New Year! New Look! New Beginnings!

For a few years now I have been supporting, informing, and empowering women! This year not only  will I be launching a new look for Made to Birth but I will also offering my doula services for residences of North Carolina! I'm still on the board here for ICAN and NCFOM and will continue to serve Onslow County Pregnancy Resource Center also. So be on the look out for my new look and info on my services! Thanks for your support!

"Medical Problems During Pregnancy Doesn't Mean a Bad Pregnancy"

I know it's "normal" for OB's to classify you as high risk if you have any medical issue. Today I want to talk about some different medical conditions what causes it and from different medical doctors stand points how to treat it.

Pregnancy and Reproduction in Autoimmune Rheumatic Diseases:

This one I hear about alot. Here's a brief introduction on what it is:
During pregnancy, profound changes of the hormonal milieu take place. The increase of free steroid hormones including glucocorticoids, progesterones and oestrogens, induces changes in functions of immunocompetent cells such as B cells, T cells and monocytes.^[1] As a consequence, clinical symptoms of immune-mediated rheumatic diseases are modified related to the prevailing pathophysiological disease process; some improve, while others remain relatively unchanged or worsen during pregnancy.

Reference: Medscape News Today

You can read more on this subject here.



Management of Cardiac Disease in Pregnancy


Here's a brief description of what this disease is and what effects it has on body during pregnancy:
Pregnancy makes a significant demand on the cardiovascular system. Therefore, it follows that women with cardiovascular compromise due to cardiac disease need specialist input and careful management pre-, peri-, and post-partum. In the latest CEMACH report, cardiac disease was the most common cause of indirect maternal deaths and the most common cause of death overall.^[1] In particular, during 2003-5, there was an increase in deaths due to myocardial infarction, thoracic aortic dissection, and rheumatic mitral stenosis. The causes of maternal cardiac deaths in 2003-5 are summarized in Table 1.

 Reference:  Medscape News Today
You can read more about this here.



How Should Crohn's Disease Be Managed in Pregnancy

A brief description of Crohn's Disease:
Crohn’s disease is a disease that causes inflammation, or swelling, and irritation of any part of the digestive tract—also called the gastrointestinal (GI) tract. The part most commonly affected is the end part of the small intestine, called the ileum.
The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The movement of muscles in the GI tract, along with the release of hormones and enzymes, allows for the digestion of food.

Reference: National Digestive Diseases
Information Clearinghouse (NDDIC)
For more on the description/causes you can find it here


When a woman has Crohn's disease, what special considerations are needed during pregnancy? So here's some information on what you can do to have a great pregnancy. HERE

Thyroid Disease while pregnant:
Here's a brief description of what thyroid disease signs and symptoms:
The signs and symptoms of hypothyroidism vary widely and some of the complaints experienced by individuals with hypothyroidism include:

• fatigue,
• mental fogginess and forgetfulness,
• feeling excessively cold,
• constipation,
• dry skin,
• fluid retention,
• non specific aches and stiffness in muscles and joints,
• excessive or prolonged menstrual bleeding (menorrhagia), and
• depression.

Hyperthyroidism is suggested by a number of signs and symptoms. People with mild hyperthyroidism or those older than 70 years of age usually experience no symptoms. In general, the symptoms become more obvious as the condition worsens. Common symptoms of hyperthyroidism include:

• excessive sweating,
• heat intolerance,
• increased bowel movements,
• tremor (usually a fine shake),
• nervousness; agitation,
• rapid heart rate,
• weight loss,
• fatigue,
• decreased concentration, and
• irregular and scant menstrual flow.

Reference: MedicineNet.com you can read more on that here

Here's what a medical doctor recommends your TSH levels be:

The new recommendations for TSH levels during pregnancy are the following:

• First trimester: less than 2.5 with a range of 0.1-2.5
• Second trimester: 0.2-3.0
• Third trimester: 0.3-3.0.

You can read more about that here.

So as we see as long as we take care of our bodies while were pregnant we can have a great pregnancy! I believe all pregnancies are blessings and as long as a woman is in tune with her body and is taking care of herself all will be well.  I just talked about a few for today.  Being pregnant with a disease or disorder doesn't have to be a drag. Find the help you need, get second opinions, make informed decisions, and stay educated on the disease/disorder.  You only get to experience being pregnant with that child(ren) once so make it a memorable one.  I hope this helps someone and encourages you to have a great pregnancy!

What is a True High Risk Pregnancy/Birth?

