No-sew Baby Wrap Instructions

I made a stop at the clearance fabric table Friday night and scored some great stuff. So yesterday I enlisted the help of my wee ones in making two no-sew wraps. One for me and I haven't decided who to give the other one to. :-)

Here are the (extremely easy) directions (I consulted this site to figure out the details)...

1) Buy about 4-6 yards of stretchy fabric (Jersey knit cotton is probably best, but I just grabbed the cheapest stretchy stuff I could find). If you need help gauging how much to buy, this site gives some good direction on the amount of fabric you will need/want. After you get the fabric, you'll want to wash it. After it's washed, check to make sure the edges haven't frayed. (No fraying means you don't need to sew. Fraying means you'll want to turn the edges under and stitch them so it will stop fraying.)...
Read the rest of this post over at my new website!

Ask Busca: Breaking Water?

Elizabeth asked:

I have a question I'd love you to explore on your blog. In many of the birth stories I've read, Moms mention having their water deliberately broken by their midwife or doctor. Can this ever contradict a woman's internal timetable for the birth? Does water sometimes not break when it should, stalling labor? Is this practice ever considered an unnecessary intervention?

Busca's babble:

Artificial rupture of membranes (AROM, or amniotomy) is very common. Some care providers routinely break the bag of waters in an attempt to speed labor, especially in women who "fail" to follow the standard labor progress curve (at least one centimeter every hour). AROM is also used to induce labor, sometimes accompanied by prostaglandin gel and/or Pitocin. When an internal electronic fetal monitor is needed (to check baby's oxygen levels), AROM is performed to gain access to the fetal scalp. Sometimes AROM helps doctors or midwives determine whether a baby is in distress--as indicated by meconium in the amniotic fluid.

Can AROM ever contradict a woman's internal timetable for the birth? Certainly. Henci Goer, in her book The Thinking Woman's Guide to a Better Birth, explains, "[I]f left alone, two-thirds of laboring women reach full cervical dilation with membranes intact, and there are advantages to this" (p. 101). The amniotic sac and fluid serve a valuable purpose--not just during pregnancy, but during labor as well. Once a woman's bag of waters is ruptured, the chance of infection increases. Because of this, doctors and hospitals generally require that a woman with ruptured membranes give birth within 24 hours. (The chance of infection is much lower if vaginal exams are avoided.) So the membranes protect both mother and baby from infection. The fluid cushions the fetus and umbilical cord. Once the membranes rupture, the risks of cord compression and abnormal fetal heart rate patterns increase.

Early amniotomy also carries the frightening risk of umbilical cord prolapse. When a baby's head has not descended well into the pelvis, the gush of fluid can carry the umbilical cord into the vaginal canal where it will be compressed by the descending fetal head. This is an obstetric emergency requiring an immediate cesarean. My blogfriend, Sarah, recently shared her experience witnessing a doctor perform an unnecessary early amniotomy resulting in a cord prolapse and emergency cesarean. Oh that story made me seethe!

Does it hurt to leave the membranes intact? A recent Cochrane review of research assessing the use of AROM in spontaneous labors came to this conclusion:

Evidence does not support the routine breaking the waters for women in spontaneous labour. . . . Amniotomy has been standard practice in recent years in many countries around the world. In some centres it is advocated and performed routinely in all women, and in many centres it is used for women whose labours have become prolonged. However, there is little evidence that a shorter labour has benefits for the mother or the baby. There are a number of potential important but rare risks associated with amniotomy, including problems with the umbilical cord or the baby's heart rate. . . . The evidence showed no shortening of the length of first stage of labour and a possible increase in caesarean section. Routine amniotomy is not recommended for normally progressing labours or in labours which have become prolonged (Smyth RMD, Alldred SK, Markham C. Amniotomy for shortening spontaneous labour. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006167. DOI: 10.1002/14651858.CD006167.pub2, emphasis added).

So, AROM carries known risks and apparently few benefits, at least when used routinely as it so often is.

