Holistic Childbirth Classes in Asheville!

November 21, 2009 at 2:32 pm (Uncategorized)

I’m pleased to announce that I am now teaching childbirth classes along with Sara Rathbone, CPM.  We’re in the middle of our first series right now, and we’re really enjoying talking about our favorite subjects: pregnancy and birth!  Our class focuses on physiologic birth, empowered choices, and emotional awareness.  Here’s what we cover in each class:

Class One: Exploring which topics each couple is interested in; fetal development (with lots of fun pictures!); Nutrition; Common Pregnancy Concerns and natural remedies; Bellycasting; Nonviolent Communication, and a birth art project.

Class Two: Clay Birth Art; Physiology of the First Stage of Labor; Comfort and Coping Techniques for the first stage; Birth Video; Intro to Homeopathy and Herbs; Labor Visualization

Class Three: Physiology of the Second and Third Stage; Coping Techniques and Positions; Birth Video; Two Homeopathic Remedies; Birth Art; Affirmations for Labor

Class Four:  Unusual Situations; Birth Attendants and Interventions (including epidurals, breaking waters, fetal monitoring, etc.); Role playing; Birth Art: power symbols; Birth Video; Pain awareness practice

Class Five:  Newborn appearance, behavior and care; Placentas and their uses; Breastfeeding; Baby Art; Closing Ritual

Please contact me if you’re interested in our classes- they’re a lot of fun and it’s great to spend time with your partner and/or other pregnant parents.  Each class forms a really sweet community.

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Informed Refusal

August 13, 2009 at 6:58 pm (Hospital Procedures, Informed Consent) (, )

Many mothers who choose to work with a doula are looking for someone to support and advocate for their choices regarding medical treatment and interventions during hospital births.  As a doula, I relish working with mothers as they do research and learn about all things childbirth, from the natural physiology of labor to the functions and effects of an epidural, and many other topics of interest.  They ask me, during this learning time, what I will do if we’re in the hospital and their doctor or nurse tries to make them do something they don’t want to do.  In the discussion that follows that sort of question, I introduce them to a concept that I wish all pregnant women knew about: informed refusal.

Most of us have heard of informed consent.  It’s the idea that a doctor or midwife will inform us thoroughly of all the risks and benefits of a procedure before we agree to it.  This is done so that a patient will understand why a particular procedure is being suggested, and also so they will not be surprised by any side effects or possible negative outcomes of the procedure.  But the understanding underlying informed consent is that the patient will consent- their agreement is implied, the information is designed to elicit that agreement.  But what if the patient has been informed of all the risks and benefits of a procedure, and she decides that she does not want to accept it?  Is she allowed to do that?

The simple answer is: yes.  Any patient has the right to refuse any and every procedure, intervention, test or anything else that hospital staff or doctors would like to perform.  In fact, if any procedure is performed without a patient’s consent, it is considered criminal battery.  Imagine the uproar if a doctor gave someone anasthesia and did open heart surgery after the patient had strongly and vehemently refused such an operation.  It would be unacceptable, and would probably elicit a national hue and cry.  The exact same rights apply to a pregnant, laboring, or birthing woman.  She has the right to refuse any and every procedure, no matter how much a doctor or midwife thinks she should have it done.  This is the right of informed refusal.

The only difference between informed consent and informed refusal (aside from the lack of consent) is that, once a patient refuses a treatment or procedure, a doctor or midwife is under the legal obligation to explain the risks of refusing that procedure.  The tone and wording of that explanation is up to the individual practitioner, and can range from a calm explanation of the statsitics to an impassioned and perhaps angry description of the danger and possible death inherent in refusing.  But the mother should keep in mind that, no matter how it is expressed, the doctor or midwife’s opinion is just that, an opinion: it is neither an order that must be followed nor a sure prediction of any sort of outcome.

