Coalition to Improve Maternity Services

Recently, I was lucky enough to attend the CIMS national forum held here in Austin. I was a bit awestruck seeing so many of the “stars” of the maternity advocacy world.  Amazing and inspiring people who have dedicated so much of their life working for mothers and babies. Professionals, consumers and volunteers all over the country continue to work on research, improving access, addressing disparities, increasing healthcare transparency, public policy and grassroots advocacy. We were all excited to meet Ricki Lake too! “The Business of Being Born” has been one of the greatest advocacy tools of our time. If you haven’t seen the movie yet, you can get it from Netflix. There is another video in the works, and a great new book and website http://www.mybestbirth.com/

You can help too! One of the important projects started by CIMS is the Birth Survey Project. Inspired by the “Listening to Mothers Survey”,  the survey’s goal is that women of childbearing age must have access to information that will help them choose maternity care providers and institutions that are most compatible with their own philosophies and needs.  If you have delivered in the last three years, please take some time to share your experiences.

Take the Survey

Beautiful Birth at center in Austin

A beautiful family centered birth at CentreVida Birth Center in Austin. Where we never cease to be awed by the mother’s love and courage and the miracle of a baby’s arrival! Thank you to this family for sharing their precious memory.

Nutrition in Pregnancy

One of the fundamental differences between the care of a midwife and an obstetrician is the emphasis on good nutrition. How a woman eats in her pregnancy can affect her physical and emotional well-being as well as the growth of her baby, a healthy placenta, and healthy perineal tissues. With a healthy balanced diet and exercise, many of the complications that can cause a woman to be considered “high risk” can be avoided.

Nutrition is at the heart of midwifery care. Midwives discuss with their clients from the first meeting to 8 weeks post partum about their diet and what changes, if any, can be made. When we ask a woman to bring a 7-day diet history, it is more for her to see and evaluate than for us . Looking at this together, recommendations can be made but many times the woman already sees the improvements that are needed just by writing down what she’s been eating.

 Balancing Your Diet

It doesn’t cost more money to eat healthy and you don’t have to shop at expensive stores to get nutritious well-balanced meals and snacks. Actually, the opposite is true as processed foods do cost more. A varied diet that consists of good sources of protein, whole grains, calcium, fresh vegetables, and fruits is the basis of a balanced diet. When you look at the food pyramid, it suggests 5 servings of vegetables. Wow!! However, the serving size is 1/2 cup and so if you eat a 2 and 1/2 cup hearty salad with lots of fresh veggies, you’ve already met your quota for the day. If you have a diet that is balanced then you don’t have to worry about getting the amounts of folic acid needed for healthy neuro-tube development between the weeks gestation 4 and 5.

 Weight Gain

The most important thing to remember in your pregnancy is that as long as you are eating healthy it doesn’t really matter what the scale says. A woman who is of average weight pre-pregnancy, will gain an average of a pound per weeks pregnancy. Since there is an estimated 40 weeks pregnancy this would equal an average of 40 pounds. Instead of looking at what the woman gains between each prenatal visit, we like to look at the overall weight gain. This can vary from woman to woman and from pregnancy to pregnancy as they each are different. It is not uncommon for a woman who is over-weight before she conceives to gain very little in her pregnancy, if any at all, and still have a healthy 8 or 9lb. baby. What a woman gains the first 37 weeks builds a healthy blood volume, adequate placenta and amniotic fluid, extra breast tissue, a vigorous baby and goes to her for breast feeding stores. What is gained the last few weeks of pregnancy will go mostly to the baby.

