I read a wonderful blog post from the Feminist Breeder. She was discussing the Baby Friendly Hospital Initiative (BFHI) and the benefits to mothers and babies. Her post Why I'm a Feminist AND a Lactivist really discusses formula marketing strategies and the effects on breastfeeding.
The BFHI sounds great to me! Hospitals receive education, collaboration, encouragement, and recognition and moms receive the breastfeeding support they need to be successful.
History of BFHI: In 1992, the Healthy Mothers, Healthy Babies Coalition received a grant from the US Department of Health. The U.S. Committee for UNICEF supported these efforts financially and with “in kind” services. In January of 1997, the U. S. Committee for UNICEF asked the Healthy Children Project, Inc. to accept responsibility for the initiative and form Baby-Friendly USA as the non-profit organization which now implements the Baby-Friendly Hospital Initiative in the United States.
When I started researching BFHI, I was surprised by the lack on response to this initiative. This was started 19 years ago, but there are few hospitals throughout the U.S. In MO, the only hospital that meets BFHI criteria is Hannibal Regional Hospital. IL has two hospitals that meet BFHI criteria, St. John's and Pekin Hospital. I'm sure other hospitals meet some specifications, such as rooming in or offering breastfeeding support. Unfortunately, there are not many hospitals that meet all 10 criteria.
I completely support a woman's right to breastfeed, but I absolutely do NOT support the drug company’s “right” to be in the delivery room. They prompt nurses and doctors to hand out products that are only designed to stand between the mother and her breastmilk. Many women do not realize that it can take 3 or 4 days after delivery for her milk to come in. Colostrum, the yellow fluid that your breasts start producing during pregnancy, is the perfect first food for your baby and will meet all his nutritional needs for the first couple of days until your milk comes in. This does not mean you have to start supplementing with formula right away. It is perfectly normal.
To become a BFH, a facility has to meet the following 10 steps:
The Ten Steps To Successful Breastfeeding
The BFHI promotes, protects, and supports breastfeeding through The Ten Steps to Successful Breastfeeding for Hospitals, as outlined by UNICEF/WHO. The steps for the United States are:
1 - Have a written breastfeeding policy that is routinely communicated to all health care staff.
2 - Train all health care staff in skills necessary to implement this policy.
3 - Inform all pregnant women about the benefits and management of breastfeeding.
4 - Help mothers initiate breastfeeding within one hour of birth.
5 - Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
6 - Give newborn infants no food or drink other than breastmilk, unless medically indicated.
7 - Practice “rooming in”-- allow mothers and infants to remain together 24 hours a day.
8 - Encourage breastfeeding on demand.
9 - Give no pacifiers or artificial nipples to breastfeeding infants.
10 - Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or clinic
Remember, as a childbearing woman, you have rights. You can choose to implement these 10 steps on your own. Discuss your preferences with your doctor and the hospital staff.
To read an article praising Hannibal Regional Hospital, click http://www.connecttristates.com/news/news_story.aspx?id=342886
Tuesday, October 11, 2011
Sunday, October 2, 2011
Newborn and Sleep
When a baby is first born, they have a short period of wakefullness, followed by some recovery sleep. This is one of the many things I did not know when my first son was born. It is important to use this wakeful time wisely. Cuddle skin to skin with your newborn, breastfeed, and start your bonding experience.
Breastfeeding soon after birth is important if you plan on breastfeeding your baby. When my son was born, I allowed the medical staff to do their newborn assessments with Logan in a bed next to me. They also took him away for his first bath. By the time he got back, he was asleep and it was hours before he woke again. I missed my first opportunity to breastfeed. I thought it would be fine, but a whole cascade of problems led me to supplement with formula. Would breastfeeding right away have changed my outcome? I will never know about the past, but I am better prepared for the future.
So, how long is a newborn's wakeful time? How long can a newborn be expected to sleep? Unfortunately, there is no set answer to this. Just like every baby will have its own personality, every baby will have his or her own sleep cycle. Some babies sleep more especially if there was an epidural or other medications involved.
