A Big Idea

As you may have heard, maternal mortality is on the rise.  According to Ina May in her new book, pregnant women today are two times more likely to die due to complications caused during pregnancy or birth, than our mothers were.  In spite of Because of rising cesarean rates, rising induction rates, maternal health disparity between the classes, and spending more money on maternity care than any other country, more women are dying today due to pregnancy related ills than in the past 50 years.  There’s a bill in the works to help with our growing problem, click here for more information.

Depressing?  Possibly.  But I have another idea:

According to Radical Doula in this article  for colorlines, poverty, lack of prenatal care, and pre-existing conditions all contribute to the rise in maternal mortality.  So, what if we reformed the maternity care system at the Medicaid level?  Republicans want to cut the Medicaid program to save taxpayer money, but I have a better idea:

Why not make just make quality care more accessible and less expensive?  How you ask?  With midwives.  Radical Doula advocates home birth as a solution, and I’m certainly not discounting that.  But I also believe in meeting people where they’re at, and with 98% of women giving birth in a hospital, I don’t know if our society is quite ready for that big of a leap.  While I think that home birth could, and should, be covered under Medicaid, I also think it’s more important to reform maternity care in the hospital setting.  Here’s how I would do it:

Provide women with more options of health care providers in a hospital setting.  Nationally, Medicaid lists Licensed Midwives, Certified Professional Midwives, and Certified Nurse Midwives, as licensed providers.  However, currently, only 11 states recognize midwives as licensed providers under Medicaid.  In Washington state, women on Medicaid were given the option of receiving prenatal care from Licensed Midwives, (LM), Certified Nurse Midwives (CNM), and Certified Professional Midwives (CPM).   In doing so, the state saved $3.1 million dollars over two years (I can’t find a link to the study, but I’m pretty sure these were the numbers).  I think by providing more options of quality care providers (i.e. midwives) to women on Medicaid, and providing incentives to physicians and hospitals to support midwifery care in their practices and in the hospitals, valuable taxpayer dollars can be saved.

In addition, midwives generally spend more time concerning themselves with the mother’s diet and emotional wellbeing than physicians do; both of which are crucial to a healthy mother and healthy baby.  I have a hunch that this simple change could make a huge difference in the number of premature deliveries, cesarean sections, and breastfeeding success among mothers on Medicaid.  (All of which mean lifetime health for both mother and baby and less money spent down the road on health care.)

I see midwives working with OB practices.  When a Medicaid client calls her OB office of choice for her first prenatal visit, she visits with one of the midwives.  The midwife assesses her initial condition, and then the woman has the opportunity to continue seeing the midwives, or see an OB.  This would be true for normal, low risk pregnancies.. all but about <10% or so.  The way I see it, there’s more caregivers to go around, no one is as over worked, stressed, or as tempted to just-do-a-section-and-deliver-the-baby-so-he/she-can-go-home-for-a-couple-of-hours-of-sleep-before-having-to-wake-up-again-and-go-back-to-work.  It just. makes. sense. to offer midwifery care to low-risk, low-income women on Medicaid, doesn’t it?

Provide the option of group prenatal care to women on Medicaid.  A recent study in Sweden found a possible link between maternal stress and cesarean section.  This study looked at the link between chronic maternal stress and preterm deliveries. They found vast improvements simply by providing group prenatal care with a midwife.  As the lovely Henci Goer pointed out:

Group prenatal care builds community and helps women feel more competent and confident, as shown by the trial’s other positive outcomes: women in group sessions were less likely to have suboptimal prenatal care, knew more about pregnancy, felt better prepared for labor, were more likely to initiate breastfeeding, and were more satisfied with their prenatal care. With social interventions, everyone wins, not just women spared a preterm birth. Best of all, there is NO downside to group prenatal care, no worries about adverse effects of treatment short- or long-term.

It hardly needs to be said that the cost of providing group prenatal care would be significantly lower than the cost of drugs to prevent preterm deliveries, or perform cesarean sections.  And what could the associated risks be of providing such care?  Go ahead, think of one!

Doula. Support.  Medicaid should cover doula support for every woman on Medicaid.  Having a doula present during labor significantly lowers the instance of cesarean section, vacuum/forceps delivery, and a need for pain medication.  Women who have a doula during labor also have better success breastfeeding, and are more satisfied with their birth experience.  Statistically, they have significantly shorter labors.  This combined with lower instance of c-section means shorter hospital stays.  Shorter hospital stays, less money spent on anesthesiologist, better breastfeeding, healthier mom/baby, all add up to money saved, immediately during birth, and in the long run.  I hardly think a doula’s fee would be as costly as all of these savings.

I suspect implementing these changes to Medicaid care would mean a drastic decrease in maternal death, but even if none of these things helped, not even a little bit, what would be the harm done?

I also suspect that as more women catch wind of the quality care provided to women and families on Medicaid, they will begin to demand the same quality of care for themselves; and for good reasons!  And again I will ask, why not?  Call me naive, but could the “down side” to such an experiment really be as costly as the number of lives lost this year due to suboptimal care?

