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…

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Birth Trauma – Part 1

Many things come up during the labor and birthing of a baby. These may or may not be emergency-level events. A woman in labor is focused on the process they are involved in: birth. The woman may not be aware of what is being discussed around them, nor the things happening that may alter their ideals of the “perfect”  birth.

Here are some things that may occur:

  • Slow dilation of the cervix
  • Labor stalling
  • Movement of the baby stops
  • Blood pressure of the mother rises

Often doctors in the hospital will want to intervene. The remedies may be interventions that you really do not need.

These interventions could possibly be:

  • Monitors
  • IV insertion
  • Inducing labor (Pitocin)
  • Or even the decision to have a c-Section (read my blog post on this here: )

The first two  can be alleviated by using gravity (walking, dancing, leaning forward onto the labor bed with feet on the floor and doing squats). Usually stressors or nervousness are the cause.

With Labor stalling, if already dilated 6-7cm, it could very well be a natural stall while going into the next stage of labor or “Transition” (Balaskas 127-131). Body tension can also effect how labor progression.

Low moaning sounds are effective here, in that the vocal cords being activated relaxes the sphincter muscle group of the pelvic floor, as Ina May states ” The state of relaxation of the mouth and jaw is directly correlated with the ability of the cervix, the vagina, and the anus to open to full capacity (Ina Mays Guide, 170). The sphincter muscles will close due to stress or fear. Goer suggests that “obstetric management can obstruct progress (The Thinking Woman’s, 108)”

Remember: Babies are birthed when they are READY. Not on some sort of perceived time schedule.  This is a process that cannot be forced.

If the baby stops movement, inform your doctor. You can use “kick counts” as a method to monitor movements if you are concerned. In active labor, the baby tends to move in a spiral as baby moves into birthing position . Sometimes stopping movement for a short period of time can be an indicator of  the baby 1) shifting position 2) resting before birthing.

Blood pressure issues could be gestational diabetes, or just stress. The cause for the blood pressure rising needs to be found. High blood pressure is also a symptom of pre-eclampsia. But if you were not having signs of this condition and diagnosed in pregnancy (which is why prenatal visits are essential) then it may be something else.

Of course, water by mouth could assist in lowering the blood pressure level. Here is suggested reading for you to understand the seriousness of this condition: https://www.acog.org/Patients/FAQs/Preeclampsia-and-High-Blood-Pressure-During-Pregnancy

So now we move onto the second part of this discussion, published one week from this page.

Orange

orange-428070_1920

Citris Aurantium: Fresh Fruit

Both the unripe and ripe fruits are used in Chinese Medicine. The unripe bitter fruit is more potent. The unripe bitter fruit (zhi shi) is used for constipation or to move stagnant chi energy. It can be used to make an expectorant for coughs. This bitter fruit is NOT recommended for use in pregnancy.

The ripe fruit has multiple properties for the pregnant woman. It is high in vitamin C and when eaten with the pulp, it contains Rutin.

A Small Orange contains the following nutrients:

Amount Per  1 small (2-3/8″ dia) (96 g) 100 grams 1 fruit (2-5/8″ dia)
Calories 45
% Daily Value*
Total Fat 0.1 g 0%
Saturated fat 0 g 0%
Polyunsaturated fat 0 g
Monounsaturated fat 0 g
Cholesterol 0 mg 0%
Sodium 0 mg 0%
Potassium 174 mg 4%
Total Carbohydrate 11 g 3%
Dietary fiber 2.3 g 9%
Sugar 9 g
Protein 0.9 g 1%

 

Vitamin A 4% Vitamin C 85%
Calcium 3% Iron 0%
Vitamin D 0% Vitamin B-6 5%
Vitamin B-12 0% Magnesium 2%

 

*Percent Daily Values are based on a 2,000 calorie diet. Your daily values may be higher or lower depending on your calorie needs.

