Epidurals: Not so Horrible After All?

I like to do things naturally, really. I like natural food, natural medicine, natural cleansers, natural births. But epidurals… well I really like epidurals. I’ve given birth three times and gladly taken the epidural each time. And every time I hear something about how awful it is to subject your body and your baby to the pain-numbing pleasure of an epidural… well, I just kind of ignore it.

So I’m rather pleased to read The Truth about epidurals by ,which relates that “concerns voiced by natural birthers are exaggerated.” And that’s a relief, because I’ve been really concerned that I was missing out on something, as I dozed through my contractions.

Ms. Moyer enumerates some of the main concerns that have been voiced about epidurals:

  • Epidurals and other pain-relieving drugs contribute to the over-medicalization of motherhood. They argue that such treatments create a snowball effect, necessitating additional interventions and intrusions: IVs, synthetic oxytocin to speed up the labor process, catheters, blood pressure monitors, and electronic fetal monitors.
  • Epidurals make it more difficult for women to push when it comes time to deliver.
  • Epidurals lengthen labor.
  • Epidurals’ numbing effects on pelvic muscles increases the risk of cesarean section, a surgery entailing a long recovery, risk for post-op infection or hernia, and future pregnancy complications.
  • Epidurals prevent newborns from suckling properly, which could impair nursing success.

After examining the available research, Ms. Moyer cuts down these popularly held beliefs. Epidurals today (which are different than those administered 20 years ago) do not impede a woman’s ability to push. Epidurals have been associated with c-sections, but not as a direct cause. One study showed that women with epidurals did, in fact, dilate more slowly and take longer to deliver, but they were no more likely to undergo C-sections than women who did not have drugs. You can read her article for a complete review of studies and findings.

So now I’ll throw in my personal experience for what it’s worth! My first birth was induced at 42 weeks. I took the epidural, pushed for about 5 minutes, and delivered a lovely, healthy baby who had no trouble nursing. My next two births were also aided by an epidural, and again I had no trouble pushing them out, and they also breastfed without any apparent side-effects. No C-sections, thank God, and no post-delivery complications. It is definitely possible that the epidurals lengthened my labor, but if you can’t feel the pain, does a little extra time matter?

I have great respect for women who birth naturally without any drugs at all. I still envy them a tiny bit. I kind of want to know what that feels like. But I’ll probably take an epidural again if given the choice.

feature image: Womenshealth.gov

The Case Against Planned Inductions

The last few weeks of your pregnancy are not “optional.” They are an important time for your baby’s development which should not be cut short by an early induction. If there are valid medical reasons for labor induction, your health-care provider will help you decide on the best course of action. But if you just want to schedule an induction for the sake of convenience or any other non-medical reason, here are some things to consider:

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feature image: Baby Announcement Wording

1. Less than 10% of babies actually arrive on their “due date.” Experts agree that a normal pregnancy lasts between 38 and 42 weeks. About 7 out of 10 babies are born after their due date! There is NO way to predict with absolute accuracy what day your baby will be born, you will have to trust your body and your baby to let you know w hen it’s time!

2. Unless you have had a first-trimester ultrasound, gestational dating is largely inaccurate. Later ultrasounds can be off by 2-3 weeks, meaning an induction at 38 weeks might actually be taking place sooner than intended.

3. First time mothers are more often overdue than not! Even 42 weeks PLUS is “normal” and is not a reason to rush into an induction.

4. The last few weeks that a baby spends in utero are an important time for baby’s development, most importantly brain development. A surge of hormones in your baby’s body might play a part in initiating labor.  According to Lamaze, research indicates that once your baby’s lungs are fully mature, he releases a protein that tells his mother’s body that it’s time. A baby born even a few weeks early is at an increased risk for breathing problems, admission to special-care nurseries and breastfeeding difficulties.