Protein

One of our favorite books is “Natural Childbirth the Bradley Way”. However, the amount of protein that is suggested in the book is probably too much. That said, the womans diet should focus on proteins rather than carbs and she should get a minimum of 60 grams per day. If you consume at least 3 portions of protein a day plus snack on protein, this should be more than adequate. Many women today are vegetarians and there are plenty of ways to get good sources of protein to meet the needs of your growing baby.  For many women, at or around 6 weeks gestation, morning sickness will begin. Not all women experience this and again it will vary from woman to woman and pregnancy to pregnancy. It is due to the increased amounts of progesterone and estrogen circulating in your body. One of the ways to hopefully decrease this symptom is to get small frequent portions of protein and/or a complex carbohydrate, usually every 1 – 2 hours. If you wake up to urinate in the middle of the night, it is a good idea to have a small snack ready by your bed. Going 7-8 hours without eating can greatly increase the amount of nausea you experience in the morning. This is probably why it is more common first thing in the morning. It will also help to avoid those hypoglycemic times that are so common in pregnancy.

Calcium

The amount of calcium a woman needs during pregnancy is 1200 mg. a day. A good average of what each serving of dairy contains is 300 mg. So this means 4 servings of dairy a day. There are a few green leafy vegetables that are just as high as dairy  such as mustard greens, collard greens, and kale.

If you are a vegan or lactose intolerant, then taking a calcium supplement will give you and your growing baby what you need. Symptoms of low calcium are leg cramps, increase irritability, and insomnia. Even dairy eaters often need to supplement Calcium during pregnancy and breastfeeding due to the high demands by the baby and the fact that phosphorus in milk can inhibit calcium absorption. The woman’s body will usually compensate by using stores, but this makes for more problems like bone decay later in life. Taking a liquid calcium/magnesium combo is easier for your body to absorb than a pill.   At about 36 weeks pregnancy, the baby’s bones really start to ossify. So if you have been free of low calcium symptoms and then they start at about this time, you probably need to up your calcium intake.

 Iron

Almost all woman will have a decrease in their iron stores between 24-28 weeks pregnancy. This is due to the fact that your body is making a whole liter of extra blood for you to help with the growing baby. The fact that you make the liquid part first (plasma)means that each red blood cell is diluted. It is also a good sign that your blood volume in expanding and it is just a normal physiological process that happens in normal pregnancies. How do you know if you need more than high iron rich foods and need a supplement? At the beginning of your pregnancy,  we  check the woman’s complete blood count (also known as CBC) as it is part of the initial lab work. This looks at the red cells and white cells. The main part of the red cell that we need to see is the hemoglobin and hematocrit. The hemoglobin is the part of the red cell that carries the oxygen and is why if a person is anemic they can be tired and short of breath. The hematocrit is the percentage of red blood cells and goes along with the results of the hemoglobin. The hematocrit is about 3 times as much as the hemoglobin on average. We  look at these values with the woman and explain what the normal levels are : Normal Hemoglobin 11.7 or Higher and Hematocrit 35-37% or higher. It takes 2-3 weeks to make a red blood cell, so if the woman is already low on her iron stores at the beginning of her pregnancy, it is probably a good idea to take a supplement before the peak of making the extra liter of blood is reached. Then, at 24-28 weeks pregnancy, we check the woman’s CBC again along with the screening for gestational diabetes. Then, one more time about mid-third trimester. 

Empty Calories

During your pregnancy, your liver and kidneys are working extra hard to filter your baby’s blood. If a woman has a diet that is full of empty calories, this puts an extra load on your liver and kidneys and can lead to toxemia, blood pressure problems, prematurity, and other risk factors in pregnancy. In the first trimester, it is sometimes hard to eat healthy between weeks 6-12 and you are trying to get in what ever you can. Don’t worry so much about it till after your 12th week. (The special “window” of time when things can go wrong in development of the neuro-tube is between the 5-6th week of gestation before the nausea starts).

Last Weeks of Pregnancy

At the end of your pregnancy starting around 36-37 weeks pregnancy, the baby’s bones start to ossify so you may need to add a supplement as mentioned above. One of the most important things to remember from this time till the baby is born, is to stay on your healthy diet. Even the most rigid health-nut can fall off track and start eating less healthy these last few weeks. Don’t forget that most of what you gain from here till the baby is born , goes to the baby. It is much easier to push out that 8 or 9 lb. baby than that 10 or 11 lb. If you don’t feel like cooking, avoid those take-out food places and just keep healthy foods that are easy to prepare around. This will help you avoid the temptation!!

