Natural Childbirth — Homebirth & Waterbirth

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Homebirth in the News 11/2008 2

Generally speaking, when homebirth is covered in the media, it is usually with a condescending attitude or outright horror at the "risks" that women take for a homebirth. As many of us now know, that is nonsense and it appears that the trend of homebirth for well screened, low risk women is on the rise. Not just on the rise with the fringe either. Homebirthers are a highly educated, professional bunch. Homebirth in the News Yesterday's issue of the NY Times had a great piece on the rising trend of homebirths in the NY area with credit given to "The Business of Being Born" for bringing much needed attention to the ridiculous state of hospital births in America today. (Go Ricky! Go Ricky!) There was another very positive article on homebirthing in today's issue of TheLedger.com. In other news... Why do we (in N America) feel such righteous indignation toward those who practice genital mutilation on girls, yet we continue to look the other way when baby boys are routinely mutilated for religious, cultural or worse yet, cosmetic reasons?? A quote from the article: "The term “female circumcision” is synonymous with female genital mutilation, and acts as a blanket term for a variety of disfiguring surgical alterations. The World Health Organization firmly opposes female circumcision and considers the removal of the clitoral hood to be a prevailing form of genital mutilation. Male circumcision, however, is a term applied only to a single, familiar cultural practice, and is not considered mutilation. Male foreskin and the clitoral hood are biologically homologous and so mutilation of these body parts should be treated with similar concern. The acceptance of male genital mutilation is an outdated social construct that needs to be looked at from a less dichotomous perspective. It’s almost the same thing, so why treat it differently?" www.cordweekly.com Also see how high copper levels may have an influence on postpartum depression at wellpostpartum.com. Apparently blood copper levels rise in pregnancy and fail to go back down post partum in a number of PPD cases. Risk factors from the article: "Copper excess risk factors: Pregnancy Presently taking estrogen containing medication (e.g. OCP, HRT) Currently take multivitamin containing copper Regularly use copper tea kettles or pans Blue-green stains in bathtub, toilet or sink (suggestive of elevated copper content of water) Family history of: Postpartum depression ADD/ADHD/Autism Wilson’s Disease" www.wellpostpartum.com Last, check out these great tips from Gloria Lemay's wonderful blog about very specific ways you can really help out someone who just had a baby. Funny reading for someone who just had a baby and had to entertain tons of visitors and very useful information for someone who genuinely wants to help out.

Infant Abduction - It Really Happens 0

Prevent Infant Abductions in Your Hospital by Karen Cinpinski An article from CNN "Missing 5-Day-Old Girl Found in Texas" demonstrates the reality of infant abduction. "On June 5, 2006 an ailing 5-day-old girl, snatched from her mother by a woman who had posed as a hospital worker, has been found and is being evaluated at University Medical Center," hospital spokesman Greg Bruce said according to the article. The article states, "It appears that she established something of a relationship -- went in the hospital, presented herself as a nurse, checked on the status of the baby and that kind of stuff," said Lt. Roy Basset, a Lubbock Police Department spokesman. According to everyone involved in this particular abduction, no one suspected the woman to be a fraud. She even wore scrubs and had a fake ID. Still, it was clear that this incident was something the woman had been planning over a period of several days. From 1983 to 1998, 177 infants were abducted according to the national Center for Missing and Exploited Children. Of that total, 100 babies were taken from the hospital (57 from the mother's hospital room) and 94 were recovered. According to JCAHO, infant abductions are usually premeditated acts; however, in most cases the particular infant abducted is taken out of impulse or opportunity. According to Child Find (www.childfind.org) there is a general profile for potential abductors and the infants abducted. These behaviors/characteristics should be known by hospital staff and mothers. Profile of the Abductor * Usually female and on average 30-years-old. * Normally overweight * Generally no prior criminal record. * Appearing normal, but emotionally immature or compulsive. * Has low self-esteem * Wants to replace a lost infant or one unable to conceive. * Announces "phantom" pregnancyand prepares for an awaiting birth as an expectant mother would. * Will make themselves known and become familiar with the hospital personnel and even the infant's parents. * Usually visits the nursery prior to the abduction asking detailed questions about hospital procedures and unit layout. * May visit more than one hospital to assess security measures and explore infant populations * Might not target a particular infant, but take the most available. * Unlikely to leave the community from which the infant was taken. Profile of the Infant * Usually seven days old or younger. * Perceived by the