Circumcision: Basic Facts (Guest Post by Rachael Heiner)

Circumcision-Basic Facts (Guest Post by Rachael Heiner)

Circumcision.  It’s one of THOSE issues, hot button topics that really hit on people’s nerves and conversations get really heated, really fast.  When I first began researching circumcision during my first pregnancy, I found that it was very difficult.  It seemed like everything I found was either vehemently anti-circumcision or vehemently pro-circumcision.  It was not easy to find out just the facts, or for me to understand the way that circumcision is viewed in our culture today.

My goal today is to present some basic facts about circumcision.  I am not for circumcision as a routine procedure.  I also have two sons who are circumcised, and I didn’t come to where I am now until later.  I am happy to discuss my opinion and how I came to this decision, but my goal with this post is to present information without too much opinion.  Staying calm and caring during dialogues on this type of issues is very important to me.  Here’s why:  as soon as one party feels the need to turn defensive, they are physically unable to listen because their adrenaline is pumping and the body goes into fight or flight mode.  At that point, you are literally incapable of having a rational conversation and your only options are to fight, or end the conversation.  I hope that I can provide you with some basic facts about circumcision, and you can continue your research from there.

Circumcision FAQ

What is Male Circumcision?

Circumcision is the permanent removal of the foreskin from a boy/man’s penis.

What IS the Foreskin and What Does It Do?

The foreskin is a double-layered fold of skin and mucous membrane that makes up roughly half of the penis’s skin when left intact.  Though many people think of it as just an extra flap of skin, in an adult man the foreskin is 12-15 square inches of skin that contains about 20,000 nerve endings.  This post on Peaceful Parenting about the difference between a circumcised and intact adult penis is a great resource for comparison photos.

At birth, and into childhood, the foreskin is adhered to the head of the penis in much the same way a fingernail is adhered to the nail bed.  As children grow, the foreskin will begin to retract and un-adhere from the head of the penis.  This can happen anywhere between toddlerhood and late teenhood.  For almost 80% of boys, it will fully retract on its own by age seven.  There is no need to forcibly retract an intact foreskin.

The purpose of the foreskin is to protect the glans and opening to the urethra when the penis is not erect.  The foreskin is the male equivalent to the hood of skin that covers and protects the exposed portion of the female clitoris.  At maturity, the foreskin is fairly stretchable.  The foreskin helps to keep the glans, which is the primary sensory part of the penis, moist and protected.  In intact males, the glans is an internal organ.  The foreskin also helps facilitate sexual intercourse by providing a natural lubricant.

Is Circumcision Painful for Babies?

Yes.  Many studies have been done on pain reception in infants and preemies.  In a 2001 study on prevention and management of pain in newborns, researchers found that “NEWBORNS routinely experience pain associated with invasive procedures such as blood sampling, immunization, vitamin K injection, or circumcision.”  Though many doctors inject an anesthetic into the base of the penis before performing the procedure, a 1998 study found that only 45% of respondents said they used anesthesia for circumcision procedures.  It can be hard for babies to express their feelings.  Some infants seem to experience pain during urination after circumcision.  Babies experience pain, and circumcision creates a wound on the baby’s body.

How is a Typical Circumcision Performed?

Several methods of circumcision are practiced depending on the doctor.  The first step is for the baby to be restrained, usually on a specially designed board where their arms and legs can be strapped down.  Some doctors give a pacifier, sometimes with sugar water, for the baby to suck on.  After administering a local anesthetic by injection or topical cream, the doctor must separate the foreskin from the penis.  The foreskin is adhered to the head of the penis, so this involves placing something under the skin and moving it around to create a separation.  The doctor can then use one of several techniques to cut the foreskin off.  This page has some examples of circumcision devices.  Afterward, the infant’s penis will usually be covered with some type of ointment to prevent the raw area from sticking to his diaper or other skin, and wrapped loosely with gauze.  The procedure generally takes around 10 minute to perform.

Other options for circumcision outside the hospital include having the procedure performed by a Jewish Mohel, pediatrician, or pediatric urologist.

Here are two video examples of routine circumcisions.  By their nature, they are graphic:

How Many Babies are Circumcised?

In its 2007 report on male circumcision, the WHO estimated that 30% of men age 15 and over worldwide were circumcised.  According to the CDC, the rate of male infants leaving the hospital in the United States circumcised after birth has dropped 10% since 1979, and in 2008 stood around 56%.  It is difficult to get accurate data on circumcision rates in the United States because not all hospitals report their data – in fact, as low as 5% do, and even with those reports babies born and/or circumcised outside of the hospital setting are not accounted for.  Some estimate the circumcision rate in the US has dropped as low as 30%, and the rate is lowest on the Pacific Coast.

Circumcision rates vary greatly by geographic location, as can be seen on this chart of circumcision rates by state.  Based on government surveys from multiple sources, it is estimated that the hospital circumcision rate for Washington state is around 12%, and one of the lowest in the nation.  One noticeable trend on this map is that states where medicaid does not pay for circumcision tend to have lower rates.  It is possible that this is because medicaid influenced the market and fewer insurance companies in total will pay for the procedure in those areas, because people do not want to or cannot afford to pay out of pocket for the procedure, because people are paying out of pocket for non-hospital circumcisions, or for some other reason entirely.

Is a Circumcised Penis Cleaner?

A well-cared for penis is cleaner!  Whether circumcised or not, the only way to keep a penis truly clean is through good hygiene.  Sometimes, the misconception that intact penises are less clean comes from a misunderstanding about smegma.  Smegma is a combination of exfoliated skin cells, skin oils, and moisture that is white in color and sometimes looks ball-like or creamy.  Men and women both produce smegma, men under the foreskin, and women around the clitoris and folds of the labia.

