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I don’t know who these photos belong to or any details of the birth. I love the way she throws her head back when the head is crowning. That coaching we see so often to “tuck the chin down to … Continue reading
It’s a special thing to have a baby in North America at Christmas time. Photos of the new baby under the tree with the gifts, extra time off from work, a time of holiness joy and good cheer, . . . you would think it would be the ideal time to give birth. Unfortunately, many little newborns end up in hospital at this time due to the timing of their arrival.Photo credit http://www.gracemogadamphotography.com/2015/05/08/newton-newborn-photography-william/
1. This is sugar time. The chocolate, cookies and candies are everywhere you look and sugar undermines the immune systems of the family members leading to colds and flu.
2. Staying up late. Parties given by neighbours, school, church, etc., tend to go late and the older kids in the family are affected and can get sick at this time by the late nights AND THE SUGAR.
3. The pregnant parent is either nesting in with the new baby or is hugely pregnant and doesn’t want to go to events, so the other parent takes the bigger kids and doesn’t pay close enough attention to the sugar or the late hours.
4. The children at school tend to be getting coughs, colds, flu and they spread it to the siblings of the new baby. Those older siblings sneezing or coughing on the new baby leads to trouble.
5. Christmas travel. A lot of pressure can be put on the family of a new baby to drive 100 miles (or more) for Christmas day family dinners. No matter how much the family thinks this is a good idea, IT IS NOT. The newborn should be kept warm and cozy at home because those long car trips are exhausting, no matter how much planning happens in advance. The nursing parent has to take care of her breasts/breast milk supply. All this is best done at home.
If the breast feeding gets thrown off at this season of the year, it can result in the newborn baby failing to thrive and/or the nursing parent getting mastitis, sore cracked nipples or a diminished production of milk.
What can you do to make sure that your new baby stays out of the hospital during this season?
1. Screen all visitors by asking them “Are you sure you are completely well? We don’t want any bugs around the new baby.”
2. Buy lots of grapefruit, kiwi fruit and oranges and make them the whole family’s dessert through this time. Keep a big bowl of this healthy Vitamin C-packed fruit out and visible. Keep stocking it up. Don’t bring sugar-y foods into the house.
3. If you have older kids in school, pay close attention to their diet and sleep. Keep them healthy. Both parents need to be responsible and communicate with each other about this.
4. Both parents need to watch their own health. Stay away from alcohol, take your vitamins, keep your schedule calm, have afternoon naps, avoid annoying people, etc.
4. Take a year off from the hype and pretend you’re in a stable with cattle lowing. In the big scheme of things, you’ll be glad you did. Have a really peaceful Christmas giving thanks for the miracle of your very own healthy newborn Christ child.
These photos are a great demonstration of how the placenta, cord and baby keep working together after the birth when left intact. They were donated by a family to their midwives and I share them here with permission. If you’d like to see them on the original website, the link is http://www.nurturingheartsbirthservices.com/blog/?p=1542
The first picture was taken within the first minute or so of the birth….and then, pictures were taken “every so often” about every 3-5 minutes when the cord had changed a little more. The last picture was taken about 15-20 minutes after the birth.
Please credit or link to the original website if you share any of these photos. Thanks, Gloria.
“Adaptation to life outside the womb is the major physiological task for the baby in third stage. In utero, the wondrous placenta fulfills the functions of lungs, kidney, gut and liver for our babies. Blood flow to these organs is minimal until the baby takes a first breath, at which time huge changes begin in the organisation of the circulatory system.
Within the baby’s body, blood becomes, over several minutes, diverted away from the umbilical cord and placenta and, as the lungs fill with air, blood is sucked into the pulmonary (lung) circulation. Mother Nature ensures a reservoir of blood in the cord and placenta that provides the additional blood necessary for these newly-perfused pulmonary and organ systems.”
Sarah Buckley, M.D.
CHEAT SHEET FOR PARTNERS
This is a brief list of ways to make a big difference for the woman who is breast feeding. Do one, some, or all, everything matters.
1. When the breast comes out, you run to get a big glass of something for her to drink. (Trust me, the minute the baby latches on, her throat will go dry).
2. Find (or buy) a low foot stool for her. (Rubbermaid makes a good one and Ikea has a cheap, functional one). Putting her feet on a stool brings baby up to the breast so she doesn’t have to hunch forward.
3. Watch her shoulders, if they are hunched forward, she’s not relaxed. Find some soft pillows to bring baby up higher or support her arms. She’ll forget about this so you keep on top of it.