 

Sweet Orange Essence Oil

The essence oil of the sweet orange blossom can be used in a diffuser for lack of energy and / or depression. Sweet Orange is an excellent choice for women who are having difficulty in labor and who are lacking energy. Do not use the essence oil in the bath during pregnancy, and use with extreme caution with infants present. Be sure to dilute with a carrier oil, such as Sunflower or Almond.

Neroli Essence Oil
Citris bigaradia

Neroli is derived from the bitter orange blossom.  It should not be used during pregnancy, but can be used during labor and right after delivery. Neroli helps with stress, fright, exhaustion, and shock. It is also great for anxiety. An excellent choice when there are complications in labor causing the mother to be exhausted, and anxious. If there has been a traumatic birth it will assist with the shock after the birth. Use only with the advice of a trained professional who knows about aromatherapeutic treatments. Do not use in a bath and limit its use around infants.

What’s Next?

In the next few blogs I will be discussing the healing aspects and nutritional aspects of some common foods. These are beneficial for a variety of reasons and good to use in dishes, or to have whole, on your plate!

These particular foods I would recommend to include in your diet for a healthier pregnancy…

 

tomatoes-1540836_1920

These will be:

Tomatoes
Garlic
Onions
Asparagus
Cabbage
Orange
Peppers
Yams
Apples
Ginger Root
Plum

Any warnings for pregnancy and lactation will be included, and where possibility of a recipe or two. All references for these are on my reference page.

NOTE: Imagery is from free-domain imagery sites.  If I have used any images that are not free to use, please email me [rosebud.cbe@gmail.com] and I will remove them.

Miscarriage – Part 2

AFTER A MISCARRIAGE

Miscarriage is a loss as much as a full-term pregnancy where the baby is stillborn. Allow yourself to grieve the loss. Those who know ahead of time, when early signs of miscarriage is observed or during premature labor, will begin the process of grieving. This is called “anticipatory grief” and it assists you to prepare for the loss. Don’t feel bad if you have a sense of relief, the uncertainty is now over and you may feel relieved your baby’s ordeal is over.

Other people may not understand your sense of loss, unless they too have had a miscarriage. You may feel alone and isolated. Don’t keep to yourself as this can add to your feeling of doubt, and sense of self-blame.

Many people will expect you to ‘to be back to normal and may say things like ‘aren’t you over this yet?’ or ‘Buck up—no use crying over spilt milk!’ Because you are still grieving so intensely, these remarks can make you wonder if your feelings are silly or unjustified (41)”. Try to surround yourself with people who will listen and care, avoiding those people who are very insensitive.

If the baby miscarried late in the second trimester, you may have memories to grapple with. Such as, when you first heard you were pregnant, the ultrasound that showed you the baby is a boy or girl, and when you first felt the baby move. These types of things are important things to remember in the process of grieving.

You may wonder how long this process will take. It depends upon you and how well you work through the grieving process! Allow yourself the time to work through the shock, anger, denial, your memories, etc.

REFERENCES:

Davis, Deborah L. PhD. Empty Cradle, Broken Heart: surviving the death of your baby. (1994) Fulcrum.

Romm, Aviva Jill. The Natural Pregnancy Book: herbs, nutrition, and other holistic choices (2003) Celestial Arts

Miscarriage – Part 1

MISCARRIAGE

A miscarriage is when a pregnancy spontaneously ends. It usually occurs before the 28th week of gestation. Miscarriages occur in approximately 20% of all pregnancies in the United States.

Many women have a miscarriage early in a pregnancy, without even realizing it. The miscarriage just seems to be a “heavy” period. Teenage girls and middle age women are the most common age groups. Miscarriages are more common early on than after the first trimester.

Those women who tend to miscarry repeatedly, or those women who really desire a baby, the loss of a baby can be devastating. Because so many people do not discuss the loss of a baby through miscarriage women do not know what to expect or what to do.

Although painful to think about, and it sounds rather blunt, a miscarriage is nature’s way of preventing an unhealthy baby from being carried to term. It may seem hard to accept, but we should realize that our bodies have a wisdom of their own and prevention of a miscarriage will not be effective with an unhealthy baby.

