Where to start with preparing for your birth experience?
There’s already a lot going on, including being tired, irritable, and feeling like you are definitely Not Yourself.
And how could you be, you have at least another human there within you, that seems to be utilizing a lot of your personal resources. There is so much to learn about this, and then there also isn’t, because having a baby, growing a baby, is really a subject women already have the technology to do, it’s there within you when you were born. All the skills and tools needed are there in your DNA, The weeks and months ahead as baby grows and develops, while you busy yourself with your life are really a classic example of just how much your body’s own technology and the new life within you, know just what to do, and in what order too.
Can you really relax this much about it? Well, yes, and yet, also no. Not quite so easy these days, with so many helpful resources available in the form of books, movies, literature, and oh yes the helpful advice from just about anyone you meet anywhere. They can all see you are having a baby. It’s hard to stay out of the line of fire, so here’s perhaps a helpful thing to remember if you get cornered by a helpful aunt with her worst case scenario stories; just remember, all new mothers have to use the bathroom A LOT. If you don’t like what you are hearing, just, look up, and say “Oh I have to …” and turn and go.
Everyone knows and it’s perfectly ok.
The majority of my tasks are affirming these very things to new parents, especially mothers. They are easily “entranced” with thoughts of food, and then open to all kinds of negative downloads. Often they forget these critical considerations:
Their doctor or midwife is monitoring everything. Yes, every little detail is measured, quantified, and analysis is complete
Their family members are studying the situation regularly and looking for any unusual anomalies, like dreams or food cravings
And then there is the literature, both online, in book stores, in the midwives offices, and even in my own library too!
And we’re all happy to lend and make available.
So what can a new mother really do during her pregnancy to really help herself prepare for this life shifting event?
Dr Odent’s notes here on my web page and you can view his wonderful Video – he just gives women such peace about their body and trusting their baby. AND I also wanted to include this wonderful article from a doctor to his client – it comes from another time – another decade, maybe even another century, yet it still rings very true and its helped many mothers achieve a relaxed pregnancy during our weeks together as we prepare for her birth experience.
First let me share what I do:
I am a clinical Hypnotherapist and NLP Licensed Trainer & Master Practitioner, DHE Specialist. I am a HypnoBirthing® Certified Child Care Educator. I’m also a Birth and Labour Coach and trained as a Doula.
I work with parents and have attended 100’s of births in the past fifteen years… I’ve attended births in major hospitals, at home, and water births; with Midwives, MD’s & OB’s. My personal mantra is “helping women get what they want”.
My other specialities are Bulimia & Eating Disorders, Phobic cures, and a whole host of other areas of speciality which I work in.
Using NLP and the HypnoBirthing model I uncover these deep structures and assist a woman out of alignment and out of rapport with TV, MEDIA & negative priming from just about any source, so mothers come to believe in their body, themselves and their baby and have established clear’ pattern interruptions’ for those that would dissuade them otherwise
I detail the visual, auditory and feeling experiences they will have and add to it, auditory MP3’s that guide the woman every step of the way, with a volume selection she has control of.
Accessing their own deeper structure I draw on personal strengths, illicit the areas of fear that are truly irrelevant to their individual births, because they have not happened to them yet! I teach them how to move out of rapport with anything that does not fit their inner image of that calm and peaceful birth. As care providers, we can all learn this process because it’s just technique! We’re doing it anyway and understanding the resultant effect of negative priming versus positive priming is what my program is all about.
In addition, because we live in a time when we have access to every kind of care and support we could want, I help parents embrace all choices. Of course, you want everything to go smoothly and without incident, and we have professionals supporting your desires all the way. There is simply no need for a mother to feel she has failed her birth, or her child and risk challenging bonding just because she believed her birth was no perfect. Let me just say, Every Birth Is Perfect. And today thankfully, we are able to choose and make possible that optimum experience for all parents. Assured and supported every step of the way.
In fact, it is now part of the “inclusive” language patterns being taught in the UK in the midwifery schools there, that the birth is without judgement about whether it’s natural or not. So mothers can feel relaxed with however the birth progresses, and not feel like they have failed.
“My Birth, MY WAY” and whose way is it? It could be the birth of the baby? It could be the birth of the mother? It can even come under the medical providers needs when they see evidence that things are not going as they would like. All the way through a birth experience, that ability to remain flexible helps the parents make powerful choices. And we are in a time when a choice is available. Thankfully.
We’ve been missing a key ingredient in the birth model in the west today.
We’ve overlooked a very essential part of an individual’s deep structure: Their Beliefs!
And how does a woman get her beliefs about her birth?
What about the Father of the child? What does he believe about Birthing, about his role in the process? About becoming a father? About being there as support at the birth? The immediate family members, what do they believe about birthing? How do they influence the process?
“The experience of our doctors has shown that every woman who enters the delivery room can be helped by hypnosis to some degree at least, and in many of them, complete freedom from discomfort can be obtained. Some doctors report over 90% of their cases are successful using Hypnosis. Not every doctor has this high percentage but a large number of them do!”
Elman – Hypnotherapy 1964, Conditioning for Hypnotic Delivery & Surgery
Neuro – Nervous system through which experience is received and processed through the five senses.
Linguistic – Language and nonverbal communication systems through which neural representations are coded, ordered, and given meaning.
Programming – The ability to organize our communication and neurological systems to achieve specific desired goals and results.
Incorporated in 1982 the Society of NLP was founded by Dr. Richard Bandler. The Model of NLP however, was co-created by John Grinder, a linguist and Dr Bandler, and Frank Pucelik together in the mid-late ’70s. They found there were a number of therapists and psychotherapists achieving exceptional results consistently however, not held in the same way by their peers who had taken the same training.
Something was different. They modelled, Virginia Satir, Fritz Perls, Milton Erickson and others, in doing so they found these individuals while achieving consistently excellent results with the clients, were unaware that they did anything special in their work. Interestingly, when gathered together, these individuals were likewise unimpressed with each other
Understanding how we organize the world “out there” into bits of information that we can utilize “in here” is the essential undertaking of NLP.
We know the five senses filter the billions of particles of data daily, filtering them through, generalizing, distorting, deleting and creating little acronyms of events that we can access easily later. Like tying your shoelaces. At 4 years old this was a challenge, at 7 you had it down, now it’s nothing you think of. Riding your bike, a struggle for balance, manoeuvrability, eye coordination at age 5, however now, it’s effortless. these are skills you have for your lifetime.
The brain functions in ways we might think are laborious and complicated, but it’s doing everything so fast we don’t experience anything other than the free flow of information. For example, our eyes see everything upside and reversed then the brain orders it and give us the correct images in the correct places.
Here’s another one: DON’T THINK OF A PURPLE GIRAFFE.
Exactly you have to First Think of it, in order to not think of it. So when people get frustrated with thinking the same thoughts, or not being able to stop thinking about something…telling them to not think about it, …is telling them to THINK ABOUT IT.
Enter Pattern Interruptions! Interrupt any brain pattern by simply THINKING ABOUT SOMETHING ELSE FOR MORE THAN 15 seconds. The internal argument ceases!
“NLP May Be The Most Powerful Vehicle For Change In Existence!” — Modern Psychology
NLP helps you find out what you want and how you can get what you want.
NLP teaches you to communicate more successfully and create the right climate for your birth.
NLP increases your sensitivity towards others body language and signals and teaches you to maintain good relationships with those close and not so close to you.
NLP opens doors to hidden resources, improves your ability to concentrate, your ability to learn and paves the way for excellence through positive priming and patterning
NLP changes your behaviour positively so that you can handle negative experiences and eliminate phobias, stress, guilty feelings and depression
Richard Bandler and linguist John Grinder, asked themselves a simple but fascinating question: “What is it that makes the difference between somebody who is merely competent at any given skill, and somebody who excels at the same skill?”
Do you see the focus? Not on what can go wrong, but rather on what can go very right! Positive versus negative priming
I asked that same question when I had a first time, 39-year-old lawyer birthing her 7-pound daughter labouring at home for five hours and transporting to the hospital for birthing just an hour later. Her birthing time, from 4 cm to birth was under 6 hours. Intact perineum. She was up and about at home a day later, running up and down the stairs to her baby in the nursery.
This mother worked with me for 6 months beforehand, she had many fears and worries, her husband sceptical at first…her caseload was heavy preparing for her year of maternity leave. She had little time to exercise, little knowledge of how her very intelligent brain worked and just following the process we worked out together
What are the chances focusing on what you want and how to get that is the very best way to achieve a powerful birth outcome?
Why rehearse and prepare for the “worst case scenario” just in case? What if you don’t even know all the things that could go wrong and let your doctors, midwives and support teams deal with all that?
“It’s my job to inform you of all the things that can go wrong during birth. If I don’t inform you of every aspect and detail, then I haven’t done my job properly.” OB Intern to the woman at 4cm clinging to her husband’s arm.
“it appears there is little distinction between hypnosis and priming except that the latter occurs without the induction of “formal’ trance, or through the medium of well-crafted suggestions. The delivery of influential and potentially negative and harmful messages to the patient’s unconscious – whether or not they are intended by the speaker. Forcible or surreptitious “thought-changing” is popularly regarded as brainwashing. Commonly associated with extreme political groups and cults, heightened suggestibility is also known to be induced through trauma, fear and confusion.
The pre-requisites to successful thought-changing as identified by the late Margaret Thaler Singer: “Thoughts, values, behaviours, allegiances and beliefs may be substantially altered in conditions where the subject is deprived of his or her own: Clothing, familiar foods, timetable and sense of control. The effect is magnified substantially when the victim is exposed to, but often excluded by the use of a highly specialized language which everyone else seemingly is party to is required to capitulate and submit to the wisdom of a superior sacred science, is discouraged from asking questions or making objections, and is constantly aware that the perceived authorities have the power of life or death.” G. Thomson, Magic in Practice. There is something more at work here, the pregnant woman is also in an altered state, fractionation, the “in and out of deeper states” constantly for hours as her body moves her deeper and deeper into the labour process and she is open to suggestions at a very deep level of the unconscious.
The perception of stress can both trigger and regulate Allostatic load.
Psychological modulators are as follows:
Sense of Control, Predictability, ritual
Outlook (optimistic vr. Pessimistic)
Ability to dissipate frustration.
Feeling you are in control of your work and personal life is one of the best predictors for a long and healthy life.Conversely feeling victimized by unpredictable forces outside of your control, can be a killer.
How much control does a birthing mother need?
Dave Elman wrote this in 1964…
He taught the doctors that worked with him what to say to the mothers so they could have this pain free, easy birth, he said :
“Address your mothers as follows;
I want to tell you about the benefits of relaxation. You know very well that if you were tense and I have to give you an injection you’d feel the entrance of that needle very sharply because of the fact that you were tense. But suppose you were relaxed and were absolutely and utterly relaxed. You can reach such a state of relaxation that you have no discomfort at all at the delivery time. When you are physically and mentally relaxed it is actually so easy to have a baby it’s actually true that in this state the contractions rather than being uncomfortable actually create a very pleasant sensation in your body.”
If a mother looks forward to the ordeal as described by her friends, the media or family, that having a baby is horrible, she looks forward to what’s she’s heard with fear and trepidation. And if I tell you all the descriptions of labour are false, all those terms and names keep a mothers attitude in the wrong state.
“There is only one thing that can prevent you from having an easy birth experience, despite all the work we do with you to prepare. Only one thing, a thing called fear!
At the time of birth you must be absolutely and totally free of fear and worry if you want to have your baby easily. We will have perfect results if you follow some simple instructions and keep fear and worry out of it” Dave Elman, 1964
Knowing what’s going to happen is as important as experiencing what is happening.
