The other day as I was scanning new books at my local library, I noticed one about high-risk pregnancy. I picked it up and glanced through it.
To be perfectly honest, I stopped when I saw the list of factors that may put you in a high-risk pregnancy.
I honestly think it would put more than 50% of the birthing population as high-risk.
Some are, to be certain, legitimate. Placenta previa, where the placenta covers all or part of the cervix, is more complicated than regular pregnancy and requires education and cesarean birth in almost all cases. I can understand the worries with existing diabetes (particularly if poorly controlled) or high blood pressure, even previous birth defects or preterm births.
But some of the others had me flabbergasted at the level of fear present in obstetrics today.
Pregnancy at less than 18 years old or more than 35 years old.
Low-socio economic status
Being underweight or overweight
Fertility treatments
Having a previous pregnancy loss (yes, singular loss. It's estimated that 10-20% of pregnancies end in miscarriage, but many may feel they have had a late, heavy period).
Having five or more pregnancies
ETC.
The list was quite long.
Why is there such fear? I'm afraid - BRUTAL HONESTY FOLLOWS - that our culture has gone so far away from death being a part of life that we are fearful from the point of conception that someone might die. We are willing to do anything to prolong life. Mothers, in particular, are pushed to self-sacrifice in order to give life to children (I am not talking abortion here. I am talking general pregnancy).
I had a miscarriage before I had my son. It was devastating and took a long time to work through. I still cry thinking about my lost little one; hearing of another's loss provokes the same pain. I lost a child and will always mourn that.
However, I fully feel there was a reason my little one should not have been born. It was his time in life to go. I won't speculate as to what the reason was (that leads down a dark path). It doesn't make it any easier to accept his death, but it is what it is.
I certainly agree that obstetrics has saved some lives that would have otherwise been lost. However, we cannot use that nor the fear of death as an excuse for the mistreatment women, babies, and families currently deal with in the system. In many cases. when presented with an unknown, watching and waiting is less deadly than the "well, we must do SOMETHING ANYTHING" attitude so prevalent in modern medicine. (Certainly we've all heard the scares regarding the current radiation levels we're subjected to with unnecessary ct scans and x-rays? I've been x-rayed for a stomach virus and high fever before. Also, think of the current MRSA superbugs in hospitals due to over-prescribing antibiotics, and the chicken-pox vaccine leading to increased shingles cases. It's got to stop somewhere soon)
We need to stop being so fearful and take back our health. For the vast majority of women, pregnancy and birth are times of health. Your best bet - see a care provider who believes this to be true rather than a care provider who believes pregnancy and birth are times where something could go wrong at any time and you need careful monitoring. Ask your WHY? questions and get second opinions. Loose the "all that matters is a healthy baby" mantra.
Monday, December 20, 2010
New book - look out for similar titles!
Just came across a new book in our local library titled The Birth Partner Handbook.
Do not be confused!!!!
This is not The Birth Partner
!
I highly recommend The Birth Partner. This new one (by a different author), not so much at all. Very much in the vein of whatever the doctor says must be right.
Educate yourself and get The Birth Partnerinstead!
Do not be confused!!!!
This is not The Birth Partner
!I highly recommend The Birth Partner. This new one (by a different author), not so much at all. Very much in the vein of whatever the doctor says must be right.
Educate yourself and get The Birth Partner
instead!
Monday, December 13, 2010
How do you know when to go to the hospital/birth center in labor? An observation.
Last night as I was waiting in the ER with my dad (minor surgical complication; he's fine), I observed the strangest thing - three women entered and were directed to the OB admission area. The strange part - none appeared to be in active labor. One in particular (only 37 weeks) sat for at least 10 minutes nearby without even a peep or a squirm. The other two (both 38 weeks) talked with nurses easily, filled out admission paperwork, and climbed into wheelchairs.
The thought in my head - Why are they here yet?!
In pregnancy, among the labor and delivery horror stories, I also often heard about the women who went in too early - "Oh don't worry, I got sent home 'x' times before they kept me."
Did no one bother to tell them that they can (and should) stay at home as long as possible?
I tell women (even those planning an epidural) that in normal labor, you should look for 4-1-1 before heading in. This helps reduce the interventions you may "need" and gets you to the hospital at the point when labor is more likely to keep going rather than stall. Getting to the hospital earlier may even get you there at a point when you can't yet have an epidural (depending on your hospital and anesthesiologist).
With 4-1-1, contractions are about 4 minutes apart, last about 1 minute each, and have been doing so for about 1 hour.
Disclaimer #1: Follow 4-1-1 unless you have another reason to go to the hospital ASAP - bleeding, foul smell with vaginal leaking, feeling something through the cervix/vagina, if you feel that labor is going too quickly, or if you are not yet 38 weeks. I'm not a doctor and don't pretend to be one :)
Disclaimer #2: Don't go to the hospital at all if you can help it! Find a good midwife and birthing center or a good homebirth midwife if you're low-risk in pregnancy. It's not just a "fad"; it's good medicine.
The thought in my head - Why are they here yet?!
In pregnancy, among the labor and delivery horror stories, I also often heard about the women who went in too early - "Oh don't worry, I got sent home 'x' times before they kept me."
Did no one bother to tell them that they can (and should) stay at home as long as possible?
I tell women (even those planning an epidural) that in normal labor, you should look for 4-1-1 before heading in. This helps reduce the interventions you may "need" and gets you to the hospital at the point when labor is more likely to keep going rather than stall. Getting to the hospital earlier may even get you there at a point when you can't yet have an epidural (depending on your hospital and anesthesiologist).
With 4-1-1, contractions are about 4 minutes apart, last about 1 minute each, and have been doing so for about 1 hour.
Disclaimer #1: Follow 4-1-1 unless you have another reason to go to the hospital ASAP - bleeding, foul smell with vaginal leaking, feeling something through the cervix/vagina, if you feel that labor is going too quickly, or if you are not yet 38 weeks. I'm not a doctor and don't pretend to be one :)
Disclaimer #2: Don't go to the hospital at all if you can help it! Find a good midwife and birthing center or a good homebirth midwife if you're low-risk in pregnancy. It's not just a "fad"; it's good medicine.
Monday, December 6, 2010
Traumatic Birth – or why some women may prefer cesarean birth
Lately, I’ve found myself wondering why some women feel cesarean birth is better than vaginal birth. It’s been something I questioned before I was pregnant and was particularly confusing when I was confronted with my own cesarean.
For me, I always wanted a natural, med-free, intervention-free birth. It was devastating for me to be confronted with a cesarean. The recovery was particularly difficult, and the couple of times I “overdid it” really were painful and debilitating.
I’m looking at future pregnancies with fear, as complications during pregnancy are more common after cesarean – placental issues, tubal pregnancies, secondary infertility. The VBAC fight was never one I wanted to be faced with, but here I am.
So how could someone be not just satisfied, but even pleased, with this? I’m slowly beginning to understand.
Recently, I read an article about post traumatic stress disorder following birth; it’s on the rise. As a medical system, we need to acknowledge that in an age where 1 in 10 women suffer from postpartum depression, much less PTSD, that it is apparently not about “just a healthy baby.”
Women need to have the opportunity to mourn the births they have lost. The ideal birth, whatever it is for that particular woman, needs to be acknowledged, and if at all possible, pursued. For me – I lost my first birth to major abdominal surgery. For some, it’s losing the ideal of pain management when a planned epidural doesn’t work, or just being able to go into labor before the pressure of induction begins.
Many women see the cesarean as what saved them – whether it did or not. Maybe it saved them from another traumatic induction lasting 48 hours or more. Maybe it was a way of attempting to control the unknown. Maybe the recovery temporarily saved them from additional childcare and household responsibilities.
As a birth professional, I’ll be honest that I’m a little biased about the solution. But fortunately there are studies and guidelines to back me up. (I’ll list them at the end.)
Childbirth education should be expanded, encouraged, and absolutely available to all. It needs to involved couples working through both their fears and expectations. It must involve current research about normal labor processes and when interventions are medically necessary as opposed to simply routine. It should provide an opportunity for couples to build relationships with others in the childbearing year, expanding their network of support.
Doula care needs to be covered by Medicaid and private insurance. Having a labor doula can decrease the need for cesarean by up to 50%. Postpartum doulas can fill the role once done by the extended family – helping the new family adjust with each child added to the family.
Midwifery care should be more widely available, particularly in rural areas where OB presence is minimal. Low-risk women should be seen first by midwives and referred to OBs as necessary.
Women with negative birth experience should report these to their care providers with the intent that questions are answered and care is altered. It wasn’t too long ago that women and families decided it was unacceptable for fathers to be in the waiting room during the birth of their own children, or that women shouldn’t be forced to undergo “Twilight Sleep” and not be mentally and emotionally present at their own birthing.
It should be no different now that we refuse to accept the parts of the system that make us uncomfortable and that are not supported by rigorous research. What we’re comfortable with may be different woman to woman – med-free, highly managed, etc – but it’s time for individualized care again.
No woman should have to feel that major abdominal surgery was an easier and more acceptable solution that the birth route her body was made and designed for.
Studies and Resources:
Expecting Trouble
– written by an obstetrician who feels 80-90% of women should have midwifery prenatal care and at least 70-80% should deliver with a midwife.
The Doula Book
– numerous studies about the benefits of a doula – from childbirth satisfaction to birth outcomes.
Healthy People 2020 Guidelines - reduce cesareans, among many others
For me, I always wanted a natural, med-free, intervention-free birth. It was devastating for me to be confronted with a cesarean. The recovery was particularly difficult, and the couple of times I “overdid it” really were painful and debilitating.
I’m looking at future pregnancies with fear, as complications during pregnancy are more common after cesarean – placental issues, tubal pregnancies, secondary infertility. The VBAC fight was never one I wanted to be faced with, but here I am.
So how could someone be not just satisfied, but even pleased, with this? I’m slowly beginning to understand.
Recently, I read an article about post traumatic stress disorder following birth; it’s on the rise. As a medical system, we need to acknowledge that in an age where 1 in 10 women suffer from postpartum depression, much less PTSD, that it is apparently not about “just a healthy baby.”
Women need to have the opportunity to mourn the births they have lost. The ideal birth, whatever it is for that particular woman, needs to be acknowledged, and if at all possible, pursued. For me – I lost my first birth to major abdominal surgery. For some, it’s losing the ideal of pain management when a planned epidural doesn’t work, or just being able to go into labor before the pressure of induction begins.
Many women see the cesarean as what saved them – whether it did or not. Maybe it saved them from another traumatic induction lasting 48 hours or more. Maybe it was a way of attempting to control the unknown. Maybe the recovery temporarily saved them from additional childcare and household responsibilities.
As a birth professional, I’ll be honest that I’m a little biased about the solution. But fortunately there are studies and guidelines to back me up. (I’ll list them at the end.)
Childbirth education should be expanded, encouraged, and absolutely available to all. It needs to involved couples working through both their fears and expectations. It must involve current research about normal labor processes and when interventions are medically necessary as opposed to simply routine. It should provide an opportunity for couples to build relationships with others in the childbearing year, expanding their network of support.
Doula care needs to be covered by Medicaid and private insurance. Having a labor doula can decrease the need for cesarean by up to 50%. Postpartum doulas can fill the role once done by the extended family – helping the new family adjust with each child added to the family.
Midwifery care should be more widely available, particularly in rural areas where OB presence is minimal. Low-risk women should be seen first by midwives and referred to OBs as necessary.
Women with negative birth experience should report these to their care providers with the intent that questions are answered and care is altered. It wasn’t too long ago that women and families decided it was unacceptable for fathers to be in the waiting room during the birth of their own children, or that women shouldn’t be forced to undergo “Twilight Sleep” and not be mentally and emotionally present at their own birthing.
It should be no different now that we refuse to accept the parts of the system that make us uncomfortable and that are not supported by rigorous research. What we’re comfortable with may be different woman to woman – med-free, highly managed, etc – but it’s time for individualized care again.
No woman should have to feel that major abdominal surgery was an easier and more acceptable solution that the birth route her body was made and designed for.
Studies and Resources:
Expecting Trouble
– written by an obstetrician who feels 80-90% of women should have midwifery prenatal care and at least 70-80% should deliver with a midwife.The Doula Book
– numerous studies about the benefits of a doula – from childbirth satisfaction to birth outcomes.Healthy People 2020 Guidelines - reduce cesareans, among many others
Post Traumatic Stress Disorder After Childbirth - particularly look at Ten Questions to Ask
Tuesday, November 30, 2010
Website Relaunch!
