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09 Feb Skin-to-Skin Love for Your Newborn

We love educating women on the benefits of midwifery care. In pursuit of that goal, I encourage you to read this blog in our series from midwife (and guest blogger), Lincey Knox LM, CPM of Heartstrings Midwifery.
 
Those first few moments after the arrival of your new baby are so important for both mother and baby. This is true not just medically, but emotionally and physically as well. Skin to skin love is not something only the mother can provide – in fact, the bonding between baby and father through skin-to-skin care is also vitally important to the process. Through these first snuggles, a newborn learns the scent of mother and father, learns to feel safe, helps establish breastfeeding, aids in the newborn’s transition to living outside the womb, and keeps him- or herself warm.

A newborn survives off of its instincts and reflexes during the first few weeks of life. Its greatest senses are those of smell, touch, and hearing. With skin-to-skin contact a new baby is able to utilize these three senses as (s)he can smell mother’s scent, touch mother’s skin, and hear mother’s heartbeat – the same sound that has been lulling baby to sleep for the past nine months.

“There are now a multitude of studies that show that mothers and babies should be together, skin to skin immediately after birth, as well as later. The baby is happier, the baby’s temperature is more stable and more normal, the baby’s heart and breathing rates are more stable and more normal, and the baby’s blood sugar is more elevated.”

Immediate skin-to-skin contact between newborn and mother should be standard of care for all deliveries. Even in the situation where a cesarean delivery is necessary, many obstetricians are beginning to facilitate skin-to-skin between mother and baby in the operating room, as its importance is recognized more and more. Hopefully this practice will continue as more care providers recognize the bonds that are formed during these precious first moments.


REFERENCES

http://www.nbci.ca/index.php?option=com_content&id=82:the-importance-of-skin-to-skin-contact-&Itemid=17

2 http://www.naturalchild.org/guest/jack_newman2.html

3 http://evidencebasedbirth.com/the-evidence-for-skin-to-skin-care-after-a-cesarean/

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19 Jan Water Birth

I frequently discuss birth options with my newly pregnant clients. ‘Should I have a home birth, birth center birth, or a hospital birth?’ ‘What is the difference between a certified professional midwife (CPM), a certified nurse midwife (CNM), or an M.D.?’ In pursuit of our goal to help shed some light on these questions, I encourage you to read this blog in our series from guest blogger, Elizabeth Spring.



Water birth is a topic that has been making recent headlines, and inciting conversation between women, obstetricians and midwives.

What are the Benefits?

Imagine yourself drawing a warm bath, slipping in and relaxing your cares away… Similarly, when a woman who is in intense labor settles into the bath or birth tub, the warm water alleviates some of the physical discomfort of labor by easing muscle tension and creating the effects of buoyancy. When the woman has less discomfort, she will naturally relax more and produce more of the amazing hormone oxytocin! Oxytocin – also called the “love-hormone”, is the primary hormone involved in love-making, labor/birth, and breastfeeding. This feel-good hormone causes more effective contractions while allowing the mother to cope with labor pains more easily. Studies conducted on the safety and efficacy of water birth to ease labor pain concluded that women who labored and/or birthed in clean, warm water were less likely to use analgesic, less likely to have severe perineal lacerations, had shorter first-stage labor (1) and were more satisfied with their birth – with no increased risk to the mother or baby (2), (3).

Common Concerns

Many people are concerned about an increased risk of the newborn acquiring an infection from a water birth, but studies show that there is no increased risk between water and land births (1). Another concern is that the baby may take a breath under the water, it is forgotten that the infant has been living in water for 9 months and that he is still receiving oxygen through the umbilical cord. You may have seen on your ultrasound that your baby is making breathing movements, this is to build muscles needed for breathing outside of the womb. 24-48 hours prior to birth however, babies stop practicing these movements due to the presence of the hormone Prostaglandin E. Until the newborn’s face makes contact with air, it will not attempt to breath unless it is in distress – which your healthcare provider would detect beforehand (4). Moms-to-be, consider adding a tub to your birth plan!  In combination with good health practices, water immersion has been established as a safe and comfortable method of child-birth, and an extremely helpful coping method during labor.

