Saturday, December 29, 2007

The Making of Mothers

"It's not just the making of babies, but the making of mothers that midwives see as the miracle of birth."

-- Barbara Katz Rothman,
Sociologist, Author of The Tentative Pregnancy,
Genetic Maps and Human Imaginations
and other books.

Ina May Gaskin has this quote up on her site:
as the "quote of the week," and I just couldn't resist posting it here.

It's so true. People ask me how midwifery care is different from seeing an OB for a monthly prenatal check-up. Sometimes it's hard to articulate exactly what it is about the Midwives Model of Care that compels mothers who have experienced it to do almost anything to find a midwife for their next pregnancy. People in the medical field are baffled as they almost never come back to the obstetrical model of care. Why?

This quote sums it up, I believe.

Monday, December 24, 2007

A Christmas Wish for Birthing Women

As everyone rushes around, gathering with family and friends for Christmas, baking cookies, piling their cars high with gifts, and eating more than ample portions of Christmas candy and sweets, I’ve thought about what I really want this Christmas.

What I want isn’t tangible, and I won’t get it tomorrow morning as a Christmas gift.

But I still wish for it, for my future, and that of every young woman who will someday face the prospect of pregnancy, birth, and motherhood.

I dream of the day….

~ When pregnant women are honored and treasured by society as life-givers and very special people.

~ When all women will be informed and educated about their bodies, birth, and babies.

~ When maternity care providers will believe that parents are good decision makers when presented with accurate information.

~ When every woman will have access to a midwife, a doula, a physician, a circle of supportive friends and anyone else she needs or wants to give her the best pregnancy possible.

~ When pregnant women walking through the grocery story will hear, “You can do it!” instead of, “I hope you signed up for an epidural! You have no idea how bad it hurts!”

~ When women aren’t expected to have perfect bodies that show no signs of having carried and birthed a baby.

~ When birth and babies again belong to mothers and fathers…. Not the state, not the American Medical Association, not the insurance companies, or the hospitals or obstetricians.

It won’t happen overnight, but it can happen when committed people work to change their own little corner of the world.

You may not be able to transform your local hospital’s policies, but you can educate your daughters, the girls in your neighborhood, your classmates and colleagues about birth.

You may not be able to stem the rising C-section rate, but you can help this mother avoid an unnecessary one.

You may not write a book that improves birth for other women, but you can write a letter to the newspaper about women’s birth options in your area.

You may never get everyone to breastfeed, but you can convince some people of the huge difference it can make in the future health of any baby.

You may never appear on a talk show about birth, but you can talk to your friends about improving birth.

You may never change the world, but you can change your world!

Wednesday, December 19, 2007

Broccoli flavored amniotic fluid and breastmilk?

There is a growing body of evidence that before you ever stick a bite of mashed carrots or peas in your baby's mouth, the way you have eaten during pregnancy and while breastfeeding your infant may greatly influence their eating preferences as babies and toddlers.

In a study reported in the December issue of Pediatrics, babies whose mothers regularly eat veggies and fruits while breastfeeding them, find that their babies are more likely to accept vegetables and fruits when tasting them for the first time as well as consume larger amounts. Sometimes it's obvious that a mother's consumption of various foods is passed on through her breast milk - like when she eats too much garlic, and the next morning the baby screws up his or her face and turns away from the breast. But this research shows that perhaps the baby can also taste green beans and peaches and learn to like them.

Research also shows us that babies tend to have the eating preferences that their mothers had during pregnancy as food flavors from a mother's diet are transmitted to the amniotic fluid that a baby lives in and drinks while in utero.

The 2004 Feeding Infants and Toddlers Study showed that 1 in 4 US toddlers did not consume even 1 vegetable on any given day. They were more likely to be eating fatty foods and sweetened snacks and beverages than any vegetables. And none of the top 5 vegetables consumed by the toddlers was a dark leafy vegetable. I bet their mamas preferred sweet snacks and beverages and fatty foods when they were pregnant.

So, yes, eat your veggies and avoid junk while you're pregnant and on through the breastfeeding phase of your child's life, if you want your baby to grow up happily eating squash, broccoli, and apples instead of Twinkie cakes and Mountain Dew!