Just relaunched my webpage. Please check it out and let me know what you think!
Thanks!
Wednesday, November 10, 2010
FAQs about Doula Services with Healthy Mama Childbirth
What is a doula?
A doula is a trained labor professional who provides support during labor and birthing. The word doula comes from the Greek, meaning “with woman.”
What help do you give as a labor doula?
I provide emotional, physical, and informational care throughout the entire course of labor. I can give you information about labor and birth to help you make informed choices, reminding you of what you have learned in classes and of your desires for labor and birthing. I provide emotional support in the form of encouragement and constant presence. I can give you suggestions to help your individual labor progress well and help you have a healthy birth. I support you physically with comfort techniques, such massage and counter pressure. I also support your partner, giving him suggestions and help for taking an active role in your labor support, allowing him to take breaks, and giving him informational and emotional reassurance regarding the birthing process. I will help you labor at home if you desire. I may also help you know when to go to the hospital or birthing center, or when to call the midwife.
What support do you not give as a labor doula?
A doula never provides medical care. I am however trained in medical interventions and can explain how they work as well as the pros and cons.
I do not replace your partner; instead I support the couple. I will help as much or as little as the couple desires. Your partner has emotional investment in you; a doula usually does not. This is both a pro and a con. Your partner’s emotional investment in you allows him to truly understand you and provide care. A doula’s lack of emotional ties allows her to be objective and unbiased in your care.
What are the benefits of having a doula? From The Doula Book (Klaus, Kennell, Klaus).
“In studies of over 5000 women involving comparisons of outcomes with and without such support [as a doula], we have seen a major reduction in the length of labor, a greater than 50 percent drop in cesarean sections, [and] a remarkable drop in the mothers’ need for pain medication.”
Why can’t I just rely on my doctor for everything?
You can, and you should, rely on your doctor for medical advice.
Unfortunately, many doctors don’t seem to have the time necessary for support. Are your prenatal visits less than 30 minutes? Do you have long wait times to see the doctor? If these are YES, then you probably have unanswered questions. Most simply don’t have the time to address basic needs such as what you eat, how you manage stress, or how you plan to arrange life post-partum.
Many women find that their doctor is not present during labor. Most doctors do not come until the pushing stage. Your doctor may not be on-call when you go into labor, and someone you may never have met may be catching your baby.
A doula is the only trained professional who will be present with you throughout your labor, birthing, and early postpartum period.
Aren’t the nurses there to help me? What about my husband/partner?
Yes, the nurses are there to help you, but the help they may be able to provide might not be what you need or expect. Nurses are responsible for a number of patients, limiting their time to spend individually with you. Additionally, their responsibilities also include a variety of clinical tasks and paperwork. A nurse will certainly help you when she is able, but you will likely find you need information, comfort, and support “NOW” rather than when the nurse is finished with another laboring mother.
As for husbands and partners – while many men feel confident before labor begins, they often find this confidence wanes as labor progresses. They may resent the fact that they have to put aside their own needs and fears to support a laboring woman. Additionally, most men lack the experience and training necessary to continually provide comfort, support, and coping techniques required for a laboring woman. Many men, no matter how well trained in childbirth education classes, find recall and actual practice of techniques more difficult than they imagined.
It is normal for men to feel this way, and doulas are there to both validate the partner’s feelings and give him the support to in turn support his partner, the laboring mother. A doula can offer the informational and emotional support the partner needs. Some partners become overwhelmed just when the laboring mother needs to most support; a doula can allow him to take a quick break while still meeting the laboring mother’s needs.
What if I want an epidural? Are you going to try to make me feel bad or talk down to me?
No! I firmly believe that each woman (and couple) needs to make the choices they are most comfortable with at the present time. I feel my job is to help you make an informed choice – I want you to know and understand all the benefits and risks “common” procedures (such as epidurals and IVs) have.
I do support natural, unmedicated childbirth, and I feel that every woman is more than capable of having that kind of birth. But I won’t think you’re a failure if you don’t have an unmedicated birth. The thing I believe is most important is a safe, satisfying, healthy birth. Some women have it with epidurals, some don’t. Some women have it with natural childbirth, some don’t.
How do you feel about hospital birth? Do you think all women should have home births?
I operate fully under ICEA’s motto of “freedom of choice based on knowledge of alternatives.” Therefore, I fully support women and families in the choices they make in childbirth from elective cesarean to home birth, whether I would personally make the same decision or not.
I fully support home birth. I also fully support each family as they make the decision of birthing location based on both the knowledge of facts and personal needs and comfort levels. Many women in the United States choose to birth in a hospital or birthing center.
Is doula support covered by insurance?
Usually no. However, some families have been able to use funds from their health savings accounts for doula services. Most families find that doula services are worth the price.
I offer payment plans for my services. I also offer some services at an add-on price. However, all basic doula services – prenatal visits, on-call period, labor and birthing support, postpartum visit, and phone/email consultation – are included in the basic price.
Also, because I am currently in the process of certification through ICEA, I offer my services at a lower price than a certified doula.
A doula is a trained labor professional who provides support during labor and birthing. The word doula comes from the Greek, meaning “with woman.”
What help do you give as a labor doula?
I provide emotional, physical, and informational care throughout the entire course of labor. I can give you information about labor and birth to help you make informed choices, reminding you of what you have learned in classes and of your desires for labor and birthing. I provide emotional support in the form of encouragement and constant presence. I can give you suggestions to help your individual labor progress well and help you have a healthy birth. I support you physically with comfort techniques, such massage and counter pressure. I also support your partner, giving him suggestions and help for taking an active role in your labor support, allowing him to take breaks, and giving him informational and emotional reassurance regarding the birthing process. I will help you labor at home if you desire. I may also help you know when to go to the hospital or birthing center, or when to call the midwife.
What support do you not give as a labor doula?
A doula never provides medical care. I am however trained in medical interventions and can explain how they work as well as the pros and cons.
I do not replace your partner; instead I support the couple. I will help as much or as little as the couple desires. Your partner has emotional investment in you; a doula usually does not. This is both a pro and a con. Your partner’s emotional investment in you allows him to truly understand you and provide care. A doula’s lack of emotional ties allows her to be objective and unbiased in your care.
What are the benefits of having a doula? From The Doula Book (Klaus, Kennell, Klaus).
“In studies of over 5000 women involving comparisons of outcomes with and without such support [as a doula], we have seen a major reduction in the length of labor, a greater than 50 percent drop in cesarean sections, [and] a remarkable drop in the mothers’ need for pain medication.”
Why can’t I just rely on my doctor for everything?
You can, and you should, rely on your doctor for medical advice.
Unfortunately, many doctors don’t seem to have the time necessary for support. Are your prenatal visits less than 30 minutes? Do you have long wait times to see the doctor? If these are YES, then you probably have unanswered questions. Most simply don’t have the time to address basic needs such as what you eat, how you manage stress, or how you plan to arrange life post-partum.
Many women find that their doctor is not present during labor. Most doctors do not come until the pushing stage. Your doctor may not be on-call when you go into labor, and someone you may never have met may be catching your baby.
A doula is the only trained professional who will be present with you throughout your labor, birthing, and early postpartum period.
Aren’t the nurses there to help me? What about my husband/partner?
Yes, the nurses are there to help you, but the help they may be able to provide might not be what you need or expect. Nurses are responsible for a number of patients, limiting their time to spend individually with you. Additionally, their responsibilities also include a variety of clinical tasks and paperwork. A nurse will certainly help you when she is able, but you will likely find you need information, comfort, and support “NOW” rather than when the nurse is finished with another laboring mother.
As for husbands and partners – while many men feel confident before labor begins, they often find this confidence wanes as labor progresses. They may resent the fact that they have to put aside their own needs and fears to support a laboring woman. Additionally, most men lack the experience and training necessary to continually provide comfort, support, and coping techniques required for a laboring woman. Many men, no matter how well trained in childbirth education classes, find recall and actual practice of techniques more difficult than they imagined.
It is normal for men to feel this way, and doulas are there to both validate the partner’s feelings and give him the support to in turn support his partner, the laboring mother. A doula can offer the informational and emotional support the partner needs. Some partners become overwhelmed just when the laboring mother needs to most support; a doula can allow him to take a quick break while still meeting the laboring mother’s needs.
What if I want an epidural? Are you going to try to make me feel bad or talk down to me?
No! I firmly believe that each woman (and couple) needs to make the choices they are most comfortable with at the present time. I feel my job is to help you make an informed choice – I want you to know and understand all the benefits and risks “common” procedures (such as epidurals and IVs) have.
I do support natural, unmedicated childbirth, and I feel that every woman is more than capable of having that kind of birth. But I won’t think you’re a failure if you don’t have an unmedicated birth. The thing I believe is most important is a safe, satisfying, healthy birth. Some women have it with epidurals, some don’t. Some women have it with natural childbirth, some don’t.
How do you feel about hospital birth? Do you think all women should have home births?
I operate fully under ICEA’s motto of “freedom of choice based on knowledge of alternatives.” Therefore, I fully support women and families in the choices they make in childbirth from elective cesarean to home birth, whether I would personally make the same decision or not.
I fully support home birth. I also fully support each family as they make the decision of birthing location based on both the knowledge of facts and personal needs and comfort levels. Many women in the United States choose to birth in a hospital or birthing center.
Is doula support covered by insurance?
Usually no. However, some families have been able to use funds from their health savings accounts for doula services. Most families find that doula services are worth the price.
I offer payment plans for my services. I also offer some services at an add-on price. However, all basic doula services – prenatal visits, on-call period, labor and birthing support, postpartum visit, and phone/email consultation – are included in the basic price.
Also, because I am currently in the process of certification through ICEA, I offer my services at a lower price than a certified doula.
FAQs about Childbirth Education with Healthy Mama Childbirth
Why can’t I just take a hospital class?
By and large, hospital classes are not designed to give you all the coping strategies I will. Hospital classes operate under this statistic – more than 80% of women get epidurals. Hospital-based childbirth educators may not be allowed to tell you that “routine” procedures such as IVs may be politely refused or modified (in this example, a heparin lock may be placed for access without compromising mobility).
Additionally, hospital classes are usually much larger than independent classes. Smaller classes allow for discussion and addressing individual concerns and needs.
A true prepared childbirth course should present you with all options. This is allows you to give true informed consent, particularly in situations when you may choose to have an IV or epidural, for example. This component of true informed choice makes an independent childbirth education class your best option.
Why are your prepared childbirth courses six weeks?
I believe that part of the reason we fear childbirth is because we don’t understand it. Our great-grandmothers learned pregnancy, birth, and breastfeeding from their mothers. Women understood that labor and birthing were skills to be learned. They learned from observation.
We’re beginning to understand that these skills still need to be learned. These skills take time, and learning such as this can’t be rushed. Rushing the information results in more difficult recall and less ease of use during birthing.
Besides information, my classes are designed to allow ample practice time as a place to simply “try out” a variety of techniques. I also aim to give each couple the time to discover your needs and beliefs surrounding birthing – time you may not have otherwise set aside.
Why can’t I just rely on my doctor for everything?
You can, and you should, rely on your doctor for medical advice.
Unfortunately, many doctors don’t seem to have the time necessary for routine questions. Are your prenatal visits less than 30 minutes? Do you have long wait times to see the doctor? If these are YES, then you probably have unanswered questions. Most simply don’t have the time to address basic needs such as what you eat, how you manage stress, or how you plan to arrange life post-partum.
Childbirth education gives you the skills necessary to communicate your needs and concerns in an effective manner during your prenatal visits. It also gives you the skills to find additional information outside the doctor’s office (not “Dr. Google” either!)
When you are an informed consumer, you are better able to ask questions during office visits. Childbirth education empowers you and allows you to have a better relationship with your doctor.
Aren’t the nurses there to help me during labor? What about my husband/partner?
Yes, the nurses are there to help you, but the help they may be able to provide might not be what you need or expect. Nurses are responsible for a number of patients, limiting their time to spend individually with you. Additionally, their responsibilities also include a variety of clinical tasks and paperwork. A nurse will certainly help you when she is able, but you will likely find you need information, comfort, and support “NOW” rather than when the nurse is finished with another laboring mother.