For my doula clients, I encourage skin to skin and breastfeeding immediately after birth. If baby is too sleepy, they should try to nurse as much as possible for the first 24 hrs. If baby is sleeping, clients should take advantage of the time and sleep herself. I would try to wake up baby after about 4 hours and encourage nursing. I don't ascribe a number to it. I say, "once you get to your postpartum room at some point baby will conk out. When baby does, it's time for YOU (and partner) to get some sleep too." Sleep will come in bits and spurts those first few weeks. So it can be a hard adjustment for all.
Breastfeeding soon after birth is important if you plan on breastfeeding your baby. When my son was born, I allowed the medical staff to do their newborn assessments with Logan in a bed next to me. They also took him away for his first bath. By the time he got back, he was asleep and it was hours before he woke again. I missed my first opportunity to breastfeed. I thought it would be fine, but a whole cascade of problems led me to supplement with formula. Would breastfeeding right away have changed my outcome? I will never know about the past, but I am better prepared for the future.
So, how long is a newborn's wakeful time? How long can a newborn be expected to sleep? Unfortunately, there is no set answer to this. Just like every baby will have its own personality, every baby will have his or her own sleep cycle. Some babies sleep more especially if there was an epidural or other medications involved.
Thursday, September 29, 2011
Rigging the Election: When it comes to elective induction, are women asking for it?
This post was originally published on Science and Sensibility for Lamaze International.
There is a growing movement, backed up by evidence, practice guidelines, and efforts by agencies including the March of Dimes, the Institute for Healthcare Improvement and the Joint Commission, to reduce elective inductions, especially those occurring before 39 completed weeks of gestation.
Media coverage of these efforts tends to frame the problem as too many women asking for early delivery with no medical reason and the solution as hospitals “saying no” to these women. But this woman-blaming paradigm is simplistic and flawed. New research shows that, not only have maternity care providers failed to convey the risks of early delivery to women, they may be offering or recommending elective deliveries despite the risks, and telling women they have a medical reason for induction but documenting the inductions as “elective”.
First, the evidence that educating women does help.
As reported in the July/August issue of the American Journal of Maternal/Child Nursing, researchers at St. John’s Mercy Medical Center in St. Louis, MO, studied the effect of a 40-minute educational intervention given in the context of hospital-based Lamaze classes. The intervention was an educational module about elective induction incorporating evidence and professional practice guidelines, taught along with the otherwise-unchanged Lamaze class curriculum. Researchers compared the elective induction rates between attendees and nonattendees in the 7-month period following the introduction of the new module. The content of the educational model was straightforward:
Specific risks of elective induction presented during the class included cesarean birth with longer postpartum recovery, pain, and potential complications as well as other associated risks such as longer labor, use of pharmacologic agents and their effects on the mother and fetus, and neonatal morbidity. Benefits included advance planning and timing with personal schedules. (p. 190)
Women were also given “talking points” to discuss with their provider if induction was recommended.
The intervention appeared to be very effective. The elective induction rate was about 37% in both attendees and nonattendees before the intervention and in nonattendees after the intervention. But 28% of women who attended the classes that included the educational content had elective inductions, a significant reduction indicating that the hospital would only need to educate about 11 first-time mothers to prevent one elective induction.
But, you might say, that still leaves more than 1 in 4 first-time mothers having elective inductions. What else might be driving this besides lack of education? Well, it might be this: the researchers also discovered that nearly 70% of women were offered elective induction by their doctors. And, not surprisingly, women whose doctors offered them elective induction were far more likely to choose elective induction, whether or not they were exposed to the educational intervention. In fact, the magnitude of the difference was much greater than with educational content. Roughly speaking, doctors would have to refrain from offering elective induction to just three first-time mothers to prevent one elective induction.
Prior to the educational intervention, when the hospital leadership were considering how to decrease the use of elective induction, most doctors believed that the problem was that uninformed women were asking for it, an assumption turned on its head by the research findings. In postpartum surveys, three-quarters of women who had “elective” inductions indicated that the physician suggested the option compared with only 25% of women who indicated that they initiated the request themselves. Class attendance had an influence on whether women chose to act on the option of elective induction, but the difference wasn’t huge. About 38% of women who attended the class and whose doctors offered elective induction chose the option, compared with 50% of those who were offered elective induction but didn’t attend the class.
