Keeping the Umbilical Cord Intact

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.

One minute after birth

One minute after birth

cord begins to thin a little and not so tightly coiled

cord begins to thin a little and not so tightly coiled

Blood still travelling back and forth through the vessels

Blood still travelling back and forth through the vessels

Flow of blood  stopping----around 10 mins after birth

Flow of blood stopping—-around 10 mins after birth

Pulsing stopped and the jelly in the cord is collapsing.

Pulsing stopped and the jelly in the cord is collapsing.

Cord is thin after 15 to 20 minutes of being intact.

Cord is thin after 15 to 20 minutes of being intact.

Quote

“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.
Source: http://sarahbuckley.com/leaving-well-alone-a-natural-approach-to-the-third-stage-of-labour

Birth of Twin Deer caught on film

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

Debbie captures birth of twin deer

Debbie captures birth of twin deer

Twins born this morning right outside my backyard window

Posted by Debbie Parlette on Tuesday, 19 May 2015

Be sure to click on the highlighted DATE, not Debbie’s name.

MIDWIFERY CARE FOR THE VBAC WOMAN

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.

Prenatal Preparation

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.

Keeping a VBAC normal

Keeping a VBAC normal

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.

Postpartum Differences

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).

    Q & A: 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.

Be Careful About Iron Supplementation in Pregnancy

This is a question that comes up a lot in pregnancy. . .”What kind of iron supplements should I be taking? My practitioner says I’m anemic.” It turns out that a lot of practitioners mistakenly diagnose anemia based on old information and lack of understanding of the physiology of the pregnant woman.

This information from Dr. Michel Odent is very helpful:

    Question for Dr. Michel Odent:

My hemoglobin is now 11.4 in week of gestation 19. A friend of mine has 7.8. Do I have to take ferrum? Is there a hemoglobin-limit?


    Answer from M. Odent

It is probable that from now on your hemoglobin concentration will decrease. The placenta – which is ‘the advocate of the baby’ – will send you hormonal messages so that you dilute your blood in order to make it more fluid. Your blood volume will increase dramatically (up to 40% to 50%). Although you’ll still have the same amount of hemoglobin available, its concentration in your blood will be lower if the placenta is working well. The most authoritative published study on this issue involved more than 150 000 thousands births (Steer P, Alam MA, Wadsworth J, Welch A. Relation between maternal hemoglobin concentration and birth weight in different ethnic groups. BMJ 1995; 310: 389-91). According to this huge study a hemoglobin concentration between 8.5 and 9.5 during the second half of a pregnancy is associated with the best possible birth outcomes. Furthermore, when the hemoglobin concentration fails to fall below 10.5 there is an increased risk of low birth weight, premature birth and pre-eclampsia.

The regrettable consequence of misinterpreting this test is that, all over the world, millions of pregnant women are wrongly told that they are anemic and are given iron supplements. There is a tendency both to overlook the side effects of iron (constipation, diarrhea, heartburn, etc.) and to forget that iron inhibits the absorption of such an important growth factor as zinc. Furthermore, iron is a powerful oxidative substance that can exacerbate the production of free radicals. The disease pre-eclampsia is associated with an ‘oxidative stress’. Pregnant women need antioxidants (provided in particular by fruit and vegetable) rather than oxidative substances.

You should print the abstract of the study I mentioned (you’ll find it via PubMed, for example) in order to be in a position to discuss with practitioners who might tell you that you are anemic and that you need iron supplements. Don’t take iron supplements as long as your iron deficiency has not been proven by specific tests (ferritin in particular).

I cannot comment on the hemoglobin concentration of your friend, first because I don’t know if she is at the beginning or at the end of her pregnancy, and also because data regarding her lifestyle and data provided by a clinical exam should prevail upon the results of one laboratory test; this test should probably be repeated and completed, according to the context. (end of Dr. Odent’s comments)

425pregnant.jpg

Here is the link to the study he talks about:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2548871/
_______________________________________________________________________
________________________________________________________________________________

This study is another piece of the puzzle that more women should know about:

University of Turin researchers have found that women who take iron
supplements during mid-pregnancy have a higher risk of gestational diabetes,
hypertension and metabolic syndrome. The study assessed iron
supplementation, along with other factors, for 1000 women-half with
gestational diabetes and half with normal glycemic levels-between 24 and 28
weeks gestation. Of the women studied, 212 were taking iron supplements,
mostly in the form of ferrous sulphate.

The researchers concluded, “Routine iron supplementation in pregnancy is a
matter of controversy and debate. The increasing reporting of harmful
effects for unnecessary iron supplementation should be carefully considered.
Further studies on larger cohorts are warranted to confirm these results,
but glucose values should at least be monitored in iron-supplemented
pregnant women.”

The full report can be accessed online at:
http://www.ajog.org/article/PIIS0002937809004438/fulltext

– American Journal of Obstetrics and Gynecology, 201(2): 158.e1-6, 2009

The Herbal Bath

This is something I have had in my files for many years. I’m posting it for those who are interested. The only time I have prepared all these herbs, we had them “cooking” while the woman was in the birth process. She didn’t like the smell so we had to interrupt the process, take the big pot outside and get the house cleared of the smell. So, lesson learned, don’t do this during the birth. I’m not in agreement about the idea of getting a woman into a bath to stop excessive bleeding or the idea of opening the labia and swooshing bath water into a post partum vulva. Actually, there are lots of ideas in here that I don’t go along with but I thought you might like to read this handout from around 1985.

