About

We're back from vacation.  Missing these:

But sleeping in my own bed last night was bliss!  I've got a few blogposts in the works in my head, but I will probably be spending most of the day unpacking, doing laundry, and restocking my refrigerator.  So, in the meantime, I thought I'd give you a little sneak peek of part of my new website: the "About" page.  Just in case you've been wondering... who is this "Buscando la luz," anyway?

I'm a mom of three, doula-in-training, soon-to-be book author, lover of mountains and trees, wannabe photographer, and a Mormon. I have a school psychologist husband I call "Ax" in the blogosphere, two daughters born in hospitals, a son born at home, and a two-year-old shih tzu we call Boston. I grew up in a variety of places (Arizona, Utah, and Massachusetts), traveling often between divorced parents. I graduated in April 2003 from Brigham Young University where I majored in English (with an emphasis in editing).

In December of 2007, I turned to Blogger as an outlet for my passionate drive to share what I learned and loved about birth, taking on the psuedonym, "Buscando la luz." When I started that blog, I was coming out of a difficult phase of my life. I had spent the previous year or so full of anger and frustration about the world. Following my second daughter's birth, I became ill repeatedly, culminating in kidney stones. Those illnesses weren't surprising considering all the negativity and darkness I felt weighed-down by. Then we moved out of the basement where we lived to cute old house with lots of sunlight.

It was incredibly refreshing moving to that sunny little house. We had literally let the light back into our lives, but I still needed to let the light back into my heart.

Then one day I found and checked out a copy of Dan Zanes' album, Night Time!, from our public library. The pure joy and beauty of that music changed me. In his version of "What a Wonderful World," the end of the song has some lyrics not found in the original---a lullabye interspersed with Spanish phrases:

Sleep mi bebe, we are all here
Buscando la luz in the city
So that you may hear the laughter
El cantar y el gozar through the night
Arruru mi nene, arruru mi nena
Y que duermas con los angeles
Arruru mi nene, arruru mi nena
Y que duermas con los angeles

I loved how the song made me feel. I especially loved the Spanish phrase: "Buscando la luz en este mundo." It basically means, "Seeking the light in this world." The song and that phrase was exactly the mantra I needed at that time in my life. Seeking the light in this world. As I bathed in the warm light in our new home, I also began filling my soul with light and positivity. When I decided to take on a blogging psuedonym, I knew exactly what I needed to call myself: "Buscando la luz." And that's what I try to do. No matter how discouraged I become by the problems with maternity care in the U.S. (and other countries), no matter how many horror stories I am bombarded with, I'm not going to stop seeking out truth and light and goodness and sharing what I discover. I am and will forever be "seeking the light."

So you can call me Buscando la luz, or "Busca," for short. Or you can call me by the Hawaiian name my mom gave me nearly thirty years ago: Lani. And, coincidentally, this light-seeker now resides in the land of year-round sunlight--the Valley of the Sun, AZ.

Now I'd love to hear about you!

Mothering at the breast

Back in January, my baby was admitted to the hospital with a bizarre rash and swelling.  During his illness and our hospital stay, I'd say he was at my breast at least 70% of the time.  When the nurse wanted to give him an I.V. for fluids, fortunately I asked, "Are you worried he's becoming dehydrated?"  After assuring her that he was breastfeeding almost constantly, they agreed to hold off on the I.V. as long as I kept track of all his feedings and he continued to have lots of wet diapers. So they gave me a chart to mark all his "feedings."  It was kind of a joke.  When a baby is almost constantly nursing both day and night?  Ha.

One of the mornings, when the nurse asked about the feeding chart, I mentioned that it was hard to keep track in the middle of the night because he was nursing so often and sometimes I fell asleep mid-feeding and wasn't sure when it officially "ended." It was clear from her facial expression that my nursing style was totally foreign to her.  She replied, "Well, then that's not breastfeeding... that's just for comfort."

