Creating a circle of support during pregnancy and postpartum

We are pleased to welcome Tracy Wilson Peters, CLD, CLE, CCCE , to the Mother’s Advocate blog. Co-author of the soon-to-be released book, The Greatest Pregnancy Ever, Tracy has been a lifelong advocate for families and babies. 

“The main concern of those around pregnant women or for people who care for a pregnant woman should be to ensure their emotional wellbeing.” ~ Michel Odent

Who are the people closest to you? Did you know that the people who are around you the most are influencing the personality and development of your baby? New science has shown that every relationship that you have impacts who your child will become. A mother’s feelings deeply affect her baby. In fact, the baby learns about his world by the feelings his mother has. When a mother has a feeling of happiness, this triggers a hormone release that the baby also feels. The same thing happens when a mother feels stress. Chronic stress is non-supportive for your health and your pregnancy. Hormones associated with depression and anxiety, such as cortisol, can reduce blood supply to the placenta and induce premature labor. So, who is in your life really matters!

Pregnancy offers a great opportunity to take steps to decrease stress in your life. Emotions and attitudes are contagious. Every encounter that you have on a daily basis can be measured on a scale that goes from nourishing to toxic. Who are the people in your life that nourish you? Who are the people in your life that drain your energy? It may not be possible to eliminate all of the people in your life that cause you stress, but you can begin to create healthy boundaries by creating a circle of support. This circle should include people who are supportive and loving in their interactions with you. Your inner circle may or may not include family members. Your circle of support should be comprised of people who you can call on when you need help, have good listening skills, won’t judge you, and can offer you emotional support. This inner circle is a sacred place. Who in your life do you want to be in your circle of support? Is there someone that you have been allowing in your life that you need to step back from?

It may help you to take a few minutes and make a list of the people that you interact with on a regular basis, including family members, friends, co-workers, and neighbors – anyone that you spend a significant amount of time with. Next think of each person holding your new baby. What feelings come up for you?  Try to tune in to the feelings that come up during this visualization. Are changes needed?

Some things to keep in mind when creating your inner circle of support:

• It’s OK to say no. There are moments when we say “yes” to others, and, in fact, we are saying “no” to ourselves.

• You can love someone and still keep them at a distance.

• Shifting who you surround yourself with does not mean judging others. Nobody has to be wrong for you to make decisions that are right for you.

• You can change your circle of influence and love those not in it from a distance.

• It’s not about being judgmental. It’s about being where you feel comfortable.

• You are your world, so if you change, the world changes.

Mothers who foster a healthy internal relationship often have nourishing relationships with the people in their lives. You are at the center of your circle. You must take care of yourself, both physically and emotionally, in order to have healthy relationships with the people in your life. Taking time to love yourself will have a positive effect on everyone in your life. When you create healthy boundaries with the people in your life, you will be giving yourself and your child a great gift: the gift of self-love and the knowledge that you can move through your world making conscious decisions about who and what is right for you.

Pregnancy is a time of change. Change isn’t always comfortable but it is a necessary part of life. Your new life with your baby will undoubtedly bring many changes in the relationships that you have.  Your relationships will change because you will change. Becoming a mother will provide many opportunities for growth.  As you move into motherhood trust your instincts. Surround yourself with people who lift you up and you will be able to give your very best YOU to your new baby.

“There comes a time in your life, when you walk away from all the drama and people who create it. You surround yourself with people who make you laugh. Forget the bad, and focus on the good. Love the people who treat you right, pray for the ones who don’t. Life is too short to be anything but happy. Falling down is a part of life, getting back up is living” – Author unknown

Author, Tracy Wilson Peters, CLD, CLE, CCCE

Married for over 19 years and mother to two amazing sons, Tracy’s experience raising her own children led her to a love for supporting expectant families. This passion encouraged her to found CAPPA, Childbirth and Postpartum Professionals Association. Tracy serves as both the CEO and as a faculty member for CAPPA. CAPPA is the largest childbirth organization in the world. Internationally known as a pregnancy expert, she has authored numerous articles, and appeared on many television networks, including FOX, CBS, and NBC.  Tracy has worked with expectant women and families for nearly two decades, attending hundreds of births as a professional labor doula and teaching classes to more than 3000 families.

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Rx for Stress During Pregnancy

Are you experiencing too much stress during pregnancy? Not sure how much stress is too much? To answer your questions we are proud to feature Laurel Wilson, Injoy Birth and Parenting Customer Advocate, Executive Director for Lactation Programs with CAPPA, doula, childbirth and lactation educator, prenatal yoga instructor and board certified lactation consultant.

During my first pregnancy, my husband and I moved to a military base in Guam, which had just been struck by the worst typhoon in a decade and looked like a warzone. This is what we would call an “acute life stressor”. And yet, terrified as I was to be 5000 miles from my family, I had a deep sense that my baby was counting on me to remain calm and peaceful – my inner life affected how he would grow.

For the sake of my baby, I braved broken glass in the streets and smiled kindly to the worn-out looking locals in Guam. I went to the beach almost every day. I held my belly, sang to my baby, breathed deeply and focused on trying to be as present and connected as possible. I focused on the things that were grounding and comforting – cuddling with my husband, looking at pictures from home, and baking banana bread.

