Birth Trauma – Part 2

What can you do to prevent problems in labor, and miscommunication with your doctor? My recommendation is to follow the recommended diet for pregnancy, exercise (for pregnant women), drink a lot of water, and attend to the prenatal visits.

Never be afraid to ask questions!

Why a certain test is being done, what does that word mean, etc. Some things I can assist you with during the Childbirth Education coursework…but asking the questions of your doctor is important. You get to know your doctor, and he/she can get to know you.

Your right as a patient is to have any procedure or test explained to you, by your doctor.

Questions such as:

-Is the particular procedure / test done because it is required?
-Who requires it?
-Why is it required?
-Is it because of doctor concern? What precipitated that concern?

Your doctor is not GOD.

If the doctor is not responding to your questions or you are not comfortable with the explanation / or attitude of the doctor you still can address the issue. Sometimes just a rewording of your question is helpful.  If still you are not being listened to, the following outlines your rights…

HIPPA law outlines a patient’s rights:

To Clear Communication

The AMA’s Code of Medical Ethics clearly states that it is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients. Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions.
[https://www.emedicinehealth.com/patient_rights/article_em.htm#communication ]

To Informed Consent

Informed consent involves the patient’s understanding of the following:

  • What the doctor is proposing to do
  • Whether the doctor’s proposal is a minor procedure or major surgery
  • The nature and purpose of the treatment
  • Intended effects versus possible side effects
  • The risks and anticipated benefits involved
  • All reasonable alternatives including risks and possible benefits.

[https://www.emedicinehealth.com/patient_rights/article_em.htm#informed_consent ]

Within the perimeters of informed consent, the doctor ethically understands the responsibility of:

  • The patient being told what the doctor is going to do
  • That the patient is helped to understand the medical implications
  • Whether it is a minor or major procedure
  • The risks and benefits
  • Alternatives with the information about risks and benefits

The patient rights also include:

  • Freedom from force, fraud, deceit, duress, overreaching or other ulterior form of constraint or coercion
  • The right to refuse or withdraw without influencing the patient’s future healthcare
  • The right to ask questions and to negotiate aspects of treatment

    The 3rd part follows in one week…

A Good Question

What needs to happen, in order to fix a broken system? Your probably wondering what I mean by a broken system. I am talking about the care of women, and especially birthing.

In a nation that has been considered “advanced” we are so far behind the eight-ball that it becomes shameful. Our c-Section rates were seriously through-the-roof, and although some improvement has been made still higher than most “civilized” countries! The average being around 31%.

Along  with that outrageous number of c-Sections are the ever-climbing mortality rates of women in birth, predominately women of color. This is shameful in a country that is supposed to be “advanced”!

On top of both high c-Section rates, and high mortality rates for birthing, is the across-the-racial-board birth trauma. It should NEVER happen! But, we have nurses and doctors who force women into procedures, who intimidate and threaten.

The media makes it seem that birth is both dangerous and extremely painful. When that consciousness is embedded in the psyche of women, and you have a medical field that relies on mechanical means to monitor births… the stage is set. We have normalized bad birthing practices, and outdated concepts about birth.

That is without discussing the current political scenarios.

The next few blogs will address the history behind, and the current information about birthing in the United States. The outdated concepts surrounding birth practices need debunking. The normalization of bad birthing practices needs to have a light shown upon it, in order to make it STOP.

It is time to become educated,

get angry,

and create a change!

My sister site will also be publishing this information, although later, at joyousbirth

Our Gynecological Health – Part 2

Normal VS Abnormal Bleeding

Normal menstruation lasts about five days and usually will follow a pattern, here are two variations:

Light –> heavy –> medium –> light –> very light
Heavy –> heavy –> medium –> medium –> light

Also, some women may spot (ordinarily brownish) or bleed at other times in their cycle besides actual menstruation. Spotting is one of the most misunderstood aspects of a woman’s cycle. A common mistake is to assume any type of bleeding episode is menstruation. True menstruation occurs after ovulation, about 12 to 16 days after. Any other type of bleeding is either anovulatory bleeding, what is considered normal spotting, or is symptomatic of a problem.
Ovulatory Spotting

Light bleeding may occur right around ovulation in some women. It is not only normal, but an indicator for fertility, a sign that tells where the woman is in her cycle. It results from a sudden drop in estrogen, just before ovulation. It occurs more in long-cycles.

