Showing posts with label Topics of Interest to Pregnant Couples. Show all posts
Showing posts with label Topics of Interest to Pregnant Couples. Show all posts

Saturday, August 18, 2018

A Spectrum of Pregnancy, Birth & Parenting Services to Meet Your Needs


After working with San Luis Obispo families for over 20 years I am more strongly committed than ever to helping families find what feels right to them for pregnancy, birth and parenting. I have a broad perspective and a depth of knowledge which is grounded in the work I have done with families making a wide variety of choices. As a doula I have been blessed to be part of over 100 births. Working beside doctors and midwives I have witnessed inspiring births both in and out of the hospital. As a birth educator I have impacted the births of several hundred babies and through my work with the Birth & Baby Resource Network, La Leche League, and the International Cesarean Awareness Network I have touched the lives of countless families in our community and beyond.

I offer a variety of support/education options to match your unique needs. Our journey together may start at any point along the spectrum. Please feel free to mix and match and make the exact support and education package that meets your needs. All classes are offered both as group or private experiences with flexible schedules.


Before You are Pregnant

Private consultations over tea: learn about options & resources in our community or review and process a past birth and discuss possible effects on future births. We can meet in the privacy of your home or at a coffee shop.                              
 

Early in Your Pregnancy

Classes: learn how to nurture your body, your baby and your relationships in my Healthy Beginnings/Healthy Choices classes.


                                                        
Preparing for Your Birth












Classes: My small group classes held, in the privacy of a home, foster a sense of belonging as we eat, laugh, learn and share together this amazing adventure. My Heart, Mind & Body series empowers and inspires you to create the birth you want.

For each class group I create a private on-line community for extended sharing of ideas, inspiration, connection and support which continues until your baby is sleeping blissfully in your arms.
Labor Land Practice: My Birth Connection Date Nights are serene spaces where all learning is experiential through relaxation, guided imagery and touch. The focus is encouraging oxytocin, the “love hormone”, to flow between you, your partner and your baby, and to teach you how to move through labor land together. These “practice” sessions are ideal for experienced birthers, homebirthers, or as an expansion of more intellectual birth classes.




Private Classes in Your Home: Every family has different needs; bed resting moms, changing schedules, or simply a desire for privacy. I try to be as flexible as possible to let you create your unique education package. Let my Class Outline be your guide. I am happy to create a series just for you!



Doula Service: I am happy to join your birth team no matter where you are planning to birth; home, birth center or hospital. We start building a trust relationship with prenatal visits in your home. Through listening I learn what you need and want to feel confident about your coming birth. I facilitate thinking and dialogue between partners to help clarify and prioritize what is important to them and help craft a birth plan which reflects these values while being well received by your care provider and staff.


I am available via phone, email or Facebook to answer questions and lend support throughout the pregnancy.

                    Once labor begins. . .

 I will stay continuously by your side
 where ever you are laboring until. . .
your baby has arrived. . .

and is blissfully breastfeeding for the first time!

I will visit your home a few days after your birth to ensure breastfeeding is going well, check on your postpartum recovery, and help you process your experience with tears, talking and laughter. I will answer questions, clarify and enlighten you on issues you may not have understood. I want you to have a thorough grasp of what happened, why, and how necessary it was, to empower you for future births.
After Your Birth

Private consultations over tea: When women suffer after a difficult birth experience it is very helpful to share your story to a listening heart who is knowledgeable enough to review your birth, answer your questions, and help you move forward in your process. I can connect you to resources for your recovery and discuss things you will need to think about for future births.

Private Postpartum Visits: I believe new mamas need to rest and adjust to motherhood in the comfort of their home. I am happy to travel to you. The first days and weeks of parenthood many new families need some additional guidance. A little hands-on help from an experienced mother/doula can give a new mama just the boost of confidence she needs.

Welcome to the parenting community!

Classes: My Fourth Trimester Parenting Support group meets every Tuesday from 10:30-12. I provide this free to the community because I believe deeply that women need support during this important transition in their lives to grow fully into confident motherhood.




Support Group: I lead a La Leche League Mothers’ Meeting once a month in the South County which is free and open to all mothers for breastfeeding advice and support.

 

Loving Guidance Workshops: These periodic workshops cover my Five Steps to Creating a Healthy, Happy, Whole Family empowering parents to move through the normal ups and downs of parenthood, take control of their own learning, and make their own decisions on how they wish to parent.

Support Group: I created “Whole”istic Mamas and Papas to provide community for families choosing to parent from an alternative point of view; attachment parenting, co-sleeping, extended nursing, baby wearing, individual vaccination choices, homeschooling, etc. It is a safe space; both in our face-to-face play day meet ups and private on-line group for asking questions, gathering information, sharing and learning from each other.













Parenting is much more fun when we share and play with others!

Let's connect! I am happy to answer questions and get you started on just the right path for you.            Call: 805.459.8145
jenniferstoverdoula@gmail.com

Tuesday, June 16, 2015

A Feminist Perspective on Breastfeeding

“Breastfeeding and Work; Let’s Make It Work.” What comes to your mind when you hear the 2015 World Breastfeeding Week’s slogan? Most Americans think of women working outside the home who juggle nourishing their babies at their breasts with the demands of a boss. This calls to mind breast pumps, bags of frozen breastmilk, and bottles left for daycare providers; mothers striving to provide the very best both financially and nutritionally for their families. If you are a politically progressive American, “breastfeeding and work” may evoke images of paid maternity leave, perhaps even as long as some European countries, which provide 1 to 3 years! If you are a woman working in an office job perhaps this slogan sets you dreaming about pretty, private, lactation rooms with cozy chairs, baby photos, relaxing music, a clean sink to wash your pump parts, a refrigerator for storing pumped milk, clean counter space and electrical outlets to plug in your double, hospital-grade, hands-free, electric pump. Or you may be one of the many women yearning for a long-enough break from running a cash register, working the sales floor, making motel beds, tending the sick, picking vegetables, or flipping burgers to drain your full breasts often enough during the day to keep your body producing enough of a milk supply to match your hungry baby’s growing needs.

These are all valid dreams and desires, but as a community lactavist and modern feminist I have a broader vision; a vision better for all of humanity.