Thursday, December 13, 2007

How much do nurses learn about natural birth?

A week or so ago, I heard from my friend, "Julie". She's a newly trained doula, finishing up her certification and has been attending births since last summer.

Julie had been invited to speak to a nursing class about the role of a doula* in the delivery room, and comfort measures that can help women cope with the pain of labor. I was excited for her and hoped that she would be a part of helping this whole class of nursing students understand and promote natural birth. I was shocked when she emailed with a report of how it had went...

"The nursing speech went well. I was surprised to learn that even though it's a maternity nursing class, the students never see a mom in labor, never do any type of labor support. Their clinicals cover newborn tests and postpartum work - not actual labor work. The professor said that she has to cover IV medications and epidurals because that's what's on the state exam. They don't have time to work on other comfort measures. It was hard to relate my info to the students since they've never seen a labor[and] can't fathom why anyone would do it without pain meds...
When I mentioned that they can really set the tone for a labor and can really influence how a mom feels, there were lots of nervous giggles. When I said something about how moms look to them for reassurance that everything is ok and that many moms feel like the nurse is in an authority position -- they actually looked panic stricken!
It puts the nurses in a slightly different perspective for me. Maybe they aren't anti-natural birth as much as they just really don't know what to do [for a mother attempting a natural birth]. They aren't trained in it at school."

These are RN students, getting a 4 year nursing degree from what is considered a top nursing school in the midwest. This class is the Maternal/Neonate one that everyone is required to take.
Julie learned that their clinicals include coming in as a women is in the final stages of pushing, just in time to do the baby's Apgar scores, weight, etc. They also do the next day post-partum vitals for the mother (blood pressure, temperature, etc).

They are not required to have any hands-on experience with a laboring woman. The actual non-pharmacological labor support, what happens during labor, etc. is one or two class periods. The professor said that she has to focus on pain medications, when to give them, when to wait, who can have what, etc. because that is what they will be tested on during their state exam. When asked about other comfort measures for laboring women, the professor told Julie that the text book does a "nice job of explaining" comfort measures.

Makes me wonder how much birth - natural or medicated or surgical - the average nurse has seen when she finishes her nursing degree and graduates as an RN! Any nurse readers, please chime in with comments and let me know how much birth you had experienced when you finished nursing school!

Maybe I shouldn't have been so shocked a few years ago when I was working as a doula in a small town hospital, and labor quickly picked up for my client. Before we knew it the mother had gone from being 3 cm dilated to 10 cm and pushing in less than 30 minutes - and the OBs had all gone home for the night.
The young labor and delivery nurse who was covering my doula client for the evening started to scream, "Noooooo! Don't push! You have to hold it in for the doctor! I can't catch a baby! I don't know how! Don't do this to me. Nooooo!" She looked positively terrified, and was visibly shaking.
She didn't catch the baby - he landed at the end of the bed, and she still shaking, picked him up and said, "Well, I guess he's okay." Then she looked at me and said, "This is my first birth as a nurse."

I was shocked. Maybe I shouldn't have been.

* A doula is a professional labor support person who stays with the mother through labor to provide physical and emotional support.

Monday, December 10, 2007

Blood Volume of a Pregnant Woman

In a conversation with a
perinatologist recently, I found
out a couple of neat facts that
you might find interesting....

~A full-term pregnant woman has an
approximate blood volume of 10 liters.
That's five 2-liter soda bottles!

~The uterus has 1/2 liter of blood
flowing through it per minute at the
time of birth/full term.

Saturday, December 1, 2007

What is Good Prenatal Care?

Awhile ago I was sitting in a seminar/class for people who work in the world of midwifery and/or obstetrics.
A very wise woman was articulating what prenatal care is all about. She said something profound that I've never forgot. In her words,

"Being a midwife or an obstetrician is not just about catching babies. Being the primary caregiver for a pregnant woman is teaching the mother to be the primary caregiver for herself and her baby. We cannot give prenatal care. We can only give a lot of information to the mother to help her give herself better prenatal care."