Today there is a body of evidence to show that my gut was right.  Stress impacts the health of the baby, the pregnancy and the mother.  While short term stress that is relieved quickly is proven to have benefits for the growing baby, the type of stress that most mother’s encounter today (including those who spend their entire pregnancy in familiar surroundings) is not normal and can change the way the baby reacts to its new world when she is born.

Short bursts of stress that are quickly resolved tell the baby that life has bumps in the road, but it’s all going to be okay. In the right doses, stress makes our babies hardy. In fact, the slight normal increase in the mom’s stress hormone cortisol in the last two weeks of pregnancy actually prepares the baby to come into the world.  It accelerated the baby’s brain development and is associated with better motor and developmental skills at age two.

What is not healthy for the mother and baby is unrelenting, chronic stress.  Unfortunately, many mothers today are chronically stressed.  They live their lives constantly on the go, jumping from task to task, engaged in activity from sun up until they drop in to bed in state of exhaustion well past sun down. This environment of stress impacts mothers’ ability to sleep (which also effects their risk of developing postpartum mood and anxiety disorders), the blood flow to the placenta, and increases the risk of preterm delivery.

There is plenty of documentation now that both chronic and severe/acute stress change baby’s brain development.  The Children of the 90’s study has shown that children exposed to chronic stress prenatally have significantly more behavioral problems and emotional disturbances as children.
So what is today’s mom to do? With the increasing pressures of today, how do we lighten our load? The good news is that it’s actually quite simple to help the body relieve stress. Below is a list of proven techniques that ANY pregnant mother can use to relieve the effects of stress:

1.  Yawn. Yes, yawn. Repeated yawning resets the brain, releases our “happy” hormones and helps the body process cortisol.  Ever notice how you feel the need to yawn when you need to pay attention but just can’t find the energy?  Yawning is like a natural, gentle boost to our brain.  It helps us feel better.
2.  Move! Talk a 10 minute walk, swim for half and hour, dance to your favorite music in the living room after you get home from work, take a prenatal yoga class!  Movement improves circulation, releases beta-endorphins and releases stress!  What? You are on bed rest? Do deep breathing. Circle your ankles and wrists, do some static stretching.
3.  Smile and laugh.  Have your best friends over for tea and giggle! Better yet, ask them make the tea and have you over, you are the pregnant momma after all! Watch your or favorite funny movie with your partner.  Do things that make you HAPPY!!!! Laughter is one of the best antidotes for stress.
4.  Nap. Allowing yourself to get at a minimum of 5 hours of uninterrupted sleep at night and having just one 10 minute nap a day helps everyone deal with stress better.  Getting the brain into the delta state of relaxation allows for body rejuvenation and improved immune functioning. Take an eye mask and your iPod to work and instead of talking at the water cooler during your break, lean back, close your eyes and rest deeply for ten minutes.

While you may not be able to remove your stressors during pregnancy, you can help remove their effects from your body. My Rx for a happier, healthier, cooing baby: yawn a bit, take two bursts of laughter, nap for ten minutes and call me for tea in the morning!

Laurel Wilson is the Customer Advocate for InJoy Birth and Parenting. She has been working with families during the childbearing year for over sixteen years as a doula, childbirth and lactation educator, prenatal yoga instructor and board certified lactation consultant. She is also the Executive Director for Lactation Programs with CAPPA and is the co-author of upcoming book, The Greatest Pregnancy Ever: Keys to the MotherBaby Bond due in the fall of 2011.

 

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Oxytocin: The Love & Birth Hormone

This week, Elizabeth Davis  – midwife, women’s health care specialist, educator, consultant and co-author of Orgasmic Birth: Your Guide to a Safe, Satisfying, and Pleasurable Birth Experience answers your questions on sex during pregnancy.

The number one priority in preparing for birth is to understand the physiology of birth and to know in advance that wherever you will be the most physically and emotionally comfortable is where you should labor.

There is a powerful player in birth called oxytocin, otherwise known as the “love hormone” because it is the hormone that we release with sexual activity. Even more, this is the hormone we release at the mere thought of sexual activity. Just thinking about a lover and becoming aroused, that’s oxytocin.  New mothers, just hearing a baby cry – even if it’s not their own – will let down their milk, and that’s oxytocin.

Never in a woman’s life is oxytocin higher than in pregnancy and during labor, as well as the moments immediately after birth (when it’s at it’s all-time peak).  Therefore if you think of birth as a sexual event, then you begin to understand how important the setting and the set of people around you really are.  It’s not too far afield to say “imagine yourself having sex with a room full of strangers parading in and out of your room.” Could you change positions spontaneously? Could you move and groan and moan and do the things that are natural in birth if you’re being observed?

In fact, we have plenty of research that makes clear that if women feel observed by relative strangers in the room, even by the fetal monitor and not least of all themselves (“Am I doing all-right? Am I doing it right?”), her labor will be affected. Think of what that does to sexuality – all it takes is a few minutes of “Oh my god am I doing it right?” and the orgasm is shot.