Anovulary Bleeding and Spotting

Once in a while an egg is not released. It could be due to the estrogen not reaching the level for the egg to release. When this happens the drop in estrogen will cause light bleeding.

For women over 40, the cause is a decreased sensitivity to FSH and LH hormones. This would result in these women not ovulating. The progesterone level is not able to sustain the lining and some spotting or bleeding may occur.

The way to know if actual ovulation did occur, is to chart the temperature. As a reminder: the temperature pattern is: low before ovulation, followed by the high temperature after.

Implantation Spotting

So when a woman notices spotting rather than bleeding a week after her temperature shifts she might want to consider a pregnancy test. This may be an indication of “implantation spotting”, because as the egg burrows into the lining of the uterus, a bit of spotting may occur. If temperatures remain high for another 18 days or more, this is an indication that the corpus luteum is viable.

Breastfeeding Spotting

After the initial flow of birth has stopped, some women may have some bleeding about six weeks postpartum. This is due to the withdrawal of hormones that were high during pregnancy.

Also there may be a fluctuation of hormones while breastfeeding because of the needs of the baby. The temporary imbalance of hormones may cause women who breastfeed a few anovulatory spotting.

Other times

• After office procedures
• While on the pill
• Or during postmenopausal hormone replacement therapy

Our Gynecological Health – Part 1

First of all, we women have left all the charting of our gynecological health in the hands of our doctors. We can keep our own records, at home.

I will be posting a .pdf file of a chart you can use as a “master sheet” of your exams and an example chart to assist you in filling it out. Use it to keep track of your weight, blood pressure, general gynecological health (which would include the breast exam, pap test, vaginal culture, etc.).

Much of what we see in our doctor’s charts, may seem to be a problem, only because we women do not understand or are taught about normal feminine health. We can understand them better when we see what actually are the “true” gynecological conditions.

These “True” Gynecological conditions would be:

• Vaginal infections
• Abnormal bleeding
• Premenstrual syndrome
• Breast lumps
• Endometriosis
• PCOS
• Nabothian (cervical) cysts

“…charting enables a woman to understand her body in a practical way (Wescheler, 230)”. A woman who charts every day is so aware of what is normal for her own body, that she can actually assist her doctor determine what is not normal based upon her symptoms. Keeping the chart of her menstruation cycle assists her In well-being, and working with the doctor.

Normal Healthy Cervical Fluid VS. Real Vaginal Infections

We live in a culture that advertises douche and sprays for vaginal “discharge” giving women the idea that they are “dirty” all the time. Douching and sprays only act to confuse the identity of healthy cervical fluid and what would be a real infection.

Wescheler explains in her book, that doctors say you don’t need either. On a talk show she watched, she says that the doctor stated that the infections from these products were “…enough to send his children to college (Wescheler , 231)”. Then there is also the yeast infection products that women self-diagnose and take every month for a “recurring” problem.

But, using the chart, detection of an actual infection will be easier, and discovered earlier. You can get treatment before discomfort sets in. Secretions mid-month are normal, but late in the month may indicate infection.

Symptoms of Vaginal Infections That Can Be Distinguished from Normal Cervical Fluid
Once you have routinely charted your normal cervical fluid, an infection can be distinguished by the unpleasant symptoms that set them apart from what is normal. Vaginal infections can range from STIs (See: The Effects of Sexually Transmitted Infections on Pregnancy) to a variety of forms of Vaginitis and of course the generic “yeast infection”.

• Abnormal discharge
• Itching, stinging, swelling, and redness
• Unpleasant odor
• Blisters, warts, and chancre sores

Avoiding Infections

Besides the consequences of douching, you should not wear clothing that is damp or too tight, as these create an unhealthy vaginal environment. Also you should wear cotton underwear, or at least cotton crotch underwear as these allow your body to breathe.

For more information see: Part 2

Sphincter Law- Part 1

doula at work
In birth work, obstetricians use the Law of Three Ps:

• Passenger (baby)
• The Passage (the pelvic structure and vagina)
• And the Powers (strength of uterine contractions)

From these Ina Gaskin believes stems the misunderstood capacity of a woman’s body from both the pregnant woman and the doctors who work with them. From the misunderstood capacities are the causative factors leading to all the interventions and procedures that now create problems in birthing, such as: Cesarean sections, Forceps use, vacuum extractors, etc.

