We are excited today to share a guest post from Jennifer Margulis, PhD. An investigative journalist, activist for children and mother of four, she has gained increased recognition recently for her eye-opening new book, “The Business of Baby.”
(Photograph credit Jennifer Margulis)
When Taylor Hengen Newman had her baby at Mount Sinai Hospital in New York City four years ago she had just a few minutes with him, skin-to-skin, as she had requested, and then he was taken out of her arms to be examined by a pediatrician, weighed, have a PKU heel prick, and warm up in an incubator. The obstetrician instructed her to push harder to deliver the placenta.
Taylor and her husband then held their baby for about twenty minutes until he was whisked away by the hospital staff.
An hour went by.
A nurse came in to say the baby had fluid in his lungs and was under observation but no doctor came to talk to the worried young couple about what, if anything, was wrong. To her knowledge, her son was not taken to the NICU. Though Taylor kept asking for her baby she did not see him again for almost five hours.
“I couldn’t find a nurse to bring me a glass of water, let alone a lactation consultant. And I had no idea where my baby was,” Taylor remembers. “I felt so disoriented. And when he was brought back to me, bathed and smelling different, I wasn’t even sure he was mine.”
When my baby girl, who was born at Crawford Long Hospital in Atlanta, Georgia, was taken out of my arms I felt like someone had cut off my arm. I ached for her in a primal way I had never felt before. Every cell in my body wanted my baby in my arms, on my chest, by my side. We had spent the past nine months inseparable. Not every mom bonds right away with their baby. I wasn’t even sure how I felt about the funny-looking creature with the skinny frog legs and sticky outy ears. But I needed her with me as urgently as I needed to breathe.
That was 14 years ago. It still hurts to think about the time we spent apart because of “hospital protocol.”
Although every hospital follows a different protocol, in most American hospitals it is standard procedure to separate the mom and the baby just minutes after birth, wash the baby with some kind of commercial soap, and take the newborn out of the room to a nursery for observation. American babies also routinely have their umbilical cords clamped just seconds after birth, are given antibiotic ointment for their eyes to protect against venereal disease, have a vitamin K shot in their thigh to avoid blood clotting disorders, and are given a hepatitis B vaccine. Though the numbers are declining, the majority of American baby boys are also circumcised within a day of being born.
Does a newborn baby really need so much medical intervention in the first few hours of her life?
Should a healthy newborn be separated from her mother, the way it is routinely done in many American hospitals?
The short answer to these two questions is no. A healthy newborn needs no medical intervention in the first few hours of life. And in the absence of a real medical emergency, the safest, healthiest, best place for a baby to be is in your arms.
Babies needs skin-to-skin: More than half a dozen studies show that the outcome for mother-baby bonding and an infant’s health is better when a mother and a baby are not separated. Dozens more nonhuman mammal studies show that early, uninterrupted contact stimulates oxytocin and other hormones, which enhance nurturing and protective feelings. Nils Bergman, M.D., who has conducted several studies on infant sleep and maternal-infant bonding, points out that animal researchers separate newborn mammals from their mothers to study the damage separation causes on the developing newborn brain. Early uninterrupted skin-to-skin contact has been shown to reduce crying, improve bonding, keep the baby warm, and facilitate breastfeeding.
It turns out that when Taylor wanted her infant in her arms was not just Taylor’s whim, it was nature’s way of insuring her baby’s survival. When Bergman was working as a mission doctor in a rural hospital in Zimbabwe, Bergman found that the survival rate of low-weight premature infants jumped from only 10 percent to 50 percent when mothers were instructed to carry them skin-to-skin in pouches on their fronts. Survival rates for bigger babies jumped to 90 percent. That experience changed Bergman’s understanding of what human infants needed after they were born. “I realized that I was seeing the real biology of Homo sapiens at work, and that what I had learned at medical school was a result of modern culture equipped with amazing technology, but no understanding of human biology,” Bergman told me when I interviewed him for my book.
Do babies need antibiotic eye ointment?: The practice of putting silver nitrate in a baby’s eyes, which became popular in the late 19th century as a way to stop babies from going blind due to infection from gonorrhea, was discontinued after silver nitrate was found to be highly irritating, cause chemical pinkeye, and even cause blindness with incorrect dosing. Using antibiotic ointment in the form of a cream or medicated eye drops is a hold-over from that practice: the idea being that it will protect a baby from chlamydia or gonorrhea or other contamination from the mother’s vagina.
The use of this ointment is recommended by the American Academy of Pediatrics and mandated by law in many states. But if you have had proper prenatal care, you have been tested for any potentially contagious STDs. If you have had a C-section and your baby’s eyes have not come into contact with your vaginal canal, there is no proven way for your baby to contract an STD from you. As mentioned above, there is a growing body of evidence that shows that the vaginal and even fecal flora that your baby is exposed to during birth is crucial to the long-term health of his immune system.
The antibiotic ointment not only irritates a baby’s sensitive eyes, it also makes it harder for your nearsighted baby to see you in those crucial moments after birth when you and he are hormonally primed to gaze at each other and bond. In countries that have dramatically lower infant mortality rates and dramatically healthier babies in the first five years of life, including Norway, Sweden, and Great Britain, medicated eye drops are not routinely given to infants.
Babies don’t need the Hepatitis B vaccine: The CDC’s recommendation that every newborn in America get a Hepatitis B shot, regardless of whether his parents have Hepatitis B, is one of the most unfortunate medical mistakes of our time. Hepatitis B is a sexually transmitted disease. Heather Zwickey, Ph.D., a former vaccine developer who earned her doctorate in immunology and microbiology from the University of Colorado Health Sciences Center, did a postdoc at Yale University, and is now Dean of Research and Graduate Studies at The National College of Natural Medicine, explains that a newborn’s immune system can’t mount an effective response to diseases or vaccines because it is protecting the baby’s brain, which would be damaged by a full-fledged immune reaction the way an adult would react to a virus or bacteria. So newborns rely on their mother’s antibodies, which they get in breast milk, to give them the immune cells and proteins needed to combat infections. Until an infant’s brain is more developed—probably between nine and twelve months old—he will only have a mild, general immune response (the scientific name for this is a TH2 response), the sort we associate with allergies, but which doesn’t tailor any of the special white blood cells (called TH1 cells) to respond to a specific bacterium or virus.