As for husbands and partners – while many men feel confident before labor begins, they often find this confidence wanes as labor progresses. They may resent the fact that they have to put aside their own needs and fears to support a laboring woman. Additionally, most men lack the experience and training necessary to continually provide comfort, support, and coping techniques required for a laboring woman. Many men, no matter how well trained in childbirth education classes, find recall and actual practice of techniques more difficult than they imagined.
Childbirth education prepares you for this reality ahead of the game. This gives you time to consider how you will deal with labor and to practice techniques that you can use. It also gives you information about normal labor and possible variations ahead of time so you are better prepared for what you encounter.
What if I want an epidural? Are you going to try to make me feel bad or talk down to me?
No! I firmly believe that each woman (and couple) needs to make the choices they are most comfortable with at the present time. I feel my job is to help you make an informed choice – I want you to know and understand all the benefits and risks “common” procedures (such as epidurals and IVs) have.
I do support natural, unmedicated childbirth, and I feel that every woman is more than capable of having that kind of birth. But I won’t think you’re a failure if you don’t have an unmedicated birth. The thing I believe is most important is a safe, satisfying, healthy birth. Some women have it with epidurals, some don’t. Some women have it with natural childbirth, some don’t.
Some women find that childbirth education allows them to “compromise,” delaying an epidural when they originally hadn’t thought that to be an option. It also gives them more options to try in the event the epidural “doesn’t take all the way,” a phenomenon that occurs sometimes when using this method of pain management.
Am I going to look stupid doing some kind of crazy breathing that my friend says didn’t help her?
Nope! I do believe that breathing patterns and techniques help with labor, but again it’s about comfort level. Personally, I can’t currently do proper yoga breathing; it’s too slow for me. Instead, I slow my breathing down to a comfortable, relaxing level. This works for me, and it’s the point of the breathing in yoga.
We will discuss your comfort level and current ways of managing stress. Your current methods can then be adapted for labor, and we can build on these with others that may work for you.
How do you feel about hospital birth? Do you think all women should have home births?
I operate fully under ICEA’s motto of “freedom of choice based on knowledge of alternatives.” Therefore, I fully support women and families in the choices they make in childbirth from elective cesarean to home birth, whether I would personally make the same decision or not.
I fully support home birth. I also fully support each family as they make the decision of birthing location based on both the knowledge of facts and personal needs and comfort levels. Many women in the United States choose to birth in a hospital or birthing center.
Is independent childbirth education covered by insurance?
Usually no. However, some families have been able to use funds from their health savings accounts for childbirth education. However, most families find that it is are worth the price. I offer a variety of classes, including customized private classes. Also, because I am currently in the process of certification through ICEA, I offer my services at a lower price than a certified childbirth educator.
By and large, hospital classes are not designed to give you all the coping strategies I will. Hospital classes operate under this statistic – more than 80% of women get epidurals. Hospital-based childbirth educators may not be allowed to tell you that “routine” procedures such as IVs may be politely refused or modified (in this example, a heparin lock may be placed for access without compromising mobility).
Additionally, hospital classes are usually much larger than independent classes. Smaller classes allow for discussion and addressing individual concerns and needs.
A true prepared childbirth course should present you with all options. This is allows you to give true informed consent, particularly in situations when you may choose to have an IV or epidural, for example. This component of true informed choice makes an independent childbirth education class your best option.
Why are your prepared childbirth courses six weeks?
I believe that part of the reason we fear childbirth is because we don’t understand it. Our great-grandmothers learned pregnancy, birth, and breastfeeding from their mothers. Women understood that labor and birthing were skills to be learned. They learned from observation.
We’re beginning to understand that these skills still need to be learned. These skills take time, and learning such as this can’t be rushed. Rushing the information results in more difficult recall and less ease of use during birthing.
Besides information, my classes are designed to allow ample practice time as a place to simply “try out” a variety of techniques. I also aim to give each couple the time to discover your needs and beliefs surrounding birthing – time you may not have otherwise set aside.
Why can’t I just rely on my doctor for everything?
You can, and you should, rely on your doctor for medical advice.
Unfortunately, many doctors don’t seem to have the time necessary for routine questions. Are your prenatal visits less than 30 minutes? Do you have long wait times to see the doctor? If these are YES, then you probably have unanswered questions. Most simply don’t have the time to address basic needs such as what you eat, how you manage stress, or how you plan to arrange life post-partum.
Childbirth education gives you the skills necessary to communicate your needs and concerns in an effective manner during your prenatal visits. It also gives you the skills to find additional information outside the doctor’s office (not “Dr. Google” either!)
When you are an informed consumer, you are better able to ask questions during office visits. Childbirth education empowers you and allows you to have a better relationship with your doctor.
Aren’t the nurses there to help me during labor? What about my husband/partner?
Yes, the nurses are there to help you, but the help they may be able to provide might not be what you need or expect. Nurses are responsible for a number of patients, limiting their time to spend individually with you. Additionally, their responsibilities also include a variety of clinical tasks and paperwork. A nurse will certainly help you when she is able, but you will likely find you need information, comfort, and support “NOW” rather than when the nurse is finished with another laboring mother.
As for husbands and partners – while many men feel confident before labor begins, they often find this confidence wanes as labor progresses. They may resent the fact that they have to put aside their own needs and fears to support a laboring woman. Additionally, most men lack the experience and training necessary to continually provide comfort, support, and coping techniques required for a laboring woman. Many men, no matter how well trained in childbirth education classes, find recall and actual practice of techniques more difficult than they imagined.
Childbirth education prepares you for this reality ahead of the game. This gives you time to consider how you will deal with labor and to practice techniques that you can use. It also gives you information about normal labor and possible variations ahead of time so you are better prepared for what you encounter.
What if I want an epidural? Are you going to try to make me feel bad or talk down to me?
No! I firmly believe that each woman (and couple) needs to make the choices they are most comfortable with at the present time. I feel my job is to help you make an informed choice – I want you to know and understand all the benefits and risks “common” procedures (such as epidurals and IVs) have.
I do support natural, unmedicated childbirth, and I feel that every woman is more than capable of having that kind of birth. But I won’t think you’re a failure if you don’t have an unmedicated birth. The thing I believe is most important is a safe, satisfying, healthy birth. Some women have it with epidurals, some don’t. Some women have it with natural childbirth, some don’t.
Some women find that childbirth education allows them to “compromise,” delaying an epidural when they originally hadn’t thought that to be an option. It also gives them more options to try in the event the epidural “doesn’t take all the way,” a phenomenon that occurs sometimes when using this method of pain management.
Am I going to look stupid doing some kind of crazy breathing that my friend says didn’t help her?
Nope! I do believe that breathing patterns and techniques help with labor, but again it’s about comfort level. Personally, I can’t currently do proper yoga breathing; it’s too slow for me. Instead, I slow my breathing down to a comfortable, relaxing level. This works for me, and it’s the point of the breathing in yoga.
We will discuss your comfort level and current ways of managing stress. Your current methods can then be adapted for labor, and we can build on these with others that may work for you.
How do you feel about hospital birth? Do you think all women should have home births?
I operate fully under ICEA’s motto of “freedom of choice based on knowledge of alternatives.” Therefore, I fully support women and families in the choices they make in childbirth from elective cesarean to home birth, whether I would personally make the same decision or not.
I fully support home birth. I also fully support each family as they make the decision of birthing location based on both the knowledge of facts and personal needs and comfort levels. Many women in the United States choose to birth in a hospital or birthing center.
Is independent childbirth education covered by insurance?
Usually no. However, some families have been able to use funds from their health savings accounts for childbirth education. However, most families find that it is are worth the price. I offer a variety of classes, including customized private classes. Also, because I am currently in the process of certification through ICEA, I offer my services at a lower price than a certified childbirth educator.
Monday, November 8, 2010
Another Care Provider in Pregnancy - Chiropractor
I was unfortunate enough this weekend to pull out my back again (and follow that up with church nursery), so I was at the chiropractor's today. It reminded me of when I pulled my back out during pregnancy, so I thought I'd share.
I feel there is no reason a pregnant woman should have to deal with "regular" backaches during pregnancy. We all act like this is totally normal, but it isn't.
Backache during pregnancy is easily treated (or at least managed) by a chiropractor. I pulled my back during the second trimester. Once it was remedied with a few trips to the chiropractor, I had no more back pain the rest of the pregnancy - even putting on those fifty pounds. (And reminder, I'm only 5'2"!)
Chiropractic care in pregnancy will help return your body to proper alignment. A good chiropractor will also help you with posture and sleeping positions that will help your body to stay pain free. The adjustments aren't painful.
At the start of the injury, you may find yourself at the chiropractor's office a few times the first couple of weeks. This is pretty normal as your body takes the time to settle into the new alignment. The chiropractor will then start to spread your visits out more. After my back was feeling great, I saw the chiropractor once a month as a check-up and slight adjustment.
I recommend pregnant women not wait until the injury is severe, or even until there is an "injury." Back pain should be looked into immediately if possible to lessen the number of adjustments needed for health.
See a good chiropractor that you feel you can trust. It's preferable (in my opinion) that you see one who has an in-house massage therapist or two; massage helps the adjustments settle in and take hold rather than moving back into the painful position.
Also, see a chiropractor who is experienced with pregnant patients. A good chiropractor will tell you if they are or not. When I was going to have the Webster technique (a chiropractic technique to assist in turning a breech baby), my chiropractor told me that while he was trained in it and comfortable seeing pregnant women for other therapies and adjustments, he hadn't done the Webster technique since college. He helped me find someone in the area who was trained and experienced in the technique - and I respect him greatly for being honest with me and helping me.
You might be surprised that your insurance will usually cover chiropractic care. My current insurance, as well as the insurance I had while pregnant, cover up 20 visits a year with my co-pay. You may want to check with your insurance to see if these visits need to be preauthorized, or ask the chiropractor's office staff when you call to make an appointment.
Wednesday, October 27, 2010
Maternal Satisfaction and Pain
If I were to do a poll about labor concerns, most people would say what they fear(ed) most about childbirth was the pain. What’s more, when most people just think of a word they associate with childbirth, the first to come to mind is pain.
(As a side note: how sad is it that joy, family, or wonder are not the first words. Instead it is pain, epidural, loss of control…)
I digress – pain and its management are very central in childbirth education models (especially in Western thought). There are many different theories of pain – all worth studying.
But the research that surprised me the most indicated that pain is not chief when it comes to satisfaction in childbirth.
Are you surprised too?
Then, of course, since its good research, it didn’t surprise me so much and it even began to make a lot of sense.
It didn’t matter so much as far as pain and its management. Women with epidurals were just as likely as women without medical pain management (drugs) to feel dissatisfied with their birth over these points – information provided, concerns recognized, and support received.
Let me break that down again – women with epidurals were dissatisfied with their birth if they felt the doctor and nurses didn’t give them enough information, didn’t address their concerns, and/or didn’t give enough support.
In fact, research seems to indicate that patients are more likely to sue if they feel they are not being communicated with and included in decision making. (see below for citation)
Can we all collectively say “Wow”?
This totally knocks the old “all that matters is a healthy baby” out of the picture. Also out the door is the idea that an epidural is the “Cadillac” of pain management.
Insurance companies, doctors, nurses, hospitals, clinics, politicians, feminists, women, and men should all be jumping all over this.
Why is it not happening?
Because this model of care in addressing all concerns, providing all information, and giving all levels of support requires a lot of time. If I were better with numbers, I’d run them to see if it confirms my suspicions – it’s cheaper to pay high malpractice premiums than it is to take fewer clients in order to spend more time with each one.
I’ve said it before, but it bears repeating – OBs (and some midwives as well as general practitioners for regular health matters) do not spend enough time counseling patients on preventative medicine and healthy lifestyle choices. How many of us were asked about our eating during our pregnancy, unless we were “gaining too much weight”? How many heard that exercise could be continued but to take it easy, without regard for our current level of fitness?
I’m getting off track – pain, however central in our minds before labor, appears to take a lower position of importance during labor.
Yes, it’s still painful.
Yes, we still want to know how to deal with it – either with coping techniques or drugs.
But for women with or without epidurals, even those with absence or pain or sensation, still have a greater need for this – information and the support it gives.
Once we recognize that and true informed consent happens, it will change everything about birthing in America.
The article that is the main focus of this: http://www.ajog.org/article/S0002-9378%2802%2970189-0/abstract Results: Four factors—personal expectations, the amount of support from caregivers, the quality of the caregiver-patient relationship, and involvement in decision making—appear to be so important that they override the influences of age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions, and continuity of care, when women evaluate their childbirth experiences. Conclusion: The influences of pain, pain relief, and intrapartum medical interventions on subsequent satisfaction are neither as obvious, as direct, nor as powerful as the influences of the attitudes and behaviors of the caregivers.
