Birth

When Your Birth Doesn’t Go As Planned

Woman Contemplating Feelings

Whether you had hoped for a home or birth center delivery and needed to transfer to the hospital, or had prepared for a natural birth and ended up having a C-section, births that do not go according to plan can be disappointing. Many mothers spend their pregnancies preparing for and creating a detailed birth plan in the hopes of having the experience they’ve always envisioned for themselves and their baby. Despite the best laid plans, birthing classes, and providers, sometimes our bodies and our babies have other plans in mind. When your birth doesn’t go as planned, it’s not uncommon to experience some negative emotions along with the excitement you’re feeling about the new baby. Many women who have experienced some form  of birth trauma  or unexpected intervention report feeling disappointed, angry, guilty, frustrated, indifferent and sometimes even resentful towards their baby or their body. These feelings usually follow birth experiences that felt out of their control, traumatic or unexpected such as having an episiotomy or emergency C-section. If your birth experience has left you feeling as though your body failed to do what you had hoped it would do, here are some ways to cope with those negative emotions and acknowledge the strength and courage in your journey.

Writing Birth Story
  1. Acknowledge your feelings: This can be difficult to do when everyone is expecting you to be overjoyed by the arrival of your new baby. However, if you are experiencing disappointment, sadness, guilt or anger about the way your delivery unfolded, it’s important to take the time to allow yourself to experience those feelings without judgment. Giving birth may be the single most important event in your life thus far and it is okay to feel sadness about any part of the labor or delivery that was traumatic or upsetting to you. If you try to push away your negative feelings about the experience, they will likely resurface at a later date as unresolved issues. 
  2. Take steps to process your grief: It is perfectly normal to experience grief following a traumatic or upsetting birth experience. It is important to allow yourself to experience the grief so that you can move forward feeling as though you have processed your feelings. Talking to your midwife or doctor and asking questions so that you can better understand and process your experience is one way to work through what you may be feeling. Two cathartic ways to process grief following birth are: telling your birth story to a trusted friend or family member or writing down your birth story. Writing or telling a detailed account of your experience can help you process your feelings of disappointment or guilt and also help you identify  all of the moments (there are so many!) of great courage and strength.
  3. Surround yourself with loving and supportive people: Limit visitors in the early weeks following your delivery to people who can be sensitive to your feelings and your experience. While not intending to be unsupportive, people may make comments suggesting that the only thing that is important is that you have a healthy baby. You can gently remind them that the experience was important to you and you are not ready to discuss it further at this time. You can also ask your partner to help play gatekeeper in the early days staving off unnecessary visitors and unsavory comments.
  4. Acknowledge the strength and courage in your story: Even if your birth didn’t end the way you had hoped, do your best to remember the amazing work that your body did. Whether you labored for 18 hours before ultimately having a C-section, endured hours of natural labor before electing to have an epidural, or had to undergo any number of interventions that were frightening or upsetting to you, your body has done an amazing thing. There is also an incredible amount of strength and courage in having to let go of your birth plan and have a birth experience that feels completely out of your control. Whatever your story is, whatever the intervention or unplanned turn your birth took, your body has done a miraculous thing.
  5. Ask for help: Whether you would like extra support from your partner, your provider, a friend to listen or to seek out a new moms’ group in your area, make the effort to reach out for help and comfort. The postpartum period, despite the awe and excitement of a newborn, can be an isolating and overwhelming experience. Adding grief from your birth experience to this mix may be too much to handle on your own. If at any point your grief begins to impact your ability to function throughout the day or seems to overwhelm the joy you have for your new baby, see your doctor or a therapist for an assessment for Postpartum Depression. Although the baby blues are a normal experience in the weeks following delivery, moms who have experienced a traumatic birth experience are more likely to develop Postpartum Depression. Ask for help right away if you feel like you might be experiencing Postpartum Depression. Click here to learn more about Postpartum Depression

If you’ve experienced a traumatic or disappointing birth experience, don’t suffer in silence. There are many women out there whose birth plans have not gone according to plan and who are left feeling guilty, angry and even depressed. There is no shame in a birth that does not go as planned and no shame in grieving the experience you did not have. Remember that you gave it your all and that is enough; that you are just as strong, powerful and amazing as all of the other mamas before you. At Health Foundations, we are here to support you throughout your pregnancy, delivery and postpartum period, regardless of whether or not your delivery took place with us, in the hospital or in the operating room. We are here for you. Contact Health Foundations to schedule a free consultation with a midwife or to find support.

 

Eight Ways to Avoid Unnecessary Interventions During Labor

Newborn with Mom

Avoiding unnecessary medical intervention is one of the most important factors in having a naturalbirth. Unfortunately, in many US hospitals, interventions are common and all too often hastily decided upon. Consequently, the rate of C-sections nationally is about 32.7 percent. The term “cascade of interventions,” refers to the domino effect of one intervention, leading to another which leads to another, resulting in a series of unplanned and undesired repercussions. If you are hoping to have a natural birth experience, knowing what you can do to reduce your chances of unnecessary interventions is important. Here are 8 ways you can increase your odds of achieving your desired natural birth experience by avoiding unnecessary birthing interventions.

  1. Create a birth plan: Creating a written copy of your birth plan will help ensure that everyone on your birthing team knows and respects your wishes and expectations for your birth experience. Although it is important to remain flexible should complications arise, a birth plan is a great way to familiarize your care providers and any participating family members or friends with specific preferences you have including avoiding unnecessary medical interventions.
  2. Use a midwife: Because of the level of specialized care, support and priority placed on natural birthing, using a midwife can increase your chances of having a natural birth by up to 95 percent. Your midwife will help prepare you physically and mentally for an unmedicated childbirth, reducing your anxiety and likely lessening the pain you will experience.
  3. Take birthing classes: Choose classes that focus on natural birth techniques to help equip you with the tools you will need to achieve an intervention free, natural birth experience.
  4. Choose a care provider and birth setting that encourage natural birth: In addition to using a midwife, choosing to birth at a birth center with a low rate of interventions versus a hospital can be a wise decision if you are hoping to have a natural birth. Hospitals often place time limitations on labor and may pressure you to opt for interventions that hasten the process if it has been drawn out too long. A birth center that is supportive of natural birth is more likely to let you labor as long as you and baby need.
  5. Hire a doula: A doula provides physical, emotional, and educational support for the mother during pregnancy and the birthing process. Research shows that having a doula assist you in your birth can reduce your chances of electing to have an epidural by up to 60 percent and cut your chances of having a C-section in half. To learn more about the many benefits of hiring a doula for both mom and baby, check out this article.
  6. Research natural alternatives for pain control: Techniques such as self-hypnosis, deep breathing, guided imagery, yoga and massage can offer non-invasive alternatives to help lessen the pain and keep you calm and relaxed during labor. Practicing these techniques during pregnancy can help prepare you for the big day once it arrives.
  7. Practice perineal massage: Utilizing massage to stretch the area around the vagina during pregnancy can help prepare you for childbirth and potentially shorten the labor process and accelerate your delivery. Begin your perineal massages after week 34 of pregnancy using warm olive oil as a lubricant and relaxing music to calm you. Having your partner help if you are comfortable with it is a great way to get them involved in birth preparation. 
  8. Know your rights: You may find yourself feeling pressured in the heat of the moment when a medical intervention is suggested during labor. Educating yourself beforehand and knowing that you have the right to accept or refuse any procedure, test, medication or treatment will help empower you to make the decisions that are best for you, even under pressure.