5. Which brings us to our next point: Full-term babies (39-40 weeks) are healthier! According to Time: “It’s kind of surprising that insurance providers haven’t curtailed the practice of early elective deliveries entirely as babies born sooner tend to have more health complications and cost more. Even babies delivered at 37 to 38 weeks can end up costing 10 times as much as a full-term newborn, according to the March of Dimes. One study found that reducing early elective deliveries to under 2% could save close to $1 billion in health care each year.”

6. An induced labor is likely to be longer, more intense, and more invasive than a natural labor. You will need IV fluids and continuous electronic fetal monitoring. You will be more likely to use an epidural to deal with the intense contractions. Inductions don’t always work according to plan, often necessitating  forceps, vacuum assistance, and c-sections. Relative to c-section babies, babies who go through labor are born more alert and are better able to breathe and latch on at the breast. (Read this article in Time.com)

7. Better in than out! All of my babies were over-due, and 3 children later I have come to the conclusion that babies are much less trouble in the uterus than out! That is my own personal opinion, of course, and I do love my children dearly!

Bottom line: Be respectful of your baby and let him be a player in his own birth. The safest birthing option for you and your baby is to wait for labor to begin on its own, and in this way you’ll give him the best possible start as he enters our world.

Are Hopsital Births Now “Scarier” Than Home Births?

AP reports that home births are on the rise by a dramatic 20 percent, from 2004 to 2008, accounting for 28,357 of 4.2 million U.S. births. And lest you think it is only the tree-huggers or families who are uninsured and can’t afford a hospital birth, think again.

Sherry Hopkins, a Las Vegas midwife, has attended the home births of many well-educated, affluent, informed women, including a pediatrician, an emergency room doctor and nurses. Home births are the new “it” thing to do.

“I do think there’s a backlash against what’s happening in hospitals,” said Gina Crosley-Corcoran, a Chicago blogger and pre-law student, who gave birth to her third baby (a V-bac) at home. “Women are finding that the hospital experience wasn’t a good one.”

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The hospital birth experience does seem to be becoming increasingly invasive and drug-dependent.  There are relatively minor inconveniences such as being poked by needles, fetal-monitoring, and being told what position to labor in. Then there are bigger concerns such as cord-clamping,  inducement, soaring C-section rates, and brachial plexus injuries. And then there is the matter of comfort: birthing mothers want to feel at ease in their own surroundings, going at their own pace, without interference from doctors who want to speed things up so they won’t miss dinner.

Dr. Joel Evans, a board-certified OB-GYN who supports home birth, calls the medical establishment “resistant to change, resistant to dialogue, resistant to flexibility.”  For many women, hospital births have become a stressful, medicalized experience where every birthing woman is treated under the same protocols.

Home births are not for everyone, especially those who are high-risk. Emergencies do happen, so it is important to be close to a hospital in case you need to be rushed there. An informed decision, careful examination of the pros and cons, together with expert advice, is always the way to go.

Robbie Davis-Floyd, a medical anthropologist at the University of Texas at Austin and researcher on global trends in childbirth, says: “Women who are truly educated in evidence-based maternity care understand the safety and the multiple benefits of home birth.”

Read more: Home birth on the rise by a dramatic 20 percent

If you have had a home-birth of are thinking of having one, we’d like to hear about it! Please share your thoughts in the comment section below.

Brachial Plexus Injuries: A Preventable Newborn Injury- Please Read!

Three out of every 1,000 babies born in the USA suffer from injuries that could have been prevented. More children are inflicted with Brachial Plexus injuries at birth than suffer from Down’s Syndrome, or Muscular Dystrophy, or Spina Bifida.  The terrifying reality is that Brachial Plexus injury is a doctor-cause damage, occurring when a baby’s head is tugged or twisted in order to pull him out of the mother, damaging the delicate nerves in a newborn’s neck.