A baby’s short-lived and immature immune response is the reason we give so many doses of vaccines in the first few months of life. Vaccines given before twelve months of age must be repeated at or after twelve months, according to Zwickey, because the immune system is not able to really learn anything from doses given before then. In nursing school, Michele Pereira’s instructors informed students that from an immunological standpoint it would be better to give vaccines to children when they are a bit older. But since parents less reliably bring children over a year old to the pediatrician, the best way for public health officials to ensure high levels of vaccinated children is to vaccinate them as early as possible. Zwickey believes early vaccination makes sense from a public health perspective but is not immunologically optimal. It is only after about twelve months that the immune system is sufficiently mature to have a memory. That is, a baby can develop antibodies in response to a vaccine, and these antibodies will stay in the bloodstream without needing booster after booster.
“Everyone who studies human immunology knows that the TH1 response doesn’t come up until the end of the first year of a human baby’s life,” Zwickey told me matter- of-factly when I interviewed her.
The birth dose of the Hepatitis B vaccine is completely unnecessary for the vast majority of newborns born in the United States. Your baby is not going to be engaging in intravenous drug use or unsafe sex and the chance of getting Hep B from a tainted blood transfusion in America is very low. But the birth dose of the Hep B vaccine is potentially very damaging. The immune system can sometimes mistakenly identify the body’s own cells as foreign, causing the body to attack itself. When the body inappropriately attacks its own proteins, a child develops an autoimmune disorder.
There has been an exponential rise in autoimmune disorders among children since the 1950s. One study found that cases of type 1 diabetes among children under five increased fivefold between 1985 and 2004. Graves’ disease, once unheard of in children, is becoming common. Other autoimmune disorders on the rise in American children include asthma, allergies, Crohn’s disease, and atopic dermatitis. One 2008 epidemiological study found that infant immunization leads to a statistically significant increase in type 1 diabetes in children.
Babies should not be bathed: We know from research published in Cellular and Molecular Life Sciences that the white creamy substance infants are born with (vernix caseosa) contains powerful proteins that have both antibacterial and antifungal properties. These proteins, researchers have found, contribute to an infant’s healthy immune system by protecting the fetus and the newborn against infection. As I’ve already mentioned, recent research has also found that as the baby journeys through the mother’s vaginal canal, he is inoculated with beneficial bacteria that will boost his immune system (babies born via C-section are colonized mostly by bacteria found in the hospital, a disturbing finding that scientists still aren’t sure how to interpret). What all this means is that when the nurses scrub your infant, they deprive him of the beneficial microorganisms and substances on his skin. The natural smell of a baby has further been found to stimulate the pleasure centers of the brain. Bathing a newborn interferes with bonding and with a human’s need to smell her baby. A baby bath can also chill an infant whose ability to regulate body temperature is still immature, according to Susan Markel, M.D., a Connecticut-based pediatrician who has been practicing for over 30 years.
And then there’s the soap itself. When the Safe Cosmetics Action Network tested a variety of brand name baby soaps five years ago they found that several contained 1,4-dioxane, a carcinogenic by-product that has been shown to cause cancerous tumors in over a dozen animal studies and has been banned in Europe. Consumers will not find the ingredient 1,4-dioxane listed on the bottle. Instead they will see “PEGs.” PEGs are made from polyethylene glycol, a petroleum-based compound that is often contaminated during the manufacturing process with 1,4-dioxine and ethylene oxide, another known carcinogen.
Johnson & Johnson’s Head-to-Toe Baby Wash, the soap used to wash newborns in most hospitals, contains PEG-80 and PEG-150 Distearate. Advertised as “gentle enough even for newborns,” “dermatologist-tested,” and “#1 hospital recommended,” Head-to-Toe Baby Wash also contains Quaternium-15, a chemical preservative that kills bacteria by releasing formaldehyde, another known carcinogen. Formaldehyde is the chemical used to embalm dead bodies to keep them from decaying. Johnson & Johnson changed their baby formula for the European market and parts of Asia virtually overnight. They also publicly committed to stop selling baby products with Quaternium-15 in the United States. But they haven’t.
When Taylor Hengen Newman became pregnant for the second time, she and her husband chose a home birth attended by midwives. By then her family had moved to Austin, Texas. The midwife handed the baby to Taylor right away. Taylor pushed out the placenta while her son cuddled on her chest. The midwife conducted the newborn exam so gently and quietly that it did not disrupt their bonding. Afterwards she rubbed Taylor’s feet with lavender oil. Otto was not given eye ointment or a Hepatitis B vaccine. He did not have a bath. They waited more than an hour to cut the cord, which they did just before Taylor got up to take a shower. This time they chose not to circumcise. Taylor’s doulas (she had two at the birth) brought her a smoothie and her husband a sandwich. Big brother Kaspar came in to see his new baby. The next day her midwife came back and gave Otto a Vitamin K shot since Taylor had been on blood thinners during the pregnancy.
“It all completely clicked that this was just a completely different way of caring for people, delivering babies,” Taylor says. “I wish medical care of all kinds could emulate this model.”
(Photograph credit Jennifer Margulis)
This article is adapted from The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby BEFORE Their Bottom Line. An extended discussion of after birth practices and relevant references for the article can be found in the book.
Jennifer Margulis is a Senior Fellow at the Schuster Institute for Investigative Journalism at Brandeis University and a sought-after speaker. Her fifth book, The Business of Baby: What Doctors Don’t Tell You, What Corporations Try to Sell You, and How to Put Your Pregnancy, Childbirth, and Baby BEFORE Their Bottom Line has been called a “must-read” by Ina May Gaskin. Join her on Twitter, Pinterest , and Facebook
During your Birth Boot Camp classes, your instructor will teach the importance of your birth team. The birth team isn’t just mom and dad and their care provider, but includes many other helpful people such as a doula and a Chiropractor.