Who decided what IS work and what ISN’T work? Men did. Our modern chauvinistic culture decided work was what men did away from home. Therefore, women weren’t working when they stayed home and raised children. Anyone who has raised children knows this is ludicrous. Raising babies into well-functioning, happy, healthy adult human beings is incredibly demanding work. The hours are ridiculously long. Your job description changes every few months. Your day is filled with multitasking, negotiating, and strategic planning. Safeguarding the next generation, assuring the continuation of the species, is arguably the MOST important human endeavor. Regardless, men deemed raising children as less important than making money; therefore, what women did was NOT work.

Sadly when the women of the women’s liberation movement fought for the right to work outside the home they adopted the male paradigm for themselves. Imagine all those career-minded women in their pant suits. Secretaries might wear skirts but any woman who hoped to climb the corporate ladder donned the female equivalent of the coat and tie. Even Hillary Clinton perpetuated this stereotype through much of her last campaign. The 1960’s feminist reasoning went like this. We want to compete in the professional world. The professional world was designed by men for men, therefore we will pretend we are men. We will pretend we don’t grow babies, we don’t birth babies, and we don’t make milk to continue to grow babies. Many of the feminists of the time, such as Gloria Steinem, DIDN’T have babies. Others, like Betty Friedan had children who were older by the time they spearheaded a cultural revolution.

The “Mommy Wars” are a direct outgrowth of this acceptance of the male construct of what is and isn’t work. The media plays into big corporations’ hands when they keep the conversation about women judging each other; “working” mothers versus stay-at-home mothers. Giant formula makers are happy the conversation stays away from the damage we are doing to the long-term physical and mental health of human beings by feeding milk proteins designed for baby cows instead of baby humans.
Purely from a science perspective the verdict is in. Breakthroughs in epigenetics, the human microbiome, gut health, and evolutionary biology all point to the same conclusion; formula feeding is a major health risk in our society, but no one is talking about it except people directly involved with lactation education. We desperately need to make a cultural shift if we want to truly deal with the obesity epidemic. Or tackle lowering our rates of heart disease, autoimmune disease, breast and cervical cancer in our country and much, much more. Studies link all of these health issues to artificial human-milk feeding.

That shift starts by valuing women’s abilities to nurture and sustain life. Acknowledge that women have brains, and uteri, and breasts that lactate. We are the crucial link between the generations. This most important ability needs to be supported by every level of society if we want the human race to thrive. We need to support not only the women who are pumping behind closed office doors, but also the women who need to pump during a break from picking strawberries, and the women who are working at home to raise kids, and the women who are nursing their children while they take calls for their in-home business, and the women who are taking their babies to work. We need to tell all mothers through our laws, through our media representation, through changes in our language, through our politics, and through our economics that all women who are providing breastmilk for their children are doing important work for all our futures. I want us to move beyond the Mommy Wars, to move beyond normalizing breastfeeding, into a culture that values and supports the significant contribution every lactating woman is making for our country, our world and our species.   

Jennifer Stover is the education chair of the Central Coast Breastfeeding Coalition, based in San Luis Obispo, CA. She has been a La Leche League leader for 5 years and a certified birth and postpartum doula for over 20 years, and founder of the Birth & Baby Resource Network.



Monday, June 15, 2015

Classic Hospital Bed Meets Ancient Wisdom

So you have read Ina May's Guide to Childbirth and plan to birth in an active, upright position. Bravo! You have taken the first step in reclaiming your birth instincts. As a first time mother you have chosen to do a "homebirth in a hospital." You took classes, hired a doula, and crafted a birth plan. Being well educated when labor began you did not rush to the hospital with the first contraction. Instead you listened to your doulas suggestions of eating, showering, baking, gardening on hands and knees, rocking in a rocking chair, swaying on a birth ball, dancing, cuddling, hanging within your partner's loving embrace, climbing up and down your stairs, and going out for a walk or two or three. 

At last the time has come to drive to the hospital. You climb in the car and instinctively know that leaning back in that bucket seat while you sit to ride to the hospital is NOT going to be fun. Each contraction is intensified without being more productive. You are so glad to be able to get out of the car. You get on your feet and instinctively lean forward, drop your knees a bit and sway gently with the contraction that hit as soon as you stood up. Strong but doable you tell yourself. 

Next stop the emergency room doors and waiting for a wheel chair to take you to your room. Now they want you to sit in a chair and wait for a chair. The idea of not having to walk sounds inviting as your labor hormones are coming on strong and making you feel drifty but the actuality is something very different. Labor sensations while in a wheel chair moving forward causes your head to swim and you grip the arms of the chair causing tension through your neck and back intensifying your pain. The pressure of the seat on your bottom causes you to lift one cheek and list to one side. Too late you realize walking would have been much better than this. You traded in your feelings of competency and confidence in exchange for a quicker way to access the privacy of your birth room because you have a strong desire to be away from the bright lights and staring eyes of strangers. 

You finally arrive at the room where you will meet your baby face-to-face and there it is; the bed. It's presence dominates the room. Next to it stands all the technology money can bring to birth; fetal heart monitor, contraction monitor, computer, read out screens, audio controls, blood pressure reader, oxygen saturation tester, IV pole with computerized medication administration box attached, in other words, all "the machines that go beep". Still it is the bed that seems to suck the life out of your idea of an active birth; an instinctual birth. Your nurse cheerily asks you to pee in a cup and climb into the bed. So after all that walking, and sitting, and rocking, and kneeling what should you say or do?  

U.S. mothers are faced with this dilemma every day or more likely night. How should you handle this moment. It will be the opening moment in the long negotiation of your birth. If you have already had a baby and experienced that moment what DID you do? How do you feel about it now? Would you do it again?

This is the theme for July's Positive Birth Movement; the hospital bed's impact on your birth. PBM started in Great Britain and is spreading around the world. I am proud to be the SLO facilitator. We will be discussing the topic of labor beds from many different angles at my coffee & conversation in July.