Symptoms may include a limp or paralyzed arm; lack of muscle control in the arm, hand, or wrist; and a lack of feeling or sensation in the arm or hand. The tragedy is that most of these birth-related injuries are preventable.  Like many of today’s problems, a little bit of education can go a long way.

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The problem is that a baby’s shoulders can become lodged behind the mother’s pelvic bones. Some practitioners panic and start pulling on the babies head. They call it “gentle traction” but it is hardly gentle.  In order to help shift the baby’s position, the mother needs to change positions, and this will help the baby to “slide out like a little fish.”

How? Laying flat on your back during labor is the WORST position for childbirth.  Although it is deemed most convenient for doctors, it narrows the birth canal by up to 30% and makes it much harder to push the baby out. Simply rolling over on your side, standing up, squatting, kneeling, or getting down on all fours will help. But never, never, never let anyone pull on your baby’s head.

C-section babies can also be injured.

Why aren’t more people aware of Brachial Plexus injuries?

The United Brachial Plexus Network explains that the reasons are complicated and include the following:

* Since there is no mandatory reporting or tracking of this injury, the widely stated assumption that the injury is usually transient cannot be validated.
* Misconceptions exist regarding the life-long implications and disabilities associated with this injury.
* Birthing practitioners do not want to take responsibility for enabling these injuries through medicinalized labor protocols.
* Medical providers are resistant to the idea that this injury is often preventable.
* Birthing practitioners have succumb to the belief that brachial plexus injuries are an unpreventable and acceptable risk of vaginal childbirth.
* Patient’s guardians often feel the injury is minimized by hospital personnel and are usually told the injury will go away after a few days or weeks.

Please watch this 5-minute video and visit the United Brachial Plexus Network website for more information. A full-length 25-minute video is available there.

“Are They Real Contractions?” Drink a Glass of Wine!

Toward the end of your pregnancy, you may experience Braxton Hicks contractions, which feel like real labor pains but do not signify the onset of labor. There are various ways to tell if they are the real deal or not, but if you call your doctor or midwife in a panic, they make this suggestion: Relax, and have a glass of wine. If the contractions are real, they’ll intensify, but if they are Braxton Hicks, they will likely go away very soon after.

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But is it safe for the baby?

Drinking an occasional glass of wine during pregnancy has been a controversial topic. Obviously, frequent or heavy drinking is dangerous for your baby, but a glass of wine here and there is where opinions differ. Some maintain that the effects of alcohol on a fetus are still unknown and it’s better to avoid alcoholic beverages altogether. Others (like most Europeans!) believe that there’s nothing wrong with an occasional drink and indulge themselves without giving it a second thought.

Regardless of where you stand on the issue, one glass of wine toward the end of your pregnancy probably doesn’t pose any hazard to your baby’s health. And if it stops the Braxton Hicks and puts your mind at ease, it’s an added bonus! L’Chayim!

Drink some water too…

Being dehydrated can bring on false labor pains as well. So in addition to your glass of wine, be sure to drink plenty of water, which may help ease Braxton Hicks as well!

Contractions: Are These the Real Thing?

During the third trimester, some women experience “false” contractions called Braxton-Hicks contractions. This is a normal occurrence, and like real labor contractions, they may increase in frequency and intensity, making you worry that you are going into premature labor. But unlike true labor, these contractions don’t grow consistently longer, stronger, and closer together.

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image from Women Health Tips

How to tell if it’s preterm labor: True labor contractions show a definite pattern. Employ the 1-5-1 formula: if your contractions last at least one minute, are five minutes (or less) apart, and continue for at least one hour you are, most likely, in labor. (This would mean you should alert your health-care provider immediately.) Braxton-Hicks contractions come and go and don’t settle into a regular pattern. Don’t forget to practice relaxing and breathing with these trial-run contractions. (Dr. Sears)

If you are within a few weeks of your due date, but the Braxton Hicks contractions are making you uncomfortable, try these measures:

  • Change your activity or position. If you’ve been sitting or laying down, try walking around. If you’re been  moving a lot, resting may provide relief. (On the other hand, true labor contractions will progress regardless of what you do.)
  • Take a warm bath to help your body relax.
  • Drink water; these contractions are sometimes brought on by dehydration.
  • Relaxation exercises and slow, deep breathing may help you cope with the discomfort.