Our ability to predict successful outcomes, to pain or stressful situations helps us cope with the events themselves and manage them.
It’s not going to last forever
I can do this, just this one surge, and now this one surge, and this one…and finally there are more behind me than in front of me, and I’m almost there.
“It’s nearly over” creates the most hopeful expectation in a birthing mother!
So what if your doctor said to you:
“I want you to practice relaxation, I want you to practice just what you have been doing here. Learn how to relax at home, so that when your baby comes, you will be all ready for it and feeling so wonderful during delivery and after delivery. Notice how that feeling of relaxation holds on and makes you say to yourself,
“Motherhood is going to be a glorious adventure for me. I’m going to love every minute of it”. And he goes on….
One of the benefits of relaxation practice is it shortens the labour period tremendously. It will shorten it almost miraculously. You’ll be so delighted because, with each surge, the surges will get more and more pleasant so by the last few surges you will actually find yourself smiling through them. And you’ll be saying to yourself that that surge is over I’m even closer to my birth, you’ll feel good, empowered, on top of your game.
You trust your body and it feels really good. You will meet your baby as soon as it’s born because you will be awake during the entire birth. After the birth you will be just as strong and empowered as you feel now, your strength will be complete, your feeling of well-being will be complete and you’ll recover so quickly much more so than ordinarily because this relaxation has served all this so well. Then when you begin to nurse you will find it so very easy and effortless, you’ll be speaking to others soon afterwards as you realize birth for you was really just terrific.
Another benefit is it reduces any of the sensations you might have during labour and allows them to pass through you easily and effortless like you would pass your hand through the water in a pool.
The sensations are shorter, the labour is shorter, and the wonderful miraculous part is because your muscles are so relaxed and open to releasing baby, your body does so without any lasting impact on muscles or tissues, and you are up and recovered easily within a few hours afterwards.”
This is what we do together, in our practice over the months before your birth. We practice relaxation.
We are now entering a new phase in humanity. At a very deep core level, we all get this….be kinder to each other.
Death is an illusion, so is separation and abandonment, however, we continue to feed ourselves regular instalments of these unnecessary fear packets that reinforce our addictions to negative priming.
You can change your birth experience and prepare yourself for parenthood through positive priming and learning relaxation so you too will be ready when your baby comes.
The process is just 5 sessions over as many weeks, and if you find yourself caught short for time, we’ve had good success over a weekend. Some parents have come to see me for the second and even third birth experiences because they sensed they could create something different. Where ever you find yourself in your birth experience, the work we do together will help you.
The program includes use of my lending library, MP3s and handouts, as well as videos and home care recommendations and guidance for the very special father too! Contact me at 604-421-1722
NLP is one of the fastest growing Coaching Methodologies –
How will a one on one sessions help me?
Dr. Richard Bandler’s famous insight : “People don’t stay the same, people either get better or they get worse”. Helping you identify the core values and beliefs that may have served those patterns and shifting strategies to make changes can make those changes quickly and relatively easily. What is often surprising is we don’t need to dig into the old wounds to examine all the debris. Most often we simply study your strategies. Are they working for you? Most probably they are. They are getting you results! The question is, are they the results you want, need or even find helpful, today.
One on One: In the privacy of our offices in Burnaby, we schedule appointments with you at your convenience
Telephone: Consultations are a great help in getting clarity on what the problem is, and how we can help you with it.
Skype Sessions: Work perfectly for distance support and we work with people all over the world in this manner.
Hypnotherapy and Neuro Linguistic Programming (NLP) provide a powerful combination of techniques and methodologies to help you resolve the issues and difficulties in your life. This combination of approaches is particularly useful as it allows us to target the changes, with small adjustments as we progress, generally it’s just a few sessions and you have learned a brand new skill.
Working with you in a very direct way, focusing on how the patterns of behaviour, beliefs, and thought processes manifest themselves and are represented makes the time we spend together efficient. We then use the information to effect re-patterning solutions. This approach we believe builds flexibility in thinking, emotional, mental and physical processes and helps overcome automated behaviours that stop people from achieving their goals.
How long will my sessions last?
We have found that we tend to see clients 3-4 sessions for most general issues, however we consult individually with clients for the most appropriate timing solution. We can generally accommodate your time requirements with a little advance notice.
What if I don’t live close to you?
We have a number of clients who fly into Vancouver and work with us over a short period of time (see breakthroughs). We can also work with you on the internet (Skype) and by phone, wherever you are situated. Please ask for details.
What is Hypnotherapy?
A Hypnotherapist is a skilled and trained helping professional guiding you to use your own powerful mind to increase motivation or change behaviour patterns by inducing a hypnotic or trance state. Sessions with a Hypnotherapist are called Hypnotherapy.
What is Hypnosis?
You could say Hypnosis is a naturally occurring altered state of consciousness in which the critical faculty of the brain is bypassed so new and acceptable selective thinking may be established. Simply put, the reasoning, evaluating, judging part of your mind (conscious) is bypassed. Which is in fact what we are subject to all of the time.
Hypnosis allows the critical faculty of the mind to be bypassed, and specific thoughts/suggestions can be accepted in the subconscious where they can propel the client toward a desired goal or change behaviour in a positive and permanent way.
Can I be directed towards thoughts or suggestions I don’t want?
No, this isn’t possible, and even while we watch individuals in stage shows, perform all manner of strange tasks, they are fully aware and have given their permission to the hypnotist to go ahead and give suggestions to their unconscious to behave in such a way for a short period of time. The conscious mind would truly never allow you to be directed towards something you didn’t want or went against your own moral code of ethics.
Every time the brain creates a new pattern in thinking you are learning, every time you learn something new your brain creates a new synaptic connection, and you are expanding your mind. When we rehash old patterns over and over, we are not learning, we are essentially standing still, firing the same button over and over, and getting the same result, while perhaps expecting something different!
These are just some of the problems we help people find valued solutions for.
Birth Affirmations by Kathy Welter -Nichols is now a beautifully mastered MP3 Order yours today!
This new recording by Kathy is exceptional dedicated to one of her moms that is having twins…these affirmations will help you rest, relax and enjoy your pregnancy and birth! And they are a great assistance to those that are assisting you! As you listen to these affirmations over the months, preparing your body, mind and spirit for the transition to mother-hood, your birthing partners can use the CD’s or they can repeat these loving affirmations for you, to you, whispering them to you, encouraging you to go deep into your inner self letting your body do the essential work for you. Relax and enjoy this masterful CD by Kathy. Order yours today
I trust my body
My body was made for this
I listen to my body and I respond easily and effortlessly.
I know the less drama I allow from myself or others, the happier I will be and my baby will be.
I easily remove myself from the dramatics of others, protecting myself and my baby.
I wait on my body to direct my next breath, my next surge, my next release of breath, my next inhale.
I am connected to my infant; my baby knows my heart beat, my breathing, my voice, the feeling of my love.
My body is perfect for birthing, it grew my baby all the while I just went about my normal living.
I trust it’s wisdom and knowledge.
I trust it’s ancient structure, and I give birth easily and effortlessly as I trust my body to do the work.
I am celebrating myself, my life and my coming birthing day
I see myself in perfect health
I affirm myself as a good mother
I am meeting my daily energy needs, I exercise regularly, I sleep and rest, I take in good foods and plenty of water
I choose to avoid unnecessary sugars and choose instead healthy sources such as fruit.
I am accepting my birth, my body as it is, and myself as a new mother
I take care with comments from others, and recognize even well-wishers can inadvertently give me suggestions that might diminish my belief in myself. I take myself away from these people quickly and easily and without dramatics.
I learn the greatest “pattern interruption” that I have is my blessed need to use the ladies room, and I use it whenever a situation is not to my liking.
I lovingly accept my changing body
I easily recognize where stress is coming from and I learn to release that easily.
I use proper foods in good proportion that is just right for nurturing this new life inside me.
I accept that others may not be as focused as I am on the baby, and I release any concerns about what others are doing and I choose to take care of myself first.
I notice when I get tense, and I consciously relax those areas of my body.
I start with relaxing my shoulders, and breathing all the way down “to my toes”.
I remind myself to relax my whole body often.
Whenever I feel tension in my back, I breathe into it, and relax.
I relax each muscle …one at a time.
My body is beautiful; I have a loving and caring team of professionals around me through my pregnancy and birth
My body is growing a new life inside
I am proud of my body and I trust it.
I trust it to add all the toes and fingers and to choose the right eye color and hair, and to make a strong heart, and lungs and body. All I have to do is continue to breathe and my body will do all the rest!
I accept each stage of the pregnancy as a new wonderful adventure.
I accept each stage of the birth as a new wonderful adventure
I accept all the states of motherhood as this same wonderful adventure
I love myself, I accept myself, just the way I am.
As I prepare for labor I remember I am in control
I trust my body, I love my body! It’s just amazing! I am an amazing being.
I wait on what is best for my baby and I let my baby set the pace
My mind and body are calm
I don’t have to do this perfectly, or like anyone else, or even like my mother.
I’m ready to become my own woman, the mother of my child, this child.
I stop my mind from running to thoughts of worry or fears, by listening to my relaxation CD’s and using positive thinking as my first affirmation.
I notice when my thoughts are fearful, and I choose to change them.I master the art of the re-frame, quickly and easily
I change the message of the thoughts as I say the following:
“even though I’m feeling unsure, a little fearful, and a little vulnerable, even though I’m not sure of what is coming or how I will be, I totally love and accept myself and my baby”.
I feel so good about this I know it’s going to empower me and I know when I’ve my baby is in my arms, I will have made a personal transition in my journey as a woman. I look forward to this transition, and I’m excited about this next phase of my life.
Eating Disorders: A Guide to Medical Care and Complications Dr. Mehler
Page 111 – 113, review Bloating:
“With pure food restriction, once a weight loss of approximately 10-20 pounds occurs, there is almost universal development of gastro issues.
This refers to the delayed emptying of the stomach, bloating is the main symptom, and it may be severe and uncomfortable.
(The recommended tests to ensure there are no additional issues – require fasting and delay recovery further )
Abdominal X-Ray, is recommended
” The bloating can be worsened by a high-fiber diet, such as the vegetarian diet that many of these patients often resort to, to treat their slow gastrointestinal transit, or by increasing a fiber-based diet or use of laxatives. Once this state has developed the reflux, nausea, bloating and even vomiting can occur and it’s no longer self induced, it’s happening as a condition of the gut.
“Heartburn may occur too, as a result of acidic reflex in the stomach…
“Although the bloating improves with weight restoration, improvement often takes 4-6 months and even as long as a year to be fully recovered, with the tummy having no bloating.
Therefore it is crucial to offer reassurance to these patients and instruct them to avoid legume type foods, which promote gas and distention, as well as excessive fiber or bran products which induce similar symptoms. This will enable them to understand that their symptoms will pass with time and that they are not “causing” the pain by eating. Likewise, patients should be in formed that refusal to eat and regain normal weight will only delay the improvement in their symptoms.
Useful approaches to this problem specifically in patients recovering from anorexia include the following:
1: Liquid food supplements, as half of the daily calories (Smoothies)
2: Gastric emptying of liquids is unimpeded by the gastric issues with solid foods
3: Use liquid food sources earlier in the meal, so these are in the tummy before solid foods, (ie: Soups and Stews)
4: Keep the food intake to multiple small meals and often, 6-7 times a day, and start the food intake daily within 30 minutes of getting up
We are bringing the system back on line, it’s going to take time. If you find your inner coach is taking you over to raw foods, or off proteins, get back on track
Use a food journal, not to count calories or anything like that, but to ensure you are getting enough protein in daily.