abductor as their newborn. * Same race as the abductor or abductor's companion. Prevention Tips Safety and security are key areas that should be involved in systems designed to prevent infant abduction. Multiple vendors have products, alarms, and other measures for protection. Hospitals should evaluate the various product options to ensure selections meet their needs. Additionally, hospitals should establish specific guidelines for staff to follow in the event of an infant abduction. Families should also be instructed concerning abduction prevention. The following are information and ideas to aid in creating guidelines and precautions for infant abduction prevention. From ankle bracelets to private entrance codes, hospitals go to great lengths to provide a secure environment for mothers and their newborns. Safe Environment The hospital environment should be assessed for potential security measures. Make sure your hospital is equipped with the following: * Security cameras in strategic locations like the nursery, stairwells, doorways, elevators, and hallways to monitor the incoming and outgoing activity. * Fire doors equipped with special alarms. Install alarms with time-delay locks on stairwells and exit doors. * Consider installing an electronic surveillance detection system. * Use baby identification bands and check the band number with the mother/father/caregiver's number before giving the infant to either parent. Also, staff should know to check the same bands for corresponding numbers before the infant is released from the hospital. * Electronic key-card system in newborn areas for staff. * Nurseries and maternity wards are located away from lobbies with street access with doors always locked. Patient Information Measures for infant identification include a variety of standard methods plus new devices: * Foot prints * Hand/finger prints * Head shots * Written description of the infant, medical records, and special identifying marks * Infant Protection Systems with baby identification bracelets and alarms (www.Accutech-ICS.com). Such systems have special ID devices that will set off alarms if the bracelet is cut or if an infant is taken from the unit/facility without permission. * Numbered umbilical cord clamps with matching identification wrist bands. These bands should be secured on the infant's ankle and wrist and the matching two should be placed on both the mother and father/caregiver's wrists. * Mark infant gowns at the neckline with the hospital name and logo so the infant is able to be quickly identified as a patient of the hospital. * Infant blankets should be marked on all four corners so the infant is readily identified as a patient of the hospital. Staff Identification Proper identification of hospital personnel is critical as an abductor may pose as a nurse, doctor, or other staff member. * All hospital personnel must wear photo identification badges with the hospital logo. Each ID badge must be worn on the outside of their clothing with the photograph facing outward. "I look for the pink badges," said Amey Walters, a new mother at Intermountain Healthcare Hospital in Utah. She said she appreciates the hospital's security measures. The hospital workers wear special pink bars on their name tags to identify them as nurses who are allowed to handle the newborns. * Anyone transporting the infant outside of the mother's room must wear an identification wristband and can only transport a newborn by use of a crib or isolette. Nursing staff, physicians, mother/father/caregiver with valid corresponding wristband are the only people to transport the infant. Nurse Janet Frank, public relations director for Orem Community, American Fork, and Utah Valley Regional Medical hospitals in Utah, said baby transporters have a special method of carrying the infant. "If a baby isn't being transported that way, we know there is a problem," she said. * Staff should identify themselves to the mother, instruct the mother of procedures their infant will be taken for, and expect the mother to question anyone not properly identified. Visitor Identification Consider ways to provide visiting times for families and friends while ensuring proper precautions are in place. * All visitors must immediately sign-in at the nurses' station upon arrival. Ask the visitor which mother they want to see, and each visitor must be signed out when leaving. * Distinctive stickers with the date of the visit should be obtained at the check-in area and given to visitors to wear while in the hospital. * No person should be allowed in without proper identification. * Mothers should be asked to designate a limited number of visitors who can come to the nursery. "We only allow people to view the baby with permission from the parents," said Kim Harmon, director of women's services at Timpanogos Regional Hospital in Utah. * Only allow visitors up to five minutes of observation time per visit to the neonatal nursery. Staff Related Factors Poor preparation and training create inconsistency and confusion, which abductors can use as an opportune time for a potential abduction. Ensure the following: * Abduction prevention measures should be reviewed regularly and there should be adequate ongoing, in-service training. Infant-abduction drills should be preformed on a regular basis. Many hospitals are aware of the risk of infant abduction and several