In our years of combined teaching, our instructors have found that employing a skilled Chiropractor can make a world of difference in a woman’s birth. From simply increasing comfort during pregnancy, to aligning the body so that a baby can turn itself into an optimal position, Chiropractic can make a huge difference in achieving a vaginal, unmedicated birth.
In fact, Jeanne Ohm, DC says, “Chiropractic care throughout pregnancy balances her pelvis, eliminating undue tension to muscles and ligaments and potentially enhancing optimal fetal positioning.” Who doesn’t want a pregnancy that feels better and has the benefits of a better positioned, head down, baby?
But if Chiropractic during your pregnancy is so important, how do you find one who knows how to work with pregnant women? There are Chiropractors who specialize and have received extra training in order to work with pregnant women appropriately and safely. They, typically, use low force techniques such as Webster.
A good place to start is the website for the International Chiropractic Pediatric Association or ICPA. The ICPA is a non-profit organization that promotes and educates Chiropractors in the healing of women and children and provides research in this same area.
If you are pregnant and looking for a chiropractor (or have children and would like someone skilled in adjusting children), you can find Chiropractors specializing in pregnancy on the ICPA website.
ICPA offers many continuing education opportunities for Chiropractors including a 360 hour diplomate program and a Webster Technique Certification. This knowledge gives a Chiropractor the ability to gently adjust a pregnant woman, helping to align her pelvis and ease ligament strain so that her birth can be as optimal as possible. Many ICPA chiropractors are also very skilled in adjusting children and infants.
If you have perused the list above for ICPA practitioners in your area and none are available, the next best course of action is to talk to local birth professionals. Midwives often have Chiropractors that they recommend whom they have found get good results, helping their mothers have more comfortable pregnancies and births. Your childbirth educator or doula may also have some good suggestions. Talking to other birthing women in your area may also prove useful.
Employing a skilled doctor of Chiropractic to assist you throughout your pregnancy is a must on your list of labor preparations. Some chiropractors are even open to visits during labor and have miraculous results. When preparing for a natural birth, doing everything we can to optimize our chances gives peace of mind and a better experience.
Find your local pregnancy Chiropractor here:Kristen Hosaka, DC and Ceci Jane Massa for the use of their photographs for this article. Dr Kristin Hosaka practices in the Burleson, TX area and Ceci Jane is a well known birth photographer and videographer in DFW.)
*Please note that there are affiliate links in this post.
For new parents, one of the most frequently asked questions is “Are you getting any sleep?” What is a new couple to do when everyone wonders how you and your baby are “performing” in this area? Here are a few simple tips that can help in those early days without resorting to less “baby-friendly” methods.
Understanding the basic needs and patterns of a newborn is very helpful. This does not sound like a tip to help baby sleep, but it will guide you and lend wisdom. Flexibility and realistic understanding of newborn needs can help your baby make more sense to you. Newborns do need to eat frequently and this does not last forever. Some of the things below can, however, gently increase sleeping stretches or calm a needy baby. As their stomach grows and milk increases, sometimes infants will have longer stretches of sleep, but pushing for that too early can stress everyone involved. For a newborn, sleeping through the night probably means about a three hour stretch. This increases! Don’t worry! When you hear people complaining that their two month old won’t sleep for ten hour stretches, remember that they are only two months old. This is a very young baby and they will require some patience.
Babies also experience growth spurts and these may cause an increase in wakefulness which can be jarring, but will often pass within a few days. Developmental milestones such as crawling or teething can also disrupt sleep patterns. Read what you can about infant needs and development. It will help in understanding what is normal behavior even if it does not involve long stretches of sleep.
Nursing or feeding your baby can be a great way to help them sleep. Babies have small stomachs- about the size of a marble at birth- and their food is quickly digested. A newborn has just come from the womb where he/she was constantly fed through the umbilical cord. Your baby has never known hunger.
He will need to eat frequently in those early days and keeping him fed will often help baby be more calm and help with sleeping. Also, many babies find comfort at the breast and will nod off and settle after a feeding.
Swaddling is a fairly simple way to mimic the tight, safe feeling that baby was so used to when they lived within your body. Notice how a new baby will often startle when laid down on their back with nothing wrapped around them. This space all around them is simply not something they have felt before! Swaddling can help a baby feel secure, calm them, and aid in extending sleep a little longer. You won’t want to swaddle your baby all the time, but during their nighttime sleep and a longer nap it can be very helpful. Of course, do not over wrap or overheat the baby.
White Noise such as a vacuum, water noises, chatter from family, or even a noise machine can help a baby calm and extend sleep. The white noise can also help drown out sharp or surprising noises that may startle a baby from sleep. Just as swaddling helps a baby feel safe like they did in the womb, white noise might remind a baby of the gently lull of water noises they enjoyed before their birth.
Co-Sleeping is helpful for many moms and babies in extending sleeping stretches. Many newborns find great comfort from being near their mother; hearing her breathing and smelling her body as they rest. This can also benefit mom because she won’t have to fully rise and run to another room when the baby is hungry, but can reach over to the side-car, co-sleeper, or her bed if they bed-share, and quickly feed baby before they are fully awake or upset and crying.
Bed-sharing should always be practiced with safety in mind and there are many options and methods that may work for you and be safe for your baby. Never sleep with your baby in your bed if you have ingested anything that would make you less aware of their presence.
Movement is calming for many babies and can gently lull them to sleep. Every grandmother on the planet knows how to place a baby on her shoulder and gently rock, walk, bounce, or soothe him or her. Movement, like many of these other tips, reminds baby of their safe home before birth and can quickly help them calm. The yoga ball you may have used in labor can come in handy after baby as a great place to bounce baby to sleep without having to walk the halls endlessly. Common baby devices like swings or bouncers can also aid in this. And, of course, grandmother is always a great option!