It’s easy to get off track with this, and suddenly stuff is happening and when you look back, “Ah, there, no protein today”
Gastroparesis is a disease of the muscles of the stomach or the nerves controlling the muscles that causes the muscles to stop working. Gastroparesis results in inadequate grinding of food by the stomach, and poor emptying of food from the stomach into the intestine. Gastroparesis induced by weight loss will generally improve with weight restoration. This, even severe bloating initially complained of, which will often present in a patient from eating an adequate meal, and progressively improves for patients over time.
A significant improvement often occurs with a weight gain of 10-15 pounds and in general largely resolves completely with weight gain back to 80-90 percent of ideal body weight.
(Each time there is restricting of foods the patient will re-experience the same bloating symptoms as the first weeks in recovery – so the FASTING for any treatments will create a setback)
Remember when you are first in recovery eating much more salmon & eggs – This is protein and will give you less gas and bloating than raw veggies, salads etc. Here a food journal helps you look back to days when the body was doing great. Colour code the food journal, perhaps PINK for positive days, and GREEN for gassy days; etc.
Dr. Michel Odent is one of the first MD/OB/GYN’s to help move us back towards Normalizing Birth: A long piece, but so worth it.
Can someone with HPV, but no warts, have a home birth?
Human papillomavirus (HPV) infection is extremely common. It does not influence the way women give birth.
What are the risks associated with a vaginal birth after an abdominal myomectomy? I am in my first pregnancy and my doctor is suggesting a C-section as the safest method. Is it possible to attempt a vaginal birth and how significant are the risks?
It is difficult to answer your questions because there are many types of myomectomies (surgical removal of fibroids) according to the location of the fibroid(s). If the doctor is suggesting a C-section to prevent a possible uterine rupture, it is probably because the fibroid was ‘intramural’ (inside the wall of the uterus). If the fibroid was ‘subserous’ (outside the wall of the uterus) or ‘pre-unculated’ (connected to the uterus by a stalk), you should not hesitate to try to give birth vaginally. You need a detailed report of the operation.
I would love to have a water birth, but there are not many people in our area who do them. Do you have any advice on how to pick a good midwife for a water birth? I am 28, healthy, and in great shape. Is there anything I need to do to prepare for our little arrival’s water birth?
Your midwife does not need any special training. She does not need any previous experience of the use of birthing pools. She just needs to be aware of a small number of recommendations. All these recommendations are based on the fact that immersion in water at the temperature of the body tends to make the contractions more effective during a limited length of time, which is in the region of an hour or two. The first practical recommendation is to give a great importance to the time when the laboring woman enters the pool. If she is patient enough to wait until the middle of the dilation, if she does not feel observed or guided, and if the room is dark enough, there is a high probability that she will reach complete dilation in an hour or two, even for a first baby. The second recommendation is to avoid planning a birth under water. In general it is better when a pregnant woman has no precise pre-conceived script of what the birth of her baby will be. When a woman has planned a birth under water she may be the prisoner of her project; she is tempted to stay in the bath while the contractions are getting weaker, with the risk of a long second stage followed by difficulties for the delivery of the placenta. There are no such risks when a birth under water follows a short series of irresistible contractions before the mother feels the need to get out of the bath. A birth under water can happen. It should not be the primary objective. The primary objective is to reduce the need for drugs.
Of course you need a deep enough birthing pool, so that your body can be completely immersed. Today it is easy to rent such birthing pools. You also need a way to check that the temperature of the water is never above the temperature of the body (37 degrees Celsius). A too hot bath is dangerous for the baby. It is better if your husband, or partner, has to prepare the bath while you are already in hard labor. Remember that a century ago the secret for an easy home birth was to make the husband busy: he was spending hours and hours boiling water. Are we rediscovering the value of old rituals?
Dr. Odent, it is an honor. I am in the USA, studying to become a midwife and noticed a peculiar quote in my Anatomy & Physiology textbook. It states that “The pain of human childbirth, compared to the relative ease with which other mammals give birth, is an evolutionary product of two factors: the unusually large brain and head of the human infant, and the narrowing of the pelvic outlet, which adapted hominids to bipedal locomotion.” (Kenneth S. Saladin, Third Edition). Do you agree with this statement, or is this merely an assumption made due to the high levels of intervention and passivity of the woman during childbirth? Thank you for your time; I truly respect all that you have done.
We cannot deny that human beings must overcome several handicaps in the period surrounding birth. The main handicap is not mentioned in your textbooks. It is the huge development in our species of that part of the brain called the neocortex. The neocortex is not basically different from what we might call the brain of the intellect. The point is that during the birth process (and during any sort of sexual experience), if there are inhibitions, they come from the powerful neocortex.
Nature found a solution to overcome this human handicap. The maternal neocortex is supposed to be at rest, so that primitive brain structures supporting our survival instincts can more easily release the necessary hormones. That is why women who give birth by themselves, with their own hormones, tend to cut themselves off from our world, to forget what they read or what they have been taught; they dare to do what a civilized woman would never dare to do in her daily social life (daring to scream, to swear, to be impolite, etc.); they can find themselves in the most unexpected, bizarre, primitive, often quadrupedal postures; I heard women saying afterwards: ‘I was on another planet’. When a laboring woman is ‘on another planet’, this means that the activity of her neocortex is reduced. This reduction of the activity of the neocortex is an essential aspect of birth physiology among humans.
This aspect of human birth physiology implies that laboring women need to be protected against any sort of neocortical stimulation. This helps us to understand the importance of quiet (since language is a powerful stimulant of the neocortex) and of a dim light. It explains also the importance of privacy (when we feel observed our neocortex is stimulated) and the need to feel secure (when we perceive a possible danger we must be attentive and alert). Because the most important aspect of birth physiology is not understood in our cultures, there is no reference in your textbooks to the handicap related to a highly developed neocortex.
It is commonplace, on the other hand, to focus on the mechanical difficulties of the birth of Homo sapiens. In fact, these difficulties are also related to brain development. Today Homo sapiens is classified as a chimpanzee with an enormous brain. At term, the smaller diameter of the baby’s head (which is not exactly a sphere) is roughly the same as the larger diameter of the mother’s pelvis (which is not exactly a cone). The evolutionary process adopted a combination of solutions in order to reach the limits of what is possible.
The first solution was to make pregnancy as short as possible, so that, in a sense, the human baby is born prematurely. Furthermore we have realized recently that the pregnant mother can, to a certain extent, adapt the size of the fetus to her own size by modulating the blood flow and the availability of nutrients to the fetus. That is why small surrogate mothers carrying donor embryos from much larger genetic parents give birth to smaller babies than might have been anticipated.
From a mechanical point of view, the baby’s head must be as flexed as possible, so that the smaller diameter is presenting itself before spiraling down to get out of the maternal pelvis. The birth of humans is a complex asymmetrical phenomenon, the maternal pelvis being widest transversally at the entrance and widest longitudinally at the exit. A process of ‘molding’ can slightly reshape the baby’s skull if necessary.
When mentioning the mechanical particularities of human birth, one cannot help referring to and comparing ourselves with our close relatives the chimpanzees. The head of a baby chimpanzee at term occupies a significantly smaller space in the maternal pelvis, and the vulva of the mother is perfectly centered, so that the descent of the baby’s head is as symmetrical and as direct as possible. It seems that since we separated from the other chimpanzees, and all along the evolution of the hominid species, there has been a conflict between moving upright on two feet and, at the same time, a tendency towards a larger and larger brain. The brain of the modern Homo is four times bigger than the brain of our famous ancestor Lucy. There is a conflict in our species because the pelvis adapted to the upright posture must be narrow to allow the legs to be close together under the spine, which facilitates transfer of forces from legs to spine when running. An upright posture is the prerequisite for brain development. We can carry heavy weights on our head when we are upright. Mammals walking on all fours cannot do the same. That is apparently why the process of evolution found other solutions than an enlarged female pelvis in order to make the birth of the ‘big-brained ape’ possible: the faster our ancestors could run, the more likely they were to survive.
Nature found several other solutions to overcome the mechanical difficulties. One of them is that when the neocortical control is reduced, the laboring woman can spontaneously—instinctively—find postures that are usually complex, asymmetrical, and adapted to the different phases of the process of rotation. Another solution is the capacity human mothers have to give birth thanks to a powerful ‘fetus ejection reflex’, that is to say a series of irresistible contractions without any room for voluntary movements… on the condition that the neocortex is at rest.
We must add that Nature found solutions to compensate the physiological pain of labor. One of them is an appropriate release of natural morphine’s. Another one is the reduced activity of the new brain, so that the painful stimuli are not processed and imprinted in the upper parts of the nervous system, and so that the memory is depressed.
We cannot deny the human handicaps in the period surrounding birth. The point is to understand the many solutions the evolutionary process found to overcome a great diversity of difficulties. Understanding these solutions is the prerequisite to rediscover the basic needs of laboring women. It is a difficult task after thousands of years of culturally controlled childbirth and a recent proliferation of theories that have mislead most schools of “natural childbirth.” What a responsibility for the generation of midwives you belong to!
Conventional pregnancy magazines are full of ads and articles on banking cord blood. Is this just a profit-driven trend or is there value to it?
Women who are supposed to give birth to the baby and to deliver the placenta without any drug should be reluctant to bank cord blood. When the physiological processes are not disturbed, human mothers have the capacity to reach a very high peak of the hormone oxytocin soon after the birth. This peak of oxytocin is vital, first because it is necessary for a safe delivery of the placenta without any blood loss, and also because oxytocin is undoubtedly the main hormone of love. This release of oxytocin is possible (in a warm place) if the mother, who is still ‘on another planet’, is not distracted at all and has nothing else to do than to feel the contact with the baby’s skin, to look at the baby’s eyes, and to smell the baby. Imagine a mother who has just given birth and who has forgotten the rest of the world while discovering her newborn baby. Then a practitioner arrives with clamps and scissors to collect a sufficient amount of blood from the cord. What a dangerous distraction! The risk is a difficult and bloody delivery of the placenta. Furthermore the baby will be deprived of a certain amount of precious blood. Well-informed women would not take such risks, while the odds that the average baby without risk factors will ever use his banked cord blood are negligible.
It is another matter in the case of medicalized births (cesarean-section, drip of Pitocin, or drugs injected routinely to deliver the placenta). In such cases, the cord is clamped anyway soon after the birth of the baby. Then the risks are mostly financial. The point is that until now there has been little experience with transplanting self-donated cells (stem cells from bone marrow are currently given by relatives or strangers). Some experts have hypothesized that an ill baby who receives his or her own stem cells during a transplant would be at risk of repeating the same disease. Long-term studies are needed. Meanwhile we must be cautious.
My planned natural birth turned out to be very traumatic. I had severe abruptio placenta. I was 24, I don’t smoke or have any of the risk factors for it, I was very healthy, I ate right and was not overweight. It happened while in the early stages of labor at home and things didn’t seem right to me. My husband rushed me to the hospital. I was in severe pain and only 4 cm dilated, my baby’s heart rate was at 70, I was hemorrhaging. They rushed me to perform an emergency C-section. My daughters had to be intubated for a short time and spent a few days in the NICU. I thought I could never be thankful for such medical intervention, but I am for it saved our lives. My daughter is two now and we are thinking about having another child. I have not found much information on what happened to me. Is it because they aren’t sure why it happens? Is it likely to happen again? Should I still try for a natural birth? How can I find out more information on it?