Article concerning likelihood of lawsuit: Communication gaffes: the root cause of malpractice claims. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201002/
Another article regarding pain management and maternal satisfaction:
Abstract – Maternal Satisfaction and Pain Control in Women Electing Natural Birth – I think this one comes to the wrong conclusion that “survey results suggest that concerns about epidurals and their effect on the baby, greater than anticipated labor pain, perceived failure of requesting an epidural, and longer duration of labor may have accounted for these findings [of being less satisfied with birth].” I think further study is needed, but that it is good to point out what the study did certainly find: “88% of women who requested an epidural for pain reported being less satisfied with their childbirth experience than those who did not, despite lower pain intensity.” http://journals.lww.com/rapm/Abstract/2001/09000/Maternal_Satisfaction_and_Pain_Control_in_Women.14.aspx
(As a side note: how sad is it that joy, family, or wonder are not the first words. Instead it is pain, epidural, loss of control…)
I digress – pain and its management are very central in childbirth education models (especially in Western thought). There are many different theories of pain – all worth studying.
But the research that surprised me the most indicated that pain is not chief when it comes to satisfaction in childbirth.
Are you surprised too?
Then, of course, since its good research, it didn’t surprise me so much and it even began to make a lot of sense.
It didn’t matter so much as far as pain and its management. Women with epidurals were just as likely as women without medical pain management (drugs) to feel dissatisfied with their birth over these points – information provided, concerns recognized, and support received.
Let me break that down again – women with epidurals were dissatisfied with their birth if they felt the doctor and nurses didn’t give them enough information, didn’t address their concerns, and/or didn’t give enough support.
In fact, research seems to indicate that patients are more likely to sue if they feel they are not being communicated with and included in decision making. (see below for citation)
Can we all collectively say “Wow”?
This totally knocks the old “all that matters is a healthy baby” out of the picture. Also out the door is the idea that an epidural is the “Cadillac” of pain management.
Insurance companies, doctors, nurses, hospitals, clinics, politicians, feminists, women, and men should all be jumping all over this.
Why is it not happening?
Because this model of care in addressing all concerns, providing all information, and giving all levels of support requires a lot of time. If I were better with numbers, I’d run them to see if it confirms my suspicions – it’s cheaper to pay high malpractice premiums than it is to take fewer clients in order to spend more time with each one.
I’ve said it before, but it bears repeating – OBs (and some midwives as well as general practitioners for regular health matters) do not spend enough time counseling patients on preventative medicine and healthy lifestyle choices. How many of us were asked about our eating during our pregnancy, unless we were “gaining too much weight”? How many heard that exercise could be continued but to take it easy, without regard for our current level of fitness?
I’m getting off track – pain, however central in our minds before labor, appears to take a lower position of importance during labor.
Yes, it’s still painful.
Yes, we still want to know how to deal with it – either with coping techniques or drugs.
But for women with or without epidurals, even those with absence or pain or sensation, still have a greater need for this – information and the support it gives.
Once we recognize that and true informed consent happens, it will change everything about birthing in America.
The article that is the main focus of this: http://www.ajog.org/article/S0002-9378%2802%2970189-0/abstract Results: Four factors—personal expectations, the amount of support from caregivers, the quality of the caregiver-patient relationship, and involvement in decision making—appear to be so important that they override the influences of age, socioeconomic status, ethnicity, childbirth preparation, the physical birth environment, pain, immobility, medical interventions, and continuity of care, when women evaluate their childbirth experiences. Conclusion: The influences of pain, pain relief, and intrapartum medical interventions on subsequent satisfaction are neither as obvious, as direct, nor as powerful as the influences of the attitudes and behaviors of the caregivers.
Article concerning likelihood of lawsuit: Communication gaffes: the root cause of malpractice claims. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201002/
Another article regarding pain management and maternal satisfaction:
Abstract – Maternal Satisfaction and Pain Control in Women Electing Natural Birth – I think this one comes to the wrong conclusion that “survey results suggest that concerns about epidurals and their effect on the baby, greater than anticipated labor pain, perceived failure of requesting an epidural, and longer duration of labor may have accounted for these findings [of being less satisfied with birth].” I think further study is needed, but that it is good to point out what the study did certainly find: “88% of women who requested an epidural for pain reported being less satisfied with their childbirth experience than those who did not, despite lower pain intensity.” http://journals.lww.com/rapm/Abstract/2001/09000/Maternal_Satisfaction_and_Pain_Control_in_Women.14.aspx
Monday, October 25, 2010
Breech Birth?
What options do you really have for breech birth? And will your doctor tell you about them?
I consider myself educated about birth and research-based practices. I studied all I could before I was pregnant and while I was pregnant.
So why did I agree to an elective c-section?
I thought I had no other option.
It frustrates me, angers me, saddens me to learn now what options I did have, but at the time had no way of finding out.
I feel lied to, mislead, coerced even.
It hurts that I feel so taken advantage of.
The situation: I made my doctor very aware throughout my pregnancy of my intention for a drug-free natural birth. This was usually met with a well-meaning but slightly condescending comment that I “really had no idea of how my labor might go, that it might be as long as 12 hours and I may change my mind.”
This should have been my first clue – a doctor should always support any healthy practice. This includes encouragement and even giving further resources. A doctor should never discourage a healthy practice. (How many of us would go to a doctor who told us starting an exercise program or diet was really hard and that we might want to change our mind once we started?!)
Late in pregnancy when he was stubbornly breech, I wish my doctor would have given me other options rather than a scheduled cesarean before my due date. Yes, I should have looked into options on my own as well. However, ethically, a doctor should give you all information. Period.
What could these options have been?
I consider myself educated about birth and research-based practices. I studied all I could before I was pregnant and while I was pregnant.
So why did I agree to an elective c-section?
I thought I had no other option.
It frustrates me, angers me, saddens me to learn now what options I did have, but at the time had no way of finding out.
I feel lied to, mislead, coerced even.
It hurts that I feel so taken advantage of.
The situation: I made my doctor very aware throughout my pregnancy of my intention for a drug-free natural birth. This was usually met with a well-meaning but slightly condescending comment that I “really had no idea of how my labor might go, that it might be as long as 12 hours and I may change my mind.”
This should have been my first clue – a doctor should always support any healthy practice. This includes encouragement and even giving further resources. A doctor should never discourage a healthy practice. (How many of us would go to a doctor who told us starting an exercise program or diet was really hard and that we might want to change our mind once we started?!)
Late in pregnancy when he was stubbornly breech, I wish my doctor would have given me other options rather than a scheduled cesarean before my due date. Yes, I should have looked into options on my own as well. However, ethically, a doctor should give you all information. Period.
What could these options have been?
- Switch to a practitioner trained in vaginal breech birth. There is at least one in the area (I know this now and with I had known then). Research says that vaginal breech birth is just as safe as cesarean breech for the baby and presents fewer complications for the mother. I believe it is unethical not to provide this information.
- Wait until I went into labor to do a cesarean. It seems that we are so focused on the pain of labor (next post will discuss a bit of this) that we forget that labor is beneficial for both mother and baby. Babies benefit from the contractions of labor; they help push fluid from the lungs in preparation for breathing. Both mother and baby benefit from the natural hormonal cocktail (which is very different from the unnatural Pitocin many get) – lactation is facilitated and the baby is better prepared for the sudden environment change. Bonding is initiated. These benefits cannot be overlooked or ignored – they equate fewer NICU stays and better lactation success. Additionally, there is some, however slim, chance that a breech baby may turn during labor. Again, it is unethical for a practitioner to neglect to mention these facts.
I’m starting very much to question going back to my current OB/GYN for future pregnancies – even though I have heard he will attend VBACs. I feel he neglected to tell me so much that I wonder what he might leave out of his VBAC “standard of care.”
I’m always looking for VBAC and breech birth information in the area, and would love to hear about VBAC and breech supportive providers – even homebirth midwives. (which, judging from the research I found for my last post, is looking to be more and more of an option)
A little end note: I would love to get my hands on this film – A Breech in the System.
I’m always looking for VBAC and breech birth information in the area, and would love to hear about VBAC and breech supportive providers – even homebirth midwives. (which, judging from the research I found for my last post, is looking to be more and more of an option)
A little end note: I would love to get my hands on this film – A Breech in the System.
Wednesday, October 20, 2010
Research regarding heparin in pregnancy
Had to do a quick post on this because I am very excited!
As you all know, I had a stroke at 20. In the following months, I underwent a lot of bloodwork and tests to attempt to determine the cause. In the absence of any other risk factors, it appears that chronic migraines and birth control pills were the cause. (Did you know that chronic migraines in women increase the stroke risk? I didn’t.) I tested negative for every single known clotting disorder.
However, I was still on prophylactic heparin during pregnancy and post-partum. I don’t mind the shots; you get used to them. I mind that it forced me into OB care. (Prophylactic – giving a medication or treatment as a preventative or just in case. It’s not treating any problems already there; it’s simply trying to prevent them.)
I just found a slew of articles against prophylactic heparin therapy during pregnancy!
I’m not pregnant again (yet), but I am so excited to have these at my disposal. I wonder where they were two years ago when I needed them and searched and searched. But I’m sure glad to have them now.
Links:
Thrombophilia and pregnancy complications: cause or association? http://www.ncbi.nlm.nih.gov/pubmed/17635737
As you all know, I had a stroke at 20. In the following months, I underwent a lot of bloodwork and tests to attempt to determine the cause. In the absence of any other risk factors, it appears that chronic migraines and birth control pills were the cause. (Did you know that chronic migraines in women increase the stroke risk? I didn’t.) I tested negative for every single known clotting disorder.
However, I was still on prophylactic heparin during pregnancy and post-partum. I don’t mind the shots; you get used to them. I mind that it forced me into OB care. (Prophylactic – giving a medication or treatment as a preventative or just in case. It’s not treating any problems already there; it’s simply trying to prevent them.)
I just found a slew of articles against prophylactic heparin therapy during pregnancy!
I’m not pregnant again (yet), but I am so excited to have these at my disposal. I wonder where they were two years ago when I needed them and searched and searched. But I’m sure glad to have them now.
Links:
Thrombophilia and pregnancy complications: cause or association? http://www.ncbi.nlm.nih.gov/pubmed/17635737
A Beginner's Guide to Charting, Part 4 - Putting it all together
Let’s review some things first. The part of your cycle where estrogen is dominant is the first part – the part before ovulation. Progesterone is dominant after ovulation – the last part of your cycle. Estrogen causes lower BBT and higher fertile quality cervical fluid. Progesterone causes a temperature shift to higher temps and a drier (non-fertile) cervical fluid.
During one’s period at the beginning of the cycle, you cannot get pregnant. When we talk about your period, I mean true bleeding and shedding of the uterine lining that is built up during the progesterone phase. You may have heard, however, of women getting pregnant during “their period” – however, this is not a true period with shedding of the lining. Rather, it is an episode of “break-through” bleeding after a long estrogen period. Anytime you are charting and have not had a temperature shift to confirm ovulation, you should assume you are still fertile – even if it has been thirty or more days of a low pattern.
How can this happen? Many times stress is the culprit here. My cycle around my wedding was 43 days long; I didn’t ovulate until a week and a half after the wedding on cycle day 25. Job stress can contribute; as can sudden increases in exercise training (exercise on its own should not inhibit ovulation and fertility, unless you are training for the Olympics and not giving yourself enough rest time. Let’s just go ahead and bust that myth).
Additionally, you can have an annovulatory cycle, a cycle without ovulation. My wedding cycle was simply a very long cycle, but you can have cycles where it seems like your body simply starts over. This is ok if it happens every once in a while, and is quite normal. However, if you only have annovulatory cycles, or have many more of them than fertile/true cycles, you should check with a doctor or midwife. Just like with really long cycles, you should use protection (if trying to avoid pregnancy) or keeping going (if trying achieve pregnancy) until you have that temperature shift. It can be hard to tell when your body will go ahead and ovulate on super long cycles or annovulatory cycles.
Here’s one of my pregnancy charts – Elias chart. You can see how we achieved pregnancy. Any time we made love before the fertile period was just for fun; same for any time after the fertile period. That fertile window is what you want to focus on. This is especially important for anyone who naturally has short cycles or long cycles. If you don’t ovulate on day 14 (again, many of us don’t), you’ll want to analyze your cycles to understand the best time to try.