Birth is very similar, women become frightened or over-analytical or anxious about their progress.  They start releasing adrenaline and high levels of adrenaline stop oxytocin production and that turns the experience into a whole different event where there can be quite a lot of pain and anxiety, not a lot of oxygen to the baby, and we see a cascade of interventions that is leading all too often to cesarean births.

A renowned expert on women’s issues, Elizabeth Davis has been a midwife, women’s health care specialist, educator and consultant for over 30 years. She is internationally active in promoting motherbaby-centered birth and is widely sought after for her expertise in midwifery education and organizational development.

She served as a representative to the Midwives Alliance of North America for five years and as President of the Midwifery Education Accreditation Council for the United States. She holds a degree in Holistic Maternity Care from Antioch University, and is certified by the North American Registry of Midwives.

Her mission is to help women embrace an integrated view of birth, sexuality, family and ecology. She travels widely, lecturing and presenting workshops on women’s health, sexuality, intuition, and midwifery. She can design a workshop or keynote to meet your group’s needs–references on request.

This interview was originally filmed for Mindful Mama Magazine and has been transcribed with permission from Mindful Mama Magazine.

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Happy Pills: Preventing the Baby Blues Naturally?

This week, Mother’s Advocate discusses the warning-signs and indications of postpartum depression with Jodi Selander — activist, mother and Director of Placenta Benefits.

MA: What is the difference between the “baby blues” and “postpartum depression” and how common are they?

JS: Postpartum depression is a very real and physiological occurrence that can begin anytime between birth and twelve months postpartum.  It is generally experienced as a series of symptoms, which are identified along a spectrum of severity — ranging from baby blues (which is the mildest and generally corrects itself in the first three to four weeks postpartum), all the way to postpartum psychosis. Postpartum psychosis is incredibly serious and often leads to hospitalization.

The majority (80%) of women experience some sort of post-natal mood instability, mostly in the “baby blues” range.  Baby blues shares many common symptoms with full-blown postpartum depression, but is not technically considered a “disorder” by the medical establishment unless the symptoms extend longer than 3-weeks. Symptoms may include: weepiness, mood instability, mood swings, feelings of anxiety, not wanting anyone else to hold the baby, unwillingness to be alone with the baby, or fear husband or partner going back to work or even leaving the house.

15-20% of women who experience the baby blues will go on to experience full-on postpartum depression.  When depressive symptoms last for longer than 6-8 weeks, a doctor may prescribe an anti-depressant.

MA: What causes mothers to feel depressed or sad postpartum?

JS: Aside from the physiological factors (hormone re-balancing and physical recovery), I believe postpartum is largely cultural. There is a lot of emphasis on building confidence during pregnancy and empowering the birth experience, but there is a real lack of practical support once the baby is born.  Those first few weeks are filled with visits from friends and family and interaction with a care provider. But once the flurry dies down, the changes that come with a new baby can become overwhelming.  It’s hard to have confidence as a mother, especially if you’ve never done it before — and the job is so important.  Every decision you make feels like a life and death situation, and women tend to internalize everything.

It’s not just “oh the baby is crying again” —  it’s “why is my baby crying again, what am I doing wrong? Why can’t I not stop this? Does this mean I’m not a good mother?” Women place a lot of pressure on themselves, and I think there’s a lot of pressure that society places on mothers as well. We elevate motherhood as a noble and worthy institution, which is fabulous, but we don’t give any sort of structure to support that pedestal.  In my own personal experience, this leads to an incredible lack of confidence — and that’s very unfortunate.

MA: When should mothers seek medical support?

JS: This is really where the husband and/or partner comes into play.  He or she should be aware of the symptoms of postpartum depression and notice when a mother is showing signs. Often a mother will not seek help for herself,  and her partner should not be afraid to seek help for her — before it becomes a serious issue.  If you notice that your wife or partner is still not herself after 6-weeks, suggest that she make an appointment so that she can be seen for treatment.

MA: What is the preventative measure, especially for women who have the baby blues?

JS: Most women who have just given birth are going to have depleted iron stores. The placenta is packed with iron and has a lot of vitamins and minerals that your body needs postpartum.  I advocate that mothers utilize placenta encapsulation — whereby it’s completely dried and then ground — to restore the body’s natural balance.

Placenta is used in traditional Chinese medicine to treat fatigue and to enhance lactation, and it has been scientifically shown to increase milk production. The hypothalamus is part of the brain that regulates the endocrine system and studies show that it takes about two weeks for the hypothalamus to receive the signal that the baby’s been born. The placenta capsules help the body to maintain homeostasis during this period, until her body would normally regulate itself.

I’ve had hundreds and hundreds of clients, and everybody calls the placenta capsules their “happy pills”. It’s nature’s perfect gift.

Jodi Selander, Director of Placenta Benefits, started researching placentophagy in 2005 during her second pregnancy. She found substantial information documenting the benefits it offered. Having dealt with depression for many years, Jodi had many risk factors for developing postpartum depression. With a B.S. in Psychology, she understood the devastating effects depression could have on women and their families. As a natural health enthusiast, she wanted an alternative to pharmaceuticals that might help avoid those issues. Jodi continues to work toward her mission of making placenta encapsulation an option for every new mother with the launch of the Placenta Encapsulation Specialist Training & Certification Course in May 2008. As a member of the placentophagy research team at the University of Nevada, Las Vegas, Jodi has helped develop and perform several research studies on placentophagy. She traveled to New Orleans in November, 2010 to present the findings at the annual meeting of the American Anthropological Association. This research is incredibly important to her mission of validating the use of placenta for postpartum recovery. Her goal is to have a qualified person in every city offering encapsulation services, so that women everywhere can enjoy a happy, healthy postpartum experience – the way Nature intended.