The blame is placed upon women, for what obstetricians see as “dysfunctional birth”. Women have birthed for eons without a hitch; doctors perceive having a baby as “a problem of physics rather than a millions-of-years-old physiological process (168)”.

The Basics of Sphincter Law

• They function best when the atmosphere is private, and familiar.
• They do not open “at will” and do not respond to commands such as “Push!”
• When in the process of opening (relaxing) they will suddenly close down if a person is upset, frightened, humiliated, or self-conscious. This is the reason why in most traditional cultures women assist women in birth.
• If the mouth and jaw are relaxed, there is a direct correlation to the ability of the sphincters opening in the cervical and vaginal area (or the anus, for that matter).

What are the Sphincters?

These are a grouping of muscles that surround the rectum, bladder, the cervix and vagina. Each has a function for the body. These muscles remain contracted to keep the openings of certain organs held shut until something needs to pass through.

How do they work?

They work in conjunction with the brain. The brain has two sections that directly influence the functions of the Sphincters. These sections are the neocortex and the brain stem (or “primal” brain).

The brain stem is the portion that is directly connected to hormonal functions, and more instinctual. The hormones it releases (related to birth) are oxytocin (the main ingredient in the drug Pitocin, used to induce labor), endorphins, and prolactin.

Whereas the neocortex stimulation works to inhibit the brain stem from hormone release. It is “stimulated” during labor by asking too many questions of a woman in labor, bright light, and failure to protect her privacy during birth.

The sphincters work with the brain stem (and its many hormonal excretions) by a relaxation response. They respond to emotions. A good example of this relaxation response is what happens when toilet functions are interrupted. Everything gets held in, and it takes a while to relax again, right?

~more on the “Sphincters” next week!

Co-Sleeping

co sleeping

Co-sleeping as defined here is “bed sharing”. It means to share the bed with your infant, for the purpose of breastfeeding, as well as bonding. This could encompass the use of the crib or bassinet in the bedroom (in general) or beside you when you sleep or not.

In Gettier’s article, she distinguishes between those parents who intentionally share the bed nightly, and the parents who are reactive bed-sharers. A ‘reactive bed-sharer shares the bed due to having “child sleep difficulties and / or to ease nighttime feeds (9)”. This would occur less regularly and are for shorter periods of time. Those parents who regularly sleep with the child, have the child in their bed for the full night.

SAFE BED SHARING

• If there are two parents within the household that choose to bed share both parents must agree to be
vigilant and responsive to the infant.

• Babies who are born small for gestational age should avoid bed sharing

• If the mother smokes, she should choose same room sharing, not bed sharing if she does not
shower nightly.

• Bottle feeding parents (without breastfeeding) should also use room sharing [never prop the bottle].

• Think of the safety of the baby, and suffocation. If you have a bed set, remove the mattresses (placing
headboards, et al into storage temporarily) and move the mattresses to the center of the room.
Babies and roll and move, get wedged between the mattress and headboard (or mattress and wall)
and suffocate.

• If you choose to keep the head and foot boards , eliminate the spaces that are between mattresses
and the head or foot board.

• Older children and pets should not be sleeping in the bed with the infant.

• Co-sleeping is not recommended if you are or have been drinking. Nor is it a good idea to share your
bed with baby if you’re doing recreational drugs.

• Bed sharing should be on a firm mattress, with no duvets or heavy bedding. Infants need to be away
from pillows or other bedding that may obstruct the infant’s breathing.

• NEVER co-sleep on a couch, recliner, or chair.

• NEVER LEAVE A BABY ALONE ON AN ADULT BED.


There benefits to bed sharing.
These include: higher percentages of breastfeeding rates, longer feeding times, increased feeding during the night. Keep in mind, babies tummies are small and they would therefore feed more frequently.

It is known that there is a greater immunological benefit in breastfeeding. It is known to be a “protective factor against SIDS (Vennemann et al 2009, Gettier, 10)”. Mothers who breast feed longer are less likely to develop breast cancer as well.

Babies who bed share are awake for shorter time periods than those who sleep separate. It is thought that bed sharing assists in a “synchronization between mother in terms of arousals and sleep stage shifts (McKenna and Mosko 1994, Gettier, 10).” Both mother and father seem to get much more sleep with bed sharing, than those who do not.

REFERENCES:

The Careful Decision to Bedshare. Lee T. Gettier. (2010) International Doula. Vol. 18, Issue 1

*A more detailed document is available at the Hokṡiyuhab Oti Childbirth Education Classes*