What about if you are trying to avoid getting pregnant? This is one of the things that I really loved about charting when I first started. Traditional birth control – shots, pills, barriers, spermicides – require that you use them throughout the cycle because they don’t tell you when you are fertile. By knowing when you are fertile, you can limit the use of these methods. (Of course, taking birth control pills 5 days out of your cycle is not going to work!) My husband is not a fan of condoms – many of us aren’t. Knowing my fertile days allowed us to only use condoms during those days; we were free to go without any other time of my cycle.
If you are trying to avoid, there are a few rules/guidelines to follow. You are free during a true period (see above!). You are free three days after a temperature shift with dry-up of cervical fluid (they have to go together). You are free anytime you do not have fertile quality cervical fluid, though the closer you get to expected ovulation, the more careful you will want to be. The best advice – chart for at least three cycles before relying totally on this method to avoid pregnancy.
There are so many other things we could discuss about the finer points of charting, but it would take a great deal of time. I suggest that everyone own a copy of Taking Charge of Your Fertility
, or at least check out a copy from the library. It’s an invaluable resource and well worth it.
Again – I have no affiliation with Ovusoft, etc. I simply like and use the software. Thanks.
During one’s period at the beginning of the cycle, you cannot get pregnant. When we talk about your period, I mean true bleeding and shedding of the uterine lining that is built up during the progesterone phase. You may have heard, however, of women getting pregnant during “their period” – however, this is not a true period with shedding of the lining. Rather, it is an episode of “break-through” bleeding after a long estrogen period. Anytime you are charting and have not had a temperature shift to confirm ovulation, you should assume you are still fertile – even if it has been thirty or more days of a low pattern.
How can this happen? Many times stress is the culprit here. My cycle around my wedding was 43 days long; I didn’t ovulate until a week and a half after the wedding on cycle day 25. Job stress can contribute; as can sudden increases in exercise training (exercise on its own should not inhibit ovulation and fertility, unless you are training for the Olympics and not giving yourself enough rest time. Let’s just go ahead and bust that myth).
Additionally, you can have an annovulatory cycle, a cycle without ovulation. My wedding cycle was simply a very long cycle, but you can have cycles where it seems like your body simply starts over. This is ok if it happens every once in a while, and is quite normal. However, if you only have annovulatory cycles, or have many more of them than fertile/true cycles, you should check with a doctor or midwife. Just like with really long cycles, you should use protection (if trying to avoid pregnancy) or keeping going (if trying achieve pregnancy) until you have that temperature shift. It can be hard to tell when your body will go ahead and ovulate on super long cycles or annovulatory cycles.
Here’s one of my pregnancy charts – Elias chart. You can see how we achieved pregnancy. Any time we made love before the fertile period was just for fun; same for any time after the fertile period. That fertile window is what you want to focus on. This is especially important for anyone who naturally has short cycles or long cycles. If you don’t ovulate on day 14 (again, many of us don’t), you’ll want to analyze your cycles to understand the best time to try.
What about if you are trying to avoid getting pregnant? This is one of the things that I really loved about charting when I first started. Traditional birth control – shots, pills, barriers, spermicides – require that you use them throughout the cycle because they don’t tell you when you are fertile. By knowing when you are fertile, you can limit the use of these methods. (Of course, taking birth control pills 5 days out of your cycle is not going to work!) My husband is not a fan of condoms – many of us aren’t. Knowing my fertile days allowed us to only use condoms during those days; we were free to go without any other time of my cycle.
If you are trying to avoid, there are a few rules/guidelines to follow. You are free during a true period (see above!). You are free three days after a temperature shift with dry-up of cervical fluid (they have to go together). You are free anytime you do not have fertile quality cervical fluid, though the closer you get to expected ovulation, the more careful you will want to be. The best advice – chart for at least three cycles before relying totally on this method to avoid pregnancy.
There are so many other things we could discuss about the finer points of charting, but it would take a great deal of time. I suggest that everyone own a copy of Taking Charge of Your Fertility
, or at least check out a copy from the library. It’s an invaluable resource and well worth it.Again – I have no affiliation with Ovusoft, etc. I simply like and use the software. Thanks.
Wednesday, September 29, 2010
A Beginner's Guide to Charting, Part 3
For some reason, women are often embarrassed about their bodies. I don’t consider myself a feminist, but it does amaze me when I see the difference in how men and women view their most intimate parts. Men usually have no problem discussing size, use, and bodily exploration, but women many times even have difficulty just calling theirs by name – vagina. This has me thinking of a scene from the movie 500 Days of Summer – Summer starts screaming “penis” in a crowded place, laughing at others’ embarrassment. I wonder how different the scene would have been if she were screaming “vagina.”
With this all in mind, we’ll be talking about the next part of charting: assessing cervical fluid. Some women are uncomfortable and embarrassed by this, but I don’t believe they should be. No man is embarrassed by his semen.
Cervical fluid (sometimes called cervical mucus, a term I find offensive because it sounds like the stuff I have in my nose during an awful cold. As a side note, why is it that so many terms relating to female reproduction are so offensive – incompetent cervix, spontaneous abortion, habitual abortion, etc. Nasty nasty.). Cervical fluid is a really beautiful thing. It helps protect the vagina from bacteria, lubricates it in preparation and fulfillment of lovemaking, and serves as a carrier and assistant to sperm. It changes throughout the cycle in response to hormones, sometimes fairly quickly. Cervical fluid tells so much about the cycle that it can be used without BBT for charting – though it is very helpful to know both.
During infertile points in the cycle (remember that women, unlike men, are fertile only a few days of their cycle), cervical fluid is usually minimal. Some may describe feeling dry, or “sticky.” When checking cervical fluid at this point, many women describe infertile cervical fluid as yellowish and the consistency of dried rubber cement – remember in elementary school art class how it balls up when rolled between your fingers? This is a very accurate description.
As a woman begins to approach her fertile period, the cervical fluid usually changes. At this point it may be white or clear. The consistency is thin, and it may stretch a little between the fingers. Some women describe feeling “a little wet” all day. (This probably contributes to the increased sex drive many experience before ovulation.)
In the days right before ovulation, the cervical fluid goes through another change. It becomes very slippery. It can be described as looking and feeling just like egg whites (many even call it egg white cervical fluid or EWCF). It stretches a good bit between the fingers without breaking. Many women say they feel “very wet” or “slippery” throughout the day. Sometimes this kind of cervical fluid even slips out when you use the toilet, causing you to not notice it.
Knowing your cervical fluid is very valuable whether or not you’re trying to conceive. Many women go to the doctor or take unnecessary treatments, believing they have an infection because something is coming out of the vagina. Knowing the normal appearance of your cervical fluid can help prevent this; it can also help you find something early on.
Charting cervical fluid is valuable as well for trying to conceive. While temperature doesn’t change until after you ovulate, cervical fluid changes as you approach ovulation. This is why I look to chart both. The cervical fluid lets me know I’m approaching ovulation; the temperature shift confirms ovulation occurred. Also, you can have cervical fluid changes without ovulating – your body geared up and got ready to ovulate, but something happened and it didn’t actually release an egg.
Knowing that you are approaching your fertile period allows you to know when to use barrier methods of birth control, abstain from sex, or try try try for that baby! Cervical fluid dries up after ovulation (or in the event you don’t ovulate, after the hormones drop off before you have break-through bleeding).
There are two ways of checking cervical fluid: outside and inside. Checking outside entails using toilet paper or your fingers to check cervical fluid on the lips of the vagina. Roll it around between your fingers to get the feel of it before you look at it. Check the appearance of your fluid; see if it stretches. Note the color. Record your findings. The advantage of outside checking is that many women feel more comfortable with it and it seems simpler. The disadvantage is that you may miss fertile quality fluid near the cervix and misinterpret your point in your cycle.
Checking inside involves putting two fingers into the vagina as far as the cervix. Draw a bit of fluid from the cervix and check it in the same way as you would check outside. I believe it is valuable to note both inner and outer checks. Be aware of your body, and learn what it can teach you.
Some guidelines and tips for checking cervical fluid:
Check the same way each time. Just like checking temperature, consistency is key. Don’t check outside one day and inside the next. If you are going to check both ways, do so at the same time every day.
Try to check at the same general time of day each day. It doesn’t have to be exact like when you check your BBT. However, you should try to pick a general time – say afternoon – so you can be consistent and remember to do it. Many women check as part of their toilet routine. This allows you to check throughout the day and around the same general times of day.
Don’t check when aroused or right after lovemaking. Arousal fluid and semen can obscure your assessment. You can also note that your fluid was “semen obscured” if you are unsure.
A great website for seeing cervical changes is this one: My beautiful cervix. Look at it and appreciate the beauty in how your body was designed.
Next post: putting it all into practice and some general tips.
With this all in mind, we’ll be talking about the next part of charting: assessing cervical fluid. Some women are uncomfortable and embarrassed by this, but I don’t believe they should be. No man is embarrassed by his semen.
Cervical fluid (sometimes called cervical mucus, a term I find offensive because it sounds like the stuff I have in my nose during an awful cold. As a side note, why is it that so many terms relating to female reproduction are so offensive – incompetent cervix, spontaneous abortion, habitual abortion, etc. Nasty nasty.). Cervical fluid is a really beautiful thing. It helps protect the vagina from bacteria, lubricates it in preparation and fulfillment of lovemaking, and serves as a carrier and assistant to sperm. It changes throughout the cycle in response to hormones, sometimes fairly quickly. Cervical fluid tells so much about the cycle that it can be used without BBT for charting – though it is very helpful to know both.
During infertile points in the cycle (remember that women, unlike men, are fertile only a few days of their cycle), cervical fluid is usually minimal. Some may describe feeling dry, or “sticky.” When checking cervical fluid at this point, many women describe infertile cervical fluid as yellowish and the consistency of dried rubber cement – remember in elementary school art class how it balls up when rolled between your fingers? This is a very accurate description.
As a woman begins to approach her fertile period, the cervical fluid usually changes. At this point it may be white or clear. The consistency is thin, and it may stretch a little between the fingers. Some women describe feeling “a little wet” all day. (This probably contributes to the increased sex drive many experience before ovulation.)
In the days right before ovulation, the cervical fluid goes through another change. It becomes very slippery. It can be described as looking and feeling just like egg whites (many even call it egg white cervical fluid or EWCF). It stretches a good bit between the fingers without breaking. Many women say they feel “very wet” or “slippery” throughout the day. Sometimes this kind of cervical fluid even slips out when you use the toilet, causing you to not notice it.
Knowing your cervical fluid is very valuable whether or not you’re trying to conceive. Many women go to the doctor or take unnecessary treatments, believing they have an infection because something is coming out of the vagina. Knowing the normal appearance of your cervical fluid can help prevent this; it can also help you find something early on.
Charting cervical fluid is valuable as well for trying to conceive. While temperature doesn’t change until after you ovulate, cervical fluid changes as you approach ovulation. This is why I look to chart both. The cervical fluid lets me know I’m approaching ovulation; the temperature shift confirms ovulation occurred. Also, you can have cervical fluid changes without ovulating – your body geared up and got ready to ovulate, but something happened and it didn’t actually release an egg.
Knowing that you are approaching your fertile period allows you to know when to use barrier methods of birth control, abstain from sex, or try try try for that baby! Cervical fluid dries up after ovulation (or in the event you don’t ovulate, after the hormones drop off before you have break-through bleeding).
There are two ways of checking cervical fluid: outside and inside. Checking outside entails using toilet paper or your fingers to check cervical fluid on the lips of the vagina. Roll it around between your fingers to get the feel of it before you look at it. Check the appearance of your fluid; see if it stretches. Note the color. Record your findings. The advantage of outside checking is that many women feel more comfortable with it and it seems simpler. The disadvantage is that you may miss fertile quality fluid near the cervix and misinterpret your point in your cycle.
Checking inside involves putting two fingers into the vagina as far as the cervix. Draw a bit of fluid from the cervix and check it in the same way as you would check outside. I believe it is valuable to note both inner and outer checks. Be aware of your body, and learn what it can teach you.
Some guidelines and tips for checking cervical fluid:
Check the same way each time. Just like checking temperature, consistency is key. Don’t check outside one day and inside the next. If you are going to check both ways, do so at the same time every day.