This interview was originally filmed for Mindful Mama Magazine and has been transcribed with permission from Mindful Mama Magazine.

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Choose Wisely: How to Select a Care Provider

Choosing the right care provider is critical to having your best birth.  This week we are so excited to feature writer Meagan Church who discusses the importance of aligning your birth ideals with your care provider.

Shortly after I discovered I was pregnant with my first, I met with my family doctor. He had stopped doing obstetric care a few months prior, so I knew he wouldn’t be my care provider for my pregnancy. Even still, I felt compelled to meet with him. I believe that meeting shaped my journey to finding the right provider for me and set the course for a more desirable birth experience.

During the visit, I asked if he had any recommendations for a care provider. Since my husband and I wanted to wait to share the pregnancy news until after the first trimester, I couldn’t turn to family or friends for advice. My doctor simply asked, “What kind of provider do you want?” I hesitated for a moment, not knowing how to respond. Basically I wanted someone who would be covered by my insurance. What else was there to know? He then said he sometimes recommended a certain OB/GYN, but I should first consider that he takes a very patriarchal approach. Then he asked if I’d ever considered a midwife. My doctor said his wife had an at-home birth with a midwife, so perhaps I should consider whether a midwife would more closely match my desires. Essentially what he was asking me to consider is what my birth philosophy was.

Before that conversation, I had never thought of there being such a thing as a birth philosophy. But in the days and weeks after that appointment, I soon learned that practices and philosophies definitely do exist. I needed to understand my thoughts on birth and find a provider who matched those, and not base my choice solely on my HMO. Thankfully my research led me to a great midwifery practice.

As I’ve talked to more and more moms, I’ve come to realize that many women enter pregnancy with the same misconception that I did, not realizing that differences other than personality quirks separate providers from one another. It’s not until much further along in the pregnancy and sometimes even after a traumatic birth experience that some women have realized their birth philosophy and their provider’s did not align. Unfortunately, I have a good friend whose story is precisely that.

From the outset, my friend’s provider showed signs of being very keen on intervention, which concerned me since I knew my friend wanted a natural birth. Throughout her low-risk pregnancy, she had more than five ultrasounds. During one of those, the doctor felt the baby looked too big and that a c-section should be considered. This was a few weeks prior to her due date. My friend called me, asking for advice. I told her to seek a second opinion. She did not want to do that so late in the pregnancy, but after doing her own research and soul-searching, she knew she could not consent to her OB’s assessment. So she sought a second opinion. She took her research and second opinion back to her doctor and said she did not feel a c-section was necessary at that time. The doctor permitted her to wait. Spontaneous labor finally did occur, but it came with the stress of timelines and interventions that my friend had hoped to avoid.

Now, of course every labor is different, but with more research and introspection up front, those last few weeks and even labor could’ve been less stressful and more empowering. So what can you do to avoid a similar situation? First of all, don’t look to an insurance company as the main way of choosing a provider (as I nearly did). Instead, understand how you hope to experience labor (with or without drugs, for instance) and how active a role you want to take in the process—the difference between a team effort and a patriarchal provider. It is not necessary to go as far as to create a birth plan in the first month, but even a general idea of how you feel toward birth can help. The more you ask questions up front and interview providers before making a choice, the better understanding you will have of not only the provider’s philosophy, but also your own. If things go south even at the very end, seek a second opinion. Unless the baby is crowning, it’s not too late.

A midwife once said to me, “You never forget having your baby, so it should be the best experience ever.” And it all starts with a first-trimester decision that could have lasting impact beyond the delivery room. Choose wisely.

Meagan Church is a writer, a reader, a black coffee drinker; a runner, a golfer and a lover of nature; a wife, a mother and a wanna be world changer. Meagan is currently working on a book about the realities of birth, babies and beyond. To learn more, visit www.Unexpectant.com. She also writes about her experiences of motherhood outside of clichés and inside the reality of it all at www.DefiningMotherhood.com.

Did you feel supported by your care provider? Who made up your labor support team?

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“Eat Right for Pregnancy, Not More!”

This week Stacey Scarborough, certified Childbirth Educator, Lactation Educator, Labor and Postpartum Doula and Doula trainer through DONA, Int. and L.E.A.N. Coach, shares her top nutrition tips for moms-to-be!

When you found out that you were pregnant, was one of your first thoughts (after, “OH boy, I’m having a baby!”) “Oh goody, I get to eat anything I want for the next 9 months!”???

It’s not uncommon for expecting women to think that pregnancy gives them license to eat as much as they want because they are ‘eating for two’.  In the last few months, there has been a noticable shift in the thinking of how much and the type of food you are eating. The awareness that you are now eating for your growing child should be the first thought in your mind as you decide what to eat, not “I get to eat whatever I want”.  We are seeing the signs of proper nutrition all around: from nutritional guidelines in the super markets, to Michelle Obama promoting breastfeeding as the best choice for our growing babies.