4. Tell her what you authentically appreciate about her feeding the baby. E.g. Thank you for all you do to make our baby healthy. You look so beautiful when you’re feeding the baby., etc etc.
5. Put a snack beside her, she needs extra calories to produce milk. A plate of sliced apples, toast with almond butter, cheese and crackers, etc.
6. While she’s feeding, scan the environment she’s looking at. When she’s sitting, you’re moving. Empty the trash, clear the clutter, mop the dust bunnies, water the plants.
7. Give her a shoulder massage.
The partner being an active participant in the breast feeding support can strengthen the family. Please add your ideas in the comments section.
1. Start with giving the birthing woman antibiotics in high doses so that the baby develops candida (thrush) and colic. Then mix in a lot of stitches, either to repair the perineum or the lower belly/uterus.
2. Separate the mother and newborn. Make the mother walk a long distance (with her stitched body) to be able to see/feed her newborn.
3. Teach her that the best (and only) way to feed her baby is to sit upright in a chair
4. Discourage sleeping together as a family. Don’t let her know that lying down to nurse will enable her (and her partner) to get much more sleep.
5. Tell her that the baby is not getting enough milk and don’t give her the tools to increase her supply.
6. Scare her into thinking that her instincts about caring for her baby are not to be trusted and that she should listen to professionals for all things to do with her baby’s health.
Journal of the American Medical Association
JAMA Original Investigation | June 01, 2015
Adverse Events After Routine Immunization of Extremely Low-Birth-Weight Infants FREE ONLINE FIRST
Stephen D. DeMeo, DO1; Sudha R. Raman, PhD2; Christoph P. Hornik, MD, MPH1,2; Catherine C. Wilson, DNP, NNP-BC, FNP-BC3; Reese Clark, MD4; P. Brian Smith, MD, MPH, MHS1,2
[+] Author Affiliations
JAMA Pediatr. Published online June 01, 2015. doi:10.1001/jamapediatrics.2015.0418
Importance Immunization of extremely low-birth-weight (ELBW) infants in the neonatal intensive care unit (NICU) is associated with adverse events, including fever and apnea or bradycardia, in the immediate postimmunization period. These adverse events present a diagnostic dilemma for physicians, leading to the potential for immunization delay and sepsis evaluations.
Objective To compare the incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death among immunized ELBW infants in the 3 days before and after immunization.
Design, Setting, and Participants In this multicenter retrospective cohort study, we studied 13 926 ELBW infants born at 28 weeks’ gestation or less who were discharged from January 1, 2007, through December 31, 2012, from 348 NICUs managed by the Pediatrix Medical Group.
Exposures At least one immunization between the ages of 53 and 110 days.
Main Outcomes and Measures Incidence of sepsis evaluations, need for increased respiratory support, intubation, seizures, and death.
Results Most of the 13 926 infants (91.2%) received 3 or more immunizations. The incidence of sepsis evaluations increased from 5.4 per 1000 patient-days in the preimmunization period to 19.3 per 1000 patient-days in the postimmunization period (adjusted rate ratio [ARR], 3.7; 95% CI, 3.2-4.4). The need for increased respiratory support increased from 6.6 per 1000 patient-days in the preimmunization period to 14.0 per 1000 patient-days in the postimmunization period (ARR, 2.1; 95% CI, 1.9-2.5), and intubation increased from 2.0 per 1000 patient-days to 3.6 per 1000 patient-days (ARR, 1.7; 95% CI, 1.3-2.2). The postimmunization incidence of adverse events was similar across immunization types, including combination vaccines when compared with single-dose vaccines. Infants who were born at 23 to 24 weeks’ gestation had a higher risk of sepsis evaluation and intubation after immunization. A prior history of sepsis was associated with higher risk of sepsis evaluation after immunization.
Conclusions and Relevance All ELBW infants in the NICU had an increased incidence of sepsis evaluations and increased respiratory support and intubation after routine immunization. Our findings provide no evidence to suggest that physicians should not use combination vaccines in ELBW infants. Further studies are needed to determine whether timing or spacing of immunization administrations confers risk for
the developing adverse events and whether a prior history of sepsis confers risk for an altered immune response in ELBW infants. http://archpedi.jamanetwork.com/article.aspx?articleid=2300376&utm_source=silverchair+information+systems&utm_medium=email&utm_
Source: this blogpost http://www.jeffereyjaxen.com/
Obviously our little guy is not getting circumcised (unless he decides he wants to when he’s older and can make that decision independently) but I was wondering how to go about cleaning him, moreso when he is a bit bigger, but like I have heard you are not supposed to pull the foreskin back, but surely at some point that will need to happen to clean in there right? I don’t want to hurt/harm him, but i want to make sure that area doesn’t get full of bacteria. What is your advice on this?