Should I call the doctor?

If you haven’t reached 37 weeks yet, and are having more than four contractions in an hour, or contractions are becoming more frequent, rhythmic, or painful, call your caregiver immediately.  In this case, it’s better to play it safe and don’t try to make the diagnosis yourself. Preterm labor is not something to take chances with. Other possible signs of preterm labor:

  • Abdominal pain, menstrual-like cramping, or more than four contractions in an hour (even if they don’t hurt)
  • Any vaginal bleeding or spotting
  • An increase in vaginal discharge or a change in the type of discharge — if it becomes watery, mucusy, or bloody (even if it’s only pink or blood-tinged)
  • Increased pelvic pressure (a feeling that your baby’s pushing down)
  • Low back pain, especially if it’s a new problem for you

Why More American Women Want to Give Birth at Home

When a pregnant woman decides that she wants a home birth, family and friends are usually shocked, and the first questions are often, “Is that safe? What if something goes wrong?”

In today’s age of medicine, pregnancy and childbirth are often as a disease or a problem that has to be “fixed” rather than the completely natural process it actually is, says Dr. Mercola.  For the 75 percent of women who have normal pregnancies, a knowledgeable and experienced midwife may be more qualified to attend birth than an obstetrician.  For some women, giving birth at home is preferable and possibly safer than doing so in a hospital.

“Safer than a hospital?” you may be asking suspiciously. The fact is thatobstetricians are trained to use surgical interventions that are often unnecessary in a normal pregnancy and delivery, and can cause more harm than good when used inappropriately. If you take a look at some statistics, you may start to see things differently.

99 percent of all U.S. births occur in a hospital, yet the United States has one of the highest infant mortality rates of any developed country (6.3 deaths per 1,000 babies born). In the Netherlands, one-third of deliveries occur in the home with the assistance of midwives, yet the infant death rate is  only 4.73 deaths per 1,000.

In terms of your own safety, maternal mortality rates rose more than 54 percent from 2000 to 2005 in the United States, while decreasing in other developed countries. One reason suggested for this scary fact may be the incredibly high rate of C-section in the United States, which accounts for nearly one-third of all births. It is actually the most commonly performed surgery in the US!

The World Health Organization states that no country is justified in having a cesarean rate greater than 15 percent, but the rate in the United States is nearly 32 percent, which even worries The American College of Obstetricians and Gynecologists.

A C-section should be used only as a last resort.  One study found that a woman’s risk of death during delivery is three to five times higher during cesarean than a natural delivery, her risk of hysterectomy four times higher, and her risk of being admitted to intensive care is two times higher.

Obviously, C-section rates are lower among home births, as well as midwife-attended births. Women who delivered at home also have fewer interventions and greater freedom in choosing their birthing style. As long as you have experienced a healthy pregnancy, a qualified midwife is a very safest birth attendant, and your home may very well be the best place for you to deliver.

If you are planning a home birth, it may be challenging to find a birth attendant you feel comfortable with. It is rare to find an obstetrician that will agree to a home birth in the United States. Certified nurse midwives (CNMs) can legally attend home births in any state, but most choose to practice in hospitals instead.  Only 27 states currently license or regulate direct-entry midwives– or certified professional midwives (CPMs)– who have undergone training and met national standards to attend homebirths. (Find the legal status of CPMs in your state here.)