While pregnant it's easy to feel overwhelmed with information and opinions from others.  What can also be stressful is not being sure what is a true risk and what is a potential risk.  I'm writing this blog for that purpose.  Pregnancy is filled with adventure and and joy from the time you take the test, to the time you have an u/s, up until birth.  What happens when something comes up during an appointment?  You panic and try to do whatever possible to keep your baby and you healthy.

The first thing I want to address is breech position!  Is this a true high risk?  Does the positing of your baby affect your pregnancy?  Because your baby is breech does this warrant an cesarean section?  Here's an article about breech birth and c/s. Quoting from the article a few lines:

Since 2000, C-sections have been the preferred method of delivery in breech births. Studies suggested that breached births were associated with an increased rate of complication when performed vaginally.

As a result, many medical schools have stopped training their physicians in breech vaginal delivery.

Now let me explore a few other aspects of breech.  Breech is a variation of normal.  Your baby may be breech for many reasons.  There many techniques used to flip or spin baby.  You could do a external cephalic version, acupuncture, and Webster's technique to say the few.  On the Spinning Babies website you can find information on all of this.  The information is out there you just have to ask.  Here's a quote from the spinning babies website: 

The breech position can be a normal response to the shape of the space inside the mother's womb. Usually, the womb is aligned to encourage the baby to be head down. Whether the reason that any particular breech baby doesn't or can't settle head down in the womb is normal or not varies just like the situations about head down babies vary. Not all head down babies have easy births; and not all breeches have difficulty. Far from it. Most breeches have smooth births when birth is spontaneous (scroll down).

Most of the time breech babies aren't given a chance. They usually induce the mom and schedule a c/s.  Did you know that  breech babies can turn during labor?  How about a twin birth where baby "B" is breech and baby "B" turns as baby "A" is born.  Did you now that most breech vaginal births have no problems, in fact it's usually smooth.  The increased death rate is due to malformations already present, prematurity and intrauterine fetal demise! States the overview on Medscap.com by Dr. Fisher.

Now lets talk about previous cesarean section, does this make you a high risk birth?  Many may say yes because of uterine rupture.  But to the contrary by the ACOG's own admission, there is no evidence to back up this recommendation. This is the reason, of course, this recommendation has been placed in Level C and is thus ACOG's confession that since there is no data, they will simply have to go on the basis of "expert opinion." This is a sad regression to the days of "trust me, I'm a doctor" in spite of the new direction of medical care to evidence-based practice. 

Furthermore with recent studies the uterine rupture rate is much lower than you think. Quoting from 20 Peer Review of  Publications uterine rupture is 0.7%.  Here's the quote:

Meta-analysis of pooled data from 20 studies in the peer-reviewed medical literature published from 1976-2009 indicated an overall incidence of pregnancy-related uterine rupture of 1 per 1,536 pregnancies (0.07%).

This is for all pregnancies with or without a previous scar.  ACOG also recommends a trail of labor after cesarean (TOLAC).  So from the this information given by Medscap we can conclude that a previous cesarean doesn't make you high risk.  This is NOT to say that there's no medical reasoning for cesareans.  This is to say that because you had a c/s before doesn't mean your pregnancy is high risk. Here's another source on VBAC's and how they carry less risk than repeat/elective cesareans (RCS,ESC).

This brings me to my last point! POSTDATES!!! Everyone gets in a frenzy when baby doesn't arrive on their "estimated due date" (EDD)  The truth being that no one can accurately pin point conception due to sperm living for up to 5 days inside the uterus.  According to Dr. Caughey the definitions and cause of postdates is this:

Postterm pregnancy is defined as a pregnancy that extends to 42 0/7 weeks and beyond.^[1] The reported frequency of postterm pregnancy is approximately 3-12%.^{[1, 2]} However, the actual biologic variation is likely less since the most frequent cause of a postterm pregnancy diagnosis is inaccurate dating.^{[3, 4, 5, 6]} Risk factors for actual postterm pregnancy include primiparity, prior postterm pregnancy, male gender of the fetus, and genetic factors.^{[7, 8, 9, 2, 1]}

Yes some women do know when they conceive because they are in tune with their bodies.  But why are we categorized the same when it comes to the date of conception using your last menstrual period (LMP).  Some women go 28 days, some 30 days, and so on.  We can't put all women in the same box.  As long as mom and baby are doing fine and there aren't anything of concern why not wait for labor to start on its own. ACOG states that a pregnancy is 38-42 weeks gestation not 37-40 weeks.  Many people say that risk arise the further you go past your date here's what the ACOG had to say about that:

postterm pregnancies. Most women who give birth after the due date have healthy newborns.

You can find this information here on this article and also go to their website to find more.