Far from being unclean, the foreskin is self-cleaning (in the same way the vagina is) since smegma is antiviral and antibacterial.  No soap is required, just warm water, especially once the boy is older and the foreskin begins to retract on its own.  For babies and young children, all that is needed is the usual baths in clean, warm water to keep the area clean.  Since the foreskin is adhered, it is not necessary to retract or ‘get under’ the extra skin to clean it.

Is Circumcision Medically Necessary?

There are no health organizations in the world that support routine infant circumcision.  Many insurance companies no longer pay for it because it is considered a cosmetic procedure.

In 1999, the American Academy of Pediatrics revised their statement on infant circumcision, saying “Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.”  However, in 2012, they revised this statement again.  Their current statement includes the following:

“Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it.”

and

“Although health benefits are not great enough to recommend routine circumcision for all male newborns, the benefits of circumcision are sufficient to justify access to this procedure for families choosing it and to warrant third-party payment for circumcision of male newborns. It is important that clinicians routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner.

Parents ultimately should decide whether circumcision is in the best interests of their male child. They will need to weigh medical information in the context of their own religious, ethical, and cultural beliefs and practices. The medical benefits alone may not outweigh these other considerations for individual families.”

Effectively, they do not support the routine circumcision of infants, but at the same time their official stance is that the benefits outweigh the risks.

Risks and Benefits

When looking at the risks and benefits of any procedure, you must consider the numbers.  I will list common risks and benefits associated with circumcision, along with some statistics and links to further information.  Many of the numbers are very small, or have wide ranges, and unfortunately it is sometimes hard to assess their accuracy.  Because circumcisions are often performed in the hospital, and then babies are sent home, complications that arise may not ever be attributed to the circumcision procedure.  There is also no requirement on doctors or hospitals to report their circumcision rates.  When looking at statistics, always consider the size of the study, when it was done, and whether the outcomes were statistically significant.

What Are the Risks of Circumcision?

Studies estimate circumcision complication rates at anywhere between 0.1 to 35%, clearly quite a large margin.  Though some studies say that the risks of complications from circumcision are as low as 0.1 or 0.2%, The American Academy of Pediatrics says “the true incidence of complications after newborn circumcision is unknown.”

Risks of circumcision include:

  • Excessive bleeding (1 in 1,000) 
  • Infection (3 in 5000
  • Foreskin adhesion (7.8 in 100
  • Need for subsequent surgery (1 in 1,000) 
  • Systemic infection (1 in 4,000)  
  • Loss of penis (1 in 1,000,000) 
  • Death (as high as 9.01 in 100,000)

Other risks include too much skin being removed resulting in painful erections or restricted growth, too little skin being removed, and scarring.

In addition to the immediate physical risks of complication during circumcision, many studies have been done about the effects of circumcision that may be carried into adulthood.  These include possible links to premature ejaculation, sexual difficulties, decrease of sexual pleasure, lasting psychological effects due to trauma, and loss of sexual enjoyment (both for the man and his partner).  Reduced sensitivity is a given with circumcision because of the number of nerve ending that are removed during the procedure.  Some think that this leads to less satisfaction as adults.

What Are the Benefits of Circumcision?

Reduction in Rates of Urinary Tract Infection (UTI)

Some studies show that there is a decrease in the rate of urinary tract infections (UTIs) in circumcised boys.  Boys are significantly less likely than girls to develop UTIs and by age 5, only 1-2% of boys will have had a UTI.  Circumcision decreases the risk of a UTI by less than 1%, so though the procedure may help prevent UTIs, the decrease is statistically insignificant.  Additionally, in a 2005 study, researchers found that to prevent one UTI, two babies would experience complications from the circumcision procedure.

Reduction in Rates of Penile Cancer

The American Cancer Society’s official guidelines now state that circumcision should not be recommended as a sole way to prevent penile cancer, and that “In weighing the risks and benefits of circumcision, doctors consider the fact that penile cancer is very uncommon in the United States, even among uncircumcised men.”  Circumcision does seem to reduce the risk of penile cancer in some cases.  Penile cancer occurs in less than 1 man in 100,000 and accounts for less than 1% of cancers in men in the United States.

Reduction in Rates of HIV

Several studies have come out recently regarding the relationship between circumcision and reduction of HIV infection rates in Africa.  We must consider the fact that we live in the United States, so whether these studies are relevant to our situation is the first question.  The data is not always easy to interpret, and forming an opinion on the circumcision-HIV issue requires digging into some research.  The CDC has found that in the United States,circumcision does not affect the rates of HIV in U.S. men.  Here are some other links on HIV and circumcision:

Reduction in Rates of HPV

Human Papillomavirus (HPV) has come into the spotlight in recent years with the development of a controversial vaccine that is now being given to some teens.  HPV is the leading cause of invasive cervical cancer in women.  In terms of health, HPV has much more of a potentially damaging effect on females, but males are able to transmit the disease.  Some evidence suggests that circumcision reduces the transmission of HPV.    This study, done among heterosexual men on 5 continents, found that neither condom usage nor circumcision was associated with the HPV DNA prevalence.  In either case, it must be used in tandem with other safe sex practices.