So I’ll ask again: how can we make this happen?

Mantras, Affirmations, and Visualizations for Labor

*disclaimer* – Even if this type of thing seems a little crunchy for your taste, please read on with an open mind, you might still find something useful… and if not, please tell me so in the comments!

One thing that I sometimes have trouble wrapping my head around is this:

If our bodies are built to give birth, why is there so much emphasis on childbirth preparation?  It seems as though we should be able to labor, squat, push out a baby, and go on about our business, does it not?  So why is there such an industry surrounding birth?  How is it possible that with so many books, blogs, documentaries, support people, and childbirth ed classes we still don’t feel we have “enough” support and information to cope during labor?

I see it like this:  yes our bodies are built to give birth, but our minds have now had centuries of fear and trauma attached to childbirth, and because the two are so inextricably connected, we must actively prepare the mind for labor, just the same as we exercise and practice labor positions.

One way to prepare the mind for birth is by using language to begin re-programming the mind for a peaceful birth experience.  Following are many different suggestions on how to do this.  Affirmations and Mantras; simple words and phrases to change thoughts of fear to those of empowerment and surrender.  Visualization exercises can also be practiced as a coping mechanism, and also as a distraction.

Affirmations:

Affirmations give you the ability to replace negative or haunting thoughts with positive, empowering ones.   The following list is merely a list of suggestions.  By the way, wave=rush=surge=contraction.   Use these interchangeably, feel free to substitute.  Getting the exactly appropriate mix of words in your affirmation can make all the difference.  Switch things around as it suits you until you’ve got it just right.

“Each surge brings my baby closer to being born.”

“My body hugs my baby with each surge.”

“Each surge of energy allows me to surrender further to my love for my baby.”

“My body won’t produce any energy it can’t handle.”

“My body is designed to give birth to my baby.”

“I trust my body to bring my baby safely into my arms.”

“As each wave washes over me, I ride the current to the shore.”

“Each contraction is actually a wave that will eventually bring me to the shore.”

“As the intensity builds, I relax deeper into the birthing energy.”

“Surrender = Love.”

“Because of my love for my baby, I am able to trust the process of birth.”

“Labor is the process by which I will meet my baby for the first time.”

“Each surge strengthens my baby’s lungs a little more.”

“Each wave of energy strengthens me a little more.”

“The power flowing through me is my own.”

“The power flowing through me is ancient and divine.”

Mantras:

Mantras have the same benefit of repetitive comfort that come with affirmations, but because mantras are generally in another language (Gurmuki, a derivative of Sanskrit in this case), our minds don’t become attached to the words like we would with English words.  For instance, chanting an English word, like “Baby” over and over again triggers lots of thoughts… baby shoes, outfits, the nursery, sleepless nights, poop, crying, love, breastfeeding, sex after the baby, motherhood, etc., etc, because we already have lots of mental ties and reactions to the word “baby”.  By chanting words that you are unfamiliar with, as in mantra, the mind is not triggered into a stream of thoughts, on the contrary, it slows the flow of thoughts as the mind becomes focused on the mantra itself.   You may chant these out loud, especially if the vibrations feel good.  You may also repeat them silently to yourself, to focus the mind.  Here are some suggestions of mantras to use during labor:

“Ong” – The creative form of the sound Om.  It’s an inherently creative sound… appropriate for creating life, no?  Chant Onnnnnnnngggggggg so the vibrations are felt in the throat.  The mouth is relaxed.

“Har” – Pronounced “Hud” (all of the “r’s” in Gurmuki are pronounced like soft “d’s”).  Another form of Creative Infinite Energy.  Can be chanted repetitively: “har, har, har, har, har, har…”

“Hari” – Pronounced “Hud-e”.  Creation in action.  Chant with Har:  “hari har, hari har, hari har…”

“Sat Nam” – Pronounced “Sut Nom”.  Sat Nam means “I Am Truth”.  By chanting long Sat Nams, the mouth stays relaxed and vibrations are felt in the throat, relaxing the cervix and vagina.

“Sa Ta Na Ma” – Pronounced with long A’s.  “Saaa Taaa Naaa Maaa”.  Increases intuition and describes the continuous cycle of life and creation.  This mantra stimulates the pituitary gland, the gland that secretes oxytocin… you know, the thing you need to start and keep labor going?

“Wahe Guru” – Pronounced “Wah Hay Goo Doo”.  Means ecstasy in experience.  It describes the indescribable experience of going from darkness to light.

Visualizations:

I’m not claiming any of this is “new” or “earth shatteringly inventive”, in fact, you may have heard some of this stuff before, but I’m gonna mention it anyways, just in case something plants itself in your subconscious, only to be recalled and be useful later on:

Visualize yourself in the ocean.  You can’t see the shore, but know that it is there.  You are floating in the water.  As waves roll in, you allow the waves to carry you towards the shore.  Trust that all waves end up on the shore, therefore you too will be brought safely back to land.