I am recently certified as a L.E.A.N.  Coach. What is “L.E.A.N.”? It is a program based upon scientific research and designed by Dr. William Sears, “America’s pediatrician”. The letters L.E.A.N. stand for Lifestyle, Exercise, Attitude and Nutrition. These four areas work together to make families healthier-at any age and any stage of life.   L.E.A.N. means understanding and living a healthy, active lifestyle. Now more than at any time of a woman’s life, she should become L.E.A.N.

The average weight gain for a pregnant woman is between 25-35 pounds and 35-45 pounds if carrying multiple babies. But it is not just how much you can eat. A pregnant woman needs to remember that whatever she eats her baby is getting also, so the better the nutritional value of her food, the healthier the baby will be in utero.  Moms-to- be who practice L.E.A.N.:

• Make lifestyle choice that protect their babies and give them the best possible start in life.
• Gain the right amount of weight by eating the right kinds of nutrient-dense foods and avoid foods that are high in saturated or trans-fats and sugar.
• Take care of their minds and bodies through exercise
• Pass L.E.A.N. principles on to their children.

So what are some of the concepts of a LEAN lifestyle and how can you get started?

Dr. Sears feels that the USDA Food Pyramid focuses too much on the quantity of food, and his program specifically addresses and focuses on the quality of food. His method of teaching about this is called “Traffic Light Eating” and is a simple, easy way to remember how to choose wisely. Classes are available that will provide you with tools to help you make good choices as you are shopping and eating.  L.E.A.N. coaches teach this concept of Traffic Light Eating:

Green Light Foods are GO foods: eat as much and as often as you would like: all grown, not manufactured, and include all and any vegetables and fruits.

Yellow Light Foods mean SLOW DOWN : these foods make up the bulk of what helps to comprise a balance of nutrients, carbohydrates, proteins, and means to eat these every day, but not too much.

Red Light Foods are STOP and THINK: these are foods that should be avoided by making a healthier choice and these include foods high in fats, sugar, hydrogenated oils, eg: cookies, candy, fatty meats, white bread, etc.

Along with nutrition information for a growing baby and healthier children, the classes also focus on ways to get the kids moving, instead of sitting so much. With the growing obesity rate in our country, it is important for parents to set a proper example of ways to get active and incorporate exercise, or how we like to call it: PLAY in to the everyday life.

Having the proper attitude is important also.  Parents who live a healthy lifestyle of activity and good nutrition will feel better, be happier and allow their bodies to work in the most efficient state, which will allow for an easier delivery, faster recovery, and healthier babies that will grow into healthier adults! One of the best gifts you can give to your children!

For more information on where to find a LEAN Coach and classes in your area, please refer to www.drsearslean.com

Stacey Scarborough is a certified Childbirth Educator, Lactation Educator, Labor and Postpartum Doula and a Doula trainer through DONA, Int. She recently completed her certification as a L.E.A.N. Coach and is excited to teach expectant and new parents about the L.E.A.N. program in San Diego and Southern California. She can be contacted at doulastace@cox.net and her website is http://www.preparingtheparents.org

What have your nutritional struggles been? How are you supported in this?

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Preparing Fathers For Birth

Expecting fathers go through a very unique experience during pregnancy and birth, and while this can be a very exciting time it is important to make sure he is prepared for the challenges to come.  This week Cara Terreri from Lamaze’s Giving Birth With Confidence blog shares her favorite tips for dads-to-be.

When a woman is pregnant, most of the outside world’s attention is on the mother-to-be. On one hand, this makes sense: it is the mother who bears the first-hand, physical experience of pregnancy and birth, and the intrinsic connection to a child who was once part of her body.

But what about the father (partner)? Fathers too, go through an experience during pregnancy and birth. First-time dads in particular must come to terms with a transition in family roles and responsibility, and deal with their own feelings of fear, excitement and anxiety. Yet, when a couple is expecting, all of the fuss and concern centers on mom: “How are you feeling? Are you sleeping well? What’s your birth plan?” Dad is more likely to hear nothing — unless it relates to mom.

Women, listen up: Dads need preparation, understanding and communication during pregnancy too! Women tend to gather and process information about pregnancy through their care providers, other women, books and Internet articles. Men however, don’t always attend prenatal appointments, and are less likely to pour over the literature or spark up a conversation about pregnancy with their peers. But that doesn’t mean they aren’t interested or don’t need support. And here’s the secret: the more prepared and informed dad is, the better equipped he will be to support and encourage you during pregnancy and birth.

The following are simple, but key, steps you can take to involve, support and prepare your partner, helping to improve the experience for both of you.

Attend prenatal appointments together. It may not be practical to see your care provider together every time, but make it a point to attend a handful of appointments as a couple. This allows dad to understand more about your prenatal care, experience exciting things like hearing baby’s heartbeat, and pose his own questions to your care provider.