In saying all this, I am in no way encouraging women to discount their caregiver’s opinion or advice.  Doctors and midwives are, in general, looking out for the best interests of mother and baby, and are giving the very best advice they can given the situation and their experience.  More often than not,  women follow their doctors’ advice, because they too want only the best for their children.  But, if a situation arises where a mother truly believes that what is being offered to her would be harmful or injurious to herself or her baby, or just wouldn’t be helpful, she has the full and undeniable right to refuse that procedure.  No doctor can “make her” do anything, and she cannot be denied care based on her refusal (in rare cases she might be transfered to the care of another provider, but she cannot be left doctorless).

Recently, I was with a young mother who exercised her right of informed refusal during an intense moment in her labor.  She was pushing out her baby, and as he was coming through her birth canal, his heart rate was dipping.  As the decelerations became more prolonged, her doctor, who had been staring in concern at the fetal monitor, walked to her side and explained to her that, while her baby wasn’t in danger yet, he needed to come out soon so that his heart rate wouldn’t slide lower, risking his life.  He told her that he could perform an episiotomy to speed the birth.  The mother shook her head vehemently, said “No!”, and then proceeded to birth her baby in the next few contractions.  I was impressed both by her ability to speak up for herself in such a stressful moment, and by her taking the situation in hand and protecting her baby in her own way, by finding the strength and purpose to birth him quickly and safely.  Her refusal did not cause her or her baby injury or harm, and she was able to resolve the situation on her own, with power and strength.  I hope that all mothers will recognize this power and strength in themselves, and that their doctors and midwives will recognize it as well.  In this way, informed consent and informed refusal will not just be informed by the doctor’s experience and wisdom, but also by the mother’s inherent knowing and birthing abilities.

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Homeopathy for Pregnancy: Pulsatilla

June 15, 2009 at 9:00 pm (Comfort Measures, Homeopathy) (, , , )

There are many remedies for the discomforts of early pregnancy.  The nausea, tiredness, emotional swings and psychological adventures can be unsettling, and many women try one thing after another to relieve them.  Over the next few posts, I’m going to introduce you to three remedies that can help to address the overall energy of the pregnant mama, and in doing so, help to relieve the turmoil of the first few months.

In choosing one of these remedies for personal use, there are two different ways you can go about deciding which one might work for you.  The first is to look for your specific symptom within the descriptions of each of the remedies, and see which one lines up best with your headache, nausea, etc.  The other way is to look at the overall description of the remedy and see if it describes you in general, or at least your general experience while you’re having the symptoms.  The more aspects of the remedy that match your experience, the more likely it is to work for you. I’ll explain a bit about dosing at the end, but remember that I’m not a homeopath, and so if you have any questions, it’s a really good idea to consult with a good ND (naturopathic doctor) or classical homeopath.

Pulsatilla

Have you ever had a gentle, flowing friend who could change emotions at the drop of a hat? She might smilingly tell you about the latest funny thing her kitten did, only to begin crying as she’s reminded of her childhood cat who is now gone. Some people think she’s a bit spacey, maybe even a little ungenuine because of the ease with which her mood and outlook changes.  But the better you get to know her, the more you realize that she feels each state she’s in fully and completely- while she’s happy, she is completely happy.  When she’s mad, she is wholly mad.  The same with all her moods, as easily triggered as they may be.  You’ve noticed that, once you get used to her changeability, friendship is fairly smooth with her.  That is, unless you forget a plan you’ve made with her, or make a dismissive comment, or act aloof around her- anything that triggers her fear of being abandoned.  She is as cuddly as the kitten or puppy she loves, as long as she feels safe in her relationships. If she feels she’s about to be abandoned, she can become incredibly emotional and clingy, calling you to find out where you are, if you still like her, and why you’ve hurt her in this way.  Once you make up, though, she doesn’t hold a grudge- she’s back to her former easygoing, sweet self.  She delights in going to great lengths to please you, and she loves creating beauty everywhere she goes.