Abruptio placentae means that the placenta separated from the uterus before the birth of the baby. It can happen before the labor starts or during labor. The separation may be complete or partial. In your case it was probably a quasi-complete separation. Your daughter was rescued thanks to an emergency C-section. Abruptio placentae is an important chapter of the program of ‘first aid in obstetrics’ we include in our information sessions for doulas. We understand why your doctors could not give you much information on what happened to you. More often than not it is impossible to find a cause for such an accident. It is noticeable that a previous abruption placentae is not usually mentioned as a significant risk factor for the advent of a similar accident at the end of the following pregnancies. The conclusion is that when you give birth to your second baby, you’ll be in the usual situation of a mother trying to give birth vaginally after a previous C-section. This means first that labor induction will be an absolute contraindication. Because you cannot extinguish in your memory the dramatic complication you previously had, you’ll probably prefer to labor in a hospital. The point is to find a hospital where they accept your project of a trial of labor and at the same time where they understand the meaning of the word privacy.
Is taking castor oil for inducing labor okay for both the unborn child and mother?
Castor oil is one of the most unpleasant ways to induce labor. It makes the mother nauseous and it often causes diarrhea. Furthermore its safety has not been evaluated by large randomized controlled studies. I personally know about several cases of fetus distress during labor obviously related to the use of castor oil. I use this opportunity to mention that women often ask me about ‘natural’ methods of labor induction. My answer is that there are no natural methods of induction. If a method is effective, it means that it is not natural, because it has preceded the signals given by the baby. We understand today that the fetus participates in the initiation of labor by sending messages that mean: ‘I am ready’. (For example the mature baby’s lungs can release in the amniotic fluid factors that play a role in birth physiology). Whatever the method, an induced labor is usually longer and more difficult (therefore more dangerous) than a labor that started spontaneously. Instead of being impatient and taking castor oil, it would be wiser to rely on ultrasound scans in order to check that the amount of amniotic fluid is still normal. This is the best way to reassure the health professionals. Today we routinely offer mothers-to-be a great number of useless scans. We must realize that the most useful ones are those done ‘on demand’ when the pregnancy is longer than usual.
Can artificially rupturing the membranes contribute to fetal distress? I know that it can speed up labor, and that shorter labors can be less distressing, but my daughter’s heartbeat dropped considerably not long after my doctor broke my water.
We cannot be sure that, in your particular case, there was a cause and effect relationship between the artificial rupture of the membranes during labor and the changes in your daughter’s heartbeat. However it is well understood that, after a rupture of the membranes and therefore after an acceleration of labor at a time chosen by the doctor (or the midwife!), the baby’s head is suddenly subject to greater pressure during contractions and the cord is more likely to become compressed. The baby must protect herself by releasing in particular the hormone noradrenaline, which tends to slow down the heartbeat. The best way to prevent the common temptation of breaking the bag of water is to avoid assessing the progress of labor with vaginal exams. This is easier when the laboring woman has complete privacy and does not feel guided. In this case an experienced birth attendant can more often than not follow the progress of labor thanks to the noise the mother-to-be is doing, the way she is breathing, and the complex postures her body can find spontaneously.
Regarding water birth, I have two questions: 1. Is there a point at which it is too early to get in the pool? 2. Is it really possible to get so relaxed that labor can stop? I wouldn’t say I was relaxed – just removed from the present and in a deep state of concentration.
1. Entering the bath too early is the most common misuse of the birthing pool. Originally we introduced the concept of birthing pool in a French hospital in order to replace drugs when the first stage is long, difficult, very painful, and when the dilation of the cervix is already well advanced. It is essential to understand that immersion in water at body temperature makes the contractions more effective during a limited period of time, which is in the region of an hour and a half. Helping the laboring women to be patient and to avoid entering the bath too early is a new aspect of the art of midwifery. However, in some cases, a bath can be useful to stop the contractions of a painful pre-labor, and therefore to make the difference between labor and pre-labor.
2. When a woman is so relaxed that apparently labor stops, it means that it was not labor, but pre-labor. In general the release of adrenaline (which induces the opposite of a state of relaxation) inhibits the release of oxytocin (the hormone necessary for effective uterine contractions).
How would you define “normal” birth?
The term ‘normal’ is useless when applied to birth. In ‘normal’ there is a cultural connotation. A birth can be considered normal in Rome, but not in Santa Fe. It is only in retrospect that a birth can be qualified ‘normal’ (the same about ‘natural’). What we need today is to qualify an attitude. That is why I suggested the concept of ‘biodynamic attitude in childbirth’. A biodynamic attitude (in farming, in childbirth, etc.) is based on a good understanding of the physiological processes. In other words it means: working with the laws of Nature.
Can you explain why water birth might be better than using the “traditional” route, i.e. drugs?
All drugs given to a woman in labor may have side effects for the mother and for the baby. When we introduced the concept of birthing pools in a French hospital in the 1970s, our primary objective was to reduce the need for pain killers and drips of Pitocin. When a labor is long, difficult and abnormally painful, it usually means that the mother-to-be is not in the right hormonal balance.
It means in particular that the pituitary oxytocin is not being released in an effective way, more often than not because the level of stress hormones is too high. Immersion in water at the temperature of the body is a way to reduce the level of stress hormones and therefore to facilitate the release of oxytocin, the main hormone that makes uterine contractions during labor effective.
Since the 1970s we learnt that obstetric medications may also have long term side effects. Visit our data base www.birthworks.org/ and click, for example, on the key word ‘drug addiction’. You’ll find a series of studies suggesting that when the mother has used certain drugs when in labor, her child is – statistically speaking – more at risk than others to become drug addicted later on in life. It is probably not by chance that, in the US, the age of ‘twilight sleep’ was followed by the ‘drug culture’ generation. Furthermore we learnt recently that the complex cocktail of hormones released by laboring women is a cocktail of ‘love hormones’. All pharmacological substitutes block the release of the natural hormones and don’t have the same behavioral effects: they are not hormones of love. So the questions must be raised in terms of civilization.
Birthing pools will seriously compete with drips of Pitocin plus epidurals on the day when a simple fact will be widely divulged. It is that immersion in water at the temperature of the body tends to the make the uterine contractions more effective for a limited period, which is in the region of an hour and a half. This implies that a new aspect of the art of midwifery will be to help women to be patient enough not to enter the bath too soon, ideally not before the middle of the dilation of the cervix. It also implies that a birth under water should not be the goal and should not be planned, although it is a possibility. When the mother-to-be is the prisoner of her project, she may be tempted not to listen to her body and to stay in the birthing pool at a time when the contractions are already becoming weaker and less effective.
What are the risks/benefits to letting your baby have a shot of vitamin K after birth?
Today there are many reasons to de-dramatize the topic and to reassure at the same time the parents who are inclined to refuse the shot and also those who prefer to do it.
To the parents who refuse the injection, we can say that they don’t take a great risk, since the chances of their breastfed baby having a hemorrhagic disease related to vitamin K deficiency is in the region of one in 15,000. It is even probable that the risks are still lower if the birth and the initiation of lactation were undisturbed. My view is that vitamin K deficiency of breastfed babies is probably no more physiological than the weight loss in newborn babies. After thousands of years of culturally controlled childbirth and lactation, we usually underestimate the amount of ‘colostral milk’, and therefore of vitamin K, a human baby has been programmed to consume during the first days following birth.
A well-constructed Japanese study showed that babies who consume 350 ml of breast milk in the first three days following birth are protected against vitamin K deficiency. Let us also remember that vitamin K deficiency is unheard of among formula fed babies.
Some parents who accepted the injection might feel guilty or anxious afterwards when hearing about two British studies suggesting that vitamin K injected at birth (not vitamin K given orally) is a risk factor for cancer in childhood. These parents must be reassured as well because the British findings have not been confirmed by other studies, particularly a huge authoritative Swedish study involving more than one million children. However one cannot hide the fact that the routine injection of 1 mg of vitamin K at birth is always associated with the injection of 10 mg propylene glycol and 5 mg phenol, the effects of which are unknown.
Would you advise a home birth or water birth when attempting a VBAC?
In an ideal world, we should not contrast home birth and hospital birth. When an effective communication has been established between the home birth midwife and the obstetrical team, it should be possible to combine what the privacy of the home can offer and what the hospital facilities can offer. If a laboring woman feels secure in her own “nest”, if an experienced, motherly and silent midwife is available, and if the first stage is easy and straightforward, it may be risky to change the environment in hard labor: a transfer to hospital can induce inhibitions. On the other hand, if the first stage is slow, difficult and very painful, it is probably better to change the environment and to go to the hospital. The point is not to be the prisoner of a project. Such strategies are valid for almost all births, but still more when attempting a VBAC.
When I introduced the concept of hospital birthing pools in the 1970s, our first objective was to reduce the need for drugs when the labor was long and difficult. Originally, we used it in particular in the case of a woman attempting a VBAC, if the contractions were becoming less effective around 5 centimeters. At that phase of labor, immersion in water at the temperature of the body is usually a way to reach complete dilation within an hour or two. Once more, it is important not to be the prisoner of a project, such as the project of giving birth under water. Many women feel the need to get out of the pool for the very last contractions.
What are the risks associated with routine ultrasound for low-risk pregnancies?
In general the most authoritative studies of the long term effects of being exposed to ultrasound during fetal life are reassuring. A Swedish study, for example, involved 19 prenatal care clinics and more than 4000 children.(1) After randomization (after drawing lots) only the pregnant women belonging to the ‘screening group’ were offered a scan at 15 weeks. After follow-up of the children, no statistically significant differences in body weight or height at 1, 4, 7 years of age between exposed and unexposed children were found. There were no differences either in terms of impaired vision or hearing during childhood.
However there are studies suggesting that exposure to ultrasound during fetal life is not completely neutral. This is the case of a large Australian study. It appeared, after analyzing thousands of cases, that frequent exposure to ultrasound tends to restrict fetal growth.(2) Such results confirmed the results of studies with pregnant monkeys scanned with doses used in human medicine.(3) This is also the case of several Scandinavian studies showing that exposure to ultrasound tends to slightly modify the proportion of right-handed and ‘non right-handed’ children.(4,5)
Since exposure to ultrasound during fetal life is not completely neutral, the selective use of scans should be preferred to routine scans. There are reasons to be cautious but, in the scientific context of 2003, one cannot refer to documented real complications.
-1- Kieler H, et al. Routine ultrasound screening in pregnancy and the children’s subsequent growth, vision and hearing. British Journal of obstetrics and gynaecology. 1997; 104: 1267-72.
-2- Newnham JP, et al. Effects of frequent ultrasound during pregnancy: a randomised controlled trial. Lancet 1993; 342: 887-91.
-3- Tarantal AF, Hendrickx AG. Evaluation of the bioeffects of prenatal ultrasound exposure in the cynomolgus macaque. Teratology 1989; 39 (2): 137-47.
-4- Savelsen KA, et al. Routine ultrasound in utero and subsequent handedness and neurological development. BMJ 1993; 307: 159-64.
-5- Kieler H. Routine ultrasound screening in pregnancy and the children’s subsequent handedness. Early Human Development 1998; 50: 233-45.
I was told I have the strep b virus, I don’t know if I had it with my 5 other children or not. I am planning on another home birth, as my others have all been, but my doctor says that 40% of babies can die or have damage from this at birth. My mid-wife says that’s not accurate and that many woman carry strep b and is not even aware of it. Do I need to take antibiotics during labor, and will the baby need drops in its eyes after delivery? I have never had either done to any of my 5 babies. If you could please give me advise or direct me to issues that would answer these questions, I would really appreciate it. I am 43 years old; this is my 6th delivery coming up app. 6-20-03.