Pregnancy is a wonderful time to learn more about your body and nutrition! Check back soon for recipes and more nutrition tips or feel free to talk to one of the midwives at CentreVida Birth and Wellness Center.

New Videos

June and I are doing our best to become a little more media savvy :-) We need more pics for our next video which will be of pregnancy and birth images. Please send yours to my email faithbeltz@yahoo.com. I am digging  some of mine out from way back!


We Believe

Another beautiful, peaceful water birth in the center this morning surrounded by the entire family. So, thought I would share this poem adapted for the center by CentreVida Co-Owner, June Lamphier..
 
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In This Center
 
We Believe in living deeply, laughing often and loving always.
We Believe we were brought together to support and care for each special mother and baby.
We Believe in celebrating together
We Believe that everyone’s feelings count, and that the uniqueness of each of us strengthens all of us.
We Believe in the power of forgiveness to heal and the power of love to carry us through.
We Believe in the power of birth.
We Believe in you and your uniqueness
 
In This Center
 

Doctors write in support of Midwifery

Your Amazing Newborn

newborn

Today we had another birth at the center. Each birth I witness, I marvel at the strength of the mother and amazing presence of the new baby. For too long our society has disregarded the baby’s experience of birth. It has become common knowledge that a mother’s well-being and level of stress in pregnancy affects her baby’s developement, but many people still question the idea that the same is true with birth. Recently, negative media images have even tried to portray a woman seeking a natural birth experience as being “vain” or “trendy”.

However, parents who seek an unmedicated and low intervention birth know the value and impact it can have on their baby. They know it is not just about the woman’s comfort and experience. They recognize the importance of those very first moments with their baby during and after delivery. When you witness a newborn open her eyes for the first time to look up to her mother in complete awareness and without interruption, you can’t help but know it too.

Now, with more and more research in perinatal psychology, we are learning that these very first experiences of life outside of the womb may have more importance than we ever imagined. I am amazed to read the science that proves what my heart already knows about the importance of these events. Check out this interview with local early parenting coach, Carrie Contey   and renowned author Joseph Chilton Pierce too for more.

At CentreVida Birth Center we incorporate practices to foster a peaceful and enjoyable experience for the baby including:

  • Allowing parents to help in “catching” their baby if they desire
  • Very gentle “handling” of baby during delivery
  • Immediate skin-to-skin contact between mother and baby after delivery
  • Delayed cord clamping and un-rushed third stage
  • Low lights, soft voices and minimal activity immediately following delivery
  • Absolutely no separation of baby from parents arms throughout postpartum time
  • All assessments and exams of baby done in mom’s arms or with baby next to mom in bed
  • Leboyer method type bath after birth for mom and baby together with low lights

The science is proving it’s not just a cooky notion..

A peaceful earth begins with Birth!

Avoiding the flu in pregnancy

Here in Texas, most of us are more than happy to see the cooler days of fall arrive. But along with those cooler nights and kids back in school, come the quickly traveling winter “colds” and flu.  This season, many families are even more concerned about protecting themselves after all the media coverage around the deaths related to the H1N1 strain last year.

The official recommendation of the CDCis that all pregnant women and children older than 6 months get the seasonal flu shot (usually a combination of 3 strains) and the new 2009 H1N1 vaccination as soon as it is available. The inactive flu vaccine has been determined to be safe for pregnant women. However, some families still have concern about the safety of vaccine additives. Thimerosol free vaccine can be requested but may be more expensive.

It is important to understand that the biggest concern is often not the flu itself, but complications resulting from the flu including phneumonia. So, because the vaccine cannot guarantee 100% protection against all flu strains or possible complications, pregnant women and their families can use the following recommendations to strengthen their immunity whether they have received the vaccine or not.