It is important for modern American women to fill their mind with images of many possible birthing positions. Positions that can be done in or out of a hospital bed. How many different positions do you see portrayed in this short film? Notice how many different ways one may "squat". How deep the squat is, how far apart her feet are set, whether or not she is rounding or arching her back, pushing her feet against something or someone, or pulling on something all make the physics and body mechanics different.  <iframe width="560" height="315" src="https://www.youtube.com/embed/0J5xlBmJHTI?list=PL197D9817EDD8A137" frameborder="0" allowfullscreen></iframe> 

For anyone to make the general statement that squatting causes babies to descend too rapidly or causes tearing isn't educated enough about squatting to see all the many nuances that can be obtained. <iframe width="560" height="315" src="https://www.youtube.com/embed/Q3wbuDSio74?list=PL197D9817EDD8A137" frameborder="0" allowfullscreen></iframe>

Many of our doctors and nurse midwives are comfortable with mothers moving into a variety of laboring positions but once the mother is in the pushing phase still desire to take over and control the process by moving her into positions they, the care providers, are most comfortable in regardless of the mothers instincts or desires. In which of these birth positions do you think your care provider will be comfortable catching? Which ones will he or she have ever done? <iframe width="560" height="315" src="https://www.youtube.com/embed/HiCgDlxdmPI?list=PL197D9817EDD8A137" frameborder="0" allowfullscreen></iframe>

In many ways I see the pushing phase of labor as the final frontier of the struggle I have been part of for so many years; the struggle to return birth to the birthing woman. As a doula the hospital labor bed represents the Berlin Wall that stands between women and their innate abilities. It is long past time to “Tear down this wall!” 

Thursday, October 16, 2014

Why Chiropractic Care for the Whole Family?

Many years ago I met Leslie Kasanoff, mother and chiropractor, when she was planning the homebirth of her second child. Since that time I have grown to understand she is a fierce wellness advocate on many different fronts. As a chiropractor Dr. Leslie practices low force or non-force techniques which work gently with your nervous system to help restore structure & function. Through analyzing the nervous system, she can detect where your body is willing to allow change & work with these areas to allow the unwinding of other problem areas. Allowing her to use 'brains instead of brawn'. No pops or cracks needed! Good thing cause she isn't any bigger than I am. Here is what she writes about why chiro care is a cornerstone of wellness.

"So what is chiropractic & how might it help you & your family? The basic tenants of chiropractic have little to do with back pain. Chiropractic theory states (and modern medicine has proven) that misalignments in the spine (subluxation) can put stress on delicate spinal nerves & cause them to misfire. Indeed science has shown us that as little as 10mm of mercury pressure- about the pressure caused by weight of a dime- can cause misfiring of nerve impulses in the spine. If you think realistically about this, you realize you could likely have several areas like this in your own spine right now and be totally unaware of it. Further, all the nerves in your entire body ultimately connect to nerves that enter & exit the spinal cord so when you think about it, every function in your body, from your heart beat to your hormone function to your immune system & more depends on the messages of nerves running into & out of your spine. AND you have NO way of knowing if all these messages are getting through unimpeded or not. The chiropractor’s job is to make sure they Are. 
Well, this all sounds like it makes good sense, you may be thinking; but what is the practical aspect of this? What can I expect chiropractic care to have an effect on? While we can’t say with 100% certainty that chiropractic will have an effect on any particular problem, I can say that in my 25 years experience, the care I’ve provided has had a positive effect on problems as varied as ADHD, colic, asthma, allergies, back pain, headaches, fibromyalgia and more. I can also say that pregnant woman under chiropractic care have easier deliveries & recoveries and that difficulty nursing can often be traced to a baby being less able to latch on to one breast due to spinal subluxation in the neck. The bottom line is that every function in your body will happen better when it is unimpeded."

Most of us don't know the history of chiropractic care and why Americans are so conflicted about utilizing this basic form of health care. This unease keeps them from attaining real health. Dr. Leslie gives us a history lesson and gets to the roots of this distrust.

"As a chiropractor who has practiced for almost 25 years, I continue to be surprised (and a little disappointed) that more people don’t recognize the positive role that Chiropractic care can play in their children’s and in their own lives. Today, I hope to help you understand the value a little better.
Thanks to the medical establishment, most people think of chiropractic in terms of a quick fix for lower back or neck pain. While chiropractic may help with these issues, this represents a very limited view of an art & science that has really been around for thousands of years.
Hippocrates is quoted as having said “in case of disease look first to the spine.” Throughout history there have been practitioners who were the ancient equivalent of the modern-day chiropractor.  In fact, the results chiropractors got during the great flu pandemic of 1917 were one of the major factors that lead to the California Chiropractic Initiative of 1922, recognizing that we are separate & distinct from medicine. But like many other ancient forms of healing, chiropractic fell out of favor with the advent of drugs, surgery and the symptomatic approaches established by modern medicine. While most people are at least aware that chiropractic care exists, herbal medicine, homeopathy & many other forms of care have been so vilified by modern medicine that many people equate them with witchcraft, quackery and worse. The real truth is that most of that is propaganda and organized medicine did, among other things, promote leeches and blood letting well past the 1900’s. It was only their steadfast organization, pressure, propaganda & boycotting of anything non-medical that lead to the decreased popularity of these forms of care. Ultimately, chiropractic is the only non-allopathic healing science that survived this assault (until the recent resurgence of others). In fact, in 1985, the AMA and several other organizations were found guilty of collusion and anti-trust for trying to systematically destroy chiropractic as a profession in the United States.
I bring this up because to this day, people have negative views of chiropractic but have no idea where those views came from. I like to say its like the wallpaper of the way we grew up; so intimately connected with the American view on health, we don’t even see it." 

Recently Leslie joined the staff of Community Health Centers in SLO. She is happy to be able to provide care to many patients who have been unable to obtain it in the past because they have had no insurance coverage. If you have CenCal, Medi-Cal or Medicare, you are allowed chiropractic care and do not need a medical referral. Unfortunately, most chiropractors cannot afford to see these patients (or see them & charge them a discounted cash fee) due to the low reimbursement rate. At CHC, they are a majority of the patients they see. 

So if any of this makes sense to you, Dr. Kasanoff would be pleased and honored to see you and your family. Simply call the Bishop St office at 805-269-0793 or the Casa St office at 805-269-1500 & ask for a chiropractic appointment with Dr. Kasanoff. 

Thanks Dr. Leslie for 25 years of helping families find better health!