Notice your baby’s rhythm after the first six weeks or so. While many push a strict schedule on a baby, experienced mothers know that babies will often settle into their own rhythm rather quickly. It helps if your own life has some routine to it so that baby can settle in around that. Babies often crave regular, predictable, rhythms. These things can be comforting to children as they grow and lend a sense of safety.
Many notice something like the following: Baby wakes around 6am and eats, then goes back to sleep for another hour or so. After waking at 7am the baby will be wakeful for a few hours then need a morning nap. This nap can vary greatly in length but may be as long as a few hours. (This is your time to SLEEP if you are behind!) After the morning nap your baby may be wakeful for an hour or two and then need an early afternoon nap. Often baby will take another evening nap after this for an hour or so and then be awake and alert and wanting to be held during dinner! Some babies will then go back down in the evening and sleep (sometimes) for one longer stretch- maybe even four hours! This might not be when you normally go to sleep, but it may be your best chance to get a big chunk of sleep. Don’t waste it! Babies often awake again around 10pm or so and may be up every few hours again throughout the night.
Of course this rhythm is not universal, but if you pay attention you will find that your child will develop his or her own little routine and helping support that and being aware of it can actually increase sleep and help you prioritize your time. Some babies will just be happier and less overstimulated if you keep to a simple home-life routine for the first few months of their life. Don’t feel bad if you are not trotting the globe! Baby is growing quickly and he or she (and you!) need rest for that important work.
Babywearing can be a beautiful combination of swaddling, movement, and closeness to mother. Many babies sleep well when in some kind of carrier, close to mom. Even when sick or overtired, babywearing can be just the thing to calm baby. If you do need to be out with baby, don’t forget your carrier so that they can still keep their sleeping rhythm while away from the house. While babywearing while away can be useful, don’t forget that some babies find the comfort of the home soothing and more conducive to sleep.
Car rides are something that many parents turn to when nothing else works. The rhythm and noise of the car will sometimes help a baby sleep when all else fails. If this is what works for you, don’t be afraid to use it on occasion! Obviously you can’t live in the car, but sometimes you just need to do what works.
Take a break! No matter what works or doesn’t work for you, don’t be ashamed to take a break. Maybe this will be when your partner returns home, or maybe you will need a mom’s group, babysitter, grandmother, or friend to help. If no one is around, sometimes, you might just need to set baby down in a safe place and walk away for a moment. An infant can quickly sense tension and a change in who is holding them may help them settle if mom is stressed and needs a break.
All mothers experience the frustration of sleep at some point with their newborn. This is almost universal. Don’t worry if you can’t figure everything out on day one, you are in good company. Take a breath, ask for help, and forgive yourself. You will learn as the baby grows and things will come together, in time.
Will all these tips work for you? Most likely not. That is OK. Take what works, try things out, and you will find the best solution for your family.
In the end, what other people always say about this time with a baby being short- it is true. Babies do not last forever, they soon grow and sleep stretches grow with them. The learning and the challenges change but the knowledge and patience you gain at this stage will help you in the years to come.
Additional reading that may be helpful to you:
Once you begin researching birth, you will probably stumble up the product known as Cytotec. Because of a powerful ability to cause uterine contractions, Cytotec has found its way into obstetric practice. What should you know about Cytotec before your birth?
Basic facts about Cytotec
Cytotec is a medication used to prevent gastric ulcers, specifically those caused by NSAIDS. Cytotec is not approved for use in labor induction, despite its common use. Cytotec is also known as Misoprostol or Miso and is a synthetic prostaglandin. Natural prostaglandins are produced and found in many places in the body, including seminal fluid, which helps show how Cytotec can act as a labor induction agent, like a natural prostaglandin might. Cytotec is also sometimes used in conjunction with mifepristone to cause abortion.
Cytotec and Labor Induction
Because Cytotec is a synthetic prostaglandin, it can cause uterine contractions. Because of this, it is frequently used in labor induction, both in and out of the hospital. Cytotec comes in pill form and is typically cut in half (since the pill is not intended for labor induction it is not dosed properly for such) and then inserted into the vagina and onto the cervix. The pill then dissolves quickly and contractions often begin. Cytotec can be given a variety of ways including orally, sublingually, rectally, and buccally.
Because the drug dissolves, it is impossible to remove once administered, as opposed to Pitocin, which is administered via IV and can be turned off or down, if needed. Still, some like to use Cytotec as a cervical ripener, often in place of (but sometimes in conjunction with) something like Cervidil or Prepadil.
Studies have been conducted comparing Cytotec to Cervidil (prostaglandin E2) and found that Cytotec caused quicker deliveries but increased hyperstimulation.
“Although misoprostol in women at term with an unfavourable cervix and intact membranes was more effective than PgE2 in achieving vaginal delivery within 24 hours, misoprostol does not reduce the rate of caesarean delivery either in all women or in the subgroup of nulliparous women, and it increases the rates of tachysystole and hyperstimulation.” (12)
It is interesting to note that the above study, in which Cervidil and Cytotec were compared in their ability to ripen a closed or “unfavorable” cervix, the primary outcome was cesarean, with the second most common outcome being hyperstimulation and tachysystole.
A Cochrane review had this to say about Cytotec useage:
“Sometimes it is necessary to bring on labour artiﬁcially because of safety concerns for the mother or baby. Misoprostol is a hormone given by insertion through the vagina or rectum, or by mouth to ripen the cervix and bring on labour. The review of 121 trials found that larger doses of misoprostol are more effective than prostaglandin and that oxytocin is used in addition less often. However, misoprostol also increases hyperstimulation of the uterus. With smaller doses, the results are similar to other methods. The trials reviewed are too small to determine whether the risk of rupture of the uterus is increased. More research is needed into the safety and best dosages of misoprostol. Another Cochrane review has shown that the oral route of administration is preferable to the vaginal route.” (13)
Despite the effectiveness of Cytotec in labor induction, there is still debate on proper doses and if it is the proper choice, as opposed to other induction drugs.