I was perplexed by her response.  What's the difference? Of course he wanted extra comfort... he was very sick, sleeping in a foreign place, being awakened repeatedly (after finally, blessedly falling asleep) for nurses and doctors to "take a peek" at his rash, being poked multiple times for blood draws and tests... of course he wanted and needed extra comfort!  But that "comfort" and my breastmilk were inseparable. Even if a baby is suckling only for comfort, the breast doesn't know the difference.  The breast responds to suckling by giving milk.

And how grateful I was that the only thing he wanted to do was nurse!  While many babies with his illness develop gastro-intestinal discomfort, blood in the stools, and other more serious problems, he never did, and I attribute that to the vast amounts of breastmilk he consumed during that time.

In my mind, nursing is so much more than "feeding."  I have never wanted to restrict my babies' suckling time to conform to when they "should" be hungry.  When one of my babies becomes distressed, the first thing I almost always offer is my breast, even if they just "ate" two minutes before.  If they don't seem interested or aren't calmed by suckling, then I try other ways to soothe them.

I was talking with a friend last week about how my babies have never taken to bottles or pacifiers.  I mentioned that my baby boy will happily drink water from a bottle when he's thirsty, and he would probably even drink milk from a bottle (though we've never tried).  The other day he found an old pacifier and sucked on it for a bit for fun.  But if someone tried to stick a bottle or pacifier in his mouth when he was grumpy, tired, afraid, or distressed, he would cast them away and only scream harder.

I am his pacifier.  I am the only answer to his deepest cries.  Nothing and no one else can give him what I can give.  Call it "just for comfort" if you want, but it's all the same to me.  In my mind you cannot separate breastfeeding, nursing, and soothing... they are all one.

There are many who would say my son no longer "needs" breastmilk or night-feedings because he's 14-months-old.  There are some who would have said he didn't need them when he was in the hospital at 9-months-old.  I say that the time when I am able to provide this gift to him will pass in the blink of an eye.  This time when only my body can comfort him is precious and fleeting.  If it means I will lose a few years of uninterrupted sleep, so be it.  If he's three years old before he's able to soothe himself back to sleep on his own, so be it.

Because of my own history and struggles with abandonment issues, there is almost nothing more important to me than establishing a secure, unbreakable attachment with my babies... telling them with my every touch and action that I will always be here... that I will never abandon them, especially when they need me the most, no matter what time of day or night.  I've never regretted one moment of nurse-comforting my children, and I feel confident that I will look back when I'm past my childbearing years with gratitude that I didn't push those precious nursing relationships away for the sake of independence or convenience.  (P.S. Moms who don't continue nursing through the second year are really missing out on the best trick up their sleeves for dealing with those daily toddler tantrums.)

Me and my almost 15-month-old nursling last weekend

I appreciate these words (shared by Sarah, one of my facebook fans) from lactation consultant, Diane Wiessinger:

Easy, long-term breastfeeding involves forgetting about the "breast" and the "feeding" (and the duration, and the interval, and the transmission of the right nutrients in the right amounts, and the difference between nutritive and non-nutritive suckling needs, all of which form the focus of artificial milk pamphlets) and focusing instead on the relationship. . . . [T]he real joys and satisfactions of the experience begin when they stop "breastfeeding" and start mothering at the breast.  (Source)

Maybe that nurse in the hospital was right, after all.  I wasn't really "breastfeeding" in that hospital, I was mothering at the breast.

Rejoicing with a friend

We must not, in trying to think about how we can make a big difference, ignore the small daily differences we can make which, over time, add up to big differences that we often cannot foresee.  -Marian Wright Edelman

Back in January, I got a surprising email from a local friend.  I discovered:

1) She was pregnant with her first baby. 
2) She had been following my birth blog.
3) She had chosen a practice of fantastic nurse-midwives. 

She also said, "I've loved reading about your home birth... I just am not 'courageous' enough to go that route on a first (maybe our next?)." 

All of these discoveries made me giddy with excitement.

Then at the end of April, she and her husband attended my "Birth Coach Boot Camp" where I shared what I believed were the best ways husbands can help their wives in childbirth.  Her due date was right around the corner, so I sent her home with my birth ball and my copy of The Birth Partner, by Penny Simkin.  And then we waited. 