Saturday, October 11, 2014

Laboring in a Secret Garden

I never know when I leave my home to join a laboring couple where the journey will take me. Sometimes finding just the right place to labor can be challenging. Driving away from Linda's house I knew from her history she wouldn't feel confident laboring in the hospital. It was also clear to me that as a second time mother her labor could change from 0 to 100 pretty darn fast and being in Arroyo Grande was no longer an option. So where to go on a hot summer day? As luck would have it Dad found us a secret garden, ideal for laboring with the breeze in our hair and the sun on our faces. 













Every birth I witness is indelibly etched into my soul. Some are long and hard; others fast and furious. They are all intense but sometimes within the intensity is a peacefulness; a serenity of love and trust that rises above the physical experience.

Monday, May 12, 2014

Consumer Reports: Cesarean Births

“How you deliver your baby should be determined by the safest delivery method, not which hospital you choose.” 

I couldn't agree more with this statement. Consumer Reports is beginning to tackle the issue of our disproportionate cesarean rate. The World Health Organization has determined that NO region, area or country should have a higher rate than 15% rate. Currently the US has a rate twice that and California's is even higher. The rate is "up 500 percent since 1970. All those C-sections have not translated into substantially better outcomes for mothers and babies. The infant death rate in the U.S. is higher than that of most other industrialized nations. And the maternal death rate actually increased slightly from 1990 to 2013, according to an analysis published May 2, 2014, online in The Lancet medical journal."

So What? 
Why should we be concerned? C-sections are safe right? Usually when they are done it is because they are safer for mom, baby or both, than a vaginal delivery right?
"A C-section—the second most commonly performed surgical procedure in the country, requiring a 6-inch incision in the abdomen and a second through the uterus—is major surgery, and thus takes longer to recover from than a vaginal delivery and also carries additional risks." 

Consumer Reports is also concerned that hospitals within a few miles of each other with similar populations can have such drastically different rates of surgical births. "And unfortunately, it’s usually much easier to find a hospital with a high C-section rate than a low one." 

Our Local Hospitals
To earn top marks a hospital had to have a c-section rate of between 5-9.5%. None of our local hospitals earned this ranking. Twin Cities comes in at the next best level between 9.5 and 11.5%. French is in the average zone at 11.5-15%. Both Marian and Sierra show up in the next to lowest ranking with between 15-21%.

Hey That's Not Fair 
You may be thinking Sierra Vista should have a higher rate because they have the high risk mothers. Consumer Reports tried to correct for this. "To level the playing field, the measure controls for some things that affect C-section rates, such as not including multiple gestations and breech births. However, this measure does not account for all differences in patient characteristics (such as chronic illness) that might affect the C-section rates of an individual hospital." So yes their rate should be higher because the high risk moms with chronic illness appropriately deliver there. The question is how much higher? Both Sierra and Marian are just a few percentage points away from being given the worst rating.

“We think it’s time those hidden numbers are brought to light,” said John Santa, M.D., medical director of Consumer Reports Health. 

Well said! Pregnant consumers and their families deserve this information in order to make true informed choices about their births.

Quotes were taken from the following 3 articles by Consumer Reports.

What Hospitals Don't Want You to Know About C-Sections:
Very good in-depth article with an excellent section on things to do to avoid a surgical birth.

Hospital Ratings; Avoiding C-sections: 
Their statistics

Safety Scores:
Finding your hospital's score.

More Research and Reading

What to Reject When You are Expecting
Good list of prenatal and during labor procedures to avoid

My Birth Statistics
Comparing my stats with our local hospitals

Tuesday, December 31, 2013

Dear Anatomy & Physiology Professor

Yesterday I finished a 12 week anatomy and physiology 2 part course. At the end I posted my professor a note in the discussion area.


I have enjoyed both Anatomy classes and have learned lots of information valuable for the various things I do. I am a birth doula, birth educator, La Leache League Leader, parent educator and more. I do have some ideas about the labor and birth chapter which I meant to contact you about. I'll still try to do that before the discussion areas get closed. 

Thank you,
Jennifer

The professor responded, "I'm glad you enjoyed the course and look forward to your input!"

So I spent a considerable amount of time yesterday going carefully through her lectures and formulating my response. I posted it into the discussion area as I had no other way to connect with her. I found out this morning that she took it down and sent me this reply, 

"To Jennifer,

Thank you for the information.  I am not able to keep that type of post up in the Discussion Area, but I read it carefully and copied and pasted it into a Word document for further review.  I am looking forward to checking out the references you included.  I think the pendulum has swung some on medication during childbirth.  When I was having my children (my oldest is 33 and my youngest is 18), women were encouraged to avoid medication if possible, while women in my mother's generation were significantly medicated.  Now, it seems that epidurals are used almost routinely, rather than reserved for special situations.


I think it's very important for women and their partners to learn as much as they can about pregnancy and childbirth, understand the pros and cons of different types of pain relief, think about their ideal situation for labor and delivery, and then discuss their wishes and concerns with a physician who comes highly recommended and who they trust.  

Thanks again for the info!"

I couldn't agree more. Women should learn all about the pros and cons, safety and risks of ALL medical procedures before they give birth but NOT in an anatomy and physiology class. In an anatomy and physiology class they should learn how a woman's body works without any outside interference. How her musculoskeletal, integumentary, sensory, hormonal, chemical and nervous systems work in concert to bring a baby into this world. 

Here is what I posted on the discussion board:

I have some thoughts about the sections in your lectures which cover normal vaginal birth. Let me explain my background. I have been a doula for over 20 years. In case you aren't familiar with this profession, a doula supports couples during the entire birth process and into the early postpartum period as well. I have been at over 100 births. Some have happened in homes and birth centers, but the majority of my clients have chosen to birth in a hospital setting. I have seen lots of babies come into this world vaginally and some via cesarean section. Along with this I am a birth educator and La Leche League Leader. La Leche League International has been educating and supporting breastfeeding women for over 50 years. They have the most up to date information and studies on lactation, breast milk, and breastfeeding. As a Leader I am trained to support mothers who desire to breastfeed through facilitating meetings and providing one-on-one support.