When left alone, sometimes the amniotic sac never ruptures--births "in the caul." I sometimes wonder whether my second daughter would have been born in the caul since my sac remained intact until my CNM broke it at 9 centimeters. Navelgazing Midwife says this about AROM and births in the caul:

I'd heard about an OB that was so disgusted with AROM that he offered a $50 bounty for every caul birth and shelled out thousands before calling the game... proving that it is possible and isn't dangerous and not AROMing did not slow labors down, but, in fact, helped women cope better.

She also shares some of her fascinating experiences witnessing births in the caul. When handled correctly, there is no harm to being born in the caul. Navelgazing Midwife's conclusion? "I find, as time goes by, that I touch membranes less and less. I believe they are there for a reason... will break when ready... and serve a purpose we might never know" (source).

For two out of my three births, my membranes ruptured before the onset of labor. In the future, should my sac remain intact (as with my second birth), I think I'll request that it be left alone.

What do you THINK?

I was sitting at the table eating dinner the other day, and my baby boy started acting like he was ready to nurse. I started thinking about taking him over to the couch to meet his request, and BOOM my milk let-down. I'd wager most nursing moms have experienced this chain of events hundreds of times.

That experience got me thinking. All I have to do is think about nursing my baby and my body responds within seconds. The salivation reflex is similar. You start thinking about something delicious and BAM... your mouth is ready for it with a gush of saliva.

And that got me thinking about how interconnected our thoughts and our biological processes are. Our thoughts can create almost instantaneous physical reactions! How amazing is that?! And how frightening too. It all depends on what you are thinking about.

So let's take this concept into the realm of birth. How can our thoughts affect the birth process? Michel Odent was the first to apply the phrase "fetal ejection reflex" to human birth. Odent has observed that when childbirth is undisturbed, delivery is an involuntary, reflexive process occurring extremely quickly and effortlessly. In order for this reflexive process to occur, a woman must be in a certain type of environment. A California College of Midwives bulletin explains:

For many mothers her need to be undisturbed is balanced by an equally powerful need to be in the “right” place and have family members of great psychological importance, as well as the doctor or midwife present, before she can “permit", at least at a subconscious level, that dynamic labor process to unfold. For those who prefer hospital care, these mothers must have arrived at the hospital before the Maternal-FER [Maternal-fetal ejection reflex] can complete itself (source).

Being at a hospital (or an interventive home birth) can also produce the opposite effect--essentially shutting-down this reflexive process:

One theory explaining M-FER is the role of primitive brain in facilitating the spontaneous processes of labor and birth. This theory also identifies as negative the influence of the neo-cortex . . . and a host of institutionally-originating disruptions such as bright lights, loud noises, coming and going or milling about of unfamiliar people, unnatural, anti-gravitational positions and frequent disruptions provided by invasive procedures such as vaginal exams, catherizations, fussing with EFM belts, etc. The “intensive care” nature of intrapartum nursing in hospitals means most women experiencing the exact opposite of “secure and unobserved” – all these nursing and medical ministrations and application of technology signal the potential for problems. They worry about themselves and their baby and feel very much like a bug under a microscope (source).

Where we are, who is with us, what they are doing, what we are thinking (or not thinking) about... all of these things have an impact on the birth process.

I saw this truth first-hand with my 2nd and 3rd births. My second daughter's posterior on-again-off-again labor didn't kick into gear until I finally said, "This has to be the real thing. We're going to the hospital!" And she was born (still posterior) within 3 hours of that thought. As I labored with my son, I am certain that my thoughts and psychological state slowed the process until my midwives had arrived and my husband was finished putting my daughters to bed. Once all the essential players were present, I surrendered to my body. My son was born less than 2 hours later. Though I wouldn't describe either of these births as fetal-ejection-reflex experiences, they did demonstrate the profound power of our thoughts and emotions as we give birth. (I hope to experience the true fetal-ejection reflex someday!)

