Short Documentary on Rising C-section Rates in the US

I recently stumbled on this short documentary done by the New Yorker on the rising C-section rate in the US. Following one woman's story, it identifies some causes of the soaring rate of C-sections, offers hope in VBAC, and shows the rewards of natural childbirth. This piece also promotes the use of a doula during labor and childbirth.

TENS in Labor

There are many techniques a doula can use to help you with the pain and discomfort of labor; like massage, counter pressure, heat and cold therapy, position changes, etc. However, recently I was introduced and trained in yet another great comfort measure for labor. The TENS (Transcutaneous Electrical Nerve Stimulation) has been used for years to help control pain and labor is a great place to see it in action.

So what exactly is a TENS?

• It is a handheld, battery-operated device, which transmits mild electrical impulses through the skin to stimulate nerve fibers in the back that is controlled by the laboring client. 
•  It reduces pain in labor while allowing the laboring woman freedom to move and walk.
•  It is especially useful for back labor.

                  

Is there research about the TENS in labor?

• Research findings on TENS (Carroll et al, 1997) have shown that laboring women using the device use less pain medication than women using a “sham” TENS device. 
• The majority of women surveyed (Chamberlain et al, 1993) rated it as moderately or very helpful in relieving pain, and would use it again in a future labor. 
• A study that investigated the use of TENS for back pain in labor found that “TENS has a specific beneficial effect on pain localized in the back.” 

Why does is work?

• Gate Control Theory of Pain: basically non-painful or pleasurable sensations travel to the brain faster than painful sensations, therefore reducing the amount of pain sensations felt.
• The TENS actually stimulates your body to make its own natural pain relieving hormones called endorphins.
• The laboring mother controls the TENS so she is able to take control, in a sense, of what is happening with her body.

Who should use it?

• Any laboring mother who has received consent from their care provider who doesn't suffer from epilepsy or have a cardiac pacemaker.

The TENS is a safe and effective way to reduce the sensation of pain during labor. If you are interested in using a TENS during your labor, contact your doula or feel free to email me and I can give you more information.

*Information modified from Penny Bussell

IBC and the Fistula Foundation

For months Informed Birth Choices has been planning a great event to encourage car seat safety and raise money for the Fistula Foundation. Finally the day had arrived. The weather was perfect for IBC's New Moms Group to host this awesome outdoor event.

Chloe Chrysanthus, an IBC doula and car seat specialist, volunteered her time to check and properly install infant and toddler car seats for free. Since 8 out of 10 car seats are installed improperly, this was a great service to all the moms who came out.

In addition to the care seat check and installation, IBC also asked for donations for the Fistula Foundation, an organization which performs surgeries to correct obstetric fistulas for women in developing nations. People graciously donated baked goods and handmade crafts to sell to raise money.

Danielle Koontz, the director of IBC, was hoping to raise around $50 and to her great surprise the money collected totaled $250! That amount is over half the cost of a fistula repair. The IBC car seat check and Fistula Foundation event was a true success and showed that women all over the world can change each others' lives for the better. Truly this event was a win-win for everyone involved! A BIG thank you to everyone involved!

Breastfeeding and Working

One of the most frequently asked questions that is asked when I am teaching a breastfeeding class is, "when should I introduce the bottle since I have to go back to work?" or "when do I start pumping when I have to go back to work?". Breastfeeding, pumping and working seems like it will be completely overwhelming to new moms, but it doesn't have to be. Learning how and when to pump can happen gradually and doesn't have to cause you anxiety.

Here are some of my tips for moms who will have to go back to work:

1. Establish the breastfeeding relationship with your baby first. It is more important to learn how to breastfeed and then worry about pumping.

2. Introduce the bottle after three good weeks of breastfeeding (if the first week sucks, then three weeks after you and baby got the hang of it).

3. When you do start pumping, try pumping in the morning when your milk supply is at its peak. Breastfeed the baby first and then pump the remaining milk. Add in pumping sessions throughout the day and eventually you will start making enough milk to store in the fridge and freezer.

4. Feed your baby from the bottle at least once a day so he/she gets used to bottle feeding.

5. Let the baby lead the feeding by holding baby more upright with the bottle at a 45 degree angle. Encourage her natural breastfeeding instincts (rooting, flanged lips, switching arms, etc.)

6. If your baby won't take the bottle from you (mom), allow someone else to offer him the bottle.

7. Pump when you can at work. It doesn't have to be when your baby would eat. Take advantage of your "pumportunities"!


How and when do all these things occur? Here is an action plan from the IBC Baby Basics class that I teach.

Are you interested in more information about breastfeeding and working? 

Kellymom.com

Webinar on breastfeeding and working:

From One to Two: Preparing Older Children and You for a 2nd Child

The sibling relationship is likely to be the longest lasting relationship that your child will have, but making that transition from one child to two, isn't always easy. Not only can it be challenging for the older child, but having another baby can also put stress on the parental relationship. Preparing yourselves and your child for the next baby can be very helpful in easing the transition.

Normal things to expect are parental conflicts, increase in stress and workload, ambivalence and/or hostility from the first child. Not all effects of a second child are negative, but the negative aspects are usually the hardest to deal with, so below are some strategies in preparing you and your child for what may come.