Other causes for miscarriages include:

• Hormonal imbalances
• Cervical looseness ( called “incompetent cervix”, a medical term)
• Infections
• Nutritional deficiencies
PREVENTING A THREATENED MISCARRIAGE

The signs of a threatened miscarriage include spotting, bleeding, or cramping which may also include a backache. These symptoms may begin suddenly or develop slowly. They can last just a few hours, or may last for days. The spotting or bleeding may be all that occurs. Or the symptoms may be more severe and cause fear that the baby will be lost. A physical exam is not wise at this point as it may stimulate the uterus further. Chances are a woman will still have the symptoms of pregnancy (breast soreness or tenderness and nausea) after spotting or bleeding. Although not always a good idea, the use of the Doppler may help reassure that the pregnancy is still viable.

GENERAL RECOMMENDATIONS

• If You are having contractions or are bleeding / spotting, do get off your feet and rest. Get up only when you need to go to the bathroom.
• Avoid lifting heavy objects and abstain from sexual activity until all signs of a miscarriage have been gone for at least a week
• Warm (not hot) baths will release tension and anxiety, and bring relief to lower back pain.
• Take time, while resting off your feet, to connect with the baby and tell the baby you want him/ or her. Send your baby your love. This may or may not be helpful, but you will feel comforted and assured you are doing all that you can for the pregnancy. Let the baby know you want the baby but also reassure the baby that if he or she must go, you understand and give permission.
• If you are unsure about the pregnancy to begin with, this is a good time to come to terms with having or letting go of the baby.

DIETARY RECOMMENDATIONS

• To prevent a miscarriage, avoid all cold-natured and cold temperature foods. Cold has a downward moving, heavy force…causing an excess of downward flow in the pelvic area.
• It is better then, to eat warmer foods that are nourishing, such as soups. Also emphasis should be on whole grain stews, hot cereals, root vegetables, and dark greens until all symptoms have been gone at least for a week. For beverages: warm tea (preferably the pregnancy teas) and room temperature water should be consumed.
• Vitamin E is thought to assist placental attachment to the uterus…reducing the likelihood of spotting or a miscarriage. Take up to 800 IU of vitamin E for about three weeks. If you have a heart disease, do not exceed 50 IU per day without discussing the supplementation with your doctor.

The Vocabulary of Pain

 

father in delivery room

The following information was written in order to understand pain in childbirth. This is a preliminary to understanding what your body senses when in labor.

Pain Threshold

The definition is “the point in which an individual first perceives the presence of pain”. This could be when ice or heat no longer is affective for blocking and / or reducing pain.
Each person has their own threshold. It is thought that threshold remains the same throughout ones life. But, Childbirth educators have found that the threshold is quite flexible. It is found that when comfort measures are used that effectively reduce pain or make it easier to bear, and the woman is distracted from her comfort measures, then the comfort measures no longer are useful. It will take a stronger stimulus to then break through the pain. Nothing had changed in the strength of the pain itself, “rather, her distraction reduced her pain threshold so that less pain was necessary in order for her to notice it (162)”.

Intensity
Intensity is defined as “the quantitative measure of how strong or severe the pain is (Ibid.)”. The usual measurement is a scale of 0 to 10. O being no pain, and 10 meaning that the pain is out of control.

Character
Character is a qualitative measure, using verbal or pictorial descriptors and analogies. Pain character may be described as burning, aching, tearing, or sharp like a knife. Character is the most important aspect to consider when managing pain.

Duration
Concerning when pain is first noted, and how long it lasts, and whether it is a steady pain or sporatic. It is particularly significant in that smaller diameter nerve fibers may, after repetitive signals become more responsive to pain signals. Many management strategies that are not pharmaceutical focus on the larger nerve fibers, which respond well.

Location
It is where the pain is perceived in the body. Depending on the location, the distress level may rise and start to interfere with eating, breathing, sleep, concentration, or the ability to otherwise function normally. If she is unable to concentrate due to location or any other aspect of the pain, she will be less able to use the pain management strategies she has learned.