Throughout your classes I have been impressed with how well you explain the body's systems both anatomically and physiologically. The more I know about the human body the more amazing its abilities seem to me. I am very passionate about women, birth and families. It is very important to me that women are given accurate information about their body's birthing and breastfeeding abilities. Unfortunately in our culture women know very little about birth and what they are told is not at all from an anatomical and physiological stand point. Instead it is heavily mixed with cultural beliefs with no regard for science. Unfortunately I believe your section on birth is skewed in this manner. Women need to know how we were designed to give birth. If they then choose to use medical and pharmacological props or interventions that will be an educated cultural choice. As this is an anatomy and physiology course, I am hoping you will consider taking a more physiologic approach to how you present birth to women. Please understand I am NOT advocating women should birth without skilled help at the ready. How much they use or need that help will depend on their unique situation. I want them to learn what their bodies are capable of doing. 

Here is what I have learned from watching women, keeping up with the latest science, and opening my mind to see past our current birth culture. Women are designed anatomically to labor and birth in upright positions. Left to their own instincts it is very rare indeed for a woman to choose to lie down to birth, especially on her back. Imagine a woman choosing to lie flat on her back to defecate or urinate. Most un-medicated women will choose to stand, semi-squat, full squat or be on their hands and knees. Unfortunately all of your graphics clearly show the supine position. This position is brought about through the use of pain medication and for doctor and hospital convenience. It is considered normal only because of cultural influences on the physiologic birth process. Anatomically it flattens the pelvis and doesn't allow for the sacrum and coccyx to move out of the way of the descending head. It also immobilizes both of the illiac bones making it harder for them to spread laterally giving the additional space needed for the baby. You mention the doctor placing the woman in a semi upright position but as long as her bottom is against the surface of a bed she will be hampered in her abilities to birth unassisted, but unassisted is what we are anatomically and physiologically designed to do.

In your course you say the doctor will tell the mother when second stage has begun. But anatomically when a mother is un-medicated she does not need to be told when to begin pushing. When the baby descends to a certain point in the pelvis he naturally triggers the fetal ejection reflex in mom. Just as when you need to vomit you know you are about to vomit. No one needs to tell you it is time or how to do it. No one needs to say how long each vomiting session should last. This is exactly like the 2nd stage of labor. The mother, even a first time mother, will spontaneously begin to push with her diaphragm and abdominal muscles. She will not be able to help it. She will not be able to stop herself. She will naturally tend to push 3 times during each contraction for approximately 6 seconds. This amount of time works physiologically for the baby. When a mother is pushing she tends to hold her breath to bear down. This breath holding reduces the available oxygen to the baby. Six seconds is an amount of time that babies tolerate well. Longer than that can cause a drop in oxygenated blood with a corresponding rise in fetal heart rate as they physiologically struggle for homeostasis. 

The un-medicated mother will know when she is crowning from the burning sensations she will feel. Most mothers stop pushing and cry out. This releases the vaginal muscles and allows for the last stretching. I agree with you that it can be helpful for a provider to gently put counter pressure on the head to keep it from coming so quickly mom’s vaginal tissues tear but this is not how the system was designed. It was designed for the mother to birth like other mammals, without assistance. Further there have been many studies done that show that an episiotomy does not keep a woman from tearing. As a matter of fact they all agree that a woman is more likely to have a 3rd or 4th degree tear if she has an episiotomy. Currently most doctors only do an episiotomy if the baby's heart rate is dropping into the danger zone. In this situation it can be life-saving.  

When the baby's head appears the supine or semi-reclined position necessitates a care provider to hold the head so the head doesn't flop backward, hyper extending the baby's neck. When a mother births in a squat the head stays perfectly in line with the body as it hangs down. In your lecture you say the doctor will rotate the baby's shoulders but most babies rotate without any assistance. It is part of the anatomical fit between mother and baby that causes them to sort of cork screw out. It is only if their shoulder is stuck under the pubic bone that this doesn't happen. Finally rather than a doctor needing to catch the baby as you suggest, the mother is capable of reaching down and catching the baby as it pops out after the body rotates into position. I have witnessed this. 

As to the physiological process, you mentioned the hormones oxytocin and prostaglandin but equally important in the process are dopamine and endorphins. This combination of dopamine, endorphin and oxytocin is the same combo released during orgasm which causes intense pleasure and a feeling of floating. In labor this powerful chemical combination changes the laboring woman's perception of the pain allowing her to endure much more than she would otherwise. On top of that she is chemically driven to bond with her new baby as soon as he or she emerges. This is a very important feed-back loop which pitocin and an epidural disrupt. It has consequences for the next phase, mothering the baby outside the uterus.

The latest studies all show conclusively that immediate skin-to-skin contact is what we are physiologically designed for rather than taking the baby away even briefly and presenting it back to mother as a wrapped bundle. The mother and baby should continue to be considered one biologic unit. They share bacteria, hormones, body fluids, antibodies, fats and proteins. A neonate has no ability to self-regulate. He does this through his mother. Hearing the mother's heart beat and feeling the rise and fall of her breath regulates his heart rate and respiration. It keeps the levels of adrenalin and cortisol at their appropriate levels; enough to cause the baby to be hyper alert without causing him physical stress. Science has proven babies should not be taken away or wrapped in blankets. This is part of the WHO Baby Friendly Initiative. Their goal is to have all babies go immediately onto their mother’s abdomen or chest unless they need life saving measures. Normal suctioning doesn't count as life-saving. If needed this can be accomplished quite easily on the mother while baby remains skin-to-skin. They are to stay this way undisturbed for the first 2 hours of life so that all of the above sharing and regulation can occur. If you haven't watched a video on delivery self-attachment yet you will be amazed! We are much more like other mammals than we have given our babies credit. When un-medicated, undisturbed, and left skin-to-skin with mom they move themselves into position and find the nipple, latch on, and begin feeding. I just attended a conference where I was blown away by the latest info about epigenetics and breastfeeding. Breastmilk contains, histones, lepten, and microRNA, which all pass to the baby. They attach into their genes and change how the genes are expressed. This is an important further step in passing on genetic information from one generation to the next.  

The third stage is more easily accomplished if baby stays with mom. This triggers further oxytocin release, especially if the baby latches and begins to nurse, which stimulates the placenta to fully separate and then keeps blood flow to the amount which brings mom back to homeostasis. She loses the extra blood she created to maintain the pregnancy which she no longer needs. There is no need for "a little bit of pitocin" as you have taught unless the mom actually IS bleeding too much. Again our physiology is miraculously designed to take care of most contingencies. Only when it is not able to do its job successfully should we vary from this amazing design which you clearly have so much respect for.