Prevention of Phimosis

Phimosis is a condition where the foreskin is unable to retract.  Because a normal foreskin does not retract for many years after birth, a diagnosis of phimosis given at a young age should be carefully considered and possibly suspect.  The foreskin remains tight through puberty and this is a normal condition.  Less than 2% of adult males experience phimosis and of those, over 75% usually respond well to treatment with steroid creams.  Circumcision is a treatment for phimosis, however due to the low occurrence of phimosis in intact adult males, some doctors are starting to prefer it as a solution for only the most difficult cases.

Religious Circumcision

Some religions include circumcision as part of their faith or common religious practices.  Circumcision is practiced as a religious rite in Islam, called Khitan, and in Judaism the rite of brit milah is traditionally performed on the infant’s 8th day of life.  In all faiths, there are a wide berth of beliefs and practices.  Whatever your faith, it is up to you to decide what is right for you and your family, and how it will fit in with your faith.  Resources exist for those who are struggling with this question, including the Jewish Circumcision Resource Center.  The most prominent religion in the United States is Christianity.  Some think that the bible dictates circumcision, and others believe exactly the opposite.  Here are a few blog posts regarding Christianity and circumcision:

Social Circumcision

Many people have questions and concerns about the social aspects of circumcising vs. keeping their baby intact.  Some of these questions include:

  • Will my son get made fun of?
  • Shouldn’t my husband make this decision, after all, he’s the one with the penis?
  • Isn’t it better to do it now when he won’t remember it?
  • But his brothers are circumcised, won’t it be a problem if they’re not all the same?

For some responses to these questions that are really great, head over to Birth Boot Camp Founder, Donna Ryan’s blog, Banned from Baby Showers, and read her post about Social Circumcision.

More Circumcision Links

Here you will find some of my favorite blog posts and personal stories on this subject.  These are not necessarily objective, and reflect the personal experiences and opinions of the authors.

Additional Sources:

Male Circumcision:  Global trends and determinants of prevalence, safety, and acceptability (WHO 2007)

Urinary Tract Infections (kidshealth.org)

Centers for Disease Control: Male Circumcision rates based on hospital discharge information (1979-2008)

 
Rachael-web
 
This article first appeared on the blog, Ready, Set, Birth! and was written by Rachael Heiner, a natural birth teacher in Bellingham, Washington. Rachael has two sons and is one of our dedicated and beloved instructors. She blogs regularly at Born in Bellingham.
 
 

 

What should I take to my birth place?

What should I take to my birth place (or have on hand for my home birth)?

When you leave for your birth place, you want to have two types of things:

1)  all the things you will need for your birth

2) anything that will make you feel more comfortable during your labor

True, you might not use everything in your bag, but knowing it is there can be incredibly comforting!

Items for mom:

This is the big day!  Don’t be afraid to take the things that will make your experience more enjoyable.

Snacks for the birth- Honey sticks, granola bars, nuts, coconut water, or anything you might enjoy snacking on should be included.  Labor is hard work and it makes a mama hungry!  Not to mention, you may be very hungry right after the birth and want something from home.  Your Birth Boot Camp instructor will give you more great ideas of food and snacks for labor!

Comfort items- Only you know what will make you most comfortable, so include those things.  A favorite pillow, mellow music, a snuggly robe or warm socks (labor often makes your feet cold!)- whatever it is you need, pack it along.  You won’t regret it.  Of course, at Birth Boot Camp, we feel like one of the greatest comfort items you can have is a well trained doula to help you and your partner during the birth.  Class three will talk about how important your doula is.  Be sure to ask your instructor for her recommendations!

Comfortable clothes to wear after the birth-  You might not leave in your skinny jeans, but that doesn’t mean you shouldn’t take your favorite pair of comfy lounging clothes.  Some women even buy something special for them to wear after the baby is born; an outfit that opens easily for breastfeeding is particularly helpful.

Nursing bra or camisole- People vary in what they prefer, but something stretchy and easy is often helpful.  Sometimes even just a tank top with a built in shelf bra is perfect.  The first few days postpartum will probably result in engorgement in your breasts.  Something that will fit no matter what is a great idea.

Items for the partner:

Don’t just pack for mom!  At Birth Boot Camp we are about training COUPLES in natural birth and your partner is your best friend and biggest fan.  Make sure you pack them some things they will need for labor.

Snacks- Dad gets hungry too and you need him alert and fed so he can be the help you need.  What are his favorite packable snacks?  Throw them in there!

The Doula-  True, you can’t fit her in the bag, but a doula is a help for dad more than anybody else.  Make sure when your interview he is there too and that they have a good chemistry with each other.

Comfortable clothes- The partner needs to stay comfortable too!  A swimsuit so they can get in a birth tub or shower with you is a great idea, as is a change of clothes and something he can sleep in so he can stay with you at your birth place.

Technology- We don’t want the phone to interrupt the birthing “zone” but your phone, camera, ipod or anything else you might be using for music playing, preserving memories, or contacting loved ones, is a great idea.  Don’t forget to bring all of their chargers!

Items for Baby:

Baby needs things too (but mostly they need you!).

Clothes- A soft and warm outfit for your baby to wear home is a must.  You probably have a special blanket or piece of clothing for the new one.  Pack those up for those first pictures.  If you are committed to cloth diapering from day one then pack your favorite snuggly diapers too.

Car Seat-  Learning to install your infant car seat is a must before you have the baby.  Check out this website tips on how to properly install your car seat.

With a little preparation, your labor and birth can be a joyous day for your entire family.  The birth of your baby will be one of the most memorable days of your life!  Congratulations!

 

Curious to learn more about Birth Boot Camp and our natural childbirth classes?  We have an online birth class option and or natural birth teachers in your area.  We also offer a comprehensive two disk breastfeeding DVD, “Breastfeeding: The Ultimate MRE”.