Summary

There are TRUE high risk pregnancies and births, such as HELLP syndrome, preeclampsia, eclampsia, (not solely based on blood pressure), IUGR,  TTS syndrome, (in multiple pregnancy), ICP, placental conditions, etc.  These require extensive monitoring during your prenatal visits and during labor.  I would add that diet and exercise can play a major role in some of these symptoms and disorders.  As long as you and baby are doing good and there's no sudden medical change in your pregnancy you can go on to birth your baby.  Ask questions and research your options before making any decisions.

Childbirth is Normal! Not an emergency!!!

   As a culturized society we have been led to believe that childbirth is an emergnecy!  But childbirth indeed is quit the opposite!  We as a soceity have been led to believe that we are to put our trust FULLY in our OB's!  Women go into their prenatal visits hoping to hear the answers they're looking for without a thought of opening a childbirth book themselves.  I find it puzzling how something so spirtiually, emotionally, mentally, and physically entacted to who you are as a woman is NOT looked at as something of concern!  We spend time working to have the living we want, the house we want, the car we want and yada, yada, yada.  But we don't care to invest time, energy, research, passion, and oh *gasp* money into childbith to have the best childbirth experience without any doubts, regrets, or fears.

 

  No we would rather go into a prenatal visit for the five minutes the OB sees you and listen to all of their insights of how we should birth our babies.  We go in strip down to sit on a thin sheet of paper in a cold small room.  We are scared to ask questions and just sit there and nod our heads to everything the OB says we SHOULD do.  Do you ever think to ask "why"?  I can answer that for you!  Because we think it's normal!  It's been driven into our minds that we are to go and be quiet not knowing what the test is for and "if" we can refuse it.  We have been taught that the OB's have ALL the answers they know what's best for you and your baby!  Someone you just met knows your body better than you? I think not...


   We are encouraged to take drugs during labor because the pain is so hard to bare.  (in some cases not all)  Very rarely do you hear an approach to childbirth being work!  Hence the word "labor"  We as women need to reach deep down inside and find the will power to birth our babies the way God made our bodies to do it.  We don't need any unnecessary interventions to help us birth our blessings!  We just need to be encouraged to trust birth and to trust that God made our bodies to do this!  Instead we have doctors telling us that we have to have our babies on the date estimated by them.  If we don't clearly something is wrong with us and we need some help! WRONG!!!

    


    There is no expiration date on your pregnancy!  Listen to your body and trust the innate to do what it's suppose to do.  Positioning is another factor that is pressed upon women!  Oh your baby is breech, tranverse, etc...Which we find that baby knows what postion is best!  Many times because of OB's not supporting women on birthing babies who are in these postions they are pressed for an induction or worse a cesarean.  With little or no knowledge of sucessful birth with these postions many women listen and go down the path of endless interventions.  This shouldn't be!  Throughout the whole pregnacy journey women should be diving into books and reading all there is to know about childbirth.


   Education is key to a successful childbirth experience.  During your pregnancy if any medical condition arises such as pre-eclampsia, gestational diabetes, GBS, fifth's disease, etc.  You should learn all there is to know about these disesas and conditions.  I will also add that these conditions doesn't necessarly qualify you for an induction or cesarean (in most cases)!  Don't allow these conditions to create fear into not having the best birth you can.  If your OB is not going to support your decisions reguarding YOUR birth then find someone who will!  Your voice does matter and it's your body and bith.  I encourage you to know what you want out of your birth experience and go for it!  Surround yourself with people who will support you and stand with you when things tend to go against the "norm" if you will.



   
   Childbirth should be a honor to expereince!  No woman shouldn't be robbed of the priviledge to birth her precious blessing!  So go for it do what seems to be against the main stream of the society!  TRUST BIRTH!!!

My Tramatic Cesarean Section with Baby #1

   I went to my prenatal appointment as schelduled with DS.  OB checked my vital signs and of course I had to pee in a cup and go back out in the waiting area.  As I sat there occasionally talking to other pregnant moms and asking the typical "How far are you? "Is this your first baby?" blah blah blah talk...

  


    I hear a nurse (or someone on medical staff) call my name and I got to sit on the white loud paper.  I was 40+3 wks at this time and the OB wanted to get an ultrasound to "make sure" everything was okay.  "Your fluid is low"  said the ultrasound tech.  I said what does that mean.  This is an excuse to get labor started she replied.  So she called the hospital behind us and told them to get a room ready for me.  I told my husband and we scrambled as we were caught off guard and had to go back home to get the labor bag.