Try to check at the same general time of day each day. It doesn’t have to be exact like when you check your BBT. However, you should try to pick a general time – say afternoon – so you can be consistent and remember to do it. Many women check as part of their toilet routine. This allows you to check throughout the day and around the same general times of day.
Don’t check when aroused or right after lovemaking. Arousal fluid and semen can obscure your assessment. You can also note that your fluid was “semen obscured” if you are unsure.
A great website for seeing cervical changes is this one: My beautiful cervix. Look at it and appreciate the beauty in how your body was designed.
Next post: putting it all into practice and some general tips.
Tuesday, September 21, 2010
A Beginner's Guide to Charting, Part 2
The first step to charting is the easiest – taking your temperature. It is a little more involved that just sticking a thermometer in your mouth whenever; so let’s look at the why’s and how’s.
Basal body temperature is one of the most important things in charting. In fact, you can do it alone (without what I’ll talk about in the next post) and get a pretty good idea of what is going on. I would even suggest that you just do your temps for a month before going into the rest of charting – ease yourself in.
In the first part of your cycle, before ovulation, your temperature is generally “low.” Average temperatures may range from 97.0-97.7, though yours may be different. The number is not what’s important – you’re looking for a pattern of lows. My general pattern for pre-ovulation temps is around 96.8-97.0, lower than “average.” However, it’s my pattern.
Right around ovulation, generally the day following, you should have a temperature spike followed by more “high” temps until your period. They might range from 97.7-99.0, but again yours may be different. Mine are usually 97.3-98.1. If mine go any higher and stay, I can usually guess that I’m pregnant and I buy a test. That’s my pattern. You’re trying to find your pattern.
How do temperature patterns show ovulation? (It’s all too convenient I know). Before ovulation, estrogen is the reigning hormone in the reproductive cycle. One of the “side effects” of estrogen is a lower body temperature. Therefore, while in the low pattern, it is usually safe to assume you haven’t ovulated.
After ovulation, progesterone takes over. One of the “side effects” of progesterone is an increase in body temperature. For some women, this increase is gradual, but most of us get a nice “spike.”
How do you determine what temp to chart? You can’t just take your temp whenever and however you want to; it changes too much throughout the day to give your resting temperature. Fortunately, it’s easy to get that BBT – no math involved.
1. Take your temp as soon as you wake up, first thing in the morning. This sounds harder than it is, and takes just a little getting used to. You need to take your temp the very first thing in the morning – before you get out of bed, kiss your husband, say good morning, stretch, etc. When your alarm goes off, reach for the thermometer, stick it in, wait for the beep. Period. Doing anything beforehand will likely alter your temperature. In order to see a good pattern, you want it to be as accurate as possible.
2. Also time is important. You want to try to take it at the same time every day. When I worked full-time as a teacher, I got up at 6:00. On the weekends, I just kept my alarm at 6, took my temp, and fell back asleep (remember that I wanted you to get a thermometer with memory? This is why!). Now, my husband gets up at 6, usually disturbing me, so I take my temp then.
3. Take your temp after at least three hours of sleep. It generally takes three hours for your body to settle down to its resting temp. Some may take longer. While at least three hours is the rule, for accurate charting you really want to be getting close to the same amount of sleep each night. An hour or half may not make much of a difference, but going to be at 1 instead of 11 probably would. If you’re unsure if your sleep was disturbed, the best thing to do is take the temp anyway and make a note. If that particular temp matches your pattern, keep it. If it doesn’t match, mark it out with an X.
4. Take your temp the same way with the same thermometer each time. Don’t change your thermometer (if at all possible) until the start of a new cycle. Different thermometers (even the same kind/brand) may read slightly differently, making a pattern hard to see.
Most women when they start out charting choose to take their temp orally. In this case, you want to try to take your temp in the same part of your mouth under your tongue every time. Different parts of the mouth are warmer than others, particularly if you sleep with your hand on your face or something like that. If you sleep with your mouth open, it may difficult for you to temp accurately. You can try for a couple of cycles if you like, or you can just try the second way.
You can temp vaginally. A vaginal temp will give you the most accurate temp; it doesn’t hang open at night (we hope!) and it doesn’t get warmer if you sleep with your hand on your cheek. Vaginal temping also gives you a little break when you’re on your period – unless you’re really dedicated (I’m not!). It’s really not difficult or gross; just stick the thermometer in and wait for the beep.
I’ve temped this way for years. I temped for a year orally before I switched. (And yes, it’s the only thing I use that thermometer for and it gets an alcohol bath!). My temps are generally a couple points higher this way and my pattern is much more stable – thus easier to read.
If temping vaginally makes you feel funny, just wait until the next post. Learn to be comfortable with your body and life will be a whole lot easier!
Basal body temperature is one of the most important things in charting. In fact, you can do it alone (without what I’ll talk about in the next post) and get a pretty good idea of what is going on. I would even suggest that you just do your temps for a month before going into the rest of charting – ease yourself in.
In the first part of your cycle, before ovulation, your temperature is generally “low.” Average temperatures may range from 97.0-97.7, though yours may be different. The number is not what’s important – you’re looking for a pattern of lows. My general pattern for pre-ovulation temps is around 96.8-97.0, lower than “average.” However, it’s my pattern.
Right around ovulation, generally the day following, you should have a temperature spike followed by more “high” temps until your period. They might range from 97.7-99.0, but again yours may be different. Mine are usually 97.3-98.1. If mine go any higher and stay, I can usually guess that I’m pregnant and I buy a test. That’s my pattern. You’re trying to find your pattern.
How do temperature patterns show ovulation? (It’s all too convenient I know). Before ovulation, estrogen is the reigning hormone in the reproductive cycle. One of the “side effects” of estrogen is a lower body temperature. Therefore, while in the low pattern, it is usually safe to assume you haven’t ovulated.
After ovulation, progesterone takes over. One of the “side effects” of progesterone is an increase in body temperature. For some women, this increase is gradual, but most of us get a nice “spike.”
How do you determine what temp to chart? You can’t just take your temp whenever and however you want to; it changes too much throughout the day to give your resting temperature. Fortunately, it’s easy to get that BBT – no math involved.
1. Take your temp as soon as you wake up, first thing in the morning. This sounds harder than it is, and takes just a little getting used to. You need to take your temp the very first thing in the morning – before you get out of bed, kiss your husband, say good morning, stretch, etc. When your alarm goes off, reach for the thermometer, stick it in, wait for the beep. Period. Doing anything beforehand will likely alter your temperature. In order to see a good pattern, you want it to be as accurate as possible.
2. Also time is important. You want to try to take it at the same time every day. When I worked full-time as a teacher, I got up at 6:00. On the weekends, I just kept my alarm at 6, took my temp, and fell back asleep (remember that I wanted you to get a thermometer with memory? This is why!). Now, my husband gets up at 6, usually disturbing me, so I take my temp then.
3. Take your temp after at least three hours of sleep. It generally takes three hours for your body to settle down to its resting temp. Some may take longer. While at least three hours is the rule, for accurate charting you really want to be getting close to the same amount of sleep each night. An hour or half may not make much of a difference, but going to be at 1 instead of 11 probably would. If you’re unsure if your sleep was disturbed, the best thing to do is take the temp anyway and make a note. If that particular temp matches your pattern, keep it. If it doesn’t match, mark it out with an X.
4. Take your temp the same way with the same thermometer each time. Don’t change your thermometer (if at all possible) until the start of a new cycle. Different thermometers (even the same kind/brand) may read slightly differently, making a pattern hard to see.
Most women when they start out charting choose to take their temp orally. In this case, you want to try to take your temp in the same part of your mouth under your tongue every time. Different parts of the mouth are warmer than others, particularly if you sleep with your hand on your face or something like that. If you sleep with your mouth open, it may difficult for you to temp accurately. You can try for a couple of cycles if you like, or you can just try the second way.
You can temp vaginally. A vaginal temp will give you the most accurate temp; it doesn’t hang open at night (we hope!) and it doesn’t get warmer if you sleep with your hand on your cheek. Vaginal temping also gives you a little break when you’re on your period – unless you’re really dedicated (I’m not!). It’s really not difficult or gross; just stick the thermometer in and wait for the beep.
I’ve temped this way for years. I temped for a year orally before I switched. (And yes, it’s the only thing I use that thermometer for and it gets an alcohol bath!). My temps are generally a couple points higher this way and my pattern is much more stable – thus easier to read.
If temping vaginally makes you feel funny, just wait until the next post. Learn to be comfortable with your body and life will be a whole lot easier!
Tuesday, September 14, 2010
A Beginner's Guide to Charting, Part 1
Also see necessary definitions.
Let’s talk a little first about what charting is and why I think all women should do it. Charting is a component of natural family planning (NFP) and the fertility awareness method (FAM). Charting allows you to analyze your fertility signs and determine your fertile and non-fertile days.
If you remember your 6th grade sex ed class, you remember how easy it seemed to get pregnant. Not quite so. Men are fertile all the time. Semen is always being produced; it always has sperm (in healthy men of course). Women on the other hand are not always fertile. We are not constantly releasing mature eggs to be fertilized at any time of the month. Most of the time, women are fertile for about five to seven days of any given cycle.
Why is this important? I’m no feminist (well, some would probably consider me one…), but I feel the birth control and birthing industries are to entirely male-dominated. Culturally, we consider it a woman’s responsibility to take birth control pills, even though women are not fertile all the time. Some even consider it a woman’s responsibility to make sure her partner wears a condom – even though that’s not her equipment shall we say. Birth control pills are costly, both financially and physically. There have been too many women who have had adverse effects from these supposedly “safe” pills. (I’m one; you’ll hear me rant about it all the time.)
Understanding your fertility through charting is non-invasive – unlike pills, spermicides (do I really want something that toxic in me!? In there!?), shots, patches, and surgical procedures. The United States has one of the highest incidences of surgical sterilization FOR WOMEN in the entire the world.
Understanding your fertility gives you more understanding about your body than taking something. This goes beyond trying to conceive. It can help you determine when your period is to be expected, when you can safely have unprotected monogamous sex, and where to start in diagnosing hormonal problems. It also gives you an intimate understanding of how your body works.
For today, we’ll just look at the supplies you’ll need. They are really simple and overall cheap. I’ll also let you know my personal preferences here.
1.A good thermometer. The heart of charting is based on your BBT. This is the resting temperature of your body – the next post will talk about how to determine it.
I like a digital thermometer that has a memory function. You need one that goes at least to the tenth decimal (97.6), but I like one that goes to the hundredth (97.68). The one that I’ve used is a BBT from Walmart. I bought my first years ago when I first started charting, and it lasted until I got pregnant. To be safe, I bought another after I started charting again post-partum. It’s white with a pink tip, and is specifically a BBT thermometer. It’s been very accurate, and it beeps when then temp is read after 60 seconds.
I tried a regular thermometer that was ready and beeped after 9 seconds. I found that it wasn’t very accurate for me. There are some that say that you must have a BBT thermometer to be accurate for those lower temperatures; that regular thermometers are just looking for fevers. I don’t know, but personally I’ve found that my BBT worked better for me. It’s worth saving your money buying one good thermometer than buying two after you don’t like the first. You’ll want this thermometer to be only for your charting.
2. Pencils and downloaded charts such as these:
(If you choose to do the next supplies, you won’t need the pencils and paper charts unless you want a backup).
Charting, in a way, is like graphing in high school math. You mark specific number points and connect the dots. You’ll want a pencil in case you make a mistake. The nice thing about pencil and paper charts is that they are relatively low-cost. I don’t regularly use them, though I have if I’m out-of-town and can’t use the next option – computer required.
3. Charting software: such as Ovusoft, Fertility Friend, and others.
The first thing you should know about charting software is this: you must be smarter than your software. Buying (or using free) software is not a substitute for understanding your own fertility and how to chart it. This is especially important when you are first starting out.
For example, most charting software starts out assuming you have a 28-day cycle, the average. It will make predictions based on those values. These predictions may very well be incorrect if your cycles are not average. However, the longer you use the software, the more it will understand your personal fertility.
I personally use Ovusoft. I bought it in 2007, and paid a one-time fee. In 2009 while I was pregnant, our computer crashed and I lost the software. Fortunately, customer service was able to send me the activation code. I downloaded the software again and started using it at no additional cost. It’s a very user-friendly software. The book that goes with it cannot be recommended HIGHLY ENOUGH! Every woman should own a copy of Taking Charge of Your Fertility. It’s explains the finer points of charting – things I won’t get into on a post.
