You know informed-choice is a legal right but how do you make those choices? (Link for printable graphic at the end.)
Although the information here will reassure any partner, this article intentionally addresses dads-to-be. All the quotes, links and videos are made by dads for dads-to-be, about their most common concerns about birth support: 1) Value; why should I pay for a doula if I’m going to be there? 2) Why do we even need a doula; what does she have that I don’t? 3) How will I be included if a doula attends?
Herbal medicine is specific category of health-care. Many herbs, including essential oils, are safe and beneficial during the childbearing year, while others can be dangerous. Pregnant women must be cautious with any remedies, especially during the first trimester when the fetus is most vulnerable. There’s a lot of misinformation concerning herbs. Here are lists of commonly used herbs that are considered safe and unsafe through pregnancy and postpartum.
Birth has been compared to climbing a mountain or completing a marathon. Being physically fit is an advantage. Exercise generally improves pregnancy, birth and newborn outcomes for people with normal pregnancies. There may be a protective factor for gestational diabetes, congenital anomalies, miscarriage, placental problems, intrauterine growth restriction, high blood pressure or fetal death. Evidence suggests that abnormal heart rates, cord entanglement, and the presence of meconium are significantly reduced. While there is no increase in premies, there may be fewer postdate gestations.
After a Caesarean birth, you will be given a list of recovery tips from your medical care provider. The following additional information contributes to optimal recovery following a surgical birth.
Post-term or post-date pregnancy is one that exceeds 42 weeks gestation. If a woman is healthy and well nourished then her placenta is likely to thrive and nourish the baby at any gestation. If there are signs that mother or baby will be healthier with baby Earth-side, then induction is warranted; otherwise it’s a much overused intervention that leads to a Cascade of Intervention.
CALENDULA PADS – For swelling, pain, heat. Make 5-10 pads 6 weeks before due date.
Calendula flowers promote healing and are soothing when applied topically.
- Calendula Mixture: Make tea from dried calendula leaves (1 full tea ball per cup water steeped for 10 min) or use tincture (20-30 drops per cup water). Add 1-2 drops of lavender essential oil or some lavender tea to mixture.
- Partially dip maxi pads – preferably long, organic – in calendula mixture briefly, just to soak top layer. Another option is to use a sprayer to wet the tops.
- Freeze pads in bowls so they’re curved like the female body. Store in Ziplocs (labeled with your name) in freezer.
- Bring the pads to birth-place! Hospitals and birthing centers have freezers.
- Apply immediately after birth.
Soothing and healing for swelling, pain, abrasions, tears, bruising. It’s safe to use with stitches. This can be prepared during early labor or ahead of time and frozen/refrigerated.
- Fill a peri- or spray-bottle with calendula mixture (above), a healing solution (below) or warm water.
- Hospitals will provide a peri-bottle. A spritz bottle works too.
- Squirt solution on perineum after every washroom use, shower/bath, or in between if extra relief is needed. Do not rinse solution off.
- If urination burns then squirt during urination or pee in the bath.
- Allow the area to dry between applications. Air-time or even a cool blow drier can be helpful.
- Note: if the rectum is sore or stitched, support the perineum with a cloth during bowel movements (like pooping into a cloth).
- Soak your perineum in a bath for 15 minutes, 3 times daily. Shallow water is fine.
- Add Epsom salt and if you wish to use herbs, add 1-2 cups raw herbs or healing herb tea, ¼ cup tincture, or up to 5 drops of pure essential oil. If you wish to use plain water then spray the healing solution after the bath.
- Some women like cool water for inflammation while others find warm water soothing. Experiment with temperatures but avoid extremes during the initial postpartum days, and keep the rest of your body warm.
- Do not sit on a donut-shaped vessel in the bath as it adds pressure.
Calendula is healing, along with other herbs such as comfrey, lavender, witch hazel, tea-tree, yarrow. Feel free to ask me about the various healing properties of the different herbs. Nice sitz-bath blends can be purchased – look for an Epsom salts base with herbs or pure essential oils; no fragrance or additives. There are some nice soothing perineum sprays on the market, such as Earth Mama Angel Baby New Mama Bottom Spray, sold in Regina at Head-to-Heal Wellness in Cathedral, or Hello Baby in East.
RECOVERY FROM DIFFICULT BIRTH
After a difficult birth follow the above recommendations plus:
- Keep knees together as much as possible for the first 2 weeks, even while walking
- Avoid stairs
- Lift nothing heavier than the baby
- Allow area to “breath” – air time or cotton panties (no synthetics)
- Avoid sitting or standing for long periods of time
- Avoid perfumes, chemicals
- Avoid straining on the toilet – good nutrition and lots of water, support perineum with a cloth during bowel movements (like pooping into a cloth)
- See a Physiotherapist who specializes in women’s pelvic floor to heal pelvic floor muscles; recover from perineum tears; avoid or heal incontinence, painful intercourse and pelvic pain
- Consider seeing a complimentary practitioner who specializes in and is experienced with maternal postpartum recovery, such as a Webster certified chiropractor or an osteopath, to help ensure pelvic organs, bones, ligaments are healthy and aligned.
SPECIAL INFANT CARE FOLLOWING DIFFICULT BIRTH
- Lots of frontal contact, skin-to-skin if possible; helps establish breastfeeding and is reassuring for baby. Babies who are held feed better, poop and pee more, and are therefore less prone to jaundice and other illnesses.
- See a complimentary practitioner who specializes in and is very experienced with newborn care, especially if there was any trauma to baby’s head (vacuum, forceps, caesarean, malposition, and/or long “pushing stage”) e.g. chiropractor, cranio-sacral therapist, osteopath.