Sensation Threshold
It is the point where the stimulus was first perceived. When reached, it is when the client first is aware of itching, cold, pressure, pain, or any other sensation. Of these, pain is the most important in that it could signify potential or actual tearing. Other sensations that may later become concerning may eventually grow strong enough to be perceived as pain.

Pain Tolerance
Defined as the greatest severity of painful stimulation an individual is able or is willing to tolerate. “Encouraged Tolerance” is the highest level of pain a person will tolerate when encouraged to try to tolerate more”. It serves a purpose, but not for women in labor as it may lower the tolerance to pain. It actually would translate to suffering rather than just pain.

Categories of Pain

Cutaneous
Occurs at the dermal level, and is sharp, localized, and generally tonic. An example would be the prick of the needle when given an injection.

Visceral
Occurring at the organ level, could be sharp or dull. There is less localization and could either be tonic or episodic. Examples: uterine contractions, severe constipation, and intestinal gas.

Somatic
It occurs at the soft tissue level. It is dull, aching, not localized and usually tonic.

Nerve Compression
The pain results from pressure on one or more nerves. It may be localized, or be referred pain to one or more regions of the body.

Protein Foods

Protein Foods

(with the protein foods containing the most essential amino acids first).

Proteins
Eggs (preferably organic, or at least “free-range”)
Milk
Fish (preferably:
Poultry (preferably: baked, broiled or stewed)
Tofu & other beans
Oats (preferably not quick cooking)
Nuts (especially almonds)
wheat
cornmeal

Protein Food Combinations

(to assure best usage of the most Amino Acids found in the food /Proteins )

Beans + Wheat
Beans + Rice
Corn bread + Beans
Corn tortillas + Beans
Lentil Curry + Rice
Pea Soup + Wheat (bread)
Pasta + milk and/or Cheese
Cheese + Wheat (cheese sandwiches)
Macaroni + Cheese
Garbanzo dip (hummus)
Sunflower seeds, peanuts, roasted soybeans (snack foods)

_______
“Diet for a Small Planet”. Fig.14, page 176
Ibid. page 181 (Chart)

Varicose Veins

WHAT ARE THEY?

Varicose-Vein

Varicose veins occur when the valves (that keep the blood flowing one way through the vessels) have become weak, which allow the blood to pool in the veins. This “pooling” causes the veins to become lax and distended.

CAUSES:

  • May be due to diet
  • Lack of exercise
  • Heredity
  • Hormone changes can cause the laxity of the valves
  • Pregnancy can be a predisposition for some women
    -Because there is a congestion of the blood in the lower extremities due to pressure from the uterus.
    -The return of blood from the legs to the pelvic area is reduced by the heavier uterus.

They are most common in the legs, ankles and feet. They can also show up in vulva (Vulvar variscosities) and anus (as Hemorrhoids). They become more pronounced as the pregnancy advances.

The vulvar variscosities usually are not noticible until birth. Some women notice the large ones during pregnancy. A gentle birth and hot compresses applied to the large distended veins will reduce damage or trauma to the veins. Occasionally bleeding or hematoma (internal pooling of blood) can occur and will require medical care.

Hemorrhoids become evident after birth, normally. So the use of gentle birthing will help with these as well. Constipation will aggravate hemorrhoids, and should be treated (although, following a good diet will reduce constipation due to the additional fiber from foods).

Usually the varicose veins will empty quite quickly after pregnancy. They are quite common during pregnancy, and usually repair is not considered during that time.

RECOMMENDATIONS

• Eat well, and drink lots of water
• Exercise! Exercise improves the circulation, and assists in both the prevention of and treatment for varicosities.
-Brisk walks for 30 minutes each day
-Or ride a stationary bike for the same length of time as walking
-Swim
-Yoga
-Belly dance moves such as pelvic rocks, and rolling/rocking the hips in a figure-eight.
-Dance!
• At least 20 minutes twice a day with feet elevated higher than the heart
• Do NOT sit in one place for too long. This would encourage insufficient pelvic and leg circulation.
• If you have severe varicose veins use support stockings (you can find them at a drug store.
• Use visualization to reduce the size and number of the varicose veins.
• You need to consider who / what is your support. You are not superwoman, and will need support during this very exciting time in your life!