Having a natural and normal birth is a noble and attainable goal. Preparation during pregnancy can only help your chances of achieving your desired birth plan. At Health Foundations, we value the natural and miraculous nature of birth and seek to empower women to realize the awesome abilities of their bodies without intervention. To learn more about how Health Foundations can support you in your goal of natural birth, contact us for a free consultation with a midwife and for a tour of our Birth Center. We are committed to supporting you throughout your pregnancy, birth and beyond.

The Home Stretch: What to Do in the Final Weeks of Pregnancy

Final Weeks of Pregnancy

The final weeks of pregnancy are filled with excitement, nerves, aches and pains and often even some impatience. Fortunately, there is plenty to do during that time period to keep you busy and ensure that you are prepared for the arrival of your baby. Here are just a few of the things that should be on your to-do list for the home stretch of pregnancy!

  • Stock up on postpartum supplies: Must have items in the weeks following giving birth include heavy duty sanitary napkins (opt for overnight strength or even Depends), comfy undies, nursing pads, lanolin nipple salve and comfortable loose fitting clothing.

Expert tip: Consider making some ‘padsicles’ by applying witch hazel and aloe to sanitary napkins and freezing them individually. Padsicles make great soothing ice packs for your recovering lady parts.

  • Sleep! If this is your first baby and you don’t have a toddler or older child running around, cherish these last weeks of uninterrupted slumber while you can. Go to bed early, sleep late when possible and catch an afternoon nap. Your body needs to rest up for the big day and the months that follow of caring for a newborn baby.
  • Nest: Many soon-to-be-moms feel the almost compulsive urge to clean and organize in preparation of the arrival of the baby. If the urge has overcome you and you have the energy, run with it and ask your family and friends to help you. Clean out the refrigerator, dust the baseboards, reorganize your closet, spot clean your kitchen and bathroom and take unwanted clothes and belongings to donate. You will have greater peace of mind bringing your baby home to a clean house where everything is in its place.
  • Stock your freezer: Now that your freezer is clean and organized, it’s time to fill it with meals that can be easily reheated in a pinch. You won’t have time to prepare dinner while you and your partner are busy caring for a newborn, so plan ahead and have some nutritional meals ready to go for when the hunger hits. 
  • Prepare your car for baby: Clean out your car and take your car seat to the fire department for instruction on proper installation. You’ll want to have this completed several weeks in advance in the event that your baby should make an early appearance.
  • Prepare a contact list: There are likely lots of people who will be anxiously awaiting the news of the arrival of your little one. Preparing a list of people ahead of time for your husband to text, email or call can remove the stress of creating it on the spot. You may also wish to give your partner’s contact info to any close friends or family that will want to check on you while you are in labor.
  • Pack your birth center or hospital bag: The contents of your bag will vary depending on whether you will be going home the day of the birth or staying a few nights. Plan accordingly with changes of clothes, toiletries, lip balm, pajamas, slippers, and anything else that you may want to have access to while you are in labor. Be sure to prepare your bag several weeks in advance as you do not want to be scrambling to pack at the last minute.
  • If you haven’t already, create your birth plan: A birth plan is a document that outlines your wishes for labor and birth experience. For help creating a birth plan, check out this article on creating a natural birth plan. Be sure to print enough copies for everyone that you anticipate will be involved in your labor and delivery.
  • Spoil yourself: These may be the last weeks that you have time to focus on yourself for a while. Take advantage of this time by doing things to pamper yourself like getting a pedicure, a massage or a haircut. Eat out at your favorite restaurant, take a bubble bath or go shopping with a girlfriend. You’ll be glad you took the time to show yourself some TLC when you are in the throes of being a new parent.
  • Finish your nursery: If you’re creating a nursery for your baby-to-be, now is the time to put the final touches on it. Wash the crib sheets and changing table covers, hang any decorations or pictures and make sure you have everything you need for baby in those first weeks at home.
  • Make space on your camera: In the age of digital cameras and smartphones, it’s not uncommon to run out of space or memory for pictures. Make sure you clean out your photos and have plenty of space to take new pictures before you go into labor. Deleting old photos is the last thing you want to be worried about when you are trying to capture your first moments with baby.
  • Spend quality time with your partner: Similar to finding time to pamper yourself, it will probably be a little while before you and your spouse have time to devote to one another. Go on dates, make dinner together, go for walks, and spend some time focusing on each other and your relationship. There are many ways to involve your partner in your pregnancy. This will help you both feel better prepared and more supported heading into the challenges of being a new parent. 
  • If you have other children, use these weeks to spend some quality time with them, remind them of their importance to the family and help prepare them for the arrival of the baby. It is also a good idea to get a gift to give to your older child “from the baby” to help lessen any initial feelings of jealousy or competition.

The final weeks of pregnancy don’t have to be stressful with a little planning, organization and time set aside to care for yourself. To learn more about having a natural birth or for any and all questions related to pregnancy and birth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center. We are here to support you from preconception to postpartum and beyond.

What Does a Doula do During Labor

If you are planning on a natural birth, you may be considering having a doula assist you in the birthing process. Whether you will be giving birth in a hospital, birth center or at home, a doula can be a tremendous asset to you and your family during this special time. Doulas are trained professionals who specialize in providing the mother with physical, emotional and educational support before, during and after childbirth. While your midwife or doctor must focus on the medical support you and your baby need during the labor and birthing process, your doula is there to provide continuous reassurance, encouragement, guidance and comfort. Here are just a few ways having a doula during labor can help you create the birth experience you want.

Natural Birth with Doula
  • Doulas are another person on your team that can help ensure that your birth plan is respected. 
  • Particularly in a hospital setting, having a doula as another advocate for you to help make sure that your doctors understand your desire for a natural birth and minimal interventions.
  • Doulas can help you find positions during labor that will ease the pain and ensure optimal fetal positioning for baby. Proper positioning can also help your labor progress smoothly.
  • Doulas can talk you through emotional blockages during the labor process that may affect your decision to continue with a natural birth. Your doula is there to remind you every step of the way that you are strong and capable of your goal of a natural birth.
  • Doulas can help make your birthing environment calming and conducive to a peaceful and memorable birthing experience. This may include utilizing aroma therapy, music you have selected, candles or anything else you feel will make you more comfortable.
  • Doulas can help with your physical comfort during labor by providing massage and other healing touch.
  • Having a doula by your side throughout the entire labor can allow your partner and other family members to relax and enjoy the experience.
  • Doulas can help photograph your birth experience and document your special day.
  • Doulas can provide an objective viewpoint should issues arise and aid you and your partner in making informed decisions that are consistent with your values and wishes for your birth experience.
  • Your doula will provide continuous reassurance and encouragement for you from start to finish, beginning before labor begins and continuing often well into your postpartum period.
  • Doulas help aid in the communication between you and your partner and your care providers.
  • Your doula can help your partner be involved in your labor at his or her own comfort level.

At Health Foundations, we have a very special opportunity for our families to work with one of our specially trained Doula Interns for free. These doulas are women who have completed their training with our Birth Center and are seeking to assist births as part of their certification process. You can visit the doula page to view the profiles of our doulas and can elect to interview potential candidates before deciding who will attend your birth. To learn more about having a natural birth with our midwives and doulas, contact Health Foundations for a free consultation with a midwife and a tour of Birth Center.