Pulsatilla is the homeopathic form of the Wind Flower, or Pasque Flower.  As the name implies, this flower grows in meadows, constantly buffeted by breezes and winds.  In the same way, a person who resonates with pulsatilla changes as the winds blow.  In fact this changeability is a key symptom for pulsatilla ailments.  If a pain changes frequently in location or intensity, if a secretion changes in color, scent or amount, or if the characteristic mood swings are present, pulsatilla is a good remedy to consider. In general, pulsatilla symptoms are also better in the open air, and better with mild exercise.  Pusatilla is considered to be one of the main women’s remedies; my Materia Medica describes it as belonging to “females of mild, gentle, plethoric, yielding disposition, who cry readily and weep while talking.  Pale, chilly blondes.”

Now I’ll address some of the specific symptoms within the pulsatilla picture.  All of these descriptions are drawn from Murphys’ Nature’s Materia Medica

Stomach:  Nausea with bitter taste.  Gas.  Belching with taste of food.  Stomach feels heavy. Persistent nausea, better after vomiting.   Vomiting with pale face, chilliness.

Head:  One-sided headaches, pulsating, bursting.  Teary eyes on the side of the headache.  Headaches better with walking in open air. 

Food:  Hunger, but doesn’t know for what.  Thirstlessness.  Craving for rich foods, creamy foods, desserts, but symptoms worse for those foods.

Stools:  Constipation alternating with diarrhea.

Breasts: Milk leaking before she’s even pregnant.   When nursing, she cries as she pulls her baby to her breast. After weaning, breasts remain very full and sore.

Pregnancy:  This remedy is specific for turning breech babies.  Along with acupuncture and chiropractic, it is a good thing to try if your baby is in the breech position after 30-34 weeks.

The standard doses for home use are 6c and 30c.  If you’re having acute symptoms, you can try 30c, one to three times a day (or more or less, as your intuition guides you).  For less acute discomfort, or if your system is particularly sensitive, you can try 6c, up to three times a day.  Check in with your body and your intuition to guide you in taking these remedies, or read about dosing on some homeopathy sites to give you more ideas.  Or, of course, check with your homeopath, who can personalize your treatment and help you track your particular symptoms and reactions.

 

 

 

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Homeopathy in Pregnancy and Childbirth: Part 1

June 8, 2009 at 6:29 pm (Comfort Measures, Homeopathy) (, , , )

I’ll start this post with a disclaimer:  I’m not a homeopath, an herbalist, or a medical practitioner of any kind.  I’ve studied some homeopathy, but I refer all my complex homeopathic questions to my homeopath, and I’d recommend that anyone new to homeopathy do the same.

That being said, I’d like to share with you all some information about one of the most gentle and profound healing modalities I’ve found in my explorations into complementary medicine.  My family uses homeopathy as our first line of treatment in all illnesses and injuries, as well as emotional upsets.  I’ve also seen my pregnant and birthing clients use it with great success.  But what is homeopathy?  How safe is it?  How does it work?

Homeopathy is a system of energetic medicine founded on the idea that “like cures like.”  This may not make sense on first glance, so I’ll begin my explanation with a description of homeopathy’s opposite: allopathic medicine.  Most drugs and treatments used in the Western world are allopathic, which literally means “other (than the) illness/suffering”.  The idea is that if you have a condition, you need to treat it with something that will counteract your symptoms.  So if you have a fever, you take a drug that brings fevers down.  If you have a cold, you take drugs that dry up mucus.  If you have pain, you take a drug that blocks your body’s pain receptors. 

Homeopathy looks at healing in a different way.  Illnesses and injuries are seen as energetic disturbances disrupting the body’s normal harmonic functioning.  If you can isolate the particular offending pattern, then you can give a homeopathic remedy with the same energetic pattern, thus canceling out the troubling energy in the body.  This may sound odd, but think back to your high school physics classes:  two waves with the same wavelength and frequency can cancel each other out (check out this link, it’s complicated, but look at the illustration for Constructive and Destructive Interference- the righthand drawing is what I’m talking about).  This theory can be a bit heady, and it can be confusing to see how it applies to the body, but in practice I’ve found that it works amazingly well.