Cytotec and VBAC
Induction has long been questioned among VBAC (vaginal birth after cesarean) mothers. This is primarily because of the risk of uterine rupture being higher among VBAC mothers than those with an unscarred uterus, and due to the additionally increased risk of rupture when induction agents like Pitocin, Cytotec, or Cervadil are used. Combining a scarred uterus with a drug that stimulates the uterus is considered riskier.
“ACOG guidelines and other authors indicate that oxytocin use during VBAC is acceptable.” (11)
Sometimes, induction becomes necessary for VBAC mothers. When needed, it has been found that lower dosages of Pitocin is the best course of option and is preferable over Cytotec or Cervidil.
“While they [Cytotec and Cervidil] were initially considered safe for use during VBAC, current reports describe ruptures in approximately 2.5 percent of women after their use (one out of 40 cases).” (11)
These rupture rates are considerably higher than those in typical VBAC mothers. When induction becomes necessary for a VBAC mother, Cytotec and other prostaglandins increase rupture rates more so than Pitocin does.
Controversy Surrounding Cytotec
Any uterine stimulant (Pitocin, Cytotec, Cervidil) can cause hyperstimulation and even rupture of the uterus. In the natural birth community, Cytotec is particularly controversial. Known as a drug which has caused both damage and death in induction mishaps, many discourage its use.
Part of this stems from this statement by the FDA addressing induction and postpartum use of Cytotec:
“These [induction and postpartum hemorrhage prevention] uses are not approved by the FDA. No company has sent the FDA scientific proof that misoprostol is safe and effective for these uses.
There can be serious side effects, including a torn uterus (womb), when misoprostol is used for labor and delivery. A torn uterus may result in severe bleeding, having the uterus removed (hysterectomy), and death of the mother or baby. These side effects are more likely in women who have had previous uterine surgery, a previous Cesarean delivery (C-section), or several previous births.” (1)
Litigation regarding the drug has also been telling. While Cytotec is cheap and easy to administer, it has also been the subject of the largest medical malpractice suit to date. David Woodruff won a California family a 70 million dollar award against a hospital and HMO who administered the drug in an induction.(4) The induction ended with a baby badly brain damaged by the powerful contractions that resulted. The money was sought, in part, to provide continued care for the child.
This video clip tells the story surrounding this landmark case.
Stories of babies and women damaged or killed by Cytotec misuse, lawsuits, and the FDA’s lack of endorsement contribute to an overall distrust of this medication especially among those seeking natural birth.
Cytotec for postpartum
Despite the controversy surrounding Cytotec, the drug is useful in certain capacities relating to labor and birth, and is particularly helpful in stopping postpartum hemorrhage.
When used postpartum, Cytotec is often inserted rectally and can cause contractions of the uterus which can quickly staunch postpartum bleeding, thus preventing excessive blood loss and even death.
“A descriptive study showed that 1000 µg of rectally administered misoprostol, when given to patients who failed to respond to oxytocin and ergotamine, controlled postpartum hemorrhage within 3 minutes.” (8)
Some research has also found oral administration to be effective. However, it is generally recommended that better studied oxytonics, such as Pitocin, be used; although, Cytotec is thought to be a good option in third world countries.
Cytotec has the capacity to save lives, when used appropriately. As with all other drugs and interventions, overuse, unnecessary administration, and excessive doses can do harm.
Be sure to speak to your care provider and find out how they will employ this powerful medication in relation to your birth.
FDA Statement regarding Cytotec
Cytotec and VBAC:
Cytotec compared to PgE2:
Cochrane Review of Misoprostol use and safety:
We are excited to share today an inspiring birth story from a couple that took a live Birth Boot Camp class. Their story is wonderful, honest, and triumphant. The right birth team (including a doula!), a confident partner, and serious preparation can make a world of difference in your birth. Enjoy reading!
Nothing about my pregnancy was textbook. I had no morning sickness, suffered no constipation and my boobs were never sore. My appetite never changed and I had no weird cravings. In addition, I ended up giving birth to my son at 13lbs under my pre-pregnancy weight (and 7 weeks postpartum I am over 40lbs under my pre-pregnancy weight).
I said, many times, that if I hadn’t known I was pregnant, I wouldn’t have known I was pregnant. At 40 weeks, I was so content and comfortable in my pregnancy that I truly feel I could have stayed pregnant for several more months. I told a number of people this, and I received the most quizzical looks. I just felt SO GOOD.
So why did my doctor insist on judging me when I went in for an initial pregnancy confirmation? Why did she feel the need to tell me that I would likely end up with gestational diabetes, which would likely require induction or a possible c-section. Oh! That’s right! Because I’m plus-sized. Apparently a person can’t be plus-sized and healthy. I mean, obviously tipping the scales at 324lbs means I have high blood pressure, high cholesterol and eat a diet short in vegetables and high in fast food. Except, it doesn’t. I have never had a cholesterol problem, I have never had high blood pressure and I eat a well balanced diet with a homemade dinner every night.
The judgment I received from my doctors office, in addition to the free formula sample I was given at that appointment (as are all new parents,) solidified my already growing interest in having my baby at home under the care of a home birth midwife. And so I did.
My midwife is amazing. She had no judgments of me based on my size. She provided helpful tips to ensure that I would maintain my health, and the health my baby, during the pregnancy. She laughed at the way my doctor filed me away into a specific category. We celebrated a victory together when my gestational diabetes test came back just as we expected – negative. She high-fived me every time I weighed in a few pounds lighter than the time before, all while we watched my belly expand and baby grow just as he should. She and I knew that I was a prefect candidate for an intervention free birth.
As I approached the 40 week mark, I grew anxious to meet this little person that the mister and I had created. This little wiggle worm who never once kicked me hard enough to cause me pain. This perfect little person that had dozens of people already head over heels in love with him.
