Tuesday, July 21, 2009

The Bradford Store in North Charlotte

If you live in the Huntersville/Cornelius area, I suggest visiting the Bradford Store. It is a family owned farm and grocery store off of Hwy 73 (the same exit as Birkdale village, just the other way off of the ramp.) They are a wonderfully kind family with great produce and good prices. Like to buy organic, they have that too! Shopping here helps to reduce our carbon emissions and provides healthy food for your family!

Top Ways to Save Money, the Environment and Your Family's Health!

  1. Prepare baby food in the blender instead of buying it.
  2. Can your homemade baby food along with other foods in Ball/Kerr jars.
  3. Breastfeed until at least one year, if not longer.
  4. Drink filtered tap water.
  5. Use reusables, especially non-plastic ones.
  6. Live in a smaller home.
  7. Eat out less.
  8. Grow your own, chemical-free garden in the spring, summer, and fall.
  9. Eat less meat.
  10. Buy in bulk.
  11. Shop at consignment stores, yard sales, and other places where you can buy items that are gently used.
  12. Turn your thermostat up in the summer and down in the winter.
  13. Turn off electronics and lights when they are not in use - especially your desktop computer!

Friday, July 17, 2009

And the Best Breast Pump is...

When I was preparing for my daughter's birth, I was told that Medela was the way to go. I purchased the Medela Pump in Style. I have had no problems with it but I can't help but thinking there are a few things that could be improved upon. Medela pumps come with only come with one size flange (the part that fits over your nipple) to start with. The Ameda Purely Yours Ultra comes with standard, medium, and large flanges. Medela has the other sizes available but they are expensive and if you are unsure which size to use this can be one more headache for a new mom.

A good friend of mine, and new mother, got the Ameda Purely Yours as her breast pump at the recommendation of a lactaction specialist. She loves it. After looking at the two webpages listed below, I can see why the Ameda may be the better option. One more thing important to mention about the Ameda pump, it is CHEAPER!

Comparison chart on the Ameda Purely Yours Ultra and "Leading Competetor"
Comparison chart of Ameda Purely Yours Ultra and Pump In Style Advanced

Medela Pump in Style below (retail about $280) - not the personal use top of the line pump by Medela.

Ameda Purely Yours Ultra below(Retail about $280) - THE top of the line personal use pump by Ameda.

Thursday, July 16, 2009

Thinking about using a midwife to deliver your baby?

Nurse midwives are less likely to use medical intervention during deliveries than doctors. Suprisingly, their deliveries have fewer complications than doctors'. This is partially due to low-risk births they attend however there are some suprising statisitics that show that a good midwife can attend a birth that has healthier outcomes for mom and baby.

Do you want to learn more about midwives? There is a great article that goes into some detail at http://kidshealth.org/parent/pregnancy_newborn/pregnancy/midwives.html

Also, read Ina May's Guide to Childbirth by Ina May Gaskin. This is a fabulous book even if you don't have a midwife attended birth. I learned so much about birthing naturally from her book and it helped me in my Maternity Nursing class!

Monday, July 13, 2009

Pitocin and Your Birth Experience

I don't know all the medical reasons to induce or augment labor. However, I do know that post-term babies are often born with the help of pitocin. Pitocin works by stimulating uterine contractions as the natural hormone oxytocin does. Pitocin is synthetic oxytocin. Oxytocin is also released while breastfeeding. You will find a lot of bad press on pitocin but this drug does have its place in birthing.

Please be informed about getting pitocin before you go into labor because many women end up getting it by IV at some point during labor. If you are trying to do a natural birth, or stay off of meds for as long as possible, be warned that contractions with pitocin will likely be more intense than your natural contractions. This is because pitocin isn't released at the same pace as oxytocin is released in your body.