You can also stay with the ocean thing, and visualize yourself surfing.  Ride each wave up to the crest during a rush, then ride back down as it ebbs out again.  Relax in the waters in between.

Visualizing a flower in bloom during each rush can help you stay focused on the opening process.

Visualize your cervix, or vagina – if you’re fully dilated, as a soft turtleneck sweater.  As the baby’s head enters the cervix/vagina, the cervix/vagina gently stretches around the baby’s head as a sweater would.

Another option is, during pregnancy, to create a “safe space” in your mind.  It can be anywhere that is comforting or beautiful to you.  Manifest this space for yourself, down to the very last detail.  As you labor, recreate the space and go there in your mind.

My “happy place”:

(not really, I’m not that nerdy, geez!)

Again, these are suggestions of exercises that can be helpful.  If something clicks with you for whatever reason, make a note of it and give it a shot.  Practice on your own, maybe lying in bed at the end of the night, so you become comfortable with the words/phrases you latch on to.  Practice also gives you the chance to find out what works and what doesn’t.

“Yoga” vs. Yoga

The conversation is short, and it usually goes something like this:

“What do you do?”

“I’m a prenatal yoga teacher.”

“Oh! … I have a friend/sister/co-worker that does yoga…” or “I took a yoga class one time…”

/conversation.

 

This is pretty standard, especially in my hometown.  I usually don’t think much about it, maybe I even enjoy being slightly misunderstood.  Call it a chronic case of teenage angst.  Whatever.

Well, I read an article on navelgazing midwife recently that really started me thinking about the meaning of yoga, I mean the real meaning.  I’m not talking about yoga as a form of exercise so much, or even a yoga class that you take.  I mean the real yoga.  For Barb, she took a “yoga” class and hated it, and then found her yoga in birth itself.  Confused yet?  Read on.

The word yoga itself means yoke, or union.  It refers to your whole self: physical body, mind, sprirt.  To practice yoga means to practice bringing these three parts of you into union.  It is therefore, by nature, an individual practice.  Yoga is most often practiced in groups, like in a class, but a good yoga class should still allow for individual experiences within the group, because the goal, even in a large group, is (or should be) to bring you into harmony with your individual Self.  Does that make sense?  Let me back up:

Here in the west, we’ve taken yoga to mean putting your body into pretzel-like positions, and achieving a state of mental peace by doing so.  This works for some, several people I know, but if you’re like me, or Barb, it doesn’t.

Most yoga classes (at least here in SA) are held in gyms, aerobic studios, or other large, loud rooms with lots of mirrors, and lots of other people.  Eyes are generally open, and wandering around the room… comparing your posture to a “better” or “worse” posture, looking at yourself in the mirror, noticing a little bit more belly than was there before, or thinking that you need a haircut, wondering where that girl over there got her top…. you get the idea.

Maybe this kind of environment speaks to you, maybe you enjoy the “challenge” of finding your own space within this group space.  Maybe you have a competitive nature, and you enjoy the quiet competition between others and yourself.  Is this something that could bring your mind peace?

That doesn’t work for me.  I prefer something quieter.  A dimly lit room, soft music, eyes closed, focusing inward.  This is my yoga.  The only competition is in my own mind, as thoughts vie for my attention.  My challenge is to become still and comfortable in the moment.  There are postures, and maybe others in the room, but everything is part of my personal experience.  By relaxing into this, I feel acceptance of myself, and my situation.  I feel peace in this.  I find stillness in the flow of thoughts, in the noises and smells in the room, and in the movements themselves.

Have you given birth before?  If so, some of this might sound familiar.  Birth is a lot like yoga – true yoga.  Both activities require a surrender of your mind to your body.  Both require relaxation, and reverence.  Both involve physical activity for a specific purpose.  (Remember, we’re talking about the definition of a yoga practice – bringing union to body/mind.)  Yoga in this way can be a great preparation for childbirth because in a yoga practice you are laying the plans for the work to be done during labor.

So then, I ask you:  What is your yoga practice?  Do you take a class, or do you find harmony in another activity?  What activities bring you peace?  Are you pregnant?  If so, how is your practice preparing you for birth?  Not pregnant?  How does your practice help you meet challenges in your life?

*note: if you don’t have a practice that does this for you, I suggest you find one.  You won’t regret it.

 

10 Steps to Better Pregnant Sleep

So obviously, pregnant sleep is much different than regular lady sleep.

As your body (and mind) prepares for more frequent interruptions during the night (the kind that come with a new baby), you don’t sleep as deeply now, and, well, have more frequent interruptions during the night.

Interestingly, towards the end of the third trimester, you will actually be in a position to function on less sleep, though this isn’t true for all of pregnancy, and if exhaustion doesn’t come with gestation, it probably will come with a newborn.