The researchers conclude:
Although education provided in prepared childbirth classes can be helpful for women in making the choice of whether or not to have their labor electively induced, the physician is a powerful influence…It is possible that patients perceive the offer of the option for elective induction as a recommendation that they actually have the procedure, particularly if they are told they are due now, overdue, or their baby is getting too big. (p. 193)
And therein lies the problem: it turns out many women having “elective” inductions think they’re having medically indicated inductions. In a follow-up study by the same research team, published in the current issue of the Journal of Perinatal Education (full-text available to Lamaze members), the researchers report more of their findings from postpartum surveys as well as data gleaned from reviewing the medical records of each woman after delivery. They write:
The most significant discrepancy between the medical record and patient perception was related to macrosomia as an indication. For example, based on the medical record, macrosomia was the indication for 26.7% of inductions; however, 39.9 of patients noted that their physician told them they needed to be induced because “my baby was too big.” The next most common reason women believed they had an induction was that they were “due now or overdue” (20.3%), yet only 35 women (6.4%) who had an elective induction were 41 completed weeks of gestation and none were more than 41 3/7 weeks. The majority of women who indicated they were induced for being “overdue” were only 1 to 4 days past their estimated due date. (p. 28)
So what’s the take-home of all of this? How do we rein in the overuse of elective induction? Clearly, childbirth education that specifically addresses the risks, benefits, and evidence-based indications for induction helps. As we have seen, fewer women exposed to this educational content will choose induction. Researchers also found that women who had inductions were more likely to have reported feeling prepared and having the reality match up with their expectations if they had taken the classes. They were also less likely to report not knowing why they were induced compared with women who were induced but didn’t take the class. In other words, the class helped women have more fruitful conversations with their care providers.
But it is clear from this research – the first to explore these issues in depth with a combination of qualitative and quantitative approaches – that we have to change provider beliefs and practices to have a meaningful impact on induction rates. It’s time for more research on what happens behind the closed doors of prenatal visits, and for clear standards that tell doctors it is not okay to offer a major medical (often turned surgical) procedure to women as if it was benign or beneficial.
The End.
Note from Me: I LOVE the talking points. So helpful to keep women informed!
There is a growing movement, backed up by evidence, practice guidelines, and efforts by agencies including the March of Dimes, the Institute for Healthcare Improvement and the Joint Commission, to reduce elective inductions, especially those occurring before 39 completed weeks of gestation.
Media coverage of these efforts tends to frame the problem as too many women asking for early delivery with no medical reason and the solution as hospitals “saying no” to these women. But this woman-blaming paradigm is simplistic and flawed. New research shows that, not only have maternity care providers failed to convey the risks of early delivery to women, they may be offering or recommending elective deliveries despite the risks, and telling women they have a medical reason for induction but documenting the inductions as “elective”.
First, the evidence that educating women does help.
As reported in the July/August issue of the American Journal of Maternal/Child Nursing, researchers at St. John’s Mercy Medical Center in St. Louis, MO, studied the effect of a 40-minute educational intervention given in the context of hospital-based Lamaze classes. The intervention was an educational module about elective induction incorporating evidence and professional practice guidelines, taught along with the otherwise-unchanged Lamaze class curriculum. Researchers compared the elective induction rates between attendees and nonattendees in the 7-month period following the introduction of the new module. The content of the educational model was straightforward:
Specific risks of elective induction presented during the class included cesarean birth with longer postpartum recovery, pain, and potential complications as well as other associated risks such as longer labor, use of pharmacologic agents and their effects on the mother and fetus, and neonatal morbidity. Benefits included advance planning and timing with personal schedules. (p. 190)
Women were also given “talking points” to discuss with their provider if induction was recommended.
The intervention appeared to be very effective. The elective induction rate was about 37% in both attendees and nonattendees before the intervention and in nonattendees after the intervention. But 28% of women who attended the classes that included the educational content had elective inductions, a significant reduction indicating that the hospital would only need to educate about 11 first-time mothers to prevent one elective induction.
But, you might say, that still leaves more than 1 in 4 first-time mothers having elective inductions. What else might be driving this besides lack of education? Well, it might be this: the researchers also discovered that nearly 70% of women were offered elective induction by their doctors. And, not surprisingly, women whose doctors offered them elective induction were far more likely to choose elective induction, whether or not they were exposed to the educational intervention. In fact, the magnitude of the difference was much greater than with educational content. Roughly speaking, doctors would have to refrain from offering elective induction to just three first-time mothers to prevent one elective induction.
