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Special Childbirth Issue

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Taking Charge OF

Your Birth

Benefits of Having Your Baby at Home C-Sections

KNOW THE FACTS

Top 10 Books for Pregnancy and Birth Supportive Dads at Birth Protecting the cave

77 natural Birth and Baby empowering websites for

issue 24 / winter 09 / $6.95

please display through 3/21/10


TM

executive editor Jeanne Ohm, DC editor@pathwaystofamilywellness.org advisory board Claudia Anrig, DC Sarah Buckley, MD Bruce Lipton, PhD Stephen Marini, PhD, DC Larry Palevsky, MD managing editor Robert Staeger contributing editors Aryn Gabai, DC Cynthia Overgard Lisa Reagan creative director Tina Aitala Engblom advertising / license coordinator Crystal Gloistein advertising@pathwaystofamilywellness.org circulation director Howard White Hwhite9611@aol.com

on the cover Taking Charge of Your Birth ......................... 6 Benefits of Having Your Baby at Home...... 32 C-Sections: Know the Facts . ...................... 38 Top Ten Books ............................................ 62 Supportive Dads at Birth............................ 42 77 Empowering Websites . ......................... 36

Pathways to Family Wellness is a quarterly publication offering parents articles and resources to make informed healthcare choices for their families. Pathways to Family Wellness provides thought-provoking information from the holistic health perspective and invites parents to explore options for family wellness. The individual articles and links to healthcare information in Pathways to Family Wellness are based on the opinions of their respective authors, who retain copyright as marked. The information provided is not intended to replace a one-on-one relationship with a qualified healthcare professional and is not intended as medical advice. It is intended as a sharing of knowledge and information. The publisher of Pathways to Family Wellness encourages you to make informed healthcare decisions based on your researched knowledge and in partnership with a qualified healthcare provider. Pathways to Family Wellness is provided to you by the International Chiropractic Pediatric Association in collaboration with the Alliance for Holistic Family Health and Wellness. Both organizations are 501-C3 non-profit status organizations and sales of Pathways to Family Wellness support their mission for public education. Images used are for illustrative purposes only.

Š 2009 Pathways to Family Wellness Issue 24, Winter 2009. Printed in the USA.

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on the cover @ Kate Callahan preciousmemoriesbykate.com

submissions Want to write for Pathways? We look for articles that challenge and confront, as well as articles that support and nourish. Want to share your photos with us? By sending us your photos, you agree that you have the right to distribute the image, and maintain that all people depicted agree to have their image published. E-mail articles to: editor@pathwaystofamilywellness.org Photos may be sent to: submissions@pathwaystofamilywellness.org Please visit our website for more details.


contents

Taking Charge of Giving Birth Childbirth is an instinctual process, inherently safe and uncomplicated. Our author shows that it’s possible to take charge of your own birth by preparing the most important birthing organ of all: your mind.

6 feature 4 letter from the editor 12 Wellness Lifestyle

The Hospital “Birth Plan”

By Molly Remer, MSW, ICCE

17 current news

By Cynthia Overgard

42 parenting

Protecting the Cave By Patrick Houser

44 holistic healthcare

Nine Essential Ingredients for a Natural Birth 48 gratitude

18 nutrition

Appreciating the Process of Birth

Eating in Labor

By Gloria Lemay

20 family living

Through a Child’s Eyes

By Susan Bartell, PsyD

24 chiropractic for life

Adjusting to a New Life

By Various

28 pregnancy

By Cathy Daub

50 informed choice

Avoid a Cesarean: Know the Facts 52 positive positional statements 54 research review 56 Mind—body—spirit

A Pregnant Pause

By Dr. Jennifer Barham-Floreani

Chiropractic Care for an Easier Pregnancy and a Safer Birth

62 recommendations

By Jeanne Ohm, DC

32 Birth

The Home Birth Advantage

By Ronnie Falcão, LM, MS

Top Ten Books for Pregnancy and Birth

36 resources

Empowering Websites for Pregnancy, Birth & Baby 38 the outer womb

When the Joy is Missing By Marcy Axness, PhD

44


letter from the editor, jeanne ohm, dc

Pregnancy and birth have held a special place in my heart for many, many years. Perhaps it comes from spending so much of my life either pregnant, giving birth or bonding with our little ones. Maybe it evolved from the 30 years I’ve spent caring for pregnant mothers and their newborns. It could be because I still spend almost every weekend teaching chiropractors and holistic birth providers pregnancy-specific care to support natural birthing. Most certainly it has been enriched by embracing the chiropractic philosophy of trusting and respecting the innate, natural order of birthing. Needless to say, it was with great pleasure and love that this issue of Pathways was born. In my years spent immersed in birthing, I have watched mothers struggle with the desire to birth naturally because of the fears imposed on them by the runaway technology-based birth industry. Before this high-tech intrusion, women gave birth without high regard for an outside authority. They worked to trust their intuition and respect their bodies’ inherent ability to function as it was created to. Under the guise of helping the process, modern medical practices spread the fear of pain, failure and disaster. They undermine the very foundation of women’s trust, and divert their ability to birth from within. Western birth practices constitute one of the most profound examples of how we have allowed the mystique of technology to overcome practical intuition. When we look at the alarming rise in the C-section rate and the increase in dangerous interventions, the record appears grim. Today, women who are choosing home birth are being scoffed at as merely following a growing fad. I find it disheartening that the normal, natural process of birth is engulfed with such fear and ridicule by the self-appointed powers-that-be. We have allowed these ideas to override our innate trust in, and respect for, our bodies’ own ability to function. Throughout my 30 years of care, I’ve discovered that the most important service we provide is to turn a pregnant mother’s attention away from her learned fears, and back to her inherent ability to give birth naturally. This starts by challenging her belief in the myth that obstetrics has irrefutably improved maternal and infant health and safety. From there, we encourage them to trust and respect their own intuition and their body’s wisdom in the age-old process of birth. When a woman seeks her strength from within, she finds the greatest inspiration—her awakened, internal spark of power.



pathways | issue 24

One of my favorite birthing videos, Giving Birth, produced by birth educator and activator Suzanne Arms, is exemplary in leading women to this place of trust and power. A midwife in the documentary offers these precious words of wisdom: “Another fear that women have is in losing control in labor, and that is something that any midwife encourages. That moment where a little bit of chaos can take over, and that woman can make those sounds and open her legs and allow that pressure, with all the love and support around her, and be vulnerable, and let that process take over… it is powerful. It is strong and it cannot be prevented. One woman told me in the middle of labor that she realized that this great power that she was feeling was, in fact, her own. It was her body. It was her baby. So instead of being in this dynamic of working against this great energy, she merged with it, and she stepped into it and she said, ‘This is me. This is my body, this is my baby.’ And she owned it. That was the turning point for her.” Another midwife adds, “This kind of understanding of birth— that the body has its own ability to deal with the pain of labor, and that the pain of labor is not unnatural or abnormal, and, if given enough support and privacy, a woman can do it, and it’s the major achievement of her own strength and creative capacity that nobody can ever take away from her for the rest of her life. That leads her to be a fiercely protective, strong, confident mother.” I am very hopeful for the future of birth, because what I see happening in all aspects of our society today is a wonderful shift in understanding and perspective. When one side of the scale becomes so over-weighted, a natural phenomenon occurs: a wake-up call, a spontaneous evolution which strives to achieve balance. To use a term coined by Bruce Lipton, Ph.D., a “newedged” science is emerging—one which rocks the cracking foundations of all fear-based, learned reductionism. As this paradigm shifts and we are reconnected with trust and respect, all aspects of our lives will evolve, including healthcare, family life, education and sustainability. What a magnificent pregnancy and birth we are taking part in!

Many, Many Blessings, Jeanne Ohm, DC


Birth is not only about making babies. Birth is about making mothers... strong, competent, capable mothers who trust themselves and know their inner strength.

Š maria nonemaker: marianonemaker.com

—Barbara Katz Rothman, Ph.D.


feature


Taking Charge of Giving Birth By Cynthia Overgard

Photographs courtesy of the author

A

commitment to natural delivery in a birth center, without doctors or pain relief of any kind on the premises, was the farthest notion from my mind the summer I learned I was pregnant. Like many other newly expecting women, I reluctantly envisioned my hospital birth to resemble every other actual and fictitious birth I had known. Agonized and disoriented, I would be rushed into a medical scene amid bright lights, confusing equipment and an assortment of intense, unfamiliar faces. I envisioned myself in the usual, dreaded position of lying on my back with knees bent, nobly trying to resist an epidural for as long as possible before finally acquiescing to the temptation, praying all the while that my baby and I would not be harmed by the anesthesia. This vision, unsettling as it was, was far too deeply ingrained by society and mainstream media for me to have realized I could choose otherwise. At the same time, I was haunted to know that surgical births were fast becoming the norm in the United States, and in fact cesarean sections had skyrocketed from 1 in 20 births to 1 in 3 within my lifetime. What was a rarity thirty years ago had earned its rank as our country’s most common major surgery, and I dreaded the possibility that my obstetrician might deprive me of my birthing experience by performing the quick but drastic procedure without irrefutable evidence that doing so was truly a matter of life and death. That early in my pregnancy, I had yet to learn that cesareans statistically posed a far greater mortality threat to both mothers and babies over vaginal birth. I was guided instead by my intuition: If my body was capable of doing something so astounding as to create and deliver into the world another human being, then I wanted to experience that miracle for myself. One evening, while conducting Internet research on childbirth, I happened across a website in which a mother shared the details of her natural home birth. To my amazement, she never described a single sensation as painful. I skeptically considered whether she withheld the negative details, or possibly even fabricated the whole tale. issue 24 | pathways




feature

But photos of husband and wife, newborn and siblings, removed all suspicion. Serenity, intimacy and laughter shaped each scene. My mind struggled to accept what I saw. Certainly I always knew natural childbirth was possible, but I never dreamed it could be so simple. My heart physically ached with longing, compelling me to admit a natural, drug-free birth was my dream. But I quickly dismissed the notion, rallying myself into society’s conventional way of thinking: Surely any educated, metropolitan woman like me would be out of her mind to birth outside of a hospital. I reminded myself that natural childbirth was nothing more than the unfortunate, inevitable fate of our ancestors. That’s why virtually no rational woman today, or so I believed, declined pain medication that was readily available and administered by experts. To think that we could numb the sensations of childbirth with an injection or an IV—surely I should consider myself among the luckiest women in history. The Myth of My First Trimester: Doctors Operate in My Best Interest I became determined to educate myself on the complexity of the obstetrics industry in our country. My education came at a cost: an ever-increasing fear of the very hospital birth I was planning. I was

That evening I told our doula what the doctor had said. She stated plainly, “Of course I remember who’s in charge. You are.” stunned to learn that doctors were held to revenue targets at hospitals; a cynicism grew within me. Natural birthing meant low revenue for medical providers. Far more disturbing were the risks and adverse outcomes associated with each money-generating intervention. Even seemingly innocuous and routine procedures were exposed as significant threats to the mother’s and baby’s safety. Moreover, each intervention increased the odds, often dramatically, that a subsequent, more radical procedure would be required, purely in response to the risks and side effects it introduced. If patients had the right to informed consent, then I couldn’t understand why more women didn’t refuse some of these interventions. Pitocin and Cytotec, for example, have never been FDAapproved for the elective induction of labor, yet countless women followed their doctors’ recommendations to use it for that very purpose. Were women provided with a full disclosure of the risks and side effects? Were they aware they could refuse? Knowing that revenue targets were hanging over obstetricians’ heads, I realized that birthing mothers had fallen victim to a powerful conflict of interest in the medical community. At my 12-week checkup, I asked my own obstetrician a straightforward question: her cesarean rate. Her response was a casual wave of the hand, claiming she hadn’t bothered to calculate those numbers in years. After pressing her relentlessly,



pathways | issue 24

she finally admitted it was at least 40 percent. Incredulously, I asked whether she truly believed life and death situations were so frequently at hand. I added that the rate of C-sections was just 5 percent in 1970, and that the World Health Organization said no place on earth should exceed a rate of 10 to 15 percent. “Some cesareans are elective,” she began. “Many women feel they would prefer to have their own doctor perform a cesarean rather than take the chance of delivering vaginally with a less familiar doctor from the same practice.” And you actually give merit to that choice? I wanted to ask. Major surgery, unnecessarily performed as a matter of familiarity and convenience? “As for emergency cesareans,” she sighed, “we don’t like if the mother is too old, too heavy or too thin, or if the baby is premature, too big or overdue. Other concerns are low amniotic fluid, multiples, placenta previa, breech positioning, gestational diabetes and failure to progress—that is, we’d like to see you dilate at least one centimeter per hour.” I was bewildered at how she could recite such an exhaustive list with a straight face, and dejectedly realized all three of my mother’s vaginal births had exceeded 10 hours. In fact, I had read that birthing, on average, lasts 12 to 14 hours. Why are women today being subjected to an arbitrary and unnaturally short timeline when our ancestors were not? And whose idea was it to brand us a “failure” in the very diagnosis, with invasive surgery as its looming punishment? “I’ll be honest with you,” she finally added. “Litigation plays a big role.” I was unprepared for the ubiquitous “litigation argument” so frequently used by obstetricians. This defense allows doctors to give the impression that they aren’t willing to take any chances, thereby creating grounds to perform a surgical birth and reduce the likelihood of a malpractice suit. The irony is that this assertion manipulates couples into inferring that a cesarean is the safer method of childbirth, when in fact it is statistically far more likely to produce an adverse outcome over vaginal birth. Ironically, my obstetrician figured she could comfort me by drawing an imaginary line along my lower abdomen to show me where she would make the incision, assuring me even the smallest bikini would hide the scar. That she misunderstood me so greatly was staggering. If we were discussing the potentiality of undergoing major abdominal surgery in order to save a life, then wasn’t the scar inconsequential? I couldn’t imagine surgeons of cancer and organ transplants reassuring their patients of the cosmetic outcome. Soon thereafter, my husband and I learned that hiring a doula—a labor assistant—would improve my odds of a comfortable, vaginal birth. When I told my obstetrician a doula would attend the birth with us, she shrugged. “Fine with me, if you really think it’s worth all that money,” she said. “Just make sure your doula remembers who’s in charge.” That evening I told our doula what the doctor had said. She stated plainly, “Of course I remember who’s in charge. You are.”


...it s’ about yours.

I am? I nearly cowered at the thought. Her words took hold as I slept. In the morning I telephoned my obstetrician’s office and asked them to prepare a copy of my medical file: I was leaving the practice. My bold move led me to a disheartening, circular thought process: Where would we deliver our baby? Fear held me paralyzed between two extremes: the doctors and medical intervention I was determined to avoid, and the agony I assumed would accompany natural birth. My husband discovered we lived an hour from Connecticut’s only free-standing birth center, and we made plans to visit the following day. After a lengthy, enjoyable consultation with the midwife director, we were led upstairs to the beautiful birthing suites. I was struck by the setting: The plush double bed, hardwood floors and floral window dressings were reminiscent of a New England bed-and-breakfast. We walked through the bedroom and into the large, marble bathroom, complete with a free-standing shower-for-two and Jacuzzi bathtub. As we walked, the midwife said, “You can deliver on the bed, in the birthing chair, on the floor, standing up, on your side, in the shower or in the Jacuzzi bathtub. We only ask that you not deliver

lying on your back—it would be painful for you, risky for the baby, and makes birthing far more challenging because it compresses the pelvis.” “Is it difficult for you when the mother chooses to birth in an unconventional position?” “No,” she smiled. “This isn’t about my convenience and comfort; it’s about yours.” That night, we came to our decision. At long last, I allowed my fear of natural birth to subside as my fear of medical intervention maintained its firm hold. From then on, I held every remaining prenatal appointment at the birth center, cheerfully driving an hour each way through the cold winter season. The Myth of My Second Trimester: Childbirth Must Be Painful To strengthen my resolve, I began telling everyone—social acquaintances, business colleagues and relatives—that I was planning a natural delivery with midwives. All the while, I quietly nursed the hope that I would come across another woman who had experienced her own unmedicated birth. Initially, it was a discouraging process—not just because issue 24 | pathways




feature

Look outside, Cynthia. The sun is rising.

natural labor was rare, but because there was occasionally some confusion as to what “natural” meant in the first place. Some women told me they had natural labor because the epidural didn’t numb them thoroughly—as if natural meant painful, rather than the avoidance of drugs. Then a woman in my prenatal yoga class told me how glad she was to have had natural labor with her first baby, until she clarified: “Wait a second—I had an epidural, and all. I’m just saying I didn’t end up with a C-section.” Aside from my own parents and brothers, who had unanimously applauded our decision, the general lack of encouragement I received—particularly from other women—was confounding. Good friends at work said I was out of my mind and showed no interest in discussing it further. A neighbor of ours enthusiastically told me she was in such agony during her own labor that she and her husband prayed, out loud, to spare her from death during the delivery. Her description horrified me until she went on to explain her labor had been initiated with a heavy dose of Pitocin at her own request, given that her parents were visiting and she wanted them to see the baby before leaving town. Each night, I recounted the day’s negative comments over

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pathways | issue 24

the phone to my mother, relying on her to help me regain my determination. What struck us most greatly was that so many people chose to perceive themselves as sufferers and victims rather than the persevering and capable women they were. To overcome my anxiety, my husband and I took a HypnoBirthing class, whose philosophy asserts that fear and tension are the actual cause of labor pain. Fearful thoughts release adrenaline, which causes the cervix to constrict rather than dilate—this, they say, is nature’s way of protecting the newborn from encountering danger. The resulting fight-or-flight response in the mother’s body prohibits blood supply to the uterus and leads to stronger contractions. It occurred to me that all other mammals are relaxed during birth; there are no cries of pain, no fear in the eyes, no bodily tension. Therefore, my job was to develop a deep trust in myself and this process. Just as the brain is the most sexual organ, so too is it the primary birthing organ. I needed to keep my cool, first and foremost, and reconnect with the knowledge that all females carry at a cellular level: My body and my baby would instinctively know how to birth, even if my conscious mind had no idea how I would ever pull it off.