Creating Your Natural Birth Plan

There are many factors to consider as you prepare for the birth of your baby and one important step is taking the time to create a written copy of your natural birth plan. A birth plan is a document that describes your expectations and wishes for the way that you would like your birthing experience to unfold. Although changes may arise and it is important to remain flexible, having a birth plan helps ensure that all of your health care providers know and respect your wishes to the best of their ability. This is particularly important if a natural, unmedicated birth is what you are seeking. The task of writing your natural birth plan may seem overwhelming at first; but let’s take a look at some of the key components you will want to include. 

Birthing Environment:

Your birthing environment and who and what you desire to have in it is an important consideration for your natural birth plan. Some questions to consider about the environment are:

  • What family members do you wish to have present during your labor, the birth and after the baby is born?
  • Do you plan to have a doula?
  • Do you wish to have your birth photographed or videotaped?
  • Are there any comfort objects you would like to have handy such as treasured photographs or a favorite pillow or blanket?
  • Do you want to have music playing? Or silence?
  • Do you wish to have the lights dimmed?
  • Would you like to have access to headphones for music or guided meditation?

Laboring:

Being prepared with ways to make your labor as comfortable and tolerable as possible is an important way to help you achieve your goal of a natural birth. There are many natural techniques that can help alleviate the pain associated with labor that do not include medication or epidurals.  Some questions to be sure your natural birth plan addresses are:

  • What props would you like to have available for labor? (For example: a birthing ball, a squatting bar or a birthing stool)
  • Do you want to be able to labor in water? (For example: in a birthing tub or shower)
  • How do you feel about fetal monitoring? Is it important to you that monitoring only be intermittent to allow you to move around more freely? 
  • What pain management techniques would you like to have available and be supported in using during your labor? (For example: breathing exercises, massage, hypnotherapy, visual imaging, acupressure and guided relaxation)  Nitrous oxide is a great alternative to pain medicine for  those who wish to utilize it during labor. 
  • If your goal is a natural birth and you are delivering in a hospital setting, be sure to address your desire to avoid unnecessary interventions. You may also wish to request that you not be offered any pain medicine unless you specifically ask for it.  

Pushing and the Birth:

Water Birth

In this section of your birthing plan, you should include information about how you would like to be supported during the second stage of labor and the birth of your baby.  Factors to address include:

  • Do you want to be told when to push or allow your body to do it instinctively?
  • Are there ways that you wish to help prepare your body further for delivery such as perineal massage, hot compresses or oils?
  • Do you want to have access to a mirror to see the baby as he is born?
  • Do you want to be able to "catch" the baby when she is born?
  • Think about the things that are important to you is an emergency necessitates a transfer to a hospital or a C-section.
  • If in a hospital setting, how do you feel about the use of instruments such as the vacuum or forceps? How do you feel about the possibility of an episiotomy?
  • Do you wish to allow the placenta to be born spontaneously versus with assistance?

After delivery:

After Birth

Some of your most important wishes for your first moments with baby will likely be included in this section of your natural birthing plan. Questions to consider include:

  • Would you like to have immediate skin-to-skin contact with your baby? Skin-to-skin contact during the first moments of life has been found to be one of the most important things you can do for your newborn. Learn more about the importance of the skin-to-skin practice
  • Would you like to delay the process of cord clamping to allow time for extra blood flow from the placenta?
  • Would you like to delay routine procedures such as eye drops, a bath, and the vitamin K injection to allow you to have time to bond with your baby?
  • Are there any routine procedures that you do not wish to have done to your baby?
  • Do you wish to save the placenta for encapsulation or other purposes?
  • In the event of an emergency C-section, who would you like to have stay with your baby until you are able to hold him? Do you wish for your partner to have immediate skin-to-skin contact?

As you can see, there are many factors to consider when writing your natural birth plan. Be sure to keep your plan direct and concise, so that anyone who is on your birth team can clearly understand your wishes. Print several copies of this document and have them available for doctors, midwives, nurses and family members on the day of your delivery. In addition to having a written birth plan, it is also important to choose health care providers that support and uphold the value of the natural birth process. Statistics show that approximately 85 % of mothers are capable of having a successful, unmedicated birth. The other 15 percent represent those who have high risk pregnancies and other complications.  

At the Health Foundations, we strive to encourage, nurture and support you in your desire to bring your baby into the world in the most natural way possible. We are confident that the sense of accomplishment you will feel when holding your wonderfully alert baby in your arms will be well worth your amazing efforts. Contact Health Foundations to learn more about planning your natural birth and to schedule a free consultation with a midwife or a tour of our Birth Center.

What is a Midwife?

Midwife Kat

Wondering if midwifery care is the best option for you?

If you are pregnant or considering becoming pregnant, you may be beginning to explore your options for the type of birth you would like to have. You probably have friends who have given birth in hospitals and may also know people who have used midwives or even had home births. But what exactly is a midwife and how does one compare to a doctor? Good question!

Simply put, midwives care for the well-being of mothers and infants during the prenatal, birthing and postnatal periods. Although in most countries midwives are the primary care providers for pregnant women, in the US they only comprise approximately 10 percent of births. They are responsible for helping mothers sustain healthy pregnancies and have meaningful and safe birth experiences in addition to providing recovery support and infant care. Similar to doctors, midwives are trained to give physical exams, detect complications, order laboratory work and screening tests, and counsel and educate the mother to be. They also are qualified to deliver babies not only in hospitals but also in birthing centers.

Where midwifery is often said to stand apart from standard OB/GYN care is in the level of personalized attention and the ‘woman-centered’ approach. Midwives strive to promote the practice of normal birth that is medication and intervention free. Whereas movies and television tend to sensationalize birth as a painful and dramatic experience in a medical setting, midwives help to facilitate the natural birthing process in a calm and comfortable environment for mom. Because their all-inclusive approach aims to support women physically, mentally, emotionally and spiritually, midwives play an integral role in not only the life of the mother but also the entire family. 

Unlike doctors, midwives come from a variety of training backgrounds. There are three types of midwives in the US: Certified Professional Midwives, Certified Nurse-Midwives and Direct Entry Midwives

Certified Nurse-Midwives and Certified Professional Midwives are educated in similar extensive training programs requiring graduate level education. CNMs however, have the nursing component in their education and typically only practice in clinical and hospital settings. Certified Professional Midwives specialize in birth outside of hospital settings including home births and independent birthing centers. Both Certified Professional Midwives and Certified Nurse Midwives have met the requirements for certification by their respective Boards, the North American Registry of Midwives and the American College of Nurse Midwives. Direct Entry Midwives however are midwives who have been trained in the discipline through apprenticeship, self-study or a school or program that is specific to the practice of midwifery. All midwives follow a model of care that emphasizes the normalcy of the process of pregnancy and birth and that places the utmost priority on caring for all aspects of the mother’s well-being.

Now that you know what a midwife is and what they do, here are some reasons that this approach to obstetrical care might be for you: 

1. You want a warm and inviting birthing environment 

Health Foundations Birthing Suite

Health Foundations Birthing Suite

With the exception of CNMs, most midwives practice in out-of-hospital settings like birthing centers and private homes. Because of this, your birthing atmosphere is more likely to be homelike, quiet and calm with no beeping.

2. You want more personalized care

Midwives tend to be more intimately involved in your pregnancy and birthing process than doctors. Your midwife will typically spend more time with you to develop your personalized birthing plan and to ensure that you are healthy not only physically, but mentally and emotionally.