The report alleging an infant being infected with Group-B Strep bacteria from placenta capsules is completely inaccurate. In reading through the details (summarized below), you’ll see that it’s impossible that the placenta capsules were the source of infection. This is not a study, but rather a media article. One story is never a scientific study. As is often the case in anything birth-related, the headline is misleading.
Waterbirth provides a wonderful and gentle birth experience for both mother and baby. Often shorter labours with fewer complications are seen. This in turn leads to a better experience for dads. Mothers rate high satisfaction with waterbirth experiences, as do fathers and birth attendants.
Fetal position at the onset of labour is one of the greatest determining factors of how the birth process will proceed. During labour the fetus makes certain movements to descend through the pelvis. The optimal fetal position is pictured below. A good way to remember the best position is to think about giving your baby a back rub every time you rub your belly.
A spot near the back of the fetal head is used to determine fetal position. The terms “posterior” or “sunny-side up” describe a baby who faces out, or is spine-to-spine with mother. “OP” is the medical jargon. The presenting part of the head is bigger in this position and the baby doesn’t flex and rotate as well as an anterior baby.
Problems Related to Posterior Position
- More difficult for baby to drop into and through the pelvis
- Pregnancy may last longer
- Membranes are more likely to rupture before the onset of labour
- Labour may progress slowly or not at all
- Back-pain during labour that doesn’t disappear between contractions
- Increased risk of tearing
- Increased risk of instrumental or surgical birth
- Increased stress on baby’s head and nervous system
However some women birth a posterior baby just fine. Those include but are not limited to, women who’ve given birth without difficulty before, those with an average or smaller baby, a labouring woman who’s able to move about freely and allow her baby to rotate into an anterior position.
Baby in optimal position: head down and flexed, back out.
Signs of a Posterior Baby
- Feeling kicks or flutters at your front
- Frequent urination (more frequent than with anterior pregnancy)
- Belly appears flat or lumpy
- Your midwife or doctor can tell by palpating your abdomen, as is done at every prenatal visit
- Fetal heart-tones may be difficult to hear
- Head is not engaged or doesn’t drop into pelvis
- Can be confirmed with ultrasound
- During labour she can also tell during an internal examination
Factors Contributing to Posterior Position
Posterior-babies can occur with no risk factors, but the following increase the chances:
- North American lifestyle – reclining in upholstered furniture, sedentary lifestyle, sitting in cars (it’s interesting to note this position is rare in cultures where women walk a lot or work bent-over, and lack Lazy-Boy style chairs and couches)
- Sitting with legs crossed
- Postural or anatomical issues
- Issue of uterine / abdominal muscles (e.g. tight psoas)
- First pregnancy
- Epidural use early in labour (hinders rotation and descent of baby) is correlated with more than 3x the rate of posterior position at birth (Tully, 2008)
- Labouring in bed or without adequate movement
- Baby who was breech and turned to vertex
- Mother with history of breech or posterior baby
- Short or tight cord around baby
- Emotional issues – fear of birth or parenting, not paying attention to pregnancy, family history of breech, relationship issues, financial concerns, stress (Frye, 1998)
Tricks for Turning a Posterior Baby to an Anterior Position
Sometimes there’s a reason (that we don’t know about) for baby to be posterior and nothing will turn her or him. But in many cases a baby can be turned. Please ask for details or referrals.
- Visualization and “talking” to your baby. Focus on letting the baby know it’s easier to get out when facing the other way. This works especially well if combined with changing your emotional environment e.g. dealing with fears, prepping for birth.
- Look at a picture of baby in proper position (e.g. Fig. 1), or have it drawn on your belly!
- Webster Technique with a chiropractor certified in its use. Pistolese (2002) cites an 82% rate of success in relieving the musculoskeletal causes of intrauterine constraint. It’s beneficial to perform the Webster Technique starting at 35-36 weeks.
- Sit with pelvis tilted forward – knees below pelvis with straight back. Instead of upholstered furniture, use a birth ball, the floor, a kneeling chair or a regular hard chair or stool
- Hands and knees – read, crawl around, or child’s pose modified for pregnant belly
- Pelvic rocking while on all 4’s – gentle cats and dogs yoga postures – several times daily
- Swimming or floating – anything with belly down like a hammock for baby to drop into
- Movement and exercise
- Sleep on left side with a body pillow – left leg straight, right leg bent on pillow
- Keep belly warm (babies may turn back to keep warm against mother’s back)
- Homeopathic Pulsatilla 200CH, 1 dose every 3 days.
- Acupuncture or moxibustion – see a Traditional Doctor of Chinese Medicine or an acupuncturist who specializes in women’s and pregnancy care.
- Deal with fears around childbirth and parenting
- Postural management – check out spinningbabies.com for some excellent postures and exercises that encourage babies to assume optimal positions for birth.
Frye, A. (1998). Holistic Midwifery, Vol 1, Care During Pregnancy. Portland, OR: Labrys Press.
Ohm, J. (2006). About the Webster Technique. Retrieved from icpa (International Chiroractic Pediatric Association): http://icpa4kids.com/about/webster_technique.htm
Pistolese, R. (2002). The Webster Technique: A chiropractic technique with obstetril implications. Journal of Manipulative and Physiological Therapeutics , 25 (6), E1-E9.
Tayler, R. (2000). Homeopathy for Pregnancy and Childbirth. Ottawa: Ottawa School of Homeopathy.
The Midwifery Group. (2008). Posterior Babies. Retrieved from The Midwifery Group: http://www.midwiferygroup.ca/downloads/position/Posterior%20Babies.pdf
Tully, G. (2008). Occiput Posterior – OP. Retrieved from Spinning Babies: http://www.spinningbabies.com/baby-positions/posterior