"The Context & Clinical Evidence for Common Nursing Practices During Labor" published in MCN The American Journal of Maternal Child Nursing, 2005, gives some great information about the use of this drug. Here is an excerpt:

"Each woman has individual myometrial sensitivity to oxytocin. The primary goals are to achieve adequate progress of labor using the lowest possible dose with the fewest side effects and to have continued evidence of maternal-fetal well-being. During the initial incremental phase of oxytocin administration (1.5 to 2 hours), uterine contractions will progressively increase in frequency and duration. Once the stable phase has been reached (after 3.5 to 4.5 hours of administration), any further increase in dosage will not result in more frequent normal uterine activity, but rather a risk of medication side effects such as hyperstimulation and nonreassuring fetal heart rate changes."

It continues with "The approach to intravenous oxytocin administration associated with the fewest side effects is to begin at 0.5 to 1 mU per minute and increase by 1 to 2 mU per minute at intervals no less than every 30 to 40 minutes until active labor is achieved...90% of pregnant women at term will have labor successfully induced with less than 6mU per minute of oxytocin."

In this article it is very important to note that low-dose protocols of oxytocin were safer for mom and baby. If you get a low-dose protocol, instead of a high-dose protocol, you will be less likely to have a hyperstimulated uterus (contractions coming too fast and furious) and less likely to need a C-Section or instrument delivery (such as forceps). Oxytocin/pitocin make it more likely for the baby to experience poor heart rates during labor due to hyperstimulation. C-birth becomes more likely because of the increase in poor fetal heart rates.

If you end up on an oxytocin protocol, I suggest asking to be on the lowest-dose protocol that the hospital has. At the hospital where I used to work, we had higher-dose protocol called the San Antonio Protocol. Good doctors choose this protocol in a perfectly normal, slow-progressing birth. If you are exhausted, have an epidural, and are willing to take the risk, go for the higher dose protocol. Just ask lots of questions and become as informed as you possibly can.

One last point this article made that I think is important: Nurses often follow the protocols while ignoring the clinical criteria for dose increases. If you are progressing at at least 1 cm per hour, you do not need and increase in the oxytocin rate. The rate of dilation is more important than the intensity or duration of contractions. Also, if your baby is having heart rate that isn't so good, the induction/augmentation with pitocin should be stopped.

This is a lot of information to keep in mind while dealing with the labor of your baby.  I suggest hiring a doula or making sure you have a very informed partner or friend.

Saturday, July 11, 2009

Sample Birth Plan

This is the birth plan I used, with some editing done to it since my daughter was born (so there is a voice of experience here too!)

Birth Preferences

Mother-to-be: Me Father-to-be: My husband Practitioner: Our doctor

This birth plan is intended to express the preferences we have for the birth of our baby. The basic idea here is we want as few interventions as possible. If situations arise where this plan cannot be followed for the safety of mom and baby, we understand. Please keep us informed and aware of our options. Thank you.

Overall, we prefer:
  • No restrictions on eating and drinking
  • No continuous IV infusions
  • No artificial rupture of the membranes
  • No augmentation of labor
  • No episiotomy
Throughout labor and birth, we prefer:
  • Dim lights
  • Calming environment
  • Intermittent fetal monitoring
  • Limited conversation and questions directed toward mom
  • Please attempt placement of IV in arm first, not wrist or hand
  • Frequent change of positions
  • Vaginal exams kept to a minimum
  • Maintain mobility as long as possible (walking, birth ball, shower, bath, up to bathroom, etc.)
  • We may not be open to having students in room, please ask first
  • Pain management: non-pharmacological comfort measures preferred for as long as possible
  • Likely no epidural until transition
  • Prefer lower dose epidural
Throughout second stage, we prefer:
  • Labor down, delay pushing until I feel pressure or fetal head visible in perineum
  • Position for birth – 1st choice: side-lying, other positions may work better though, we want to do what is best for mom and baby
  • If I’m able to feel need to push, allow spontaneous pushing
  • Encourage breathing out while I push
  • Prefer to tear than have an episiotomy
  • Support perineum to control birth and prevent tearing
  • Third stage and immediate baby care preferences:
  • Place baby on my abdomen
  • Evaluation of baby on my abdomen
  • Delay cord clamping if possible
  • Allow dad to cut cord (if he’s up to it!)
  • Skin to skin and breastfeed
  • No separation of mother and baby if possible
1st hour postpartum:
  • Limit visitors. We want this time to bond with baby.
Newborn care:
  • Breastfeeding only
  • No pacifiers or bottles
  • Sugar water ok during painful procedures
  • Pediatrician: ______________