3. You want to avoid unnecessary interventions

Often in hospitals if your labor is not progressing quickly enough, they will administer drugs to speed up the process. The drugs can then cause the mother to have more painful contractions that consequently end up leading to the decision to have an epidural. The epidural tends to slow the progress of labor again which can ultimately lead to the decision to perform a C-section. Under the care of a midwife, you will not be rushed through your labor. All efforts will be made to respect your wishes of a natural birth and help you control your pain using alternative methods such as massage, acupressure, showers and baths, homeopathy and changing positions.

4. You want to be able to move around during your labor 

Midwives encourage mothers to try a variety of different positions throughout their labor to ensure that they are comfortable and progressing steadily. In hospitals, you will often be hooked up to IVs and monitors that necessitate staying in your bed. Your midwife will instead monitor your baby intermittently so that you can move about freely while laboring.  

5. You want to know who will be delivering your baby ahead of time

Often with traditional OB/GYN and hospital care, you will not know the doctor who will be on duty the day of your delivery.  Because midwifery care is aimed to be a more personalized experience, your midwife or members of your midwifery team with whom you have already developed a trusting relationship will most certainly be present on the day of your birth. 

Overall, midwives are a great option for women seeking a traditional, natural, and personal birthing experience and who wish to develop a trusting and rewarding relationship with their caregiver. Many midwives also perform regular wellness and primary healthcare that extends beyond the time of your pregnancy and birth. If you are high risk or are experiencing any complications in your pregnancy, consider combining the care of an obstetrician and a midwife. At Health Foundations, you can also elect to experience our Birthing Center’s quality of personalized care in a hospital setting under the care of our own Dr. Dennis Hartung. To learn more about the choice to have a midwife assist you in your pregnancy and birth journey, contact Health Foundations to schedule a consultation or schedule a tour of our Birthing Center.

The team at Health Foundations is seeking to redefine the maternity and women’s health care experience in America. P.S. We're hiring!


see some amazing birth stories:

Shorten Labor by Eating This Fruit

Did you know that you can increase your chances of a shorter and easier labor just by adding a particular fruit to your diet in the last few weeks of pregnancy? One study published in the Journal of Obstetrics and Gynecology found that women who ate dates in the last 4 weeks of pregnancy dilated faster and had faster labors compared to those that did not consume dates. dates

The Study

The date and pregnancy study was carried out at Jordan University of Science and Technology, who studied 114 women from February 2007 to January 2008. The date consuming group (69 women) consumed at least 6 date fruits per day in the last 4 weeks of pregnancy compared to the non-date consuming group (45 women) who had none. The two groups were similar in terms of gestational age and maternal age.

The date consuming group were more dilated upon admission to the hospital, had a higher proportion of intact membranes, a greater rate of spontaneous labor, a lower rate of induction, and an average of 7 hours shorter labor compared to the non-date consuming group.

The researchers concluded that eating dates in the last month of pregnancy can reduce the need for induction and augmentation of labor and may shorten the overall duration of labor.

Researchers believe that something in the dates mimics the hormone oxytocin, a hormone involved in labor, among other things.

Dates

Date fruit (phoenix dactylifera) comes from a date palm tree which has long been cultivated for its fruits. Date fruits (which contain a hard seed inside) can be soft or dried and enjoyed in a number of ways. Dates are a terrific source of potassium and also contain sugar, protein and a number of vitamins and minerals. They can serve as a great natural sweetener. Dates can be stored in a glass jar in a cupboard or in the fridge.

Date Recipes

Date Energy Balls

These vegan and paleo energy balls are a quick and easy treat, perfect for snacking! These would also make great labor snacks.

Makes: 24

Ingredients

  • 2 cups walnuts, or other nut/seed of choice
  • 1 cup shredded, unsweetened coconut
  • 2 cups soft Medjool dates, pitted
  • 2 T coconut oil
  • 1 t sea salt
  • 1 t vanilla extract

In a large food processor, process the walnuts and coconut until crumbly. Add in remaining ingredients and mix until a sticky, uniform batter is formed. Scoop the dough by heaping tablespoons, then roll between your hands to form balls. Arrange them on a baking sheet lined with parchment paper, then place in the freezer to set for at least an hour before serving. Store the balls in a sealed container in the fridge for up to a week, or in the freezer for an even longer shelf life.

You may also roll them in shredded coconut or cocoa powder before chilling.

Date Walnut Bread

Ingredients

  • ½ cup blanched almond flour
  • 2 tablespoons coconut flour
  • ⅛ teaspoon celtic sea salt
  • ¼ teaspoon baking soda
  • 3 large Medjool dates, pitted
  • 3 large eggs
  • 1 tablespoon apple cider vinegar
  • ½ cup walnuts, chopped

In a food processor, mix together almond flour and coconut flour. Add salt and baking soda. Next add the dates until mixture resembles coarse sand. Add eggs and apple cider vinegar. Lastly, pulse in walnuts. Transfer batter to a mini loaf pan. Bake at 350° for about 28 to 32 minutes. Allow to cool in pan for 2 hours before removing.

Chocolate Cranberry Power Bars

Ingredients

  • 2 ¼ cups pecans, lightly toasted
  • ¼ cup cacao powder
  • 15 large medjool dates, pits removed
  • 1 tablespoon vanilla extract
  • 10 drops stevia
  • 2 tablespoons agave nectar or honey
  • ½ cup dried cranberries (you can add more if you like)

Blend pecans and cacao powder in food processor until combined and coarsely ground. Add in dates and process until blended into dry ingredients. Process in vanilla, stevia and agave until well combined. Stir in dried cranberries with a spoon.

Press mixture into an 8 x 8 inch baking dish. Freeze for 1 hour, or until firm, then cut into 16 squares. Enjoy!

Newborn Male Circumcision

What is circumcision?

Male circumcision is the surgical removal of some or all of the skin covering the tip of the penis, called the foreskin or the prepuce. In the United States, this surgery is often performed within the first few days of an infant’s life, when it is considered the most “simple.” It can also be performed later in life, should a man choose, though the procedure is considered “more complex.”

Infant male circumcision is one of many decisions parents are asked to make during their pregnancy or shortly after their boy is born. Socio-culturally speaking, this issue is very controversial and carries a lot of cultural, religious, and ethical charge. We believe that informed decision-making is paramount and want to empower our families to make an educated decision about infant male circumcision. While we cannot cover all of the information about male circumcision here, we hope to offer a broad look of this issue, as a launching point for gathering more information.

How prevalent is circumcision?

Globally, it was estimated in 2006 that approximately 30% of the world’s men were circumcised. The practice is nearly universal in some parts of the world (in most of these countries the practice is done almost exclusively for religious or cultural reasons), while in other areas the numbers are quite low.

In the United States, most estimates show that between 70-90% of males are circumcised, with the numbers peaking in the 1960s and falling by 5 to 10% since then. The practice has seen a greater decline in other developed nations including Canada, England, other parts of Europe, and Australia. The rates also vary by race, region, and class in the United States today.

The Controversy

There are a variety of views about circumcision. Generally speaking, those in favor of circumcision point to medical evidence that circumcision offers some health benefits to men. These advocates state that the benefits of the procedure greatly outweigh the potential risks. Some believe that circumcision should be performed for religious or cultural reasons (this is the more common reason, globally speaking).

Critics of the procedure believe it is entirely unnecessary, traumatic, and painful to a child.

