Thursday, July 18, 2013

Nutrition in Pregnancy {A Birth Circle topic}

Nutrition is arguably the most important element of prenatal care. So why is nutrition so important? Because you're growing a human- cells, bones, muscle, fat, brain. To grow a baby you need adequate blood supply to support your body's added effort, to be physically prepared for birth and to support the placenta that is responsible for nourishing the baby. 

The Brewer Diet is based off of the concept of supporting this extra blood supply that begins to double at 8weeks and has increased by 50-60% around week 30.  Dr. Brewer recommended an average of 2700 calories per day, a well balanced diet inclusive of each food group, as well as 75-100grams of protein. The protein is what builds and supports the necessary blood supply. The key to achieving this intake of protein is not supplements, rather whole foods. Eggs, lentils, beans, milk, meats, cheese ~ all of these are excellent sources of protein.

Calories are subjective; each person is different. If you don't count calories in your every day life, how are you to know what the extra 200-300 calories, recommended by mainstream sources like APA, really means? Instead of focusing of quantity- how much weight you're gaining, how many more calories you're eating- focus on quality. Eat more whole foods, being sure to include all of the food groups according to your personal dietary preferences, avoiding food additives, pesticides and excessive sugar. If counting calories is your thing, consider your lifestyle and what number pregnancy this is. Eat well to be well. The important factor is balance. [Quite often a sugar craving is related to dehydration or a lack of protein.] So let's talk about the importance in each food group.

Protein is essential not only in maintaining a healthy blood supply but in the strength of your uterus as well. Adequate protein in your diet is to an easier labor as training is to an efficient marathon run.

Fats support the growth of the baby's brain and promote a good start for breastfeeding. Indulge in full fats when pregnant; cook vegetables with butter to best absorb their nutrients. Enjoy peanut butter, avocados, full fat milk and yogurt. Raw milk has even more fat that homogenized whole milk but of course it is important to know your source. Full fat yogurts are great for vaginal health as well.

Probiotics and fermented foods support good gut flora and prevent infections such as bacterial vaginosis, yeast and group b strep.  Some examples of fermented foods are kefir, kombucha and yogurt.

Too much sugar can contribute to unhealthy bacteria levels as well as stress the fetus; sugar is best in moderation. Try and focus of healthy sugars when you do consume and more organic and balanced options, such as fruits or coconut ice cream with nuts. Cutting out white sugar and white flour in your third trimester may decrease your risk of tearing.
Minerals are essential in your diet, even if you're taking a prenatal vitamin. Sea salt is an excellent source of these minerals, including iron which your baby stores up during the third trimester. Good salt levels from natural, unprocessed salt also keeps your fluid levels and blood pressure under control.

Calcium, whole grains and vitamins are essential to a balanced diet. Eat well to be well.  Eat small portions often; this can also maintain a healthy blood sugar level without extreme highs or lows. Avoid artificial ingredients.

Other helpful foods

include papaya for heartburn and ginger for morning sickness. Indulge in red raspberry leaf tea and dates in
your third trimester, which may be beneficial for your labor.

For more in-depth information, enjoy this --> podcast <--

The usual suspects

AAP recommends avoiding certain fish due to mercury levels; sushi, soft cheeses, raw eggs/meat and lunch meat due to bacteria.

Other Birth Circle topics:
Pregnancy can be a wonderful part of the Journey of Life. Did your care provider mention the importance of nutrition to you? What changes did you make to your diet?

Monday, July 15, 2013

Why The Wait? {The importance of labor}

There is a lot of evidence to demonstrate the problems with induction but I'd like to focus on the benefits of letting labor start naturally.

Spontaneous labor begins from a combination of fetal maturity and the emotional state of the mother's health. This concept makes apparent the benefit of labor in regards to neonatal health- the onset of labor demonstrates that the baby was ready to be born.

There are many benefits of labor {even if you're planning the big C}

A cesarean comes with more complications than a vaginal delivery, though may be necessary for a number of reasons. If a cesarean section is not medically imminent or you are electing a c-section, a beneficial option may be to labor prior to the cesarean.  By scheduling your cesarean you'll miss out on the many benefits of the hormones of labor.