Prior to the educational intervention, when the hospital leadership were considering how to decrease the use of elective induction, most doctors believed that the problem was that uninformed women were asking for it, an assumption turned on its head by the research findings. In postpartum surveys, three-quarters of women who had “elective” inductions indicated that the physician suggested the option compared with only 25% of women who indicated that they initiated the request themselves. Class attendance had an influence on whether women chose to act on the option of elective induction, but the difference wasn’t huge. About 38% of women who attended the class and whose doctors offered elective induction chose the option, compared with 50% of those who were offered elective induction but didn’t attend the class.
The researchers conclude:
Although education provided in prepared childbirth classes can be helpful for women in making the choice of whether or not to have their labor electively induced, the physician is a powerful influence…It is possible that patients perceive the offer of the option for elective induction as a recommendation that they actually have the procedure, particularly if they are told they are due now, overdue, or their baby is getting too big. (p. 193)
And therein lies the problem: it turns out many women having “elective” inductions think they’re having medically indicated inductions. In a follow-up study by the same research team, published in the current issue of the Journal of Perinatal Education (full-text available to Lamaze members), the researchers report more of their findings from postpartum surveys as well as data gleaned from reviewing the medical records of each woman after delivery. They write:
The most significant discrepancy between the medical record and patient perception was related to macrosomia as an indication. For example, based on the medical record, macrosomia was the indication for 26.7% of inductions; however, 39.9 of patients noted that their physician told them they needed to be induced because “my baby was too big.” The next most common reason women believed they had an induction was that they were “due now or overdue” (20.3%), yet only 35 women (6.4%) who had an elective induction were 41 completed weeks of gestation and none were more than 41 3/7 weeks. The majority of women who indicated they were induced for being “overdue” were only 1 to 4 days past their estimated due date. (p. 28)
So what’s the take-home of all of this? How do we rein in the overuse of elective induction? Clearly, childbirth education that specifically addresses the risks, benefits, and evidence-based indications for induction helps. As we have seen, fewer women exposed to this educational content will choose induction. Researchers also found that women who had inductions were more likely to have reported feeling prepared and having the reality match up with their expectations if they had taken the classes. They were also less likely to report not knowing why they were induced compared with women who were induced but didn’t take the class. In other words, the class helped women have more fruitful conversations with their care providers.
But it is clear from this research – the first to explore these issues in depth with a combination of qualitative and quantitative approaches – that we have to change provider beliefs and practices to have a meaningful impact on induction rates. It’s time for more research on what happens behind the closed doors of prenatal visits, and for clear standards that tell doctors it is not okay to offer a major medical (often turned surgical) procedure to women as if it was benign or beneficial.
The End.
Note from Me: I LOVE the talking points. So helpful to keep women informed!
Monday, September 26, 2011
What is a Doula?
I finished my training seminar through DONA yesterday! I am super excited and ready to tell everyone I meet about doulas. The class taught me so many useful strategies for labor support, comfort measures, and progressing labor. I get so enthusiastic when I start talking about doulas, then I get the inevitable question.... "What is a doula?"
The short answer is that a birth doula is a trained labor assistant who does whatever the laboring mother or her family needs during the birth of their baby. She is there to support the mom and empower her choices. A postpartum doula is a woman who helps the new family make the transition to parenthood or eases the entry of the next baby into the family. Doulas are not medical assistants or midwifes.
Often, people will assume that they don't need a doula because their partner will be at the birth or because they have family around who can help after the baby is born. I'm thinking, perhaps, that this is because doulas are still a relatively new thing and people don't see how a doula could help them.
When I'm with a family at their birth, there is a lot that I do. I provide information, about the birth process, about the different birth options, about comfort measures, and what has helped other moms. I remind them that they are a consumer, who is paying for a service from the hospital, midwife or doctor. In hoing that, I hope to empower them to make informed choices and feel that the are in control. Physically, I'm there to hold their hands, rub backs and feet, tell them that they can do this and that they will make it through. I can facilitate communication between the laboring woman, her partner, and her clinical care providers.