swirl illustration © istockphoto.com / blue67

The Myth of My Third Trimester: Birthing Requires Assistance As it turned out, I did not ease gradually into labor like many women: My first contraction was intense enough to bring me to my hands and knees, and the second followed within four minutes. I was 6 centimeters dilated when we arrived at the birth center an hour later. It was just before dawn, and my midwives were cheerful upon seeing us. One of them wrapped an arm around me as we walked to the birthing suite and exclaimed, “Just imagine, Cynthia, you’re going to meet your baby today!” I eased into the heavenly warmth and weightlessness of the Jacuzzi, where I found my place between control and surrender. Without a single tube, needle or machine in the room—not even an identification bracelet around my wrist—there was no sense of being an ailing patient rather than the healthy woman I was. Hardly a word was spoken, and I was able to turn inward as nature demanded. I envisioned my baby and reminded myself that the more I relaxed, the faster I would dilate. The HypnoBirthing techniques apparently worked, because I was at 10 centimeters within the hour. I took long drinks of water and spoke in relaxed conversation during those brief, merciful moments of total reprieve between contractions. Soon I felt an unbelievable force of energy making its way through me. Our doula knelt as she held a cool washcloth to my forehead, and whispered her only words during the entire birth: “Look outside, Cynthia. The sun is rising.” Her comment brought me from the internal present to the external. It was a clear morning in early March, with shades of red and orange across the horizon. What a beautiful day to be born, I thought. Then, precisely when I knew I was birthing the next soul into the world, I was overcome with gratitude for the serendipitous course of events that had occurred to allow our baby to emerge from a mother who was calm, safe and loved. With the final surge, our baby was lifted from the water and placed on my chest. My eyes were squeezed shut in that instant, and everyone saw the gender except me. In those first sublime moments of contentedness and relief, I held our newborn to me tenderly and completely forgot to check. My husband waited for the cord to stop pulsating before cutting, and the midwives helped me to the bed and layered warm towels over my body as we initiated breastfeeding. Despite my small frame and our baby’s hefty weight of 8 pounds 14 ounces, the labor had lasted just three and a half hours since its onset at home. When the post-birth examination was complete, we were encouraged to take a few hours of private family time to rest

in bed. Nestled snugly between mother and father, our son, Alexander, gazed contentedly into our eyes. We walked into our home as a family within eight hours of Alexander’s birth. Whether it had been good planning or good fortune, I ended up with the beautiful, natural birth I longed to experience. I was proud of myself for pursuing the dream that had exposed my fears. And yet, I was humbled. I had once believed newborns to be frail and helpless, dependent on the rest of us to push, pull or cut them free from the womb. As much as I had relied on my husband and our birthing team, I realized I could now look into the eyes of my true birth partner. Alexander had worked as intensely as I had, and he, too, needed nourishment and rest to regain his strength from his own achievement. I marveled to consider that, without the supportive and loving presence of all the others, Alexander and I still would have attained his beautiful birth. The respect I instantly felt for my newborn son was the most enduring of all my lessons learned. How to give birth is a choice that women need not surrender to others. At times, our preparation was arduous: My husband and I had conducted countless hours of research on the host of decisions that come along with birthing and parenting. We

As much as I had relied on my husband and our birthing team, I realized I could now look into the eyes of my true birth partner. challenged one another with complicated questions ranging from logistical to moral, and we consistently faced opposition from a misinformed but well-meaning society. We replaced fear with trust, and misconception with fact. Empowered as individuals and as a couple, we eventually quieted the outside noise and heard our own articulate voices. And this is what we learned: We learned what it meant to take full responsibility for ourselves and our baby. We learned how to make informed decisions, consciously and carefully. We learned to stop explaining ourselves. And in the end, one truth spoke clearest: Whether she chooses to birth at home, a hospital or a birth center, it is the right—in fact, the responsibility—of every woman to plan her own baby’s birth with the information, honor and freedom to which she is entitled. 

Cynthia Overgard, MBA, HBCE, became a certified HypnoBirthing practitioner and a natural birthing advocate after the birth of her son, Alex. In June 2009, Cynthia experienced another water birth when she gave birth to her 9 lb. 7 oz. daughter, Vanessa, during a planned home birth. She and her family live in Westport, Connecticut, and enjoy a holistic, vegetarian lifestyle. Cynthia is a professor of finance at the University of Connecticut and a published writer. To contact Cynthia, visit hypnobirthingct.com. View article references and author information here: pathwaystofamilywellness.org/references.html. issue 24 | pathways

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Š istockphoto.com / xxxx

wellness l i f e st y l e


By Molly Remer, MSW, ICCE

The Hospital “Birth Plan” T

© istockphoto.com / xxxx david cox

here is a fairly normal course of events for women giving birth in a hospital setting. In order to be truly prepared to give birth in the hospital, it is important to be aware of today’s standard hospital procedures. All hospital procedures and interventions can be refused under your right to informed consent, but doing so requires knowledge, strength and attentiveness. I hope the following list of things you may encounter in the birthing room will encourage you to talk with your medical care provider in advance about hospital routines and your own personal choices, as well as help prevent unpleasant surprises during your baby’s birth. This list has been modified from content in Woman-Centered Pregnancy and Birth. These points might not necessarily reflect how your own hospital operates; that’s something for you to investigate and discuss with your medical care provider. The following are typical, routine procedures encountered in hospital births. If you are made aware of their standard protocols, you’ll be better prepared to deal with them if and when they arise: • To have at least some separation from the person

who brought you to the hospital due to filling out admission paperwork, parking the car, providing a urine sample, being examined in triage, etc. • To be told to remove all your clothing and put on a

hospital gown.

• To have staff talk over you, rather than to you, and

to have many different people walk into your room whenever they want without your permission and without introducing themselves. • To have your cervix examined by a nurse upon

admission and approximately every hour thereafter. If you allow it, you may have multiple vaginal exams per hour by more than one person. • To have an IV or a saline lock inserted into your arm. • To be denied food and drink until the birth.

(At best, expect clear liquids or ice.) • To be asked to give a urine sample and perhaps

a blood sample. • To have an ID bracelet attached to your wrist. • To have to sign a consent form that states your

doctor will be responsible for making the decisions about your care—rather than you. •

To have a fetal heart rate monitor attached around your belly—two round discs on straps that will often stay with you continuously until you give birth (or, at best, for 15 minutes out of each hour of your labor).

• To have your water manually broken at about 4

centimeters. Afterward, they might go a step further and screw an electrode into your baby’s scalp to measure the heartbeat and place a tube in your uterus to measure your contractions. issue 24 | pathways

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wellness l i f e st y l e

• To be offered pain medications repeatedly, even if you have

stated you do not want them.

Never ask permission to do what you

• To be offered Pitocin at some point during your labor “to speed

things up.”

want; go ahead and do it unless the

• To be told you must remain in your bed through most of your

hospital staff actively stops you.

• To either have your legs put in stirrups or held at a 90 degree

(An example of this is of getting up and walking around during labor.)

labor, especially when pushing. angle at the hips. • To be told when to push, and perhaps even told you are not

pushing correctly. • To be given an episiotomy if someone else determines that

your perineum will not stretch. • To have the cord clamped and cut before it finishes pulsating. • To have your baby suctioned repeatedly. • To be given a shot of Pitocin to make your uterus contract

and deliver the placenta. • To not be asked if you want to see the placenta. • To hold your baby on your chest for a few minutes, before it

is taken away to be dried, weighed, warmed by a machine and checked over. • To have antibiotic eye ointment put into your baby’s eyes without

first being asked permission. • To have your baby receive a vitamin K injection without first being

asked permission. • To have your baby receive the Hep B vaccine without first being

asked permission. It is important to note that much of this treatment is different from what you deserve, and that you have the right to refuse any of the above procedures and recommendations. At minimum, what you deserve are what Lamaze calls the Six Healthy Birth Practices: 1. Let labor begin on its own. 2. Walk, move around and change positions throughout labor. 3. Bring a loved one, friend or doula for continuous support. 4. Avoid interventions that are not medically necessary. 5. Avoid giving birth on the back and follow the body’s urges to push. 6. Keep mother and baby together—it’s best for mother, baby and breastfeeding. So, how do you work around these routines and achieve your desire for a natural birth? and do not want. While you might accept certain procedures, you have the legal right to refuse anything. You might also want to develop a backup plan for how to deal with any unexpected situation that arises. • Take an independent childbirth class (e.g. Lamaze, Bradley, Hyp-

noBirthing, Birth Works, etc.) and learn a variety of techniques that focus on trusting your body so that your “toolbox” is well-stocked.

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pathways | issue 24

© istockphoto.com / asterix0597

• Go through the above list and decide which procedures you do


• Hire a doula, or bring a knowledgeable, helpful, experienced

friend with you. It can help to have a strong advocate by your side—particularly if this isn’t a role your husband or partner is willing or able to assume. • Never ask permission, but proceed with what you want to do

until hospital staff attempts to stop you. (An example of this is eating, or getting up and walking around during labor.) • Bring light foods and drinks and quietly partake as you

please. Restricting birthing women to ice chips is not evidence-based care. • Leave the hospital early, rather than remaining the full length

of your allowable stay. This will minimize unnecessary separation from the baby and any additional interventions. • Request a nurse who is supportive of natural birthing. Better

yet, ask your doctor or the hospital staff in advance for the names of those nurses, and request whichever of them is on duty at the time of your birth. • Put a sign at eye level on the outside of your door saying,

“Natural birth in progress. Please do not offer pain medications.” • Labor at home for as long as possible. If you arrive at the hos-

pital too early, you will increase the risk of unnecessary medical intervention. Once your contractions require your full focus and attention, start heading to your birthing location. • Use the hospital bed as a tool, not for lying down. • Retreat to the bathroom if you feel you need to get away.

People tend to leave us alone in the bathroom; you can use that as your place to focus and regroup. Also, because we are conditioned to relax our pelvic muscles when seated on the toilet, spending some time there can actually relax you and help the baby descend. • Use the “broken record” technique: If asked to lie down for

monitoring, say, “I prefer to remain seated,” and continue

z i n e m a g a

f o r

i n g t h i n k

• Do not lie down, even if you agree to fetal monitoring. Sit on

the edge of the bed, on a birth ball or chair near the bed, or kneel on the bed and rotate your hips during the monitoring. • Bring a birth ball with you and use it—sitting near the bed

if necessary. Birth balls have many great uses for an active, comfortable birth. When any intervention is recommended during your pregnancy or labor, remember to use your “BRAIN”—that is, ask about the Benefits, Risks and Alternatives, check your Intuition, and ask what would happen if you did Nothing. If an intervention is aggressively promoted during your birth, you can not only refuse that intervention, but you can also ask, “Can you guarantee in writing this will not harm my baby? Please inform me of the risks and then show me the evidence supporting your recommendation.” A classic example is the recommendation of Pitocin due to “failure to progress.” Pitocin not only increases your chances of unnaturally intense contractions, but dramatically increases the likelihood of subsequent interventions as a result of the risks it introduces. Keep in mind that each and every medical intervention has been shown to increase the use of further interventions. All interventions have potential risks for you and your baby. A great birth, where you are in control, is possible in any setting—provided you understand your rights, know what to expect and have strategies to protect yourself from unnecessary medical intervention. Finally, birth is not a time in a woman’s life when she should have to fight for anything. If you feel you are preparing yourself for “hospital self-defense,” that’s a cue to explore other birthing locations and care providers. Also, remember that hope is not a plan. If you find yourself hoping for what you want (rather than simply being confident that you’ll get it), it could indicate your intuition is onto something, and it’s time to take another look at your current birth plan. 

hey, mama!

BRAIN,CHILD t h e

to reinforce that preference without elaborating or arguing.

r s m o t h e

2 Volume 9 Issue

Spring 2008

e for Inappropriat Children r kids?

FOR ALL THE ISSUES THAT GO UNSAID AT THE SOCCER GAME OR IN THE WAITING ROOM, THERE’S BRAIN,CHILD MAGAZINE.

ect you Can you prot Should you?

d The Needle anon e D s ie the StAud er scientist-moth

Just a sampling of why you’ll laugh, cry and think:

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PLUS FOR THAT? KIND OF OLD ISN’T FORTY G MEMOIRS ON PARENTIN FATHERS TAKE DREAMS, INTERPRETED Y YOUR PREGNANC

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One mother’s report on short-term homeschooling

The great VACCINATION debate

When another mother LOSES IT—and when that mother is you

A diaper-free infant: smart or crazymaking?

An investigation into the ECO-HOUSEWIVES movement

Essays by Barbara Kingsolver, Jane Smiley and other great writers

Spectacularly average kids


wellness l i f e st y l e

BEFORE You’re Admitted dismiss feelings of doubt and uneasiness. A key point is to select a provider whose words and actions match. For example, if you are told episiotomies are only done “when necessary,” then make sure you ask specifically for their statistics to ensure you are dealing with facts and not rhetoric. If you don’t want surgery, don’t hire a surgeon. Find a midwife or family physician who attends births and is skilled at delivering babies, rather than an OB with a high cesarean rate who is skilled at surgery.

If there are multiple hospitals in your area, choose the one with the lowest cesarean rate rather than the one with the nicest birthing rooms or most decadent postpartum meal. Hospitals—even those in the same town—can vary widely on their policies. Practice clear and assertive communication with your doctor and reinforce your preferences often. You deserve quality care that is based on your unique needs and wishes.

Do not choose your birth options based on insurance coverage, but rather on the location where your needs will be met most effectively. We take out loans for cars, houses and other material objects—recognize that your investment in supportive care providers for a birth of your choice is much more important, as it will affect your child’s well-being for the rest of his or her life.

Discuss in advance the type of nursing care you would like and request that your doctor put any modifications to the normal routines in your chart as “doctor’s orders.” If your doctor is unwilling to do this, consider it a potential red flag.

Read empowering books, watch natural birthing DVDs and connect with women who have had natural births. This will instill confidence and trust in your body, your baby and your innate birth wisdom. Use affirmations to help cultivate a positive, joyful, welcoming attitude.

Suggest that your partner read a book like The Birth Partner or Fathers at Birth.

Practice prenatal yoga, such as on the Lamaze Yoga for Your Pregnancy DVD.

Learn relaxation techniques. A calm mind and deep breath cannot be taken away from you, no matter what happens. The book Birthing From Within contains several breath-awareness strategies.

During pregnancy, ask questions and research any medical procedure that is recommended to you, such as a

available for free download. It contains a summary of all the research behind common forms of care during pregnancy, labor and birth, and whether the evidence supports those procedures.

Ask for the blanket consent form in advance and decide whether to sign it, or modify and initial it as needed. Ensure you are truly giving your voluntary informed consent rather than signing away your rights in advance of your birth.

Consider the ways you might be sabotaging yourself. If your greatest fear is having a cesarean, then don’t choose a doctor with a cesarean rate higher than the 10 to 15 percent range recommended by the World Health Organization. If you are giving yourself an excuse like, “I can’t switch doctors this late in my pregnancy,” know that you can switch—no matter how far along you are. A great book to help you explore these kinds of questions is Mother’s Intention: How Belief Shapes Birth, by Kim Wildner.

Believe you can achieve the birth of your dreams, so that you and your baby can enjoy a beautiful, empowering and positive birth!

non-stress test, a regular sonogram or a gestational diabetes test. A good place to start is at Childbirth Connection (childbirthconnection.org), where they have the full text of the book, A Guide to Effective Care in Pregnancy and Childbirth,

Molly Remer, MSW, ICCE, is a certified birth educator, writer and activist. She is a La Leche League leader and the editor of the Friends of Missouri Midwives newsletter. She has two wonderful sons, Lann, 6, and Zander, 3, and lives in a straw bale house in central Missouri. She blogs about birth at talkbirth.wordpress.com and midwifery at cfmidwifery.blogspot.com. View article references and author information here: pathwaystofamilywellness.org/references.html.

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© istockphoto.com / milena sobieraj

Choose your doctor carefully. Don’t


current news articles

The C-Section Backlash The World Health Organization says that a nation’s cesarean section rate should be below 15 percent, and the International Cesarean Awareness Network (ican-online.org) believes that there is no justification for any country having a rate higher than 10 to 15 percent. With the United States’ rate looming at 30 percent, the evidence suggests there are situations occurring where women are being forced to have a C-section beyond their desire to have a natural birth. One such case with international attention is an Arizona woman whose hospital’s policy does not allow VBAC (vaginal birth after caesarean). Rather than succumb to the knife a second time (the first was an emergency procedure), mother Joy Szabo has voiced her feelings that forced C-section is akin to rape, as both are forced entry into a woman’s body without her consent. The comparison has resonated with natural-birth advocates around the globe. The hospital’s current position is that if Szabo were to refuse a C-section at the time of birth, they would seek a court order to overrule her. For Szabo, her public refusal to submit to operational policy of a hospital has sent her to a birthing center over five hours from her home. For the rest of us, who live in a time when nonhospital-based birth centers are a rarity, our response is critical. Does natural birth become a privilege to only those who can access it? Should women be forced to have a C-section based upon unproven policies? To find out more, contact ICAN at ican-online. org or find your local natural birthing provider.