Oxytocin is a significant hormone of labor; research shows numerous benefits such as protecting your baby's brain during birth.  Oxytocin is a key player in breastfeeding- not only facilitating bonding but also as part of the hormones of labor that influence the let-down of milk. Prolactin is the major hormone of milk synthesis and though it doesn't peak until closer to birth, it is present throughout labor. Endorphins are also released during labor. Oxytocin and endorphins are interrupted by pitocin and epidurals. [Essential oils, such as lavender, can also be used to release endorphins.]

Another benefit of labor are the contractions- which strengthen the uterus. Contractions also squeeze the babies lungs, helping to expel fluid along with the hormones that prepare the lungs for life outside of the womb. Among these hormones are catecholamines excreted by the adrenal glands of the baby, preparing them for the transition into life outside of the womb. The alertness of your newborn from these hormones also facilitates bonding, while the increase in white blood cells begins to build immunity.

Babies delivered via cesarean without labor are more likely to have respiratory problems; this could be due to not being ready for delivery, the lacking hormones and not having the lungs being squeezed by contractions.

Women undergoing cesarean deliveries without labor were more likely to develop a bacterial infection.(Resource: PubMed

On this Journey of Life we strive to give our babies the best start at life. One way to do that is to make educated decisions. Feet free to utilize the studies and information cited here while consulting with your preferred care provider in making the best decisions for your pregnancy and birth.

More in Why The Wait: Delayed Cord Clamping

Will you wait for labor to begin on its own?

Monday, July 8, 2013

Final Rules for Midwifery Scope of Practice and Licensing

Just so that you're all aware: The Final Rules for Midwifery Scope of Practice and Licensing in Arizona. Effective July 2014. -via Arizona Department of Health Services, filed rules

Wednesday, July 3, 2013

Don't Hate, Let's Educate {Birth}

Stop the Mommy Wars is derived from the concept that the only choices we have control over are our own. What another mom chooses is her decision – who are we to judge that?  We are each free to make our own decisions and we should support another mother in her own decisions, creating a stronger community.  While I fully believe this is an excellent idea to stop the growing trend of pop culture pitting moms against each other, I also feel we have other battles placed in front of us that must be confronted. So should we fight one another, insisting that each person is in the right? No: Don't Hate, Let's Educate.

Your birth, your way. I firmly believe that and as a doula abide by that; I support whatever kind of birth my client chooses.  Here's the catch- I educate my clients. They are making informed choices.

The problem lies, once again, in our misinformed culture. Fear is rampant!  Less than half of all expectant mothers will have taken a childbirth preparation course by the time they give birth. A good majority of those who do take a course take one in a hospital setting. In a hospital course you learn how to be a good patient. You learn some basics about the stages of labor but not what you need to know; not evidence based birth. You'll learn what your [medical] pain management options are but most won't tell you all of the risks of an epidural or that a doula helps to relieve your pain naturally and is associated with a more positive birth experience. They'll tell you the process of admitting you to the hospital but not tips to keep your labor from stalling; they have pitocin for that. They don't work to undo the fear that has been bestowed upon us by our pop culture and the collective memory we've built from that culture.  It's easy and cost effective when birthing mothers can be put into the system, boxed up and released.

But we are each individual mothers with unique births, bodies and babies- we deserve to be treated as such. Don't Hate the system because it treated you unfairly, Let's Educate and spread the word that this is a human rights issue; autonomy of choice. This is what I'm talking about!
home birth, gentle birth, birth quotes
A cause that directly affects the health and well-being of millions of women around the world. That cause is human rights in childbirth.
You, mother who doesn't research and just does as your told in the birthing room, I judge you. I judge you and I apologize for that but if we are to take back birth then there is no room for mothers who don't care. We need all the support and advocacy we can get because birth matters.

So is this OB vs Midwife? Hospital vs home? Technology vs nature? No! We can all respect one another. I will respect your choice to birth in the hospital with an epidural if you respect my choice to birth at home without drugs. I respect yours because I've researched yours. Have you researched mine? I'm not asking if you believe it, I'm not asking you to achieve it. I'm simply asking you to be informed. Understand that home birth is a safe option for a healthy, low-risk mother. It's OK if it's not the choice for you, I don't judge you; I simply want you to know that pregnancy is not an illness. I want you to know the epidural is not free of risks. Do you know the benefits and joy of natural birth? Or are you overwhelmed by fear of the pain we have been programmed to expect in childbirth?
"So many North American women have experienced the pain of labor, and then had an epidural, that our collective memory about birth is now full of hurt but is missing the feelings of ecstasy and success that natural birth provides." -Cynthia Gabriel