References:

  1. http://www.ncbi.nlm.nih.gov/pubmed/16147851
  2. http://www.ncbi.nlm.nih.gov/pubmed/15346814
  3. http://www.ncbi.nlm.nih.gov/pubmed/10971083
  4. http://www.arquitecturadematernidades.com/sites/default/files/administrator/BLOG/20140707BagneraVSpotro/estudio-queensland_waterbirth_2013.pdf

****** If you’re not pregnant yet, pre-conception care is what you do to prepare yourself to become pregnant. Come learn how to enhance your health in preparation for optimal fertility, a healthy full-term pregnancy, a straightforward labor, a rapid recovery, successful breastfeeding – and of course,a bright, healthy beautiful baby! Learn how nutrition, changes in body composition, exercise and sleep can positively impact female and male fertility and impact the health of any future pregnancy. 

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postpartum

08 Dec The Midwifery Model of Care

I frequently discuss birth options with my newly pregnant clients. ‘Should I have a home birth, birth center birth, or a hospital birth?’ ‘What is the difference between a certified professional midwife (CPM), a certified nurse midwife (CNM), or an M.D.?’ In pursuit of our goal to help shed some light on this question, I encourage you to read this blog in our series from guest blogger, Elizabeth Spring.


The Midwifery Model of Care

Licensed midwives have specific guidelines on which they base their method of care. Midwives themselves vary as much as any one person from another, but their core beliefs and practice protocols are built upon the same foundation. The Midwives Alliance of North America and the Midwifery Task Force have defined this foundation in a statement titled The Midwives Model of Care (1), which  includes the following:

  • Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing cycle
  • Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • Minimizing technological interventions
  • Identifying and referring women who require obstetrical attention

The application of this woman-centered model of care has been proven to reduce the incidence of birth injury, trauma, and cesarean section while providing a healthy outcome for mother and baby (2).

 

From this foundation, midwives develop common philosophies of the midwifery model. The International Coalition of Midwives has written a document outlining common philosophies entitled The Philosophy and Model of Midwifery Care. Some of the foundational aspects included in this document are used to define the model of care that midwifery provides: 

  • Midwives trust that women are capable of natural childbirth, thus midwives partner with women to achieve each mother’s desired birth.
  • Birth is a natural physiological process, and pregnancy is a state of health.
  • Childbearing is a hugely profound experience in women’s lives.
  • Women should be supported in healthy choices for their pregnancy, birth and postpartum. Midwives are to be continuous partners with women in their decisions and experiences during this time, not authoritarian “providers”.
  • Midwifery care is holistic, avoiding unnecessary interventions and using a thorough knowledge of the expectant families’ cultures, beliefs, and life experiences. (3)

 

For other blogs in this series please see:  What is the Home Birth Experience Like? and Is Midwife Attended Birth Safe?

References

****** If you’re not pregnant yet, pre-conception care is what you do to prepare yourself to become pregnant. Come learn how to enhance your health in preparation for optimal fertility, a healthy full-term pregnancy, a straightforward labor, a rapid recovery, successful breastfeeding – and of course,a bright, healthy beautiful baby! Learn how nutrition, changes in body composition, exercise and sleep can positively impact female and male fertility and impact the health of any future pregnancy. 

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21 Nov What is the Home Birth Experience Like?

Lincey KnoxAs you can imagine we have a lot of newly pregnant women here at Holistic Wellness. It’s a huge perk of the job! I frequently discuss birth options with my newly pregnant clients. Should I have a home birth, birth center birth, hospital birth? Should I use a certified professional midwife (CPM), a certified nurse midwife (CNM), or an M.D.? I’m excited for you to read the following post regarding the safety of midwife attended birth from midwife and guest blogger Lincey Knox, LM, CPM

What is the Home Birth Experience like?

______________

When a woman is empowered to set the tone for her own labor and birth she will naturally desire a safe and relaxing atmosphere.

In a home birth setting, the client is surrounded by the scents, sounds, and familiarity (own bed, bathroom, etc) that she is accustomed to, adding to her sense of safety and security. Feeling safe and allowing one’s body to relax and surrender to the natural process of labor is important. “It is safe to say that a woman should give birth in a place she feels is safe…For a low-risk pregnant woman this can be at home…” The relationship built between client and midwife facilitates a sense of trust and security and is an important aspect of safety in home births. Trusting the caregiver allows a woman to focus on the task before her rather than being concerned about what procedures may be done to her or the baby, which you find in most hospital settings. Midwives provide woman-centered care for low risk pregnancies. A midwife enters the home of her client with an attitude of respect continuing to facilitate a feeling of trust and safety as the woman labors and births at home.

Studies show risk in home birth is equal to or lower than the risk of delivering in a hospital and is associated with a much lower occurrence of intervening procedures during labor and delivery.

“Recognizing the evidence that births to healthy mothers, who are not considered at medical risk after comprehensive screening by trained professionals, can occur safely in various settings, including out-of-hospital birth centers and homes.”