Lots of importance is given to bodily comfort to help you stay asleep during pregnancy, and Giving Birth With Confidence recently posted this helpful article on better sleep during pregnancy. These are certainly important, as if you are uncomfortable you will not sleep as well than if you were actually comfortable.  So proper support, hydration, and going to bed earlier can certainly contribute to a more restful night of Zzzzs.

The problem that I see with pregnant sleep, is that your body only makes up for part of the equation.  If your mind is not ready for sleep, you probably will not sleep.  Or at least not sleep well.  By preparing your mind for sleep before you get into bed, you stand a better chance of getting a few hours of restful sleep instead of several hours of exhausting sleep (yes there is such a thing).

1.  Turn off the TV and computer.  Stop texting.  Turn off all devices. – 30 minutes before bedtime.  Give your eyes and mind a break from all the stimulation of technology.  It’s easier to relax to sleep if you give yourself some wind down time at the end of the night.

2. Take a warm bath, or shower, or at least wash your face, hands and feet. And since we’re winding down, relax with a warm bath or shower.  If you don’t have time for that, at least wash your hands and face in warm water.  Rinse your feet in cold water, and begin to disconnect yourself from your day.

3. Brush down your hair, even if it is short. Brush or comb your hair.  If it is long, braid the hair so it won’t get in the way while you sleep.  Combing the hair down is relaxing.

4. Gently stretch your muscles. Take a few minutes to stretch out.  Practice a few life nerve stretches. This will help you feel contained and relaxed.

5. Drink a glass of water. Most likely you will wake up to go to the bathroom regardless of whether or not you drink liquids in the evenings.  Since dehydration can also wake you up in the middle of the night, it’s best to stay hydrated so once you do wake up to go to the bathroom you’ll fall back asleep easier than if you were dehydrated.

6. Give yourself a foot massage. Grab a little oil (almond, olive, and coconut oils are all great, but pretty much anything you have in your kitchen will do), add some essential oils if you wish (lavender, neroli, and chamomile are all especially relaxing), and begin to massage your feet one at a time.  As you massage, continue to disconnect yourself from the world.  Bonus points for getting a massage from your partner!

7. Read something inspirational, meditate, or say your prayers. (Avoid reading anything overly stimulating, graphic, or anything you just can’t put down.)  If we’re talking about relaxing before bed, and falling quickly into a deep sleep, it should stand to reason that you should avoid reading anything graphic or suspenseful at this time.  These things can trigger the stress hormones that will keep you from relaxing to sleep.  Save these books for other times, like waiting during prenatal appointments.  OR, read a bit if you must, but then do some of the previous relaxation measures after you read so you can go to bed with a calm mind.

8. Lie down, get comfortable (ha), and begin long deep breathing through your nose. Once you’re in bed, find a comfy spot and begin long deep breathing. Begin by breathing through both nostrils and then block the right nostril with the right thumb and begin breathing through only the left nostril.  This has a cooling, calming effect on the mind.

9. Once you’re breathing deeply, begin the following visualization: Visualize a room in your mind.  The room is empty except for a large box.  Begin to put your worries, to-dos, projects, problems, anything that you start thinking of, or that has been on your mind; put it in the box.  Don’t start thinking about any one of these things, just put it in the box and move on.

10. Continue long deep breathing.  As thoughts enter your mind, put them in the box, focus back on the breath. Keep it up, you’ll be asleep soon. 

For more information on yogic sleep, and more suggestions, check out this page at 3ho.org.

Nighty night!

Adelaide’s Birth Story

My “dream blog” (dlog?) features a weekly birth story.

Birth stories are fascinating to me, whether they’re inspirational, complicated, or whatever, it’s amazing how the quintessential human experience is experienced so uniquely.

So, in an effort to bring this dream to fruition, I offer my birth story.  This is how I remember it, with all the details that stood out to me,  (read: it’s long — you’ve been warned) but I am happy to have documented Adelaide’s birth this way so I can look back later and be reminded of the little things that made this time so special and unique to me, or similar to other women.

Enjoy!

One week away from my given “due date”, I knew I would not still be pregnant in a week.  That evening, I began having rushes in the middle of the night.  I was so excited I got out of bed and began timing them by myself.  They were about 8 minutes apart and not very strong, but I couldn’t help but hope that this was the beginning.  After all, we had been told to head into the hospital once rushes were strong and about 5 minutes apart.  Well, 8 minutes is close right!?  Wrong!  Eric went to work the next morning and then again the morning after that while nothing happened with me. Nothing.

I continued to have rushes at night, but during the day they would vanish without a trace.