Our culture has been programmed to fear birth. When birth moved out of the home and into the hospital it became a mystery. Little girls no longer see birth as a normal part of life but as an illness that needs medical care. Everywhere you turn you see complications and pain and no mother wants to be the only woman in the birth circle talking about her blissful or ecstatic birth. Are you getting your information from the media? Are your friends, coworkers and complete strangers bombarding you with horror stories? What would happen if you surrounded yourself with positive birth stories? Have you considered finding a birth circle? Do you have a doula or other caring support persons?
childbirth education, preparing for birth, doula, midwife, 

Midwives may provide an excellent source or childbirth education but if you're getting your information from an obstetrician, you must understand that they are trained surgeons; they are trained to manage complications in birth! Don't be ignorant when choosing your care provider. Do you know your care providers birth philosophy? This should be one of the first questions you ask when in search for a care provider. You shouldn't have to settle or compromise. [<--Trigger warning]
Why is it that we get pregnant and call the surgeon! 

The United States spends $98 billion annually on hospitalization for pregnancy and childbirth, but the US maternal mortality rate has doubled in the past 25 years. The U.S. ranks 50th in the world for maternal mortality, meaning 49 countries were better at keeping new mothers alive.

So what's different here than in those other countries? Do they have better technology than us? No. What's missing here, in the United States, is the midwifery model of care. Only 8% of mothers are seeking a midwife for their prenatal care and birth. When are we going to catch on? When are we going to realize that birth is a normal life event. Not only does birth matter, mothers matter! It's not enough to merely say "the baby's healthy, that's all that matters."

There's not near enough of a concern for the rising cesarean rate. Can a cesarean save lives? Yes. Are all  these cesareans we're having necessary- not even close. The WHO recommends a cesarean rate below 15%; anything above that and our outcomes are not improving alongside of the rise in this major abdominal surgery. We are at a national average of 32%.

Take charge of your birth. Know what interventions increase your likelihood of a cesarean.
It is NOT ok that we are using pitocin to elictively induce labor.

Daily Med Plus

Don't Hate, Let's Educate. Surely, a mother who knew the risks of induction to her baby and to herself would not choose this. But as a culture, we have made pitocin far too permissible in birth and ignored the dangers of it. Roberto Caldreyo-Barcia, MD said,

Pitocin is the most abused drug in the world today.

We are disregarding the importance of mother nature and creating detrimental affects.
Infographic courtesy of Plumtree Baby

Beyond all of this, it's more than just this moment, this birth; pitocin impacts so much more. Michele Odent, MD first began exploring the desensitization of oxytocin receptors.
Oxytocin is the hormone of love and bonding and human connection. If the oxytocin system is damaged, or a child’s oxytocin receptors become desensitized, the ramifications are huge. Click here to read more about how pitocin impacts can be life-long. 
A recent ACOG survey found that in 43% of malpractice suits involving neurologically impaired babies, Pitocin was to blame. Is this really a risk you want to take because you're uncomfortable towards the end of your pregnancy? Of course not! But mothers are not being told of the risks and so we are overly seeking convenience. This "convenience" is affecting us as a society. This is what I am so angered by. I don't know your circumstances, I don't judge you; what I judge is ignorance. What I am enraged by is the lack of knowledge and respect for choices made surrounding birth. Why is this risk such an easy option to obtain but to VBAC you have to fight? You'll be told the risks of that and you'll be told in a way that makes you fearful, regardless that a vaginal birth may be a safer choice.
Fear mongering is not ok! Ever!

In conclusion: we must respect each women in the choices she makes for her birth and understand that she made the choice she felt best with the knowledge and support she was given. Don't Hate, Let's Educate. We need to stop bashing one another for the choices the other has already made and start reshaping the way our culture views birth. If we can influence the way we think about birth- trusting mother nature, understanding this normal life process- we can begin rethinking our choices and positively influencing future generations. But with so much negative influence from pop culture and a lack of prevalence in the midwifery model of care, where is a simple consumer to begin improving birth? [<---The answer here.]

Previously in Don't Hate, Let's Educate: Vaccinations and Baby Feeding
For more in evidence based birth to help you make informed choices, follow the Journey of Life.

What's important for your birth ?

Contact info

Jennifer Valencia | Labor & Postpartum Doula | 928.300.1337


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