It is exceptionally rare that a baby born at term with a normal birth weight dies from a B strep infection. Those who are more vulnerable are premature babies and small-for-date babies. Three studies published in authoritative medical journals suggest that the use of a vaginal spray of chlorhexidine is as effective as antibiotics. For mysterious reasons these studies are not well known. I include the abstract of the most recent one. It is better not to give eyes drops to the baby at birth and to rely on the results of an antibiogram (in the unlikely occurrence of an eye infection).
Abstract: -1- Facchinetti F, Piccinini F, Mordini B,Volpe A J Matern Fetal Med 2002 Feb;11(2):84-8 Chlorhexidine vaginal flushings versus systemic ampicillin in the prevention of vertical transmission of neonatal group B streptococcus, at term.
OBJECTIVE: To investigate the efficacy of intrapartum vaginal flushing’s with chlorhexidine compared with ampicillin in preventing group B streptococcus transmission to neonates.
METHODS: This was a randomized controlled study, including singleton pregnancies delivering vaginally. Rupture of membranes, when present, must not have occurred more than 6 h previously. Women with any gestational complication, with a newborn previously affected by group B streptococcus sepsis or whose cervical dilatation was greater than 5 cm were excluded. A total of 244 group B streptococcus-colonized mothers at term (screened at 36-38 weeks) were randomized to receive either 140 ml chlorhexidine 0.2% by vaginal flushing’s every 6 h or ampicillin 2 g intravenously every 6 h until delivery. Neonatal swabs were taken at birth, at three different sites (nose, ear and gastric juice).
RESULTS: A total of 108 women were treated with ampicillin and 109 with chlorhexidine. Their ages and gestational weeks at delivery were similar in the two groups. Nulliparous women were equally distributed between the two groups (ampicillin, 87%; chlorhexidine, 89%). Clinical data such as birth weight (ampicillin, 3,365 +/- 390 g; chlorhexidine, 3,440 +/- 452 g), Apgar scores at 1 min (ampicillin, 8.4 +/- 0.9;chlorhexidine, 8.2 +/- 1.4) and at 5 min (ampicillin, 9.7 +/- 0.6; chlorhexidine,9.6 +/- 1.1) were similar for the two groups, as was the rate of neonatal group B streptococcus colonization (chlorhexidine, 15.6%; ampicillin, 12%). Escherichia coli, on the other hand, was significantly more prevalent in the ampicillin (7.4%) than in the chlorhexidine group (1.8%, p < 0.05).Six neonates were transferred to the neonatal intensive care unit, including two cases of early-onset sepsis (one in each group).
CONCLUSIONS: In this carefully screened target population, intrapartum vaginal flushings with chlorhexidine in colonized mothers display the same efficacy as ampicillin in preventing vertical transmission of group B streptococcus. Moreover, the rate of neonatal E. colicolonization was reduced by chlorhexidine.
-2 – Burman LG,et al. Prevention of excess neonatal morbidity associated with group B streptococci. Lancet 1992; 340: 65-69
-3 – Taha TE, et al. Effect of cleansing the birth canal with antiseptic solution. BMJ 1997; 315: 216-20.
How serious are the consequences if meconium shows up in the amniotic fluid during labor? Is this necessarily an emergency?
When the meconium shows up in the amniotic fluid during labor, it means that the baby is releasing a hormone of the adrenaline family called noradrenaline. This hormone is released when the baby must adapt to a low supply in oxygen. The effect of a release of noradrenaline is to provide enough blood to vital organs having priority (such as brain, heart, and kidneys) by reducing the amount of blood going to organs that are not yet vital such as the bowels. That is how the green-brown tarry sterile substance that fills the bowels is eliminated into the amniotic fluid.
In other words, meconium staining during labor does not mean fetal distress and is not necessarily an emergency. It means that a physiological system of protection of the fetus is at work. That is why it is always a particular case that should be interpreted according to the phase of labor, the progress of labor, the duration of pregnancy, the number of babies the mother had previously, the place of birth, etc. Let us mention that a tainted liquid during labor is almost the rule in the case of a breech presentation and is not usually related to the release of noradrenaline.
Amniotic fluid inhalation occurs in 2% to 5% of babies with tainted liquid. Among them, some will develop meconium aspiration pneumonia and will go on mechanic ventilators. Very few of them will have residual health problems. The practice of suctioning the mouth and throat of the baby just before the delivery of the shoulders is now considered useless. The routine intubation and suction of the trachea just after birth in the case of meconium staining is also considered useless according to recent studies. It does not improve the outcome.
What might be some reasons that a woman would have low or high amniotic fluid levels in pregnancy? What effects can these levels have on the well-being of the baby? and what, if anything, can be done to increase her chances of having “normal” amniotic fluid levels?
When a woman has too low levels or too high levels of amniotic fluid, the point is not to wonder what can be done to modify the amount liquid surrounding the baby. The priority is to detect a possible cause for such a deviation from what is considered ‘normal’. It is impossible, within a paragraph, to analyze all the possible causes for a polyhydramnios (more than 2 liters of liquid) or an oligohydramnios (less than 300 mL at term). I must underline that there is a common tendency to over diagnose polyhydramnios. In other words, many women are wrongly told that there is too much liquid.
How often does ultrasound find something wrong that can be fixed before birth? I would like no ultrasound but still want to be safe.
Apart from discovering a gross abnormality that leads the doctor to offer a late abortion (and exceptionally a very risky intrauterine operation), ultrasound scans rarely find something wrong that can be fixed before birth. In the case of a pregnancy that started while a mother is still breastfeeding and has no menstruation, the scan can give an idea of when the baby had been conceived (this is not exactly something wrong that can be fixed!). When the baby is really overdue an ultrasound scan can demonstrate that there is still a normal amount of liquid. Such a scan can be effective to reassure the doctor and therefore to postpone and even to avoid labor induction.
An experienced practitioner does not usually need a routine scan to suspect a breech presentation at 37 weeks or after, or to suspect a real placenta praevia. It is well known that ultrasound scans are not accurate to evaluate the size of the baby in the womb. Anyway if the baby seems to be too small, the recommendation should be: “Eat well and be happy”. Such recommendations can be given without the help of ultrasounds.
I have been a type I diabetic since early childhood. I have no complications, and have consistently had an A1c (measure of diabetic control) close to that of a non-diabetic. I am on the heavy side, but otherwise in very good health. I currently work with type I diabetics, and they often report a snowball of interventions when they have their babies at the hospital due to being categorized as “high risk” (whether or not they have good control). I am planning to get pregnant soon and very fearful of how my birth experience will be affected by being treated as “high risk.” The OBs I have talked to are very eager to intervene in the natural course of my pregnancy. I have not, however, found a midwife who is willing to “risk” working with a type I (even CNMs doing hospital birth and working collaboratively with OBs). What can I do at this point?
If you have been diagnosed as diabetic in early childhood, you are probably the best person in the world to control your own metabolisms. As soon as you are pregnant try to evaluate as accurately as possible the day of conception (if your cycle is not always perfectly regular), taking into account details of your private life that will be easily forgotten later on in pregnancy. Apart from diabetic control (and detecting a gross abnormality if you are ready for an abortion), always wonder what the medical institution can offer to you. If you are offered a test, always ask questions about its immediate practical implications. For example: ‘Why an ultra-sound scan at 32 weeks? What can you do now if the baby is too big or too small? ‘Nothing’. At the end of pregnancy, avoid the usual misinterpretations of hemoglobin concentration that lead to give pregnant women iron supplements. Iron inhibits the absorption of zinc. When you are diabetic, you must not play with the absorption of zinc.
It is probable that after 37 weeks the doctors will start talking about the size of the baby. Whatever the method, it is always difficult to evaluate the weight of a fetus. If they say that the baby is too big and if you don’t feel comfortable with a scheduled C-section, try to obtain the principle of a trial of labor. It is a guarantee that your baby will have given the right signal, and that you and your baby will have released hormones that give a last touch to the maturation of the lungs. If you give birth in a hospital where CNMs work with doctors, if you don’t go to the hospital before being in really hard labor, and if you belong to a family where women give birth easily, why not a quasi-normal pregnancy and a birth by the vaginal route?
I am 35 weeks, one centimeter dilated and very uncomfortable. When is it safe to start naturally inducing labor at home and what are the dangers in using castor oil?
At 35 weeks, the point is to hope that labor will NOT start prematurely. It is not usual to ask questions about induction at that phase of the pregnancy. Labor induction cannot be ‘natural’. It is always a way to precede the signals given by the baby and by your own body. Castor oil is unpleasant (diarrhea) and potentially dangerous.
What are some of the possible health risk associated with induction?
An induced labor is more difficult than a labor that started spontaneously. The needs for drugs and intervention are increased.
Labor induction probably has lifelong consequences for the child. I suggest that you visit the ‘Primal Health Research Data Bank’ (www.birthworks.org/) via the key word ‘labor induction’. It will lead to several studies suggesting that labor induction might be a risk factor for autism.
My interest in autism started in 1982, when I met NikoTinbergen, one of the founders of ethology, who shared the Nobel prize with Konrad Lorenz and Karl Von Frisch in 1973. As an ethnologist familiar with the observation of animal behavior, he studied in particular the non-verbal behavior of autistic children. As a ‘field ethnologist’ he studied the children in their home environment. Not only could he offer detailed descriptions of his observations, but at the same time he listed factors which predispose to autism or which can exaggerate the symptoms (1). He found such factors evident in the period surrounding birth: induction of labor, difficult forceps delivery, birth under anesthesia, and resuscitation at birth. When I met him he was exploring possible links between difficulty in establishing eye-to-eye contact among autistic children and the absence of eye-to-eye contact between mother and baby at birth.
It is probably because I met Niko Tinbergen that I read with special attention, in June 1991, a report by Ryoko Hattori, a psychiatrist from Kumamoto, Japan.(2) She evaluated the risks of becoming autistic according to the place of birth. She found that children born in a certain hospital were significantly more at risk of becoming autistic. In that particular hospital the routine was to induce labor a week before the expected date of birth (and to use a complex mixture of drugs during labor).
There are many reasons why further studies about labor induction as a possible risk factor for autism (and other abnormal behavior) are urgently needed. The first one is that the authors of the oldest studies included in our database came across risks associated with induction, whereas the most recent studies did not take into account this variable. ‘Labor induction’ should be explicitly taken into consideration, because it can be associated either with birth by the vaginal route (with or without intervention such as forceps), or with caesarean birth. Another reason is that the epidemic of autism and the epidemic of induction seem to have developed side by side. Most importantly, a third reason is that the results of recent studies suggest that children with autistic disorder show alterations in their oxytocin system.(3)
Such findings are of paramount importance at a time when an accumulation of data from animal studies confirms the potent effects of oxytocin on social behavior, communication and rituals. Artificial induction of labor in general, particularly the use of drips of synthetic oxytocin, create situations that undoubtedly interfere with the development and the reorganization of the oxytocin system in such a critical period. This only fact is a reason for further epidemiological studies focusing on labor induction as a possible risk factor for a great variety of abnormal or subnormal behavior.
1 – Tinbergen N, Tinbergen A. Autistic children. Allen and Unwin. London 1983.
2 – Hattori R, et al. Autistic and developmental disorders after general anesthetic delivery. Lancet 1991; 337: 1357-8.
3 – Green L, Fein D, et al. Oxytocin and autistic disorder: alterations in peptides forms. Bio Psychiatry 2001; 50 (8):609-13..
I am researching early vs. late umbilical cord clamping. What is your opinion on the issue? any suggestions or more resources?
Clamping the cord before the delivery of the placenta is to interfere with the physiological processes.