Birth Boot Camp- Training Couples in Natural Birth

 

Making Room For Baby

Make Room for Baby

 

The transition to parenthood is a unique experience in that some look forward to this time, while others fear the changes that will come.  One thing is for certain:  No matter how prepared you think you are (or aren’t), something is sure to surprise you along the way!

Bringing Baby Home is a workshop developed by the Gottman Institute and is based on years of research studying young couples during this transition period.  The Gottman group has found that 67% of couples showed some decline in relationship satisfaction during the first year after their baby is born, while 33% of couples showed no decline or even had an increase in relationship satisfaction.  To help shift these numbers in a positive direction and keep YOUR relationship in the “satisfied” group, let’s talk about some of the common changes you can expect during that first year.

1. There is a Profound Philosophical Shift

  • Women and men realize they are not only daughters and sons, but are now also mothers and fathers.  This can bring upon a heightened sense of responsibility, obligation and pride for new parents.
  • Time starts to take on a new meaning.  Many couples will now refer to life events as “Before Baby” or “After Baby.”  This change is quite the example of the impact a new child can be on the family unit.
  • Relationship roles may become more traditional than they were before, possibly causing strain on the relationship.  It can be helpful to discuss role expectations before and after the baby is born.

REMEDY: To maintain relationship satisfaction, couples need to become more of a WE than two MEs.  Take the time to communicate your feelings and concerns with one another.  Having a child with your partner also allows you a great opportunity for closeness as you both love and care for your new baby together.

2. Relationships Change

  • Conflict in the relationship tends to increase dramatically within the first year.  While this may not be true for every couple, it is important to recognize when increased conflict is occurring, and to know that this is completely normal.
  • Sex typically declines dramatically.  Of course we all know sex is off limits for 6-8 weeks after birth, but what about after that?  With poor sleep schedules, multiple life changes and increased stressors, it is no wonder a couple’s relationship can suffer in the intimacy department.
  • Conversations and communication between partners often decline dramatically.  Again, with lack of sleep and a new busy schedule of caring for the baby, it can be difficult to find time to connect.

REMEDY: To maintain relationship satisfaction, it is important for couples to realize that these changes are complete NORMAL.  Increased conflict, decreased sex and communication are not necessarily signs that your relationship is headed south.  These are simply cues that the transition to parenthood is taking place all around you.

3. Fathers Often Withdraw

  • When a new baby is born, new mothers often receive support from other women.  Sometimes this culture of support for the mother can alienate father and make him feel as though he is not needed in the care of his child or partner.
  • Fathers are often more than happy to withdraw and spend more time working.  This is something they know how to do and are good at doing.  It’s also a way for father to “help” by providing for his family.
  • Fathers are more likely to withdraw if the relationship with Mom is distressed.  When parents don’t make time to connect with one another, this can impact Dad’s relationship with the child.
  • Babies are more likely to withdraw from unhappily married fathers (this may be because the fathers withdraw first).

REMEDY: Keep fathers involved with their children.  Especially if mother is breastfeeding, let father give the baby baths, change diapers and play with them during their waking hours.  All types of interaction are important with your new bundle of joy.

4. There are Physical and Psychological Changes

  • New parents are sleep deprived and stressed for an extended period of time. 
  • Sleep deprivation and exhaustion can make you depressed.  Depression can exhibit itself as irritability, low motivation, or lack of interest.
  • Sleep deprivation has a profound effect on the brain.  One study found that when healthy volunteers were deprived of restful sleep for just one month, they became clinically depressed.
  • Sexual desire may decline dramatically after birth.   Don’t worry – this is normal, and typically improves after the first year.
  • Psychologically, a woman may be emotionally unavailable to her partner.  New moms tend to be very focused on providing care for their babies, which can result in less attention being given elsewhere.
  • Decreased sex and emotional availability from mom can make the dad withdraw even more. Men tend to feel unwanted when sex becomes infrequent, effecting their willingness or ability to connect with their partners.

REMEDY: Make sure that emotional intimacy is restored soon after the baby’s birth to maintain relationship satisfaction.  The Bringing Baby Home workshops can provide many essential tools for new parents to keep their relationship strong and healthy while making the transition to parenthood.  Check out their website at www.bbhonline.org for local workshops in your area.  Another great resource is “And Baby Makes Three” by Drs. John and Julie Gottman.  You can also check out our website anytime for new information: www.makingroomforbabysd.com.

 

*Much of the information in this blog comes directly from the Couples Workbook for the Bringing Baby Home workshop, developed by Drs. John and Julie Gottman.  Jennifer Lundy-Aguerre, Licensed Marriage and Family Therapist, is a Certified Bringing Baby Home Educator and works with new and expectant parents in her private practice in La Mesa, CA.

Preparing for a VBAC

Preparing for a vaginal birth after cesarean (VBAC) isn’t a whole lot different than planning for a natural birth. Tell people you want to push a baby out of your vagina without drugs, they may look at you like you have three heads…the same goes for VBAC.  There tends to be a lot of fear surrounding VBAC and a woman who is planning one may unexpectedly invite opinions from dozens of people around her, most of them negative.  People often want to spread rumors about the very worst scenario because it’s far more interesting than what is normal.

There are some things you have to take really seriously in order to accomplish your goals.  Below is a list of some of the most important steps you should take when planning your VBAC.

First of all, finding a truly supportive provider is probably THE most important piece to your journey.