Nine days after her due date, she sent me an email announcing that her daughter "was born last night at 10:44 p.m.  She is 7lbs 14 oz and 20 inches long.  We're both doing well."  I couldn't wait to hear all about the birth, but I didn't want to pester her about it, so I waited.

A couple of weeks later, I got a knock at my door.  There was my friend.  She said, "I have a bunch of things for you," returned to her car, and came back with my birth ball, my book, an envelope, a typed document (multiple pages of birth details!), and a sweet treat.  We chatted for a few minutes while she told me about her birth.  With the exception of having her water broken, everything had gone as she had hoped--intervention-free and unmedicated.  She was full of thanks for my help.  I was full of giddiness with joy for her.  It made my day.

After she left, I opened the envelope.  It was a thank you card.  She said, "I feel like I owe you a big thanks for so many things.  I've appreciated your passion and encouragement during this pregnancy."  More warm fuzzies.

Then I read the document with all the wonderful birth details.  Oh what a joy to read.  Because her midwives had three clients in labor that night, it was a little chaotic for them.  In the end, my friend's baby was caught by the nurse.  Her thoughts afterward:  "I felt empowered, like we could really do this on our own--we practically had!"  When the midwives came back in, they began talking about her needing to be stitched-up and delivering the placenta, but my friend remembers "not caring what anybody was saying and just happy to have the baby on my stomach."  The very last thing she wrote in that document was that she remembers:

Feeling grateful for the birth coach class our friend had offered.  It helped me feel empowered to say what I needed without fear. . . . It also helped me to put special emphasis on making sure I provided positive feedback by telling them the things that helped.  Finally, it introduced us to techniques of providing counter-pressure.  That turned out to be the only pain relief we needed!

 There are days when I throw mini birth-tantrums, and say, "Forget it!  I'm wasting my time trying to make a difference!  Nobody even cares!"  And then there are days when I know that I can never stop sharing what I know and love about childbirth.  The day my friend said, "Thank you," was one of those days.  A magical day.  

Never stop sharing, my friends!  Never give up.  We are making a difference.  Maybe only for one woman here and another woman there, but those women are worth it.  And so are their babies.  And there is nothing in the world like rejoicing with them as they bathe in the joy and empowerment they feel from their positive birth experiences.  Nothing in the world.

Is water birth safe?

(Trying out our birth pool a week before my home birth.  
I labored in the water, but delivered on my bed.)

I realized several weeks ago that there was a fairly important gap in my personal research on the subject of water birth.  While I have read a lot about it in books, heard rave reviews from friends, and seen countless water birth YouTube videos, I hadn't personally delved into the scientific literature about water birth.  Anecdotal and second-hand evidence can be very helpful, but I wanted to see the nitty-gritty facts myself.  Especially after I did a google search and found an OB's blogpost slamming water birth and all its dangerousness.

What I found was that most of the scientific journal articles that come up through a water birth Google search were anecdotal reports and/or case studies of individual cases where doctors suspected that a water delivery contributed to a child's death or poor health.  The general sentiment among doctors is fairly well summed-up in this concluding statement (from an article in the journal Pediatrics) penned jointly by a pediatrician, nurse, and obstetrician:

After reviewing the literature, we stop to ponder: what evidence of harm would be enough to convince us to stop the practice? Should the report of a single drowning be enough? Apparently, it was not. At this point, we are convinced there is no evidence to support any benefit of underwater birth for the neonate, and plenty of evidence to suggest harm. (source)

Another doctor was so bold as to say:  "Water births currently provide no apparent benefit in childbirth" (source).  The introductory paragraph of his article had me chuckling to myself:

Despite an absence of supporting evidence, proponents of water births claim benefits and disregard concerns while continuing to fail to subject this approach to the rigors of scientific inquiry. This desire to ignore the facts may be particularly prevalent among individuals who prefer nontraditional delivery techniques.