Some people talk about the importance of choice—that parents should be able to make a choice about whether or not to circumcise their child. Others argue that the choice should be with the child because it is their body—in this view, circumcision is not considered ethical to perform on someone who is not able to make that choice.

Parents are often weighing all of these views and conflicting information in the context of cultural and familial norms. That is, many of the men in our country (and within our families) are circumcised, so there may be an additional pressure (stated or unstated) to conform to this norm.

It can be helpful to become aware of the reasons you may feel compelled toward or against the procedure as you explore this issue for yourself or your family.

The purported pros of male circumcision

In the US, the practice began in the late 1800s, prior to the germ theory of disease, when circumcision was thought to be “morally hygienic” (reducing sexual excitation) and even curative of such things as paralysis, masturbation, epilepsy, and insomnia. Those views have changed, but the health benefits of circumcision are still widely touted by the dominant medical community in our country.

For a long time, the American Academy of Pediatrics had remained neutral on the practice of circumcision. Then in 2012, it changed its policy (on which many insurance and social health care decisions are made). This new statement on circumcision stated that medical evidence shows that the health benefits of circumcision significantly outweigh the potential risks. They stopped short of actually recommending the practice, however, and instead said that families should have access to the procedure if they so desire.

The health benefits of male circumcision, as described by the AAP report include but are not limited to the following:

  • Reduced lifetime risk of urinary tract infections
  • Lowered risk of some cancers of the penis and prostate
  • Lowered risk of some, but not all, sexually transmitted diseases

They claim that the benefits outweigh the risks by 100 to 1 and that 50% of all those uncircumcised will experience some negative health effects as a result. They also claim that circumcision does not appear to have any negative effects on sexual sensitivity or function later in life.

The purported cons of male circumcision

There are many reasons given against male circumcision. The group Intact America, one of several organizations in the United States that are against circumcision, offers the following 10 arguments against circumcising, which you can read more about on theirs and other websites. 

  1. There is no medical reason for "routine" circumcision of baby boys and it is not recommended by any major organization in the nation.
  2. The foreskin is not a birth defect; it is a normal, sensitive, functional part of the body.
  3. Federal and state laws protect girls of all ages from forced genital surgery and they should protect boys as well.
  4. Circumcision exposes a child to unnecessary pain and medical risks
  5. Removing part of a baby's penis is painful, risky, and harmful.
  6. Times and attitudes have changed and it is becoming more acceptable not to circumcise.
  7. Most medically advanced nations do not circumcise baby boys
  8. Caring for and cleaning the foreskin is easy and being intact doesn’t present hygienic concerns.
  9. Circumcision does not prevent HIV or other diseases
  10. Children should be protected from permanent bodily alteration inflicted on them without their consent in the name of culture, religion, profit, or parental preference.

Risks of circumcision

Significant complications are believed to occur in approximately one in 500 procedures.  One source states that over 100 infant males die each year as a result of circumcision complications, although this number is hotly contested by some members of the medical community and does not seem to be supported by medical data (although reports of circumcision deaths are not actually reported to the CDC, making it difficult to gather data at all).

Possible complications of circumcision can include:

  • Local Bruising
  • Bleeding
  • Scarring (always occurs)
  • Adhesions
  • Puncture and skin bridges
  • Amputation
  • Difficulty breastfeeding
  • Difficulty with urination
  • Long term aggravated response to pain
  • Infection
  • Subsequent corrective surgery
  • Permanent disability or death

Many also argue that because the foreskin is so sexually sensitive, that circumcision reduces sexual pleasure and function.

This list doesn’t include the potentially negative psychological impact of this procedure on the newborn child, which is more difficult to account for.

Bottom Line

As mentioned we encourage our families to research and talk to their pediatric care providers about circumcision. We hope this article serves as a “launching off” point for one’s own exploration of this issue and we hope that each family makes an informed decision based on their own preferences and values, as well as a clear understanding of the available information on circumcision.

Resources

http://www.mayoclinicproceedings.org/article/S0025-6196%2814%2900036-6/fulltext#tbl4fne

http://www.mayoclinic.org/tests-procedures/circumcision/basics/why-its-done/prc-20013585

http://pediatrics.aappublications.org/content/early/2012/08/22/peds.2012-1990

http://www.nytimes.com/2012/08/27/science/benefits-of-circumcision-outweigh-risks-pediatric-group-says.html?_r=0

http://www.who.int/hiv/pub/malecircumcision/infopack_en_2.pdf

http://www.jurology.com/article/S0022-5347(12)05623-6/abstract

http://www.intactamerica.org

http://www.circumcision.org/

http://www.cirp.org

www.cirp.org

Minnesota births at homes and birth centers rise more than 150 percent

Press Release by MCCPM

St. Paul, Minn.—The number of Minnesota babies born outside of a hospital setting rose by 156 percent from 2004 to 2012, according to birth certificate data from the Minnesota Department of Health.

More than 1.3 percent of births (904 babies) in Minnesota in 2012 occurred outside of a hospital—mainly in homes and freestanding birth centers—up from 0.5 percent of births (366 babies) in 2004.

press release graph

Births occur outside of hospitals more frequently in greater Minnesota than in the Twin Cities metro area. In 2012, 1.7 percent of babies born in greater Minnesota counties were born outside of hospitals, while 1 percent of babies in the seven-county metro area were born outside of hospitals, according to health department data.

Nationally births outside of hospital settings have increased since 2004. According to the Centers for Disease Control and Prevention, the percentage of births occurring outside of hospitals increased from about 0.9 percent of U.S. births in 2004 to about 1.4 percent of U.S. births in 2012, its highest level since 1975. In 2012, 53,635 births in the U.S. occurred outside of a hospital, including 35,184 home births and 15,577 births at birth centers.

__________________________________________________________________________________

About the Minnesota Council of Certified Professional Midwives

The nonprofit Minnesota Council of Certified Professional Midwives promotes, protects, and preserves midwifery as practiced by certified professional midwives in the state of Minnesota. The council is committed to safe maternity care provided in an out-of-hospital setting. For more information, visit http://www.minnesotamidwives.org.

Birth Story: Women should be running the world!

ElenaJane

Birth Story of Elena Jane

As told by mama Emily

Elena Jane was born Sept. 7 at 12:45 a.m. She weighed 8 lbs, 1 oz and was 21.5" long. Here's how it went down:

T-minus 5 days until the 42- week mark. Monday, Sept. 8 was 42 weeks, this was Wednesday, Sept. 3. We met with Midwife Monica, she had me wear a belly band to make sure everything was lined up. A belly band sounds nice -- oh it supports your back from your massive belly. But, actually it was kind of painful and I had to wear it over night. I kept coming up with excuses to take a shower so I could have a reprieve for 10 minutes.

T-minus 3 days until the 42-week mark -- Friday, Sept. 5. We met with midwife Monica in the morning and she checked things out. She said things had progressed slightly since last time and my cervix was soft. I was dreading the herbal induction but by this point had succumbed to the fact that this is probably in my future. Monica suggested we do the Foley catheter--I would need to return that afternoon so Midwife Amy could insert the Foley. I was sent home with the herbal induction if, by Sunday morning, nothing happened I would need to start the herbal induction -- which is ingesting something every 15 minutes followed by a lot of time in the bathroom (as I've heard).

My husband, Geoff, and I left with my bag of "goodies". We decided to go to Mickey's diner in St. Paul to load up on a greasy meal (figured it was similar to an herbal induction, right!?) and then went to Como zoo to walk around. Luckily, I took a 2-hour nap before going back to the birth center to get the Foley.