of these hospitals do routine "baby abduction drills" in the mother/baby units. Hospital staff doesn't always know if the code called is a drill or the real thing; and they all have to make sure their patients are accounted for. Timpanogos Regional Hospital's marketing and public relations director, Jacque Brown, said at one of the drills they used a test patient, where a baby was registered with an identification badge, and then taken out of the hospital by a family member. The mother played along as though her baby was actually missing. "I think the scariest thing we've ever done is actually one of these drills. We knew what was going on, but the staff did not," Brown said. As it is done with all of the drills, the hospital went into lockdown, but this time there was a real baby missing. * Hospital personnel should be alert to any unusual behavior they encounter from individuals such as: o Repeated visiting "just to see" or "hold" the infants o Questioning about hospital procedures and floor layout such as "When is feeding?" or "Where are the stairs located?" o Taking uniforms or other means of hospital identification. o Physically carrying an infant in the hospital instead of using a crib or isolette. o Anyone carrying large packages, totes or duffel bags off the nursing unit should have their belongings examined. Such behavior should be reported immediately to the unit supervisor. * Be aware of the possibility of diversionary tactics being used as a part of the abduction. An abductor could create a disturbance in another area of the hospital to create an opportune distraction. * Be conscious of targeted rooms like those out of view of the nurses' station, close to stairwells, fire exits or elevators. * Nursery doors should remain locked and never left unattended. Policies and Procedures * All infant abduction protocols and response plans should be in writing and known to all hospital staff. * Ensure that either the mother or the nursing staff always supervises infants. The infant should always remain in the direct line of sight of either the hospital staff or mother/father/caregiver. Infants should never be left unsupervised. * Provide the parent(s) with educational material and handouts explaining hospital policies in place to protect the safety of infants. Also, teach the parents/family the importance of abduction precautions. * Instruct the patient/family to notify the nursing staff immediately if they have any questions or concerns. * Do not post the mother or infant's name, address, or telephone number where it is visible to visitors. * Only give out information about the infant to the mother/father/caregiver and always verify the infant ID number on the wristbands before releasing the information. * Infants should be taken to mothers one at a time. * Require visual proof of the identification and matching wristband for a person taking an infant from the hospital. * At the time of discharge, the mother/dischargee must bring the mother's ID band and photo ID. After analysis of several recently reported infant abductions, JCAHO found problems in the procedures and systems of hospitals. Common Problems * Security equipment not available, operational or used as intended * Problems in visualization of key areas * Inadequate patient education * Staff related problems * Information related problems * Cultural factors inhibiting confronting unidentified visitors Ways to Minimize Error 1. Reduce reliance on memory. Nurses, doctors, and other hospital staff have an overwhelming amount to remember daily. Use checklists for assessments and procedures. 2. Simplify. Keep policies and procedures simple to guarantee staff compliance, but complete to ensure patient safety. Reducing the number of steps makes it easier for staff to remember, fulfill and perform policies and procedures. 3. Regulate. All policies, procedures and forms should be clearly documented and standardized. Staff must be oriented, trained and demonstrate competence in these policies. All nurses should be instructed during an initial orientation and each quarter in abduction prevention procedures, precautions, and guidelines. 4. Use restrictions. If a divergence/discrepancy occurs in procedure, create a "stop" process so that proper action must be ensured before proceeding. If any difference occurs in patient identification or transport to mother, create "stops" so the baby is identified and secured. 5. Inform. Actively involve mothers in the care of their newborn. Inform the parent(s) about policies and procedures that are designed for infant safety and security. 6. Reduce handoffs. Reducing the number of steps, persons involved and handoffs will reduce the risk of errors. "If mom wants to give the baby to grandma, that's mom's choice, but the hospital staff [is] only going to give the baby to mom," said Brown. Have the same personnel provide care as much as possible to reduce inconsistency and risk of unfamiliar personnel. Multiple caregivers or handoffs to other departments increase the chance that the mother may not know who is with her baby. 7. Keep a safe environment. Make sure the hospital work environment focuses on safety and prevention. Ensure that there is good visibility of infants and entry/exits, restricted access to unauthorized personnel and the ability to "lock down" quickly. 