Clare's Home Birth After Caesarian

 I read an interesting article in Midwifery Matters magazine by Clare Caro who jumped through all the hoops put in her way to have a home birth after a previous caesarian section (CS). She was traumatised by her first birth where she says she was in labour for 3 days which ended in an emergency CS.

Women who are in labour for such a long time have mainly adrenalin to blame. As soon as women start to have contractions they become afraid and anxious. This is because society has taught them that labour WILL be painful and pain is to be feared, hence the fear. Watching One Born Every Minute should be banned for all women as it plants the seeds of fear that sprout and grow as labour approaches. Adrenalin, the natural result of anxiety, 'sticks' to the human cervix and makes it harder to open so labour goes on and on and on.

Just like me with my second, Clare lied about her due date from her last menstrual period so that she would have extra time to go into labour before the INDUCTION word would be mentioned. She justifies this by saying “I felt slightly bad for telling a lie, but if women are being told a date that has a 7% chance of being true, then who exactly are the ones being lied to here?”

Clare says that home births are a natural choice when giving birth as you feel safer in a place “free from intruders, dark, warm and quiet. A place that harks back to the cave, where for thousands of years our ancestor's would have found safety from the world outside.” She goes on to explain how as soon as she reached hospital with her first they insisted on performing a vaginal examination (VE) and how this made her feel violated as she was put under pressure to have one. All women who present to a hospital in ? Labour are expected to undergo a VE, if you do not want one then you will not be allowed onto the labour ward. Some birth centers do not perform a regular VE, they use their experience of labour to assess the contractions and watch the woman's body language to decide if someone is in labour or not. A VE is very useful information for midwives and lets us plan your labour. However, if you decline then you should not be punished for it. Also lying down in labour is very uncomfortable and may make the contractions become painful so ask the midwife to be as quick as possible as you need to be upright for a pain free labour.

Clare explains that when you are at home you can relax and feel safe so that your brain can enter a theta frequency which is the deepest level of conciousness that we can experience in a waking state. This is what relaxation techniques taught in this blog and outlined in the books strive to achieve, a level of total relaxation whilst still being awake.

Eating Miso soup in labour was a new one on me. Apparently it contains all the 9 essential amino acids, is high in Vitamin K and minerals. This is the beauty of being at home in labour, you can eat and drink what takes your fancy and move around, adopting different positions to suit your own personal labour.

Clare had her home birth with no problems at all with a midwife she knew and her own doula in attendance. Whilst pushing her baby out in her bathroom after a nice warm bath she states “There was no time for thoughts right now, I was my body not my mind.” This is how women who are totally centered on their labour feel, no one shouting PUSH at them, just going with the flow of a fast moving stream delivering your baby to you.

“hot flannel (on the perineum to help it stretch) and immense contractions, and with just one of those contractions out came a head and body – slipping right into my hands, I placed the baby gently on the towels in front of me. Nick and I got to know our girl, touching her, holding her and holding onto each other. Here she was, at the end of the journey.”

See the post VBAC AT HOME? ( http://painfreelabour.blogspot.co.uk/2012/05/vbac-at-home.html ) for why a home birth could be the best way to avoid a second CS. However, an interesting fact that Clare brought up was to do with how hospitals in the USA sew back together a uterine opening, they do it differently to our surgeons in the UK rendering their CS scar weaker and more likely to rupture. Do they do this on purpose so that they can keep on getting more dollars for performing section after section and to hell with what the woman wants? Would not be surprised. 

Breast Feeding - giving baby more than you thought.

Human milk has been found to contain complex sugars known as oligosaccharides with far more variety than our fellow mammals. There are to date 200 human milk oligosaccharides (HMOs) identified and they are the third most abundant ingredient after lactose and fats. However, it has been discovered that babies cannot digest HMOs, so what are they for?

It is known that HMOs pass through the stomach and small intestine without being digested and are destined for the large bowel where most of our useful bacteria are. Kuhn and Gyorgy et al determined that the HMOs in human milk are there to feed microbes in your baby's gut.

The microbe who benefits most from the HMOs is Bifidobacterium longum infantis (B. infantis), often the most prolific microbe found in the guts of breast fed babies.  In repayment for being fed such a plentiful diet the B. infantis releases short-chain fatty acids, a food for gut cells. This food allows the gut cells to make proteins that act as a glue, sealing any gaps between the cells that could allow harmful microbes into the blood stream causing infection. B. infantis when fed on cow milk does not perform this service and explains why breast fed babies are so much healthier.

Research shows that breast fed babies have higher IQs. HMOs could be responsible for this. B. infantis also releases, when fed on HMOs, a nutrient named Sialic Acid. The amazingly fast brain growth that humans experience is nurtured by Sialic Acid and so it is safe to say that human milk makes your baby clever. Cow milk does nothing for a baby's immune system or brain development.