On Saturday April 13th (at 40w3d) I woke up in the wee hours of the morning with the most horrendous stomach cramps – much like when you have a stomach virus and absolutely MUST go to the bathroom RIGHT-THAT-SECOND. So I quickly waddled my way to the bathroom… except nothing happened. The sensation went away, to then be replaced by intense pressure in my lower abdomen. I thought, “well – this is interesting, and NOTHING like I had expected. Could this possibly be the start of labor??”
I waddled my way back to bed, and figured I’d try to sleep through whatever was happening. Except I was so excited at the prospect of this being IT that I couldn’t get back to sleep.
The pressure sensations remained, and sleep remained elusive, so I took myself downstairs to my couch – it’s the place I always want to snuggle up when I’m not feeling well. As soon as I settled down into it, I fell right asleep; waking every 15 minutes or so to another pressure sensation. At around 7am, I decided to go upstairs and let the mister know that we seemed to be onto something here.
He bolted out of bed with an enthusiastic: “IS IT TIME!?” and set to working on our list of things to
do in early labor, which included stocking up our bare fridge and pantry. I called my best friend, Seana, who was also my doula, as well as my midwife to let them know that there was SOMETHING happening. Seana said she’d be by in a couple hours to scope things out, and that I shouldn’t be surprised if it eventually stopped. The thought of whatever was happening suddenly stopping frightened me. My sister-in-law had 3 days of prodromal labor, and I was not keen on experiencing a fate similar to hers.
Sadly, after many hours of semi-regular pressure waves they started to be further and further apart. By 7pm that night, they were completely gone.
I went to bed certain that I’d have a repeat performance, so every time I woke during the night to pee. I silently scolded my body for not kicking labor into gear. When the mister and I woke up Sunday morning (April 14th, 40w4d) we were both disappointed that nothing happened. I decided to lounge in bed, while he went downstairs to make breakfast (can I just share that he is A-MAZE-ING).
About an hour after eating (scrambled eggs and whole-wheat toast with goat cheese, for those wondering) I bolted out of bed with the same urgency as the last time. Except, this time my bowels emptied themselves. Several times. Oh great, I remember thinking, I’ve caught some type of stomach bug!
I make my way back to bed and decide that sleeping the day away sounds completely justifiable. My body, however, had other ideas. The pressure sensations from the day before were back, and yet completely different. They were less pressure and more pain. Chris and I timed them for an hour before we decided we should notify both the midwife and Seana.
Since my contractions were only lasting about 30 seconds and coming every 7-8 minutes, we were instructed to call the midwife back when they were lasting at least a minute and coming every 5.
This is where my details start to get fuzzy… well, not the details, but their sequence of order. I remember my friend Emily stopping by with the potatoes we asked her to pick up for us (for the stew Chris was making for the midwives). I remember throwing up (several times!). I remember coming downstairs for a bit and I remember Seana coming by to time contractions and eventually leaving to tend to some errands she had. At some point, I went back upstairs to our bedroom (which had become quite cave-like with the drapes shut).
As the contractions increased in duration and intensity, I did whatever felt right to me. While I was downstairs I laid on the couch, but would jump up and walk over to our wall and lean against it, swaying my hips, with each contraction. While I was upstairs I did much the same, but would start off on the birth ball or the bed. Somehow I managed to pass out, more or less, and snooze hardcore in-between each contraction. Since the contractions came on in a wave-like sensation (meaning the sensation would start off very mild and build up into its full intensity, only to taper off again) I was always given fair warning before they got too intense.
I very much labored within myself, focusing solely on the sensation of the contraction and breathing/rocking/moaning through it. I didn’t want to be touched or talked to. Poor Chris; we had taken two different birthing classes to learn how he can help me cope with the intensity of labor and I wanted NONE of it.
Eventually the midwife came by to check on me. Since I had a colposcopy a few years back, she wanted to work out any scar tissue sooner than later, and it’s a good thing she did! Though I have no idea how long I’d been laboring at this point, when she came by I was only at a 1, but with some evening primrose oil and some massaging I popped open to a 3 with my next contraction.
My midwife then left, as I had a ways to go. I continued to labor in my own little world – pacing around the upstairs, leaning against walls, rocking on the birth ball. I just kept doing what I felt like doing. Eventually, though, I wanted to just curl up and sleep so I parked myself on the bed and stayed there until the tub was filled.
And oh happy day when the tub was ready! I parked my happy self in there and just floated in my little warm oasis between each contraction. Seana, bless her doula soul, gently poured warm water over my back, shoulders, neck, and chest and it was GLORIOUS! She and Chris took turns wiping my face with a cool washcloth, and after each contraction I was offered water (which was actually an electrolyte mix Seana made with essential oils and honey). I felt like a queen! Like a hard working queen.
At some point my midwife reappeared and checked me again, massaging my cervix some more. I was a 6 and with some massaging I opened to almost an 8. I had a cervical lip, so she instructed me to do some lunges with each contraction, which I wasn’t happy about, (I was still in the pool) but I diligently did with each oncoming contraction.
As the evening progressed, I realized I was hungry and hadn’t eaten for HOURS (no thanks to all my early labor barfing) and I asked for something to munch on. I nibbled on saltine crackers and honey, which helped to work out my jaw that had decided to seize up on me, and continued to joke and chat. I surprised even myself with my chatter and jokes, since I knew that (at last check) I was coming into transition… and I was DREADING IT. All my reading had told me that transition was going to be awful. Yes, it’s usually the shortest phase of labor, but it also tends to be the hardest. So I waited… and waited… and waited. Then I started to feel pushy with each contraction. When my midwife checked me again, I was good to go. Holy hell, I didn’t have a “the world is ending, rip this baby from my body, NOW” transition.
I started pushing in the birth tub… I THINK I was more or less squatting, but I really don’t remember. After some time, (since I had no concept of time, I really have no idea how long, exactly) I was asked to move from the birth tub to the birthing stool, since the tub didn’t seem to be working. I begrudgingly hoisted myself out of the tub and onto the stool.
When the stool wasn’t producing any results, I laid down on the bed and had a very hospital like experience. There were no stirrups, but I had two people holding my legs up and I curled my chin down onto my chest and pushed with all my might. When this still yielded no results, a grab bar was brought in and with my two legs being supported, a third person held the other end of the bar and pulled.