Why?  While we all know from research that VBAC is almost always the safest option for both mother and baby (and ACOG agrees), many providers put unnecessary restrictions on VBAC moms.  Some common examples are “You have to go into labor before 40 weeks (or 39 weeks).”  “If your baby is measuring big, you will need a repeat C-section.”  “You will need to come to the hospital ASAP in labor and be on continuous monitoring.”  “You will not be allowed anything by mouth (no drink, no food) in case you need an emergency C-section.”  “I will not use pitocin under any circumstances.”   “If your baby has any heart decelerations at all, you will be taken in for a C-section.”

None of these restrictions/guidelines are evidence-based for any laboring woman, even VBACs.  Women attempting a VBAC deserve to have just as much freedom to labor and birth as any other woman. Familiarize yourself with the guidelines of the Mother-Friendly Childbirth Initiative and find someone who best fits those guidelines.  That will be your best bet at a wonderfully successful VBAC and will be safest for you and your baby.  These restrictions only increase your chance of having another C-section without improving outcomes.

Second, you need to deal with your emotional healing regarding your C-section.

Meet with other women who have had similar experiences, in person if possible, or online, or both!  Talk to a counselor if there are issues you are not able to move past.  Eliminate the naysayers.  If there are friends are family who are not supportive, you have to avoid the subject with them or stay away from them.  Even people who are neutral are not necessarily a great presence at your birth.  I distinctly remember my mom and dad sitting in the corner of the hospital room looking at me laboring with my first attempt at VBAC .  Seemed like a good idea beforehand, I mean my mom pushed out 7 babies like a birth ninja, including one homebirth and a set of full-size twins, baby A was breech.  But….it was not a good idea…birth is intimate and while I don’t want my parents watching me have sex or poop, they shouldn’t have been watching me labor either.  They did not get invited to my next birth.

Third, get educated with your partner!

Learn everything you can about birth that is going to HELP you have your VBAC .  Be empowered by the information you get.  Take a GREAT childbirth education class with your husband so he can be on board and help you during this amazing journey.  Chances are, both of you are not reading all the exact same childbirth info or perceiving it the same.  Get interactive with a classroom and a teacher…find a class with great statistics on vaginal and natural birth.  Yes, natural birth.  Even if you aren’t sold on natural birth, take the class because it will give you more tools and more tools increase your odds.  Just take the plunge!

Fourth, don’t skimp on your doula just because you have a great provider and a super supportive husband.

An experienced doula (find one who understands VBAC thoroughly) can help you where you don’t know you need help.  She can protect your peaceful bubble.  She can take you further than you ever thought you could go.  However, a doula can’t birth for you, so it’s important that you set the stage so that she can help you on your own journey.  Dads can remember to ask nurses to keep the lights low and use soft voices.  Create a space, and a team who will work together seamlessly to give you what you want for this amazing birth.

Now let’s talk about physically what is happening.  You have a scar on your uterus.  That’s it.  Your uterus has healed enough to make and grow a baby and odds are in your favor that you can birth your baby without incident.  Do your research, know that VBAC is safe with the right support.

Fifth, get moving!  Exercise is important.

Walk a mile a day and stay active.  Stretch.  Do prenatal yoga, it helps with stamina, breathing, relaxation, and so much more.  Find  a CHIROPRACTOR who is trained in the Webster technique.  Even if you don’t ‘believe’ in chiropractic care, you are a having a VBAC , you need your pelvis to be aligned properly.  One of the biggest causes of C-section is a baby who doesn’t want to move down into the birth canal…and the biggest cause of a baby who doesn’t want to move down is either the mother’s hips are torqued, the baby’s head is not positioned correctly, or both.  Chiropractic care solves both.  Start seeing your chiropractor around 20 weeks for the best results.  Also find out if they are willing to adjust you in labor…this is fabulous!!

Sixth, eat great, amazing foods.

Fall in love with REAL food and nourish your body and your baby.  Make sure your muscles are strong and ready to do the work of labor.  It’s not easy stuff.  It’s a marathon and like any other athlete, you need to treat your body like a machine that is made for this process.  Don’t junk it up.

Seventh, ABDOMINAL BREATHING.

Do it!! Do it every time you feel a braxton hicks contraction.  Practice, practice, practice.  It needs to be second nature by the time you go into labor and you should do it with contractions without even thinking about it.  It helps direct baby’s head onto the cervix and makes contractions more effective.  It also gives you something to focus on.  I credit my very short active phase of labor to abdominal breathing.

Eight, learn about Spinning Babies, as in www.spinningbabies.com.

Gail Tully is amazing.  She gives a list of daily balancing exercises (they might look a little crazy) that really really work.  You MUST pay attention to your posture, stop sitting on furniture (because it causes malpostioned babies) and keep your belly forward leaning to encourage your baby in a good position.  Say goodbye to your recliner until after baby is born.  Squat, sit on the floor, or on a birth ball, not the soft, cushy couch.  Get on your hands and knees and rock your pelvis a LOT!.

Ninth and last but not least, once you have really stacked the deck of cards in your favor, stop reading birth stories.  Stop talking about birth.  Let go of any expectations or prior feelings about birth you had when starting this process.

You’ve chosen great people to help you, you need to let go, breathe, and let them support you.  Your only job during birth should be to breathe and relax…not be worried about what is going on around you.  This is your journey.   It is unique to you and your baby and your body.  It does not have to follow suite to any other birth you have read about or seen or heard of.  This IS you.  Love yourself and be gracious for every wonderful, powerful contraction and milestone that brings you closer to your new baby.