Top image: © istockphoto.com / Milena Sobieraj Bottom image: © nico nelson / creativecommons

thedailybeast.com/blogs-and-stories/2009-10-17/the-c-section-backlash

A Woman’s Nation: Reclaim Your Right to Birth Right The Shriver Report has revealed that number of women in the United States workforce now equals that of men, and that healthcare tops the lists of priorities for both sexes. In an article for The Huffington Post, well-known author, lecturer and birth advocate Christine Northrop argues that this is the perfect moment to reform the way we look at birth in the United States. “I have spent the last 30 years educating women about the wisdom of their bodies, including their innate ability to birth normally,” she writes. “Yet our so-called healthcare system...sees the female body and its processes (like labor) as an accident waiting to happen.” You can read the whole article—an excellent overview of the issues surrounding birth—online at huffingtonpost.com/ christiane-northrup/c-section-or-natural-birt_b_323422.html. Saving Home Birth in Australia Australian homebirth midwives are still struggling for their right to continue their valuable services. Recently, Homebirth Australia led a successful lobbying effort to have the “Medicare related” legislation to be considered in a Senate committee. The group’s lobbying efforts included an unprecedented letter-writing campaign; approximately 2,000 letters were received. The website below offers the most up-to-date information on the ongoing effort to keep private home birth a viable option for Australian mothers. yourherbalmedicine.com/blog/saving-home-birth-in-australia

U.K. Women are Being Denied a Choice in Birth Just 4.2 percent of pregnant women across the United Kingdom can choose whether to have their baby in hospital, at a birth center or at home, according to the National Childbirth Trust. According to a report published in October, more than 90 percent of women are denied a choice of where they give birth, despite a government pledge that all mothers-to-be in England would have that right by the end of 2009. partytow.com/e/2009/10/26/study-says-that-90-of-women-had-no-free-choiceof-place-of-birth

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nutrition

Eating in Labor

Trusting the Mother’s Gut Instinct By Gloria Lemay 18

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Photo courtesy of Dr. Laelle Martin, DC, of Brilliant Life Chiropractic

he wheels of progress seem to turn excruciatingly slowly over at the American College of Obstetricians and Gynecologists (ACOG). The organization has just come out with official policy that reverses its position on withholding beverages from birthing women. The lightbulb has finally come on: Nothing is helped by completely starving a woman and her unborn baby. Midwives needn’t worry that this will send homebirthers rushing into the hospital for their births. It will likely take another 30 years for ACOG to come up with a policy about what kind of drink might be most helpful and how to get it out of food services at 3:00 a.m. The homebirth experience provides a window into what happens with the human mammal who is not told what to eat or drink, and who can open her own fridge or cupboard any time she wants. When a woman eats to her own satisfaction in the early birthing hours, that food does not digest in the usual way. The hormones of birth slow digestion to a crawl. However, the food in the stomach provides energy, via sugars, to the birthing woman and baby. The reason that some women vomit when nearing the pushing stage is that the body automatically calibrates how much sugar is needed and, at transition, the levels drop dramatically in order to protect the baby’s brain from a lactic acid buildup while the baby’s head is being compressed and pushed through the pelvis. Where did I learn this? An amazing article published in Scientific American many years ago. An unmedicated birth is a very trustworthy process. Wholesome nutrition taken in through the mouth (as opposed to through an IV) will be absorbed or ejected in the best interests of the baby and mother. 1976: My Personal Homebirth Experience I had a vision for my birth. While baking muffins, I would squat down to open the oven door, and push the baby out. My friends and attendant would exclaim, “You are amazing!” So when I began having regular sensations at 8 a.m., I got up and began baking the muffins. In labor, I baked all day. There were muffins piled on every counter surface. I ate quite a few of them, washing them down with orange juice. At 2 a.m. the next day, it all came out of me, vomited up completely undigested. I pushed the baby out about an hour later. Needless to say, my actual birth was a lot more down-and-dirty than the one I’d envisioned. Over the years, I’ve seen some unusual eating patterns in women birthing at home. There is so much in birth work that defies the general rules that I feel rudderless at times, which leads to a temptation of making up rules to live by. I realized one day that I only knew one thing that was consistently true about birth: No one can eat during the pushing stage. That rule comforted me, even when everything else in obstetrics seemed chaotic. Then, during a home birth of a second baby, the mother asked, “Do we still have some of those Rusk biscuits?” She was handed the dry, Dutch cracker and munched it down. I was appalled! She was defying my rule! So much for my nice theory. But since the mind abhors a vacuum, I made up a new rule: No one can eat when the baby’s head is crowning. That, too, was good for quite a while. Eventually, however, a first-time mom said at full crowning, “Can I have a few raisins?” There went that rule, too, darn it. I pity the folks at ACOG who they think they can make protocols, rules and guidelines that will cover all births in all situations. A better goal would be to have clinicians who could think for themselves, distinguish complications from a normal birth, relax when things are taking a while, and marvel over the consistently fascinating process of human birth.  Gloria Lemay is a lecturer, midwifery educator and traditional birth attendant in Vancouver, BC, Canada. She specializes in VBAC and water birth. She has served birthing women since 1976 and is an advisory board member of ICAN and a contributing editor of Midwifery Today magazine. A mother and grandmother, Gloria wants her tombstone to read, “She spoke up for babies.” View article references and author information here: pathwaystofamilywellness.org/references.html. issue 24 | pathways

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family living

Through a

Child’s Eyes

By Susan Bartell, PsyD It’s a very important moment in the life of your family: You’re adding a new member! In growing families, a new son or daughter is often also a new brother or sister. Many families face the question: Should my child be present to greet her new sibling

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© Heather Burchinal / Photos courtesy of the Gatlin Family, Azie Chiropractic Clinic

ifferent people will have very different reactions to this idea. Some will think it’s terrific—a really wonderful shared experience for parents and child, not to mention a powerful bonding moment for the child and her new sibling. Other people will be shocked that a parent would even consider exposing a child to what they perceive as a traumatic experience. One mom told me that she didn’t think she would be able to concentrate and that she might even be embarrassed for her daughter to see her in labor and giving birth. Still others will be on the fence, unsure of which is the right decision for their family. It’s important to examine the pros and cons of this issue in order to decide which choice is right for you. And if you do decide to have your child present at the birth of your next baby, we have some suggestions about how to make the experience as positive as possible. Experts Don’t Agree The experts who favor having a child present at a birth say that it can be a powerful and positive experience that contributes to a feeling of family closeness. Since parents include the child in many phases of the pregnancy as it develops, having the sibling at the birth is an extension and natural conclusion of this. Many midwives, who tend to be more accepting of children at births than traditional obstetricians, report that most children are thrilled to be there, and that they bond with their new sister or brother immediately. Other supporters suggest that the child’s presence at the birth might reduce sibling rivalry later on. Even among the supporters, however, there is disagreement regarding the ideal age at which children can benefit from the experience. Many feel that a child must be adequately prepared before attending

a labor and delivery, and must be able to understand verbal explanations quite well. Among these experts there is a general consensus that about three years old is the youngest age that a child can adequately comprehend what is being explained, and ask questions, if necessary. Other proponents feel that, depending upon the child and the birth, a child of any age should be able to attend. “The really young ones seemed almost oblivious, as long as they were being held by a trusted adult—usually a best friend of Mom, or a granny,” says a seasoned midwife, who has attended dozens of births at which siblings of various ages were present. “They haven’t learned as much fear yet, in my opinion.” On the other hand, some people believe it can be too difficult for a child of any age to view his mother in labor and giving birth. Their concern is that the sight of blood, coupled with seeing their mother in pain, can be very traumatic for a child, and that viewing the actual birth could be overwhelming. Furthermore, they suggest that the child’s presence might be distracting or difficult for the mother, who already has a large enough burden in laboring and giving birth. Some obstetricians worry that the child will get in the way. Others warn that you never know when a crisis might arise during labor and delivery, which you probably won’t want your child to observe.

Many midwives report that most children are thrilled to be there, and that they bond with their new sister or brother immediately.

Temperament and Age Regardless of what the experts say, you know your child best. Use your good sense to make the final decision. You might have a very sensitive child who gets scared easily or has nightmares, and choose not to have him at a birth. What’s more, you can’t assume that an older child will not be scared. There are issue 24 | pathways

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family living

Okay, I’ve decided. Now what? Here are some things you should do to make the experience positive for you and your child: Ask your child if he wants to attend. Never force or coerce a reluctant child or teenager, and make it clear that he can change his mind at any time. Also, tell him that he can leave at any time during the labor or delivery if he is uncomfortable or scared, and you will not be at all hurt or upset. Prepare your child for the birth by describing in a calm and matter-offact way what she should expect to see. Use age-appropriate language and don’t spare the details. Children need a realistic idea of the pain and blood they may witness. Explain that Mom’s body makes a lot of extra blood for the birth and that it is supposed to come out. They also need to know that the birth will probably take a long time (as long as three TV shows or more), and that the baby may be blue and cry a lot when it is born. Get at least one video that shows childbirth and encourage your child to watch it as often as possible before the actual day. (Try Spiritual Midwifery, which can be ordered online through farmcatalog.com.) A book with graphic pictures is also very useful—Giving Birth and A Child is Born are both recommended by parents who’ve had their children at a birth. Explain that having a baby is very, very hard work, and that sometimes it helps to make “really big work noises” and “hard, hard work faces.” It’s a good idea to encourage your child to practice making funny noises and faces with you, focusing on exerting effort.

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Ask an adult with whom your child is comfortable to be responsible for him throughout the entire process. This person should not be the father or anyone else directly involved in the labor and delivery. This adult and your child should both know that if the child cries, becomes scared or asks to leave, he should be taken out immediately. Your child should be told in advance who will be in charge of him. Older children and teenagers also need the support of an adult, but of course they may not need to be taken care of in quite the same way. If your child is very young (though even with some older children), you might want to consider having her at the delivery only. It can be hard for a young child to endure a long wait and see her mother in labor, but witnessing the birth can still be exciting. If the child will attend the labor and delivery, pack some snacks, drinks, toys and books. It’s also a good idea to arrange a place to sleep. Remember, this is a big decision. You should always give yourself the option to change your mind, even at the last minute or during labor. Arrange to have your child interact with the baby as soon as possible after the birth. This will help forge the initial bond between your older child and her new sibling. If you are still really unsure how your child will respond to the experience, consider this: If you allow her to witness the labor and delivery, she might be scared by it, it’s possible that she will continue to feel upset long after the birth. Obviously, this would be stressful for her, for you, and for her relationship with the baby. Remember, you can’t undo this once it’s been done. So if you really think your child won’t respond well, go with your gut feeling and don’t do it. You can always videotape the birth and let her watch it afterward when there is time to stop and process it as you go along. But if you feel it would be a wonderful experience for your family, be open and flexible. Most of all, listen to your child. 

our experiences “There was nothing more beautiful than Ian climbing into bed with Brian and me, and holding his baby brother for the first time. It was pure magic. The look on Ian’s face is something I will cherish for the rest of my life.” —Lauren Hamm “Our first two children became so enthralled by their little sister’s birth. It opened their eyes to the circle of life and made them realize the beauty of having another sibling. It also let them see that babies just did not arrive... they witnessed the miracle of life.” —Ron Nathanson “As my second son was born, my older son (then 2.5 years old) called out, ‘I like him! I like him!’ Then, when the midwife asked who was going to cut the cord, he stepped right up and said ‘I will do it!’ We hadn’t planned for this—it was completely spontaneous. But he did it (with a little help).” —Molly Remer “The beauty of their faces when the head comes out and their eyes meet for the first time is indescribable.” —Jessica Dietrich-Marsh

Dr. Susan Bartell is America’s No. 1 family psychologist. She has been helping parents and kids lead happier and healthier lives for nearly twenty years. Dr. Susan’s latest book is Dr. Susan’s Fit and Fun Family Action Plan. You can learn more about her at drsusanbartell.com. View article references and author information here: pathwaystofamilywellness.org/ references.html.

© Heather Burchinal / Photos courtesy of the Gatlin Family, Azie Chiropractic Clinic

tough 6-year-olds, and 14-year-olds who are very sensitive. Sometimes younger children are more open to the idea, but become uncomfortable with seeing their mother in this way as they get older. This is particularly true of adolescent boys, who can be extremely opposed to witnessing their mother give birth.


We knew our daughters (Rylie, 5, and Sydney, 3) would be involved with every aspect of our pregnancy. We prepared them by watching baby shows, reading books and telling them the truth about what might take place. Nothing was kept secret. They were on the bed excitedly watching our birth and were assigned the job of helping cut their baby brother’s cord with Daddy. The girls instantly bonded with their brother. After the initial bonding, my midwife prepared us a warm herbal bath. Baby Brody Maddox and I were able to relax and get to know each other in the healing herbs. We both loved it! He was wide-eyed and appeared to be taking it all in. Having our daughters involved only amplified the joy our home birth brought us! We would not have changed a thing! —Tammy Gatlin


Adjusting to a New Life

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photographer: colleen harris / photo courtesy of martin harris, dc

chiropractic for life


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bottom left: photo courtesy of yost chiropractic; top right: photo courtesy of marco caravaggio, dc / photo by sabrina boussou

arents often ask why a newborn baby should be checked by a chiropractor. Adjustments help alleviate spinal subluxations (misalignments of the vertebrae) caused by intrauterine constraint, abnormal positioning in the uterus, and spinal distress from the journey through the birth canal or during the delivery process itself. Ideally, babies should be checked and adjusted as soon as possible after birth. Incidence of Need M.S. Gottleib, a well-published researcher, reviewed the effects of the birth process and concluded, “The trauma from the birth process remains an under-publicized, and therefore significantly under-treated, problem.” “Survival of the newborn is governed mainly by the integrity and function of the vital centers in the brain stem,” writes Andrew Towbin, a prominent researcher on birth trauma. “Yet paradoxically, the importance of injury at birth to the brain stem and spinal cord are matters which have generally escaped lasting attention.” Another published researcher, G. Gutmann, documented a study of more than one thousand infants. He found that approximately 80 percent of all newborns had some form of nerve dysfunction. Gutmann concluded that many health problems can arise from misalignment of the first vertebrae in the neck, resulting in a lowered resistance to infections in the ears, nose and throat. He also noted, however, that even an adjustment using the lightest pressure of the index finger could normalize an infant’s clinical picture. His colleague, V. Fryman, examined 1,250 babies five days after birth and found that 95 percent of this group were not only misaligned, but also had cervical strain. She also noted that the infants responded to specific spinal and cranial care with immediate muscular relaxation and a greater ability to sleep. Another renowned researcher and practitioner, Heiner Biedermann, has done numerous clinical studies relating upper cervical misalignment in the newborn to prolonged labor and the use of extraction devices. He, too, has recorded significant improvements in the health of infants who receive specific adjustments after birth. Nerve dysfunction associated with birth trauma may result in problems such as breathing weakness, mood irritability, digestive disorders, difficulty with feeding and attachment, sleeping problems, immunity deficits and neurological impairment. Left uncorrected, subluxations and their resulting nerve system dysfunction may develop into numerous health issues for the baby.

Proven Safe Recently the International Chiropractic Pediatric Association published the preliminary results of its study in Explore: The Journal of Science and Healing, in an article entitled, “The Safety and Effectiveness of Pediatric Chiropractic: A Survey of Chiropractors and Parents in a Practice-Based Research Network.” The preliminary data confirms what chiropractors have known for over 100 years: Chiropractic care for children is safe and effective. On the issue of safety, out of 5,438 office visits, there were only three adverse events reported from the adjustments—a .00055 percent chance of negative reaction. Demonstrating a risk factor well below 1 percent, this study shows that children have a greater than 99 percent chance of suffering no problems when receiving chiropractic care. Furthermore, the three adverse events reported in the study were minor discomfort following the adjustment. Each was readily resolved with continued adjustments. In the study, over 90 percent of the chiropractors and parents reported an adjustment-related improvement with respect to the children’s presenting complaints. Even more interesting is the discovery of benefits unrelated to the initial problems. Both parents and doctors reported better sleeping patterns, improved behavior and more robust immune system function while under chiropractic care. Increasingly, scientific research is supporting the clinical experience of chiropractors. Chiropractic care is growing in acceptance as a viable necessity for newborns. A Crucial Difference The following pages present three viewpoints of a newborn life-saving collaboration, offering us a vitalistic perspective of chiropractic in practice. In this story of home birth, the attending midwife is not only present throughout the entire labor and birth, she is also the provider who offers the first follow-up well baby visit. Additionally, a homebirth midwife’s understanding of biomechanics in birth is generally superior to her obstetric peers; therefore, her assessment of birth and her recognition of potential trauma to the infant are more acute as well. When a woman gives birth in a hospital, she and her baby are usually released as healthy, at which point the obstetrician’s role is generally complete. If a problem with the baby’s health arises several days later, the birth team is not a part of the newborn examination. Rather, the mother goes to a pediatrician or an

Increasingly, scientific research is supporting the clinical experience of chiropractors. Chiropractic care is growing in acceptance as a viable necessity for newborns. issue 24 | pathways

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chiropractic for life

emergency room, and there is an inherent disconnect between the baby’s birth and the baby’s condition. An added disadvantage is that the treating doctors are seldom qualified to consider a potential neuro-musculo-skeletal cause resulting from birth, which is often an integral part of the health status. Such problems are often easily remedied with a trip to the chiropractor, if only the obstetrician were informed enough to make that call. Finally, within the usual obstetric paradigm of birth, a mother’s intuition is not often considered. This story, therefore, demonstrates the power of a holistic, integrative team of providers who recognize each other’s specialty and acknowledge the mother’s intuition, as well.

fingertip pressure on the baby’s back or neck, while other times they may choose to use a hand held instrument to adjust the baby’s spine. Chiropractors sometimes also lightly massage the muscles on either side of the baby’s spine and other relevant areas of the body. Infant adjustments are very gentle, and typically a baby will be soothed by an adjustment, or even sleep through the process! It is important to note that 65 percent of neurological development (i.e. development of the brain and nervous system) occurs in your child’s first year. It is therefore imperative to ensure your baby has every opportunity to maximize his or her nerve function during this critical period.  —Jeanne Ohm, D.C.

Chiropractic Adjustments for Babies Chiropractic adjustments for newborns differ significantly from those performed on adults. Often the chiropractor will use light

Article contributions from a lay midwife, mother, attending chiropractor and a chiropractic author.