CAUTION: Never massage the varicose veins! Massaging the veins can cause clots to dislodge and lead to an embolism. Embolisms are dangerous! If you see signs of phlebitis (swelling, heat, pain, infections around the veins) you should see the doctor or midwife right away.

DIETARY RECOMMENDATIONS

Follow the “baby wise” diet . Be especially careful to eat whole grains, high quality proteins, fresh vegetable and fruits as often as you can.

• Vitamin C with bioflavonoids is vital for assisting the walls of your veins to be strong.
• Foods with high vitamin C: citrus fruits, rose hips, dark green leafy vegetbles, cherries, alfalfa sprouts, strawberries, cantaloupe, broccoli, tomatioes, and green peppers.
• An additional 2,000 mg. of C with bioflavonoids can also help
• Vitamin E also is good for the vascular system. Take 200 to 600 IU a day. If you have heart or blood pressure problems begin with 50 IU and work up to 400 IU over a three month time-frame.
• B complex vitamins. Whole grains, nutritional yeast (I take mine in orange juice), and yogurt (its helps maintain intestinal integrity ).
• Green Vegetables…romaine (stop eating the low-vitamin Iceburg variety) lettuce, butter lettuce, turnip greens, kale, collards, mustard greens, dandelion greens, and turnip greens. Steam these, do not boil!

HERBALS

• Nettle leaf tea (One herb in the “Pregnancy Tea” blend I use) . Infuse by making 1 ounce of herb to 1 quart of water and allow to steep for 2 hours. Drink a cup to up to a quart a day depending on severity.
• Garlic, onions, oatstraw, calendula, motherwort, can also be consumed. Please consult an herbalist for guidance on their use.
• Kelp. Kelp can be added to soups or taken in a tea form.
• Deficiencies in essential fatty acids may make the varicose veins worse. Take 500 mg. of one of the following oils once each day: evening primrose, flaxseed oil, black currant oil, or borage oil.

REFERENCES:

Romm, Aviva Jill. The Natural Pregnancy Book: herbs, nutrition, and other holistic choices (2003) Celestial Arts

Lowdermilk, Dietra Leonard and Shannon E. Perry. Maternity and Women’s Health Care, 9th ed. (2007) Mosby.

Stress, Part 3

Stress

stress

Stress and Pregnancy

This is a huge transitional period for the family unit, and usually characterized as stressful. Due to new roles to learn, adjustments within the family unit, communication patterns are re-established. These shifts may trigger biologic changes, hormonal function shifts, and immune system vulnerability.

The whole family unit is thrown off it equilibrium due to restructure of family roles, adjustments to family goals, physical and emotional changes that pregnancy may bring. This is the case for the average and normal situation and pregnancy. What about other circumstances or high risk pregnancy?

If the pregnancy is from an already stressful situation such as a rape or domestic violence has occurred, the stressor of pregnancy brings additional problems. Decisions need to be made to assist the mother, if other children are involved, their safety attended to.

In high risk pregnancy situation, stress is further aggravated if hospitalization is required. “High risk” is a label given to those whom the health of the baby or mother to be is threatened.

The pregnant mother’s ability to adjust and or adapt to the situation may be in jeopardy by the excessive level of stress. The mother must understand the causative factors in being labeled high risk and accept the situation in order to have a good outcome. As well as the pregnant mother, all other family members need to assess, accept, and readjust to this prognosis.

Unfortunately, pregnancy on the reservation is almost always considered high risk. This is due to poverty, gang activity, teenage pregnancy, alcohol consumption and drug abuse.

Only YOU can change this! Change the additional stressors in your life, and then you can change the outcome of your pregnancy and delivery!