 
Abbey-Web
 
Abbey Robinson is a natural birth teacher and doula in South Lake, TX.  A mother of four, she had three cesarean sections before her vaginal birth.  Abbey also serves on the Advisory Board for Birth Boot Camp as our resident VBAC expert.  She also works as a chapter leader for the Tarrant County Birth Network and with ICAN (International Cesarean Awareness Network). You can find her at www.SouthLakeBirthClass.com.

 

Curious to learn more about Birth Boot Camp and our natural childbirth classes?  We have an online birth class option and natural birth teachers in your area.  We also offer a comprehensive two disk breastfeeding DVD, “Breastfeeding: The Ultimate MRE”.

Birth Boot Camp- Training Couples in Natural Birth

Why Writing Your Birth Story Matters

Recently, I stood in a parking lot speaking with a woman I had never before met. I quickly learned that she, like me, was the mother of three little ones. Soon enough she began telling me her birth story. Within less than 10 minutes of having met this total stranger, she used the term “vaginal” in our conversation. And I didn’t blink an eye. Why? Because words like that and situations like this have become quite commonplace since I’ve become a mother. And I love it.

Before having kids, I was a pretty modest person, at least modest enough to never use the word “vaginal” with a stranger, or even a very good friend. Becoming a mother did away with that problem. It’s not unusual for me to use the word “placenta” or “nipple” at the dinner table filled with mixed company. I understand that not everyone appreciates these sorts of stories over lasagna, but I do it anyway because motherhood has taught me that sharing stories is important and vital. I now realize that every mom has a story to tell, and if we allow a space for moms to tell their stories with openness and honesty, it could greatly improve the outcome and circumstances for others.

As the creator of a website that discusses the reality of birth, babies and beyond, I have heard many birth stories. And, I’ve come to realize just how important they are. Just a few weeks ago, I was speaking with a doula about writing her own story. She wasn’t sure where to begin or what to say. This is a woman who has cared for women as they have birthed their own babies. She has been a part of other women’s stories, but she hadn’t fully considered what her own story was. After I asked a few questions, she said, “thank you for helping me come to the revelation that I have a story.”

Here’s the truth: every mother has a story. Some are funny. Some are embarrassing. Others are full of unpredictable twists and turns. Some went according to plan and others were rude awakenings. But every woman has one. And every story matters.

And, here’s another truth: writing your story matters. How so? The act of putting your story into actual words can have a very therapeutic and cathartic effect on you. But, the benefits aren’t just for you. The following are four reasons why you should write your birth story:

To Remember

Let’s face it, memories fade and especially so when sleepless nights and infant care are a part of your daily life. Taking the time to put your story into words as soon as possible will preserve details that your mind won’t recollect later. For instance, I nearly forgot about the guttural moans and groans that emerged from me during my third labor. It’s hard to believe something like that could slip my mind, but it happens. That’s why it is important to write your birth story to preserve it, reflect on it and remember it for your lifetime.

To Educate

Through the research and interviews I’ve done for Unexpectant, I have come to realize just how important the stories we hear are, and how much impact and influence they can have over our lives. I’ve learned that if stories of c-sections are all a woman hears, she has a different perspective of birth than a woman who has been surrounded by women who believe in natural birth. Every birth is different, but the more stories we hear, the more perspective we have and the more educated we are on what the possibilities of birth are. So tell your story not just for your own benefit, but for the benefit of others, so they can learn from your experience.

To Gift

Call me a narcissist, but I love talking to my mom about the day I was born. There is something about hearing the story of how I entered the world that somehow grounds and connects me. I don’t know if my son will feel that same way when he grows up, but the words are preserved for him nonetheless. Having written his birth story, I feel it is a gift to him (and his future wife) to understand how he was born.

To Heal

Birth is a life-changing event in many ways. Regardless of how perfect or imperfect it was, reflecting on the experience gives you the ability to work through the events and emotions. Some will feel a great sense of empowerment from birth. Others will need time to work through negative emotions and memories of what happened. One honest mother told me that her kids were spaced further apart than what she had hoped for because of how traumatic birth had been for her. She needed time and space before she could go through it again. She needed the chance to heal. Writing a birth story allows a woman to organize her thoughts and gain a better perspective on her experience. It gives her the opportunity to release the story and heal.

So take a few moments to write your birth story. Put away the inner critic and just write about what comes to mind. It doesn’t have to be perfect. It just needs to be honest and real and uniquely yours.

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Meagan Church is married to her high-school sweetheart and is the mother of 3 kids. She is a writer and children’s book author. She is also the brainpower of the online resource www.Unexpectant.com, exploring the realities of birth, babies, and beyond. Connect with her on Twitter @unexpectant [https://twitter.com/unexpectant]

Breech Options – Guest Post by Lauren McClain

mybreechbabylogoUnless you have or once had a breech baby, you probably aren’t even reading this first sentence. Breech is rarely on a woman’s radar because it is rare and, well, what is there really to know about an upside-down baby? Unfortunately, a lot of women get caught at the end of pregnancy with a surprise breech and don’t have much time to figure out what to do about it. That’s where I come in.

I planned a home birth and ended up with a footling breech and a cesarean, in part because I felt I had no options. Without information, I didn’t have any options. Learning some basics about breech birth ahead of time can save you a lot of anxiety and hassle in case you discover a breech at the end of your pregnancy. I created a website to help parents of breech babies learn and make decisions about their care.

Probably your reaction to the news your baby is breech will depend largely on how your caregiver feels about it. Some midwives, for example, treat the breech baby as just a variation of normal and nothing to be worried about. Most US obstetricians treat it as an automatic c-section (also saying there’s nothing to worry about). Some areas of the country are more breech friendly than others. Your chances of having professional support for a vaginal breech birth in large part come down to geographical lottery.