A CHIROPRACTOR’S EXPERTISE here is a remarkable story I’d like to share about one of my experiences as a chiropractor. I’m not seeking personal credit, nor do I believe this is a miracle above other miracles. It’s simply a demonstration of what is supposed to happen when neural interference is removed and connectivity is restored. This is a story about healing, and a reminder that miracles should be the natural state. On June 4th I received a call from Ellen, the midwife who assisted me during both of my home births. She was calling from the house of another client, whom I had referred to her. The mother, Shakira, had birthed a son, Abdullah, 36 hours prior. According to Ellen, Abdullah had a very slow and irregular heart rate of about 76 beats per minute—well below the normal newborn range of 120 to 140 bpm. He was also yellow, which raised added concern, given that jaundice typically doesn’t set in so quickly after birth. He had nursed a few times, but was otherwise listless and unresponsive. Ellen told me that during the birth, she had seen Abdullah’s head clear in one direction and his shoulders clear more than 90 degrees in the other. She had not held the head or restricted the baby’s movement in any way. During the post-partum visit, she felt intuitively that something was wrong, and that it was the odd presentation and potential neck trauma causing the problem. She asked if I could come to the home immediately, and I agreed. When I arrived, I checked the baby’s spine and cranium. My exam indicated that his occiput and atlas (the lower cranial bone in front of the upper neck vertebrae) were significantly out of alignment. I adjusted the baby and let him lie there for about 15 minutes, periodically checking his heart rate. I then checked him again. The occiput was holding, so I slightly adjusted the atlas one more time, having found no other cranial or spinal misalignments. We waited another 15 minutes. Suddenly, some red splotching began to appear over his previously yellow body. As we listened to his heart rate, we witnessed the activation of his body’s innate intelligence to re-regulate itself. Within minutes, his red splotching turned into an even, pink skin tone in front of our eyes. The yellow hue was gone! His rooting instinct kicked in and he nursed with a strong and healthy latch for ten minutes. I checked him once more to ensure the adjustments were holding. At this point, his reflexes seemed to come alive; he was alert and active. By the end of the hour, his heart rate had completely normalized to 120 to 130 bpm. Interestingly, his testicles had also descended within that hour. That may have been a coincidence, but it seems noteworthy given all the other healthy indicators we witnessed as a result of the adjustments. Ellen and I left together. Once we were alone, she told me she believed Abdullah’s adjustment saved his life. In her experience, his failure to thrive had made him a likely candidate for SIDS. It was staggering to process the magnitude of what had happened. Being a part of Abdullah’s remarkable transformation has been one of the blessings and wonders of my life. And yet, what we had witnessed was no miracle; it was simply a reminder of how flawlessly the body responds when all its circuits are connected. Abdullah continued to thrive and engage in all normal newborn activities. When I examined him during a follow-up visit, his heart rate remained in normal range, as did his skin tone and reflexes.  In retrospect, I realize none of this could have taken place had my midwife not recognized the need for chiropractic adjustments in the first place. How many other babies would benefit from having practitioners who understood the importance of chiropractic care? Dr. Kathy, Chiropractor

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A MIDWIFE’S INSIGHT t was June 2nd; I was called to attend the home birth of a 32-year-old woman. It was her second planned home birth. I arrived at 11:30 p.m. Her first assessment showed her at 6 centimeters dilated and 85 percent effaced, with the baby at 0 station. The baby’s position was ROT (Right Occiput Anterior) with good heart tones at 144 beats per minute. Her membranes spontaneously ruptured at 1:32 a.m. with clear fluids. The baby’s head came out facedown, showing a rotation to the mother’s right thigh. But as the anterior shoulder was presenting, I realized it was the left shoulder! I quickly encouraged him to rotate to the mother’s left leg, and he was born at 1:46 a.m. He cried immediately and was placed onto his mother’s belly. At 2:17, he nursed successfully. Everyone looked healthy and I left at 3:30 that morning. I returned for a postpartum visit on June 4th to find the baby very lethargic. He showed slight jaundice, had an irregular heartbeat of about 76 bpm and his testicles were undescended. He had passed meconium three times. He had a newborn rash, was passing gas, and had a good Moro reflex. The mother said he had could latch successfully, but would not nurse for a long time. When he showed interest in nursing, his heart rate went to 108 bpm, but then settled back to a range of 60 to 84 bpm. The family said he was very quiet and didn’t cry much. I called Dr. Kathy, the chiropractor I work closely with, to come and check him, because I suspected something had happened in the upper neck during his uncustomary descent in the birth canal. She adjusted him twice, with one last follow-up to make sure he held the adjustment. She said there were definite, severe misalignments in the atlanto-occipital area of the spine, which she had corrected with the adjustments. I reevaluated the baby after the second adjustment. His jaundice had cleared, his heart rate had increased to 120 to 132 bpm, and even his testicles had descended! When I talked to the mother the next day, she said he had a vigorous cry, was alert and maintained good color. I personally feel that we may have prevented a SIDS episode by having rechecked the baby’s heart on the postpartum visit and getting him adjusted by a chiropractor to restore normal nerve function in the upper neck. Ellen, CPM

I

hree viewpoints A MOTHER’S INTUITION listened to the midwife’s words as she performed the postpartum checkup for my newborn son. “He’s jaundiced already,” she said, “and he’s lost a full half pound.” I feared something was wrong. My baby boy, only 36 hours old, was pale and relatively unresponsive. She told me his heartbeat was too slow. It was 76 beats per minute, and irregular. “Here, listen,” she said, putting the stethoscope to my ear. I heard a very slow heartbeat with an unusual pause. She looked at me and said, “It’s too slow. He needs a chiropractic adjustment—now.” Fortunately, our chiropractor friend was available to come immediately and check on him. For my midwife and me, time seemed to stand still. My four older children looked on, bewildered and concerned. The chiropractor performed an assessment of heart tones, an exam of the spine and cranium and a gentle and specific adjustment on his little body. We laid him down to see if his body would hold the adjustment; what we saw was nothing short of amazing. His near-lifeless body started to change. His pale white skin began to redden and my midwife scooped him up and rushed him to the window. “Look at him,” she said. “The jaundice is gone!” His reflexes awakened and my baby rooted to nurse as I held him to my breast. I nearly cried as he suckled like a normal, healthy baby. His heart rate came within normal range, and we all sighed with relief. The next day I spoke with my midwife and I told her that my baby boy was completely red. She said, “It’s called blood flow!” and we laughed. Then her tone changed. “Had we not gotten him adjusted, I fear that in a few days you would have lost him,” she said. The gravity of her statement made me feel very, very grateful. We saw our dear chiropractor for a follow-up, and we said to each other, “Thank God! It’s truly just amazing!” She told me that in her 10 years of practice, she had never seen such a severe upper-neck misalignment in a newborn. Throughout my entire pregnancy I had expressed to my midwife and others that something was different, but I just couldn’t put my finger on it. It wasn’t necessarily anything bad, but maybe something I wasn’t prepared for. We are all blessed with intuition. My midwife said that perhaps what I sensed may have been a heads-up, so to speak. I am eternally grateful I had people around me who were blessed with the foresight to recognize the real problem and the skill to correct it. Now my baby boy is thriving. My other children have, in my chiropractor friend’s words, their new, new baby brother.  Sharika, Mother of Abdullah

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issue 24 | pathways

27


pregnancy

Chiropractic Care for an

Easier Pregnancy and

Safer Birth

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pathways | issue 24

Y

photo courtesy of mark flannery, dc

By Jeanne Ohm, DC

ou might have noticed that chiropractic care is becoming an important part of birth preparation for many pregnant women these days. These women are realizing the benefits of regular chiropractic adjustments as they prepare for safer, easier birthing for both themselves and their babies. Chiropractors have actually cared for pregnant women for many years. Recently, however, with the increased interest in natural birthing, and in an effort to avoid having a C-section, a growing number of mothers have incorporated chiropractic into their prenatal care. To understand how chiropractic care can contribute to a better birth, it is important to look at the mother’s and baby’s biomechanics throughout pregnancy. As a mother’s weight increases, her center of gravity shifts outward and her postural compensations respond accordingly. In addition, the ligament laxity necessary for birthing adds to instability in all of her joints, including her spine and pelvis.


top left:© lisa young, istockphoto.com / top right © rosemarie gearhart, istockphoto.com / bottom left: photo courtesy of mark flannery, dc

“The potential for damage in pregnancy and the postpartum period to a woman’s neuro-musculoskeletal structure is great,” Varney’s Midwifery warns. “Shifts in the center of gravity forward and slightly up destabilize her posture and realign the carriage of weights and forces through her joints, predisposing nerves, muscles, bones, and connective tissues to damage. Increased levels of relaxin and elastin further aggravate this situation.” Changes During Pregnancy These hormonal and structural changes can lead to spinal and pelvic misalignment and the lower back pain many women experience during pregnancy. Lower back pain, in and of itself, is a burden to a woman’s daily function and quality of life. However, the misalignment of the spine and pelvis have a far more crucial consequence to a mother and her developing baby. In chiropractic, these misalignments are called subluxations. These insidious blockages cause stress overload to the mother’s nervous system, potentially impairing any of her vital systems and organs. During pregnancy, when a mother’s body systems are basically functioning for two, any interference to the nerve transmission supporting their function can be detrimental to her health and well-being, as well as the growing baby’s. Reducing this nerve system stress is a key ingredient for normal bodily function. Another effect of spinal and pelvic misalignment throughout pregnancy is a condition imposed on the baby called intrauterine constraint. To understand this, it is important to look at the mother’s anatomy and see the relationship between her pelvic biomechanics and the baby’s positioning. The mother’s pelvis has

Intrauterine constraint can create torsion in the uterus, limiting available space for the developing baby. This can inhibit the development of the baby’s spine.

various key ligaments attached that support her uterus. As the baby grows, their role becomes increasingly important. If her pelvis is in biomechanical balance during pregnancy, the uterus will be supported symmetrically. This allows the baby optimal room for movement in utero and provides it the opportunity to develop free of constraint. Conversely, if the woman’s sacrum (the major triangular bone in her pelvis) is out of alignment, it will affect the alignment of her entire pelvis. Misalignment of the pelvis will create an uneven pulling effect on the uterine ligaments, which explains why some women feel sensitivity on one side more than the other. Intrauterine constraint can create torsion in the uterus, limiting available space for the developing baby. This can inhibit the development of the baby’s spine. Gross misalignment conditions like torticollis create excessive stress to the baby’s developing neuromuscular system, and can impair his nervous system and adversely affect virtually any of the body’s systems and functions. Intrauterine constraint not only compromises fetal positioning, but can also impair the future health of the baby. The optimal position for birth is anterior vertex (rear-facing, head down). When a baby presents breech or posterior, it often is the result of issue 24 | pathways

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pregnancy

The unique expertise of chiropractors can detect and correct these misalignments with a gentle touch to the

an imbalance in the mother’s pelvis, forcing the baby to assume a compromised position. Even if the baby is vertex, the head may be tilted off to one side. This tilting is termed “ascynclitic.” While this position is less troublesome than breech or posterior, it could still result in a lengthier, less comfortable and more complicated birth. Ideally, the baby’s neck should be flexed forward without a tilt to either side. The body’s intelligence wants the easiest route out for the baby. If mother’s biomechanics are compromised, obstetric interventions are more likely to be recommended and implemented. Each and every intervention has significant side effects for both mother and baby. Many drugs and procedures are used “off label,” meaning the FDA has not approved them for their obstetric application. Furthermore, such interventions are often not evidence-based, and therefore their effectiveness is questionable, at best. Preventing Interventions All obstetrical interventions increase the risk of subsequent and more serious procedures. For example, with any intervention (e.g. Pitocin, epidural anaesthesia, etc.), the risk of mechanical delivery (the use of forceps and vacuum extraction) and surgical delivery (C-section) multiplies substantially. These unnatural modes of delivery are risky and traumatic to both mother and baby. Proper prenatal chiropractic care, however, is a valuable tool to decrease the reliance on these invasive delivery procedures. Medically classified birth trauma is when the baby has fractured clavicle and humeral bones, overt neuromuscular damage such as Erb’s and Bell’s palsy, or severe spinal cord injury. Chiropractic classification of birth trauma is much more specific and distinct. Evidence of birth trauma is when the baby has misalignments to his or her spine affecting nerve system function. These less obvious traumas can be detected by doctors of chiropractic as soon as a child is born. The unique expertise of chiropractors

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pathways | issue 24

can detect and correct these misalignments with a gentle touch to the baby’s cranium and spine. When parents understand the importance of nerve system function and the potential trauma of birth, they recognize the importance of having their infants checked immediately after birth. Fortunately, today’s parents are becoming increasingly aware of the importance of the mother’s pelvic biomechanics throughout pregnancy. Giving it due attention will not only result in a more comfortable pregnancy, but will optimize the baby’s developing systems in utero and contribute toward achieving optimal fetal positioning for a safer and easier birth for both mother and baby. To find a doctor of chiropractic who offers specialized attention and consideration for pregnant women and infants, visit the ICPA website at icpa4kids.org.  Dr. Jeanne Ohm has been working with pregnant mothers for almost 30 years in her family wellness and chiropractic practice. Jeanne’s professional mission is fulfilled by traveling internationally to provide chiropractors with the skills and passion to care for more pregnant mothers and children. Additionally, she is committed to educating birth practitioners with the information to support natural birthing in their practices. She and her husband, Dr. Tom Ohm, are the parents of six healthy, home-birthed children. She can be reached at makinmiracles.com or on Facebook. View article references and author information here: pathwaysto familywellness.org/references.html.

Top Left: © rosemarie gearhar, istockphoto.com / Top right: photo courtesy of mark flannery, dc / Bottom right: courtsey of martin rosen, dc

baby’s cranium and spine.


birth

The Home Birth Advantage The physical and emotional benefits of birthing at home By Ronnie Falcão, LM, MS

W

hen it comes to what’s best for you and your baby, you can consider a midwife-assisted home birth as safe an option as birthing in a hospital or free-standing birth center. At a home birth, your privacy will be respected and you can enjoy birthing in an intimate, family atmosphere. By birthing at home, you’ll be treated like a woman going through a natural process. Too often in hospitals, birthing women are made to feel more like patients with a dangerous condition. Homebirth midwives carry the same equipment and medications found in a birth center. These includes handheld Dopplers and state-of-the-art machines for continuous monitoring of the baby’s heart rate, if necessary. Midwives also bring suctioning equipment and an oxygen tank to every birth, in the rare event they are needed. Anti-hemorrhagic medications will be on hand to prevent postpartum hemorrhaging, as will suturing equipment in case you tear. In fact, midwives practicing in homes or independent birth centers can do everything that a midwife in a hospital could do. A 2009 Canadian study compared safety rates for planned home births and planned hospital births attended by the same cohort of midwives. They also evaluated the safety of planned physician-attended hospital births for a matched population of low-risk women who could have opted for homebirth or hospital-birth midwives. Of the three groups, the homebirth group had the highest safety statistics, including the lowest rate of interventions, serious perineal tearing and hemorrhaging. Babies born at home required resuscitation

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photo courtesy of christina smith and her midwife, illysa foster of sistersmidwifery.com

less often than those born in the hospital, and were less likely to experience meconium aspiration. Thus, the study indicated that home births were not only safer for low-risk mothers than any other birthing environment, but that they also called for less medical intervention. One key difference is that professional midwives, in whichever setting they practice, work to recognize problems that could potentially interfere with a safe birth, and seek to correct them before they become major problems. They are also trained to handle life-threatening emergencies that can occur suddenly during a birthing, such as shoulder dystocia, postpartum hemorrhage or placental problems. Interestingly, each one of these emergencies occurs beyond the point when a cesarean section is still an option. During the hours leading up to a birth, if a cesarean becomes necessary, there is a safety margin of 30 to 75 minutes in which to assemble a surgical team. For this reason, many midwives recommend that women labor within 30 minutes of a hospital as their emergency backup plan. This provides the same safety margin as women birthing in hospitals. A landmark study on homebirth safety was published in the British Medical Journal in June 2005. Like the 2009 study, this study showed that home births and hospital births had similar overall safety rates, but that there were fewer interventions and fewer complications for the home births. This prospective study with a rigorous research design is was most comprehensive North American study regarding birthing location options. A suite of homebirth safety studies from the United Kingdom in 1996 also showed home to be as safe as or safer than a hospital for low- and moderate-risk women. In a 1999 review of all the literature on the relative safety of different birthing locations, childbirth researchers Luke Zander and Geoffrey Chamberlain concluded, “No evidence exists to support the claim that a hospital is the safest place for women to have normal births.” Safety Begins at Home There are several reasons why midwife-attended home births are safer than hospital births for most women. The first is that birth is a natural bodily process that works best without interference. A home birth with a midwife attending assures you that risky medical intervention will be kept to a minimum. (For example, Pitocin and epidural anesthesia, routinely administered in hospitals, introduce significant risks to both mother and baby.) Most problems that arise at home can be corrected with position changes or by providing the mother with food or better hydration—safe and helpful tools which are, ironically, often forbidden in many hospitals. The second reason that home birth is safer is that the infection rate at home births is less than half that of hospital births. There are several reasons for this. First, the baby is born with the mother’s antibodies, passed through the placenta. These include immunity to the family’s household germs. Hospitals are notoriously germ-infested, and a mother isn’t able to offer herself or her baby the same degree of immunity from that environment. Second, homebirth midwives know not to wash off the protective, antibacterial vernix covering the baby’s skin. Third, because mothers and

babies are never separated, the baby’s immature immune system is able to function optimally, without the stress and disruption of the baby being taken from its mother. Furthermore, the continuous mother-baby interaction fosters successful breastfeeding, which is the baby’s best protection against infection from the moment of birth. Midwives provide continuity of care and comprehensive mother/baby care at a level impossible in the assembly-line nature of hospitals. Many women wonder whether they’ll be able to give birth at home without drugs; in fact, most women do just fine. Many women who have had babies both at home and in the hospital assert that birthing is much less painful at home, in familiar surroundings, with birth attendants who could cater to every need. Childbirth classes teach about the fear-tension-pain cycle, whereby fear increases tension, causing the cervix to constrict rather than dilate, which in turn increases pain. It’s a process that’s counterproductive to birthing. When fear is absent from the birthing environment, the opposite cycle can play out: confidence-relaxation-comfort. That is, the more confident you are, the better able you are to relax, and the more comfortable you’ll be. This allows your body to secrete endorphins, which are the natural pain relief intended by nature for the mother’s body during natuMidwife-attended home ral childbirth. As a laboring woman’s births are safer than hospibody produces more oxytocin to increase the tal births for most women. effectiveness of her contractions, she also producA home birth with a midwife es an equivalent level of endorphins for pain relief. attending assures you that (These endorphins aren’t produced if the mother risky medical intervention is under stress or feeling afraid.) It is not uncommon will be kept to a minimum. for women to become increasingly relaxed as labor progresses, due to their endorphin levels climbing as the intensity increases. It’s easy to imagine how being in your own home can increase your confidence and ability to relax. A birthing tub provides even greater comfort, immersing the mother in the warm weightlessness of water. Water birthing offers the woman the option of laboring and birthing in a tub. When a baby is born in water, the baby continues to receive all of its oxygen through the placenta until it is above water and using its lungs successfully. Thus, there is no risk of drowning, even if the baby crowns slowly over several contractions. The buoyancy provided by the water seems to help the mother and baby find the optimal position for birthing. In addition, the warm water increases blood flow to the uterus, which not only provides the necessary oxygen to the baby, but facilitates cervical dilation and reduces pain. Babies born in water are usually in excellent condition, and they are easily comforted by the familiarity of warm water. issue 24 | pathways