Most importantly, I'm there continuously. From the time that they call me to tell me "it's time," I stay with them. While your doctor, midwife, or nurse might have other moms in labor or office hours to attend to, your doula just has you.
Evidence to support the use of doulas or other trained labor support professionals:
http://childbirthconnection.org/article.asp?ck=10174
What is a doula info from DONA:
http://www.dona.org/mothers/index.php
The short answer is that a birth doula is a trained labor assistant who does whatever the laboring mother or her family needs during the birth of their baby. She is there to support the mom and empower her choices. A postpartum doula is a woman who helps the new family make the transition to parenthood or eases the entry of the next baby into the family. Doulas are not medical assistants or midwifes.
Often, people will assume that they don't need a doula because their partner will be at the birth or because they have family around who can help after the baby is born. I'm thinking, perhaps, that this is because doulas are still a relatively new thing and people don't see how a doula could help them.
When I'm with a family at their birth, there is a lot that I do. I provide information, about the birth process, about the different birth options, about comfort measures, and what has helped other moms. I remind them that they are a consumer, who is paying for a service from the hospital, midwife or doctor. In hoing that, I hope to empower them to make informed choices and feel that the are in control. Physically, I'm there to hold their hands, rub backs and feet, tell them that they can do this and that they will make it through. I can facilitate communication between the laboring woman, her partner, and her clinical care providers.
Most importantly, I'm there continuously. From the time that they call me to tell me "it's time," I stay with them. While your doctor, midwife, or nurse might have other moms in labor or office hours to attend to, your doula just has you.
Evidence to support the use of doulas or other trained labor support professionals:
http://childbirthconnection.org/article.asp?ck=10174
What is a doula info from DONA:
http://www.dona.org/mothers/index.php
Tuesday, September 20, 2011
Why Choose Natural Childbirth?
Do you remember the old addage, "If you can't say something nice, then don't say anything at all"? It is true. Especially with a sensitive pregnant woman!! I'll admit it, my hormones are making me a little cranky and I cry at the drop of a hat. Commercials, songs, looks from strangers, a joke from my husband... they all bring on the tears right now.
The point is, please be sensitive and supportive of a mother's birth plan. As a doula in training, I support all types of birth choices. You want an epidural? Yay for you! You want a natural birth? Yay for you! I just want the mom and baby to be happy and healthy. However mom plans to get there, is HER choice.
Now, the reason for my post has to do with insensitive comments. Many of them coming from close family and friends. I would like a natural birth for this baby. There are many benefits of natural birth and if you do your research you will see why. Unfortunately, I am a little scared of the unknown. My son was birthed with an epidural, so a natural birth is a frightening. It does not help my confidence when people try to talk me out of my plan. Comments like, "You won't get a medal for enduring pain" or "Just get the epidural, you'll love it" are actually put downs.
I had an epidural and I did not LOVE it! It did take away my pain, but I was strapped to a bed for over 2 days! I don't care about a medal, I'm doing what's best for my child. Maybe this is all for naught. I might be induced again, but I want the chance. I want the choice to labor in my own way and some support would be awesome. Please and thanks!
While reading Dr. Robert Bradley's book, he compared the effects of an epidural on a newborn to a parent giving a 5 year old cocaine. That comparison made me a little paranoid. Okay, more than a little paranoid. I want my baby to have the best start possible. Babies that are born with an epidural are more likely to come out lethargic, with low blood pressure, erratic heart rate, or low oxygen.
I have 2 articles discussing the benefits of natural labor. I will link them here incase you would like to educate yourself.
http://www.suite101.com/content/natural-birth-vs-epidural-childbirth-a202270
http://www.aimsusa.org/ImprovingThroughScience.htm
The point is, please be sensitive and supportive of a mother's birth plan. As a doula in training, I support all types of birth choices. You want an epidural? Yay for you! You want a natural birth? Yay for you! I just want the mom and baby to be happy and healthy. However mom plans to get there, is HER choice.
Now, the reason for my post has to do with insensitive comments. Many of them coming from close family and friends. I would like a natural birth for this baby. There are many benefits of natural birth and if you do your research you will see why. Unfortunately, I am a little scared of the unknown. My son was birthed with an epidural, so a natural birth is a frightening. It does not help my confidence when people try to talk me out of my plan. Comments like, "You won't get a medal for enduring pain" or "Just get the epidural, you'll love it" are actually put downs.