Having been in charge of more than 10,000 ‘non-managed third stages’ of labor in the French state hospital of Pithiviers I cannot see any reason to interfere with the exchanges of blood between the newborn baby and the placenta. We must keep in mind that it is between the birth of the baby and the delivery of the placenta that a woman has the capacity to release the highest possible peak of the hormone oxytocin. The release of oxytocin is always highly dependent on environmental factors. The main condition, in the particular case of the third stage of labor, is that the mother has nothing else to do than to look at the baby’s eyes and to feel the contact with the baby’s skin…in complete privacy, without any distraction. Clamping the cord or trying to detect the time when the cord stops pulsating are powerful distractions that ‘brings back to our planet’ a woman who had ‘forgotten the rest of the world’.
Needless to recall that this peak of oxytocin is necessary for a safe delivery of the placenta and that this hormone has well-documented behavioral effects (it is the main ‘hormone of love’).
I have genital herpes and am pregnant. I want a natural childbirth, but have been told that a C-section may be necessary. I thought that I would pass antibodies onto my baby? If I have a lesion at the time of birth can I still deliver vaginally? What are my options?
I understand that you have recurrent herpes and that the first invasion preceded the current pregnancy. In this case you have probably developed low-weight antibodies (IgG) that cross the placenta, so that your baby is immunized: it is not unwise to give birth by the vaginal route. It would be different if the first invasion had occurred recently, while you are pregnant. In this case you would have developed only high-weight antibodies (IgM) that do not cross the placenta and that do not protect the baby in the womb.
I recently suffered a 4th degree tear, 1 centimeter into the rectum it was repaired by a surgeon. This began as a wonderful homebirth labor, the delivery was tough though, nuchal arm, shoulder dystocia, 10.6 baby. The doctor realized that it was out of his scope and I was transported to the hospital for repair. What are my chances of another natural birth?
Most obstetricians will advise you to have a C-section for the birth of the next baby; however the vaginal route might be possible if you are given the opportunity to give birth in complete privacy, for example with nobody else around than one experienced, motherly, low-profile and silent midwife. In such a context, if you don’t feel guided, it is highly probable that you’ll have a powerful ‘fetus ejection reflex’ and that you’ll find spontaneously a position that is not dangerous for the perineum (usually an asymmetrical kneeling posture).
I was interested in finding out more about the antibody called Rhogam and possible adverse effects before agreeing to take it for my RH sensitivity. With the birth of my other child I did not take it and everything was fine, is it really as important as they make it sound?
RhoGAM is the name of a trademark of anti-D immunoglobulin’s. It is injected (during pregnancy or just after the birth) to mothers who belong to the blood group Rh negative. An Rh negative woman may conceive an Rh positive child if the father is Rh positive.
The objective of this injection is to prevent the formation by the mother of ‘anti D’ (= anti RH) antibodies that might be detrimental for the babies in future pregnancies only. In other words it is a way to reduce the risks of accidents caused by a conflict between mother and babies. The most typical accident caused by this sort of blood incompatibility is a severe jaundice related to the destruction of fetal red blood cells. Today these accidents are exceptionally rare in developed countries, first because women don’t have many babies (only children who have older siblings are at risk), and also because the prevention is routinely recommended.
Such explanations are necessary, so that informed women can decide if the injection is really useful in their particular case. For example if a pregnant woman knows that the baby’s father is also Rh negative, she does not need the injection. Another woman might also decide not to have the injection because she knows that she will never be pregnant again (e.g. a ‘miraculous’ unexpected conception in her late forties).
Let us mention that today most anti-D products do not contain any mercury derivative, and that their viral safety is well accepted.
My sister delivered her third daughter on 11.25.03. The baby was 11 days post-mature. After two previous inductions on an unripe cervix, she made the informed decision to allow labor to begin naturally. On the Saturday before delivery, my sister felt an almost unbearable contraction while grocery shopping. Within hours she reported to me that the baby was not moving, and although we have not yet discussed it, I think she knew her baby was gone. We managed an almost completely natural hospital birth, the only intervention being use of the external monitor. Needless to say, the nurses were unable to find a fetal heartbeat. After 6 hours of un-medicated labor, her child delivered stillborn. Her death was blamed on the heavy presence of meconium. Her birth weight was 7lbs. 2oz. Can you offer me any information that I could pass on to my sister that would help her stop blaming herself for being stubborn and repeatedly not showing up for her scheduled inductions? This experience is shaking my belief in the natural approach to pregnancy and childbirth.
This ‘unbearable’ pain, followed by the death of the baby and the presence of heavy meconium, is highly suggestive of a ‘partial placenta abruption’. This means that the placenta stopped working properly because it was suddenly more or less separated from the uterus. This rare accident is unpredictable. It can occur at any time during the last months of any pregnancy. More often than not there is no obvious cause. It is more common among women who already had babies. It can follow an abdominal trauma. A previous intra-uterine intervention (e.g. a C-section) is a risk factor. The chances that this accident occurs again when your sister is expecting another baby are very small.
How can I get my baby to turn head down? I am 36 weeks pregnant and desperately want to birth this child at home. Methods we are currently trying are: manual version by the midwives, breech tilt (behind in the air on all fours and also on a tilt on my back), moxabustion, pulsatilla 200 in two doses, two days apart, headphones taped to my lower belly with lullabies softly playing, meditation, pleading! I have an appointment scheduled with my naturopath to try other options: osteopathic adjustments and/or acupuncture and later a higher dose of pulsatilla 1M after risk of preterm labor has passed. This is my second birth (9 years apart). My son was born without any complications in 6 hours. Is there anything else we can try?
Many babies turn by themselves after 36 weeks. This is probably why all the methods you mention have a high rate of immediate successes. As a last resource, why not trying the medical way, that is to say an experienced obstetrician doing a manual version under ultrasound scan control, while the uterine muscle is in a state of relaxation thank to the use of ‘tocolytic’ drugs? By the way, I would not be scared by a vaginal breech birth in your case, since your first baby was born in six hours.
Mirror Neurons to help turn baby * Note from Kathy Welter follows
As a quick note here, I’ve had great success in babies turning, using Hypnosis, having mom and dad both visualize baby in right position, that is head down back on the left side. Babies are experienced at communications with mother and dad after the 34th week, a time when Mirror Neurons are mirroring images between mother and baby constantly. What happens is mother keeps hearing about baby in wrong position and focuses on this. Talks about it, worries about it, and keeps seeing baby with the wrong position. Instead stop all this talk and start looking at images of the optimum birth position, when you visualize baby see baby in the right position
Visualize the midwife and doctors confirming to you, hear their voices saying, that baby is in perfect position. It’s very effective.
I had planned on a homebirth with my son (now 6 months old). When I was in the pushing stage, the Midwife discovered that he was in a frank breech position. I was uncomfortable with the idea of delivering at home in this case, so I elected to go to the hospital and got a cesarean. I have been told I will never be able to have a baby vaginally again. Is this true?
I have often been surprised by how easy a delivery can be after a previous caesarean in late labor. One of the plausible interpretations of such easy births is that when a woman is trying to give birth vaginally after a previous in-labor caesarean, this implies that she has already had an opportunity to develop her uterine receptors to the hormone oxytocin. In other words, the second time her uterus is more sensitive to the effects of the hormone that makes contractions effective.
According to the most authoritative studies, a trial of labor is successful among approximately 70 to 80 per 100 women. Several studies have established predictive scores for the success of such trials, so that women may be given an individualized answer. I don’t know everything about your story, but I assume that your chances are high. Of course, for obvious reasons, the published studies could not take into account the degree of privacy, which might be the most important factor for success. Electronic fetal monitoring probably has a strong negative effect that has not been evaluated in the particular case of a vaginal birth after cesarean.
I have met several women who were in a panic after telling their doctor that they would prefer to try a vaginal delivery in spite of a previous caesarean. The reaction of the doctor was to focus on the risk of uterine rupture. After this some of these women could not get rid of vague and terrifying bloody mental pictures. Today clinicians are in a position to provide a reassuring and individualized risk assessment. Thanks to a series of recent authoritative studies, it is easy to explain that the risk of uterine rupture during a vaginal birth after cesarean is in the region of 1 for 200 trials, if the labor has not been induced. The main risk factor for uterine rupture is induction. You also need to know that a rupture can be suspected if there is a failure to progress or if the baby’s heart rate is not reassuring. During the intervention a dehiscence (a ‘window’) may be found, more often than a complete rupture.
I delivered my first born in the water and had a wonderful loving experience. My plans were to deliver my second also using hydrotherapy. However, the hospital I where I planned to deliver has suspended all water births/labors due to rising cost of insurance. With only 10 weeks remaining in my pregnancy I am faced with finding another hospital, mid-wife or alternative birth plan. I know this is a personal decision, but I am confused about potentially having the birth I desire and leaving the midwife I trust. Any words of wisdom that might help me feel comfortable with my choice?
How lucky you are! You had a wonderful experience when your first baby was born and now, while expecting your second baby, you can still rely on a midwife you trust! When we introduced the concept of birthing pool in a French hospital in the 1970s our objective was to replace drugs in the case of a difficult and long labor. It was what you rightly call a sort of ‘hydro-therapy’. A ‘therapy’ is to treat what is abnormal. It is very probable that for the birth of your second baby you will not need any ‘therapy’, if you are in a situation of real privacy with a silent, low profile and experienced midwife. What is more important for you: a midwife you trust or a birthing pool available? I can guess your answer if the question is asked that way.
My sister and I were discussing childbirth. She is very influenced by her friend, a nurse, to have an intrusive, medicalized birth. What kind of resources can I share with her to show her that a natural childbirth is a wonderful and safe birth choice?
You might first explain to your sister and her friend that a natural childbirth is not a choice. This term can only be used in retrospect, when a woman has given birth without any drug and without any intervention. The environment where you give birth is the real choice. You must explain that your main objective is safety and that according to common sense an easy birth is safer than a difficult birth. So your priority is to make the birth as easy as possible thanks to an environment that can satisfy your basic needs when you are in labor.
Your basic needs are easy to explain in the current scientific context. Physiologists, scientists who study the body functions, tell us that adrenaline (the emergency hormone we release in particular when we are scared or when we are cold) makes difficult the release of oxytocin, the hormone necessary for effective uterine contractions. You can explain that you release a lot of adrenaline when you are in an unfamiliar and clinical environment. You can add that, in contrast, you can imagine yourself giving birth in a familiar environment, with – for example – nobody else around than an experienced, motherly, low profile and silent midwife knitting in a corner. It is probable that in such an environment your body will work well.
The second aspect of the safety preoccupation is: what to do if there is something wrong? In the age of the safe C-section and widespread cell-phones, there is usually an easy answer to this question, which should always be the second one.
Many health professionals need to learn to think in terms of ‘ratio of benefits to risks’. Where out of hospital births are concerned, they immediately ask: ‘what will you do if…’ instead of asking first: ‘how to make the birth as easy as possible’.
You are asking what kind of resources you can share. You might share data about the Dutch birth statistics. In Holland, where 82% of the midwives are independent primary care givers, about 31% of the births occur at home, and an autonomous midwife attends many of the hospital births. The rates of C-sections are around 10% for the whole country and more than 90% of the laboring women do not need an epidural anesthesia. The birth outcomes are much better than in the USA (number of babies alive and healthy at birth).
Do not recommend books about ‘natural childbirth’ because they are usually written for the converted. Instead you might suggest updated books focusing on one of the main aspects of industrialized childbirth, such as ‘The Caesarean. Free Association Books 2004’. In order to help your sister and friend to learn to think long term, you might indicate the ‘Primal Health Research Data Base‘ that is specialized in studies exploring the long term consequences of what happened at the beginning of our life. It appears that the way we are born has lifelong consequences and that, today, in spite of the safe caesarean, we have good reasons to try to rediscover the basic needs of women in labor and of newborn babies.
