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Why Not Home? Home Birth vs Hospital Birth

6/29/2018

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​Home Birth vs Hospital Birth

Please note: This post is not meant to sway clients one way or the other in terms of their childbirth choices. As a doula, I support women no matter what they choose. I simply wish to shine some light on some observations I’ve noted about the various options that women have for their births.

Each woman is different, and each birth is different. Most of the births I have attended have been in hospitals. I’ve worked with some incredible hospital births. Most go swimmingly, and I’ve seen women have wonderfully empowering experiences there.

On the other hand, I’ve been a firsthand witness to the effects of interventions. Most of the time, medical birth interventions, despite their legitimate risks, are overall safe and usually well managed.  

However, I’ve seen the effects of invisible passive interventions as well. The clock is a perfect example of a passive intervention, and its effects are very real.

“Textbook birth” happens in one place, and one place only: the textbook. The range of “normal” in everything related to birth is vast, yet most hospitals tend to confine “normal” down to a rather narrow window. Women tend to be “allowed” to labor for “X” number of hours, they can push for another “X” number of hours, and the placenta must come within another “X” amount of time.

I see something very different in home births.

Homebirth midwives respect the birth process too much to restrict it down to a fixed series of allowable proceedings. They understand that the body can start and stop labor, that some phases can go unusually quickly and others can take longer. Midwives do not define labor by a set “allowable” time since their practice is not governed by a hospital’s rigid status. As long as the mom and baby are both doing well, labor is respected and permitted to take its course. When a stage of labor takes longer than normal, midwives carefully watch, listen, monitor medical safety, and let the birth proceed as usual.
Which begs the question: how does the hospital differ? What do they do when labor doesn’t always go according to the allowable textbook timeframe?  In my experience, most normal, healthy women are given a myriad of interventions to force the process along, and many ends up in the OR with a cesarean. They often refer to the Friedman’s Curve as a guideline to call an “arrest in labor” and a need for a cesarean. I do see differences between hospital to the hospital due to policy and provider to provider due to their experiences, but for the most part, cesarean for Failure to Progress according to the textbook definition of the Friedman’s curve is really happening and many times unnecessary.

Birth interventions are known to increase the risk of cesarean so this is not surprising. However, it can be devastating to women who truly wanted to experience birth, or who were frightened of having a cesarean.

I talk to a lot of women that want to hire a doula so that they can avoid the operating room – they want to avoid having a cesarean. Doulas absolutely do reduce the incidence of cesarean for many reasons. However, my encouragement for women that truly desire to impede the risk of cesarean is to carefully consider your provider. Hospitals are wonderful places for the most part. But one cannot accurately predict exactly what their birth is going to look like beforehand. If your desire is to avoid the OR, perhaps it’s time to consider other options.

The hospital is not your only option. It can certainly be a good option, but it is not your only one. A new study on home birth safety concluded childbirth at home with midwives in the US to be a safe option for low-risk pregnancies. I encourage you to consider exploring all of the available options during your pregnancy. You can always switch your provider – up until the moment you go into labor! Read Care Providers in Pregnancy to learn more about the difference in providers. If you are considering home birth, contact me for some great referrals and care in Massachusetts!
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I support you no matter what you choose – just make sure that the choice you make is for sure the right one for you.
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How Will Teething Affect Your Baby’s Sleep?

6/23/2018

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​Teething is an exciting time when your baby starts growing up and forming his or her mouth. However, it can be an uncomfortable situation that affects the baby’s sleep and yours. Here’s how:

It Causes Pain
Dentists say the most prevalent of the signs of teething is the pain. It hurts for a tooth to erupt through the gums. Just talking about it can feel painful. Teething hurts for adults too, so your baby is likely to fuss and have trouble sleeping because of the soreness. Teething rings can help with the pain. The cold feeling that they get when they chew on the teething rings is quite soothing. You can also purchase some numbing agents that you can rub on the baby’s teeth, as well.

The Baby’s Temperature May Rise
Researchers explain that the teething process may also slightly raise the baby’s temperature, which will also make him or her uncomfortable. Your little one may have trouble sleeping because of that, as well. However, teething will only elevate the baby’s temperature a little bit. If you notice a massive increase in your child’s temperature, he or she may be sick. The illness probably has nothing to do with the teething if the temperature is above 101.

It May Cause Irritability
Irritability is another sign of teething that may affect your little one’s sleep. The baby may cry a lot during this time because of the pain and discomfort. According to children’s medical experts, your child may also be angry and seem generally fussy during the entire time. Teething has a variety of symptoms that will affect a child’s sleeping patterns. Irritability is just another one of them. You can try to use love and comfort to combat the problems with irritability. For example, you can embrace him or her for a little while or sing a warm song to help calm the child down.

Restlessness Occurs
Your baby may be generally restless during the teething process without any accompanying symptoms. He or she may just have difficulty falling asleep. The teething period is just a trying time. Parenting experts explain, trying to distract the child or giving them something cold can help them relax enough to fall asleep. Patience is a necessary skill while a child is teething because most of the time there isn’t anything that you or your child can do but wait it out. It will pass, it will end, it just takes a bit of time, so hold out until then. That being said, playing some soothing music in conjunction with a cold treatment may help the baby to fall asleep faster.