So how do you find the right homeopathic medicine?  This is where a homeopath can come in really handy.  For some common complaints, there are some standard homeopathic remedies you can use.  I’ll discuss those in another article.  But for more complex complaints, one has to research the specific symptoms in a Homeopathic Repertory (I use Murphy’s) and then decide on the right remedy by studying the descriptions of the first few choices in a Materia Medica.  Again, complicated, but fascinating. 

There are many hundreds of homeopathic remedies described in a good Materia Medica.  Each entry lists symptoms for specific body parts, such as Limbs, Head, Stomach, etc, and also lists mental and emotional symptoms associated with the remedy.  But how do we know which symptoms are alleviated by which remedies?  This is where the history of homeopathy is especially intriguing.

In the late 1700’s and early 1800’s, a medical doctor named Samuel Hahnemann became frustrated with the rough medical techniques of his day (such as purging and bloodletting).  While doing medical research, he noticed to his curiosity that quinine, the herbal drug used to treat malaria, would cause the symptoms of malaria if a healthy person overdosed with it.  He began experimenting with other herbal remedies and found that many of them, in overdose, caused the same symptoms they were purported to treat.  So he then developed a way of taking virtually any substance from its physical state to a pure energetic state. (watch this video to see how)  Then he and a group of brave souls tested each remedy, taking massive doses (way more than we take when treating a symptom) to induce each remedy’s energetic state in their bodies.  Since they were not already ill, the energetic patterns stayed in their bodies instead of canceling out, and they observed the symptoms the remedies caused and painstakingly recorded each minute detail.  The result: a record of the overall symptom picture of each remedy, which is an invaluable tool in treating illnesses today.  Thank you, Home0pathic Cowboys and Cowgirls!

So how does this work in a real-life illness?  I’ll use myself as an example.  About a week ago, my 20-month-old daugher and I weaned.  For the past week, my breasts remained full of milk, and as the week progressed, my left breast got progressively more sore and I began to have a headache, stomachache, and flu-like symptoms.  I tried massage and sage tea, but they didn’t help.  So I looked up my symptoms in my homeopathy books. I found several remedies that addressed breast pain, and I looked them all up in my Materia Medica (the description of each remedy and its effects).  I found Bryonia, a remedy that described pain that was agonizing on movement, and made better by being still.  It addressed headaches, stomachaches, and breast pain.  Cool made it better.  All of those fit my symptoms, so I began taking the remedy.  Soon after, I fell asleep during my daughter’s  nap (something I don’t usually do anymore), and after I woke, I felt the emotions I’d been holding on to surrounding weaning beginning to surface.  That night I took another dose, and then I slept well and without too much pain, and the beginnings of a fever disappeared.  The next morning, I took a dose again, and some milk released from the affected breast.  All my flulike symptoms disappeared.  By the afternoon, my energy had returned and my breast was feeling much better.

My return to health could be seen as a coincidence, something that would have happened without the homeopathy.  But this is exactly how homeopathy works: it provides a clean slate from which the body’s natural healing responses can resolve the symptoms of illness and injury.  In my case, it definitely stopped a disease process that was rapidly developing into an infection.  And it has worked with similar rapidity in many other cases where my family has used it. 

This has been quite a long post!  Thanks for sticking with me.  In another part to this series, I’ll describe some common remedies that pregnant and birthing women have used, and later I’ll also list some remedies that work great on children.

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The Purpose and Value of Labor Support

May 23, 2009 at 2:46 pm (Comfort Measures, Doula, Informed Consent) (, , , , , )

Labor support is not a new concept.  Traditionally, a birthing mother’s female relatives and friends would gather to assist her through labor, birth and the postpartum, with or without the added assistance of a trained birth attendant.  Now, with an increasing number of extended families living great distances from one another, and with the demands and pressures of modern life and careers, that traditional support has been interrupted.  Women labor in the unfamiliar environment of hospitals, alone or with the support of a husband or partner who may have no prior experience with childbirth.  The creation of the professional doula’s role serves to address that lack of experienced, usually female, support that women used to provide for one another.