I'm not about to suggest that water birth was the norm among our ancestors, but I would hardly call stirrups+hospital bed the "traditional" delivery technique.  Women have only been giving birth strapped to beds for a tiny portion of human existence.  And I won't waste my time addressing his claim that ignoring the facts is prevalent among those who prefer to deliver in "nontraditional" ways.

It can be frustrating and confusing trying to find the facts when it comes to water birth.  The most comprehensive review of the water birth research (that I'm aware of) is the Cochrane review.  Here's what the Cochrane researchers concluded in 2004:

There is evidence that water immersion during the first stage of labour reduces the use of analgesia and reported maternal pain, without adverse outcomes on labour duration, operative delivery or neonatal outcomes. The effects of immersion in water during pregnancy or in the third stage are unclear. One trial explores birth in water, but is too small to determine the outcomes for women or neonates.

So, basically, what we know from the scientific literature is that immersion in water can make labor less painful, but apparently we don't have rigorous enough scientific evidence to demonstrate the relative safety of water deliveries when compared with land deliveries. 

There are other studies demonstrating many benefits of water birth (though I can't personally vouch for the level of scientific scrutiny used by the researchers).  While these studies seem to have been primarily ignored or dismissed by the medical community, they can still be helpful as we strive to explore all the evidence. Here are some of them:

Waterbirths: a comparative study. A prospective study on more than 2,000 waterbirths.

Experience with water births: a prospective longitudinal study of 9 years with almost 4,000 water births

A retrospective comparison of water births and conventional vaginal deliveries.

Effects of water birth on maternal and neonatal outcomes.

Midwife Ronnie Falcao's website also contains a wealth of information on water birth safety.

I think it's helpful to keep in mind that adverse outcomes can occur regardless of mode/location of delivery, and that many modern obstetric practices have been shown by scientific study to be risky or questionable.  So I'm a little baffled by some doctors' outrage about water birth and their claims that it shouldn't be allowed to continue without rigorous scientific support.  If only they required the same standards for their own practices.  Back in April 2009, I quoted Jennifer Block from Pushed:  "A recent ACOG survey found that in 43% of malpractice suits involving neurologically impaired babies, Pitocin was to blame" (p. 137), and again: "Even Williams Obstetrics offers a sobering history: 'Oxytocin is a powerful drug, and it has killed or maimed mothers through rupture of the uterus and even more babies through hypoxia from markedly hypertonic uterine contractions'" (p. 138).  Yet many doctors still pump women full of Pitocin, often with little or no medical necessity.  Given that the percentage of women giving birth underwater is miniscule compared to the number of women being routinely administered Pitocin (a powerful drug with known and frightening side effects), I think tackling the Pitocin problem is far more urgent.

I would love to see a huge randomized controlled trial exploring water birth.  I would love to see this matter rigorously addressed.  In the meantime, what can we do?  I suppose each of us must use whatever tools available to us to determine what is best and safest for our individual circumstances.  For me, that includes my own intuition and Spiritual guidance from my Creator who knows the birth process and my body better than any other being.  I may not be able to determine, with certainty, that water birth is safe for you or anyone else.  But I feel confident I will be able to determine down the road whether it's right for me.

I'd appreciate any wisdom, stories, and insights you might have.

"I don't agree with home birth"

I've encountered several statements similar to this one over the last week:

"While I do not agree with home birth..."

A few things come to mind when I hear this statement.

1) How can you "disagree" that home birth was right for me or anyone else?  Do you know my medical history?  Do you know my midwives' level of experience and the quality of their outcomes?  Do you know your own care provider's?  How many home birth studies have you examined? ....

Check out the rest of this post over at my new website!

Bearing life and bearing witness

I couldn't restrain myself from proclaiming via blog comment the burning testimony in my heart.  And I figured I'd share it here as well. I use terminology and lingo familiar to members of my faith (The Church of Jesus Christ of Latter-day Saints), but I hope any and all of my readers will be inspired and uplifted by this expression of things near and dear to my heart. 

