Monday, October 26, 2009

The Ten Pound Baby - Too Big!

I've heard it a hundred times and I should be used to it. But I'm not.
It happened again last week.

My friend was having her third baby. She's already pushed out two babies without problems - an 8 pound and a 9 pound baby.

She's into natural birth, even considered a home birth... but then got nervous thinking about it and went on with the obstetrician. He is a nice man. I like him a lot. If I had to pick a doctor, he'd be in the top dozen that I know. But he works in the hospital and thinks the way he was trained.

Two months ago my friend came home from a prenatal with the shocking, horrifying news, "Mary, they did an ultrasound and my baby already weighs over five pounds! He's gonna be HUGE by my due date!"

I talked her through it: She'd already pushed out a 9 pound baby. This one probably wouldn't be that much bigger, if even that big. She has a great body for having babies. If she was worried about her baby getting big, she could stay away from refined carbs and sugars.
She looked skeptical. I wondered if she really was scared of doing labor again and was hoping for a c-section. I hoped not, but I had to think that perhaps that was going through her head... I loaned her some books and told her that she'd already done it twice, and I was sure she could do it again.

About two weeks ago, they did another ultrasound. This time she was told that her baby already weighed a whopping TEN pounds! Her doctor didn't like the idea of her birthing a 10+ pound baby, and she really didn't like the idea. They mutually agreed that she'd have an elective cesarean section on the following Monday. She'd be 37 weeks. Everything would be fine.

So last Monday, her belly was sliced open and this "giant baby" was extracted. He weighed 6 pounds, 7 ounces. She sighed and laid there waiting for everyone to put her insides back together while he cried and squirmed in the warmer.

The doctor smiled - another successful c-section! No respiratory problems for the baby, no issues with the mother. The ultrasound estimate of size was a little off... but no harm was done, so that really didn't matter, right?

The nurses smiled, too. All was well as the new daddy stood near his baby and held his hand and the mommy was stitched neatly closed.

This is birth... the American way.

Morning Sickness Remedies

Is there anything worse than to be excited about being pregnant, but to feel so nauseous that you can't enjoy it for months?!

I share these suggestions with my homebirth clients frequently, and thought that others might benefit from the knowledge as well. So here goes....

The cause of morning sickness is not really known, although there are many theories, including hormonal changes in pregnancy (elevated levels of estrogen and human chorionic gonadotropin [hCG]), low blood sugar (perhaps caused by not eating, thereby creating a vicious cycle), gastric overloading, slowed peristalsis (intestinal action), a body overloaded with toxins, and any number of other possibilities.
Nausea occurs in half to three-quarters of pregnant women. Most women experience the worst nausea and vomiting at about 11 weeks gestation. It typically begins around 5-6 weeks. About half of pregnant women with nausea and vomiting find it completely gone by 14 weeks and 90 percent by 22 weeks. Women with a multiple gestation (twins, triplets, etc.) often have longer-lasting and more severe nausea and vomiting. The theory is that the extra hCG produced during a multiple pregnancy may be the cause.

Persistent and severe nausea and vomiting beyond the first trimester may indicate hyper emesis gravid arum or hydatidiform mole and should be taken seriously.

There are so many different things that can help morning sickness, but there certainly isn't a "one size fits all" remedy! One or all or any combination or none may be effective for a particular individual. For many women, just knowing that something might help is comforting!

The following suggestions are well-known and fairly common remedies that often help alleviate or eliminate nausea and vomiting during pregnancy.

Please do not take these suggestions as medical advice! Always consult your care provider before trying something new!

1. Eat small, frequent meals, including a protein food each time, as often as every 2 hours, or just “graze” continuously, not allowing more than an hour or so to pass without putting something in your mouth. The food is more apt to be retained than 3 large meals a day and prevents the blood sugar from dropping enough to cause nausea. If this seems to work for you, keep snacks by your bed (almonds, cheese sticks, yogurt, peanut butter and apples, etc) and eat several times during the night when you wake to go to the bathroom. This will keep your blood sugar from falling by morning, leaving you feeling nauseous upon awaking.

2. Eat dry crackers or toast or plain yogurt before getting up in the morning.

3. Sip on ginger or raspberry leaf tea. The best ginger tea is made by pouring one cup boiling water over 3-5 slices of fresh ginger root. Let steep 5 minutes and sip slowly.

4. Take Ginger capsules with your meals.

5. Avoid foods with strong or offensive odors.

6. Many women claim that homeopathics are effective in easing morning sickness. The remedies are specific to symptoms. Research Pulsitilla, Sepia, Nux Vomica, and Ipecacuanha. Additional remedies to consider include: Antimonium Tartrate, Argentum Nitricum, Petroleum, Sulfur, and Tabacum. Good references are: “Homepathic Medicine for Women” by Trevor Smith, MD, and “Homeopathic Medicines for Pregnancy and Childbirth” by Richard Moskowitz, MD.

7. Drink carbonated beverages - especially ginger ale. (I wouldn't recommend doing this on a
regular basis, but it does help some women with severe nausea!)

8. Rest.

9. Vitamin B6 (pyridoxine) either 25 mg four times a day or 50mg twice daily can be very effective.

10. Use medication. Some women find 50mg Vitamin B6 and 1 Unisom tablet at bedtime in addition to 25mg B6 twice daily to be very helpful. (Or, 25mg B6 and ½ Unisom tablet three times a day). Unisom can cause drowsiness, and of course, consult your healthcare provider before trying any medication!

Feel free to comment, adding your own suggestions or what did or did not work for you.
I welcome the collective wisdom of pregnant women and their care providers everywhere!

The Best Care for Healthy Pregnant Women

As technical advances become more complex, care has come to be increasingly controlled by, if not carried out by, specialist obstetricians. The benefits of this trend can be seriously challenged. It is inherently unwise, and perhaps unsafe, for women with normal pregnancies to be cared for by obstetric specialists, even if the required personnel were available. Specialists caring for women with both normal and abnormal pregnancies, because of time constraints, have to make an impossible choice: to neglect the normal pregnancies in order to concentrate their care on those with pathology, or to spend most of their time supervising biologically normal processes, in which case they would rapidly loose their specialist expertise.

Midwives and general practitioners, on the other hand, are primarily oriented to the care of women with normal pregnancies, and are likely to have more detailed knowledge of the particular circumstances of individual women. The care that they can give to the majority of women whose pregnancies are not affected by any major illness or serious complication will often be more responsive their needs than that given by specialist obstetricians.

-A Guide to Effective Care in Pregnancy and Childbirth,
Enkin, Keirse, and Chambers, Oxford University Press

Tuesday, October 13, 2009

People Tell You...

People tell you how tired you'll be,
but they don't tell you...
that you'll be able to survive without much sleep
because the simple act of looking at your baby
is stirring, gratifying, energizing.

- Carol Weston