The birth doula’s role is to provide nonmedical support to mothers, families, and/or their friends throughout labor, birth, and the immediate postpartum. This support may take the form of physical comfort measures such as gentle massage, hand holding, positional support and recommendations, as well as many other techniques gleaned from modern and traditional sources.  Doulas also nurture their clients emotionally, providing encouragement and acceptance throughout the intense experience of labor.   Another part of the doula’s role is her advocacy for her clients.  Doulas meet with their clients prenatally and listen to their needs, values, and plans for their birth.  They assist their clients in gathering information about aspects of labor and birth that are important or of concern to the client.  During labor, a doula can help to facilitate communication with medical caregivers, and she can remind the mother of aspects of her birth plan or prenatal conversations.  This advocacy does not extend to speaking for the client, or to making decisions for her.  Doulas must be careful to shed all of their own values and standards of what constitutes a good birth, choosing instead to serve as a recorder and reminder of the mother’s decisions and needs.

The birth doula has responsibilities to the women and families she works with, her colleagues, the labor support profession and society in general.  “The doula’s primary responsibility is to her clients.” (DONA Code of Ethics)  She allows and encourages her clients to make their own decisions regarding their care.  She maintains their privacy and confidentiality, and does not spread information she has heard in client meetings to anyone else.  The doula strives to assist each mother who is seeking labor support in finding a doula.  She makes sure she is available to provide the care she has agreed to provide, and if she is unavailable, she makes sure to have a backup doula who can serve the client in her place.  She maintains reasonable fees which she clearly communicates to her clients, as well as the services provided for those fees.  With respect to her colleagues, the doula maintains a fair, reasonable, respectful relationship with them, and treats their clients with courtesy.  Doulas support their profession by maintaining its “values, ethics, knowledge and mission.” (ibid.)  When possible, she provides some clients with free or reduced cost services, to continue the “vision of ‘A Doula For Every Woman Who Wants One’” (ibid).  Finally, a doula commits to advocating for the health of women and children across society.

When birth doulas act according to their roles and responsibilities, the rewards to mothers and children are obvious and encouraging.  According to the findings of Hodnett’s et al meta analysis of 15 trials from North America, Europe and Africa, “Women cared for during labor by a birth doula, compared to those receiving usual care were

Cesarean sections have documented risks for mothers “including infections, hemorrhage, transfusion, injury to other organs, anesthesia complications, psychological complications, and a maternal mortality two to four times greater than that for a vaginal birth,” (http://www.childbirth.org/section/CSFact.html), and risks for babies, including “increas(ing) the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial costs. Even for mature babies, the absence of labor increases the risk of breathing problems and other complications.” (ibid)  The decrease in cesarean birth for women accompanied by a doula in turn decreases the risks of these negative outcomes, and so therefore doula care has a positive effect on the health and wellbeing of laboring women and their newborns.

 An equally important consideration is the mother’s satisfaction with her birth experience.  Since mothers who have the help of a doula are less likely to remember their birth as a negative or traumatic event, they may be less likely to succumb to certain postpartum mood disorders, such as postpartum depression and post-traumatic stress disorder. 

These scientifically verified outcomes of labor assisted by a doula are encouraging in a country whose maternal and neonatal mortality rates rank among the worst in the developed world. “American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found.”  (http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/)  Doulas, with their information gathering and nurturing support, are well-placed to assist families in achieving a healthy, positive, and powerful birth, and therefore the best possible start for their life together as a family.

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Do You Doula?

May 16, 2009 at 2:49 pm (Uncategorized)

Just watched a sweet little film called Do You Doula?