 Scientist have put HMO fed B. infantis to the test and so far they are protecting your baby from:

• Salmonella.
• Listeria.
• Vibrio cholerae (cholera).
• Campylobacter jejuni (bacterial diarrhoea).
• Entamoeba histolytica (dysentery).
• E. coli.
• HIV.

Research is now being done on premature babies who can develop a fatal gut condition called necrotizing enterocolitis (NEC). As the name suggests, the baby's gut is being eaten away by bacteria which commonly turns the gut tissue black. Premature babies are now being fed breast milk and B. infantis to try and prevent NEC. B. infantis is no use without the HMOs proliferate in breast milk. They will not protect the baby if fed cow milk alone. Premature babies are not good at sucking but maternal milk can be pumped and kept out of the fridge for 5 hours to ensure that the ingredients are still alive when given to baby, often via a feeding tube. This new research could revolutionise how we feed early babies and put a stop to the all too common condition of NEC.

Active Birth Pools

The benefits of using water for labour and birth are well known…




Here are the facts…

1. Relaxing in a deep pool of warm water can be a wonderful aid in labour. It’s worth having a pool mainly for this reason.
2. Using a birth pool helps mothers to considerably reduces the need for medical pain relief.
3. The buoyancy of the water supports the mothers body weight allowing her to relax more easily and deeply. They can cope better with contractions and also rest more comfortably in between them.
4. It’s easier to use upright or squatting positions and move freely from one position to another, than it is on land.
5. Being in a birth pool gives mothers an increased feeling of privacy and security. This enhances the secretion of hormones which stimulate uterine contractions and act as natural pain killers and relaxants.
6. Studies show that labours tend to be shorter overall when a woman enters the pool at around 5cms. dilation.
7. Fewer women need the help of obstetric interventions.
8. I cannot get rid of this number 8 no matter how I try.
9. Now there is a number 9 as well!!!
10. Thank you Keith for your lovely information on pool births.

11. Active Birth Pools keith@activebirthpools.com

     

    
    

     

Avoiding Induction of Labour - 2

In the last avoiding IOL post I reported on the use of date fruits, in the last 4 weeks of pregnancy, to get you into labour before your due date. Well.

Just for you I have been eating date fruits to see what they did to a non pregnant woman with some interesting results.

Our guts are made up of smooth muscle as reported previously in this blog. The uterus is also made up of the very same smooth muscle. There is only one type of smooth muscle and it all works in the same way.

So. I started eating date fruits at the rate of one a day and there was no difference that I could detect. So I moved up to two a day and have noticed a big difference in the way the smooth muscle in my gut is working extra well.

This is really good news as my guts are not known for their regularity if you know what I mean.

Therefore, I can say with confidence that eating date fruits do have an influence on smooth muscle. The research that I reported on recommended that pregnant women eat SIX date fruits a day for the last 4 weeks of their pregnancy, they had some very impressive results.

Dare I try eating THREE date fruits a day?

For you I will do anything.

Please please please let me know if the date fruits work for you and how many you had to eat.

P.S. I cut mine up into a salad or my daily porridge. Yummy. xx

Research shows Pool Births are the Best.

Study confirms… Women who labour in water have lower rate of epidural analgesia

 

23 June 2016: K.D. Brainin
Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia (cervix not opening) in first stage of labour
Objectives:
To evaluate the impact of labouring in water during first stage of labour on rates of epidural analgesia and operative delivery in nulliparous women with dystocia.
Design Randomised controlled trial.
Setting University teaching hospital in southern England.
Participants 99 nulliparous women with dystocia in active labour at low risk of complications.
Interventions Immersion in water or standard augmentation for dystocia (amniotomy and intravenous oxytocin).
Main outcome measures:
Primary: epidural analgesia and operative delivery rates.
Secondary: augmentation rates with amniotomy and oxytocin, length of labour, maternal and neonatal morbidity including infections, maternal pain score, and maternal satisfaction with care.
Results:
Women randomised to immersion in water had a lower rate of epidural analgesia than women allocated to augmentation (47% v 66%, relative risk 0.71 (95% confidence interval 0.49 to 1.01), number needed to treat for benefit (NNT) 5).
They showed no difference in rates of operative delivery (49% v 50%, 0.98 (0.65 to 1.47), NNT 98), but significantly fewer received augmentation (71% v 96%, 0.74 (0.59 to 0.88), NNT 4) or any form of obstetric intervention (amniotomy, oxytocin, epidural, or operative delivery) (80% v 98%, 0.81 (0.67 to 0.92), NNT 5).
Conclusions:
Labouring in water under midwifery care may be an option for slow progress in labour, reducing the need for obstetric intervention, and offering an alternative pain management strategy.
(Extract from abstract of Randomised controlled trial of labouring in water compared with standard of augmentation for management of dystocia in first stage of labour by Elizabeth R Cluett, Ruth M Pickering, Kathryn Getliffe, Nigel James, St George Saunders published in British Journal of Midwfery January 26, 2004)