Can you tell me your opinion on herbs that initiate/prepare for labor, specifically blue and black cohosh?
Because they are obsessed by the date they were given for induction, if their labor has not started spontaneously, some women are tempted to use non-medical methods. These women don’t always realize that any effective method (from acupuncture to herbs, nipple stimulation and sexual intercourse) implies that labor may start before the baby has signaled its maturity. There is no natural way of inducing labor. The risks associated with the use of some methods are well documented.(1-5) This is the case of blue and black cohosh. Blue Cohosh (caulophyllum thalictroides) contains vasoactive glycosides and an alkaloid known to produce toxic effects.
1 – Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med 2004; 351(3): 302-303.
2 – Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh.
Med J Aust. 2003 Oct 6;179(7):390-1
3 – Rao RB, Hoffman RS. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient.
Vet Hum Toxicol. 2002 Aug;44(4):221-2.
4 – Vitetta L, Thomsen M, Sali A. Black cohosh and other herbal remedies associated with acute hepatitis.
Med J Aust. 2003 Apr 21;178(8):411-2
5 – Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication.
J Pediatr. 1998 Mar;132(3 Pt 1):550-2.
Do you have any information about natural vaginal birth after a previous birth fistula injury? I’m being advised to plan a cesarean but I really want a natural birth. My fistula was vaginal/rectal and healed without surgery, but I would hate to have another, possibly worse one, with this birth.
If your absolute priority is to eliminate the risk of a recurrent vaginal/rectal fistula, everybody will advise you to plan an elective cesarean.
If your priority is to give birth vaginally, your particular case must be looked at in detail. It is noticeable that the opening between vagina and rectum healed without surgery. We might claim that it was not a real fistula, because the usual definition of the term vaginal/rectal fistula implies that the opening is lined with epithelial cells: this makes spontaneous healing almost impossible. If the healing was spontaneous, it is probable that there is now a high quality scar that cannot open again. All surgeons know this general rule.
I assume that this opening between vagina and rectum occurred after a long and difficult second stage of labor on your back, with a lack of privacy (several people around and somebody guiding you). Next time you might try to give birth in a different environment, ideally with nobody else around than an experienced, motherly, silent and low profile midwife. In such a context, you’ll reach more easily an ideal hormonal balance and your body will find the best possible postures to avoid a prolonged compression of the posterior wall of the vagina (for example complex asymmetrical postures on hands and knees).
Finally nobody can give you a precise advice. You must decide what your priorities are. You must take into account your intuition.
My wife and I are expecting our first child and would like a homebirth (preferably a water birth). My wife has tested positive for Group B Strep and she plans to avoid taking antibiotics in labor. Would labor/delivery in the water carry any increased risk?
Let us first recall that Group B Streptococci very rarely infect an average birth weight baby born at term. The risks are higher in the case of a premature or low weight newborn baby. Let us recall also that B Strep comes and goes, and that the test must be repeated as close to the due date as possible. It has been claimed that inserting in the vagina a crushed or cut clove of garlic during three to five nights usually makes a second test negative.
I share the point of view of your wife and I am not comfortable with the fact that a great part of the population is now exposed to antibiotics just before being born. There are already studies suggesting that early exposure to antibiotics might be a risk factor for allergic diseases later on in life. Furthermore such a widespread practice might explain the increased incidence, in some medical centers, of neonatal infections by antibiotic-resistant strains of e-colis.
There are therefore serious reasons to give a great importance to a series of studies suggesting that the efficacy of a local vaginal treatment with the antiseptic chlorhexidine is comparable to the efficacy of antibiotics in the prevention of such neonatal infections. You cannot discuss this issue with health professionals without providing the relevant references. For mysterious reasons these studies are not well known, although published in authoritative medical journals.
If the first stage of labor is long and difficult in spite of complete privacy, there is no reason why your wife would not try to reduce her level of adrenaline through immersion in water at the temperature of the body (I originally introduced the concept of birthing pool in a French hospital in order to avoid drugs when the labor is difficult). If your wife suddenly has a series of irresistible contractions and does not want (or has not the time) to get out of the pool, the baby may be born under water.
1. The Swedish Chlorhexidine Study Group. Burman LG, Christensen P, Christensen K, Fryklund B, Helgesson AM, Svenningsen NW, Tullus K. Prevention of excess neonatal morbidity associated with group B streptococci by vaginal chlorhexidine disinfection during labour. Lancet. 1992 Sep 26;340(8822):791; discussion 791-2.
2. Facchinetti F, Piccinini F, Mordini B, Volpe A. Chlorhexidine vaginal flushings versus systemic ampicillin in the prevention of vertical transmission of neonatal group B streptococcus, at term. J Matern Fetal Med 2002 Feb;11(2):84-8
3. Taha TE, et al. Effect of cleansing the birth canal with antiseptic solution. BMJ 1997; 315: 216-20.
4. Stray-Pedersen B, Bergan T, Hafstad A, Normann E, Grogaard J, Vangdal M. Vaginal disinfection with chlorhexidine during childbirth. Int J Antimicrob Agents 1999 Aug;12(3):245-51
5. Christensen KK, Christensen P, Dykes AK, Kahlmeter G. Chlorhexidine for prevention of neonatal colonization with group B streptococci. Effect of vaginal washing with chlorhexidine before rupture of the membranes. Eur J Obstet Gynecol Reprod Biol 1985 Apr;19(4):231-6
6. Kollee LA, Speyer I, van Kuijck MA, Koopman R, Dony JM, Bakker JH, Wintermans RG. Prevention of group B streptococci transmission during delivery by vaginal application of chlorhexidine gel. Eur J Obstet Gynecol Reprod Biol 1989 Apr;31(1):47-51
How can I avoid an episiotomy? I had one with my first child (hospital birth, no anesthesia) and the memory of the pain while being stitched up and for months afterwards is terrible! My first arrived quite fast, after about 4 pushes and he weighed only 2.5kg. Looking back, I think my episiotomy wasn’t necessary. What can be done before and during labor to avoid this procedure? Should I have pushed ‘less’?
The best way to avoid an episiotomy or a dangerous tear is to give birth with nobody else around than an experienced, motherly, silent, and low profile midwife who does not guide you. If you don’t feel observed and guided, you can more easily ago to another planet, stop being rational, and just listen to your body. In such a context there is a high probability that you’ll find yourself in the best possible posture, for example on hands and knees. If the need for privacy was understood, ‘episiotomy’ would become a topic for historians.
I am 7 weeks pregnant with my second child and would like a natural birth. My first birth was long and my cervix did not open for several days. Realizing that I was depleted of food and energy, we opted for interventions to help the labor progress. Is it possible that the abnormally large amount of amniotic fluid I had over-stretched my uterus, causing the contractions to be ineffective? Is there a way to encourage my body to have less amniotic fluid this time around? Any input you have would be most appreciated!
The first important point is to avoid calling a midwife (or going to a birthing place) before the time when you are absolutely sure that it is really hard labor. During the night don’t switch on the light if you can stay in bed in the dark. Don’t walk if your body asks you to lie down. Eat and drink if your body asks you to eat and drink, but don’t eat and drink if you don’t feel hungry and thirsty.
When you are in hard labor, remember that the length of labor is usually proportional to the number of people around. Avoid the presence of anybody who might release adrenaline. The best situation I know for an easy birth is when there is nobody else around than an experienced, motherly and silent midwife who does not behave like a guide or an observer. The most common cause for a long and difficult labor is the presence of the baby’s father. I know that what I say is not politically correct. However, at a time when there is an epidemic of ‘failures to progress’, it is becoming acceptable to smash the limits of political correctness.
Meanwhile watch the moon, listen to the music you love, and avoid reading books about childbirth, particularly chapters about amniotic fluid.
Can you explain in detail “the accordion method”, or refer me to a book or other resource that does?
It would be premature to explain in detail what the accordion method is, because our research center is still in the process of evaluating its efficacy. The objective is to reduce the maternal body burden in man-made fat-soluble chemicals before the conception of a baby. We all have in our bodies hundreds of chemicals that would not have been there sixty years ago because they did not exist at that time. They belong to families such as PCBs, dioxins, etc. They accumulate over the years in our adipose tissues. Since the late 1990s we have gathered a sufficient amount of data to realize that one of the main threats for the health of the unborn generations is intrauterine (pre-birth) pollution by such molecules.
The basis of our program is to repeat short fasting sessions in order to mobilize the stored lipids. During such sessions there are more free fatty acids (and therefore pollutants) in the blood. This is the right time to combine all the possible routes to try to eliminate some of them. We rely mostly on sweat, bile and the intestinal route. Because women recover quickly their weight soon after each session our program is called ‘accordion method’.
My hemoglobin is now 11.4 in week of gestation 19. A friend of mine has 7.8. Do I have to take ferrum? Is there a hemoglobin-limit?
It is probable that from now on your hemoglobin concentration will decrease. The placenta – which is ‘the advocate of the baby’ – will send you hormonal messages so that you dilute your blood in order to make it more fluid. Your blood volume will increase dramatically (up to 40% to 50%). Although you’ll still have the same amount of hemoglobin available, its concentration in your blood will be lower if the placenta is working well. The most authoritative published study on this issue involved more than 150 000 thousands births (Steer P, Alam MA, Wadsworth J, Welch A. Relation between maternal hemoglobin concentration and birth weight in different ethnic groups. BMJ 1995; 310: 389-91). According to this huge study a hemoglobin concentration between 8.5 and 9.5 during the second half of a pregnancy is associated with the best possible birth outcomes. Furthermore, when the hemoglobin concentration fails to fall below 10.5 there is an increased risk of low birth weight, premature birth and pre-eclampsia.
The regrettable consequence of misinterpreting this test is that, all over the world, millions of pregnant women are wrongly told that they are anemic and are given iron supplements. There is a tendency both to overlook the side effects of iron (constipation, diarrhea, heartburn, etc.) and to forget that iron inhibits the absorption of such an important growth factor as zinc. Furthermore, iron is a powerful oxidative substance that can exacerbate the production of free radicals. The disease pre-eclampsia is associated with an ‘oxidative stress’. Pregnant women need antioxidants (provided in particular by fruit and vegetable) rather than oxidative substances.
You should print the abstract of the study I mentioned (you’ll find it via PubMed, for example) in order to be in a position to discuss with practitioners who might tell you that you are anemic and that you need iron supplements. Don’t take iron supplements as long as your iron deficiency has not been proven by specific tests (ferritine in particular).
I cannot comment on the hemoglobin concentration of your friend, first because I don’t know if she is at the beginning or at the end of her pregnancy, and also because data regarding her lifestyle and data provided by a clinical exam should prevail upon the results of one laboratory test; this test should probably be repeated and completed, according to the context.
Contact me to for more information today 604-421-1722
Order your book/card set/& MP3’s directly from me and save!
Any use of substance or behaviour that is compulsive and is damaging to the person using it.
TYPE & CONSTANT USE:
What type of substance?
How often do you use it?
How much is consumed?
Alone or with others?
How intense is the experience? Until you are drunk, pass out, black out?
Until you pass out from vomiting?
Your commitment must start with an understanding you want to live differently. You are the only one that can decide this. No assurances from others – that have changed their path or altered their behaviours will make up for a lack of commitment in yourself. It must be 110% I will give my all, because I am done with living this way.
Even though you may be making this commitment in a foggy state of mind, the deeper part of you, struggling, knows this is what it wants.