It was a great overview of doula care.  It interviewed moms, dads, doulas, and medical professionals and asked them what kind of care doulas provide, how mothers can benefit from that care, and how doula care differs from and meshes with medical care.  At the end were some lovely statistics about the effects of doula care-  similar facts about doula care can be found in Klaus’  The Doula Book.  My favorites were that doulas reduce the need for epidurals by 60%, and the occurrence of Cesareans by 50%. 

I liked the mom and dad who both said that they primarily hired a doula for the dad- so he wouldn’t worry about his wife and would have someone to ask about what was normal while she was coping with labor.

I do wish that the film hadn’t started with a doula who was crying about how her birth had been stolen from her.  I don’t want my clients to have the idea that without me, they would be disempowered in their birth- I believe that however they choose to birth is right for them.  But that same doula said later that a very important factor in a mother’s satisfaction with her birth is her perception of her own power, so her message overall was a positive one for birthing mamas.

Thanks for this informative film!

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What’s in Your Doula Bag?

May 14, 2009 at 5:40 pm (Uncategorized)

doula bag 004My clients are always interested in what I’m going to bring to their birth.  I thought I’d do a little inventory of what’s in my bag right now, what still needs to go in there, and what my favorite things are to use at births.  And if any other doulas or midwives are reading this- let me know what’s in your bag, too!  What’s the one thing you wouldn’t want to be without?  What’s the most helpful at your births? I hope to expand my bag just as I expand my knowledge- by sharing with other birth professionals so we can all serve women better. 

Mamas, too- let me know what helped you the most at your births.  What would you have wished your doula had that she didn’t?

Here’s what I carry:

For mama-

  • Organic sports drink- usually lemon flavored so as not to interfere with homeopathic remedies.
  • Some hard candies for energy and to sweeten mama’s mouth if she throws up.  Lately I’ve been using pomegranate candies, and everyone loves them.
  • A few granola bars.
  • Flower remedies: at present, I have Bach’s Rescue Remedy, Aspen (for unnamed fears), Impatiens (for impatience), Chicory (for letting go) and Perelandra’s ETS plus (another rescue remedy-like solution)
  • My 30c homeopathy kit and a few 200c remedies.

    doula bag 002

    homeopathy kit

  • Massage oil
  • Arnica oil
  • St John’s wort oil
  • Lavender and peppermint essential oils (careful to keep them separate from the homeopathy)
  • An unopened chapstick, unscented.
  • Hairbands
  • 2 large wooden combs (for gripping during contractions)
  • A wooden toy (see picture) that’s soothing to play with.
  • Playing cards.
  • Lansinoh.

    labor toy

    labor toy

  • Organic alcohol wipes.
  • Hot/Cold pack and cover
  • Books: The Thinking Woman’s Guide to a Better Birth (better at resolving disputes with caregivers than talking from the doula) by Henci Goer, Homeopathic Medicines for Pregnancy and Childbirth by Richard Moskowitz, and the Labor Progress Handbook by Penny Simkin and Ruth Ancheta.

For me:

  • A few sandwiches
  • Water bottle
  • A clean shirt
  • A watch
  • Pen and notebook
  • A knitting project, just in case
  • Some cash
  • Cell phone and charger

If I had to choose one thing I couldn’t be without, it would be the massage oil.  After that, I would choose my homeopathy kit (if mama likes homeopathy- some clients don’t), and the wooden toy.  I used the toy at my last birth, and the mom just twirled it and twirled it through contractions.  It was very calming for her. I still want a nice rebozo and a TENS unit.

Even though I carry a lot with me, and sometimes use a lot of what I bring at births, I still feel that my hands and to a lesser extent my voice are the only things I really need.  With those, I can massage, do reiki, calm a mama and hold her up, and the rest of it is mama finding her own way as I watch her in wonder.