I had an epidural and I did not LOVE it! It did take away my pain, but I was strapped to a bed for over 2 days! I don't care about a medal, I'm doing what's best for my child. Maybe this is all for naught. I might be induced again, but I want the chance. I want the choice to labor in my own way and some support would be awesome. Please and thanks!
While reading Dr. Robert Bradley's book, he compared the effects of an epidural on a newborn to a parent giving a 5 year old cocaine. That comparison made me a little paranoid. Okay, more than a little paranoid. I want my baby to have the best start possible. Babies that are born with an epidural are more likely to come out lethargic, with low blood pressure, erratic heart rate, or low oxygen.
I have 2 articles discussing the benefits of natural labor. I will link them here incase you would like to educate yourself.
http://www.suite101.com/content/natural-birth-vs-epidural-childbirth-a202270
http://www.aimsusa.org/ImprovingThroughScience.htm
Friday, September 16, 2011
Bradley Method
Let me tell you about my preparation for the birth of my first son. It was a 1 day "Express" childbirth center. The educator leading the course had us try on external electronic fetal monitors, showed us an internal fetal monitor, prepared us for a ceasarean section, and made me a little more worried than I already was. We toured the birthing rooms and got a sack lunch. It was a waste of time.
Now I am pregnant again and considering a different approach to childbirth education. The first class that springs to mind is the Bradley Method.
I recently started reading Dr. Bradley's book "Husband-Coached Childbirth: The Bradley Method of Natural Childbirth" and I have been very impressed. He backs his statements up with facts and gives you scientific evidence to support his practices. It is not your average "hippy-dippy" view of natural childbirth. He is modern, understanding, and compelling.
Some women are turned off by the full name of the class, Husband-Coached Childbirth: The Bradley Method of Natural Childbirth. Why does it have to be a husband? Can you have a friend, doula, partner, or parent be your coach? The name says no, but in reality the answer is yes.
Some women want more than just their husband or partner in the delivery room with them. Do you 'need' another support person? Ask yourself the following questions. Can your husband solely handle all of your demands as a woman in labor? Will he be able to tell you whats normal and whats not? Will he have a dozen different tricks up his sleeve to help make you more comfortable? Will he know how to advocate for your wishes in the labor room? A doula is trained and experienced just for childbirth. Maybe you want her in there as extra support... Or maybe you want her for your coach. That is the beauty of childbirth, you make the decisions. It is your body and you are bringing a new life into the world. Do whatever makes you the most comfortable!
Now I am pregnant again and considering a different approach to childbirth education. The first class that springs to mind is the Bradley Method.
I recently started reading Dr. Bradley's book "Husband-Coached Childbirth: The Bradley Method of Natural Childbirth" and I have been very impressed. He backs his statements up with facts and gives you scientific evidence to support his practices. It is not your average "hippy-dippy" view of natural childbirth. He is modern, understanding, and compelling.
Some women are turned off by the full name of the class, Husband-Coached Childbirth: The Bradley Method of Natural Childbirth. Why does it have to be a husband? Can you have a friend, doula, partner, or parent be your coach? The name says no, but in reality the answer is yes.
Some women want more than just their husband or partner in the delivery room with them. Do you 'need' another support person? Ask yourself the following questions. Can your husband solely handle all of your demands as a woman in labor? Will he be able to tell you whats normal and whats not? Will he have a dozen different tricks up his sleeve to help make you more comfortable? Will he know how to advocate for your wishes in the labor room? A doula is trained and experienced just for childbirth. Maybe you want her in there as extra support... Or maybe you want her for your coach. That is the beauty of childbirth, you make the decisions. It is your body and you are bringing a new life into the world. Do whatever makes you the most comfortable!
Monday, August 22, 2011
Prenatal Testing
Let me preface this entry by stating I don't like surprises. When I was younger I would hunt for my Christmas presents. I never wanted a surprise Birthday party, because it had to be planned ahead of time. When my husband was ready to propose I helped him pick out the ring. If you tell me you have a surprise, I will probably bug you until you tell me all about it. I go with the saying, "Knowledge is power."