Tips to take to the delivery room

When babies are born, they come out of where? As a child, we are astonished at how a baby can come out...but as a grown-up we are supposed to do it! Below I have listed 6 pieces of advice (my research-based opinions) for the big day.
  1. Birth Plans are helpful - mostly to you, your spouse/partner and your doctor. When writing my birth plan, I had to do my research. The plan gave me the perfect opportunity to discuss my "ideals" with my husband (important since he's there to advocate me when I can't.) It also gave me a clear list of things I needed to go over with my doctor. Some hospital nurses may read birth plans (as they should) but I know my first nurse did not. If I'm ever a Labor and Delivery nurse, I will read birth plans.
  2. Allow labor to begin on its own, inductions and augmentation of labor should only be done if medically necessary (3).
  3. Beware of Pitocin. Pitocin can be great or it can be EVIL. Sometimes it is medically necessary but if it isn't necessary, just don't do it. I didn't go with pitocin, even after one nurse said I would need it due to risk for infection. Luckily I am informed and knew that I wasn't at risk for infection only 8 hours after my water broke. Also, I knew that if I did start to run a fever (a sign of infection) it would be okay because in our country we have running water AND antibiotics! I argued with that nurse through my contractions and was able to go epidural free for another 3 hours. Luckily, the next nurse I had wasn't the threatening type.
  4. Try to have the baby while in the side-lying position - first-time moms are less likely to have bad tears in this position. If you choose side-lying, lay on your left side because more oxygen can get to your baby this way. Lying on your right side is fine also, just not as ideal (FYI, I was on my right because the left side was too uncomfortable for me.) Squatting is probably the best position (1) but it's not going to happen if you have an epidural. If you aren't a first time mom, then your position is less important.
  5. Try not to be too eager for the epidural. I chose to go as long as possible without an epidural. I am all for natural births but once you hit about 5 or 6 centimeters, it gets tough. I just wanted to be able to walk around the room, the hall, get in the shower, GO TO THE BATHROOM, and simply be mobile as long as possible. Based on all that I read, I felt it was healthier for my baby and me to go without the epidural for longer.
  6. Labor down - Don't push until head is visible in perineum if baby is healthy and showing no signs of distress. (Perineum is your vaginal opening.) Instead, sit upright in bed and wait for baby's head to come down with gravity. This saves you a lot of effort and shortens the pushing time. Recent studies have also shown that prolonged pushing time may not be healthy for mom or baby (2).
  7. Read Ina May's Guide Childbirth and have no fear. I just thought, "my body was made for this." Lamaze also helped.
  8. Avoid all unnecessary medical intervention (3). Having a baby is a natural and healthy process. Healthy babies are born every day without the help of a doctor or hospital. I do believe the hospital is the safest place to have a baby, just in case something does happen. But, just because you are in the hospital, it doesn't mean you have to have a "medical" birth.

1. Does Epidural Analgesia Affect the Rate of Spontaneous Obstetric Lacerations in Normal Births? Journal of Midwifery and Women's Health. 2007.
2. Management of the Second Stage of Labor in Women with Epidural Analgesia. Journal of Midwifery and Women's Health. 2008.
3. Preserving Normal Birth. Journal of Obstetrics, Gynecological and Neonatal Nursing. 2008.

What is this blog about?

Hello and welcome! I have created this blog to share with everyone my passion for being a well-informed parent. The basic theme here is to keep things as natural and simple as possible. I believe that our country is in a natural awakening right now and I am so thankful for it. I believe that the natural way is almost always the best way. I am not going to say modern science is evil, because it's not. But why use chemicals, medications, and surgeries when they are not necessary? When it comes to medicine, the least invasive way to fix the problem is the best in my book. When it comes to our food, "Give me spots on my apples, but leave me the birds and the bees, please!"

Being a mommy is a hard but amazing job. Each day I am in awe of the little bright-eyed girl that God placed in care of my husband and I. Happy reading.