Like most of the women I know who chose to give birth at home, I studied the issue out in my mind extensively--even exploring the views of home birth opponents to ensure that I looked at the issue from all sides and didn't make the wrong choice. By the time I made the decision to give birth at home, I had spent the previous five+ years of my life studying childbirth. But even all of the science, facts, research, numbers, and stories wouldn't have been enough for me to take on the real, though minimal, risks inherent in home birth without fervent, deep, heartfelt consultation with the Lord.

I have never agonized over a decision more than I did over this one. We probably wouldn't have even considered a home birth if it hadn't been for certain financial circumstances in our life, but home birth was clearly the path that made the most financial sense for us. Above all, I did NOT want to make the wrong choice and put myself or my baby at increased risk, so it weighed extremely heavily on my mind. So we studied it out in our minds, worked hard to be completely open to the Lord's guidance, searched, pondered, prayed, and decided that home birth felt like the path we were being led to.

Next we asked the Lord if it was right, and my husband gave me a priesthood blessing I will never forget. It was one of the most tender and beautiful spiritual experiences of my life. I felt the most incredible burning in my heart--like I was being filled with the burning, life-giving love of God. I have never in my life received a more strong, intense, powerful answer to prayer. Then, throughout the rest of my pregnancy, when I had moments of weakness, my husband and the Lord reminded me of that powerful witness, and the Lord, in His tender mercy, promised me that we would be watched over and kept safe as I gave birth. And we were.

Do I think home birth is the right choice for everyone? Absolutely not. Do I think all birth attendants are safe? Absolutely not. I chose my midwives specifically because of their astoundingly superior stats and experience and because safety was extremely important to me. I think all women should drill their potential birth attendants about their stats and experience before choosing to put their lives and their babies' lives into a stranger's hands. There are many excellent doctors and midwives out there, and there are many lousy doctors and midwives out there. It seems like the wisest course to be sure you're getting one of the excellent ones.

Sometimes the Lord's guidance contradicts what the world sees as logical or rational or obvious. But personal revelation always trumps limited mortal understanding.

I love Elder Holland's words: "After you have gotten the message, after you have paid the price to feel His love and hear the word of the Lord, go forward. . . . You may, like Alma going to Ammonihah, have to find a route that leads an unusual way, but that is exactly what the Lord is doing here for the children of Israel. Nobody had ever crossed the Red Sea this way, but so what? There’s always a first time. With the spirit of revelation, dismiss your fears and wade in with both feet” (source).

I know that our Heavenly Parents care deeply about birth. I know that God did not send over 1/3 of his daughters to this world with bodies incapable of giving birth vaginally. I know that God is eager to help us make vital decisions impacting our pregnancies, babies, postpartum emotional health, and future health and fertility. Giving birth is one of the most important tasks God has given to women on this earth, and I know that He can and will and loves to help us as we navigate that beautiful journey.

Magnesium Manifesto

"There is no life without magnesium." -Mark A. Sircus

I feel so overwhelmed. There is simply so much to say, and I have no idea how to say it all coherently because my mind has been spinning with all this new, amazing information for almost a week. I'll do my best. (And I'll pepper as many of my research sources as I can fit in throughout the post, so I'd recommend clicking around and checking them out.)

Magnesium is incredibly important.  (Especially for pregnant women, but I'll get to that later.) Magnesium is probably most well-known for its partnership with calcium in muscle function--calcium contracts muscles, magnesium relaxes them.  But magnesium is actually involved in far more than that.  From what I gather, every time a nerve cell fires, magnesium is required to control the entry of calcium into the body's cells.

Dr. Christianne Northrup sums it up nicely when she says, "Magnesium is essential for the functioning of more than 300 different enzymes in the body, particularly those that produce, transport, store, and utilize energy. . . . In short, living without adequate levels of magnesium is like trying to operate a machine with the power off" (source).  And Mark A. Sircus, a magnesium proponent, describes magnesium as "the source of life" and "the lamp of life" because of its essential role in plant photosynthesis and human bodily functions (source).

As I've immersed myself in studying this amazing mineral over the past week, I have come more and more to see it with deep awe and reverence. Magnesium is at the core of all life and life-giving.  I'm in love with magnesium.

