Choice in the Elective Cesarean Debate

October 25, 2011 By Sweetbirth Leave a Comment

 

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Problematizing Choice in the Elective Cesarean Debate

  A consideration of Henci Goer’s research around the issue of elective cesarean surgery in the United States reinforces the contention that the popular representation of elective cesarean surgery as a choice over which women are demanding more control is in fact both misguided and misinformed. Goer suggests that the research that is cited to buttress the claim that women prefer cesarean surgery over vaginal birth “supports nothing of the kind,” cites ten different studies that have been conducted to ascertain women’s preferred mode of birth and concludes that rather than electing or requesting cesarean surgery, the vast majority of women “merely agreed with the decision…or wanted [a cesarean section] in belief that it would be safer for themselves or their infants” (Goer 2001, 34).

   What comes out is the recognition that the representation of elective cesarean surgery as a safe and equal alternative to vaginal birth that women are demanding the right to choose is supported by existing ideologies and power systems rather than based on any clear picture of scientific evidence!!! However, because perceived science is the dominant and authoritative voice that surrounds birth within a Western medical model of care, this representation is accepted as true and serves to further a picture of cesarean birth as normal and safe, despite the fact that, upon investigation, these claims appear to “contravene everything known about the comparative risks” (Goer 2001, 34).

  The result of placing the debate about elective cesarean surgery within the context of a rights-based discourse is that cultural ideologies about equality and autonomy are employed without any consideration for the broader economic, social and bureaucratic factors that surround and contribute to the lived experiences of women. And while we must admit, it is possible to imagine a situation in which a woman, in conjunction with her doctor’s advice and information, pursues and receives cesarean surgery, may be and many times are happy with her decision and pleased with the outcome of a live and healthy baby. However, the contention here is that, while this scenario is imaginable, it is a far cry from the “groundswell of consumer demand” (Goer 2001, 35) that the Western media representation of the debate would have us believe exists. The hegemony of a biomedical perspective relies, in part, on the public perception of its knowledge as right, true and the best information on which to make decisions and take actions.

Resource:

Goer, Henci. (2001) The Case Against Elective Cesarean Sections. Journal of Perinatal & Neonatal Nursing 15(3): 23–38.

Filed Under Choice in the Elective Cesarean Debate, Pregnancy Tagged With birth plan, Pregnancy, VBAC

Pregnancy Nutrition

January 23, 2011 By Sweetbirth Leave a Comment

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Every day of the week you and your baby should have: 

  1. One quart (4 glasses) or more of milk. Any kind will do: whole milk, low fat, skim, buttermilk, or cheese, yogurt, ice cream, etc….
  2. Two eggs, (hard boiled, in french toast, or added to other foods).
  3. One or two servings of fish or seafood, liver, chicken, lean beef, lamb, pork, beans or any kind of cheese.
  4. Three good servings of fresh green leafy vegetables: mustard, collard, turnip greens, spinach, lettuce, or cabbage.
  5. Two or three slices of whole wheat bread, cornmeal, cornbread, or tortillas.
  6. A piece of citrus fruit or glass of juice of lemon, lime, orange, tomato, or grapefruit.
  7. Three pats of butter.
  8. Four to six servings of other fruits and vegetables.

Also include in your diet:  

  1. A serving of whole grain cereal such as oatmeal or granola.
  2. A yellow or orange-colored fruit or vegetable seven times a week.
  3. Liver once a week. (if you like it)
  4. Whole baked sweet potato twice a week.
  5. Plenty of fluids, water, juice etc.
  6. Salt food to taste for a safe increase in blood volume.

You may substitute proteins if you wish, being sure your proteins are complete, and that you get approximately 100 grams per day, If you substitute, also be sure all the elements necessary for a well balanced diet are available every day.  Healthy fats are very important as well such as avocado, nuts, coconut milk, etc.

More than 70% of pregnancy induced conditions are preventable with good exercise and great nutrition!

For a complete guide to pregnancy nutrition for normal pregnancy as well as high risk I highly recommend this site.

http://drbrewerpregnancydiet.com/

Filed Under Nutrition, Pregnancy

Creating a Birth Plan That Works

January 22, 2011 By Sweetbirth Leave a Comment

Richardson Birth Plan

 

  The birth of your baby is one of the most memorable, life-changing, exciting experiences of your life. You will want to spend some time thinking through your hopes and wishes for this special day. Starting with a brainstorming session with your partner, try to write down as many of your thoughts and plans for your birth as you can. Your journal will help you both prioritize and articulate your ideas for creating your birth plan.

  A birth plan is a simple, clear, one-page statement of your preferences for the birth of your baby. Having a copy for every person involved in the birth will help each person understand each other and work out communication issues before the big day. Because there are so many aspects of birth to consider, it is best not to wait until the last minute to create your plan. You will want to discuss it with those who will support and care for you.