Finally I want you to imagine what would physiologically occur if the mother and neonate were all alone immediately after birth. What would the mother do? Would she immediately clamp and cut the umbilical cord as you have stated the is done in our hospitals? Highly unlikely. Therefore what is supposed to occur? As you detailed so well, the baby's circulation and respiration have major changes that need to happen. These will generally take place quite peacefully without any gasping or stress to the baby. There is significant pressure around the baby's chest when it is squeezing through the vagina. When the baby is born there is therefore a significant drop in pressure which causes air to try to rush into the lungs. Also there are nerves in the skin of the neonates face which, when exposed to air for the first time, trigger him to breath in. This is why babies can be born under water and not drown. They do not attempt to breathe until their face is lifted out of the water. Further as long as the cord and placenta are intact and still pulsing the neonate continues to receive oxygenated blood from the mother through the placenta. The cord is covered with a substance called Warton's Jelly. When the air hits the cord it dries this out and triggers the cord to slowly stop pulsing. Meanwhile inside the baby his body is working to close the foramen ovale and reroute the blood. Most cords will pulse for 5 to 10 minutes after birth and placentas stay adhered to the wall for anywhere from 15 to 30 minutes. This gives the baby buffer time. I don't believe in this scenario there is a fall in blood PH, but I could be wrong. This also gives the mother/baby system time to bring their blood exchange into homeostasis with the neonate receiving exactly the right amount of blood. If you clamp the cord too soon you will leave 1/3 of the fetal blood in the placenta. This blood is needed by the neonate for many reasons. They are discussed in one of the links below. 

Thank you for listening and thank you for expanding and deepening my knowledge of the human body. I'm very glad I took this class. If you wish to ask me further questions about labor, birth or breastfeeding please email me at jenniferstoverdoula@gmail.com.

A standing unassisted birth video: https://www.youtube.com/watch?v=zFMHB4RqpjI  

An MRI study of Pelvimetry in 3 positions:

Further explanation about up right positions: http://www.givingbirthnaturally.com/birth-positions.html

Discussion of labor hormones and how catecholamines disrupt the natural hormonal cascade:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595201/  


Delayed cord clamping: http://www.scienceandsensibility.org/?p=5730

The requirements for a hospital to become Baby Friendly certified:http://www.babyfriendlyusa.org/about-us/baby-friendly-hospital-initiative/the-ten-steps

Importance of skin-to-skin contact: http://www.medscape.com/viewarticle/806325

Breast Crawl video: https://www.youtube.com/watch?v=zrwfIcPB1u4   

I hope dear reader you found this information helpful to you. Please feel free to share it with others. You can link to this blog or share it via Facebook. Even copy and paste it into an email or on your own web site. Please remember to attribute it to me.


Monday, December 30, 2013

California Measles Outbreak; What's a Parent to Do?

Yesterday I caught the tail end of Dave Congalton on the radio talking with a local pediatrician who has written a new e-book about baby's first year. She was adamant about vaccinations and was sure that if parents were simply told the facts by their doctor they would automatically want to vaccinate. During the short time I was listening, 2 other docs called in to FULLY support vaccinations.                                 
She also said we were having a measles epidemic in California. At that point I called in. I asked her how many cases there actually were. She backed off and said she shouldn't have called it an epidemic but an outbreak. I told her I thought the cases were in vaccinated people. She said no they were unvaccinated. (Keep reading to see she and I were both right and wrong on that one.) She said this kind of bad information was the problem with the internet spreading false info. She accused parents of getting poor information off the internet and then being too frightened to do the right thing for their kids. So this morning I went to the internet to see what I could find out about measles in CA. Here is some info you should know.

Facts on California's measles outbreak
From the CDC web site:
"Measles causes fever, runny nose, cough and a rash all over the body. About one out of 10 children with measles also gets an ear infection, and up to one out of 20 gets pneumonia. For every 1,000 children who get measles, one or two will die."                

Also from our government:                                                
"HEALTH ADVISORY – February 19, 2014

14 Measles Cases in the State of California in 2014

Fourteen cases of measles with onset in 2014 have been reported to California Department of Public Health. (In all of 2013, 189 people have been reported to have the disease. This represents the second largest number of cases in the U.S. since measles was eliminated in 2000.)
Among the 2014 California cases, four case-patients had traveled outside of North and South America, with three traveling to the Philippines. Nationally, an increase has been noted in the proportion of measles cases with travel to the Philippines. Measles cases from recent years have reported travel to Germany, France, England, India, and China, among other destinations.

Of the 2014 California case-patients without international travel, three had contact with known measles cases, two had contact with international travelers and five are under investigation to identify potential sources.

Of the 12 cases with known measles vaccination status, 8 were unvaccinated (7 were intentionally unvaccinated and 1 was too young to be vaccinated). That means 4 were vaccinated and 8 were not. So a third of the cases were in vaccinated people and 2/3 in unvaccinated. Why are vaccinated people getting sick? Had they only had the initial vaccine and not the booster or did they fave both shots and the life-long immunity they said we would have isn't turning out to be true? 

Please note they are NOT talking about deaths or even tell us how severe the cases were; simply that they had measles.

The last large outbreak of measles in the U.S. occurred during 1989-1991, with 17,000 cases of measles and 70 deaths in California.

Let's compare this to influenza. For the 2013-2014 flu season the California Department of Public Health says there were 332 deaths in California. 

Efforts to increase immunization rates in the 1990s were successful and endemic transmission of measles in the U.S. was eliminated in 2000.

Here is what eliminated actually means. In 2000 there were 86 cases in the US and 19 in California. 

 In 2013-2014, a large measles outbreak in the Philippines has resulted in over 1700 cases and 21 deaths. This outbreak has led to measles importations to Australia, Canada, the UK, and in many U.S. states. Additionally, measles is currently circulating in most regions of the world outside of North and South America."