If you don’t want a c-section, are worried about having a vaginal breech birth, or are just looking into the options, you are likely to encounter a great deal of folk anxiety. There is a lot of nameless caution circulating around vaginal breech birth in much of the western world. For the most part, nobody will really say why, explain the mechanics, or give you any options. They just believe it is dangerous. Your questions, if you are able to ask them, may be met with indifference, impatience, condescension, or worse.

You have the right to know the things that your doctor knows about your breech baby, and to know that there are many things s/he doesn’t know.

Here are some questions you might have.

Why are babies breech?

            There is a small small possibility that your baby is breech because of a developmental abnormality. Breech babies have a higher incidence of problems at birth, both congenital and birth-related. You need to know that 93% of breech babies are born normal. Some researchers are calling vertex position (head down) the first developmental milestone. But in all likelihood, this baby is perfectly normal.

            If you or your baby’s dad were breech, or there are other breech babies in your family history, breech position may run in your family. In this case, your baby is less likely to turn and less likely to have any kind of abnormality. It’s just a family thing. Go weird!

            Certain ways of sitting encourage a baby to just plop. Sofas, recliners, and bucket seats (like in a car) are notoriously bad for baby’s position. Midwives who work among the Amish noted a significant increase in breech babies when their communities switched from using hard chairs only to using couches and recliners. Here is a long list of other reasons your baby might be breech.

Should I try to turn my baby?

Although cesarean breech birth is more risky than cesarean head-down birth, your doctor is unlikely to give you much help or encouragement if you want to try to turn the baby. If you would rather avoid cesarean, you should try to turn the baby and/or start looking for another doctor/midwife.

How do I turn the baby?

There are many, many ways people have claimed success in turning breech babies. Many can be done by you at no cost. Doing inversions and the breech tilt, hypnotherapy, homeopothy, and chiropractic care can all turn a breech baby.  You can even turn a breech baby with essential oils.  Here is a comprehensive list of turning options for you to peruse.

What about ECV?

An ECV or External Cephalic Version is when the practitioner uses her hands on your belly to nudge and push the baby into a head-down position. Rates of effectiveness vary enormously with the practitioner. Of 3,700 women in twenty-six studies on ECV, there were only complications leading to cesarean in two cases. It is considered very safe, but in many cases is done in a labor and delivery ward in case it puts you into labor or distresses the baby. More on  ECV for breech.

Can I still have a vaginal birth?

Recent studies show that vaginal breech birth is just as safe or safer than cesarean breech birth for the baby. Vaginal birth is almost always safer for mom.  Extended or frank breeches are especially well suited to vaginal birth.  The foremost vaginal breech birth practitioners (doctors and midwives) tend to agree that it is a higher-risk birth and that having an experienced, confident caregiver is the best way to assure safety. Check out a comparison of vaginal and cesarean breech birth, see if you might qualify for a vaginal breech birth, and look into planning one.

So why does my doctor recommend a cesarean?

Breech birth can be more risky than head-down birth. Due in part to a flawed study released in 2000 and a history of insurance companies threatening teaching hospitals who taught breech skills, most caregivers today have had no opportunity to deliver a breech baby. The study was debunked around 2006, and ACOG released a statement recommending vaginal breech birth in select cases. Unfortunately, so few people now remember how to attend a breech birth, and the ACOG recommendation for inexperienced doctors is to perform a cesarean. Vaginal breech birth is just starting to come back, mostly in the UK and Australia. But it is available here by a few learned  midwives and doctors.

mybreechbabyprintableguide

Download a FREE printable Guide to Breech at www.mybreechbaby.org, your one-stop-shop for support, resources, and information about breech babies and breech birth.

Transition From Couple to Family

Babies are truly amazing. They bring much joy into our lives. Babies have the ability to make you experience a love deeper than you have ever felt was possible. And given the fact you and your partner are responsible for this tiny and precious new life, makes the experience even more special.

However, with all the joy and love of welcoming in a new baby, often comes difficulties and challenges of which can be stressful and tough on any relationship. The keys to keeping a relationship strong during major life transitions, such as babies, work transitions, moving, illness, etc., are the same as those needed for a healthy relationship in general.

 I asked Dr. Donna Bilu Martin,  a working mom of a three year old and expecting her second baby, to contribute her thoughts.

 Martin said,

 “Respecting your partner and showing your partner respect is crucial. Appreciate and value their opinions and needs, even when they may differ from your own. Discussing differences in a calm, loving way will keep the lines of communication open and let each person feel safe and loved. Giving each other breaks when you feel exhausted and overwhelmed is important.  Spending time together as a couple, even if just for a few hours, can foster feelings of closeness and reinforces the bond between you.  Leaning on each other and working together to overcome difficult times will ultimately strengthen the relationship.”

Dr. Bilu Martin makes a valuable point. Once you and your spouse have entered the role of parent, it is crucial that you spend meaningful time with each other. This allows you to maintain a healthy and balanced relationship that will, ultimately, bring you closer together. Set up a time to make a plan together and make it a priority to make sure that it happens, because with babies come many situations where plans change spur of the moment. Also, make sure to make time for yourself, too. Don’t give up things that make you happy, such as your career, hobbies, friends, and exercising. These things are important for maintaining physical and mental health, as well as sustaining energy for your new baby and family.