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birth

The experience of birth for the baby at home is usually very gentle. We know that babies recognize voices during late pregnancy, so it is believed that the baby recognizes the midwife’s voice as someone nonthreatening and familiar. Homebirth midwives don’t use any devices that go inside the uterus or might be uncomfortable for the baby, and women are encouraged to birth in a position they choose. Positions chosen by the mother, such as an upright position, or on her hands and knees, tend to minimize stress on the baby and facilitate an easier birth. Many homebirth couples choose to catch their own baby, and the assessment of baby’s well-being right at birth can be easily done with the baby still in the mother’s arms. Some midwives don’t ever hold the baby until the mother feels ready to have the baby weighed. Most parts of the newborn exam can be performed with the baby in the arms of the mom or dad. And because there is no rush to cut the cord, the baby receives all of its nutrient-rich cord blood, as nature intends. Families who already have a little one at home appreciate how much easier it is for the older sibling to adjust to a new baby when their mom doesn’t mysteriously disappear for a few days. It may be wise to have a special family friend or a professional child doula there to care for the older child during the birth, but many siblings happily participate during the birth or sleep right through the excitement.

choose to catch their own baby, and the assessment of baby’s well-being right at birth can be easily done with the baby still in the mother’s arms.

Ronnie Falcão, LM, MS, is a homebirth midwife practicing for twelve years in and around Mountain View, California. A direct-entry midwife trained through a homebirth apprenticeship and a residential internship at Casa de Nacimiento birth center in El Paso, Texas, she was licensed in 1997 under the California Challenge Process through the Seattle School of Midwifery. Ronnie is editor of the Midwife Archives at gentlebirth.org/ archives. Her personal web page is gentlebirth.org. View article references and author information here: pathwaystofamilywellness.org/references.html.

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pathways | issue 24

photo courtesy of Melinda Uhl (Lisa Lucas, photographer)

Many homebirth couples

Easier Than You Think The logistics of planning a home birth are often not as complex as couples assume. Babies born at home get a birth certificate and social security number, just like hospitalborn babies. (Your midwife can provide the necessary paperwork.) Birth kits with disposable supplies can be easily purchased online. Even larger items, such as birthing tubs, can be affordably purchased or rented. Home birth is legal, and because it is far less expensive than hospital birthing, in some states insurance companies will cover the cost or even negotiate an in-network rate for out-of-network providers. In California, for example, even some HMOs cover home birth. Insurance coverage for home birth varies tremendously from state to state and from one health-insurance carrier to the next, so it is important to contact your own insurance company for more information. When you do so, you can tell them that the savings associated with home birth as the norm are estimated to be around $15 billion annually. On an individual level, if you’re paying out of pocket for your birth, you may end up spending $2000 to $5,000, depending on where you live and the services you get. (For example, many homebirth midwives will include well-care newborn check-ups for several weeks after the birth, right in your home.) Hospital births range from $8,000 to more than $30,000 for vaginal births, and can run as high as $50,000 for cesarean births, which involve additional days in the hospital for mother and baby as a result of the major surgical procedure. Home birth provides an opportunity for a safe and satisfying birth experience, putting the needs of the baby first. She’s the most important person during the event: Shouldn’t she be treated like it? 


{to come} ® ®

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issue 24 | pathways

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resources

Empowering Websites for r e s o u r c e s , i n f o r m at i o n a n d d i r ec to r i e s o f p r ac t i t i o n e r s 

BirthCenters.org A comprehensive resource of birth centers BirthPartners.com Natural childbirth options: international listings CFMidwifery.org Information and resources promoting midwives HomeBirth.org.nz New Zealand homebirth association Homeopathic.org National center for homeopathy HPAkids.org The Alliance of Practitioners for Holistic Family Health and Wellness ICPA4Kids.org Family wellness chiropractors, articles, resources MANA.org Midwives alliance for unity and strength MaternityCoalition.org.au Australian umbrella organization supporting maternity services Midwives.org.au Promoting, supporting and strengthening midwifery in Australia Midwife.org/Find.cfm Find a certified nurse or midwife Naturopathic.org American Association of Naturopathic Physicians

r e s o u r c e s f o r p r e g n a n c y a n d b i rt h

Acupuncture.rhizome.net.nz Parent’s acupressure and acupuncture guide for pregnancy and childbirth AmericanPregnancy.org Comprehensive pregnancy information AmtaMassage.org Find a practitioner, become a therapist BirthIntoBeing.com Resources for home birth, natural birth and water birth BirthingTheFuture.org Suzanne Arms presents articles and DVDs on natural birth BirthInternational.com/links/birth.html Birth International BirthPsychology.com Association for Prenatal & Perinatal Psychology and Health ChildbirthSolutions.com Supportive information on birth choices ChildbirthConnection.org Resources on pregnancy, labor and birth ChoicesinChildbirth.org Helping women make informed decisions FathersToBe.org Effective preparation and support for fathers HenciGoer.com Referenced, informed choices in childbirth www.HomeBirth.org.uk Home birth support in the U.K. HomeBirthAustralia.org Home birth support in Australia HomeBirthVideos.org Excellent compilation of birth DVDs for viewing and purchase ICAN-Online.org International Cesarean Awareness Network: outstanding information InaMay.com Website of Ina may Gaskin, leading midwifery advocate, author, innovator LifeHealthChoices.com Making informed health choices for you and your family MercierTherapy.com Massage therapy training for pregnancy, and better birth MindfulMotherhood.org Mindfulness practices for pregnancy and early motherhood MotherandChildHealth.com Natural pregnancy, birth, children and parenting information MotherFriendly.org Coalition for Improving Maternity Services NewDawnPublish.com DVDs, training for dynamic body balancing PlusSizePregnancy.com Information for plus-size pregnant women PushedBirth.com What to really expect in today’s modern birthing system SpinningBabies.com Easier childbirth with optimal fetal positioning ThePinkKit.com DVD sets to instill birthing confidence TheUnnecesarean.com Useful information in avoiding unnecessary cesareans TheBirthSurvey.com An online consumer survey of women’s birth experiences WaterBirth.org Supporting and educating women who want to birth in water WhatBabiesWant.com Understanding the consciousness of infants and babies in utero

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pathways | issue 24


Pregnancy, Birth & Baby b i rt h e d u c at i o n , d o u l a s a n d h y p n o b i rt h i n g p r ac t i t i o n e r s

Alace.org International birth and wellness project BirthingFromWithin.com Resources, educators and doulas BirthWorks.org Resource directory emphasizing trust and self-confidence BradleyBirth.com Husband-coached childbirth Dona.com All about doulas and finding a doula HypnoBirthing.com Learning how to connect with your inherent birthing potential Google.com Find HypnoBirthing in the U.K., Australia and New Zealand ICEA.org Promoting freedom of choice in birthing Lamaze.org Supporting natural pregnancy, childbirth and parenting

u n a s s i st e d b i rt h i n g

EmpoweredChildbirth.com Empowered childbirth UmbrellaNoize.com/stuff/Emergency%20Childbirth.pdf A manual for emergency childbirth UnassistedChildbirth.com Articles, DVDs, forums UnassistedHomeBirth.com Articles, links, DVDs UnassistedHomebirth.com/Fathers Fathers’ questions answered YouTube.com/results?search_query=infant+cpr&search_type=&aq=-1&oq= Infant CPR

m ag a z i n e s f o r p r e g n a n c y, b i rt h a n d e a r ly c h i l d h o o d

CompleatMother.com The magazine of pregnancy, birth and breastfeeding Magazine.Lamaze.org Natural pregnancy, childbirth and parenting MidwiferyToday.com Articles on the practice of natural childbirth Mothering.com The birthplace of natural family lifestyle PathwaysToFamilyWellness.org Vitalistic articles and resources for family wellness

newborn ne e d s a n d i n f o r m e d c h o i c e s

AttachmentParenting.org/pdfs/API_Infant_Sleep_Safety_Brochure.pdf Infant sleep safety guidelines AVN.org.au Australian Vaccination Network DoctorsOpposingCircumcision.org Physicians for Genital Integrity FamiliesForNaturalLiving.org Families for Conscious Living HolisticMoms.org Community groups and forums connecting parents JewsAgainstCircumcision.org supporting families who don’t circumcise KellyMom.com Breastfeeding and parenting LaLecheLeague.org Breastfeeding community groups and resources LifeHealthChoices.com Education, advocacy, options Mercola.com Research and information on all aspects of health from Dr. Mercola NoCirc.org National Organization of Circumcision Information Resource Centers NVIC.org National Vaccine Information Center ThinkTwice.com Global Vaccine Institute WestonAPrice.org Wise traditions in food, farming and the healing arts

Links available at www.pathwaystofamilywellness.org

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Š istockphoto.com / xxxx

the outer womb


When the

JOY

is Missing

An Organic Perspective on Postpartum Depression By Marcy Axness, PhD

Postpartum depression is one of those everyday terms we use, though few of us understand what it means. We know it is important and serious, but it remains abstract. How does one recognize postpartum

© istockphoto.com / claudette carracedo

depression? What does it feel like? A simple web search provides these symptoms: extreme fatigue, loss of interest in activities, sleeplessness, sadness, tearfulness, anxiety, hopelessness, irritability, appetite change, poor concentration and feelings of worthlessness and guilt. As vague and complex as this may seem, postpartum depression can almost always be detected by a single screening question: Does the mother feel joy? If she suffers from any form of postpartum depression, it’s possible she’ll say “no” outright. But she’ll also be likely to hedge, with words like, “I know I’m supposed to feel joy… and sometimes, occasionally… there are brief hints of joy...” Many new mothers experience what I call Chronic Covert

Postpartum Depression (CCPD). They suffer behind a façade of frantic perfectionism that effectively obscures the possibility of even considering whether something could be wrong. Years ago I wrote about my own struggles with a CCPD. This is how I described it. [I had] vague but persistent fears of incompetence, an intangible but relentless drive running deep inside me to always be trying to do it better, or at least do it right. Do what right, I couldn’t define. I just knew that I rarely felt a respite from this steady pressure that seemed to define my life after becoming a mother. And it seemed that I was angry, silently resentful, most of the time. When there were no specific tasks to accomplish, like diapering or feeding or driving us somewhere, I felt deep discomfort at simply being with my baby. I had learned from my RIE (Resources for Infant Educarers) parent/ infant class that babies and children thrive on this “wantsnothing time”—that it’s as nourishing to their psyches as food is to their bodies. But as soon as I would sit down on the family room carpet with my baby, to just be there while he explored and played, the resistance would rise issue 24 | pathways

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the outer womb

When we spend a lot of time with a child of a particular age, our own unresolved feelings from that age tend to surface. up and I would quell it by suddenly thinking Oh, I’ve got to jump up right now and call about those slipcovers, or Maybe I should plan tomorrow’s dinner, or I’d better go wipe the water spots off that table. The refuge of life’s droning busywork. We had planned for Ian to sleep in a cradle in our room during the early weeks, but on our first night home his snuffling baby noises kept me so on edge, his closeness so chafed at me, that he was alone in his own room beginning the following night. Then I could feel tense and guilty from safely down the hall. My first years of mothering were thus: my need to escape Ian’s crushing dependency on me; and the guilt, anger and ever-present gnashing conflict of my two deepest impulses—to attach, and to pull away (not necessarily in that order). When Ian was about four months old, I said to my husband, “I feel like he’s sucking all the me out of me.” But actually he was sucking the real me, terrified and enraged, out of hiding. And there it was: I was hiding. Seeing Ourselves in Young Faces I recently had the honor of speaking at a wonderful conscious pregnancy and childbirth conference in Brazil. This gave me the opportunity to validate what I had long since suspected was a powerful factor in postpartum depression. Child psychologist Erik Erikson taught that when we spend a lot of time with a child of a

particular age, our own unresolved feelings from that age tend to surface. When a mother holds a baby in her arms, the baby she once was is there too, reawakened. Accordingly, Dr. Cláudia Orthof sees a central postpartum focus as “the art of meeting yourself again.” The question is, is the mother prepared for this? We focus so much upon preparing for childbirth, and so little preparing for motherhood. Is the new mother ready to face whatever might lie dormant from her own early days—perhaps confronting her own long-banished feelings of longing, grief or rage? If not, she might slip into the “hiding place” of postpartum depression. Conversely, it is believed that if the mother’s own birth and postpartum relationship with her mother was joyous, uncomplicated and uninterrupted, she will be far less likely to suffer from postpartum depression. The latest research on attachment and brain development reveals that it is in the context of the mother’s gaze that the infant discovers who he is; his brain wires itself accordingly. One of the first indications of depression is that one avoids the gaze of others, including that of a baby. And a baby who cannot find his mother—and thus himself—within her gaze is drastically disadvantaged in the complex developmental task of composing his “self.” As Dr. Eleanor Luzes said at the conference in Rio de Janeiro, when a mother is “unprepared to be seen,” the child suffers as deeply as the mother. The Dangers of Forced Separation Our culture is seriously handicapped around this issue by the way we handle birth. Biological necessities clash with our

Postpartum Support Resources Postpartum Support International • postpartum.net Solace for Mothers • solaceformothers.org (offers support for moms and caregivers) PTSD After Childbirth • angelfire.com/moon2/jkluchar1995 Trauma and Birth Stress (TABS) • tabs.org.nz

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Facing the Storms of Autism? You’ll L♥ve this survival book!

existing cultural norms—procedures which aren’t normal at all when we remind ourselves we are mammals. Everywhere in nature, when we try to “skip a grade,” to hurry past any developmental stage, problems arise. A butterfly will die when “helped” with the shedding of its chrysalis. When mother and baby—in accordance with most hospital protocols—miss out on their opportunity for undisturbed eye-to-eye bonding and skin-to-skin contact in the hours after birth, or are separated by a well-meaning night nurse who wants to give the mother a rest, the mother is deprived of nature’s powerful biochemical leg-up to her momentous new role. (Hormonal fluctuations are not believed to cause postpartum depression. They can, however, reflect and intensify it once the condition is present.) Cultural anthropologist Robbie Davis-Floyd points out that a woman giving birth shares a similar psycho-physiological profile as those involved in other rite-of-passage rituals. By virtue of the cascades of oxytocin, prolactin and natural opiates that flow during an unmedicated labor, she is open to birthing not only her child, but entirely new layers and levels of herself. But when there is no one present to help hold and support the mother through this awakening, depression can settle upon her as her hormones further engage her in a relentless downward spiral. The uninterrupted postpartum connection between mother and baby needs to be regarded as a potent, protective factor against postpartum depression. What I needed all those years ago was someone to know my story, recognize my risk factors and support my growth through and beyond my own pain. I needed someone to lovingly urge me to not give in to that deep impulse—nothing more than a memory, really— to pull away. What I most needed was what felt the most deeply unfamiliar: connection. 

Marcy Axness, Ph.D., is an early-development specialist, adjunct faculty member of Santa Barbara Graduate Institute’s prenatal and perinatal psychology program, and counselor in the Los Angeles area, specializing in fertility, pregnancy psychology, adoption and early parenting. She can be reached 818-366-7310, or via her website at quantumparenting.com. This article first appeared in the Journal of Prenatal & Perinatal Psychology and Health, Volume 21, Issue 4, 2007. View article references and author information here: pathwaystofamilywellness.org/references.html.

