to have a Cesarean Section, vacuum or forceps-assisted birth

 

There are 2 different types of Doulas: Birth Doula and Postpartum Doula

Birth Doulas – Offer education and assist women in planning and carrying out their birth plans and expectations. They stay with the women throughout labor and offer emotional support, help with physical discomforts, creats an open line of communications between the women, her partner, and her care provider.

Postpartum Doulas – Offer education and support on things related to after birth such as breastfeeding, physical and emotional recovery, newborn care, bonding, light housekeeping and meal preparation. Research shows that families transition much easier with a good support team including a doula.

 

DOULA DO’S AND DONT’S

Do’s:

*Prepare and educate women and families for birth

*Help create a birth plan that includes expectations, wants and needs, and things you are uncomfortable with

*They help create a safe space allowing comfort, open communications between families and care providers, and emotional support

*They are advocates for mothers and partners during labor and childbirth

 

Dont’s:

*They are NOT medical professionals and therefore do NOT offer or perform any medical services such as exams, fetal heart monitoring, medical diagnosis, deliver babies, etc.

*They do NOT judge you or decisions you make

 

How much does a Doula cost?

Fees can be anywhere from $400-$1000 depending on the individual doula and the services she provides.

 

 

RESOURCES

http://www.dona.org/mothers/

http://americanpregnancy.org/planningandpreparing/postpartumdoula.html

http://www.mindbodygreen.com/0-11595/what-is-a-doula-and-why-you-should-have-one-during-after-birth.html

http://ssbdoula.weebly.com/birth-services.html

http://evidencebasedbirth.com/the-evidence-for-doulas/

 

 

Posted in After Birth, Home Birth, Hospital Birth, Labor, VBAC, Water Birth. Tagged with , , , , , , , , , , .

8 Common Hospital Interventions You CAN Avoid

 

Doctor and Patient

There are several common hospital interventions that ARE avoidable. Contrary to common belief, the hospital staff doesn’t always have your best interest at heart, and they are not always right. I have no problem admitting that hospitals can save lives when an emergency occurs, but they often try and do intervene even if it isn’t necessary.

Some of the most common interventions during a hospital birth include:

* Epidural – injections results in loss of sensation including pain by blocking the transmission of impulses through nerve fibers in or near the spinal cord. More than 75% of women receive an epidural at some point during labor.

* Pitocin – synthetic oxytocin used to promote uterine contraction and speed up labor.

* Continuous Electronic Fetal Monitoring – external and internal monitoring systems that track the heart rate of your baby during labor. Studies show that continuous monitoring does not have better outcomes than intermittent monitoring and may increase the chances of having an unplanned Cesarean Section.

* Urinary Catheters – some care providers push to give you a catheter during labor so you don’t have to worry about going to the bathroom during labor. However, having a catheter restricts your movement and usually means you cant leave your bed. Movement and position changes is very helpful during labor especially if you are progressing slowly. It encourages your baby to get into the right position for birth, and if you are attached to a catheter, your chances of being able to move around and change positions is slim to none.

* Artificial Rupture of Membranes – Also known as breaking the water. Some care providers push for this in order to promote labor progression, however, studies show that there are no more better outcomes than if you would let the membranes rupture on their own. Your water does not have to break for you to go into labor. Some babies are even born still inside the caul.

* Directed Pushing – History shows directed pushing started when women were extremely medicated and needed help knowing when to push. Most care providers still today like to direct you when to push and when not to even if you are having a natural birth. Your body knows when it should push and your contractions do most of the work for you.  However, if you receive an epidural you lose almost all feelings below your chest, so during labor if you cant feel your body, its very hard to know when to push. Avoiding an epidural will help avoid being directed to push.

* Episiotomy – A cut made in the tissues between a women’s vagina and anus. Studies show that 30-35% of women receive an episiotomy and many studies show that they do not improve outcomes of 3rd-4th degree tears. Some studies show that an episiotomy increases the chances of having a 3rd or 4th degree tear. An option to avoid episiotomy include using a warm compress or rubbing olive oil or against the women’s perineum.

* Cesarean Section – a surgical procedure with an incision made through a women’s abdomen and uterus in order to deliver their baby/babies. Today, 1 out of 3 women are having a Cesarean Section with numbers rising!

 

Ways to avoid these common interventions:

* While searching for your care provider, ask what their statistics are on each of these interventions and learn their procedures and policies. You may run into a provider that has policies and procedures that do not match your expectations and wants. This is where you have to do a little work. KEEP SEARCHING. Find a provider that is best for YOU. Just because ONE care provider does not share the same views as you, does not mean that another provider wont. You DO have options, you may just have to work to find the right one.

* Before you give birth at the provider of your choice, take a tour, learn your way around where you will be giving birth, and ask as many questions as you can think of at the time. I would suggest spending a few days coming up with questions ahead of time and ask anymore you may think of while you are on a tour.

* Hire a birth doula. They will be your support throughout the whole process from finding the right care provider to helping you have the birth experience that you want. Studies show “Overall, women who received continuous support were more likely to have spontaneous vaginal births and less likely to have any pain medication, epidurals, negative feelings about childbirth, vacuum or forceps-assisted births, and C-sections. In addition, their labors were shorter by about 40 minutes and their babies were less likely to have low Apgar scores at birth.”

* Write a birth plan. Include everything you want your birth to be, what interventions you want to avoid and which ones you are okay with, how you want to labor, etc. Don’t forget to write a plan for emergencies as well. You want to be as prepared as possible, whether you plan on giving birth in hospital, birth center, or at home. Going over the “just in case” scenarios is always a good idea for you and your family.

* Once you write your birth plan, make sure everyone that you plan on being involved with your birth knows exactly what you want and expect. Not only your family and birth supporter like your doula, but also your care provider. It is important that they know your expectations and what you are and are not comfortable with.

It is your right to be well informed about anything having to do with your healthcare. You can avoid a lot of unnecessary interventions by just being informed about what could happen and why. You have the right as a patient to just say NO! In the end, it is your body, your right, and your responsibility to take control of your healthcare. 

 

 

Resources:

http://chriskresser.com/natural-childbirth-v-epidural-side-effects-and-risks

http://www.fitpregnancy.com/pregnancy/labor-delivery/common-interventions-during-labor-delivery

http://givingbirthwithconfidence.org/2010/07/practices-that-promote-healthy-birth-avoid-interventions-that-arent-medically-necessary/comment-page-1/

http://chriskresser.com/natural-childbirth-vi-pitocin-side-effects-and-risks

http://www.webmd.com/baby/news/20050826/episiotomy-rates-too-high-say-experts

Posted in Hospital Birth, Labor.