  Try to remember to be flexible, because deviations may be necessary. You will also want to remember the goal: the safe birth of your little bundle of joy. Keeping the goal in mind, the following step-by-step guide will help you create your birth plan.

1. Compile Considerations:

  Find out ALL the routine policies and procedures for “mommy care” in your birth setting. If you do not agree with something that is a routine part of birth at your particular setting, you may want to talk further with your health care provider as this is a red flag. As you learn about the typical care provided, you will realize areas you want to mention in your plan.  You may also realize that your care provider or facility may not accommodate your birth desires.

  You may want to consider one page for an uncomplicated birth/postpartum and a second page about how to handle complications should they occur. The following list of questions may seem overwhelming, but now is the time to think them through. If a question does not pertain to you, cross it off the list, then prioritize the ones that mean the most to you.

  •  
    • Who do you want to be there?
    • Do you want a Doula?
    • Will there be children/siblings present?
    • Do you want mobility or do you wish to be confined to a bed?
    • What activities or positions do you plan to use? (walking, standing, squatting, hands and knees)
    • Would you prefer a certain position to give birth?
    • What will you do for pain relief? (massage, hot and cold packs, positions, labor imagery, relaxation, breathing exercises, tub or Jacuzzi, medication)
    • How do you feel about fetal monitoring?
    • How do you plan to keep hydrated? ( full eating and drinking rigts, sips of drinks, ice chips, IV)
    • Do you want pain medications, or do you want to avoid them? Do you have preferences for which pain medications you want?
    • Would you like an episiotomy? Or, are there certain measures you want to use to avoid one?
    • What are your preferences for your baby’s care? (when to feed, where to sleep)
    • Do you want a routine IV, a heparin/saline block, or nothing at all?
    • Do you want to wear your own clothing?
    • Do you want to listen to music and have focal points?
    • Do you want to use the tub or shower?
    • For home and birth center births, what are your plans in case of hospital transport?
    • If you need a cesarean, do you have any special requests?

2. Consult Health Care Provider:

  Most of the time, health care providers have a set routine of how things are done. They have been trained, and they want what is best for the birth as well. They may or may not be welcoming of your birth plan. They might feel it is a list of demands, or that you may be setting yourself up for failure and disappointment if everything doesn’t go precisely as planned.

  Keeping in mind that every birth is different and that a “normal” birth may have a wide range of definitions; use wording like “birth preferences,” “our wishes for childbirth,” “as long as birth progresses normally,” or “unless there is an emergency.” Make an appointment with the labor and birth area of your hospital or birthing center to have staff look over your plan and provide feedback and suggestions. Kindly request to spend time in an empty birthing or labor room to get a feel for where you will be and what you might want to add to your packing list, like extra pillows, pictures, music.

  After this step, you will feel more confident about your birth plan and have greater confidence in your choice of birth location.

3. Confidence & Control:

  During childbirth, many women feel like they are losing control. A birth plan helps you to feel confident and in control as much as possible and helps you feel part of the decision making even if unexpected events occur.

  Try to plan for the unexpected by using phrases like, “If a cesarean becomes necessary…” During birth, if you feel pressured to comply with something you are unsure of, ask if this is an emergency situation; ask if you can have more information on any alternatives and time to think about it. See if they can check back with you in a little while.

4. The Power of Positive Thinking:

  Try to have your birth plan focus on the positive, instead of a list of what you don’t want. Use words like, “We hope to” or “We plan to” or “We anticipate.” Try not to use phrases like, “We don’t want” or “We want to avoid.”

Here are some examples:

  • “Regarding pain management, I have studied and understand the types of pain medications available. I will ask for them if I need them.”
  • “Regarding an episiotomy, I am hoping to protect the perineum. I am practicing ahead of time by squatting, doing Kegel exercises, and perineal massage. I would appreciate guidance in when to push and when to stop pushing so the perineum can stretch.”
  • “Immediately following the birth, I plan to keep the baby near me. I would appreciate the evaluation of the baby be done with the baby on my abdomen, with both of us covered by a warm blanket, unless there is an unusual situation.”

Some websites containing great birth plan expamples are:

  1. http://www.birthingsupport.org/sample_birth_plan.htm
  2. http://www.birthingnaturally.net/birthplan/sample/
  3. http://www.childbirth.org/interactive/ibirthplan.html

 

Compiled using information from the following source:

Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 7.

Americanpregnancy.org/birthplans

Filed Under A Birth Plan That Works, Pregnancy

Safe Herbs for Pregnancy

January 13, 2011 By Sweetbirth Leave a Comment

What’s safe & what’s not

  So kids are back in school, everyone’s coughing and sneezing on each other ( not just the kids!), herbs during pregnancy, dallas doula, dallas childbirth class, dallas lacatation support, dallas breastfeedingand the flu seems to be everywhere! What’s a pregnant woman to do? It’s hard to know what’s safe to take to either boost your immune system naturally or to fight off an illness that’s already there.