And, unfortunately, most of us are low on magnesium. Magnesium and calcium must be maintained in their proper balance in order to function correctly, but the average modern American consumes far more calcium than necessary and not nearly enough magnesium. That excess calcium can disrupt many important functions. Instead we should take in more magnesium than calcium or at least a 1:1 ratio.

There are myriad ways that magnesium deficiency can manifest itself in your body. Some of those are:

• Anxiety and panic attacks
• Asthma
• Nausea and vomiting
• Headaches and migraines
• Abnormal bowel function, constipation, etc.
• Heart disease
• High blood pressure 
• Muscle pain, cramps, and spasms
• Depression
• Hypoglycemia
• Kidney disease and kidney stones

And low magnesium can lead to several problems of particular interest to women, both pregnant and not pregnant:

• Recurrent miscarriages and premature labor
• Premenstrual syndrome
• Menstrual cramping and bloating
• Infertility caused by spasms in fallopian tubes
• Pregnancy leg cramps
• Pre-ecplampsia
(Source)  

So how do we ensure that we get enough magnesium?

Our ancient ancestors would have obtained more than enough magnesium through plants, nuts, and seeds from the earth's rich non-depleted soil and through soaking in the pristine ocean's limitless supply of magnesium chloride. With soils depleted of nutrients and oceans often too far away and/or full of toxins and pollutants, we aren't quite so lucky. But we can do our best with what we've got.

What are the best food sources of magnesium?

You pretty much can't go wrong with dark leafy greens, nuts, seeds, legumes, salmon, and whole grains.  Some of the best among those sources, according to The World's Healthiest Foods:

• Pumpkin seeds
• Spinach 
• Swiss chard
• Sunflower seeds
• Sesame seeds

Magnesium is also found in hard water.  One site I visited explained:

In a survey of 25 cities in the US, the lowest death rates from heart disease were found in areas where the drinking water supplied above average levels of magnesium. Part of Texas has the highest levels of magnesium in drinking water, and also the lowest cardiovascular mortality rates in the US Australia has some of the lowest drinking water magnesium levels, and also the highest cardiovascular death rate in the world.

How can we improve the body's ability to absorb dietary magnesium?

Avoiding or limiting certain magnesium-depleting foods and beverages will protect your body's magnesium stores, including:

• Soft drinks
• Sugar and refined carbs
• Excess unhealthy fats
• Alcohol 
• Caffeine
• Excess animal protein
• Certain medications, such as diuretics and steroids/corticoids

Increasing consumption of probiotics and prebiotics has also been shown to increase the absorption of essential minerals, in part because of their ability to break down the mineral-binding phytic acid in foods, releasing those formerly bound minerals for absorption. (See here)

Getting vitamin d through regular sunlight exposure will also improve your body's ability to retain magnesium and calcium.  Sunlight seems to do this more efficiently than vitamin d supplements. (See here) 

How else can we get magnesium?

Ocean water is a limitless source of magnesium chloride.  And, based on my internet research, magnesium is better absorbed through the skin than the gut.  If you live near a beach with clean water, regular soaks should benefit your magnesium levels.  For the rest of us, taking baths with epsom salts (magnesium sulfate) or magnesium chloride flakes will raise levels of magnesium in the body.

Magnesium is also available, of course, in oral supplements, but these can cause diarrhea in some people.

Pregnant Women, Listen up!

Clearly magnesium is essential for all of us, but I'm becoming convinced that maintaining adequate magnesium levels could reduce or eliminate a large portion of the pregnancy complications women encounter.  And, as I listed earlier, magnesium can also remedy many of the other complaints associated with our womanly cycles.

Dr. Christianne Northrup shared a story that illustrates what I'm talking about:

I was first introduced to magnesium during my obstetrical training, where I saw how effective magnesium sulfate was in preventing seizures and restoring normal blood pressure in pregnant women suffering from toxemia. Magnesium is also frequently given to women having preterm labor to stop contractions. It works! 