Women who receive less medical intervention generally stay in hospital for a shorter period of time.
The combination of an intervention free birth – with a short hospital stay result in a better experience for mother and baby.
Hospital staff and resources can be employed more efficiently.
Importantly – this results in significant financial savings!
A birth pool is a simple, inexpensive piece of equipment that can make a major impact on the quality of care and cost of having a baby.
The experience of hospitals who have birth pools shows that the cost of installing a pool is soon recouped by savings achieved through the reduced use medical methods of pain relief and intervention and shorter hospital stays.
www.activebirthpools.com

Avoiding Induction Of Labour

One of the main reasons that women are unable to give birth on their local birth center is that they go past their due date and face Induction Of Labour (IOL). This is usually offered when you are 10, 11 or 12 days past your date. Women undergoing IOL are not usually allowed on birth centers due to the extra risk to baby from a speeded up labour where baby may become distressed. This risk can result from the hormone pessaries used to initially soften and open your cervix or from the hormone drip that makes the contractions stronger and more frequent.

Researchers have found a very surprising way to try and avoid IOL. They recommend women start eating date fruit four weeks before their due date and have had some encouraging results.

The research was carried out at Jordan University of Science and Technology in 2008. Women were asked to eat SIX dates per day four weeks before they were due till they were in labour. They had a control group who did not eat any dates at all.

The women who ate the dates were more dilated when presenting in labour. On averate 4cm compared to 2cm. Intact membranes where more common amongst the date eaters, 83% vs 60%. As you know from reading this blog it is better for a pain free labour if your membranes remain intact untill you are ready to push.

Spontaneous labour occurred in 96% of those eating the dates compared with 79% who did not get a date. Use of the drip to speed up labour was only 28% in the date group and a very significant 47% in the control group.

Early labour was shorter in the date group and the researchers concluded that the consuption of date fruit in the last four weeks of pregnancy significantly reduced the need for IOL. So, in the interests of science I bought a bag of ready to eat dates to see what they tasted like. I liked them and am currently eating one a day to use them up. Not sure I could eat 6 a day, would have to cut them up and put them on porridge or have them with ice cream. But, what the heck, who cares what they taste like as long as they work.

Let me know how you get on. x :-Q

Ref: Al-Kuran O, Al-Mehaisen L, Bawadi H, Beitawi S, Amarin Z. (2011) The Effect of Late Pregnancy Consumption of Date Fruit on Labour and Delivery. Journal of Obstetrics and Gynaecology 31(1) page 29-31.

The Peaceful Birth Project, avoiding induction of labour and PPH.

 Ancient Wisdom and Research Agree: Amazing Fruit Eases Labor and Prevents Postpartum Hemorrhage

 


The date fruit is the product of the date palm, a tree native to Northern Africa and the Middle East. There is a wide variety of dates including the better known Medjool and Deglet Noor. Each variety is unique in size, sweetness, flavor, and texture. Containing at least 15 minerals such as potassium, calcium, iron, magnesium and zinc, 23 types of amino acids, vitamins, carbohydrates, protein, 14 types of fatty acids, dietary fiber and a lot more, these sweet little fruits are a nutritional powerhouse. [International Journal of Food Sciences and Nutrition, 2003]

The photo is from a study published in the Journal of Obstetrics and Gynaecology which concludes that eating 6 dates daily during the last four weeks of pregnancy “significantly reduced the need for induction and augmentation of labor, and produced a more favorable, but non-significant, delivery outcome”.  Some significant findings:

• Cervical dilation was significantly greater in the date-eating mamas upon arrival at the hospital

• 83% of mothers who consumed dates had their membranes intact upon admission at the hospital 

• 96% of the women who ate dates went into labor on their own

• Use of Pitocin (synthetic Oxytocin) was significantly lower in women who consumed dates (28%), compared with the non-date fruit mothers (47%)

• The latent phase of the first stage of labor was almost 7 hours shorter in the date-eating mothers compared with the non-date fruit eaters (510 min vs 906 min). Not bad for eating a few dates!

Very interesting research comparing the use of dates and Pitocin in the management of postpartum hemorrhage.  The study demonstrates a significant reduction in the amount of postpartum bleeding experienced by women who consumed date fruit compared to women who received synthetic oxytocin (Pitocin). The randomized clinical trial was done in two hospitals. Immediately after the delivery of the placenta one group was give 50 gram of dates. Another group  received 10 units of synthetic oxytocin in an intramuscular injection.  Blood loss mean in the end of first hour after delivery were significantly different in dates and oxytocin groups (104 ml vs 141.6 ml) The researchers suggest that dates are effective for management of postpartum hemorrhage because dates have Calcium, serotonin, tannin, linoleic acid, enzimes, iron and other nutrients beneficial to control bleeding and prevent anemia. Khadem, Sharaphy, Latifnejad (2007)