Learning to Dance in the Rain A Mother’s Holistic Approach for Helping Her Child with Down Syndrome and Autism

Autistic Heidi Pearson

Take a glimpse into a real home where autism took root. Learn survival skills to “weather the storms of life” with a disabled child. The complex issues of autism are simplified and holistic ideas are offered in this educational, heartwarming, and inspiring true story.

w w w. e l a y n e p e a r s o n . c o m

Family Wellness First

Interested in the latest research on family health and wellness? Sign up for our free e-newsletter. www.pathwaystofamilywellness.org


parenting

By Patrick M. Houser

Š istockphoto.com / xxxx

Protecting the Cave


T

he ancient archetype of a father during birth is that of him standing guard at the opening of the cave, protecting the birthing mother and newborn from danger. As we move through time, he comes closer to the actual location of the birth itself—waiting, protecting. By the late 20th century, he enters the birthing room and becomes more involved. His earliest role in the birth process was to ensure survival—to protect the family from wild animals, or perhaps other tribes. As birth has become more industrialized, his role appears to have altered. But could it be that by entering the birthing room, the father is returning to his initial, primal role of protecting his loved ones? In our culture today, the threat could be drifting dangerously close to the mother and baby—from inside the birthing room itself. Has our modern approach to birth interfered with the natural physiological process to such

Has our modern approach to birth interfered with the

opposite page: photo courtesy of the hilen family / photo by fran hill, doula / petroglyph photo © istockphoto.com / pedro antonio salaverría calahorra

natural physiological process to such a point where fathers are now needed to protect in a new way? a point where fathers are now needed to intercede? To protect in a new way? Interventions of every unimaginable kind are rampant, and much of what is being done to the mother and child is as unnecessary as it is risky. Suppose that the modern role of a father is to prohibit the excessive bombardment of people, equipment and drugs from interfering in the very natural and ordinary process of birth. Many interventions at birth are the result of overimaginative professionals, most with good intentions, who have been medically trained to intervene in a nonmedical process. Humanity cannot invent a drug superior to that which the mother’s body can manufacture, nor can it produce a doctor whose experience is as vast and wise as a mother’s instinct. If a mother is properly protected in a safe and sacred environment, free from unnecessary interventions, distractions and interruptions, she can get on with the business of birth. She will use her “instinctual brain” to access all of the hormones and inner resources required to birth her baby with love, safety and empowerment. When it comes to hospital births, a father’s biggest challenge is penetrating the gauntlet of a foreign and unnatural environment. A new father can expect to face emotions and decisions that he cannot necessarily anticipate in advance. These pertain not only to himself, but also to those he loves and feels compelled to protect. There are no prepared answers as to how he can do this. He can, however, ask questions, demand reasonable and satisfactory answers, and trust in his ability to protect, just as he trusts in the mother’s ability to birth. 

Fathers in the

Chamber When my water broke five weeks early and things were not progressing the way everyone else thought they should (they were pushing for interventions), my daughter’s father stood up for me when I was getting worn down. I am so grateful to him for staying so strong and supporting me in the birth decisions that were so very important to me. i Brooke Fister Conner We used the Bradley Method for our home births, so I was there to coach her and support her physically and emotionally, and to be there for her every need. i Matthew McCabe My husband spent eight hours rubbing my back, bless him. I even tried to pretend a rush wasn’t coming on so he could get a break. He saw through that. He also persuaded me to have a home birth— best decision ever! i Samantha Van Norman At the birth of my second son, Max, I lost my cool. Labor was hard and furious and I kept saying, “I can’t do it. I can’t do it. I need drugs!” My husband held my hands and said in the clearest voice, “Pam, you are doing it.” He was instrumental in helping Max to come into a candle-filled water birth of peace. I couldn’t have done it without him, and I have never loved him more. i Pam Jarboe I was there by her side throughout. Wouldn’t want to start a family any other way! i Peter Sayegh He walked with me for the first 24 hours as I tried to walk my little boy into this world. Then, when it was time, he brought my heating pad, massaged my back and sacrum, and just listened. He stroked my brow, gave me my water and helped me focus! i Meggan Medley My husband was the calm at all seven of our home births—especially the one where it was just him, and the cord was around our baby’s neck. He supported me emotionally and physically, since I stood for a number of them. He even did massive cleanup when necessary. i Mary Jo Horner

Patrick M. Houser is a grandfather and father of two sons. The birth of his first son revealed to him the need to understand birth more fully; Patrick’s second son’s arrival, in 1980, was the first documented water birth in the United States. These experiences have formed his life’s work and led him to nearly 25 years of passionate advocacy for birth choices. Patrick has a degree in marketing, has owned a natural health center, and for 10 years owned and ran a construction firm in Austin, Texas. He is the director of The Source Foundation International, a UK registered charity that promotes health and choice from pre-conception through birth and throughout life. Patrick is also a speaker, writes articles and is the author of the Fathers-To-Be Handbook, originally published in the UK and now available in a U.S. edition. View article references and author information here: pathwaystofamilywellness.org/references.html. issue 24 | pathways

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9

holistic healthcare

Essential Ingredients for a Natural Birth

In addition to regularly

during your pregnancy, consider these nine holistic paths to strengthen your mind, body and spirit for your upcoming birth.

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homeopathy

Homeopathy is a gentle system of care that has been around for hundreds of years. Because there are no side effects, nor is there any risk of addiction or toxicity, homeopathy is safe for pregnant women and babies. Homeopathy is rooted in the belief that the body knows how to heal itself, and the mind and body will work together in that process. The main sources for homeopathic remedies are plants, animals and minerals. These are extremely diluted to the point where even a trace amount is undetectable. Homeopathic doctors receive years of training in thousands of remedies, and are able to offer a very specialized level of care. Some of the areas in which homeopathy may assist during the prenatal and postpartum stages include fertility, morning sickness, heartburn, con-

stipation, helping a breech baby to turn, induction of labor, overcoming breastfeeding challenges and managing postpartum depression. There are also remedies to assist children through various life transitions. Homeopathy has a wide scope and remedies exist for virtually every mental, emotional and physical ailment.  Piper Martin, B.Ed., DS Hom.Med. • PiperMartin.com

naturopathy

Naturopathy is based on the principle that the body knows how to restore itself to full health. Treatments can include a mix of nutritional counseling and supplementation, herbal medicine, flower essences, essential oils and homeopathy. Returning your body to optimal health is a process of treating the original cause of ill health, removing blockages to this healing ability and improving the functioning of all the systems in the body. The approach is holistic, encompassing all aspects of being: physical, mental, emotional and environmental.

© istockphoto.com / homeopathy: Jozsef Szas-Fabian / naturopathy: Sandra Caldwell

visiting your chiropractor


There are many reasons it can be a good idea to work with a naturopath throughout your pregnancy. These include the emotional (e.g. working through feelings that can arise during pregnancy using Bach flower remedies) or physical (e.g. using homoeopathic remedies to support the nervous system physically). Naturopathic remedies can ease many pregnancy-related discomforts, from cramping, morning sickness and nausea to more serious conditions such as infections and high blood pressure. Natural remedies are a good alternative to medications, particularly during pregnancy, as they are more gentle on your body and your baby, and have no side effects when prescribed properly.  Louisa Glindemann, AdvDN, AdvDBM, DNut, DRM, DAroma MATMS, MNHAA, MADC • YourNaturopath.com.au

© istockphoto.com / hypnobirth: jo unruah / doula: josef phillip/ acupuncture: mark feerhy

acupuncture

The theory and practice of acupuncture is based on a holistic healthcare system that has been used in Asian countries for thousands of years to diagnose, treat and prevent illness and to maintain health and wellness. Acupuncture includes a diagnostic process that considers the person as a whole, rather than focusing on any individual symptom. Once areas of disharmony are identified, stimulating the appropriate points with very fine needles (the size of a strand of hair) restores the body to optimal energy flow, called qi [“chee”], which relieves symptoms and restores health. Acupuncture treatments safely support a woman through each trimester of her pregnancy. Because qi is the body’s energy system, it contributes to the proper functioning of all bodily organs and physiological processes, including reproduction. Acupuncture treatments throughout preg-

nancy can balance the mother’s qi, thus supporting both the health of the mother and the developing baby. There is strong evidence indicating that acupuncture is effective at offering relief for some of the most common prenatal and postnatal symptoms, including morning sickness, nausea, heartburn, fatigue, constipation, anxiety, edema, insomnia, carpal tunnel, sciatica, gestational diabetes, breech presentation, delayed labor, lactation issues and postpartum depression.  Acupuncture can provide a safe and effective alternative, without side effects, for women seeking holistic care and wellness during pregnancy. Lynn Keating, L.Ac. • acuportpw.com

hypnobirthing™

HypnoBirthing is a complete, 12-hour childbirth education course for couples, in which the premise is that fear and tension are the cause of labor pain. Women and their birth companions gain a deep trust in normal birth and learn easy self-hypnosis techniques, because focus and relaxation, the defining attributes of hypnosis, are powerful tools for remaining calm and maintaining control. What makes HypnoBirthing unique is that the course is centered on the most important birthing organ: the brain. For the laboring mother, a single fearful thought can result in a surge of adrenaline that can tighten her cervix, increase pain, decrease oxygen to her baby and stall labor. When confidence and trust are the woman’s primary emotions, her birthing body secretes oxytocin instead. Oxytocin is the endorphin that promotes pleasurable emotional and physical responses that accompany intimacy and bonding. We have all heard that seeing is believing. But in truth, believing is seeing. When a woman is convinced that she is capable of birthing her baby calmly and with confidence, she is far more likely to experience that outcome.

Evolution has spent three million years perfecting childbirth. Our job is to trust in this process, allow our minds and bodies to relax, and watch the miracle unfold. Cynthia Overgard, MBA, HBCE • HypnoBirthingCT.com

labor doula

The word doula [“doo-lah”] comes from a Greek word meaning “woman servant,” but in the modern context refers to women who provide nonmedical support to childbearing women. Doulas attend births in all birth facilities. The doula acts as liaison between parents and practitioners during the birth, and supports the couple through a natural, satisfying, non-invasive childbirth experience. A labor doula has more than 40 hours of specialized training to support pregnant women before and during labor. Most doulas will meet with the couple two or three times before the due date, during which she will review their birthing options. She will be on call 24/7, starting two weeks before the due date, and she will often visit the couple’s home after the birth to support the mother’s breastfeeding. When labor is underway, she provides emotional and physical comfort measures, including breathing and relaxation techniques and finding the optimal positions for labor and birth. Although she cannot interfere with any medical practice, she can provide parents with information to make informed choices and can facilitate communication with healthcare providers so that the birthing mother is always aware and in control as her labor progresses. Studies have shown that using a doula tends to result in shorter labors with fewer complications, less need for pain relief or interventions, greater success with breastfeeding and a lower incidence of postpartum depression. To find a doula in your area, go to dona.org. Alice McNulty, R.N. • MoonSpiritDoula.com


holistic healthcare

During pregnancy, one of the most noticeable physical changes is the new distribution of weight. The breasts enlarge, uterus grows and hips expand, while the lumbar curve of the spine exaggerates. Without the proper support and movement, these postural changes can cause labor and delivery to be much more stressful than need be. To create the healthiest pregnancy possible, it is best to integrate massage, stretching and movement into each day. Movement, in the form of a gentle walk, is very important to ensure that the baby settles into the correct position for birth and you remain limber and loose for a stress-free delivery. Prenatal massage can come in various forms, ranging from a traditional Swedish massage to light massage work that could include other modalities. While preparing for the second and third trimester, the Mercier technique (a deep-tissue type of massage) can help to prepare a woman’s pelvic muscles for birth. Many massage therapists are trained not only to do massage but various other modalities as well. It is best to seek out a therapist who is certified in Mercier or Bodywork for the Childbearing Year.  Jennifer Mercier, Ph.D. • MercierTherapy.com

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homebirth midwife

A midwife provides holistic care to pregnant women with a personalized, loving touch. She spends at least one hour at each prenatal appointment to find out who you are, what you’re feeling, what you’re thinking and what’s important to you. A homebirth midwife wants you to have the safest, most beautiful, empowering and peaceful birth possible—right in your home, where you and your baby can birth calmly in a setting that is familiar and comfortable for you. A homebirth midwife knows that the moment a woman walks out her front door to head to the hospital, she has unknowingly decided upon her first unnecessary intervention. For millions of years, women have been having babies without tools, tubes, tests, chemicals, machines, drugs and doctors. All your ancestors had babies; other mammals continue to birth without interference. You can, too. Midwives can obtain midwifery certification through a variety of different paths, and their philosophies can very greatly. Because some midwives practice more like med-wives, it is important to ensure that the person you choose is in keeping with your own beliefs. As she advises you, take note of whether she is coming from a place of trust rather than fear. Listen to her language, her advice and her warnings. Does she have a deep appreciation and respect for natural

birth? Is she successful at supporting women without interventions, without inducing labor and without unnecessary tests? Make sure she speaks with you about good nutrition and helps you to make choices in your life that will support a wonderful pregnancy and help ensure a good birth and a healthy baby. Each baby gets only one chance at being born. This is why your relationship with your midwife should be based on deep care and mutual respect. That’s when you know you’ve found the midwife that you and your baby deserve.  Nancy Wainer, CPM, HBCE, CC • BirthdayMidwifery.com

prenatal yoga

Prenatal yoga offers a wide range of benefits for both you and your baby. Many women find their way to this beautiful dance of breath and movement when they discover they’ve been blessed with the opportunity and responsibility to birth a new life. The physical change that takes place over the course of your pregnancy is both miraculous and humbling. Through the focus on alignment and breath, yoga can help relieve many of the mild discomforts of pregnancy, including back, hip and joint pain, swelling, nausea, breathing difficulties, fatigue and insomnia. In addition, yoga improves posture, stability, flexibility, strength, endurance and relaxation. This creates more space for your baby as you find yourself increasingly relaxed. As a result, your developing baby not only receives more oxygen but also finds himself in a cozy, safe, and nurturing environment in which he can thrive.

© istockphoto.com / massage: Yanik Chauvin / yoga & pilates: jabejon / Midwifey photo © Jason Lander

massage


NATURAL PREGNANCY, NATURAL BABY Natural Remedies for Pregnancy, Birth and Post-Partum Discomforts

But the physical benefits are only one reason to practice. The emotional and spiritual benefits are just as compelling. When you practice yoga, you learn to surrender to and fully embrace your pregnancy and birth with a sense of equanimity, joy and inner strength. Most important, you learn to tune into your wisdom deep within—the mother’s wisdom that teaches you to trust your body, your heart and, above all, the connection between you and your baby.

by Sunshine Coast chiropractor

Dr. Stacey Rosenberg

Nina Antolino Jagetic, RYT, BE, MBA

pilates

From the moment you learn you are pregnant, prenatal pilates will help you achieve the strength, energy and endurance to guide you through pregnancy, birth and motherhood. Pilates is an exercise method that focuses on building strength and flexibility, as well as sharpening the mind/body connection. Key pilates principles, including breathing, concentration, whole body movement, alignment and relaxation, help facilitate a more comfortable pregnancy and delivery by making you feel strong, calm, and more in tune with your body and your baby. By activating and strengthening your core, the deep muscles that stabilize your pelvis and lower back, your everyday movements will become easier and more balanced. Pilates is an extremely individualized form of exercise, especially during pregnancy. Movements are simple, and modifications are made throughout pregnancy to accommodate changing energy levels, a growing belly and varying levels of stability around the pelvis and spine. Exercises that focus on the arms and upper back help prepare the mother for long stretches of holding and nursing infants. Proper spine alignment and pelvic stability will cut down on common aches and pains felt as a result of loosening ligaments around your joints. Stretching and release work help to alleviate tension in the body and foster relaxation. Prenatal pilates is a wonderful way to prepare your body and your mind for this exciting time in your life. You will be treating yourself and your baby to a truly rewarding experience with benefits that will last a lifetime.  Rachel Prior

Resources and authors’ complete bios are available at: pathwaystofamilywellness.org/references.html

“Natural Pregnancy, Natural Baby” is Dr. Stacey Rosenberg’s first book. It features 150+ pages of prevention, tips, techniques, remedies and resources to help ease the common complaints of pregnancy. It includes nutrition, pre-natal bonding, comfort measures, herbs, homeopathy, ergonomics, chiropractic, acupressure, yoga, breast-feeding advice, Hypnobirthing® and much more! For more information, including ordering and a list of retailers “Natural Pregnancy, Natural Baby”, visit Dr. Rosenberg’s website: www.GibsonsChiropractic.com


gratitude

Appreciating

the Process of

Birth By Cathy Daub

The knowledge of how to give birth is already inside every woman. Women need encouragement to have more faith in, and a greater appreciation for, their bodies’ wisdom. The nonprofit organization Birth Works International provides that encouragement by utilizing a unique, innovative and experiential program integrating awareness, trust and appreciation. Here’s how this guiding philosophy can

Š kleine gelbe ente / creative commons

enrich your birthing experience.


Awareness of Thought Awareness is the key to giving birth. “Awareness of what?” you might ask. Try this little experiment with your own body. In your mind, think about the big toe on your right foot. Immediately sense that you are now aware of your big toe, although just before that, your awareness of your body was someplace else. Now focus your attention on the little finger of your left hand. Can you feel a change? Your awareness is now more in your little finger than in your toe. Now bring your awareness into your lower pelvis. Immediately, that is where the mind goes. In labor, too many women try to run from awareness of their pelvis because of their strong contractions. (This avoidance can be exacerbated by other factors, such as sexual abuse or previous birth trauma.) Some methods of childbirth preparation teach forms of distraction as a way to cope with strong contractions. But how can one work with the body without being aware of it? Awareness is consciousness. A woman in pregnancy, labor and delivery, who has her consciousness fully in her body—in her pelvis—welcomes the strong contractions. She works with them to make them more effective, knowing that the stronger her contractions, the sooner her baby will be born. She feels empowered and confident. Trust in the Wisdom Birth Works has always promoted a philosophy and belief that the knowledge of how to give birth resides within every woman. Therefore, women do not need to be taught how to give birth—after all, how can what is instinctive be taught? When women are encouraged to surrender to the process or trust their body’s wisdom, they might not know how to do it at first. “How can I let my body birth my baby,” they wonder, “when my mind doesn’t know what to expect?”

“Little by little, the mind will have to let go because it will learn that it cannot think a baby into the light.”—Jean Childers-Arnold But the body does many things without our even having to think about it. Consider all that happens when we sleep at night. We fall asleep one minute, and seemingly the next minute, we’re awake again—yet six to eight hours have passed. All the while, the body carries out its functions of breathing, digesting and maintaining a steady heart rate. In the case of birthing, the uterus contracts and all intercellular exchanges take place, regardless of whether the woman understands what is happening. The body simply knows how to conceive a baby, nourish that baby through pregnancy, dilate a cervix, birth a baby and supply milk for breastfeeding. Take a moment each day to contemplate the wonders of the human body. Allow it to fill you with wonder and awe. Be grateful. “Little by little, the mind will have to let go because it will learn that it cannot think a baby into the light,” wrote childbirth educator and prenatal yoga instructor Jean Childers-Arnold. “If we have led her to the place where she has faith, she will feel that that earthly body knows what it’s doing. After all, she didn’t tell the egg to ripen, he didn’t steer the sperm. Just like that, it all happens, without our needing to think about it.”