  1. Wash hands often
  2. Take a food based multi-vitamin
  3. Get plenty of rest and at least 3 liters of filtered water or herb tea per day
  4. Avoid processed foods, white sugar, and excessive grains and gluten
  5. Add a live cultured probiotic supplement
  6. Eat foods high in antioxidants
  7. Be sure your diet has the right balance of Omega-3 oils
  8. Take homeopathic Oscillococcinum

If you think you may be exposed to the flu:

  1. Take Echinacea tincture 3x day  (this is safe in pregnancy)
  2. Take an extra 3,000 mg of Vit C per day
  3. Eat organic garlic
  4. Take Elderberry Syrup 3x day

There are many other complimentary health practices which can benefit the immune system including yoga, exercise, lymph drainage, chiropractic adjustments and acupuncture. And last but not least.. don’t forget to laugh and love!

If you want to know more about how to avoid the flu in pregnancy, contact us at www.centrevida.com

Response to media

Last week another “attack” against homebirth and midwifery aired on the “Today Show”.

The tactics are the same as they have been for many years, all the way back to the “witch hunts”. Instead of giving factual information about the possible pros and cons of  choices in birth, the story played on the ultimate fear that any parent has.. that something may happen to their child.

While I am not aware of who may have initiated this story, I am aware of the strong opposition that ACOG has to midwives and out-of-hospital birth. They have published statements which state they do not support the option. This opinion goes back to the very beginning of the medical profession. Back to when colleges and medical schools were first established, institutions which only allowed male students at the time. These new Doctors were sent to the colonies and had to find ways to discredit the local health workers, who were often midwives.

And here we are now, movies like “The Business of Being Born” are teaching parents more about their options in birth along with the benefits and risks. This type of information is leading to more and more families searching out the midwifery model of care. So, those who oppose the option are finding ways to impart fear and distrust without any facts to back it up. In fact, American medical journals still state that there are no adequate studies to determine the safety of midwifery and out of hospital care. 

How does one support new drugs on the market after only small trials, but disregard the proven safety of birth itself by thousands of years of human existence. How does one ignore the fact that the countries with the lowest infant mortality rates have midwives and out of hospital births integrated into their healthcare systems. How are large comprehensive studies like the CPM 200o study of homebirths and the recently published Canadian study on midwife attended births left out of the conversation.

Midwives of today are experts in normal pregnancy and birth. They are trained to identify potential complications. They help women avoid some of the most risky circumstances like pre-maturity, pre-eclampsia, and fetal distress caused by drugs and interventions. They strive to compliment and coexist in the system. They respect surgeons and the use of medical technology when it is needed. Their goal is a safe outcome and they have proven results of achieving that goal without unnecessary interventions.

I continue to hold hope that someday parents will be given accurate information to make their own informed decisions about their families and their births. I hold hope that medical decisions will be based on evidence and not fear or politics. I hold hope that traditional midwifery will be integrated into the system. I hold hope that more and more women will reclaim trust in their ability to birth. Finally, I hold hope that the baby’s experience of a gentle and respectful birth will potentially alter the future of generations of children and our society as a whole.

One bloggers story

Another Midwife sent me this..

You may not know who “Dooce” is, but she is an extremely popular US blogger with a LOT of followers — her Twitter feed has over a million on it. She also made the 2009 list of Forbes Top 30 most influential Women In Media list — this includes women like Oprah & Ellen DeGeneres.

She just had her second baby and has blogged a three-part birth story. It’s a great read –she basically documents her sudden discovery around 30 weeks of the Ricki Lake book and her discovery of the “world of natural childbirth” which she previously had disparaged, or at least ignored. Fascinating to see what kind of influence this ends up having.

Here are the links to the three parts:

http://dooce. com/2009/ 07/13/labor- story-part- one

http://dooce. com/2009/ 07/27/labor- story-part- two

http://dooce. com/2009/ 08/04/labor- story-part- three

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