Most pregnant moms feel this way about our babies. We can't see inside our own bodies, so we have tests and ultrasounds to tell us about this tiny new life. Is he healthy? Is is safe? How big is he? When is he due? What will he look like? Will it be a boy or girl? These questions plague moms to be.
Then we come to the prenatal testing. I am currently in my second trimester. There is a whole list of tests that I can choose from. My doctor's office offers: Amniocentesis, Maternal Serum Alpha-Fetoprotein Screening (MSAFS), Percutaneous Umbilical Cord Blood Sampling (PUBS), Quad Screen, or Triple Screen Test. There are risks and benefits to each of these. American Pregnancy Association has a great breakdown of each of these tests.
Personally, I am choosing not to do any invasive procedures. I will probably only do the Quad Screen. The Quad Screen is a maternal blood test. The screen is essentially the same as the screening tests that look for only three substances (Triple Screen), except the likelihood of identifying pregnancies at risk for Down Syndrome is higher through the evaluation of Inhibin-A levels. These tests DO NOT diagnose a problem; they only signal that further testing should be done. Except for the discomfort of drawing blood, there are no known risks or side effects associated with the quad screen test.
What tests did you have done? Why or why not?
Most pregnant moms feel this way about our babies. We can't see inside our own bodies, so we have tests and ultrasounds to tell us about this tiny new life. Is he healthy? Is is safe? How big is he? When is he due? What will he look like? Will it be a boy or girl? These questions plague moms to be.
Then we come to the prenatal testing. I am currently in my second trimester. There is a whole list of tests that I can choose from. My doctor's office offers: Amniocentesis, Maternal Serum Alpha-Fetoprotein Screening (MSAFS), Percutaneous Umbilical Cord Blood Sampling (PUBS), Quad Screen, or Triple Screen Test. There are risks and benefits to each of these. American Pregnancy Association has a great breakdown of each of these tests.
Personally, I am choosing not to do any invasive procedures. I will probably only do the Quad Screen. The Quad Screen is a maternal blood test. The screen is essentially the same as the screening tests that look for only three substances (Triple Screen), except the likelihood of identifying pregnancies at risk for Down Syndrome is higher through the evaluation of Inhibin-A levels. These tests DO NOT diagnose a problem; they only signal that further testing should be done. Except for the discomfort of drawing blood, there are no known risks or side effects associated with the quad screen test.
What tests did you have done? Why or why not?
Monday, August 15, 2011
Personal News
I have wonderful news to share with my birthy friends... I am pregnant! We are so happy. There were no interventions or drugs needed this time. Since I am diagnosed with PCOS and had a difficult conception with my first son, this is a real miracle!
I went to my OB doctor yesterday. I am 12 weeks along and we heard the external fetal heartbeat. Everything looks great so far. I can't wait to bring you all along on this journey with us.
I went to my OB doctor yesterday. I am 12 weeks along and we heard the external fetal heartbeat. Everything looks great so far. I can't wait to bring you all along on this journey with us.
Wednesday, June 22, 2011
Risky Business
I have a friend who is choosing to schedule a C-section electively. This just breaks my heart. She had her first baby by C-section and is now choosing to go that route again. She is not trying a VBAC or working to deliever her baby by other means.
Cesarean section (c-section) is delivery of a baby by surgery. C-section can be a lifesaving operation when either you or your baby's health are at risk. If it is not an emergency situation, C-sections are high risk and may lead to complications for both the mother and baby.
I firmly believe that women have become to comfortable with the idea of children being born this way. It is acceptable and even preferred by some. Evidence shows that for healthy moms and babies, natural birth is definitely preferred over a birth with interventions.
I know that C-sections are life saving procedures. I know they are an important part of our maternity care. I’ve read the books and seen the evidence. I know what demise occurred before C-sections birth was an option. Trust me it was not pretty.
However, it has been noted that most C-section births occur Monday through Friday around 5 and 10pm. So OBs (surgeons) can be home for dinner and night-night time. C-section birth is certainly easier on the OBs schedule. His or her part is over in 30 minutes and they’re outta there.
Complications for Mom
Future Risks
If a woman who has had a cesarean section becomes pregnant again, she is at increased risk of:
Cesarean section (c-section) is delivery of a baby by surgery. C-section can be a lifesaving operation when either you or your baby's health are at risk. If it is not an emergency situation, C-sections are high risk and may lead to complications for both the mother and baby.