© tennessee-mary / creative commons

Appreciation of Balance The Dalai Lama once said, “Remember that not getting what you want is sometimes a wonderful stroke of luck.” Living in the spirit means seeing what comes your way as a gift. It sees all of life as a teacher who gives many lessons. Many people say they want peace. Allowing the self to be pulled down when bad things happen, or raised up when good things happen, does not confer peace. It leads to imbalance, and a waste of mental and physical energy. When there is balance, there is equanimity. What are some events in your life that you still hold on to with a negative feeling? Human perspective is usually limiting in its nature, while the spirit is broad and expansive. The next time you don’t get what you want, try asking yourself the question: “How is this serving me? Where is the gift?” This might yield some insights that can lead to peace, understanding and even appreciation for the experience you have had. Gratitude brings peace and unites us with our inner spirit. A woman birthing in gratitude connects her with the power of birth. 

Cathy Daub, PT, CCE (BWI), CD (BWI), CD (DONA), MAM (Maya Abdominal Massage) is the founder, designer and president of Birth Works International (BWI), located online at birthworks.org. She is the author of Birthing in the Spirit: A Human Values Approach to Childbirth. View article references and author information here: pathwaystofamilywellness.org/references.html.

issue 24 | pathways

49


informed c h o i c e

Avoid a Cesarean

Know the Facts These facts are presented by the International Cesarean Awareness Network with the hope that parents, childbirth educators, doulas, nurses, midwives and doctors together can effectively reduce the rate of unnecessary cesarean sections and their effects.

A cesarean section is major abdominal surgery used for the delivery of an infant through an incision in the mother’s abdomen and uterus. The incision may be made across the bottom of the abdomen above the pubic area (transverse) or in rare instances, in a line from the belly button to the pubic area (vertical).

Many reasons given for a cesarean, especially prior to labor, can and should be questioned. These include macrosomia (large baby), maternal age and parity, assisted reproductive technology, CPD, dystocia, failure to progress, breech, fetal distress and even prolonged second stage. There are very few true indications for a cesarean section in which the risks of surgery will outweigh the risks of vaginal birth.

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When a cesarean is necessary, it can be a lifesaving procedure for both mother and baby. However, psychological outcomes such as negative feelings, fear, guilt, anger and postpartum depression are common consequences of both emergent and elective cesarean sections. A cesarean section is only indicated in the following situations: •

complete placenta previa at term

transverse lie at complete dilation

prolapsed cord

abrupted placenta

eclampsia or HELLP with failed induction of labor

large uterine tumor that blocks the cervix at complete dilation (most fibroids will move upwards as the cervix opens, moving it out of baby’s path).

true fetal distress, confirmed with a fetal scalp sampling or biophysical profile

true absolute cephalopelvic disproportion or CPD (baby too large for pelvis). This is extremely rare and only associated with a pelvic deformity (or an incorrectly healed pelvic break). Fetal positioning during labor and maternal positioning during second stage, most notably when women are in a semi-sitting position, cause most CPD diagnosed in current obstetrics.

initial outbreak of active herpes at the onset of labor

uterine rupture


The cesarean-section rate remains alarmingly higher in many industrialized countries than the 10 to 15 percent average recommended by the World Health Organization, causing unnecessary risk to both mother and baby. Healthy People 2010, a health promotion program managed by the U.S. Department of Health and Human Services, recommends a reduction in cesarean births in the US to 15 percent by 2010. A cesarean poses documented medical risks to the mother’s health. These risks include infection, blood loss and hemorrhage, hysterectomy, transfusions, bladder and bowel injury, incisional endometriosis, heart and lung complications, blood clots in the legs, anesthesia complications and rehospitalization due to surgical complications. Rate of establishment and ongoing breastfeeding is reduced, psychological well-being is compromised and there is an increased rate of emotional trauma. Potential chronic complications from scar tissue adhesions include pelvic pain, bowel problems, and pain during sexual intercourse. Scar tissue makes subsequent cesareans more difficult to perform, increasing the risk of injury to other organs and the risk of chronic problems from adhesions. Onehalf of all women who have undergone a cesarean section suffer complications, and the mortality rate is at least two to four times that of women with vaginal births. Approximately 180 women die annually in the United States from elective repeat cesareans alone.

The risk to your infant from the very low incidence of uterine rupture (less than 1 percent) after a prior cesarean is much less than the risk to your infant from respiratory distress as a result of a scheduled cesarean.

Vaginal Birth After Cesarean (VBAC) is safer for both mother and infant, in most cases, than is routine elective cesarean, which

is major surgery.

© istockphoto.com / nancy nehring

Each successive cesarean greatly increases the risk of developing placenta previa, placenta accreta and placental abruption in subsequent pregnancies. These complications pose life-threatening risks to mother and baby. Cesareans also increase the odds of secondary infertility, miscarriage and ectopic pregnancy in subsequent pregnancies.

Cesareans can delay the opportunity for early mother-newborn interaction, breastfeeding and the establishment of family bonds.

A cesarean poses documented medical risks to the baby’s health. These risks include respiratory distress syndrome (RDS), iatrogenic prematurity (when surgery is performed because of an error in determining the due date), persistent pulmonary hypertension (PPH), and surgeryrelated fetal injuries such as lacerations. Preliminary studies also have found cesarean delivery significantly alters the capability of cord blood mononuclear cells (CBMC) to produce cytokines. An elective cesarean section significantly increases the risk to the infant of premature birth and respiratory distress syndrome, both of which are associated with multiple complications, intensive care and burdensome financial cost. Even with mature babies, the absence of labor increases the risk of breathing problems and other complications. Far from doing better, even premature and at-risk babies born by cesarean fare worse than those born vaginally.

Cesarean rates are influenced by nonmedical factors. These include: individual philosophy and training, convenience of doctor or patient, the patient’s socioeconomic status, peer pressure, fear of litigation and financial gain.

In the United States, obstetricians offer defensive medicine as an excuse for the astronomical and sharply rising U.S. cesarean rate. Deliberately performing unnecessary surgery in the belief it avoids lawsuits is indefensible. That many obstetricians seem oblivious to this profound violation of ethical principles is shocking.

This fact sheet was provided by the International Cesarean Awareness Network (ICAN) and reprinted with permission. Founded as Cesarean Prevention Movement in 1982, ICAN has chapters, individuals, an international newsletter (the Clarion), an e-mail line and a website ready to give you support and information. For more information, please call 1-800-686-ICAN or visit ican-online.org. issue 24 | pathways

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positive positional statements and reports

Safer Childbirth Consumer Reports has supported the findings of a striking new review of maternity care. Several costly, unproven techniques are rising in the United States without a similar increase in positive outcomes. Some of the most troubling methods being used are induced labor (which has more than doubled from 1990 to 2005), epidural painkillers (with high rates of adverse effects, high fetal heart rate and low newborn assessments), electronic fetal heart monitoring (which has a high cost, but no proven positive outcome) and cesarean sections (accounting for a third of all U.S. births). More conservative practices have been found to cost-effective as well as helpful in raising the level of health in newborns. Some of these procedures are prenatal vitamins, the use of a midwife, upright and side-lying positions during delivery and early mother-to-baby skin contact. When considering how to effectively use birthing options in the U.S., it is important to consider these striking results. consumerreports.org/health/medical-conditionstreatments/pregnancy-childbirth/maternity-care/

childbirthconnection.com/article.asp?ck=10575

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bottom left image: Š jason lander / creative commons

New Report on Evidence-Based Maternity Care As low birth weight and pre-term births continue their decade-long increase in the United States, dedicated health professionals are pushing back against these spiraling trends. In an effort to identify where improvements can be made, studying systematic reviews allows professionals, policymakers and parents to make better, evidence-based choices for birthing care. Many proven maternity care methods that have little or no adverse effects are currently underused compared to more expensive and unproven methods. The greater use of prenatal vitamins, smoking cessation programs, more natural birthing positions, delayed cord clamping and early mother-baby skin-to-skin contact have all been proven in systematic reviews to improve outcomes for mothers and babies. These methods also reduce the overall cost of having a baby, which currently tops the list of highest charges for any condition at a hospital. Choosing a natural birth using proven methods is the source of momentum to change our spiraling system.

top right: Š istockphoto.com / debbie lund

overview/maternity-care.htm


Improve Maternity Care The International MotherBaby Childbirth Initiative has compiled 10 Steps to Optimal Mother/Baby Maternity Services. Here is their summary.

The HPA:

Step 1.

Alliance for Holistic

Treat every woman with respect and dignity.

Family Health and Wellness offers resources and timely information

Step 2. Possess and routinely apply midwifery knowledge and skills that optimize the normal physiology of birth and breastfeeding. Step 3. Inform the mother of the many benefits of continuous support during labor and birth, and affirm her right to receive such support from companions of her choice. Step 4. Provide drug-free comfort and pain relief methods during labor, explaining their benefits for facilitating normal birth.

helping parents make informed health care choices for pregnancy, birth, and childhood. We are committed to supporting parents who seek a holistic

FIND A HOLISTIC PRACTITIONER:

www.hpakids.org

model of health care and empowering parents to build healthy bodies and spirits in their families. Visit our web site to find a holistic practitioner.

Step 5. Provide evidence-based practices proven to be beneficial. Step 6. Avoid potentially harmful procedures and practices. Step 7. Implement measures that enhance wellness and prevent injuries and emergencies. Step 8. Provide access to evidence-based, skilled emergency treatment. Step 9. Provide a continuum of collaborative care with all relevant healthcare providers, institutions and organizations. Step 10. Strive to achieve the Baby Friendly Health Initiative (BFHI) 10 steps to successful breastfeeding. A more comprehensive list is available here: imbci.org/ShowPage.asp?id=174

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research review

Recent Research Updates Prenatal Ultrasounds With autism appearing rapidly on a national and international level, many theories have been made about how such a devastating condition can emerge so quickly. Due to the widespread prevalence, many “normal” procedures for pregnancy are being examined for potential neurological damage. One particular practice that is under severe scrutiny is the use of ultrasound. The World Health Organization and the U.S. Food and Drug Administration have, on many occasions, published reports that stressed caution for the use of ultrasound, especially for nonmedical purposes. The major source of concern is the increase in temperature in the developing brain and nerve system from the use of ultrasound. Other high-temperature therapies, such as hot tubs and saunas, have been shown to cause neurologic disorders in fetuses. Autism, thought to be caused by misplaced brain cells, has a high correlation to ultrasound use; the cause is currently under examination. Take caution with your developing baby and limit (or eliminate) the use of ultrasound during pregnancy. midwiferytoday.com/articles/ultrasoundrodgers.asp

Ultrasounds Affect Brain Development Scientific experiments have found that overuse of prenatal ultrasound can cause abnormal brain development due to misplacement of brain cells. Several high-profile disorders are thought to be the result of abnormal brain cells, including autism spectrum disorders, epilepsy, dyslexia and schizophrenia. Expectant

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parents who use ultrasound for nonmedical purposes, such as keepsakes and home videos, are subjecting their unborn children to high doses of ultrasound that could prove hazardous to brain development. With the rise of serious neurological disorders in children, maintaining a low level of prenatal ultrasound is beneficial for your child’s brain development. msnbc.msn.com/id/14231914

Epidurals Impact Newborns When considering whether or not to receive an epidural anesthetic during labor, doctors often overlook the potential impact it has on the baby once it has been born. One report has gathered several scientific papers that show that epidurals not only limit a mother’s ability to position herself and to feel pain, but also increase the use of internal fetal heart monitors and Pitocin [Pathways 23, Fall 2009], cause an increased use of vacuum or forceps extraction, and can be hazardous to breastfeeding infants. Due to the decreased production of hormones caused by epidurals, many new moms have difficulty producing breastmilk, and many newborns have problems latching on to the breast. With all of the crucial benefits of breastfeeding, the use of epidurals can be dangerous to both mother and child. community.babycenter.com/journal/buddhasbabies/2302315/the_evidence_ says_epidurals_do_impact_newborns

Purposely Breaking Water Doesn’t Speed Delivery A large review of 14 randomized controlled studies involving more than 5,000 women suggests that a common procedure


in labor, intentionally breaking the water, has no effect in reducing the length of labor and no health benefit to the baby. It was concluded that the procedure did not shorten labor, decrease the need for Pitocin, diminish pain, reduce the use of instrumentation in delivery or help prevent serious maternal injury or death. The report found that the procedure might be associated with an increase in C-sections and a reduced risk of a lower reading on the Apgar scale, which rates babies’ conditions at birth. Dr. Rebecca Smyth, the review’s lead author, says, “We advise women whose labors are progressing normally to request their waters be left intact. There is no evidence that leaving the waters intact causes any problems, and there is not sufficient evidence to suggest any benefit to either themselves or their baby.” cochrane.org/reviews/en/ab006167.html nytimes.com/2007/10/30/health/research/30chil.html

C-Sections and Premature Deliveries A New England Journal of Medicine article from March 2009 highlights the importance of a natural course of birth. The study examined women who elected to have cesarean sections, a classification that means there was no reason for the surgery beyond convenience of the doctor or the mother. In the studied cases, babies born this way were found to have increased likelihood of hospitalization, poor lung function, infections and other problems. While the trend to schedule cesarean section surgery for timing reasons continues to increase, these serious negative effects of the practice should be considered.

abcnews.go.com/Health/WellnessNews/story?id=8146003&page=1

Pregnant Women and Exercise Exercise for pregnant women has been a controversial issue in the past, but no longer. Research once again agrees that pregnant moms should engage in low to moderate levels of exercise every day of the week. As recently as the 1990’s, some doctors were still recommending that moms-to-be refrain from exercise out of concern for the unborn baby. After considerable study, current research has documented that pregnant women who exercise have decreased their aches and pains, improved their mood, decreased swelling and lowered their blood pressure, all without any negative effects on the fetus. Swimming and cycling were found to be the best exercises for late-term women. Even those who did not exercise before getting pregnant are encouraged to start once receiving the results of their pregnancy tests. As usual, an evaluation by your healthcare provider is recommended before beginning any exercise program. livescience.com/health/090805-pregnancy-exercise.html

Chiropractic Care for Safer, Easier Births

C-Sections Linked to Asthma A study from the National Institute for Public Health and the Environment in Bilthoven, Holland, has found that children who were born with a cesarean section are 79 percent more likely to have asthma. The study examined almost 3,000 8-year-olds and determined that a C-section birth is a major indicator for asthma. For health professionals, this has become a strong case for limiting C-section use, as the last few days of development, as well as the birthing process itself, are both critical to the proper development of the lungs and immune system. Future scientific investigation will need to determine whether the increase in childhood asthma is linked to increase C-section use.

Webster Technique to Avoid C-section A 41-year-old woman was recently reported to have avoided a planned cesarean section due to breech presentation through the use of the Webster technique. The Webster technique is a method used by chiropractors to release tension in the pelvis and sacrum, thereby allowing the fetus to turn into the appropriate birthing position. The Journal of Pediatric, Maternal & Family Health reported that after five visits to the chiropractor using the light-force, specific-contact adjustments of the Webster technique, a fetus turned from breech position into vertex position, the normal position for birthing. Current cesarean section rates make the procedure the most common operation in America; the Webster technique is emerging as a safe, effective and non-invasive way to correct breech position.

thenewwellness.com/?p=1243

atypon-link.com/MCY/doi/abs/10.5555/pmfh.2009.2009.2.1e

dispatch.com/live/content/science/stories/2009/08/02/biology.html

Wellness Lifestyle and Pregnancy © istockphoto.com / digitalskillet

hood of obesity, insulin-resistance and cardiovascular disease. The key is to maintain adequate dietary and lifestyle control for about three months prior to conception.

Mother’s Health Before Conception Linked to Fetal Development Parents-to-be have many things to consider about diet and health over the course of a pregnancy, but science has shown a strong link between early fetal development and maternal lifestyle during the very first days after conception. Essentially, a mother’s lifestyle (her food and exercise habits) plays a vital role in the activation of genes during the first few weeks of fetal development. Babies that developed in a high-fat diet environment in the early weeks of pregnancy were found to have higher likeli-

Chiropractic for Dystocia in Labor A recent chiropractic study was published that gives hope to mothers wishing to give birth at home. At 23 hours into labor, chiropractic care was initiated on a 26-year-old woman who had a lack of cervical dilation, diminished contractions and decreased fetal heart sounds. With appropriate care, including shifting positions under midwife recommendations and gentle, specific chiropractic care using the Webster technique, her baby girl was born healthy after 34 hours of labor. Despite the misconception that a slow birth needs to be sped up, conservative care can be used to naturally replace pharmacological intervention. atypon-link.com/MCY/doi/abs/10.5555/pmfh.2009.2009.1.1b

issue 24 | pathways

55


mind–body–spirit

A Pregnant Pause Pregnancy is obviously a time of great physical change in a woman’s life,

© istockphoto.com / xxxx

but take the time to honor the emotional journey as well.