In the right setting, with a low risk mother/baby pair and a trained and trusted midwife home birth is safe. Research your options and find a midwife that supports you in choosing what is best for you and your baby!

For other blogs in this series please see:  The Midwifery Model of Care and Is Midwife Attended Birth Safe?

Byline: Lincey Knox, LM, CPM

For those seeking additional information, the paper, Care in Normal Birth: a practical guide from the World Health Organization is an amazing resource.

****** If you’re not pregnant yet, pre-conception care is what you do to prepare yourself to become pregnant. Come learn how to enhance your health in preparation for optimal fertility, a healthy full-term pregnancy, a straightforward labor, a rapid recovery, successful breastfeeding – and of course,a bright, healthy beautiful baby! Learn how nutrition, changes in body composition, exercise and sleep can positively impact female and male fertility and impact the health of any future pregnancy. 

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10 Nov Is Midwife Attended Birth Safe?

Lincey Knox, MidwifeAs you can imagine we have a lot of newly pregnant women here at Holistic Wellness.  It’s a huge perk of the job!  I frequently discuss birth options with my clients. Should I have a home birth, birth center birth, hospital birth? Should I use a certified professional midwife (CPM), a certified nurse midwife (CNM), or an M.D.?   I’m excited for you to read the following post regarding the safety of midwife attended birth from midwife and guest blogger Lincey Knox, LM, CPM

Is Midwife Attended Birth Safe?

Is Midwife Attended Birth Safe? As a midwife, this is probably the question I hear most often. While the mother generally asks about the more relational aspects of care, the father is often more concerned with the impact a home birth will have on the family’s finances – and more importantly – the safety of his wife and child. As a midwife, one of my greatest responsibilities is to help my clients make informed choices by presenting them with accurate facts and the most up to date information available. Midwives are advocates and a source of support for mother and baby.

Planned home births are chosen by more and more women. The questions surrounding the safety of home birth are currently at the forefront of several studies. Women who receive care with a midwife are receiving woman-centered, personalized care that empowers women to make informed choices about their prenatal care and labor preferences.

So what are the studies saying? Almost all of the studies examined showed that women who had a planned home birth with a midwife had significantly less vaginal tears, postpartum hemorrhages, episiotomies (3.1% v. 16.9%), and labors ending in cesarean deliveries (7.2% v. 11%).  With home birth deliveries there are fewer unnecessary antepartum interventions for both the mother and the baby.

OUTCOMES FOR NEWBORNS:

Depending on the study you read, you will find conflicting reports. Some studies show that the risk of home birth is too great to consider it safe, while others show that the incidence of neonatal death (death of a baby between days 1 and 28) and the rate of medical interventions are much lower at home compared to at the hospital.  Where the studies differ is in the outcome for the newborn. Some studies show that neonatal mortality rates are higher for women that choose a planned home birth with a midwife. However, it is important to point out that not all of these studies used “planned” home births in compiling their data. A planned home birth is safer than an unplanned home birth and should not be lumped together in the same category of home birth.  An unplanned home birth is often an unattended birth and thus the mother and baby are at increased risk as there is no provider attending to the mother/baby pair.  In addition, there are strict guidelines that midwives use in order for a mother/baby pair to qualify for a home birth. In cases where working within the safety of these parameters can not be assured, then a birth center or hospital birth is recommended for the safety of both mother and baby.

A study entitled “Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician” conducted in Canada looked at home births with midwives vs. hospital births. This study showed perinatal death at a rate of 0.35 per 1,000 births for home births and 0.64 per 1,000 births for hospital births,. The study also showed other benefits of home birth including less need for neonatal resuscitation, decreased meconium aspiration, and decreased need for NICU admittance. The safety of the baby is reliant on the health of the mother, risk factors associated with her pregnancy, the overall feeling of safety and trust of the client in her caregiver, and the education and experience of the midwife attending the birth.

Stay tuned for part II of this blog!

References:

1 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/
2 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth
4 http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Planned-Home-Birth
5 http://www.nct.org.uk/birth/home-birth-safe
6 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2742137/
7 http://www.ncbi.nlm.nih.gov/pubmed/9271961

****** If you’re not pregnant yet, pre-conception care is what you do to prepare yourself to become pregnant. Come learn how to enhance your health in preparation for optimal fertility, a healthy full-term pregnancy, a straightforward labor, a rapid recovery, successful breastfeeding – and of course,a bright, healthy beautiful baby! Learn how nutrition, changes in body composition, exercise and sleep can positively impact female and male fertility and impact the health of any future pregnancy. 

Read More