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My Doula Herb Garden

May 5, 2009 at 4:54 pm (Doula, Herbs) (, , )

St John's Wort

St John's Wort

This weekend I went to the Asheville Herb Festival with my daughter and our 9-year-old friend.  We spent  a happy hour wandering, looking at all sorts of green growing things, and talking about plant medicine.  I intended to pick up some staples for my garden, but I got drawn into the medicinal herb area.  As I spoke with the girls about how each herb can help women and mamas, I decided it was time to start my own doula herb garden.  Here’s what I chose:

Motherwort:  A pretty little plant with pink flowers, it promotes relaxation and helps to de-jangle mama nerves.  I used it after Stella was born, when caring for two rowdy boys and a brand-new baby girl pushed me right up to the edges of my coping abilities. 

Chamomile:  An all-around good herb to have in a garden.  Its flowers make a lovely and calming tea.  I mix it with red raspberry, alfalfa, and nettle to make a nurturing and nutritional brew for the mamas I know.  Chamomile tea is also great for a nursing mama (and as it goes through the milk, it helps to calm the babe), and it’s wonderful for young kids as well.  My boys love to drink it, and it tones down my eldest son’s energy when he’s wound up too tight.

Lavender:  Another calmative with a great scent.  Combined with other herbs, it makes a great sitz bath. I love lavender tea, and the dried flowers can fill a small stuffed animal or pillow for a new baby gift.  Lavender essential oil is also a great addition to a massage oil, for mamas or babies.

Comfrey:  A skin and tissue healer.  Comfrey is another good addition to a postpartum sitz bath, especially if mama has torn or had an episiotony.  Comfrey poultices or comfrey salves are great on scrapes, cuts, and sprains. And the fuzzy leaves are fun to rub:)

Blue Cohosh:  This one isn’t going in my doula bag, as its effects are stronger and need to be monitored by a midwife or doctor.  But I planted it anyway, in anticipation of the midwifery training I plan to embark on in a few years.  Blue Cohosh is a labor enhancer, and can sometimes be used to induce labor as well. 

I plan to include many more herbs as the summer goes on- I’ll let you know as I plant more gentle and helpful herbs!

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Acupuncture and breastfeeding

April 28, 2009 at 10:23 pm (Uncategorized)

A client who’d had her baby 3 days ago called me, asking if it was normal for her breasts to be rock-hard, sore, and for no milk to be coming out.  I comisserated with her about engorgement, and suggested cabbage leaves to relieve the pain, and reverse pressure softening to help her baby latch on.  I made plans to visit her that afternoon, so I could watch her breastfeeding and see if I had any tips for her. 

When I arrived at her house a few hours later, her acupuncturist was there.  She was working specifically on the engorgement, trying to relieve the heat and get the energy moving.  I puttered around, doing dishes and bringing a slightly jaundiced Mr. Baby outside for a brief sunbath.  When the treatment was over, my client wanted to try nursing.  We woke her baby, and with the help of some RPS (an incredibly simple and helpful technique) she got him latched on.  As soon as he started nursing, her other breast started leaking milk (before that she’d only been able to express colostrum).  In a few seconds, we started to see her baby’s jaw move in the suck-swallow pattern, and we heard the unmistakeable sound of him gulping down his first meal of mama milk.  After he’d nursed on each breast, her engorgement was relieved, and she felt much better.

We were all amazed at how quickly the acupuncture helped this mama.  She’d been trying to express milk all day, and her baby had been antsy and hungry while they both waited for her milk to come down.  Within less than five minutes of her treatment, milk was flowing freely and easily, and she was celebrating the fact that “these things *do* work!”  From now on, I’m going to recommend acupuncture to all my first-time nursing moms.

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VBAC’s in the media

April 6, 2009 at 10:54 pm (Hospital Procedures, Informed Consent)

While perusing the magazine rack at my local coffee house, I found an article entitled “The Trouble With Repeat Cesareans” in the March 2nd edition of Time magazine.  I’d recommend reading it in full, but I’ll share a few details.  I find it heartening that a national publication is covering the difficulty many American women are having in completing a successful VBAC. 