Oh, so glad you asked, Karin. Right now, and until he is about 4 years old, his foreskin is actually attached to the glans just as the fingernails are attached to the nail beds. You only clean what is seen. Never retract the foreskin or you could damage that natural attachment and don’t let any medical professionals do it either.
When he’s about 4, he’ll reach into his pants and find that “toy” and then he will start playing with it. (They continue that till about age 80). That is the only way that the foreskin should come back—the boy doing it himself. Most boys/men simply retract their own foreskin in the shower and rinse with plain water and replace the foreskin. That is all the cleaning that is needed. It’s very easy.
This is a link to the brochure that I give out to mother’s of boys as a pdf. http://www.nocirc.org/publish/4pam.pdf Congratulations on your new little son. Love, Gloria
Additional comment, June 12,2015 Bodies are designed for pleasure. Only a big meanie would deprive anyone of having fun with their own body. Part of my education on boys having fun with their toy came from my brothers. When we were little, my mom would plunk all 5 of us kids (we were 18 months apart in age) in the bathtub. My brothers would do very impressive tricks with their toys,– popping out the shiny purple surprise from inside the foreskin. There was no need for my mom to clean anything, All that bathtub play took care of things. Gloria
You’ll have to view this little two minute video of a mother deer giving birth to twins on FB by going to the date link below. Here’s a photo as a sneak peek. Gloria
Be sure to click on the highlighted DATE, not Debbie’s name.
Midwifery Care for the VBAC Woman
by Gloria Lemay
© 2001 Midwifery Today, Inc. All rights reserved.
[This article first appeared in Midwifery Today Issue 57, Spring 2001.]
Someone asked me recently what things are done differently with vaginal births after cesarean (VBAC) as opposed to a first baby. Midwives usually reply to this question with a reassuring, “Oh, we treat you normally,” but there are differences in the two situations that can be distinguished in midwifery practice.
The full history of the events leading to the cesarean is very important. With a VBAC client, ask her to get her operative record, nurse’s notes, anesthetist’s report, pediatric report—get all the records and go over them thoroughly. Often the couple did not get full or accurate information about what was going on. Sometimes there’s a little “clue” as to what went wrong that could help to prevent a cesarean from recurring. Sometimes there is a big chunk of information that didn’t get communicated. I saw one set of records where the only indication for the cesarean was the note from the obstetrician that “this woman is a natural childbirth fanatic.” Another set of cesarean records had no indicator whatsoever of why the woman received abdominal surgery when she had given birth at l9 years old. When she told her parents that the midwife was perplexed and could see no reason for the surgery, her father admitted to her that he had stayed in the visitor’s lounge all day and had been verbally threatening to the doctor: “If anything happens to my daughter, I’ll sue you!” This helped the daughter to understand what had happened to her and also helped her to be firm with her father that he was to be nowhere near her VBAC birth.
With VBAC births it is important for the midwife to work with the dad prenatally. A VBAC father is in a horrible position because, despite the fact that his wife had an operation and a long recovery, he still got a live wife and baby at the end of it all. VBAC dads are often “fantasy bonded” to the medical system and terrified of childbirth in general.
The good thing is that they listen very carefully and really know when the care is better and more thorough and when the practitioner is authentically on their team. I find that if the midwife talks to them very honestly, they can trust and be fully supportive when the birth time arrives.
If the woman has dilated past five centimeters in the first birth, I plan for it to be fairly fast—like any second baby. If the woman has not gone into the birth process or not dilated past five the first time, that’s all right, she’ll still give birth vaginally, but we have extra midwives on call to bring fresh energy if the others get discouraged or tired. We plan for it to be like going to two births in a row. The point that the woman reached in her first birth is often a psychological hurdle for her. If she dilated to six centimeters the first time, the news that she is seven or eight will be a relief and a breakthrough. One of our clients, a minister’s wife, said over and over again in her pregnancy: “I just want to feel what pushing is. If I only get to push, I’ll be happy. I just want to know what other women mean when they say they had to push.” She’d had a Bandl’s ring in the first birth process and the cesarean was done at five centimeters. We were praying that the complication wouldn’t repeat. She dilated smoothly and began to push. With each push she would exclaim “Thank you Jesus, thank you Jesus!” What a wonder it was to watch her push out the baby, a girl whom she named Faith.