By Saturday morning, (after three nights of timing rushes, and two days of nothingness) I was tired and cranky.  I woke up and decided I had enough of being pregnant and that by Monday I would not be pregnant any more!   So Eric and I went for walks all day.  It was hot and I was tired, but determined to get labor going.  I ate pasta, and a piece of plain toast.  We watched movies and episodes of Lost, and as the day progressed, my rushes were definitely stronger, but no closer together than about 10-15 minutes.  Then in the evening around 8 o’clock, they became much more powerful, and closer.  Now they were about 7-8 minutes apart.  I threw up at some point, and I didn’t want to get off of the toilet.  I kept thinking I needed to pee every time a rush started, so I would make it to the bathroom and just sit there on the pot.  The rush would end and I’d waddle back into the bedroom and lay back down until the next one started… repeat the process.  We called Jan (the midwife on call) and she told us to wait until I was rushing every 5 minutes and call back.  It was the middle of the night at this point.  I was tired so I slept between rushes, with Eric lying against me.  He would gently wake me up when it was time for another one, and would then help me rest in between.  I felt so close to him, and it was nice and cozy, so I was able to relax.  Around 4am, I threw up again… on the floor, in the middle of a rush.  It was uncomfortable.  Then immediately, instead of rushing every 8 minutes, I was rushing every 4 minutes.  Then after a couple more rushes, 4 minutes became 2 minutes, 1 minute, 45 seconds between rushes!

We had talked about this in class, how as you got closer to pushing, the rushes would be less than a minute apart.  I had GBS so Jan told me ahead of time I should plan on spending about 5 hours in labor at the hospital so I would get enough antibiotics that Adelaide wouldn’t have to have some kind of testing done.  Oops.   Eric called Jan again and she finally told us to head to the hospital.

The ride to the hospital was unpleasant because I couldn’t get comfortable in the car, but at least it was dark outside and there was little traffic.  The (freaking long) walk from the parking garage to the delivery room was very difficult.  I had to stop every minute and lean on Eric (who was already carrying two pillows, a suitcase, and my giant purse), have a rush and then walk on.  It felt like hours.  A nurse passed us and told me that I was almost there and I wanted to punch her.

We arrived in the labor and delivery wing of the hospital at 5:15 am. (Eric was keeping an eye on the clock.)  Eric was asked to wait outside while I was to change my clothes and let them “examine” me, alone.  This was the only time during my labor I felt discouraged, like I couldn’t continue.  The lights were bright, I was alone, and I had to be very still while they checked the baby’s heart rate on the monitor.  A nurse checked my cervix to see how open I was, and she was not very gentle.  I was having a rush as she checked me, and I felt I was in great pain.  This would be the only time I felt pain during my labor.

The nurse reached up for my cervix and found Adelaide’s head instead.  I was 9 centimeters dilated!  Whoa!  (Labor at home to avoid unnecessary examinations and interventions — check!)

Eventually they took us to our labor and delivery room and Jan arrived.  The lights in here were dim, and I was comfortable on my bed.  Eric held one of my hands, and Jan held the other.

I should mention that I felt it would be very important for me to be able to move around during labor, I didn’t want an IV or to be hooked to the fetal monitor, but I was hooked up to these things.  I had to receive antibiotics for the GBS, and therefore had to have the fetal monitor on.  As it turns out, I couldn’t have moved from that bed if I was forced out of it.  I found a comfortable spot in a semi-reclining position and would not budge.  Jan was there the whole time (which was only about 2 hours).  She tended to Eric, who needed a chair to sit on, tissues, and water and wouldn’t leave my side to get things for himself.  I was unaware of his needs, or the fact that he was crying.  I was so deep in labor.   He said he was in awe of how strong I was.  I didn’t feel very strong actually, not yet… just focused.

I felt very focused, and very connected to Adelaide.  I told her how excited I was that all of this was happening, and that I knew that she was working hard also, and I thanked her for that.  I told her that I would do everything I could to not hinder the process so that we could meet her soon.

As the rushes came, I visualized myself surfing.  I would ride, ride, ride, ride the wave until it subsided, then I would relax in the waters.  When another one would come, it washed over me, and I stayed with it along the all the way up to the crest, and then back down again.

I felt I was in a very deep meditation, not in the transition part of labor, which I had heard was the hardest part.  It was intense sure, but I didn’t feel that it was anything I was incapable of handling.  After all, it was the force of my own body at work; I just had to trust the process.

Finally I felt like I wanted to push, so I said so.  Jan gave me the go ahead and I began to “push”.  Except pushing didn’t help to relieve the pressure I felt.  I did what I thought I was supposed to do, you know, what you see women do:  bare their teeth, hold their breath, and bring their knees up to their chest.  It wasn’t helping.  Finally Jan told me to surrender and let my body do the work, not to try so hard (or something like that).  So I did.  Suddenly, I wasn’t pushing at all.  I wasn’t doing anything.  The rush would come, and the pushing happened of its own accord.  It was amazing.  The power was incredible.  If I wasn’t confident and trusting of my own body, it might have been frightening.  But as it was, it felt really good. I think my eyes were closed, and then I heard Jan say, “With your next contraction your baby will be born.”  I could hardly believe it.