I know we learned about the Foley in childbirth ed class or at the Health Foundations complications class, but until I actually had to have it, I don't think I filed it in my brain as something to recall. The Foley catheter is a thing that is inserted into your cervix and then two small balloons are filled up with saline solution on each side of the cervix. This is meant to aid dilation. It falls out on its own around 4 cm, otherwise you have to have it taken out. I was scheduled to have it removed on Saturday at 4 p.m.

As soon as midwife Amy filled the balloons, I got instant cramps all over. By the time I came home, the pain was so bad, I called the midwife line to see if there was anything I should do -- I couldn't imagine having this constant pain until 4 p.m. the next day. I will remember Monica's words forever, "Well, Emily, it sounds like it's doing what we want it to do, which is put you into labor...so wrap your head around that!" I laughed and thought, OMG -- no kidding, I can start doing my relaxation and breathing (for some reason that didn't occur to me until she told me that). Monica said to focus on if contractions were coming and going and to call if they got close together or especially if the catheter fell out.

Once I had that to focus on, the contractions were more manageable. I could barely eat anything for supper (rice and cream of mushroom soup) and then I went to bed. The contractions lasted all night but by the morning, they had lightened quite a bit so I could eat a solid breakfast (thank goodness or I don't know if I would have had the energy). After breakfast we went for a walk which picked things back up quickly -- we didn't make it for a long walk and we had to stop every 5 - 7 minutes to work through a contraction.

I got back and called the midwife Amy to check in and let her know where we were at. She said she'd see me at 4pm but to rest and eat some oatmeal. Geoff went and got me some oatmeal of which I could eat half -- and then in less then an hour the contractions were so bad, the oatmeal came back up. Geoff called again to let Amy know the contractions were consistently 5 minutes apart ( I was also concerned b/c I needed to get to the birth center for antibiotics b/c I tested positive for group B strep -- and they said I should go in about 5 min apart). Amy said to really try to get some sleep and she'd see me still at 4pm.

I went to bed to try to get some good shut eye but within 15 minutes I had to pee and out came the catheter -- those balloons were WAY bigger than I had thought...Not quite a raquet ball but I'd say maybe two ping pong balls on each side. As it was coming out I thought, what good practice for birth -- HA (not the case). This was at 1:45pm on Saturday.

We ended up meeting Amy at the birth center at 3:30pm. She wasn't quite there when we arrived so I had some lovely heaving and ho-ing out on the deck until she arrived. As soon as she opened the door, I went into the birth room (the one on the left), knelt on the ground with my head on the sofa and dealt with a few more contractions while I got my antibiotics. I heard my husband ask Amy, "Do you think we'll need to go home or is she far enough along to stay?" Amy said based on the noises I was making, I was staying (I was relieved).

My doula, Kim, arrived shortly after. I started working through contractions in the shower on a birth ball, which was nice and then Amy had me get up and walk up and down the steps and around the studio upstairs. I don't know what we would have done without our doula there, it was nice for Geoff to be able to take a break or stay with me when I wanted. I was so out of it, I didn't notice any lapse in having someone there to help me. And I later found out that he had eaten dinner at some point...who knew!?!

Around 6 or 7pm, Dr. Amber (chiropractor) came to adjust me. Her three cute kids walked in and I was again heaving and ho-ing in the waiting room. They were so cute but I couldn't say a word to Amber!  After the adjustment, Dr. Amber had me go to the bed and hang one leg over the bed ( I think we watched a video of this in class) and labor there for a bit. After several of these on each side, Amy checked to see where I was at.

With Amy's check, my water broke because it was right there and she said I was fully dilated and ready to push! I couldn't believe it! It didn't even seem possible, I kind of just assumed at that point that the baby would be in me forever and I would have contractions the rest of my life. She said once I stood up, I'd probably feel a lot less pressure and an urge to push.

I did feel less pressure but never really had the urge to push -- just pushed when I had a contraction as they told me. This was 9:30pm. I started pushing on the birth stool -- not really a fan. I felt kind of like the gorilla I saw at the zoo that morning -- just sort of sitting there with my big belly while everyone watched me from every angle. Then we did squats in the shower -- these were my least favorite as they were the most painful, I think I thought the baby would accidentally fall out on the hard shower floor (I'm an idiot) and I didn't like that I couldn't rest in between pushes -- just stand. Then we labored on the bed in the normal legs raised position -- and a little with the birth ball on the bed..by far my favorite because I liked that I could rest in between. However, Geoff and our Doula sure had to be strong to basically be my make-shift stirrups!

We rotated between all of these positions maybe three times. Every time Amy suggested the shower squat thing I gave her a bit of a stink-eye (she later told me!) but complied because I knew the pain meant it was working. Throughout I thought I would not have enough energy to get through it. A few spoons of honey I think pushed me through.

Finally, we got to the point where I could feel things happen and Amy told Geoff to get ready to catch the baby. She had one of the nurses (Monica - a nurse in training and her first birth) take his place to hold my leg. That was exciting for me because I knew it was close. I asked if I could push even if there wasn't a contraction, I was ready for the finish line. I pushed and felt her head come out. Amy told everyone to wait (while she moved the umbilical cord from around the neck). I remember just being super still and then she said, "ok" and I was still. That felt like 10 minutes of waiting for -- I didnt realize she was saying ok for me to finish pushing. I just watched her and it felt like silence. Then she looked at me and said, "ok, push" and that was super easy! Elena's slippery squirmy body went from Geoff's hands to my stomach --- It was awesome!

I remember saying something along the lines of, "Holy @#$&, I cannot believe women have done this for so long. We deserve a huge amount of money and women should be running the world!"

The rest is a blur -- I had to get that darn placenta out. I had to cough a bunch which was hard because I was sore everywhere and my throat hurt from groaning for 12 hours. Ok, it wasn't anywhere as close as hard as birth but I was just tired and wanted to cuddle my baby. Geoff was nervous because there was bleeding and clotting that the nurse was concerned about but they all calmly did what they said would happen in the complications course (super helpful). I was on cloud 9 and didn't really have any concerns.

We packed up and headed home at 5:30 a.m. It felt a little weird to be driving home with an infant after having no sleep at all and going through that but it was nice to be home. All things said and done: Labor for 33-ish hours, active labor for 12-ish hours, pushing for 3 hours, 0 drugs (well accept for the antibiotics and ibuprofen afterwards), 0 herbal inductions :), 1 cutie pie and 1 happy family!!

I can't say enough about how amazed I am with the nurses and midwives at Health Foundations. What an amazing profession they have been called to do. I could never do it but I am so grateful for them!

Emily, Geoff, Elena & Ella bean (the dog isn't too jealous!)

_DSC0259 - Copy

Estimated Due Dates

While we place a lot of emphasis on a woman's due date, the truth is these estimates of a baby's possible arrival are not very good indicators of when baby will actually be born. Believing this myth has the potential to set birthing families up for unwarranted pressure and stress and can lead to negative birth outcomes such as unnecessary testing, inductions, and c-sections. Learn more about estimated due dates here.

Flower essences

SAMSUNG DIGITAL CAMERAFlower essences are an amazing and lesser-known healing resource that can be quite amazing for expectant and new mamas, and, really, anyone.  We offer a line of flower essences by Santosha Birth and Wellness that are specifically for conception, pregnancy, birth and motherhood.  We also have a new acupuncturist that is trained in the use of flower essences.  With all the buzz about flower essences, we wanted to share a bit more about what flower essences are and why they are so wonderful for the childbearing cycle.  