I’m sorry I don’t know the source of this to credit the author. Gloria Lemay

Beginning of the quote:

THE HERBAL BATH
This bath mixture should be prepared, strained and put together in a large container ready for the bath. Remember, this bath is also used as treatment for heavy bleeding, and must be ready for immediate use if necessary. A quart or two of strong shepherd’s purse and extra comfrey (fresh if possible) should be set aside for internal use and for adding to the bath if needed.

¼ C sea salt
1 ounce Uva Ursi
1-2 ounces Comfrey
½ – 1 ounce Shepherd’s Purse
1 large bulb fresh garlic

Have ready for emergency use:
2 quarts strong shepherd’s purse tea
2 quarts strong comfrey (fresh if possible)
1 qt. alum root tea, or alum crystals

Simmer the tea and let set for some time before straining. Simmer the tea leaves again to get their full benefit. If you have garden fresh comfrey, do not simmer—use raw. Whiz it in the blender, strain and add to the tea mixture in a large container. Whiz the fresh garlic, add this and the sea salt to the mixture. Cover, label and set aside. Add to the warm bath water when needed.

This herbal bath is highly recommended for every woman following childbirth. There is absolutely no danger of introducing an infection, if the baths are done correctly. The garlic and sea salt make the bath solution aseptic. Uva Ursi is a specific for healing a woman’s reproductive organs. Comfrey contains alantoin, a cell proliferant, which causes the edges of wounds to grow together. It is very healing and soothing. Shepherd’s purse is excellent for preventing and controlling excessive bleeding.

The bath should be taken shortly after the birth. If the placenta has not been expelled, and you would like to get in the bath, you may do so. When you feel a contraction coming on –squat over a bowl and push it out.

A warm bath to soothe after the birth.

A warm bath to soothe after the birth.


The water should be comfortably warm, but not hot. The water should be about hip level. Lie back, spread your legs and swoosh the healing waters up inside the birth canal. Thirty minutes should be the minimum time in the bath. You will find the bath very soothing, relaxing and rejuvenating.
The baby should be put in this bath with you. The herb bath will start the healing process of the cord stump, and it may drop off as early as 3 days. In this bath, your baby will become mellow, and may even smile. He will unfold, stretch and float in the lovely weightless, warmness of the water. It’s wonderful to watch his pure joy at finding something so familiar and enjoyable in this new world. Caress and speak softly to him. He will love this communication, and will respond by total eye contact and facial expressions. When the infant is taken out of the bath, he should be patted dry, not rubbed. Dress him in soft, warm things. Put him to bed with you and let him cuddle up next to your warm body.

End of quoted material.

Oh Canada

Mulidzas-CurtisWilsonflag_n

I saw this piece of Canadian First Nations Art on Facebook and thought to myself, “Hmmmm, I love it and I also know a woman who has a flag manufacturing business. I should get them together.” I didn’t hear a thing about it after that and, today, I was tagged in a post on FB announcing that the flag is being produced. I am so pleased. . . what a wonderful age we live in where it’s so simple to network people who do excellent work.

Here’s what the artist said:
Mulidzas-Curtis Wilson (facebook account name)

Gila Kasla-Greetings,

It has been a long time coming…but I would like to announce that my rendition of the Canadian Flag is finally going to be produced into an actual flag that can be hung and flown. I have been working with The Flag Shop based in Vancouver and they will be producing the design on a flag that measures 27″ x 54″. The flag will be screen printed on 200 denier nylon. It will be finished with rope and toggle in the sleeve, which is the standard way flags are finished in Canada.

These flags will be available at the beginning of March through their website and also through their 13 stores across Canada (Vancouver and 12 others). They offer shipping all over the world. These flags will be sold for $79.95 and I am posting this to get an idea of who would be interested in ordering a flag. If you or someone you know is interested in purchasing a flag, would you please send me a private message? Email info@curtiswilson.ca

Gila Kasla-Thank you

If you know someone who orders flags for civic functions, please have them consider this one. Let’s get some publicity going for this project, too.

New: Class series on WizIq begin soon

New, Live Online Midwifery Classes on WizIq

http://onlinemidwiferyed.blogspot.com/2011/09/midwifery-101-live-online-classes-on.html
Midwifery 101, Classes begin on Thur April 19, 2012 and continue to the end of August 2012. $150 for 20 live, online classes with Gloria Lemay, 60 mins long.

http://onlinemidwiferyed.blogspot.com/2011/09/midwifery-102-continuing-classes.html

Midwifery 102, Classes also begin on Thur April 19, 2012 and continue to the end of August 2012. $89 for 10 live, online classes with Gloria Lemay, 60 mins long.
These classes are designed for students who have completed the Midwifery 101 course.

For times and lots more information on how to join WizIq and a free sample of a class, see the links above. Feel free to share this post.

Thank you for a great series of classes. I always laugh when I watch you and have enjoyed these classes so much. I have learned a great deal about how I hope to practice. Your love of your work shines through when you teach and I admire your respect for the women you serve. Trista Tetro