This continued for some unknown amount of time and I was getting exhausted. I knew it was sometime after 8pm, because the one and only time I asked for the time it was 8-something. What I didn’t know, is that it was also after midnight by then, and with only saltine crackers, honey and Seana’s electrolyte beverage fueling me, I had more or less reached my limit. In addition, my contractions were now double and triple peaking, so I was working MUCH harder than before. The team could tell I was getting too tired, and they tried all they could to motivate me.
Seana knew how much I was looking forward to reclining back on ANYTHING, since I had been avoiding it at nearly all costs for fear of a posterior baby. She kept telling me that “very soon you’ll be able to recline back as much as you like!”. Chris was a champ, telling me over and over again how much he loves me, and what a wonderful job I was doing. Though they meant well, they felt like words that have been said a thousand times to a thousand different women, and I found no encouragement in them.
I continued to push with each contraction, thankful that I had a few minutes in between, but complaining every time a new one crept up. I think I said, “Oh man, not again!” more times that night that I’ve ever said in my entire life! With each push that the water didn’t break, I was becoming more hopeful that little man would be born in the sac, which is a rather rare occurrence and has strong spiritual meaning in some cultures. Seana could see that the bag of waters was holding back my progress, and though she also wanted him born within it, she decided it was time to break it.
After a few more pushes with the grab bar, my midwife suggested I have a shot of vitamin B to boost my energy levels, as she could tell my pushes weren’t as effective as they had been earlier. Not one to want to prolong the entire experience, I quickly agreed and took the shot in the butt. I was then moved back onto the birth stool and I could instantly tell that the Vitamin B was doing the job. The contractions were much more intense (not more painful), though they were still double and triple stacked.
As I was pushing with all my might, I could hear Seana and my midwife discussing little man’s hair color, since they could see his head. OMG! We’re almost there if they can see his head! THIS was the determination that I needed, because within a few minutes, I felt a LOT of stinging (I recall more or less crying that it strung WAY too much) and then this release of pressure… not too dissimilar to taking a GIANT poop after being constipated for a few days.
I heard crying instantly, and there was a bustle of activity as little man was lifted up onto my chest for me to snuggle on.
Holy crap. I had just given birth.
Before I could even really let it all sink in, the activity picked up again and little man had his cord clamped. Though we had intended to do delayed cord clamping, his umbilical cord actually snapped on its own. We have absolutely no idea why, or how… they are quite strong. So for his to have literally snapped, (not to mention have several other gashes as well as some micro tears) is a mystery that we will probably never have an answer to.
After 17 hours of labor, including 2 hours of pushing, and a second degree tear (requiring a few stitches) Colin Christoper Avedano-Tucker was born into the hands of his Auntie Seana on Monday April 15th at 2:34a.m. We are absolutely smitten with our little miracle!
(All photos graciously contributed by Babymoon Birth Services in Sonoma County. You can find her here: http://babymoonbirthservices.weebly.com/ and here: https://www.facebook.com/Doula.Seana.)
Birth Boot Camp has been honored to have so many amazing instructors who can be found across the country. Today we want to recognize one of them, Debbe Canonne. Debbe certified as an instructor in September at our San Clemente, CA training.
Debbe volunteers as a doula with Heart & Hands, a volunteer doula program associated with the University of California in San Diego (UCSD). The UCSD Heart & Hands program strives to provide a doula for any woman who needs one birthing at their hospital. Debbe (who was also a doula at her own grandchild’s birth!) has volunteered for 675 hours with Heart and Hands and been present at a total of 42 births. Of those only 3 were cesarean sections, proof in and of itself that doulas are a powerful asset to a birth.
Here is a picture of Debbe with her plaque:
And here is a picture of the gorgeous ice sculpture commemorating the unique, service oriented, doula program that Heart & Hands organizes for UCSD.
Debbe is also a certified lactation education counselor. After attending births she saw how many women needed help with breastfeeding immediately after the birth. She says,
“Even though this is the most natural way to feed a baby and babies are born with innate actions that assist them in doing this (smell, rooting, sucking, head bobbing, etc.), it is still a learning experience for both the new mother and her baby. I became a certified lactation education counselor (CLEC) soon after joining Hearts & Hands to facilitate that learning.”
We love having Debbe on the Birth Boot Camp team. Not only is she one of the most fun and energetic people you will ever meet, her experience and tenderness make her an asset to any birth.
We love to hear why instructors chose to certify with Birth Boot Camp. Debbe says:
“I choose Birth Boot Camp because of it’s strong evidence-based curriculum and great class materials-including the breastfeeding DVD. As a CLEC, I was totally impressed with the information on that DVD for new moms.”
Debbe is truly a great lady who strives to serve women in her community. If you are looking for a childbirth class or a doula in the San Diego area, check her out. You can read more about Debbe on her website here- http://www.douladebbebirthingbasics.com/
Kudos to women like Debbe and organizations like Heart & Hands that are making knowledge and support related to birth more accessible for ALL women. We are glad to know you.
Every woman who gives birth will deal with postpartum recovery. Despite the universal nature of this time in our lives, we seem reluctant to talk about the realities of what happens and what we need to be more comfortable. Here are a few items and tips that you won’t regret preparing before the birth of your baby.
Pads and Diapers
Of course you need some kind of diaper for your baby, but unbeknownst to most women is how helpful grown up diapers are for mom. Women lose blood immediately after birth and it continues on for weeks. The time and heaviness of postpartum blood loss (or lochia) varies from one woman to the next and is often heaviest with the first baby.
Typically, blood loss will be heaviest in the initial days following birth and slowly decrease until it is mostly or totally gone by about the sixth week. Having a wide variety of pads (and yes a few pairs of mom sized diapers) on hand is a wonderful idea and one which will save your partner the awkward moment of trying to figure out what feminine products you might want during a midnight trip to the corner store.