Predictive Model: The Nature of the behaviour Defines the Problem
Start with reduction of use, make this an easy win, just 2 glasses a night and alternate with 8 ounce of water, for a week, even on the weekends, keep to your commitment
Exercise – + water increases the cellular flush from the system, reduce the use of other addictive patterns and behaviours, change breaks addiction in half.
Increase the protein,
Add Vit B/C Complex 100, xs 3 a day
Add in Omega 3 – 4500 2 xs a day + GABA 500mg 2xs a day
Beliefs and behaviours change:
How are you feeling ? and the next day, reducing use to 1 glass + water
Reducing the intensity of use and frequency
What type of drinking have you been witness to in your life?
Relationships – currently are they based in the consumptive use of alcohol?
The deeper self:
What’s important to you Right Now?
What do you want to achieve with your life?
What are your success’s from the past/ achievements/goals completed?
Clearing Toxic relationships – relationships with others may be around the use of alcohol, and even though you may use more than others right now,
When you stop completely, they will experience a pulling back – they do this, even though you don’t. They don’t want the reflection of
Sobriety when you are in recovery. Expect some relationships will change. When they do, allow for the shift into a more insular life for a short time
Sober Living – the quality of exceptional living
How will you know when you are in recovery? – When you notice you are not “thinking about it” every moment of the day
When your thoughts are more in line with your goals and life style
When you are in place with what you want, and are achieving it without the need for distractions through addictions
Life choices and styles are less rigid, more fluid, relationships are much easier
The ones that are more challenging, you easily allow to slip away, moving into 2nd or 3rd position
You allow your emotions instead of trying to stop, suppress or use a substance to distract you
Plan to commit 3 months, 90 days to this, at the completion of this time, a review with another is needed. Someone that supports your recovery fully. Not someone encouraging you drink with them again, or lets go get ice cream. This is a lifestyle change, with choices that support a healthy life.
You may slip, if you do, if you get convinced by another to try something, stay in first position, where you have more control over your behaviours. This is not the time to slip out of your body and “oh they just wanted me to join in”. You can’t afford this. Alcohol is your weakness and you made it this way. You can never allow it the power over your life again, nor give that power to another human to convince you to just “try it”.
A great way around this kind of pressure, is use your olfactory system, – SMELL it, it’s every bit as enjoyable, and you don’t have to take it into your body.
Kathy & Harry both work extensively with interrupting addictive patterns and behaviours. If you are in trouble and are seeking a private solution to your recovery, contact us today. We also treat drug addictions. We are a private practice located in Vancouver, B.C. Canada
How we help you with PostPartum & Post Natal Care:
For women that are unsure, or have had a legacy of difficult births handed down through their family, these sessions with Kathy are life saving. Resume the deep bonding with your baby, recover and resume your relationships with others too.
Understanding we are 70% environment and possibly up to 30% of our DNA relives the fear intellectually, however, to secure your place in the birthing room, Kathy uses, NLP & Hypnosis to restructure essential beliefs that are creating issues that just aren’t necessarily real!
If you have the slightest fears, it’s better to deal with these, THIS side of the birthing room, and ensure you have the clear head, mind and heart for your birthing day!
Clearing mother and daughter issues
Clearing father & daughter issues
Clearing sibling issues
Clearing family of origin issues
Clearing fear of failure and so much more…
These are all examples of one on one sessions Kathy has done for women needing to be fully free to be themselves going into one of the most powerful life experiences they will have! She ensures you “pick up your power”, empowering yourself!
Sessions are usually 60-90 minutes in length and are in addition to other courses or labor support.
Hypnotherapy for Post Partum
“The Body Unconscious is where Life Bubbles Up in us”. D.H. Lawrence.
Traumatic Birth Recovery –
How can you help me?
Difficult births are possible and do happen even with all the extensive planning and training, it can leave a mother feeling like her birth was not the way she wanted it at all. Taking the time to reframe this early after the birth, allows the mother to regain her balance and focus and stay on task with the many demands her new born is going to ask of her.
I use hypnotherapy and NLP to assist my mothers in reframing the birth so it does not disturb her emotional recovery, and her relationship and bonding with the new infant. Time, patience and healing.
Loss of an Infant
If I know of someone struggling, how can I help?
This is an area of deep personal spiritual growth and takes time for healing. Helping parents to let go requires training in areas of bereavement. I have extensive training in this area. For assistance or consultation, please contact me at 604-421-1722 or email: Kathy
If someone you know is struggling with loss or depression following the birth of an infant, notice the signs and encourage them to get some help. It can make all the difference in their lives and the life of their newborn.
Signs of Post Partum stress or depression:
All mothers are tired after the strenuous energy of a birth, however, sometimes it’s more than just recovering from a birth, sometimes things happened that the mom is just not recovering well.
To feel safe, as she allows herself to explore her feelings and her thoughts. These two are highly connected and during birth, she is highly suggestible. Therefore, the statements, the looks, the beliefs that she experiences through her birth can often leave her feeling lost, a failure and fearful for both herself and her infant.
SOME SIGNS OF DEPRESSION:
No Joy, no happiness with her infant – the “good enough mother” but not the joy and love in being a mother
A “blunted” mother, sad, motionless, fatigued, distant from her baby and her family and even herself.
Angry, Unnecessary fears, negative thinking
Not sleeping, emotional, and unable to cope with baby’s needs
Or fear of leaving baby unattended even for a moment
Severe dreams interrupting sleep
Not eating, finding everything extremely negative
Not showering or maintaining self care
Disinterest in the baby, good enough, but not loving or interested in the infant.
Disinterest in the family life
Lack of attention when speaking to her, anxiety, not available for intimate relationships
Sleeping through babies cries
Not wanting to leave the house
Shortness of temper or completely lack of emotional response
These can be signs of postpartum depression and are easily attended to without the involvement of drug therapies, which can be harmful to baby.
How Can Hypnotherapy Help PostPartum Depression?
Not unlike, PTSD, Post Traumatic Stress Syndrom, with similarities, operating at a “machine pace” the residual disappointment of chilbirth, traumatic interventions, & fear, overwhelms the mother’s nervous system.
Essentially 3-4 sessions of hypnotherapy will rebalance the new mothers brain chemistry so that her natural internal system simply “re-boots”. When we have long periods of interrupted or shorten sleeping, the brain does not release the levels of serotonin and endorphins needed which we generally get during a regular 8-10 hour nights sleep.
When that is interferred with over longer periods of time, this interruption can create distortions in the body and the brain.
Hypnotherapy allows the mother to achieve the deep state needed to “re-start” the brain chemistry and after 3-4 sessions over a few days time, her own internal system will come back to it’s full state.
Kathy Welter-Nichols, is a Clinical Hypnotherapist, HypnoBirthing certified educator and a Post Partum Doula
She also provides Labour Support and offers MBMY /training programs for new parents. 604-421-1722
Often we say we want something, Many of us don’t even get started on it because we fear we won’t get it.
What does your heart say about the matter? Stop for a moment, ask the question and “listen”. The heart only answers in the “now” frame, so if it’s not in the present time, its still the mind talking. The mind is endless, hoping to offer helpful antidotes to life’s quandaries. It’s always searching and seeking… the heart tells a different story… are you listening
Did someone tell you, something was too expensive and wasn’t meant for you?
That you can’t have it,
Can’t have what you want
Laughed or made fun of your hopes and dreams.
Establish a new internal mantra, speak these to yourself out loud so your voice gets strong saying them
I have a successful business
I’m married to an amazing man
I deserve to be happy
The only person who can build my confidence and self belief is me
Outside praise will never feel good enough, until I praise & reward myself
Tell the truth, use straight talk, avoid embellishments and distorting the facts –
Your deeper self is always listening
I am good enough
I am enough
I am valued and I value myself
I deserve better…
Choose not to take on negative comments from others – just leave them where they are – you have a choice.
Self worth and confidence is a skill you keep developing ACTION IS THE FIRST STEP
I’m not sure…
And because I’m not really into taking action – 90 days is the goal
Break it down into daily habits or smaller tasks and then lets time line it!
What’s the project? Now Create a To do List:
List what’s needed in the project
Take the project, and then run it to the final day, now look back to the beginning, right NOW
Now back to front, look back from that completed moment, and watch as every item
Drops into the “Time Line” Each day, what do you need to do to accomplish to get to the finished project?
Seek out people who can help you, encourage you, and make things easier.
What do you need to do to create this project ?
Decide Now, what must you do first
Small steps, take the first one, set up the plan… the goal, and then list your project in steps
Contact me today for more information on this program, it’s just brilliant. 604-421-1722
Sometimes its the hardest thing to do!
Who am I?
What do I want?
How do I get it?
How do I stop myself?
What if I don’t get it? What if I do?
What would I have to give up to get it? Maintain it?
I can’t have that
He’s too good for me
I’ll never be able to get that
Words carry energy
You start to believe them And other people start to believe whatever you are saying too
Where to start?
Go back to the start or origin of the story? There was a reason you began to distort, delete and generalize your power in this way. Do you remember why you created this version of yourself? Once a client shared with me, she was quite attractive in High School, and got teased by her brother a lot at home. He would joke in front of his friends, “oh she can get any guy” and they would all laugh at her. So she started to tell a different story to stop/interrupt their teasing. She would say things like “I’m not that, I’m not, I’m fat, I have freckles, I’m not that good in school, I’m not that smart with math or sciences…” and the guys would nod and leave her alone.
After a while they stopped teasing, but the story stuck there inside her mind rolling around. A story to make people stop bullying her, had become her story to share with the world.
Another client shared her father wouldn’t listen to her unless she had a problem, then he would begin solving it for her, and it was always the wrong way. And he always added that it was a lucky thing she had him to figure out her problems for her otherwise she would be lost in the world. At 55, she’s still suffering from this internal “installation” that she is lost without her father’s guidance.
Powerful positive thoughts and feelings far out-weigh the negative ones
Recognize your story, it’s origins, and take back your power from them. Cancel, clear, delete; and create brand new images. Take all the colour out of those images and make them grey, black & white and just blow the dust away. They are not true. You can be attractive and still be smart too. You can solve your own problems and if dad has no other way to connect with you that’s his loss.
Replace negative statements with a single positive word
First get rid of them, use : Cancel Clear Delete or Cancel Cancel Cancel. And just stop the thoughts.
What if I can’t what if I keep thinking them? Notice the minute they start and STOP right there, now do something else to distract you from that thought. Still persisting? Then hear is what you tell that persistent internal voice that is really just trying to help you “So What”. So what. So what.
Inner mantras you can do for yourself right here:
I am –
I am doing
I am being
I control my own thoughts, they no longer control me,
I am an abundant wealthy millionaire and I feel it in every cell of my body
I am in a successful relationship that feeds all levels of growth and potential
I believe in myself and my ability to create what my heart desires most
Your thoughts and words match your life, and these are the only ones you tell others. This is who I am. And they are the only things you listen to from your inner voice. Go ahead and connect to the inner voice and those things it sometimes says to you: “I’m not safe, things are out of my control, I’m suffering, I don’t know what to do”
These are all generalizations, that are deleting true information, they lump all the images and inner voices into one big jam up. And it stresses you and tumbles about in your mind. Go ahead now, and reframe these using the positive reframing:
I am safe right now
I am in control of my life right now
I choose not to suffer in any way
I know what to do to help myself right now
Your thoughts and actions create your reality
Make another choice, Right now!
A Great Exercise:
3 goals you want to come into fruition in the next 90 days and then next 12 months
What you really want and not what you have been told you should do or want?
What are they? List them now
Stop, take a breath , relax, what do you want?
A great place to start is what is your dream for your life? What is it? What was it – if you have to go back, what did you want to be when you were seven?