In 2013 there were 189 cases of measles in the US and 15 cases in California. There were NO deaths. Now I want you to think about the numbers of people you know in California who had the flu this year. We probably each know at least 15 people. Of the California measles cases, 11% needed to be hospitalized, so 17 people were seriously ill. Pneumonia was the reason for hospitalization for 4 of the cases. It is important for pregnant mothers to note that 2 of these hospitalizations were for pregnant women and 1 miscarried. Let's look closer. Ninety-nine percent were import associated. In other words there was contact with someone who brought the virus into the US from abroad or was in contact with someone who was in contact with someone who had been abroad. Another interesting item is that 8% of the cases were in vaccinated people. 

How Does This Compare to the Flu?

Let's see what Web MD says about the flu:

Here's a rundown of some important flu statistics, based on the best available data.

Percentage of the U.S. population that will get the flu, on average, each year: between 5% and 20%.
That is with the current flu vaccination rate. So what percentage of the US population is 159 measles cases? The US Census Record says there are 316.99 million people in the US. So last year's outbreak was .00005% of people in the US.

Number of Americans hospitalized each year because of flu complications: 200,000, on average.
Remember there were 17 people hospitalized for measles complications last year. The last big outbreak of measles occurred from 1989-1991. Each year there were approximately 18,000 cases in the US with approximately 3,600 hospitalizations. 

The number of people who die each year from flu-related causes in the U.S.: ranges from 3,000 to 49,000.
During the last big outbreak of measles in the US approximately 41 people died each year.

In the U.S., influenza and pneumonia were the eighth leading cause of death in males in 2009.

Number of flu vaccine doses available in the U.S. for the 2013-2014 flu season: Between 135 and 139 million.
That means that if all the doses get used they will have vaccinated 44% of the population for flu. The federal government wants a 90% vaccine rate for measles and they say are meeting or exceeding that goal! Less than 1% of young children are not vaccinated  and most of the unvaccinated kids are for economic reasons. So what percent of all the kids in the US are not vaccinated due to parental choice? I couldn't find that number. Obviously it is less than 1%. 

So where does all this fear come from? Most of it stems from one situation in New York where many people in one extended family became ill with measles. This family had chosen not to vaccinate due to philosophical reasons. They had family members who traveled to Europe and brought home an unwelcome souvenir. In total there were 65 cases of measles in New York. Here is the final word of why the the CDC is concerned:  "imported measles cases can result in large outbreaks, particularly if introduced into areas with pockets of unvaccinated persons."

From the National Vaccine Information Center:
(this is the organization which the medical establishment is talking about when they say crazy 
anti-vaccine people)  
"In 1960, three years before the first measles vaccine was licensed in the U.S., there were 380 deaths from measles recorded."            

Are vaccines safe or not?
Now let's explore the possible side effects from getting the MMR vaccine. Remember very little in life is 100% safe so with life there is risk. What are those risks?

From the CDC: 
"Moderate Problems
Seizure (jerking or staring) caused by fever (about 1 out of 3,000 doses)
Temporary pain and stiffness in the joints, mostly in teenage or adult women (up to 1 out of 4)
Temporary low platelet count, which can cause a bleeding disorder (about 1 out of 30,000 doses)

Severe Problems (Very Rare)
Serious allergic reaction (less than 1 out of a million doses)
Several other severe problems have been reported after a child gets MMR vaccine, including:
Deafness, long-term seizures, coma, or lowered consciousness, and permanent brain damage
These are so rare that it is hard to tell whether they are caused by the vaccine.
(Please note they give us NO numbers)

From the National Vaccine Information Center: 

"Common side effects from the MMR vaccine include low-grade fever, skin rash, itching, hives, swelling, reddening of skin, and weakness. Reported serious adverse reactions following MMR vaccination include seizures, brain inflammation and encephalopathy; thrombocytopenia; joint, muscle and nerve pain; gastrointestinal disorders; measles like rash; conjunctivitis and other serious health problems.

As of March 1, 2012, there have been 898 claims filed in the federal Vaccine Injury Compensation Program (VICP) for injuries and deaths following MMR vaccination, including 56 deaths and 842 serious injuries. (Again we have no numbers of doses of vaccines to help us understand what percentage of doses; or true level of risk. I'm not even sure if these numbers include multiple years.)

Using the MedAlerts search engine, as of July 9, 2012 there have been 6,058 serious adverse events reported to the Vaccine Adverse Events Reporting System (VAERS) in connection with measles vaccine since 1990, with over half of those occurring in children 3 and under.

Evidence has been published in the medical literature that vaccinated persons can get measles because either they do not respond to the vaccine or the vaccine’s efficacy wanes over time and vaccinated mothers do not transfer long lasting maternal antibodies to their infants to protect them in the first few months of life."

There are other theories about vaccines long term risks beyond immediate reactions. None of these, as far as I know, have been proven. Conversely I don't know that there are any long-term studies on vaccine safety. Questions out there which I feel bear looking into are the potential vaccine/autoimmune disease link. Especially after seeing that the CDC says one of the moderate immediate reactions can be pain and stiffness in the joints in teens and women. Autoimmune diseases are definitely on the rise. Is this caused by vaccines? The anti-vaccine group would like you to think so. As far as I know we have no scientific studies to definitively make that connection yet. I want long term studies done. I want studies done on bundled vaccines, not individual vaccines. I don't believe the scientific community has done enough research into the possible synergistic effects of bundling vaccines. I think the fact that we now have potential humans to do matched studies on right here in America is fantastic. I don't want studies with unvaccinated people from third world countries compared to people in the developed world. I want us to follow long-term some of the now unvaccinated US kids and a matched group of vaccinated US kids. Let's really find out some concrete answers. Until then I'm not sure anyone knows. 
                                                                                               
What's a parent to do?
Parents need to make wise choices for their children. Are you planning to travel outside the US? Will you be having world travelers come into your home or be in contact with them in some other way, such as, airplanes, buses, trains, or hotel rooms? Perhaps you want to vaccinate. Perhaps 2 measles deaths in a 1000 cases is too high a risk for you to comfortably take as a parent. As doctors love to say (the doctor on the radio yesterday said it too) when it is your child 1 death is too many. Of course they NEVER factor in that, 1 death from a vaccine reaction is also 1 death too many for any parent. What is important to me is that you have solid information to make your own best choices. 

Then I want you to find a doctor who will listen to you as a parent, help educate you and then will allow you to make your choices without shaming you in any way; or worse yet fire you as a client. I want to take a moment to acknowledge one such local pediatrician, Dr. Renee Bravo. Here is what one of my "Whole"istic Mamas said about a recent visit. 