It came, and Jan told me to open my eyes to watch her entrance into our world, and there she was!  I saw Adelaide, our baby girl for the first time!  And she was so beautiful and purple!  I have never felt such bliss and euphoria.  I don’t even remember feeling pain as her head was crowning, and I tore slightly but didn’t feel a thing.  Both of her shoulders and then the rest of her came out all at once *pop* and I needed one stitch.  Nothing mattered except that I had her, and I was done!  Eric cut the umbilical cord, and witnessed her birth.  I didn’t want for him to watch her being born because of my own insecurities, but I am so glad he did.  No amount of words can describe the love and energy in that room.  It was amazing.

We spent almost two beautiful hours in bliss and love together, just the three of us, drinking in this anticipated moment.  I felt so strong, that I could do anything, and I knew that if I had that power come through me, then that was the true power of a mother: the unstoppable force of surrender and love.  I’ve never felt so strong and beautiful.

Then, because of hospital policy, I had to ride up to our postpartum room in a wheelchair.

And because of the GBS, Adelaide went with her dad to the nursery for blood work. Now I felt empty and alone.

After it all

Next time, I’m definitely staying home.

Grrr.

Dear New Baby Blog,

I know how powerful words are, written and otherwise.  I therefore promise to use you as a means to write positive, informative, or encouraging posts.  I understand that my personal preferences regarding OB/midwife, hospital/home-birth, medicated/non-medicated birth may not be the preferences of my readers and I therefore should not attempt to state any of my (many) opinions as “advice”.

I want to refrain from using you, dear little blog, as a complaint department.  There are plenty of wonderfully written, smart, snarky blogs like this one and this other one to deliver the snark much more effectively than I ever could.

I just wanted you to know, that I promise to use the force of my words with caution ’round here, and not let you fall into any kind of “anti-establishment” target for criticism.  These pages should be for everyone interested in the wonders of pregnancy and birth, and I don’t want to remove myself from potential readers by presenting slanted, false, or overly-opinionated information.

Lots of love,

Alissa

Having said that…

I do understand the power of words, and therefore I fully realize the damage that could be done by the misinformation presented in this video clip, Go ahead, watch it.  I’ll wait…

Hmph.  What do you think?  No big deal?  See below.

I feel that it is important to fight this.  Science and Sensibility has already posted a wonderful criticism of this clip that you can read here.

I, however, was too irritated by this clip to stop there, the clip is just not honest!   Dishonesty bothers me.  A lot.

I’ve written a letter to the producers of the show expressing my outrage, and providing reasons for my response.  I will post this letter here, in case anyone is inspired to send a letter of your own, or copy mine and send it as your own.

There are too many conflicting opinions regarding birth options to let this kind of falsified information circulate around in the midst of the already overwhelming number of facts and opinions surrounding epidurals, and other medications associated with childbirth.

So here is my letter.  What would/will you say to the “Doctors”?

To Whom It May Concern:
After watching the recent segment on your show regarding epidural anesthesia, I am appalled by the blatant misinformation presented by “Drs.” Masterson and Ma regarding epidural anesthesia.
I firmly believe that an epidural anesthetic is a boon to women who must give birth by cesarean section, and I understand that many women are frightened of pain associated with childbirth, and choose to numb the sensations with an epidural. Also, my opinions regarding pain medication during labor have no place in this letter and have no bearing on my anger with your segment.
I am infuriated at the misleading opinions given by so-called “experts” in your show. A doctor should be a respected and trusted institution. Doctors hold the lives of their patients in their very hands, and therefore a relationship of trust between doctor and patient is crucial. When a “doctor” (such as Drs. Masterson and Ma) gets in front of a camera and provides false information and information taken out of context, this trust is broken. By stating that “the epidural will not get into the mother’s bloodstream and will not cross over the placenta”, this has been proven untrue in several studies. In fact, drugs in epidural anesthesia show up in the baby’s bloodstream in levels at least as high as those in the mother. These same studies have proven that babies whose mothers were given epidurals in labor are more likely to be drowsy at birth, have difficulty breastfeeding, and be lethargic after delivery. This certainly suggests that the epidural would affect the baby, contrary to what the Drs. M stated in the show.
By stating that the mother’s stress hormones cross the placenta and cause harm to the baby, that statement is taken out of context and should therefore be viewed as false. The stress hormones released by the mother are necessary to facilitate a quicker second stage, as at very long second stage can be risky to both baby and mother. Actually, women who have an epidural in place have been proven to have longer second stage labors because they are not actively working with their pelvic muscles to push their babies out. Therefore, by stating that an epidural would “help the mother to push”, and that she “may tear as a result of not having an epidural”, is a blatant lie as it is well known that epidural anesthetic numb the nerve receptors in the pelvis and therefore more frequently require deliveries using forceps, vacuum extractors (which would require an episiotomy), or even cesarean. Especially for first time mothers, epidural use can decrease chances of having a natural delivery by up to 50%. Women who do manage to deliver naturally with an epidural in place have a greater chance of tearing because they will not be able to feel their pelvic muscles. Without these sensations, they may need directed pushing, which carries an increased risk of tearing.
By far, the most damaging lie told in this segment is that an epidural is actually “good for the baby”. In fact, there are considerable risks involved with receiving an epidural to the baby as follows:
• Rapid breathing for the first few hours after birth
• Vulnerability to low blood sugar
• Difficulty with breastfeeding and lethargy following birth leading to poor suckling, and decreased bonding between mother and baby.
• Epidural anesthesia puts the mother at a higher risk for cesarean section. Babies born by cesarean section may have breathing difficulties after birth.
• By having an epidural in place, the mother may require augmentation of labor by artificial oxytocin drip. There are too many risks to the baby from these drugs to be discussed here.
The risks to the mother from receiving an epidural are as follows:
• Slow second stage labor, requiring augmentation by artificial oxytocin drip. Many risks are associated with augmentation of labor, too many to be discussed here.
• Increased use of forceps or vacuum extractor, requiring an episiotomy, which can be painful after birth, and may become infected.
• The epidural also numbs the bladder causing the woman to be catheterised.
• The woman may experience itchy skin,
• Headache,
• Maternal fever,
• Shivering,
• Possibly nausea and vomiting