Maintaining open and effective communication is very important. Listen to your partner when they express their feelings and needs, because life has changed for them, too. This will prevent harboring feelings of resentment and anger towards each other. Remember to ask one another for advice and to not make important decisions without the other’s input. Try to share the role of diaper changing, feeding, washing, etc. As the child gets older, discipline your child in a way that you both agree on. Parenthood is a partnership and one parent should not carry the burden more than the other.

Along with the joy a baby brings into a home, financial stress often makes its way into a household. Set a budget with your partner and stick to it. Start with the necessities and see where your spending can be limited. Things such as doctor bills, clothing, and daycare can add up quickly.  If you haven’t planned ahead of time, you may find yourself stuck in a bad situation, causing increased strain between you and your partner. Small changes can create a huge difference.

Growing your family is a beautiful part of life that should be looked at positively and with excitement. With teamwork and open communication, your marriage and family will nurture and expand with happiness, appreciation, and lots of love!


About Isaac

Back CameraIsaac Farin is a Licensed Marriage and Family Therapist (LMFT) in the state of Florida. He has a Master’s degree in both Marriage and Family Therapy and Mental Health Counseling. He is a Clinical Member of the Association of Marriage and Family Therapy (AAMFT) and an Associate Member of the American Society of Clinical Hypnosis (ASCH). Isaac is an AAMFT Approved Supervisor and he is currently working on his PhD. dissertation at Nova Southeastern University. Isaac is also a certified clinical hypnotherapist, a medical meditation consultant, stress management consultant, and a mental health clinician. Isaac’s true passion in the field surrounds strength-based approaches to both individual, couples, & family therapy; systemic, Ericksonian therapy and hypnosis, mindfulness, solution focused, solution oriented, and solution informed. Isaac has worked with individuals, couples and families in a variety of contexts such a private practice, outpatient psychiatric centers, psychosocial rehabilitation centers, and home-based therapy visits. He is experienced in working with clients living with substance abuse issues and mental health challenges.

The Benefits of a Doula

 

Sometimes called a labor assistant, a doula is person who assists a woman in labor.  In recent years, doulas have become more popular and widespread.  Research and personal experience show that a doula can be an integral part of a woman’s birth team, not only during labor but before and after. 

What is a doula’s role?

The role of a doula is to act as both emotional and physical support for a woman in labor.  A doula does not replace medical personnel, such as a midwife or doctor, but supplements their care.  A doula should be familiar with the various  positions that a woman can assume to speed labor or help make her more comfortable.  She may remind the family of the things that they have learned in their childbirth classes.  A doula can also provide hands on, physical comfort measures such as massage and counter-pressure.

Emotionally, a doula can also be an asset.  As a woman familiar with labor or who may have experienced labor herself, she can recognize what words or affirmations can be helpful to a woman struggling in labor.  Since a doula typically has some training or at least experience being around birth, she can also recognize where a woman is in labor and be a knowledgeable comfort to the family, letting them know that they are close to the end or when they should head to their birth place. 

Benefits of a doula to the birth partner

It is important to note that the doula doesn’t just benefit the mother, but can be incrediblyhelpful to her partner without replacing his important role.  A woman’s partner knows her on a personal level and can help her in ways that nobody else can.  He has, hopefully, taken birth classes with her and learned some of the basics of birth and labor. 

Sometimes, couples who prepare well together don’t feel the need for a doula, but they shouldn’t dismiss the idea altogether.  During labor and birth, an extra pair of hands is almost always helpful.  The doula can do hands on things and can comfort the mother, but she can also give dad a break when he needs a nap or a bathroom run.  She can even help with food preparation or caring for other children, if that is what you specifically hire her to do. 

The presence of a  warm, knowledgeable, and skilled doula is something that, very often, the PARTNER is more grateful for than the birthing mother! 

Doulas and improved birth and baby outcomes

Several studies have found that the presence of a doula vastly improves the birth experience for the mother, lowers intervention rates (like cesarean section and Pitocin), and shortens labor.  Not only did the presence of a doula decrease birth interventions, it seemed to drastically lower the rates of epidural use.  For a woman planning a natural birth, a doula can be a fabulous investment.

A small study, based in Sacramento, California, USA, found that doulas not only improved birth outcomes but increased breastfeeding success. 

“In summary, doula care increased the odds of improved childbirth and breastfeeding outcomes.”

The same study also found that the presence of a doula shortened the second stage of labor (when mom was pushing) and improved APGAR scores.  Truly, a doula doesn’t just help mom, she is good for the baby too.

How do I find a doula?

How do you find a doula that is right for you?  Start by simply talking to other people in your community.  Friends, your childbirth educator, your midwife, and anybody else you may know who is familiar with doulas can be helpful in getting you started in the right direction. 

Sometimes local birth networks, hospitals, or birth centers have “Meet the Doula” events where you can come and meet many local doulas and find one who works best for your family. 

In Conclusion

The presence of a trained doula can have a measurably positive impact on birth outcome, lowering intervention rates, lowering cesarean section rates, improving infant APGAR scores, and even improving breastfeeding success.  A doula can benefit the mother, her partner, and the baby and is often an investment the family is grateful they made. 

References:

Continuous Emotion Support From a Doula in American Hospitals

http://www.ncbi.nlm.nih.gov/pubmed/2013951

Doula Presence Improves Satisfaction and Lowers C-section

http://www.ncbi.nlm.nih.gov/pubmed/18507579

Doula Care and Breastfeeding Success

http://www.birthwellpartners.org/wp-content/uploads/2011/06/Doula-Care-Early-Breastfeeding-Oucomes-and-Breastfeeding-Status-at-6-Weeks-Postpartum-Among-Low-Income-Primiparae.JOGNN-2009.pdf