Having an extra sheet folded and placed under your side of the bed for the first few weeks can also be helpful and save you from needing to wash all your linens each morning . Giving birth can produce a lot of fluids.
As mentioned above, there will be blood loss. (We recommend the diapers because they tend to ensure that blood won’t get on your bed.) In addition to blood loss, the first days of milk coming in can involve a lot of leaking, particularly at night. If you are practicing some form of safe co-sleeping or just have your baby with you intermittently in the night, there can also be spit-up in your bed. In addition to that, newborn diapers can, occasionally, be explosive. Sleeping with an extra flat sheet (folded in half or in quarters) can make it easy to just throw that in the laundry in the morning, when necessary, rather than stripping the entire bed.
With their tiny, ping-pong ball sized tummy, a newborn baby needs to eat frequently. You, by necessity, will spend a lot of time sitting and feeding that sweet and hungry little baby. Having a special “station” reserved and set up for just that can really relieve some stress. A basket full of your nursing necessities is a wonderful idea, as it can be easily moved wherever you end up feeding the baby.
Some things to include in your nursing station basket might be:
- Diapers and wipes for your baby. Babies often have a bowel movement after eating. Did I mention their little tummies?! Having something set up means that if you need to change them after they nurse on one side then you won’t have to get up and fumble around in another room for what you need.
- Snacks and drinks for mama. Every time baby eats, you lose some calories. And while it may be true that in our weight obsessed society, postpartum women are often pressured to lose weight immediately, you will need healthy calories, frequently. Stashing some healthy snacks can curb your cravings and help you avoid junk. Don’t forget the water- nursing takes a lot of your fluids and gives them to baby, so stay hydrated! You will feel better and it might even help with your milk supply.
- Lip balm. For some reason, sitting and feeding that baby can really make your lips feel dry. Having some lip balm on hand can make you more comfortable.
- TV remote, phone, or a book. Staring into the eyes of your fresh babe is a wonderful pastime and one not to be missed! Sometimes, you might want have some reading material, a show to watch, or even just have your phone on hand to communicate with others, when you do have the downtime that nursing requires.
For some women, breastfeeding is as natural as eating. For others it can be a bumpy road, especially in the early days. For this reason it can be incredibly important to have on hand some resources so that you have help when you need it most.
Books such as “The Breastfeeding Book” by Dr Sears, “Ina May’s Guide to Breastfeeding” or “The Womanly Art of Breastfeeding” by La Leche League International, are all wonderful resources that you can turn to in the middle of the night.
Local resources like the numbers for your local La Leche League, lactation consultant, or even some good friends who successfully nursed their babies will be invaluable. Never underestimate the help that a trained and experienced woman can do for your nursing relationship.
We also highly recommend our DVD, “Breastfeeding: the Ultimate MRE” because of it’s professional quality, fabulous interviews, and in-depth information from IBCLC, Mellanie Shepherd. This DVD is of amazing quality and can answer many questions, in case you don’t have typical local resources available to you. Not to mention, that video can make great entertainment while you sit and nurse! You can find our breastfeeding DVD on Amazon.
While your typical postpartum lists include only things that a baby won’t even remember like shoes, changing tables, and matching nurseries, you might find some more practical items to be even more helpful. A few, easy to put on, outfits for baby, like buttoned footed sleepers or sleep sacs can be great for those early days when baby sleeps and needs to be changed a lot. A baby carrier such as a sling or soft shelled carrier can keep even a fussy baby content while, at the same time, freeing up your hands for other work you need to do. Other than that, your baby won’t have many needs that don’t directly involve your love and attention.
A safe place for your baby to sleep is a necessity too, but needn’t be an expensive crib. Babies are often happier (and can stay closer to mom and dad) in a bassinet, a sidecar, or a co-sleeper. What is most important is that baby is safe, on firm bedding, and feels loved.
Nobody wants to listen to that sound advice, “Sleep when baby sleeps,” but it really is a good idea. Some comfortable clothes can really help you be able to snatch sleep when you need it. A few things that have some stretch and can be worn as your body returns back to its pre-pregnancy state really come in handy. Getting yourself a couple things that are both stretchy and make you feel cute might be a lovely investment.
The sage advice from experienced midwives to “Dress so that people won’t stay too long at your home,” might also be important to listen to so you don’t get too overtired in the first weeks when you really need to rest.
Figuring out who will do what in those initial weeks is incredibly reassuring. A house still needs to be run and kept in serviceable order so that everyone can eat and function, but mom should not be wearing herself out doing it, especially in the first few weeks. Whether dad, a close friend, grandma, or a postpartum doula helps out, make sure that the things you need are covered. A simple list of what needs to be done can be found in the final chapters of your Birth Boot Camp Field Guide. Fill it out. You won’t regret it.
When you have a baby, there is recovery involved. Being prepared for the things that nobody ever talks about can help you mentally, emotionally, and physically in the early postpartum period. Your health and happiness will make that transition from woman to mother that much easier.
It might sound a little messy, but the early days with a baby are short, intense, yet indescribably beautiful. Enjoy and prepare for them!
Birth Boot Camp® childbirth classes strive to prepare couples for natural birth. In an effort to continually improve our curriculum and provide the absolute best education available, we seek feedback from our students.
Our instructors are required to compile statistics from their students. As a company, we spend many hours reaching out to our online students to find out how their births went and their thoughts on the class. We compile all of the information we receive and use it to make updates and improvements.
At the time of this posting, we have received reports on 359 students, total.
Without further ado, we present the current Birth Boot Camp statistics:
In contrast, the national US C-section rate is 32.8%. (Source, CDC.)
The overall US epidural rate is 61%. (Source, CDC.)
We are excited that we can offer an education that can help families have the birth that they desire.
You CAN have an amazing birth! Education makes the difference.
Curious to learn more about Birth Boot Camp and our natural childbirth classes? We have an online birth class option and/or natural childbirth instructors in your area. We also offer a comprehensive, 2-disk breastfeeding DVD, “Breastfeeding: The Ultimate MRE.”