Not one word was mentioned of these risks in your segment. I might wonder who is funding this program, though I would not be surprised to find several pharmaceutical companies sponsoring this misinformation being presented to hundreds of thousands of women for the benefit of their companies, and to the detriment of public health and opinion.
I can see how your program could be used to benefit many. To receive quality, sound, medical advice whilst lounging on a sofa could be a wonderful resource to many who may not have regular access to specialists such as those brought onto your show. However, to provide false information under the guise of medical knowledge and experience is simply unethical.
By presenting a one sided, unfounded view such as the segment on epidurals did, you will cause your knowledgeable viewers to lose faith in the doctors on your program, and possibly the medical establishment as well.
I beseech you to consider what doctors are supposed to represent, and think about the good you could be providing, instead of pushing your own falsified agendas and pleasing your advertisers.

Appalled and Angry,

Alissa Smith

10 Ways to Safely Boost Energy During Pregnancy

I doubt I need mention the injustice of caffeine restriction and pregnancy induced exhaustion.  Even though 1-2 servings a day is still “allowed”, caffeine will only provide a temporary energy boost, often leaving you feeling more drained after the effects wear off.  Also, caffeine interferes with sleeping patterns, and who needs more trouble sleeping, am I right?

Fear not, I have solutions!  I have compiled a list of ten simple (some more so than others), safe, and natural ways to boost your energy on the spot and over time.  Read on for my suggestions, and add your own in the comments!

Happy Gestating!

1) Stay Hydrated

If you are consistently low on energy, you may not be drinking enough water.  Ample water intake is essential for energy and overall health, especially now that your body has more fluids to circulate and replenish.  The majority of your fluid intake should be water, with smaller amounts of juices, herbal teas, milk, etc.  Avoid caffeine free sodas and sugary drinks, as the sugar in these beverages cause your blood sugar to spike initially, only to drop later, leaving you exhausted.   You should aim to drink at least 64 oz. of fluids a day, with water being most of those fluids, but if you still feel thirsty, drink more!

2) The Dancer’s Nap

This is a simple, effective and restful technique shared by Gurmukh in her (wonderful) book Bountiful Beautiful Blissful. Sit in a comfortable chair with your back supported either by the back of the chair or with pillows.  Elevate your feet above heart level with your feet uncrossed.   Cover your eyes and begin to breathe long and deep.  You may play relaxing music, or relax in silence.  Rest for 15 minutes.  It should be noted that this is a truly restful exercise because you will consciously be relaxing your mind.  Plopping down on the couch in front of the TV does not have the same effect.  Not to say that a little mindless TV watching can’t be relaxing, it just does not have the same regenerative effects as a conscious relaxation practice such as this one.

3) Ginger Tea

Ginger tea is spicy and energizing.  Place 4-5 small pieces of freshly peeled ginger in a cup with boiling water and let steep for 5 minutes.  Ginger tea strengthens the nervous system, helps prevent fatigue, and bonus!: may help reduce pain associated with uterine cramps!  Don’t drink more than 1-2 cups per day, as excess doses may exacerbate heartburn, and consult your caregiver about using ginger if you are on medications.

4) Hydrotherapy

Cold-water hydrotherapy has numerous health benefits.  Benefits of a cold shower each morning can be discussed here.  But you don’t need a full on shower to replenish your energy.  Simply rub your hands together briskly under cold water, then begin to splash the cold water on your face.  Pay special attention to the forehead, splashing cold water until the skin no longer stings, keep going!  In addition to leaving you energized, this also gives you focus!

5) Get Active!

Although it may seem counterintuitive when you are feeling tired to try and do more, and we certainly don’t underestimate the rejuvenating effects of a good night’s sleep, but light exercise can also help to boost your energy.   Go for a walk, do some light stretching (forward bends, and gentle back bends and chest openers are particularly energizing), or have a “5 minute dance party” in your living room.  Ideally, take your activity outdoors to soak up some extra vitamin D, further boosting your mood and energy!