Those are some of the ways that you can tell that your baby is teething. Be patient and loving, and this difficult stage will pass. Your baby will come out of it with the most gorgeous teeth ever.

If you’re looking for more information on infants and other small children, make sure to check out our blog!
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Positively pregnant

6/9/2018

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​Positively PregnantYou just haven’t felt yourself lately. Your breasts are tender, you feel tired, bloated and your heart seems to be working over time.  You may even be feeling that you are coming down with something.

Wait.  ...When was my last period??

You grab a pregnancy test at the nearest pharmacy and head home in anticipation. Is this it? You wait anxiously for the 2 minutes to creep slowly by as you watch the test window like a hawk preparing an attack on it’s prey…
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You rub your eyes in shock and take a closer look…
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POSITIVE!
…Well, now what?

It’s hard to know where to start! Here are some clear cut first steps to take as you prepare for your journey into pregnancy.


1. Call your Primary Care Physician.
Check in with your primary care physician to confirm your pregnancy with a blood test. When you talk to them, make sure to check about your current medications to see if you should still be taking them.

2.  To Share or Not to Share? That is the question.
And there is no right or wrong answer. It can be incredibly hard not to tell your friends and family as soon as you find out you are pregnant, but I recommend trying not to post it to social media just yet – at least not publicly. Allow yourself some time to mentally adjust to the pregnancy, the upcoming birth, and the life changes that are soon to follow.
Some decide to keep their newly developing baby a secret for fear of a miscarriage. Or, they will decide to tell only a select few close family members or friends until the first trimester is over. The pregnancy is most vulnerable during the first 12 weeks, and after the first trimester, the chance of a miscarriage drops dramatically (down to 10% of all known pregnancies). If you decide to wait for this reason, that is just fine.
And if you decide to announce your excitement to the world, that is fine too! Just make sure you do what you really feel is best for you.

3.  Call the Midwife!
Or OB/GYN. Ask friends and family for recommendations for local recommendations if you do not have a prenatal or women’s care provider. You will want to know which OBGYNs and Midwives worked best with their patients and provided satisfactory experiences to women. Google their names and see what you can find out. We can also help to match you up with a care provider that may be suited to you best.

Choosing a primary care provider is likely one of the most important decisions of your entire pregnancy and you don’t need to determine who you’d prefer to work with right this very minute. Keep in mind that you are hiring your provider to provide you a service, so at the end of the day, you are in charge.

4. Supplements
Like an apple a day, daily supplements can help give your baby the best start.

Ask your provider or general care doctor for a prescription for a prenatal multivitamin, preferably with DHA Omega -3s. Many medical insurance companies will cover prenatal vitamins in full, although fewer will cover a prenatal with DHA – the building block for the development of the brain, eyes and heart. Don’t waste your money on over the counter vitamins if you don’t have to. Check with your insurance company to see what they will cover.

Folate is a supplement essential in DNA production, repair, and function. Studies show it can help prevent neural tube defects of the spinal cord and brain – such as spina bifida or anencephaly when taken before pregnancy through the first trimester. Some research suggests that folate may help lower your baby’s risk of other defects as well, such as cleft lip, cleft palate, and certain types of heart defects.

Research supporting Vitamin D’s role in immune function, healthy cell division and bone health has been released(1). Vitamin D is necessary for the absorption and metabolism of calcium and phosphorus. Many studies are finding a connection between low serum vitamin D levels and an increased risk of certain types of cancers, autoimmune disease, neurological disease, insulin resistance, and cardiovascular disease.
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5. Research!!
There is so much to know! DON’T WAIT until you are at the end of your pregnancy to research your pregnancy and birth options, and I encourage you to read evidence-based information.

Evidence based information: 
Websites: Childbirth Connection, Evidence Based Birth, Birth Without Fear, Spinning Babies, and Mama Natural.
Books: Ina May’s Guide to Childbirth, Spiritual Midwifery, The Birth Partner, The Thinking Woman’s Guide to a Better Birth
Documentaries: The Business of Being Born I & II

Steer Clear of: 
Websites: theBump, WebMD, BabyCenter, Parents.com, What To Expect and of course, Facebook.
Books: What to Expect When You are Expecting, Your Pregnancy Week by Week, Becoming Baby Wise
TV: A Baby Story

6. Rest
Many women experience lethargy during the first weeks of pregnancy. It’s hard growing a baby; Your genetic map is being encoded and using the building blocks to create a little human and it’s nurturing placenta. So don’t apologize for allowing yourself to get some rest – you need it.

7. Seek a Doula
It’s never too early. A doula is not a medical professional but can help you navigate choices in the confusing medical world. She can share evidence-based education to help you prepare for your birth. Many times as doulas, we hear “I wish I had you to talk to from the day I found out I was pregnant! Why did I wait so long?!”

Take a look at Improving Birth’s Fact Sheet on Doulas.

Congratulations on your pregnancy!

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