It’s explains the finer points of charting – things I won’t get into on a post.I’ve also used Fertility Friend. It’s a nice simple software, online-based. And it’s free (though additional features are available by subscription). I highly, highly recommend putting it on the FAM setting if you do use it. The others are less accurate, especially in your first few cycles. Every once in a while, even on the FAM setting, Fertility Friend gets confused and doesn’t give you accurate assessments. This is where you need to be smarter than your software.
4. Your fingers. Yep! But I’ll explain this in later posts.
For the record: I have no affliation with any of the products mentioned here.
A Beginner's Guide to Charting, Definitions
Basal body temperature (BBT) – your body’s resting temperature, almost always lower than 98.7
Cervical fluid or cervical mucus – the fluid within the cervix that is created by the body as a carrier for semen. The fluid changes as ovulation nears to allow conception to take place.
Charting – keeping track of BBT and cervical fluid throughout cycles and using that information to determine fertile and non-fertile days.
Fertility awareness method (FAM) – recognized by the FDA as an aid to conception, also used by many as a method of “birth control”. Based on BBT and cervical fluid checks. May or may not involve abstaining during fertile days (can use “back-ups” such as condoms)
Fertility awareness method (FAM) – recognized by the FDA as an aid to conception, also used by many as a method of “birth control”. Based on BBT and cervical fluid checks. May or may not involve abstaining during fertile days (can use “back-ups” such as condoms)
Fertility Friend – an online based charting method, free for basic service, monthly fees required for “premium services”
Natural family planning (NFP) – a method of “birth control” recognized by the Catholic church, involves abstaining during fertile days. Based on BBT and cervical fluid checks
Ovusoft – a charting software, requires one-time payment for the software. Not available for MACs. Currently testing a web-based version.
Ovusoft – a charting software, requires one-time payment for the software. Not available for MACs. Currently testing a web-based version.
More definitions to be added as needed!
Tuesday, September 7, 2010
Benefits of Red Rapsberry Leaf
As you know from my last post, I’m taking an online herbal course.
One of the best traditional, natural “treatments” I’ve seen for all women is Red Raspberry Leaf (various Rubus species). Let’s break down the why’s and how’s.
Red Raspberry Leaf is a uterine tonic. This means simply that it helps tone the uterine muscle. For pregnancy, this has been reported to shorten labors (a 2001 study published in the Journal of Midwifery and Women’s Health). This is probably due to the fact that the tonic action strengthens the muscle so as to assist the uterus to contract more efficiently. Contrary to what some may worry, it won’t start labor – as a uterine tonic, it doesn’t make your uterus contract; it helps it do the work (see suggestions and contraindications below).
Because it has these tonic capabilities, some midwives recommend women drink an especially strong infusion during labor and during the immediate post-partum period. It is thought that Red Raspberry Leaf will improve post-partum hemorrhage by assisting uterine contractions. Some women report that “after-pains,” those painful post-partum contractions usually associated with second (and more) babies, are lessened or eliminated.
These reasons alone are enough – but what about the rest of us who aren’t pregnant?
The uterine tonic action of red raspberry leaf can also improve women’s cycles. If you experience painful periods, especially associated with severe cramps, heavy flow, and passage of clots, it is certainly worth it to try Red Raspberry Leaf. The tonic action may assist your body in shedding the lining without needing to cramp.
Some midwives report that Red Raspberry leaf helps prevent miscarriage. (Other report that it is contraindicated in the first trimester, see below). It also reported to ease morning sickness during pregnancy and diarrhea any time due to its tonic work in the intestines and stomach.
What about benefits besides the tonic action?
Like Dandelion (yeah, the stuff that grows in your yard!) and Red Clover, Red Raspberry Leaf is high in calcium and potassium (it also has vitamins A, B, C, and E, and phosphorus). The need for calcium in women’s diets is well-documented. For pregnancy, this increase in calcium not only supports the rapid growth necessary; it also may help with those awful “charley horses.” For postpartum and women otherwise enjoying their fertility through regular cycles, the calcium and potassium support regular bone health. Remember that nutrients we are able to obtain through food sources (and herbals, because after all they are food too) are better absorbed by the body than the best over-the-counter supplement.
Some research indicates that Red Raspberry Leaf also increases milk production. Others report that it can help lower blood sugar levels in diabetics. It may also be used to treat flu and fevers.
So, how does one take it?
I believe, like so many other supplements that you can buy capsules of Red Raspberry Leaf. However, I much prefer to take it as an infusion. You might think of an infusion as a very strong medicinal tea. You can buy Red Raspberry Leaf tea bags, but they tend to be expensive and may be mixed with other herbs or otherwise weakened. I bought my leaf from Frontier by the pound.
For pregnancy, I personally would suggest you take the infusion daily. You may want to make a strong infusion for labor. Some women have even made an infusion and frozen it to have the ice cubes to suck on during labor!
For general womanly health, I would suggest taking the infusion at least during the second half of your cycle (easy to do if you chart your cycles, otherwise take it for about two weeks before you expect your period).
Here’s how I suggest you prepare it.
Generally, you should use 1 tbsp dried herb per cup of water (2 tbsp fresh per cup). This is true for Red Raspberry Leaf. If you are planning to take it during pregnancy, I suggest you make a quart (4 cups) a day and sip on it throughout the day. The directions below are for a quart.
Boil 4 cups of water in a small pot. Take 4 tbsp of dried Red Raspberry Leaf and put it in the bottom of a jar. Pour your 4 cups of boiling water over the Red Raspberry Leaf and allow it to sit for 20 minutes. (Some say to infuse overnight. I have tried both and can’t really tell a difference.) Refrigerate and enjoy. You can sweeten it taste – honey is good – or even mix it with fruit juice, which I what I usually do.
Contraindications? and other suggestions.
Some sources tend to be on the conservative side and recommend against Red Raspberry Leaf during the first trimester; they are worried that it may “over-stimulate” the uterus and cause miscarriage. From my research, this seems very much to go against the way Red Raspberry Leaf works as a tonic. However, you may want to abstain from the infusion during the first trimester, for your peace of mind more than anything else. I believe your stress level and peace of mind affect your pregnancy; do what you feel is best.
I found once source that indicated that the infusion was contraindicated during breastfeeding, though it did not explain its reasons. Nearly all other sources indicated that the infusion promoted lactation (and therefore would not be contraindicated). Again, use your own judgement.
These are some of the sources I used in writing this entry:
From Susun Weed – Her wonderful Herbal for the Childbearing Year
along with this webpage: http://www.susunweed.com/Article_Pregnancy_Problems.htm
An article by Chandramita Bora: http://www.buzzle.com/articles/red-raspberry-leaf-tea-benefits.html
An online source that quotes Susun Weed: http://www.truthseek.net/Raspberry.html#anchor_147
http://www.brighthub.com/health/alternative-medicine/articles/81895.aspx
Various herbals such as those by David Hoffman
and The Earthwise Herba
l by Matthew Wood
One of the best traditional, natural “treatments” I’ve seen for all women is Red Raspberry Leaf (various Rubus species). Let’s break down the why’s and how’s.
Red Raspberry Leaf is a uterine tonic. This means simply that it helps tone the uterine muscle. For pregnancy, this has been reported to shorten labors (a 2001 study published in the Journal of Midwifery and Women’s Health). This is probably due to the fact that the tonic action strengthens the muscle so as to assist the uterus to contract more efficiently. Contrary to what some may worry, it won’t start labor – as a uterine tonic, it doesn’t make your uterus contract; it helps it do the work (see suggestions and contraindications below).
Because it has these tonic capabilities, some midwives recommend women drink an especially strong infusion during labor and during the immediate post-partum period. It is thought that Red Raspberry Leaf will improve post-partum hemorrhage by assisting uterine contractions. Some women report that “after-pains,” those painful post-partum contractions usually associated with second (and more) babies, are lessened or eliminated.
These reasons alone are enough – but what about the rest of us who aren’t pregnant?
The uterine tonic action of red raspberry leaf can also improve women’s cycles. If you experience painful periods, especially associated with severe cramps, heavy flow, and passage of clots, it is certainly worth it to try Red Raspberry Leaf. The tonic action may assist your body in shedding the lining without needing to cramp.
Some midwives report that Red Raspberry leaf helps prevent miscarriage. (Other report that it is contraindicated in the first trimester, see below). It also reported to ease morning sickness during pregnancy and diarrhea any time due to its tonic work in the intestines and stomach.
What about benefits besides the tonic action?
Like Dandelion (yeah, the stuff that grows in your yard!) and Red Clover, Red Raspberry Leaf is high in calcium and potassium (it also has vitamins A, B, C, and E, and phosphorus). The need for calcium in women’s diets is well-documented. For pregnancy, this increase in calcium not only supports the rapid growth necessary; it also may help with those awful “charley horses.” For postpartum and women otherwise enjoying their fertility through regular cycles, the calcium and potassium support regular bone health. Remember that nutrients we are able to obtain through food sources (and herbals, because after all they are food too) are better absorbed by the body than the best over-the-counter supplement.
Some research indicates that Red Raspberry Leaf also increases milk production. Others report that it can help lower blood sugar levels in diabetics. It may also be used to treat flu and fevers.
So, how does one take it?
I believe, like so many other supplements that you can buy capsules of Red Raspberry Leaf. However, I much prefer to take it as an infusion. You might think of an infusion as a very strong medicinal tea. You can buy Red Raspberry Leaf tea bags, but they tend to be expensive and may be mixed with other herbs or otherwise weakened. I bought my leaf from Frontier by the pound.
For pregnancy, I personally would suggest you take the infusion daily. You may want to make a strong infusion for labor. Some women have even made an infusion and frozen it to have the ice cubes to suck on during labor!
For general womanly health, I would suggest taking the infusion at least during the second half of your cycle (easy to do if you chart your cycles, otherwise take it for about two weeks before you expect your period).
Here’s how I suggest you prepare it.
Generally, you should use 1 tbsp dried herb per cup of water (2 tbsp fresh per cup). This is true for Red Raspberry Leaf. If you are planning to take it during pregnancy, I suggest you make a quart (4 cups) a day and sip on it throughout the day. The directions below are for a quart.
Boil 4 cups of water in a small pot. Take 4 tbsp of dried Red Raspberry Leaf and put it in the bottom of a jar. Pour your 4 cups of boiling water over the Red Raspberry Leaf and allow it to sit for 20 minutes. (Some say to infuse overnight. I have tried both and can’t really tell a difference.) Refrigerate and enjoy. You can sweeten it taste – honey is good – or even mix it with fruit juice, which I what I usually do.
Contraindications? and other suggestions.
Some sources tend to be on the conservative side and recommend against Red Raspberry Leaf during the first trimester; they are worried that it may “over-stimulate” the uterus and cause miscarriage. From my research, this seems very much to go against the way Red Raspberry Leaf works as a tonic. However, you may want to abstain from the infusion during the first trimester, for your peace of mind more than anything else. I believe your stress level and peace of mind affect your pregnancy; do what you feel is best.
I found once source that indicated that the infusion was contraindicated during breastfeeding, though it did not explain its reasons. Nearly all other sources indicated that the infusion promoted lactation (and therefore would not be contraindicated). Again, use your own judgement.
These are some of the sources I used in writing this entry:
From Susun Weed – Her wonderful Herbal for the Childbearing Year
along with this webpage: http://www.susunweed.com/Article_Pregnancy_Problems.htmAn article by Chandramita Bora: http://www.buzzle.com/articles/red-raspberry-leaf-tea-benefits.html
An online source that quotes Susun Weed: http://www.truthseek.net/Raspberry.html#anchor_147
http://www.brighthub.com/health/alternative-medicine/articles/81895.aspx
Various herbals such as those by David Hoffman
and The Earthwise Herbal by Matthew WoodTuesday, August 31, 2010
Rosemary Decoction
I’m taking an online herbal course for doulas and midwives through BirthArts.net. I decided the other day that for one of my assignments, I’d try a rosemary decoction for a hair rinse. I’m using rosemary because I’ve got fairly dark hair. I’m hoping for a few things from this – that it’ll strip some of that left-over “wash-out” color that’s there, and that it’ll help with the grease that seems to plague me this time of year. As I go more into the course, I’ll be sharing some of my other assignments that are specifically for the childbearing year.