6) Change Your Diet

While this approach may be the most effective for sustaining energy, this is also the most difficult.  By eating simple, clean, and easy to digest foods (think cooked and raw fruits and veggies, nuts, whole grains, (no processed flours), yogurt, nuts and legumes) and by avoiding slow to digest sugars, fats, and fatty proteins, your body will need less energy to digest your food, allowing more energy to be available to you for other things.  Be sure you are still getting adequate protein (75-100g a day), but keep it lean (think chicken, fish, tofu, edamame, nuts, and fruit smoothies with a protein supplement). Include soluble and insoluble fibers as well as lots of roughage from raw fruits and (especially) green veggies to round out your meals and snacks.  It may take a few days for your body to adjust, but once it does you’ll feel clean and refreshed.

7) Pranayam (Breath Work)

The breath is a powerful force affecting all parts of your well-being.  As powerfully as breath can clear the mind and relax the body, it can also help energize the mind and body!  Try these simple breathing exercises to increase your energy:

8 stroke breath for energy and stress release: Sit in any comfortable posture.  Let the eyes close and begin to inhale in 8 equal strokes through the nose.  Exhale in one long smooth stroke through the nose.  This exercise forces your attention to the breath.  Inhaling in 8 strokes is invigorating, the long exhale is relaxing.  The exercise will leave you clear headed and balanced.  Practice for up to 11 minutes.

Right nostril breathing for energy: Block the left nostril with the left thumb.  Breathe long and deep through only the right nostril.

8 ) Yoga Postures and Inversions (*please read disclaimer)

*disclaimer – although most healthy women with an uncomplicated pregnancy may continue to practice inversions late into pregnancy, for some women it can create an unsafe drop in blood pressure.  If you become dizzy or faint at any time, please discontinue the exercise and try the provided modification.  Please consult your caregiver if you have concerns, and do not attempt if you are concerned about your or your baby’s wellbeing.

Inversions increase blood flow to the heart and brain, thus increasing oxygen flow to these areas.  While some inversions are not well suited to pregnancy, most women (read disclaimer) will be able to practice these postures safely.

Most everyone should be able to practice the other poses.

Dancer’s Nap Position:  See suggestion #2 for instructions on how to assume this position.  Elevating the feet above the level of the heart also helps to prevent swelling of the feet and legs, and increases circulation to the upper body.

Triangle Pose:  Come into an all fours position.  Turn the toes under and straighten the knees.  Push the buttocks up, and roll the armpits towards each other.  Knees can be bent and heels can be off the ground, but ideally you will form a “triangle” with the ground.  Push the upper body back so that the head is in line with the elbows.  Rest here as for up to a minute, or as long as you are comfortable.

Child’s Pose:  This pose can be performed in place of the others.  Sitting on the heels, spread the knees as needed to make room for the belly.  Lower the upper body towards the ground in front of you, resting the forehead either on the floor, or on a cushion on the floor.  Arms can be stretched out in front, or resting along the sides.

Life Nerve Stretching: Sit on a mat or rug placed on the floor; you may also sit on a cushion.  Stretch your legs out in front, spreading the legs as needed to make room for a growing belly, and reach towards your toes.  Holding onto the toes is not essential, placing the hands on the knees, shins, ankles, or even thighs is perfectly fine, and with practice you will be able to deepen the stretch.  Lengthen the spine and stretch forward and down.  Let the chin fall towards the chest.  Breathe deeply in this posture for as long as you are comfortable.  By (eventually) lowering the head below the heart center, you increase circulation to the brain and feel grounded and focused.

Gentle Back Bends: Stand barefoot with the feet directly under the hips.  Do not lock the knees.  Imagine the pelvis as a bowl of soup, you don’t want for soup to spill out of the front, or the back.  (This means to keep the hips in a neutral position for balance, so don’t stick your butt out!)  As you inhale, stretch the arms up over the head and slightly back, behind your head.  Don’t push the belly out, instead concentrate on pressing the heart center towards the ceiling.  You should feel a stretch across the chest and through the armpits.  Hold for a few breaths.

9) Essential Oils

Peppermint, lemon, bergamot, eucalyptus, and orange oils are all invigorating.  I especially like a peppermint/orange oil blend.  Be careful not to get any colored oils on your clothes, they will stain!  Blend oils with almond oil and give yourself a foot (or whole body!!) massage.  Or, blend with water in a spray bottle, and mist yourself whenever you need a boost.

10) Load Up on Energy Dense Foods

If you’re intimidated by the thought of a total diet change, try loading up on foods and supplements specifically dense in energy and nutrients.  Almonds and almond butter, avocado, apricots, ginger, oatmeal, bananas, chlorophyll (either as a supplement or in lots of leafy greens), bee pollen, and dates are all dense in energy and trace minerals to promote energy.   And don’t ever skip breakfast!!!

How do you maintain your stamina without relying on caffeine or supplements?