I firmly believe that women have become to comfortable with the idea of children being born this way. It is acceptable and even preferred by some. Evidence shows that for healthy moms and babies, natural birth is definitely preferred over a birth with interventions.
I know that C-sections are life saving procedures. I know they are an important part of our maternity care. I’ve read the books and seen the evidence. I know what demise occurred before C-sections birth was an option. Trust me it was not pretty.
However, it has been noted that most C-section births occur Monday through Friday around 5 and 10pm. So OBs (surgeons) can be home for dinner and night-night time. C-section birth is certainly easier on the OBs schedule. His or her part is over in 30 minutes and they’re outta there.
Complications for Mom
- Infection: Infection can occur at the incision site, in the uterus and in other pelvic organs such as the bladder.
- Hemorrhage or increased blood loss: There is more blood loss in a cesarean delivery than with a vaginal delivery. This can lead to anemia or a blood transfusion (1 to 6 women per 100 require a blood transfusion).
- Injury to organs: Possible injury to organs such as the bowel or bladder (2 per 1002).
- Adhesions: Scar tissue may form inside the pelvic region causing blockage and pain. This can also lead to future pregnancy complication such as placenta previa or placental abruption.
- Extended hospital stay: After a cesarean, the normal time in the hospital is 3-5 days after giving birth if there are no complications.
- Extended recovery time: The amount of time needed for recovery after a cesarean can extend from weeks to months, having an impact on bonding time with your baby (1 in 14 report incisional pain six months or more after surgery).
- Reactions to medications: There can be a negative reaction to the anesthesia given during a cesarean or reaction to pain medication given after the procedure.
- Risk of additional surgeries: Such as hysterectomy, bladder repair or another cesarean.
- Nausea, vomiting, and severe headache after the delivery (related to anesthesia and the abdominal procedure).
- Maternal death: The maternal mortality rate for a cesarean is greater than with a vaginal birth. The risk of death for women who have a planned cesarean delivery is very low (about 6 in 100,000). For emergency cesarean deliveries, the rate is higher, though still very rare (about 18 in 100,000).
- Emotional reactions: Women who have a cesarean report feeling negatively about their birth experience and may have trouble with initial bonding with their baby.
- Premature birth: If gestational age was not calculated correctly, a baby delivered by cesarean could be delivered too early and be low birth weight.
- Breathing problems: When delivered by cesarean, a baby is more likely to have breathing and respiratory difficulties. Some studies show an increased need for assistance with breathing and immediate care after a cesarean than with a vaginal delivery.
- Low APGAR scores: Low APGAR scores can be the result of anesthesia, fetal distress before the delivery or lack of stimulation during delivery (vaginal birth provides natural stimulation to the baby while in the birth canal). Babies born by cesarean are 50% more likely to have lower APGAR scores than those born vaginally.
- Fetal injury: Very rarely, the baby may be nicked or cut during the incision (1 to 2 babies per 100 will be cut during the surgery).
Future Risks
If a woman who has had a cesarean section becomes pregnant again, she is at increased risk of:
- Placenta previa: The placenta implants very low in the uterus. It covers all or part of the internal opening of the cervix (the birth canal).
- Placenta accreta: The placenta implants too deeply and too firmly into the uterine wall.
- Women who have c-sections are less likely to breastfeed than women who have vaginal deliveries. This may be because they are uncomfortable from the surgery or have less time with the baby in the hospital.
- If you are planning to have a cesarean section and want to breastfeed, talk to your provider about what can be done to help you and your baby start breastfeeding as soon as you can.
Thursday, June 16, 2011
Social Media
Today I have a beef with social media. Texting, Facebook, Twitter... Blah! What happened to our old ways of communicating? I wanted to share some good news with my family. I love to tell people in person and watch their reaction. I love to involve my son and make a production out of things!
Instead I found out that my special news had been posted all over Facebook. I was so disappointed... So here is my question to you...
Do we use social media too much? Have we forgotten how to communicate in person?
Instead I found out that my special news had been posted all over Facebook. I was so disappointed... So here is my question to you...
Do we use social media too much? Have we forgotten how to communicate in person?
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