8. Team training. An effective team will make fewer errors so training can enhance teamwork. Develop mechanisms to train new and current staff on policies/procedures, safety measures, new equipment and ensure proficiency. Also, encourage feedback because this will correct behaviors leading to problems and will minimize error. A good idea is to establish a review mechanism for identifying system errors to reduce errors rather than focusing blame on individuals. Infant abductions are generally infrequent, yet devastating for anyone involved. It is important for hospital staff, nurses, and the mother and father/caregiver to be aware of the potential threat and to keep security measures in mind. Preventative methods and guidelines are the first step to creating a safe environment for a newborn. The second is continuing to follow through with the precautions. This is something that can be prevented. For a list of references please contact Karen Cinpinski at KarenC@Accutech-ICS.com or 800-356-2671 ext 1130. About the Author: Karen Cinpinski is the Marketing Associate at Accutech-ICS (Innovative Control Systems) headquartered in Franklin, Wisconsin. Karen has been vital to the marketing and development of the Accutech product line. Accutech-ICS is a market leader in RFID security systems for infant, pediatric, and long-term care facilities and maintains a strong role in RFID asset tracking solutions. Visit Accutech on the web for more information! Sheryl's comment: This highlights another benefit of home birth. You just don't have to worry about a stranger walking in your living room and running off with your newborn when you homebirth. The likelihood of babies getting switched is also fairly slim in a homebirth. If you do choose to deliver in a hospital for whatever reason, then insist on room-sharing or co-sleeping with your baby. Don't let your baby out of your sight. Send somebody along with your newborn if they need to remove him/her and you cant go along. Infant abductions, while rare, are a horrifying reality and one that can easily be prevented by keeping a family event away from institutions and at home where it belongs. Image Source: http://flickr.com/photos/seandreilinger/289152748/

Emergency Childbirth: You Need To Know What To Do 10

Author: Anne Childs When it comes to childbirth, most women are able to make it to the emergency room or their prearranged birthing centers; however not all are. While there is a good chance that you will make it to your intended destination before your baby arrives, what would you do if you couldn't make it? Unfortunately, a large number of expectant parents have no idea. That is why it is important that you take the time to familiarize yourself with emergency childbirth, just in case. Perhaps, the best way to familiarize yourself with emergency births is by speaking to your pregnancy care physician, whether that professional be your primary care physician, an OBGYN or a certified nurse midwife. There is a good chance that your pregnancy care provider will briefly touch on the subject of an unexpected birth, but it is important that you know as much as you can about the situation, including what you can and cannot do. For that reason, you may want to make a list of questions that you should ask him or her. One of the most important questions that you need to ask your pregnancy care provider is where you should or shouldn't have your baby. Depending on the situation, you may not have a choice, but you might just have one. For instance, if you are going into labor at your home, you may want to know where the best delivery location would be. From a medical standpoint, you will want an area of your home that is safe and clean, but also one that will be comfortable. Your OBGYN, primary care physician, or certified nurse midwife should be able to give you the most accurate answer.* During emergency childbirths, it is recommended that the births occur on clean surfaces, at least a surface that is clean as it could possibly be. Although you might not have enough time to make it to the hospital, there may be enough time to sanitize the area in which you plan on giving birth. The only problem with sanitizing your birthing area is that not all cleaning products are safe for you and your child. That is why it is advised that you seek professional assistance. If cleaning supplies need to be used, it is important that you know which ones are safe and which ones are not. Cleaning supplies are not the only items or supplies that you need to be concerned about. As beautiful as childbirth is, it can also be messy. That is why it is often recommended that you wear protective clothing, such as gloves, and have a number of towels or blankets on hand. You should ask your pregnancy care provider what items, as well as how many, you should have on hand. In fact, your healthcare provider should be able to provide you with an emergency birthing checklist or you could easily make your own. Although it is best to get your information directly from your own pregnancy care provider, you can also familiarize yourself with emergency childbirth by using the internet or by buying a pregnancy book from one of your local retail stores. These books and online resources may not provide you with as detailed or as personalized information, but they can do in a pinch. If at any point you find that you have unanswered questions or need further