What are flower essences?

Flower essences are type of botanical medicine that works on the energetic level (like acupuncture does) to positively affect the emotions, energy, and deeper soul levels. Flower essences are especially suited to helping people overcome obstacles, heal the past, reduce negative thoughts, actions and perspectives, cope with changes and challenges, and achieve greater joy and peace. Put simply, flower essences are energy medicine—they safely and effectively address root causes of emotional and physical issues to bring healing and growth on all levels (physical, emotional, mental and soul).

Odorless and virtually tasteless, a flower essence is an infusion of flowers stabilized in water and a small amount of brandy to preserve. 

What is the history of flower essences?

Flower essence therapy has been used by indigenous people for centuries and have been thoroughly studied and developed in the West for over a century. Dr. Bach, a British physician and homeopathic doctor, was the first to develop a robust system of flower essence therapy in the early 1900s. His system included 38 flower essences and his blend, Rescue Remedy® is the most famous of all flower essences. Dr. Bach’s early death left room for further development and refinement of this system and additional flower essences have been added to this healing system.

Master herbalists such a German healer Julia Graves (creator of the Lily Circle) and Flower Essence Service, among others, have continued Dr. Bach’s legacy, producing high quality flower essences that yield profound results. The Lily Circle (used in Santosha's blends) is exceptionally well suited for female archetypal issues and those surrounding birth and motherhood, but are equally powerful and healing for all people.  

Why flower essences?

There are so many reasons why flower essences are an incredible healing tool, especially in the childbearing cycle.  

They are safe: Because flower essences work on the energetic rather than biochemical level, they don’t pose the same risks that some pharmaceuticals, herbal tinctures, and essential oils may pose. This makes flower essences particularly attractive for treating issues that may arise in the childbearing cycle, when other treatments may not be advised. Flower essences are completely safe for use in pregnant women, birthing women, nursing women, newborns, infants, and children (and even pets and plants, evidence shows!). There are NO known contraindications.

They are gentle: Flower essences are gentle, they don’t work by force, nor do they overwhelm the body or mind. Flower essences are subtle, yet powerful and profound in the positive change they produce.

They address root causes of physical ailments and emotional/spiritual conditions. Flower essences often get to the source of one’s physical or other ailments. By addressing underlying emotional/mental/energetic/spiritual factors contributing to dis-ease or challenges, flower essences heal the deeper levels of one’s being and when they are healed, the body follows. What better time than pregnancy to clear out what doesn’t serve us and make room for greater wellbeing in parenthood? The healthier and happy we are going into parenting, the better we can be for ourselves and our children!

How do you use a flower essence?

Flower essences are commonly taken by mouth, with 4 drops taken orally 4 times a day. This is a general guideline—a person in an acute situation (e.g. labor) may take an essence as frequently as every 10 minutes as needed. Taking an essence frequently is the path to desired change. Because there is a small amount of brandy in the essence, some pregnant women or sensitive individuals may prefer not to take the essence directly under the tongue. You can add an essence to beverage—covered water is best (but tea or juice can also be used). For those that wish to avoid ingestion entirely, flower essences can be sprayed or applied on to the skin, clothing, bedding or air. One can also take a flower essence bath.

How long should one use a flower essence?

Many flower essence practitioners note a definite cycle period in taking a flower essence, typically two to four weeks though this can be longer or shorter for some and depending on the reason for use.

Can flower essences be used together with other healing modalities?

Flower essences can be used alone or in conjunction with other therapies to enhance a healing process. They have been used with great success by flower essence practitioners, naturopathic doctors, massage therapists, psychologists, medical doctors, veterinarians, and other health care practitioners.

How do I learn more?  

If you want to learn more about flower essences, you can speak with us at an upcoming appointment or contact Santosha Birth and Wellness directly at www.santoshamama.com.  

We're having a good time-- a birth story

Baby Jacob’s Birth Story as told by Rochelle Matos birth6As a birth doula, childbirth educator and mother of 4, I know that birth rarely goes exactly as you hoped or imagined it to be. However, in the birth of my fifth baby I experienced what I would call, “my ideal birth”. It was absolutely amazing and I’m so thrilled and thankful for the experience!

In the weeks leading up to Jacobs birth, I would have contractions from about 4pm-9pm every 15 minutes or so, nothing too strong, but it was comforting to know my body was getting ready. The day before his birth, these same easy sort of contractions started in the morning and kept going – all day. I wasn’t in labor, but this was different, so I texted my friends who were going to attend the birth that I was experiencing something new – just a heads-up. We had a wonderful evening as a family going on a picnic and swimming at a local beach. Got home and went to bed as normal.

That night, at 2:00am, on July 4th, 2014, I woke up with a real, strong contraction. Afterward I went to the bathroom and noticed some bloody show. “Is this for real? A 4th of July baby?” I kept thinking. I went back to bed and had another contraction at 2:30 - again, super strong - definitely different from the weeks leading up to this point. After lying in bed for another 15 minutes, I was feeling restless with lots of adrenaline. I got up and brushed my teeth and did my hair. Yup, I wanted to look pretty for the birth, so I straightened my hair at 2:45am. After that I felt calmer, and went back to bed at 3:00am. I contracted 2-3 more times and at 4:00am told Luis that I was in labor, he promptly encouraged more sleep, so we rested until 5:00am when the contractions were coming every 20 minutes. At 5:30, I called the birth center, Amy told me to eat breakfast and see what would happen as the sun came up. I did as she suggested, eating breakfast with my husband, but had a hard time determining if labor was going to continue or fade. At this point, the contractions were anywhere from 10-20 minutes apart and not getting closer… however they were so, so strong that after each one I would think, “I should be at the Birth Center by now”. At 7:15am I asked if I could come in, we made a plan to meet at the Birth Center by 7:45am.

Health Foundations birth centerLuis loaded the car, I texted my friends and called our doula. I told everyone that we were heading in, but since I wasn’t sure if this was really going to happen, I told them to wait on standby. The drive to the birth center was fun, Luis and I really enjoyed the morning together – I kept saying, “we should get up before the kids every morning and hang out together”. It was awesome to have a morning, just the two of us, it felt sort-of like a mini date morning together. We arrived at the birth center at 8:00am. Amy was still setting up so we wandered about upstairs… it was nice to have the birth center to ourselves and relax.

Initially, in my birth plan I requested no vaginal exams, however I was uncertain if I was really in labor, the contractions at this point were still 10-20 minutes apart. I asked Amy to check me, so I could decide if the team should come on in. She did, and found I was a 7-8cm. I was so relieved and that little bit of knowledge helped me to relax, I was in labor and going to have a baby - today!

labor #1At this point, I was experiencing a quite a bit of back labor. Amy suggested the TENS unit and I was eager to try it out for myself. It was really helpful – it didn’t take the pain completely away, and I still needed Luis to put pressure on my back, but it felt like a little massage to help ease the pain during and between contractions.

labor4

 

At 8:30am, we asked our team to come on in to the birth center. As the birth team started arriving, I welcomed them - we chatted and laughed. Everyone was surprised by the joking and smiling of the morning. I kept saying “we are having a good time” in reference to the birth stories I read in Spiritual Midwifery by Ina May Gaskin. And I really was having a good time, it was so fun to have my friends and family come and be with me on this special day.

laughing

 

By 9:00am, Sibyl our doula, Anna my sister-in-law and photographer, Laura my friend and videographer, and Liz, with 2-week-old Maeve, all arrived at the birth center. Having everyone come was a wave of joy. When the last person drove up front of the birth center, I looked out the window and said, “Now that everyone is here we can go have a baby”. I had hoped everyone would be able to come, but with kids and busy lives it was all uncertain - I am amazed that they could all be there. Quickly, the labor picked up – with the frequency of contractions increasing.