Preparing the Parents:
The birth of a second child can sometimes begin the most difficult year in a couple's relationship, therefore working on the parental relationship can have a positive results on parenting. Communication is the key to avoiding conflict.

Here are some questions to ask each other before your second baby is born:

• What is your vision of the division of labor?
• How should we handle it if our expectations aren't met?
• What has worked well for us, as parents, so far?
• What has been stressful about our teamwork?
• How can we prepare for a new baby?
• What causes you stress with our first child?

Every change requires a loss. Think about what you might lose and talk to your partner about your concerns (time together, sex, sleep, personal time, etc.)

Preparing the Child:

Although there are many things that you can do to prepare the older child for a sibling, the child's personality has the greatest effect on the reaction to the new baby. Also, his/her developmental stage can really effect how he/she reacts to the baby sister/brother.

Here are some things to try that may ease the transistion:

• Read sibling books together
• Play baby doll games
• Teach older child the do's and don'ts with the new baby
• Maintain scheduling consistency as much as possible
• Encourage questions
• Describe where they will go and who will watch them during the birth
• Encourage involvement in preparations
• Embrace resistance and regression
• Carve out along time
• Don't make promises that you can't keep.

When children are making the transition into the role of big brother/sister, they need to know that their emotional needs are taken care of. They need to feel included, respected, important, accepted, and secure.  Also, avoid overt favortism, treat each fairly, honor the children's difference, avoid comparrisons and labeling them, and don't assume that all conflict is bad.

Having a second child can be very stressful on the family during which a lot of adjustments occur, but it also a very joyous time. So, prepare yourselves and your child for the wonderful addition to your family.

For more on sibling adjustment you can listen to the is free webinar.

Books:  Beyond One, Jennifer Bingham and How to Raise Emotionally Healthy Children, Gerald Newmark

Easter Surprise!

So the week before Easter was super crazy. I won't bore you with details but it involved an overnight postpartum visit, my parents spending one night, hosting a neighborhood Easter egg hunt, preparing for in-laws coming into town for a 3 day visit, my 31st birthday, and oh yeah, did I mention it was spring break so both kids were home. It was a bit stressful, but totally do-able.

A midst all the hoopla, I remembered that I had a client that was 7 days overdue. So I checked in with her via text. Everything was the same (i.e. no contractions or signs of labor) and she told me that she was nervous about the possible looming induction. So I said not to worry and gave her a list of natural labor starters and with a focus on nipple stimulation 2-3 times a day with a breastpump on low. And I thought, "Ok, great, I'll be able to get through the holiday weekend with no baby."

As I am laying down to sleep after an exhausting Saturday of running around and hosting my in-laws, I get a text that my overdue client is in labor. "Ahhhh!", I think, "not now!" After a couple of hours of phone doula-ing, I knew it is time to go. We met at the hospital. Everything went great and a healthy baby was born bright and early Easter morning.

Despite my original lack of enthusiasm, I was so excited for the parents and they seemed over-joyed with the whole birth experience.  I think the lesson learned there is that you never know how the day will turn out and as a doula we have to always be ready to serve and put our best foot forward for moms (and dads) who really need you.

Happy Easter!

Baby Blues or More?

Are you wondering if you have the "baby blues" or if it's something more?

The baby blues occur right after birth and resolve on it's own in 3-5 weeks. They symptoms of the baby blues are tearfulness, irritability, sadness, sleeplessness, anxiety, exhaustion. But what if those symptoms don't clear up on their own in about a month? You may be suffering from Postpartum Depression or Anxiety (Postpartum Mood Disorder-PPMD). PPMD is not uncommon. Up to 20% of all women suffer from PPMD across cultural and socioeconomic lines. PPMD can occur up to a year (or longer) after the birth of a child and may have begun while you were pregnant.

Early intervention is key if you think you might be suffering with PPMD. There are many sources of help available online and in person, whether you need medical, therapeutic, or social support. Reaching out or having someone reach out for you is the most important thing to getting help.

Ok, so what if you haven't had your baby yet, but you are looking into PPMD as a precautionary measure. Here are some risk factors and stressors that can increase your chance of suffering with PPMD.

Risk Factors:

• Depression or anxiety before or during pregnancy
• Previous cases of PPMD
• Intense fear of child birth
• History of mental illness and/or substance abuse
• Poor support system
• Abuse
• Loss of pregnancy or child
• Loss of one's own mother
• Medical complications in mother or baby
• Social Isolation
• Abrupt weaning
• Thyroid dysfunction
• Multiples (twins, triplets, etc.)

Stressors:

• Environment (home, work, finances, safety)
• Biological (history of infertility, hormones, thyroid issue)
• Relational (partner issues, family issues)
• Genetics (predisposition for PPMD)

Dads (or partners) can also be at risk for depression or anxiety after a baby is born. It is important that they get help too!

If you are suffering with PPMD or think you are at an increased risk, talk to your care provider, your doula, your lactation professional, your child's pediatrician or anyone who can help you reach out. There are also great online resources. Postpartum Support International helps women across the world be well.

It is ok to not be ok... it is not ok to stay not ok. 

There are people who can help!