Make childbirth classes mandatory. Childbirth education classes are designed for moms and dads. For dads who don’t always read up on birth (and for moms who read too much), an in-person, interactive class that teaches the ins and outs of birth, including coping techniques and strategies, is invaluable. Lamaze class educators, for example, are trained to engage with fathers and partners through targeted questions and hands-on practice.

Create your birth plan together. Wouldn’t it be great to have your own personal advocate to make sure labor and birth is as healthy and safe as possible? You can! Creating a birth plan with your significant other ensures that both of you are on the same page during the big day. If dad knows ahead of time that you wish to remain mobile in labor or avoid continuous monitoring, for example, he will be better prepared to support you and speak to your care providers if necessary. For ideas on what to include in your birth plan, check out the Six Lamaze Healthy Birth Practices.

Check in with dad. Keep the lines of communication open! If you don’t have a regular date night, make it a new habit that continues after birth and throughout parenthood. When you make the time to connect with each other, be sure to ask about his thoughts regarding pregnancy and birth in addition to expressing your own. Ask open-ended questions like, “Tell me what you think about our birth plan.” or “How do you feel about our care provider?” or “What worries you the most about birth?”

For more insight on preparing and understanding fathers during the childbearing time, check out the Giving Birth with Confidence series, “Focus on Fathers.”

Cara Terreri is the site administrator for Giving Birth with Confidence, the Lamaze online community for expectant moms, and has worked with Lamaze for the last six years. Giving Birth with Confidence is written for and by real women (and men) and offers a meeting ground to share stories, find answers and provide support during pregnancy, birth, breastfeeding and parenting. In her free time (every last bit), she is mom to two active little boys. Through blogging and advocacy, Cara enjoys helping women discover their power and ability in birth.

What challenges did you experience as a couple? Did you feel supported?

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The Ultimate Price of Unnecessary Interventions: Part 1

Maternal mortality rates in the U.S. are much higher than statistics show, and birth interventions are often responsible. Beginning today, the Mother’s Advocate Blog is presenting a 3-part series about maternal mortality — the ultimate price of unnecessary interventions. This week, Maddy Oden shares the tragic story of her daughter and granddaughter’s deaths, and how she’s raising awareness about maternal mortality.

Tell me a little bit about your personal experiences with birth, and how they inspired you to become a birth advocate.

I had three of my own children, and all were natural births in a hospital — they were beautiful births. I had also been at many births of my relatives and friends. Then, my daughter was induced with cytotec — she died as a result, and my granddaughter died with her. I then became determined to make sure that cytotec (which, although was a standard of care for inducing labor wasn’t approved by the FDA to induce labor — it was approved for treating ulcers), wasn’t used anymore. I became an advocate because of what happened to my daughter, and subsequently found out that she wasn’t the only one. A lot of women have adverse effects from being induced by cytotec, up to and including death. I formed the Tatia Oden French Memorial Foundation in honor of my daughter, and in my pursuit of making sure cytotec is not used.

These events also led me on a path to become a doula. I have since attended a number of births to ensure that what happened to my daughter doesn’t happen to anyone else. My goal is to be at any birth I can, and to make sure it’s a safe one.

The prevalence of maternal mortality isn’t something that most women are aware of. Why does this need to change?

It needs to change because women in the U.S. don’t know about it. It needs to change because it happens a lot. Maternal mortality doesn’t happen as much (thank God) as cesarean sections, but it still happens a lot. One of the largest problems is that maternal mortality isn’t reported as much as it happens — the statistics are skewed. We know that many causes of maternal mortality are created by the medicalization of birth — the use of technology and interventions — but until all maternal deaths are reported and investigated thoroughly, women will never know the true incidence. My daughter’s death wouldn’t have occurred if we had known about cytotec. Women need to be aware of the incidence of maternal mortality, and know that as soon as interventions begin, their chances increase.

What is the most rewarding result you’ve achieved from all of the work you’ve put in to standing up for birthing mothers and their babies?

Babies being born healthy and un-medicated. And moms having an un-medicated birth, no matter where it is.

How does being a doula bring your journey and quest for safe and healthy birth full-circle?

Well, for one thing, if I knew what I know about birth now in 2001 when my daughter died, she wouldn’t have.

Also, when I’m in a position when I have to be present at a cytotec birth, I can be there with the mother, to ride out the gamut of effects. When a mother is in the hospital and cytotec is administered to soften her cervix, the nurses can’t sit there and watch her. The machines they’ll hook a woman up to really do pick up most everything that’s going on, but humans have to be watching the machines to prevent complications or an emergency. As a doula, I sit there, and when breathing or contractions are slamming a woman against the wall, I can call in the medical team and they can react much more quickly — preventing complications and saving the lives of both mom and baby. I can (try to) make sure the mother doesn’t die.

Regardless of cytotec, if I can decrease the intensity of a mother’s contractions through all the means we have — changing positions, herbs, heat, walking around, soaking in a tub, using acupressure — that to me is also very rewarding, and brings it full-circle, because nobody could (or did) do that for my daughter.

Tell me about the Safe Motherhood Quilt Project, and how you’ve since become allies with some of birth advocacy’s most prominent supporters?

When my daughter died, my son-in-law was on the Internet a lot, and found the Safe Motherhood Quilt Project. He asked me to make a square for Tatia, so I reached out to The Farm Midwifery Center to get the specifics of the square. Weeks went by, and between the grief and forming my nonprofit foundation, I just couldn’t make it. I called The Farm back, and gave them my apologies.