“Much ado has been made recently of women who choose to have cesareans, but little attention has been paid to the vast number of moms who are forced to have them.” (emphasis added)  This an important point for both first-time mothers and those who are pregnant after a Cesarean.  Many physicians consider it their duty to restrict a mother with a previous C-section to a surgical delivery in subsequent births.  During research on the rights of informed consent and refusal, I stumbled on a discussion between physicians about “those women” who try to deny C-sections when their practitioners refused to attempt a VBAC.   A lone doctor (immediately one of my heroes) argued that, ultimately, it is a woman’s choice what is done to her body.  He acknowledged the ethical dilemma faced by a doctor who truly thinks a C-section is the safest option, but concluded that if a mother refused one, it was his duty to attend her vaginal birth and usher her through it as safely as possible.  This was not the opinion of most of the other doctors in the discussion, however.  They lamented the VBAC movement and discussed tactics for convincing a woman to have surgery, regardless of her wishes.  To them, informed consent meant doing something because your doctor had informed you it was the right choice, and informed refusal was something to be dismissed with ever-more-dire predictions of disaster if their recommendations were ignored.  I don’t know how many OB’s similarly discount the right of birthing women to determine their own decisions regarding medical care.  I do know that, if a woman wants a VBAC, in many areas around the country she’s fighting an uphill battle, and she should come to the birthing suite armed with information and a doula (our nurturing and comfort techniques have been shown in studies to decrease the incidence of Cesarean sections).

The article described the climate that has contributed to the decrease in VBAC availability in the US.  “In a 2006 ACOG survey of 10,659 ob-gyns nationwide, 26% said they had given up on VBAC’s because insurance was unaffordable or unavailable; 33% said they had dropped VBAC’s out of fear of litigation.”  Doctors are afraid of being sued if there is a bad birth outcome, and they have been encouraged to believe that VBAC’s are likely to lead to a bad outcome.  But is this really true?  And what are the risks of repeat Cesareans, as compared to the risks of VBAC?

“The risk of uterine rupture during VBAC is real….but rupture occurs in just 0.7% of cases.”  Add to that the fact that uterine ruptures, although they have serious potential complications for mother and baby, are not necessarily fatal to either.   And uterine ruptures can also occur in an unscarred uterus, especially when the mother is given Cytotec to induce her labor (see this article by Marsden Wagner, a reknowned researcher into American birth practices). 

“With each repeat cesarean, a mother’s risk of heavy bleeding, infection and infertility, among other complications, goes up.  Perhaps most alarming, repeat C-sections increase a woman’s chances of developing life-threatening placental abnormalities that can cause hemorrhaging during childbirth.”  This point cannot be emphasized enough.  During their “informed consent” process, are mothers being given this information?  If so, why is there the pervasive cultural belief that C-sections are somehow easier on the mother’s body than natural birth?  Mothers need to know that Cesareans pose significant risks to their reproductive and abdominal health- I personally would not approach this risk lightly, and would only choose a Cesarean if the risks to my baby’s or my own health truly outweighed the risks of the procedure.

Not mentioned in the Time article, but worthy of mention here, are the risks to the baby resulting from a Cesarean.  Babies who are born via c-section are more likely to develop difficulty breathing than babies born vaginally.  There is the risk that, if dates were miscalculated, a baby could be delivered prematurely.  And babies can be injured during the cesarean.  See this link for references and more info on Cesareans.

I am so glad that the VBAC dilemma, and the risks of Cesarean sections, are being covered in the national media.  Once doctors and mothers look at the real risks of Cesareans, we will have motivation to return to the VBAC-friendly practices of the 80’s and early 90’s, to the benefit of mothers and babies everywhere.

For more information on VBAC’s, and Cesareans in general, you can visit:

http://www.ican-online.org

http://childbirthconnection.org/

Any book by Marsden Wagner, Henci Goer, or Nancy Wainer Cohen

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