By Dr. Jennifer Barham-Floreani

© istockphoto.com / butterfly: Yulia Remezova / lotus: Huiping Zhu / nest: Eric Hood / OPPOSITE PAGE: Photo courtesy of Rosa Gonzalez / Photographer: Dr. Tracey Wright, Maui

P

regnancy is a transformative time in a woman’s life, bringing about powerful physical, mental and emotional changes. The mind and body work together to form an intelligent organism in which every part affects the whole. Pregnancy is an ideal time to assess the quality of conversation that you have with yourself—and enhance it, if possible. The brain has two parts that govern emotions and feelings: the limbic system (often called the seat of emotions) and the pre-frontal cortex (which regulates our feelings). Emotions are communicated to the body via the nervous system, which uses neurotransmitters to release chemicals that cause positive or negative physiological changes. When we are stressed or anxious, for instance, our nervous system stimulates particular organs and glands to produce chemicals that put our body in a heightened state. While this is appropriate in certain situations, most of the time it’s merely a conditioned response stemming from stress or anxiety. Sustained over a period of time, this chemical release can be detrimental to our health. Fear, tension and anxiety affect muscles, tendons and ligaments and can create subluxations (misalignments) in the spine, which in turn affect our nervous and immune systems. These chemicals can also cross the placental barrier and have a direct effect on the developing foetus. Therefore, pregnant mothers must not only take care of themselves physically, but mentally as well. While unpleasant feelings are a natural part of life, it is wise to create calm thoughts as often as you can during gestation. Of course, this is easier said than done. Some women feel very ill during the first trimester, which, if the symptoms continue throughout the pregnancy, can lead to severe physical and mental fatigue. Other women struggle more with the overwhelming emotions that pregnancy can engender. Expectant mothers may feel daunted by significant bodily changes: bigger breasts, a protruding belly and overall weight gain. Far from experiencing the ‘radiant glow’ of pregnancy, these changes can leave women feeling grotesque and unhappy. Whatever feelings you have about your pregnancy, it is important to honour them. Acknowledge and express your negative emotions, and then balance those thoughts with positive visualisation. In doing so, you enrich not only your birth experience, but your other relationships as well. Releasing Negativity On the surface it appears that pregnant women all experience a similar event. Deep down, however, each of us carries specific references from our past that create our own reality. Some references may be more traumatic than we expect. Address your uneasiness, if you feel safe to do so, and look to where these emotions are anchored. Take a deep breath and try to relax. You might feel anxious about your capacity to parent, but remember that nothing in life happens by chance. You’ll be amazed at the support available to you if you choose to move through life with a positive and gracious attitude.

issue 24 | pathways

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mind–body–spirit

develop dynamic power to reshape matter into what you want…. Whatever you believe in intensely, your mind will materialise. –Paramahansa Yogananda

Positive Visualisation Visualisation is an extremely powerful tool for helping to access both your conscious and unconscious brain. In every aspect of our lives, we move in the direction of our most dominant thoughts. The repetition of this positive visualisation creates the opportunity for your brain to trust and believe those thoughts. I found bath times to be wonderful opportunities for me to visualise each of our births. I visualised the birth in great detail: how the labour would begin, how I would feel and who would be there. Then I would think about second and third stages: seeing what my baby would look like, and imagining our first visitors. I would run the same positive images through my mind each night. Visualisation can also reveal areas where you are feeling resistance or fear. As you imagine the scenario of your labour, notice anything that sparks negative feelings. Take the time to explore these feelings in greater detail. Ask yourself why you might be afraid of something, and what you could do to feel more supported or confident. Visualisation can be even more effective when it is guided by a practitioner, such as a kinesiologist. Because our subconscious often hides the truth, protecting us from our deeper fears, sometimes a trusted person who can work with our energy patterns can help release blockages we might not even be aware of. Chiropractic Care Every thought that passes through our mind has a chemical consequence, just as the chemicals passing through the body affect our thoughts. This symbiotic relationship is facilitated by our nervous system, which carries messages from our brain to our body and back again. Nerve dysfunction in the body can be a result of multiple stressors, including physical trauma (some from as far back as a person’s birth), exposure to pollutants, chemical toxins in the body, inadequate diet and so on. We might not be consciously aware of nerve dysfunction. It can behave like an irritating noise in the background of our lives, subtly affecting our vitality and well-being, altering our moods and perception. Left unresolved, it can result in sickness or disease. Chiropractic care is an excellent way to promote the balance between body and mind and naturally improve our mood. Correcting misalignments in the spine releases chemicals such as dopamine and certain endorphins, increasing our sense of well-being.

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pathways | issue 24

© istockphoto.com / pregnant woman: pgiiam

Mental whispers

When I was pregnant with our first child I tried to find women who had positive labour stories to tell me. Such women were few and far between. Over the years, having since spoken to hundreds of women, I’ve realised that it wasn’t so much that their labours were horrific—it was more that the words they used to describe them were cries for acknowledgement. Labour is hard work, and it’s a hell of a lot harder if you don’t have the right support. Before your labour, sit down with your birthing partner or a close friend or relative and write down the attributes of your ideal birth. Also write down your fears and concerns, so that you can discuss these with your midwife. Take time to discuss your partner’s concerns as well, and clarify the role he or she would like to play during the birth. It is important to acknowledge the references—your prior experiences, expectations and preconceptions—you both have around birthing. Discuss where these thoughts might have originated and whether they support your current birth choices. What actions do you need to take to feel differently, if necessary? Who can you speak with about them? What can you read?


Studies show that people receiving chiropractic care are less affected by stress, have more energy, think more clearly and have a greater quality of life. Alongside chiropractic care, many other healthcare options are available to support and nurture your pregnancy. Taking the time to discover these wonderful, holistic practises is a way of turning your attention to the needs of your baby and body. Focus on Your Baby Your baby needs as much of your focus during your first trimester as it does in your last. Unfortunately, regardless of the countless pregnant sensations we have, many of us do not allow ourselves to really ‘feel’ pregnant until about 36 weeks in. Most of us have so many work and social commitments that we neglect self-care until those last few weeks. Yet unlike cramming for an exam, we can’t cram good thoughts for our baby into the last few weeks of our pregnancy. During pregnancy, allow yourself time to be still and connect with your baby. Allow your life to slow down. Consider activities you could refrain from—or could add to your day—that would give you time to sit and acknowledge your thoughts and feelings. Use this time to talk to your baby and really connect with him or her. When you choose to be conscious of the magical events occurring within your body, pregnancy can indeed be a lifechanging event. Your thoughts and feelings play a pivotal role in shaping this experience, and the health of your mind is just as important as the health of your body. Your baby is receptive to all of your thoughts, positive and negative. The time you spend calming your mind and dealing with fears will prepare you for the journey of parenting that lies ahead. 

Dr. Jennifer Barham-Floreani is a mother of four, chiropractor, business owner and writer. She was recently awarded both Australian Chiropractor of the Year and Victorian Chiropractor of the Year. Jennifer’s work is respectful yet thought-provoking, and encourages parents to define their own health culture. Jennifer is married to a chiropractor and raises her children with strong health principles. Adjusted since birth by her chiropractor father and growing up in one of Australia’s largest chiropractic families, Jennifer is not a recent adoptee of wellness philosophies. She is passionate about holistic parenting, which she believes requires constantly sourcing knowledge on how to nurture her children’s health and well-being and strengthen their life force physically, emotionally and spiritually. View article references and author information here: pathwaystofamilywellness.org/references.html.

Allow yourself time to be still and connect with your baby.

© istockphoto.com / xxxx

Allow your life to slow down.

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complete your pathways collection

pathwaystofamilywellness.org/backissues.html

Back Issues Available

#1: Spring 2004 The Biology of Belief Dr. Bruce Lipton Ultrasound The Deadly Influence of Formula Women’s Health Risks I

#2: Summer 2004 Antibiotics Healthcare Philosophy Child Playgrounds Movement and Infants Sun Exposure Women’s Health Risks II

#3: Fall 2004 Stress in Infancy Chiropractic in Pregnancy & Postpartum The Family Bed The Backpack Dilemma Women’s Health Risks III

#4: Winter 2004 ADD/ADHD: Pulling the Plug on TV Finding a Pediatrician Child’s Immune System Maximum Brain Potential Mercury Rising

#5: Spring 2005 Why Wear Your Baby? Breastfeeding Basics Our Children’s Needs Chiropractic & Infertility Spinal Stress in Children Cesarean Section

#6: Summer 2005 The Outside-In Child Engineered Food Threat Childbirth Affirmations Involving Dad Time for Play Everyday Road Trip With Your Baby

#7: Fall 2005 Autism and Vaccines Fevers: Source of Strength The Real Dangers of Soda Homebirth Dad’s Role in Play Being Child-Centered

#8: Winter 2005 Listening Oversanitization Watch Your Language Women’s Innate Knowledge Breastfeed a Toddler Have a Happy Marriage

#9: Spring 2006 Breastfeeding/Bedsharing Co-Sleeping & SIDS Your Independent Toddler Cesarean Section Stop Saying “Good Job” The Well-Balanced Child

#10: Summer 2006 How Do Vaccines Work? Baby Wearing Midwives Pain in Labor Breastfeeding in Public Handling Advice

#11: Fall 2006 The Myth of ADD Herbal Antibiotics Don’t Eat It! Breastfeeding / Chiropractic A Look at Stress Joyful Positive Parenting

#12: Winter 2006 Digestion Toothpaste Toxins Choose Grassfed Better Choices for Colic Breastfeeding Twins Crying for Comfort

#13: Spring 2007 How Do Vaccines Work? Smart, Healthy Kids Growing Pains & Chiropractic Care Vertical Birth Mindful Parenting

#14: Summer 2007 New Approaches to Healthcare Mom’s Weekend Pass Webster Technique Re-Valuing Free Play Babies Safe in Motion Sun Exposure

#15: Fall 2007 What Every Mother Knows Well Beyond Medicine From Stress to Bliss Of Love and Milk Respect Dr. Joe Dispenza Eating Right for Sleep

#16: Winter 2007 Healing a Life Beyond Organic Ease into Wellness Pelvic Pain Cluster Feedings and Fussy Evenings Vaccines and Your Rights

#17: Spring 2008 Gift from the Future Benefits of Laughter How to Choose a Holistic Practitioner Cradles of Life Fluoride Informed Consent

#18: Summer 2008 Raising Generation PAX Yoga for Kids Playing Pediatric Drug Testing The Law of Prayer

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#19: Fall 2008 Green Our Vaccines Paradigm Shift in Medicine & Science Inconvenient Cancer Truth ADHD: Holistic Approach Sensory Processing Disorder What Babies Really Need

#20: Winter 2009 Expectant Parent’s Guide to Chiropractic Serious Problems in Maternity Care Pharmaceuticals are Gateway Drugs Relieving Child’s Stress Getting Over Cold Medicines

#21: Spring 2009 5th Anniversary Issue Autism 10 Best Books on Autism & Vaccinations Aluminum Measles Misunderstanding Your Right to Choose

#22: Summer 2009 Colic Lyme Disease 10 Best Books to Improve Family Health Links to Autism Control Healthcare Costs Pitocin Risks

#23: Fall 2009 Ear Infections 10 Additives to Avoid Swine Flu Hospital Births: Dangers Car Seats Are for Cars One MD’s Journey to Holistic Care

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10boo recommendations

Pathways’ Top Ten Books for Pregnancy and Birth Spiritual Midwifery  By Ina May Gaskin

Now in its fourth edition, this is the seminal book that introduced a whole generation of women to the concept of natural childbirth! The first section details the experiences of parents and midwives during the birth experience, including tales from women who were babies in earlier editions. The second section is a technical manual for midwives, nurses and doctors, including information about the safety of techniques routinely used in hospitals during and after birth, information on postpartum depression and maternal death. A must for any mother’s library, the book also includes resources for doulas, childbirth educators, birth centers and other organizations and alliances dedicated to improving maternity care at home and in hospitals. Ina May Gaskin is one of the founders of the Midwives’ Alliance of North America.

gentle birth, gentle mothering Sarah J. Buckley, MD Foreword by

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Gentle Birth, Gentle Mothering   By Sarah J. Buckley, MD

Newly updated for 2009, Gentle Birth, Gentle Mothering gives parents the information needed to create a safe, satisfying and gentle start to family life. Dr. Sarah Buckley, family physician and mother of four, shares the science as well as the wisdom of gentle choices in pregnancy, birth and parenting. Buckley explains the logic and scientific safety of normal birth, and the conditions we need to optimize the flow of our “ecstatic hormones.” Running the gamut from pregnancy to breastfeeding to gentle discipline, this book has earned high praise from recognized conscious-living advocates. Deepak Chopra, M.D., gave it high praise, saying, “Sarah Buckley creatively integrates mind/body wisdom with the latest scientific research to provide women with the essential tools they need to make conscious choices throughout their pregnancy and birth.”

Childbirth A Doctor’s Guide to Natural and Early Parenting Choices

Mother’s Intention: How Belief Shapes Birth   By Kim Wildner Bob Collier, publisher of Parental Intelligence, calls Mother’s Intention “an insight into modern childbirth that gives you the facts, not the fiction, plus tons of encouragement and support for every mother-to-be who’s searching for the positive experience that is rightfully theirs. Rarely has the phrase ‘a must read’ been used with such good reason. It is a must read, but not only for mothers-to-be, their

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partners and their professional carers. Everyone even remotely interested in understanding the childbirth experience and its meaning in our lives will benefit from reading this outstanding book.”

Spontaneous Evolution   By Bruce H. Lipton, PhD, and Steve Bhaerman Bringing children into the world during economic meltdown, environmental crisis and seemingly endless warfare can be overwhelming for new parents. But this inspiring and practical book will give parents (and everyone) a positive orientation to see the world as a fresh place of daily possibilities. In Spontaneous Evolution: Our Positive Future (And a Way to Get There From Here), Bruce Lipton, a world-renowned expert in the emerging science of epigenetics, teams up with political philosopher Steve Bhaerman to offer a new and hopeful story about humanity’s evolutionary destiny. Infused with intelligence and wit, Spontaneous Evolution is an insightful, playful and ultimately hopeful look at the unfolding destiny of our species—and how parents can play an active role in birthing the evolution of humanity.

Birthing in the Spirit   By Cathy Daub Cathy Daub explores the spirit though the values of truth, right action, peace, love and nonviolence, showing how their practice can completely change how women approach birth today. Birthing in the Spirit empowers women by showing how connecting with the spirit helps make birth a peak experience that can serve as a source of strength during parenting years. It encourages women to not be afraid of their own power in labor, and inspires fathers and caregivers to be more sensitive to the psychological and spiritual needs of a birthing woman so she will produce hormones of joy—the first experience a growing baby will have.

Birthing From Within   By Pam England, MA, CNM This book was born of Pam England’s personal experience of planning a home birth for her first child and ending up with a C-section. Her inquiry into what happened led her to approach birth from within, and to teach mothers and practitioners around


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the world how to do this as well. (Her second child was born at home.) Birthing From Within offers women firsthand insight into labor, and provides guidance through the emotional, spiritual and cultural mists that enshroud birth. Highlights include proven pain-coping techniques, inner exploration through journaling and birth art, birth from the father’s perspective, how to ask questions and get information, compassionate use of drugs, spiritual cesarean birth and ways to discover your own wisdom and birth power.

Active Birth   By Janet Balaskas Janet Balaskas is internationally renowned for pioneering the concept of “active birth” in the late 1970s. The central principle of an active birth, as presented in this seminal book, is for the woman to be free to move spontaneously and be led by her body, adopting upright positions during labor and birth. This cross-cultural practice makes birth easier, safer, more efficient and less painful. With the 1981 publication of her historic “Active Birth Manifesto,” Janet Balaskas inspired the Active Birth movement to campaign for women’s right to adopt upright positions during labor and birth. Today this describes the global movement toward a “woman-centered” approach designed to facilitate normal birth physiology.

© istockphoto.com / baby: Minko Mihaylov

Pushed   By Jennifer Block A former editor at Ms. magazine, Block traveled the country to witness several births—from a planned cesarean to an underground home birth—and reports here on her experiences. In Pushed: The Painful Truth About Childbirth and Modern Maternity Care, she asks common-sense questions, such as, “Do routine C-sections, inductions and epidurals really equal medical progress?” What she finds is alarming. • More than half of women who give birth in the United States are given drugs to induce or speed up labor. • For nearly a third of U.S. mothers, childbirth is major surgery: the cesarean section. • For women who want to avoid the hospital, the alternatives can be hard to come by, unaffordable or even illegal.

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technology at the expense of maternal and infant health. It also makes the case that this is—or at least, should be—the next great women’s rights issue.

Having a Baby, Naturally   By Peggy O’Mara With this book, Peggy O’Mara, the longtime publisher and editor of Mothering magazine, synthesizes the best theories and safest practices used in natural childbirth, including recommendations from the World Health Organization, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. Throughout, O’Mara reinforces her belief that each woman’s pregnancy and birth experience is a one-of-a-kind event. This book is for the thinking woman who intends to make smart, informed decisions about her pregnancy and birth. Having a Baby, Naturally is a celebration of childbirth and an accurate and objective guide to helping women fortify their spirits, develop trust in their bodies and make the best possible choices to protect their new baby’s health.

Fathers-To-Be Handbook   By Patrick M. Houser This book introduces the reader to the ancient archetype of a father at a birth— standing guard at the opening of the cave to protect the birthing mother and their child. Throughout history, men have moved closer and closer to the actual location of the birth, and have, over the last century, often entered the birthing chamber itself. But has the father’s essential job changed, or has the need for protection moved closer to the mother and child? Today’s fathers are more active than ever in the birth and upbringing of their children. The Fathers-To-Be-Handbook offers practical education for new fathers, from riding the waves of pregnancy, birth and early fatherhood to supporting a woman’s rhythm while maintaining their own balance.

Pushed reveals that while emergency obstetric care is essential, there is compelling evidence that we are overusing medical issue 24 | pathways

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You are assisting at someone else’s birth. Do good without show or fuss. Facilitate what is happening rather than what you think ought to be happening. If you must take the lead, lead so that the mother is helped, yet still free and in charge. When the baby is born, the mother will rightly say: “We did it ourselves!”

© istockphoto.com / xxxx © istockphoto.com / debbie lund

—Lao Tzu, from The Tao Te Ching, c. 500 B.C.

Pathways to Family Wellness - Issue #24  

Pathways Magazine provides vital resources for family wellness. Our articles give parents the necessary information to actively participate...

Pathways to Family Wellness - Issue #24  

Pathways Magazine provides vital resources for family wellness. Our articles give parents the necessary information to actively participate...