Ina May (Gaskin) later called me up, told me that she had made a square for Tatia, and asked if she could stop by and show me, as she was going to be in California. Ina May and I ended up having tea and chatting for hours, and in the process, I asked her if the quilt was on display any other places than in Tennessee — I wanted to have it displayed in Oakland. She suggested I call the Mayor’s office, so I did, and he ended up paying for an entire maternal mortality event at the Oakland Museum. Ina May and Dr. (Marsden) Wagner spoke, and about 300 people attended. I believe it helped bring the issue of maternal mortality into public view.

Afterward, both Ina May and Dr. Wagner agreed to be on my foundation’s board, and I help Ina May reach out to families who have suffered a loss from maternal mortality (about making quilt squares or to simply console). We work together to provide support to families in need.

What is the next step?

What is definitely needed in the U.S. is a uniform death certificate, although there’s bound to be political pushback. The Center for Disease Control estimates that maternal mortality is four times higher than reported. So, there needs to be a mandatory box on the death certificate in every state that designates whether a woman was pregnant at her time of death. If the box is checked, a mandatory, thorough investigation into the cause of death should occur. It’s the only way statistics will ever be correct, and the true causes of maternal death will be known — which is the only way maternal mortality will ever decrease. When my daughter died, California didn’t have box — so she wasn’t counted as a mother who died in childbirth.

Also, women need to know that we can birth our own babies, even catch our own babies — and that complications arise, but not nearly as much as they say. We’re not taught that birth is a natural process, so research needs to be put out there, alternatives and options presented, and if nothing else — we need to learn to trust in birth.

Maddy Oden, birth and community advocate, is mother to three children, Tatia, Marcus and Kofi, and grandmother to seven grandchildren. She is the founder and executive director of The Tatia Oden French Memorial Foundation a doula, and a hospice volunteer.

Mother’s Advocate wants to facilitate a safe and supportive community for birth advocates, educators, and expectant mothers. You’re welcome to share any thoughts about or experiences with maternal mortality.

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Prenatal Stress: Why it Matters And How to Cope

You have done everything possible to ensure a smooth, healthy pregnancy — but what about labor and birth? Mary Oscategui, baby planner, birthing options advocate and mother herself, joins us this week to share ways pregnant women can cope with the stresses of an approaching birth. She encourages mothers to acknowledge their fears — for the health and well-being of both themselves and their babies.

As a health practitioner, baby planner and single mom, I understand the challenges and stressors that can affect an expectant mom in preparation for birth — trust me, I’ve been there! Your baby is soon to arrive and the excitement is present, but along with that excitement can come many different emotions — some easy to cope with, and some not. You may be feeling anxious and stressed with a lot of questions and uncertainties weighing on your mind. Will I feel pain? How long will my labor last? Will my baby be OK? What if he/she is not breathing? What if the cord is wrapped around his/her neck? What if I have complications? Will I be able to handle motherhood?

As an expectant mom, your first reaction may be to hide these uncomfortable feelings — you may feel ashamed or embarrassed to share them. Giving birth is our natural birthright, however, that does not mean we also don’t have the freedom to experience some fears or doubts. Suppressing such feelings of anxiety and stress can not only take a toll on your body, but on your baby as well. It’s important to be aware of your fears, anxieties and stressors — and to address them. Doing so will only improve the health of you and your baby, and the outcome of your birth.

How do stress and anxiety affect a pregnant woman and her baby?

When an expectant mom feels anxious and stressed, her nervous system causes physiological changes in her body. Adrenaline and the stress hormone, cortisol, release into her bloodstream, causing her body to react in a fight-or-flight response. As a result, her digestive system slows down, which prevents essential nutrients from being absorbed into her body and passed on to her baby. Her muscles become very tense, making it difficult to think clearly and relax. These physiological changes can lead to premature labor, or even complications during labor.

Babies exposed to a variety of stress hormones, toxins and malnutrition inside the womb may develop a host of problems during their fetal growth and after they are born. Their bodies have to undergo certain biological changes in order to cope with a high-stress environment. In October of 2009, The UK Times reported new research that shows exactly how stress can harm a baby’s development, and how that stress can lead to long-term problems.

According to research by Vivette Glover, a professor of perinatal psychobiology, maternal anxiety affects the placenta by reducing the activity of the main barrier enzyme that hinders the hormone cortisol from reaching the fetus. The babies of women who were stressed during pregnancy had lower birth weights, lower IQs, slower cognitive development, and more anxiety than those born to the other women in the study.

How can women cope, and prevent stress and anxiety?

When I was pregnant, I found a few things essential to my (and my baby’s) well-being.

Acceptance

I had to accept and feel comfortable with my feelings, and not to try to resist them. It is perfectly normal to have some doubts or fears surrounding labor, especially if you are a first-time parent. Once you allow and invite your feelings to be present, you will be able to take the steps you need to take care of yourself and your baby, while reducing — if not eliminating — stress all together.