  Unfortunately there’s not a lot of evidence based research done in America on the effectiveness and safety of herbal use. Instead there is a safety rating method that is used to determine what’s safe and what’s not.

Here is an example of how the safety rating method is used:

Using a couple stalks of rosemary to cook and flavor your chicken breast is not going to pose a risk to your healthy pregnancy, however if you were to use rosemary in medicinal amounts, it could be dangerous. The same goes for other common herbs like garlic, ginger, sage, and turmeric. All of these herbs could possible pose dangers in your pregnancy when used in large medicinal dosages, however is completely in average food consumption.1

Herbs to avoid during pregnancy
  The following herbs are considered Likely UnSafe or Unsafe during pregnancy : 2

Saw Palmetto – when used orally, has hormonal activity
Goldenseal – when used orally, may cross the placenta
Dong Quai – when used orally, due to uterine stimulant and relaxant effects
Ephedra – when used orally
Yohimbe – when used orally
Pay D’ Arco- when used orally in large doses; medicinal
Passion Flower – when used orally
Black Cohosh – when used orally in pregnant women who are not at term
Blue Cohosh – when used orally; uterine stimulant and can induce labor
Roman Chamomile – when used orally in medicinal amounts
Pennyroyal – when used orally or topically
  This is a list of herbs that are regularly recommended by care providers:
So this is VERY important: NEVER SELF DOSE OR DIAGNOSE WITH ANY MEDICATION, INCLUDING HERBS.

  Every woman is different, therefore every pregnancy is different, with its own specific needs. The best and safest way to use herbs is to talk about them with your midwife, holistic physician, herbalist, naturopathic, or homeopathic practitioner. If you are not under the care of one of these you can easily find one on the web. A regular physician is not likely to understand herbs because it is not part of western medicinal studies.

  Also, educate yourself not only for your safety but to also ensure the best outcome for you and your baby. Be your own advocate! You should research not just the kind of herb, but also what part of herb is safe ( Stem, root, leaf, ect.) and the best and most effective way it can be used. This can be in a tea or tonic, or maybe capsule.

Safe herbs for pregnancy
The following herbs are rated Likely Safe or Possibly Safe for use during pregnancy:3

Garlic- This supplement is great for fighting off infection.
Ginger root – This is a useful herb to use if you have bad nausea and vomiting. It is most commonly used in tea or capsule.
Oats & Oat Straw – This is a great herb that is rich in calcium and magnesium. It helps relieve anxiety, restlessness, and irritated skin. It can be found in bath mixtures, or topical ointments.
Peppermint Leaf – This is a great way to reduce all those early pregnancy symptoms we sure could do without. It’s helpful in relieving nausea and flatulence.
Raspberry Leaf – This herb is rich in iron. It’s many different reasons for use are to help tone the uterus, to increase milk production, help curb nausea, and to ease labor pains. Some studies have even reported that using this herb can reduce complications, leading to a reduction of intervention use during birth.4 You can find red raspberry leaf in many pregnancy teas may see pregnancy teas that are made from red raspberry leaf to help promote uterine health during pregnancy.
Slippery Elm Bark – This is a very powerful herb and should be mixed in foods or smoothies. You should use this to help relieve nausea, vomiting, heartburn, reflux, and vaginal irritation not associated with a yeast infection.
  Listed below are some herbs that have been classified as having insufficient reliable information available, however they are commonly recommended by care providers for pregnant women. As stated before, always be your own advocate and do extensive research.

Chamomile (German) -This herb is used in so many ways from tea, oils, capsules, ect. It has high counts of calcium and magnesium and is commonly used to help aid sleeplessness. It also can be used to ease joint inflammation.
Dandelion – This herb is used in many forms like Chamomile. It is rich in Vitamin A, calcium, and iron. The root and leaf of dandelion can help with a mild case of anemia and suits well when needing to nourish the liver.
Evening Primrose – Can be used to maintain moodiness or other hormonal issues. Evening Primrose contains natural prostaglandins and this helps in softening and ripening the cervix.

Resources:
To find an alternative medicine doctor for your family click here.
For a guide to herbal descriptions and their different uses click

here.

Here is a list of books that can be ordered through your favorite bookstore:

The Natural Pregnancy Book, by Aviva Jill Romm, Ina May Gaskin
Herbs for a Healthy Pregnancy, by Penelopy Ody
The Naturally Healthy Pregnancy, by Shonda Parker

1, 2, Natural Medicines Database http://www.naturaldatabase.com/

3 Women’s Health Series: Herbs of Special Interest to Women. J Am Pharm Assoc 40(2):234-242, 2000.

4 Raspberry leaf in pregnancy: its safety and efficacy in labor. J Midwifery Womens Health. 2001 Mar-Apr;46(2):51-9. PMID: 11370690

Much work is cited from books, speaking with midwives and internet research.

Filed Under Herbs, Pregnancy