 

  I grab my labor bag and maybe things not needed at the time but as women we want to be sure the we pack almost everything.  The ride back was hard I was scared I didn't know what to expect and I didn't have any knowledge on how to even go through labor or breastfeeding. (I was young)  Going to check in seemed like a lifetime of questions and waiting.  Finally in my room and now it's time! A nurse came in and got me ready starting an IV and getting anything I needed at the time.




  No one explained that they were inducing me and giving me pitocin.  My contractions started and it seemed like a normal menstral cycle.  I figured hey if this is it then I'm set I can do this.  Little did I know the affects of the pitocin would make my baby's heartrate sky rocket and my blood pressure to bottom out and become unstable.  Time was passing very slow and it seemed like nothing was happening.  Then my labor took a turn for the worse.


 

 I was informed that baby's heartrate keeps dropping and they wanted to put internal monitors on baby's head (yes inside my woohoo).  The first attempt failed and I thought I was dying at this point.  Second attempt by a differnt nurse no success.  So they called in an OB who was on call and he wasn't gentle at all.  He shoved his hand up my vagina and seemed to twist and turn it and still no monitors were attached to baby's head.  At this point I was sore and angry.  The nurse said she would give me some pain medication and allow me to rest.




  I was informed if the baby's heartrate continued to drop they would do a cesarean section.  I started to cry because I didn't understand why all of this was happening.  I attempted to stay calm and eventually dosed off.  Then what felt like a minute of sleep a number of medical personel came flooding in my room and asked me to get on all fours.  There  were so many people talking and one stated to me that I have to have a c/s.




  Tears streamed down my eyes as I was wheeled out of my room to an operating room and my husband stood afar off and I could see the tears in his eyes as he didn't understand what was going on and why.  I remember the fear that took over me and I felt helpless and abandoned.  Voices were all around me and I remember them talking amongst themselves and one said "Do we have time to shave her?" "No" was the reply.


   Then a nurse looked down at me and said they're going to pour something cold on you.  As they poured this ice cold liquid on me I was unaware that they were gassing me.  I remember looking at the OB and reaching for his hand then I was out.  I later woke up to a very intense pain and I felt like I was hit by a train.  I was moaning and groaning and in and out of conscienceness.  I didn't get to see or hold my baby until a day or two later.  No one told me how bad the pain would be to walk, sit up, cough, sneeze, hold him, go to the bathroom, breath, or even just move.


 

 The pain was out of this world bad and I cried when I tried to move or sit up because it was so horrible.  My baby would cry and it took what seemed like forever to turn on my side and sit up to reach in the plastic bassinet thingamagig. I didn't get to breastfeed and everyone else held him before me.  I felt robbed!!! Why, and how could this have happened to an very healthy pregnant woman.  How did I go from being a happy young woman awaiting her baby's arrival to a sore confused mom who doesn't know where to start.  I was like many young moms uneducated!  I though that the OB's knew best for me and thats all that matters.

  

  Well I'm here to tell you that's not true!  Educate yourself and know what your rights are.  My prayer and goal for this blog is that woman will seek the truth on childbirth.  You don't have to go through what I went through!  Read and go to natural childbirth classes and get all the education you can.

"Taking the Horror out of Childbirth!"

Contractions, breathing, and pushing oh my.
     Why is it that we have been cultured to think that childbirth is a diesease?  I walk up on conversations all the time about childbirth and how "AWEFUL" it is.  God made our bodies to carry, birth, and feed our precious babies and we can do it without an OB shoving their hands inside us and strapping us to a bed with our legs spread eagle.  I'm not against hospitals but it can tend to go to the extreme on how we view childbirth as a society.  If we dare choice to trust our bodies and birth the way we feel then they label us as putting our babies in danger.  Homebirth oh that's another story for another day.  Truth be told woman have been having babies since Cain, and Abel.  I just want to speak on behalf of all women today and say " You were made to birth"!  Psalm 139:14 says "...you were fearfully and wonderfully made..."  Wow fearfully and wonderfully made!  You can birth you baby the way you feel and trust birth!  I've had two c/s and one unassisted birth!  I know what it feels like to be told your body CAN'T work and that I will NEVER be able to have a vaginal birth.
   Well I guess I proved them wrong!  It took alot of determination and support from family and friends!  I got linked up with ICAN and began my journey to having the birth I wanted!  I educated myself and worked through fears and all the critizism that the OB's declared over me.  Was it easy no but I was determined to find answers to why they told me I couldn't birth my babies.  This is why I started my blog because I want to help people that see themselves in the same boat I was in many years ago.  Young, uneducated, afraid, helpless, hopeless, just down right feeling low.  I want to tell woman how they CAN birth their babies.  You don't have to be afraid pop on over and let me be your support along with the other mama's who may pop over to give you their personal experience.