assistance, you are advised to seek assistance from a professional healthcare provider. Whether you learn about emergency childbirth through your physician, the internet or a printed resource guide, you are advised to follow all of the information and directions given to you. It may also be a good idea to take additional precautions. For instance, it will likely be recommended that you have the above mentioned supplies on hand; however, you may want to take it a step further. It may be a good idea to keep the materials needed for an emergency childbirth in number of different locations, such as your car or your workplace. Despite the fact that your labor and delivery may go exactly as planned, there are no guarantees. By asking the above mentioned questions, you should be prepared for anything that happens, whether it be expected or not. The information you will learn may come in handy; however, it is important that you share it with those that you will be around. Since you will be occupied, you will need to rely on assistance from those around you, whether they are medical professionals or not. About the author: Anne Childs is a contributor to Healthline who has also conducted many seminars focusing on childbirth and other issues related to women's health. Sheryl's comment: A. Childbirth is not an emergency for the mother or baby. If your baby is ready to come out, it is exciting and thrilling! B. Childbirth outside of a hospital is only an emergency for the OB-GYN's car payment C. You should be familiar with how birth works no matter who (if anyone) is attending the birth. D. You can give birth in any room in your home including your bathroom. If it is clean enough for you and your newborn to live in or to conceive the baby in, then it is clean enough to give birth in. E. You will be catching your baby so the surface that you are kneeling or squatting on is somewhat irrelevant. Clearly you are not going to give birth in your cats litter box or in a obviously unsanitary location. We are talking about western civilization here people, not the third world. Think "reasonably clean" or "company is stopping by clean" F. Lay down a shower curtain or some old towels. Childbirth without incisions and episiotomies is a lot less bloody. There will be amniotic fluid however, so be prepared for that. Some women give birth in the bathtub, over the toilet or on a tiled floor for easy cleanup. If you are at home, fill the tub, climb in and get ready to meet the new love of your life. Location is really not that big of a deal. G. Don't welcome your baby into the world with latex gloves. That is insane. You will be holding your baby for years in your bare hands. Why is this crucial moment any different? H. Try a lotus birth and you wont have to worry about cutting the cord. If you do want to cut the cord (PLEASE only cut if after it is done pulsing) then cut it with a clean/sterile scissors. You might want to have a large bowl on hand to place the placenta if you do not do a lotus birth. If you were in fact planning a hospital/birthing center birth, then the doctor or midwife will want to examine the placenta to make sure it is intact. (Otherwise how can they get paid?) Image Source: http://flickr.com/photos/ouij/50115629/

Planning a Homebirth 0

[caption id="" align="alignleft" width="390"]Planning a homebirth Waterbirth at home[/caption] Author: Nicky Pilkington Once upon a time, women's only childbirth option was to give birth at home. As medicine evolved, doctors' offices and hospitals became the norm for labor and delivery which created an entire industry but not necessarily to the benefit of women and children. Rural communities remained isolated from modern facilities and midwives took their place by the mother-to-be side at the time to give birth arrived. Today, midwives are professional health care providers, qualified and accredited by medical boards. This is the result of an increasingly common trend: giving birth at home. Whatever the reason, many women prefer to stay at home often attended by a midwife. There is no place like home, and that saying takes the right place when pregnancy comes to end. Planning a homebirth will reduce the tension of labor, thus facilitating delivery if you are a pregnant woman in good health and without previous miscarriages or pregnancy complications. Hospitals are committed to bringing you the ultimate technology experience, and their services are useful if your gynecologist has determined that you will need medical assistance during the childbirth process, but the cold atmosphere of a hospital room can never be compared with your bedroom. Any expectant mother has the right to decide where she wants to give birth and if you are generally healthy and have had an uneventful pregnancy with no special conditions, then there is no reason in the world that you could not choose to birth in the privacy of your own home. The first step is to choose your birth attendant. Although not set in stone, you will often find that a lay midwife will assist you in your home while a CNM (certified nurse midwife) will work in a hospital setting along side of an obstetrician. Please do not be fooled by a CNM (or 'medwife') and try to have a "natural birth" in a hospital setting. It does not happen and they will frequently do unnecessary and dangerous interventions to you and your baby to "speed things along". If you want a natural birth, you have to deliver at home, period. Take some time to check the attendant background and qualifications, then schedule an interview and ask all what you need to know, including number of births attended and the names of a few persons you can talk with for references. It is vital that you question the time they allow you to labor (if they will do potentially dangerous and unnecessary things like give you pitocin, episiotomies or yank on the umbilical cord to "speed things up"). Most lay midwives have the brains to avoid cutting the cord until it is done pulsing. This is one of the best reasons to have a home birth. One of the most important preparations you can make for a successful home birth is to consider any eventual complication. Make sure that the person who will attend you is familiar to emergency procedures and has the appropriate equipment in case of postpartum hemorrhage, the need to resuscitate a newborn, or any other unexpected medical event. If you are planning an unassisted homebirth you should know infant CPR yourself and have transportation to the hospital lined up should you start bleeding or have some other complication. Your midwife may also have oxygen and masks on hand as well as some other basic birthing supplies. Lastly, remember to check your insurance coverage, because many plans will not cover home birthing. If everything goes okay, you can give birth in your own home, that of your parents, your best friend, or in a home close to a hospital or the physician who keeps your medical history records. About the author: For more information about home birthing and childbirth information you can check out childbirth.me.uk Buy the Book: The Homebirth Advantage [affiliate link] Image Source: http://flickr.com/photos/myjuly/537376204/

Pregnancy and Birth for First Time Mothers 3

Pregnancy and Birth for First Time Mothers Pregnancy and Birth for First Time Mothers If you are pregnant for the first time, the idea of childbirth can be frightening and a bit overwhelming. Typically, a pregnancy takes anywhere from 38 to 42 weeks. Though many first-time mothers indicated that their babies were delivered past their due date, it is always best to be ready and prepared for what is to come during childbirth. With the advent of modern science and technology in childbirth and childcare, many modern women are afforded more advantages with regards to information about childbirth than their older counterparts had, and many of these women take advantage of these opportunities. Instead of spending 38 to 42 weeks getting all worked up about childbirth, take the opportunity to learn and educate yourself on the beautiful process of birth as well as how to care for your newborn. Many hospitals and communities offer prenatal classes to prepare you for childbirth during the third trimester. Not only that, libraries as well as the Internet, offer a wealth of information on matters concerning childbirth and child care. Remember though, even with all the preparation every woman's childbirth is different and unique. It is important to remember that Calm Preparation for Childbirth can equip you with knowledge and this will make you well informed. Knowing that millions of women have been successfully giving birth since the dawn of time offers little consolation to most women. This is because the fear of the unknown is terrifying. Ample knowledge can provide a small sense of control over the whole situation. Now women are actively involved in their birthing plans and inform their doctor or midwife how they would like the childbirth to be carried out if all is well with the baby. Although complications can limit your childbirth choices, there are various options that you can choose from for your birth plan. To prepare for childbirth you can opt to take up childbirth classes, hire a doula or labour coach, and read up on the subject. Even though the idea of childbirth and labor can be scary for a first-time mother, in the end it will all be worth it. Once the baby is placed in the mother's arm, all the pain and discomfort will become nothing but a vague memory. By learning and understanding the labor and delivery process, you can help prepare yourself for the childbirth. There are many women who claimed that attending Lamaze classes eased their mind as they know what to expect. Having a labor coach, be it your spouse, a partner, your best friend or even a doula can greatly help you throughout the whole process. More and more women are choosing Unassisted Childbirth and there are others out there who choose a waterbirth or assisted home birth. The thing that ties them all together is the fact that each labour and delivery experience will be different for all women. While you may have had a rough idea as to the type of experiences you would likely have during the birth of your children, take note that there are many other issues and factors that could have an effect on that idea. Remember that the most important thing about all of this is the end result, having a beautiful healthy baby which will make it all worthwhile. Author: Juzaily Ramli About the author: Juzaily Ramli is the owner of Pregnancy Website , Pregnancy Signs and Pregnancy Stages Find out why it is so important to be prepared for your pregnancy. Image source: http://flickr.com/photos/bframe/406052093/