 

labor #3

 

I made my way back to the birthing suite, knowing I’d want to get into the water soon. I looked around the room, it was so beautiful and everything was ready. I had set up my birth altar from the Sacred Pregnancy journal & class, I was wearing my birth necklace, Luis was with me every step of the way, rubbing my back and kissing me. Amy, my midwife, whom I truly trust, was ready. After a few really strong contractions I was ready for the tub.

 

Birth Altar

 

At 9:30am, I climbed into the tub and again looked around the room, everyone was here; it was perfect. I made a joke about everyone watching me enjoy my hot tub and where is my margarita and we all laughed. Did I mention we were having a good time?

 

Tub w: Birth TeamI rolled on to my knees away from everyone, facing Luis to get ready for baby to come. We quietly talked for a few moments, sharing this little break together. It was a private and intimate moment. Then I had the beginnings of wanting to push. I reached inside to see if baby was close – nope, he was about three inches inside. 10 minutes passed.

tubwluis

 

tubamy1tubamy2Next contraction, I felt an overwhelming downward pressure, I couldn’t decide if I should relax or push, so I panicked, I can’t do this. I started shaking my head, I couldn’t breathe and my midwife, husband and doula were all talking to me and encouraging me. “Just Amy,” I said, “Just Amy”. She reminded me to slow my breathing, she told me I was strong, and that I could do this. I repeated her words and calmed down.

After a few little pushes, Luis got in the tub and I felt again where baby was at (hoping he was about to crown), nope, still an inch inside. With the next contraction, I felt like a bowling ball was moving through my body, it was so intense, I pushed short easy pushes as Amy encouraged, I reached down tubwithbackpressureand felt the head slowly coming, I stopped pushing wanting everything to stretch, and his head slowly eased out. I said “head”. I could feel the bag of waters around his head, like a soft helmet. Then the bag released and I said “bag broke”.

At this point I knew I was going to survive – one more push and I’d be done. With the next contraction, I gave a good strong push and his body slid out of mine. I opened my eyes to see my baby under the water, and slowly brought him up to my chest. The bag was still on his face and Amy pulled it off. As soon as I heard his first little whimper, I breathed a big sigh of relief and laid my head back on the tub. It was 9:51am.

birth1

 

birth2

birth3

birth4

birth5

birth7

birth8After a bit of holding and laughing and rejoicing we climbed out of the tub to the bed. In bed we delivered the placenta and started nursing. While nursing in bed, I discovered a knot in his umbilical cord, which I thought was really cool. We had some food, continued to nurse, and enjoy baby Jacob. Slowly the birth team took off and soon it was just Luis and I and Jacob resting in bed together. Bliss!

laughinginbed

knot

 

After four and a half hours at the birth center we were ready to make our way home. That night, we could hear the 4th of July fireworks as we lay in bed with our fifth baby - we even saw some from our window! It was a celebration of his birth, a beautiful day and new beginning for our family.

 

babywithflag

 

Photos by Anna Botz

More Evidence About Water Birth 

Amanda5 This week Evidence Based Birth released a statement of findings on the safety data available about water birth.  As you may recall, we blogged about water birth earlier this year, shortly after the American Congress of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatricians (AAP) released a joint statement warning about the possible risks of water birth.  This warning resulted in some Twin Cities area hospitals stopping their practice of water births.  Since then, many hospitals have reinstated their practice of water birth in light of overwhelming evidence that water birth is a safe option for many women.

Health Foundations did not alter their water birth practices as a result of this statement, as the evidence was not there to support any such change.  We were honored to serve many women in the Twin Cities who wished to have the option of water birth and chose to change providers to allow for this option.

Evidence Based Birth’s (EBB) recent thorough account of the evidence available on water birth echoes and extends the case for water birth set forth by the American Association of Birth Centers (AABC) and The American College of Nurse Midwives (ACNM) back in April. This EBB article focuses primarily on the safety information available for birth (that is, actual delivery) in water, as the safety of water immersion during labor has already been well established.

Kinds of Research on Water Birth

Discussed in this article are the types of studies that have been used to gather information about the safety of water birth, including but not limited to:

  • Qualitative descriptions of water birth
  • Retrospective surveys
  • Small randomized trials
  • High quality prospective studies
  • Case control studies
  • Case reports

Each of these kinds of studies has their benefits and drawbacks and varies in the quality and reliability of the information they produce. For example, case reports are considered the lowest level of research evidence available.  They only discuss a single event, which can potentially give us information about rare occurrences but cannot give us any reliable information about the overall safety and risks associated with water birth.  The ACOG/AAP statement issued earlier this year was based primarily on this kind of evidence, while it ignored other, higher quality forms of evidence available.  The EBB article also asserts that this statement relied on outdated literature review and made several significant errors of fact.

While the evidence presented in the EEB article is far too detailed (which is a good thing!) to cover in this blog, we wanted to share this resource as a great place for our clients to learn more about water birth safety research currently available.  We feel this is a prudent and thorough analysis that allows women and their families to gather the information they need to make an informed decision about water birth.

As a helpful high-level guide, available high-quality research is presented on the following topics:

 Effects of water birth on mothers:

  • Normal vaginal birth
  • Episiotomy rates
  • Perineal tear and trauma rates
  • Need for pain relief and pain scores
  • Length of labor, by stages
  • Postpartum blood loss
  • Birth positioning
  • Hands-off delivery
  • Maternal satisfaction with water birth
  • Pelvic floor function

Effects of water birth on infants

  • Perinatal mortality
  • APGAR scores
  • Respiratory complications
  • Birth injuries
  • NICU or Special Care Nursery admission
  • Umbilical cord pH
  • Shoulder dystocia
  • Newborn infections
  • Group B Strep
  • Newborn microbiome
  • Umbilical cord tears
  • Newborn resuscitation

The article goes on to cover frequently asked questions about water birth, such as:

  • “Why do women get out of the tub in labor?”
  • “What evidence is available about VBAC water birth?”
  • “What are the contraindications for water birth?”
  • “Why do some women report choosing or enjoying water birth?”
  • ‘What rare adverse events have been reported?”

The bottom line

In this article, EBB includes a section about what all this detailed information means for women as they consider this choice in pregnancy.

While new research continues to improve our understanding of water birth safety, the evidence suggests that low risk women experience a lower episiotomy rate, have higher rates of intact perineum, and use less medicine for pain relief when they choose water birth.  While the benefits to newborns are less clear, so far the evidence shows that fewer or equal rates of NICU admission are seen in babies born in water compared to on land.

This research review repeats the sentiment made in the 2014 AABC and ACNM statements that “water birth is a reasonable option for low-risk women during childbirth, provided that they understand the potential benefits and risks.”  The review further states that universal bans on water birth are not evidence based.

 

We encourage you to read this article on water birth and to ask us questions about this birth option during your prenatal visits.  It is supremely important that our families have the best evidence available to make informed and empowered decisions about their pregnancies, births and postpartum.