All humans have a certain propensity to self-sabotage, and the VBAC woman must be on guard against her own defeating patterns. The midwife must be bold in pointing out ways that the woman is repeating dumb moves—there’s no place for us being “nice” if it will mean another cesarean. An example of this: If the woman had a cesarean with five support people, she will be cautioned to keep her VBAC private.
Privacy and quiet are a must, and we will be very forceful about setting up logistics before the birth so that the woman can birth in peace. In short, the VBAC is high priority because this woman’s whole obstetrical future rides on its success.
We show the couple lots of videos of beautiful VBAC births because one video is worth a thousand words. If you don’t have your own, purchase a copy of my dvd “Birth with Gloria Lemay” which shows a beautiful VBAC waterbirth. Art therapy is helpful in creating the environment before the birth day. I place a big sheet of drawing paper in front of the father and mother with lots of colored pencils and instruct them to, “Draw your birth cave” or, “Color your birth.” When they are finished, I write the date on the two drawings and put them away in my files. After the birth, we take them out and are amazed at the details that were drawn weeks before and later manifested in the actual birth.
I schedule longer appointments with VBAC women because they seem to need to obsess. I don’t have solutions to many of their fears but it seems to help to just be able to talk to someone who cares and understands. I usually also ask them to, “Tell me how you know that this time you’re going to have a vaginal birth?” The answers always amaze me. One woman said, “Because this time I’m not depending on my doctor or my midwives—me and my husband are going to have this baby.” I suggested that she give up depending on her husband, too. She looked terrified at that idea but I could see that she understood; she looked me in the eye and said, “Right!” That was the moment I knew she would do it. She’s had three water homebirth VBACs since then, and after each birth her first words were, “I did it.”
VBAC women are so grateful for the opportunity to birth normally that they are often shy to ask for the extra things that make a birth beautiful, such as a Blessingway ceremony or a waterbirth. The midwife must remember to offer and encourage the mother to think “really beautiful birth” rather than “bare minimum birth.” I find it helpful to ask, “This is the only second baby you will ever have—what would make it really special?”
The Day of the Birth
In my practice, no one gets induced in any way or gets pain medication. This policy is very important for all women but especially for VBAC women. If there is a small chance of uterine rupture, we must have everything on our side to prevent it (the rate of VBAC uterine rupture without induction is 0.4 percent or less than one in 200*). It is beyond my comprehension how anyone could give a VBAC woman misoprostol (Cytotec), oxytocin or castor oil or strip the membranes or use any other form of induction when that would triple her chance of having a uterine rupture.
I believe that VBAC women have longer, gentler births because Nature is compensating for the scar. There is no hurrying. I would be terrified to induce a VBAC woman but feel safe to attend her at home if her body is pacing itself naturally. We keep it in the back of our heads that the signs of rupture are stabbing pain, unusual bleeding, decels of the baby’s heart, or a peculiar shape of the abdomen but we don’t look for problems if they don’t exist.
We are especially careful with the birth of the placenta in a VBAC because there is a slightly increased chance that the placenta might be adhered to the scar, and we do not want to have a uterine prolapse caused by pulling.
After the birth, VBAC women need to be told that they can walk upright. They can’t believe that they can straighten at the waist right after giving birth. Then, they can’t believe it when we ask them to do sit-ups and leg raises on day one. Usually by day three when we go to visit, their husbands say, “Oh, she’s gone to the gym.” With VBAC women, the complaints are very few in the postpartum period because they are comparing to post-surgery pain and any minor scrapes and bruises seem like nothing.
In the years following the birth, these women and men send us more clients than anyone else, and if we’re in legal trouble, they’ll be at all the rallies, raise money, stamp the envelopes, write letters to legislators, and be our true friends for life. A VBAC is an amazing experience for the birth attendants as well as the family. Very Beautiful And Courageous (VBAC).
Two Types of Pelvises
by Gloria Lemay
Q: From a midwife: A great many Asian women are very small and small-footed, yet I hear that many of them birth vaginally. Would you comment on pelvic size?
A: When I get a VBAC client and she is endlessly self-psychoanalyzing and beating herself up for having a c-section, I usually say, “Look you made two big mistakes! First you were born in the wrong country, and second you were born in the wrong century—if you’d been born and raised l00 years ago in France, for instance, you would have given birth vaginally.” When I teach my workshops, I tell the students there are two types of pelvises in allopathic medicine: l) contracted, and 2) adequate. In midwifery, there are two types of pelvises as well: l) roomy, ample, and 2) you could get a pony through there!
Gloria Lemay is a Private Birth Attendant in Vancouver, British Columbia, Canada and a frequent contributor to Midwifery Today and The Birthkit.
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