I started out by going into my garden and gathering some rosemary. I needed four tablespoons worth of rosemary for the two cups of water I was going to use – two tablespoons for each cup. Here’s my rosemary. (The extra that I gathered went for chicken at dinner!)
I started out by going into my garden and gathering some rosemary. I needed four tablespoons worth of rosemary for the two cups of water I was going to use – two tablespoons for each cup. Here’s my rosemary. (The extra that I gathered went for chicken at dinner!)
I put a pot on with the water and measured out my rosemary. Once it was starting to boil, I turned it down to simmer. The rosemary needed to simmer for twenty minutes.
Here’s the rosemary after just a couple of minutes.
Here it is after about ten minutes.
(I did dishes while it simmered…little man was napping and I was taking all my opportunities to get stuff done!)
After it simmered, I strained off the rosemary and had just my decoction. I used this measuring cup because it was what was handy to run down the hall with to get a quick shower.
I didn’t let it cool very much, which I certainly will the next time. I usually take a shower in the evening, so next time I plan to make the decoction in the morning and let it sit.
For my shower, I decided it would do me no good to use my regular shampoo and conditioner with the rinse. I grabbed some of my son’s shampoo instead, which is the BEST stuff for little ones. We have used California Baby’s Sensitive shampoo and bodywash for him since he had a bad outbreak of eczema. He hasn’t had an issue since. (For the record, before we switched, we had used Burt’s Bees which is great, but has scents in it like everything else. The stuff from California Baby is totally unscented and awesome – and I have absolutely no affiliation with them)
After I used the shampoo, I rinsed with the rosemary decoction. I could have gotten by with just a cup, especially since my hair is currently really short (thank you bad hairdresser!). I let my hair dry naturally, because that’s what I always do.
This is a bad picture of my hair before the shower and rinse.
This is my hair as it was almost drying, before I did anything to it.
This is after quickly running a straightener through it. There’s no product in my hair. It’s the softest it has ever been. Awesome. I also fixed up my bangs a bit.
Sunday, August 29, 2010
Recommended Reading for Pregnant Women
Nearly as soon as a woman is pregnant, she begins looking for books to help her fill-in-the-blanks between doctor appointments and ultrasounds. This is no easy task considering all the books that are out there. Here is a short list and review for some of the books I found most helpful, as well as some to avoid.
This is one of the best books I read while I was pregnant. It's easy enough to read straight through it, but it's also a great reference book. Unlike many pregnancy books, it goes into the first few months of your newborn's life rather than ending at birth and the hospital stay. My copy is full of highlights and marks.
Amazing book. . It’s aimed specifically to birth partners (as though you couldn’t tell), but I found as an expecting mother it was very valuable for me as well. Good book to read through together and discuss. Also good to toss into the birth bag for reference as needed. It’s even designed for this with “tabs” on the pages so you can flip through and find what you need.
The Doula Book by Marshall Klaus, John Kennell, and Phyllis H. Klaus. - A great book to acquaint you with the idea of a trained labor companion. Doulas don’t replace partners; they support the whole family in birthing.
by Marshall Klaus, John Kennell, and Phyllis H. Klaus. - A great book to acquaint you with the idea of a trained labor companion. Doulas don’t replace partners; they support the whole family in birthing.Ina May’s Guide to Childbirth 
by Ina May Gaskin - Sure she’s a bit of a hippie, but she knows birth. This book is full of birth stories to empower and encourage. It also discusses pregnancy, labor, and birthing in a way that makes you feel like a real, powerful, strong woman
by Ina May Gaskin - Sure she’s a bit of a hippie, but she knows birth. This book is full of birth stories to empower and encourage. It also discusses pregnancy, labor, and birthing in a way that makes you feel like a real, powerful, strong womanThe Thinking Woman’s Guide to a Better Birth. 
By Henci Goer - A great book for women and partners on the edge with hospital interventions. Henci has thoroughly researched common procedures, outlining risks and benefits. She also gives alternatives and discusses how to talk to your care provider about these things.
By Henci Goer - A great book for women and partners on the edge with hospital interventions. Henci has thoroughly researched common procedures, outlining risks and benefits. She also gives alternatives and discusses how to talk to your care provider about these things.The Nursing Mother’s Companion 
by Kathleen Huggins and The Ultimate Breastfeeding Book of Answers by Jack Newman and Teresa Pitman - Great references for the breastfeeding mother. If I had to pick one, I’d go with the first. It’s a simpler read (though both are very readable) and has easy to skim organization of topics.
by Kathleen Huggins and The Ultimate Breastfeeding Book of Answers by Jack Newman and Teresa Pitman - Great references for the breastfeeding mother. If I had to pick one, I’d go with the first. It’s a simpler read (though both are very readable) and has easy to skim organization of topics.The Hidden Feelings of Motherhood. 
By Katheleen A. Kendall-Tackett. - A must read during the postpartum period. This book helped me acknowledge my own post-partum depression and worries. Can be checked out from the library.
By Katheleen A. Kendall-Tackett. - A must read during the postpartum period. This book helped me acknowledge my own post-partum depression and worries. Can be checked out from the library.The Baby Book. 
By Sears. The Vaccine Book by Sears. - Though I haven’t read all of the Sears library, I’ve read these two. The Baby Book is huge and comprehensive, not something you can read through easily, but great to have around. The Vaccine Book is very balanced if you’re just curious about the whole debate. It’s an easy read as well.
By Sears. The Vaccine Book by Sears. - Though I haven’t read all of the Sears library, I’ve read these two. The Baby Book is huge and comprehensive, not something you can read through easily, but great to have around. The Vaccine Book is very balanced if you’re just curious about the whole debate. It’s an easy read as well.The No-Cry Sleep Solution
. By Elizabeth Pantley and William Sears. - As we are beginning to learn that the cry-it-out approach doesn’t work for all and may cause damage to those it seems to work for, here’s a great alterative. Teach your child how to fall asleep rather than to get so tired they have no other choice.
. By Elizabeth Pantley and William Sears. - As we are beginning to learn that the cry-it-out approach doesn’t work for all and may cause damage to those it seems to work for, here’s a great alterative. Teach your child how to fall asleep rather than to get so tired they have no other choice.Books I suggest you avoid:
The What to Expect Series. While I’ve not read them, general consensus has it that these books tend to promote fear. You don’t need any added stress. If a complication occurs in your pregnancy, you can seek information as needed. Don’t scare yourself with all the what-ifs. There are better books out there.
Wednesday, August 25, 2010
What is my role as a doula and childbirth educator?
As a member of the childbirthing profession, I am a member of a number of listserves and email groups online. This week, one of the groups erupted with such a discussion that the current moderator stepped down and the group is going to have to re-form anew.
The topic: epidural kits and discussing epidurals in the classroom.
Some argued that having epidural kits “normalized” the idea of an epidural and made it easier for couples to get one. Others argued that without discussing epidurals, you are not actually providing informed consent. I take the second stance.
I have come to the conclusion in my own life that decisions that are best for me may not be best for others. Decisions that are good for me NOW may be different than decisions I made in the PAST or different from the decisions I may make in the FUTURE.
What does this have to do with childbirth education?
I do not think the focus of all childbirth education should be a natural birth at any cost. I don’t think we’re ready for it here in the U.S.
Please, don’t get me wrong. I think every woman that absolutely can do so, should have a natural childbirth. It’s good for her and for the baby.
But if we focus childbirth education as an all-or-nothing, we lose the women who may be on the fence. When we alienate women, we only hurt ourselves. (This, I think, is a failure of the feminist movement. But that’s a whole ‘nuther ballgame).
There are plenty of women out there who think that they cannot possibly cope with the pain and other distresses of childbirth. These women need to be empowered, not made to feel that they are less of a woman if they have an epidural in their birth. If they are empowered with information, maybe next time they have a natural birth in the hospital (as difficult as that may be). Then maybe they have a homebirth.
The woman who grows as a result of all her childbearing decisions will be the biggest advocate for natural birth. This is especially true among her close friends and her DAUGHTERS.
I have been trying to think about it that way as I formulate my classes. I want to support women in whatever birth they choose, even if it’s not the birth I would have.
“You had an epidural? How did you feel about that?”
“Stadol? That helped you get through?”
The topic: epidural kits and discussing epidurals in the classroom.
Some argued that having epidural kits “normalized” the idea of an epidural and made it easier for couples to get one. Others argued that without discussing epidurals, you are not actually providing informed consent. I take the second stance.
I have come to the conclusion in my own life that decisions that are best for me may not be best for others. Decisions that are good for me NOW may be different than decisions I made in the PAST or different from the decisions I may make in the FUTURE.
What does this have to do with childbirth education?
I do not think the focus of all childbirth education should be a natural birth at any cost. I don’t think we’re ready for it here in the U.S.
Please, don’t get me wrong. I think every woman that absolutely can do so, should have a natural childbirth. It’s good for her and for the baby.
But if we focus childbirth education as an all-or-nothing, we lose the women who may be on the fence. When we alienate women, we only hurt ourselves. (This, I think, is a failure of the feminist movement. But that’s a whole ‘nuther ballgame).
There are plenty of women out there who think that they cannot possibly cope with the pain and other distresses of childbirth. These women need to be empowered, not made to feel that they are less of a woman if they have an epidural in their birth. If they are empowered with information, maybe next time they have a natural birth in the hospital (as difficult as that may be). Then maybe they have a homebirth.
The woman who grows as a result of all her childbearing decisions will be the biggest advocate for natural birth. This is especially true among her close friends and her DAUGHTERS.
I have been trying to think about it that way as I formulate my classes. I want to support women in whatever birth they choose, even if it’s not the birth I would have.
“You had an epidural? How did you feel about that?”
“Stadol? That helped you get through?”
“You did everything you could to breastfeed this one? What do you think about breastfeeding the next one?”
Women are nasty enough to each other as it is. Don’t let that come over into the curriculum realm…
A lot of times, I think, we as childbirth educators and doulas forget that this is not our birth. Two wise women on another list this week talked about this concept in a great way.
Women are nasty enough to each other as it is. Don’t let that come over into the curriculum realm…
A lot of times, I think, we as childbirth educators and doulas forget that this is not our birth. Two wise women on another list this week talked about this concept in a great way.
From Polly Perez -
The Difference in Feeling Responsible TO and FOR
When you feel responsible TO others....
- You show empathy, encourage, share, confront, level, are sensitive, listen.
- You feel relaxed, free, aware, high self-esteem.
- You are concerned with relating person to person, feelings, and the person.
- You are helper/guide.
- You expect the person to be responsible for themselves and their actions.
- You trust and let go.
When you feel responsible FOR others....
- You fix, rescue, control, carry their feelings, don’t listen.
- You feel tired, anxious, fearful, liable.
- You are concerned with the solution, answers, circumstances, being right, details.
- You are a manipulator.
- You expect the person to live up to your expectations.
There is such freedom in that! (This kind of freedom is why I got out of teaching public school. I’m not wholly responsible for this kid’s A or F. His parents and he are responsible as well.)
My job as a doula or childbirth educator is to inform. As a doula, I consider this to be very secondary unless the couple also hires me as an educator. I can’t make anyone want to learn and find out and question. If you’re not satisfied with every single thing your care provider suggests, I can point you in the right direction and show you where to find information for your truly informed consent. But I can’t make you read it. And I can’t make you ACCEPT it. As a childbirth educator, I can present that information to you, but again, I can’t make you ACCEPT it.
We need to keep informed choice at just that – CHOICE.
As a side note, but very related to the idea of choice, here’s an article about the availability of midwives and how it changes maternity care for the better. Note – it doesn’t say choosing a midwife, but just that the choice is available. I think all women with normal pregnancies should be seen by midwives, but again, we’re not there yet…How I hope we are soon!
My job as a doula or childbirth educator is to inform. As a doula, I consider this to be very secondary unless the couple also hires me as an educator. I can’t make anyone want to learn and find out and question. If you’re not satisfied with every single thing your care provider suggests, I can point you in the right direction and show you where to find information for your truly informed consent. But I can’t make you read it. And I can’t make you ACCEPT it. As a childbirth educator, I can present that information to you, but again, I can’t make you ACCEPT it.
We need to keep informed choice at just that – CHOICE.
As a side note, but very related to the idea of choice, here’s an article about the availability of midwives and how it changes maternity care for the better. Note – it doesn’t say choosing a midwife, but just that the choice is available. I think all women with normal pregnancies should be seen by midwives, but again, we’re not there yet…How I hope we are soon!
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