It makes me all the more wishful that we could guard all women from negative influences or comments in their labors. A friend told me this week that she had planned and hoped for a drug-free birth with her first daughter, but her nurse told her, "Honey, you can't do it." Imagine what kind of thoughts that negative statement produced in her! Of course she got an epidural. (And chronic back pain at the epidural site to go with it... still bothering her over two years later. Fortunately she was able to have her son without drugs and had a vastly better experience.) Women in labor internalize what they hear. What might be a simple statement can have a huge impact on her thoughts and thus her body.

I'm looking forward to exploring this topic further. What do you think about when you're in labor and giving birth? Do you think it affects the process? I'd love to hear your experiences.

Reducing Infant Mortality

Great 17 minute film! Thanks for the heads-up, Jill.

Reducing Infant Mortality from Debby Takikawa on Vimeo.

Pick and Choose

I've been stuck on the topic of sleep lately. This morning I turned to Google when I started wondering whether my 3- and 5-year-old were getting enough sleep. I found this WebMD site listing the amount of sleep children need at various stages. It also gives tips. Knowing how I feel about cosleeping and night nursing, you can probably imagine how I reacted to this advice from WebMD:

Allowing your child to soothe herself and put herself to sleep unassisted are critical to establishing good sleep habits, sleeping soundly, and preventing future sleep problems. As Mark Weissbluth, MD, says in his book Healthy Sleep Habits, Happy Child, "The failure of our children to fall asleep and stay asleep by themselves is the direct result of parents' failure to give their child the opportunity to learn . . . self-soothing skills. . . . Some parents can't leave their kids alone long enough for them to fall asleep by themselves. . . . The major sleep problems in babies 4-12 months old develop and persist because of the inability of parents to stop reinforcing bad sleep habits" (source).

Dr. Weissbluth wouldn't think too highly of us! I might start feeling like a failure... except that my 3-year-old and 5-year-old take a mere 3-10 minutes to fall asleep most nights (without crying) and then stay peacefully asleep until 10-12 hours later. Perhaps I haven't irreparably damaged their "healthy sleep habits" by soothing them to sleep as infants (and toddlers) after all? (Can a 4-month-old really have "bad sleep habits" to reinforce?) Some of my fondest early childhood memories are of my dad singing us lullabies while we fell asleep and my grandma lying down with me until I fell asleep so I wouldn't be scared. Those were moments when I felt an intense sense of peace, security, and love... things I desperately needed at that time in my life (I had an emotionally traumatic early childhood). I'm so grateful my caregivers didn't fret over "reinforcing bad sleep habits" when I needed or wanted their assistance falling asleep.

Thank goodness we can pick and choose our experts! Isn't it funny how you can find opposing "expert" opinions on just about any topic? In terms of infant sleep, I much prefer Dr. James J. McKenna's take on things! He says:

[I]rrepressible (ancient) neurologically-based infant responses to maternal smells, movements and touch altogether reduce infant crying while positively regulating infant breathing, body temperature, absorption of calories, stress hormone levels, immune status, and oxygenation. In short, . . . cosleeping (whether on the same surface or not) facilitates positive clinical changes including more infant sleep and seems to make, well, babies happy. In other words, unless practiced dangerously, sleeping next to mother is good for infants. The reason why it occurs is because... it is supposed to ("Cosleeping and Biological Imperatives: Why Human Babies Do Not and Should Not Sleep Alone").

Of course I couldn't help feeling smug about this one:

Western parents are taught that "co-sleeping" will make the infant too dependent on them, or risk accidental suffocation. Such views are not supported by human experience worldwide, however, where for perhaps millions of years, infants as a matter of course slept next to at least one caregiver, usually the mother, in order to survive. At some point in recent history, infant separateness with low parental contact during the night came to be advocated by child care specialists, while infant-parent interdependence with high parental contact came to be discouraged. In fact, the few psychological studies which are available suggest that children who have "co-slept" in a loving and safe environment become better adjusted adults than those who were encouraged to sleep without parental contact or reassurance ("Babies Need Their Mothers Beside Them").

Thank goodness for access to information. With libraries and the internet, we can examine the differing view points about child-rearing (or childbirth or any other topic) and find what feels right for us. I'm grateful to have found what works for me and my family.