"Just wanted to share my positive experience yesterday. I've known Dr Bravo for probably 25 years & have been bringing my children to him since my 1st was born almost 11 years ago. I respect him & think he's a great person. Yesterday I brought baby #4 in for her 2 mos checkup. I was really nervous to tell him I didn't want vaccines for my baby since I'd unknowingly vaccinated my other 3 children & thought he might possibly hassle me like his associate did. When he asked about shots for this visit I declined & he said "no problem, whatever you want to do I'll support!" He said we could do delayed vaccines (he said he really likes Dr. Sears schedule), even more delayed, or none at all, just let him know. Then he said "you know you really only need most of these if you're traveling to a 3rd world country anyway." No hassle, no debate, just pure support. Yet another reason why I respect him!"

I know this was a lot to read but it is important that all of us base these kinds of parenting decisions on a real understanding of the facts. 

Next, since it is "going around", I wanted to give you info on how to tell if your child has measles and what your doctor can do. If you think you or your child has measles, or you have been exposed to measles, the sooner you go to your doctor the better if  you want to utilize their help. 

IMPORTANT: Do NOT go to your doctor without FIRST calling. Let them know you think your child has been exposed to or come down with measles. Ask IF they wish you to come in and HOW they plan to minimize risk to their other clients. Babies do not get vaccinated for measles until they are 12 months old. Therefore the kids most vulnerable to having difficulty fighting off the infection are not vaccinated.   

What do measles look like?
From the Mayo Clinic web site:
Description: a red, blotchy rash that usually appears first on the face and behind the ears, then spreads downward to the chest and back and finally to the feet.

Measles signs and symptoms appear seven to 14 days after exposure to the virus. Signs and symptoms of measles typically include:
Fever
Dry cough
Runny nose
Sore throat
Inflamed eyes (conjunctivitis)
Sensitivity to light
Tiny white spots with bluish-white centers found inside the mouth on the inner lining of the cheek, called Koplik's spots
A skin rash made up of large, flat blotches that often flow into one another
The infection occurs in sequential stages over a period of two to three weeks.

Infection and incubation. For the first seven to 14 days after you're infected, the measles virus incubates. You have no signs or symptoms of measles during this time.

Nonspecific signs and symptoms. Measles typically begins with a mild to moderate fever, often accompanied by a persistent cough, runny nose, inflamed eyes (conjunctivitis) and sore throat. This relatively mild illness may last two or three days.

Acute illness and rash. The rash consists of small red spots, some of which are slightly raised. Spots and bumps in tight clusters give the skin a splotchy red appearance. The face breaks out first, particularly behind the ears and along the hairline. Over the next few days, the rash spreads down the arms and trunk, then over the thighs, lower legs and feet. At the same time, fever rises sharply, often as high as 104 or 105 F (40 or 40.6 C). The measles rash gradually recedes, fading first from the face and last from the thighs and feet.

Communicable period. A person with measles can spread the virus to others for about eight days, starting four days before the rash appears and ending when the rash has been present for four days.
When to see a doctor


What if I think my child has measles?

More from Mayo
Call your doctor if you think you or your child may have been exposed to measles, or if you or your child has a rash resembling measles.

No treatment can get rid of an established measles infection. However, some measures can be taken to protect vulnerable individuals who have been exposed to the virus.

Post-exposure vaccination. Nonimmunized people, including infants, may be given the measles vaccination within 72 hours of exposure to the measles virus, to provide protection against the disease. If measles still develops, the illness usually has milder symptoms and lasts for a shorter time.
Immune serum globulin. Pregnant women, infants and people with weakened immune systems who are exposed to the virus may receive an injection of proteins (antibodies) called immune serum globulin. When given within six days of exposure to the virus, these antibodies can prevent measles or make symptoms less severe.

Medications

Fever reducers. You or your child may also take over-the-counter medications such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin, others) or naproxen (Aleve) to help relieve the fever that accompanies measles. Don't give aspirin to children because of the risk of Reye's syndrome — a rare but potentially fatal disease.

Antibiotics. If a bacterial infection, such as pneumonia or an ear infection, develops while you or your child has measles, your doctor may prescribe an antibiotic.

Vitamin A. People with low levels of vitamin A are more likely to have a more severe case of measles. Giving vitamin A may lessen the severity of the measles. It's generally given as a large dose of 200,000 international units (IU) for two days.

How do you tell if it is measles or chicken pox? 
Also from the Mayo Clinic site:

Chickenpox infection usually lasts about five to 10 days. The rash is the telltale indication of chickenpox. Other signs and symptoms, which may appear one to two days before the rash, include:

Fever
Loss of appetite
Headache
Tiredness and a general feeling of being unwell (malaise)Once the chickenpox rash appears, it goes through three phases:

Raised pink or red bumps (papules), which break out over several days
Fluid-filled blisters (vesicles), forming from the raised bumps over about one day before breaking and leaking
Crusts and scabs, which cover the broken blisters and take several more days to heal
New bumps continue to appear for several days. As a result, you may have all three stages of the rash — bumps, blisters and scabbed lesions — at the same time on the second day of the rash. Once infected, you can spread the virus for up to 48 hours before the rash appears, and you remain contagious until all spots crust over.


The disease is generally mild in healthy children. In severe cases, the rash can spread to cover the entire body, and lesions may form in the throat, eyes and mucous membranes of the urethra, anus and vagina. New spots continue to appear for several days.

What if my child has Chicken Pox?

Most children do not need to see a doctor other than to tell you they have chicken pox. When do you need to see a doctor?

From the CDC:
For people with chickenpox at risk of serious complications, call a health care provider if the person:
is older than 12 years of age
has a weakened immune system
is pregnant
develops any of the following:
fever that lasts longer than 4 days
fever that rises above 102°F (38.9°C)
any areas of the rash or any part of the body becomes very red, warm, or tender, or begins leaking pus (thick, discolored fluid), since these symptoms may indicate a bacterial infection
extreme illness
difficult waking up or confused demeanor
difficulty walking
stiff neck
frequent vomiting
difficulty breathing
severe cough

Good luck with your decision and good parenting!