In the other 23, midwife-attended births are illegal.  A campaign is currently underway to expand state licensing of CPMs so that women who want a home birth can choose from a qualified pool of applicants, but until that happens you have a few legal options for homebirth:

  • Find a certified nurse midwife (CNM) who attends homebirths in your state or in a nearby state (then travel to that state to give birth)
  • Find a CPM who is either licensed by your state or in a nearby state (then travel to that state to give birth)
  • Use a CNM but give birth in a hospital or birth center (a compromise)

To find a midwife in your area, try:

  • Midwives Alliance of North America
  • Mothers Naturally
  • American College of Nurse-Midwives
  • Midwifery Today
  • BirthLink (Chicago area)

For more information: Should American Women Learn to Give Birth at Home?

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Reflexology & Acupressure to Induce Labor

There’s no reason to worry if your pregnancy progresses past 40 weeks, but it may make you antsy to give birth already! In addition to that, if you are nearing 42 weeks and your doctor starts talking about an induction, you may want to do something to start your labor naturally.

Reflexology and acupressure are both safe and often effective means of stimulating labor. They are similar in that they both work by applying pressure to certain points on the body. Acupressure involves the whole body, while reflexology focuses on the feet, hands, and ears (primarily feet). Additionally, they are based on different concepts of energy flow throughout the body.

Precautions

  • The following pressure points should not be accessed before you reach your 40th week of pregnancy.
  • Always check with your doctor or midwife before doing anything to stimulate contractions
  • Pressure points may feel tender, but it should not hurt you. If you feel pain, reduce pressure and make sure you have the right spot!
  • If a contraction starts, stop the pressure and wait until the contraction ends. Then you can apply pressure again.

Reflexology Points

Thumb Point: Press firmly on the center of your thumb for a few minutes, then switch to the other thumb. This is one of the most effective points used in reflexology for inducing labor.  It stimulates the pituitary gland to release oxytocin, one of the main hormones that causes the uterus to contract.

Arch of Foot: This point is located inside the arch of the foot, just in front of the heel. Apply firm pressure, but not so hard that it causes pain. This point is  also very helpful in relieving intense pain during childbirth.

Inside Heel: Apply pressure to the point just inside the heel of the foot, aligned with your ankle. If it feels tender you’ve found the right spot.

Between Toes: Apply pressure one finger’s-length below the point between the big toe and the second toe. This point will also be tender when you find it.

Acupressure Points

Webbing between your thumb and forefinger. Press or massage the top of this webbing. This point affects the large intestine which surrounds a portion of the uterus, stimulating contractions.

Shoulder muscle. Press and massage the highest point of your shoulder muscle.

Inside ankle. Find the point four finger’s-width above the inside of your ankle. Apply pressure; it helps ripen the cervix and strengthen weak contractions.

Outside ankle. To help the baby descend toward the pelvis, put pressure on the point between your ankle bone (outer ankle) and Achilles tendon (which runs up the back of your leg).

Lower back. This point is actually located one finger’s-width above your buttocks crease.  Feel for a small indentation and massage for a minute.

Roof of Mouth. Using your tongue, press on the roof of your mouth with your tongue as far back as you can. This is a handy one you can use as you go about your daily routine!

feature image from holistic therapy room

Reasons They Won’t Give You an Epidural

Many women out there love their epidural! Epidural anesthesia uses an injection of drugs into the epidural space in your lower spine.  An epidural works by blocking the transmission of nervous system signals to your brain, thereby limiting or suppressing your feelings of pain.

Epidural anesthesia has become the most common form of pain medication for labor and birth, but it’s not for everyone.  Here are some common reasons an epidural might not be right for you:

  1. Your Body Type: Sometimes, the doctor has no easy access to the epidural space. Factors that might make it difficult to find the right spot include obesity, scoliosis, scar tissue, unusual spinal archtecture or previous surgeries.
  2. Drug interactions: Some medications, such as blood thinners, can make an epidural risky or ineffective.
  3. Existing health issues: If you have a low platelet count, or other blood disorders, there is an increased risk of internal bleeding in the spine.
  4. Timing: In some hospitals, anesthesiologists are available only at certain hours of the day, or certain days of the week. They may simply be busy and unavailable. Also, if you come into the hospital in advanced labor, or with a very quick labor, there might not be time to get an epidural in place.
  5. Infection: If you have an infection on your back, you definitely don’t want your anesthesiologist putting a needle through that area.  It might cause the infection to spread to the spine and other areas of your body, which could lead to major problems.
  6. Heavy bleeding or shock: Often, having an epidural lowers blood pressure. Therefor, if you are bleeding heavily or are suffering from shock, your already lowered blood pressure can make the situation even more dangerous.
  7. Hospital restrictions: Some hospitals have policies about when you can have an epidural. Some stipulate that you must be at a certain point in labor (for example, four centimeters dilated) before an epidural can be given. Others may decide that epidural should not be given after a certain point of labor (for example when you’ve reached full dilation).

Source: About.com

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10 Ways to Relieve Labor Pains

Well, really in my opinion there is only one way, and it works like magic. It’s called an epidural. Ok, just kidding (but not really)!!  However, if you are looking for drug-free ways to relieve labor pains, there are many techniques out there, and many women have had exhilarating (if not completely pain-free–sorry!) natural births. Lamaze.org offers these 10 tips to staying within your “comfort zone.”

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1. Find a Soothing Environment

Your birth setting must feel safe to you. It should have space to walk and bathe, as well as a variety of options to enhance movement, comfort, and pain relief: a soft bed, CD player, rocking chair, birth ball, low stool, and/or squatting bar. It should also have policies that encourage you to try a variety of positions. Access to appropriate medical care is crucial if problems arise.

2. Choose Your Team Carefully

Knowledgeable, caring midwives, doctors, nurses, partners, loved ones and/or doulas create a supportive birth team. When you’re treated with respect and patience, stress and inhibitions decrease, and you can more easily find your best coping mechanisms.

3. Learn About Labor

The more knowledge you have, the fewer surprises you will experience. Find out everything you can about labor from books, magazines, Web sites, videos, classes, a hospital tour and discussions with your health-care provider, doula, family and friends. Familiarize yourself with the procedures and customs at your hospital or birth center. Such discussions are best had before labor.

4. Express Your Fears

Are you worried about pain and labor, needles, medicines or losing control? Speak with a knowledgeable and trusted friend, childbirth educator or doula. Voicing your concerns can bring relief as well as practical solutions to your concerns. Stating your preferences in a birth plan can also help calm fears.

5. Practice Rhythmic Breating

Breathe fully in a slow rhythm during contractions. Release tension with each exhalation and try moaning. Also try taking quick breaths, about one every 2 to 3 seconds (20 to 30 per minute). Your partner or birth coach may be able to help you keep your rhythm with eye contact, rhythmic hand or head movements, or by talking you through contractions.

6. Use Imagery and Visualization

Focusing on something that makes you happy (like your partner’s face, an inspirational picture or favorite object) engages your senses and decreases your awareness of pain. Listen to music, a soothing voice or a recording of ocean waves, and imagine yourself in a relaxing environment.

7. Take a Warm Shower or Bath

A warm shower is soothing, especially if you can sit on a stool and direct a handheld showerhead onto your abdomen or back. Bathing in warm water is relaxing, and it may even speed up labor.

8. Keep Moving

Move around as much as you can. Walk, lean, sway, rock and squat. Some positions will be more comfortable than others.

9. Seek Relief with Warm or Cool Compresses

Place a warm pack on your lower abdomen, groin, lower back or shoulders during labor. A cold pack or latex glove filled with ice chips can soothe painful areas. Cool cloths relieve a sweaty face, chest or neck.

10. Indulge in Gentle Touch or Massage

Have your partner or doula massage you in whatever way provides the most relief for you.  Whether it’s someone holding your hand, stroking your cheek or hair, or patting your hand or shoulder, touch conveys reassurance, caring and understanding.

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