Support

I sought support. This could be through an expectant mom’s group, a childbirth education class, or a qualified professional — such as a birth doula. By working with a birth doula, or attending a birth education class or expectant mom’s group, you can prevent or reduce stress levels dramatically. Birth doulas are trained to provide expectant moms emotional and physical support in preparation for labor, and are also present during labor for support. Childbirth education classes are designed to inform expectant mothers of their options for labor and birth, and prepare them for the journey. An expectant mom’s group can also be another great resource, as you will be able to relate to and share all the uncertainties and fears you are going through with other women who are going through the same process.

Sleep and Relaxation

I made it a priority to rest. It is so important to make sure you are getting as much sleep as your body needs, as well as taking some down time throughout the day. Your body repairs itself during sleep, and also works to restore any imbalances that are occurring. When you compromise sleep, you become more susceptible to stress, as your immune system has to work harder to maintain proper levels of functioning throughout the day. Also consider taking some down time through a yoga or meditation class, a brisk walk, bubble bath, or even by lightening your workload.

Nutrition

I found that nutrition played a very powerful role in both coping with and the prevention of stress while I was pregnant. Caffeine, sugar and processed foods can trigger stress, so it is best to avoid them. Eat whole, fresh organic foods: fruits, vegetables, protein, and healthy fats that are easy to digest, and contain bio-available nutrients that are especially high in B vitamins and minerals. Exposure to sunshine for a few minutes of day will help your body absorb these nutrients. Of course, be sure to consult your midwife, doctor or nutritionist for your specific dietary needs.

Should you seek medical help?

If you have tried everything and find yourself helpless or depressed, it’s always best to seek medical attention. There are many professionals who are dedicated and committed to supporting you through your journey, and can provide you and your little one on board with the necessary help.

Mary Oscategui, CBP [IABPP], CPT, is the founder and CEO of The International Academy of Baby Planner Professionals (IABPP). She is an international business consultant and educator specializing in maternal health, fitness and going green. She is also the founder of TheBabyPlanner.com, EcoFit Mom and Physical Awakening. Mary is a writer, speaker, coach, author and birthing options advocate. She enjoys empowering, educating and supporting expectant and new parents to know all their options, so they may confidently make the best decisions for themselves and their baby in the most objective, healthy, safe way. Through IABPP, Mary introduced a new approach to the baby planning industry by focusing on the needs of her clients through parental education and emotional support.

How did you cope with the stresses of anticipating labor? Did you utilize a support group or birth professional? What tips do you have for other expectant moms?

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Nurture Yourself!

Caring for yourself properly during pregnancy gives you the physical, spiritual and emotional strength to care for yourself during labor and birth — which means bringing your baby into the world in the best, safest, and healthiest manner. This week, healthy lifestyle expert and women’s advocate, Anna Getty, provides a few tips and tricks for nurturing yourself during pregnancy, which will create a fulfilled, enlightened, powerful foundation for labor, birth and beyond!

One of the most important things anyone ever told me was to nurture myself during pregnancy — I did, and I’m so glad I listened. Rest and relaxation gave me the energy to move forward, to birth — and now, they give me the energy to parent. I see a lot of expecting moms who are overwhelmed and exhausted. It is crucial that we take care of ourselves — love, nurture and refuel ourselves — since running on empty during pregnancy leaves a woman less than equipped for childbirth. I napped regularly through my pregnancy — and up until recently, when my 4-year-old decided napping isn’t an option anymore!

Here are some additional tips for a nurturing pregnancy:

Resting doesn’t always mean “sleeping.” Light a few candles, turn on calming tunes and slip into a warm bath. Relax, take a moment, be grateful for this time (and your baby!), and breathe. If candles and soft music aren’t in the mix, it’s OK! The most important thing is to simply soak in serenity.

Incorporate massage. There is nothing like the hands of your partner rubbing your back, neck and feet, but if being massaged isn’t an option — massage yourself. When I was pregnant, I spent time before I went to bed rubbing sweet coconut cream into the souls of my feet. It’s truly revitalizing!

Get some fresh air — take a walk around the block. Do this every evening after dinner, letting the day unwind beneath your swelling feet. Reflect and let it all go. Post-birth, put your baby into a carrier and take longer walks, or hand baby off to your partner — and take ten minutes outside of the house for you … and only you.

Meditate — it’s not complicated, I promise! Simply close your eyes, slow down your breath, and focus on just being for a few minutes. Clearing your mind momentarily makes necessary mental space for focusing on you, your baby and your birth.

Love yourself as you love your baby! Creating pregnancy rituals will nurture, recharge and empower you for the important task ahead — birth. The things you do for yourself during pregnancy and birth will support you as you enter the next (amazing!) phase of your life, motherhood.

Anna has played many roles over the course of her remarkable life: Chef. Actress. Fashionista. Kundalini yoga teacher. Not to mention writer, holistic lifestyle expert and mother. But through it all, she has maintained a keen sense of self, a grounded perspective, and a passion for healthy living, spiritual fulfillment and respect for the environment that she wants to share with others. Anna has been featured on many TV shows, in many magazines, and written two books: “Anna Getty’s Easy Green Organic” and “I’m Dreaming of a Green Christmas,” both from Chronicle Books. Visit her at www.annagetty.com.

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