A good friend of mine, Alexa, had her third baby in 1994. About seven weeks before the baby was due, she started to have contractions that would only stop when she lay down. Because she was 2.5 centimeters dilated and almost fully effaced (conditions often present when a woman goes into labor with a full-term third child), she was put on bed rest. Luckily this helped, and she was able to avoid a lengthy stay at the hospital. After having her baby, Alexa was extremely run down, had frequent migraines, and severe muscle cramps. She decided to go to a Naturopath for help. He immediately diagnosed severe magnesium deficiency, and she was given weekly magnesium IVs to correct the imbalance. . . .
 
Alexa's OB/GYN was insistent that she get 1500 mgs of calcium every day to protect her baby's and her bones. He told her to take a couple of Tums, an antacid, any day she didn't get enough calcium from the food she ate. Tums contains calcium, and it was the calcium "supplement" he recommended to all his patients. (This was his strategy for keeping her calories from dairy fat down, too.) He never recommended that she increase her magnesium, just her calcium. It's not surprising that she had a magnesium deficiency after following his advice during three pregnancies.  (Source)

This story is frustrating for so many reasons.  But I want to focus on what Dr. Northrup says in the first paragraph.  Doctors know that magnesium helps women with toxemia and preterm labor.  So my question is... if they know it, why do they wait until a woman comes to the E.R. to pump her full of magnesium?  Why are they putting women on bed rest when they have preterm labor instead of teaching them about optimizing their magnesium levels?  Why aren't women with recurrent miscarriages or infertility or PMS or excruciating menstrual cramps being tested for low magnesium?!

Why aren't we all being told how crucial it is to keep our magnesium levels optimal?


I couldn't know this information and not share it.  So here I am.

Magnesium is crucial. 

Please spread the word.

Dolphins and Birth Plans

While I was in California a few weeks ago, we hit the beach. Almost as soon as we got there, we saw something swimming several yards out in the water. At first I didn't know what it was and sort of screamed (thinking shark), "There's an animal!" Once it became clear it was a pod of dolphins, I had to smile to myself, reminiscing.

I used to be mildly (or... very) obsessed with dolphins as an adolescent. I had dolphin figurines, dolphin stuffed animals, dolphin posters, dolphin videos, dolphin stationary, dolphin everything. I did book reports about them, dreamed of swimming with them, toyed with becoming a marine biologist because of them, etc.

I was reminded of that adolescent dolphin fascination again this morning.

Years ago, my sister saw Marsden Wagner's Creating Your Birth Plan at Overstock.com for cheap and, knowing my passion for all things birth-related, she told me about it. I had never heard of the book itself, but I knew simply because it had Marsden Wagner's name on it that it was a book worth having. So I ordered it, and it has basically been collecting dust on my bookshelf ever since.

About 2 weeks ago we got word that my sister-in-law is pregnant after years of infertility. I'm ecstatic for them. And, naturally, I'm feeling protective of her and wanting to do all I can to ensure that she has the best birth experience possible. So I was perusing the birth books on my shelves about a week ago, contemplating which one(s) I should lend to her first, and I pulled out Creating Your Birth Plan, thinking it might be a good one to start with (especially since it has an M.D. in the by-line). As I flipped through the book, however, I realized that I'd probably better read it before I lend it out to anyone, just so I know what I'm sharing with people.

(I lent her Penny Simkin's Pregnancy, Childbirth, and the Newborn and The Birth Partner instead. Her husband's currently in physical therapy school, so it seemed fitting to start them off with the words of a fellow PT.)

So I've been skimming through Creating Your Birth Plan off and on over the past week or so. This morning I lingered on p. 176 where Dr. Wagner shares some fascinating details about dolphin birthing. Here's an excerpt:

At its physical and emotional best, support for women in labor has always reminded me of dolphin birth. When a dolphin gives birth to a calf, several female dolphins swim in a circle close to the laboring mother. Slightly farther away, another larger group of all the remaining females in the pod circle around the laboring dolphin. Then, even farther away, all the male dolphins in the pod circle around her. The entire collective comes together to protect the laboring dolphin and her emerging calf from intrusion and harm. A woman giving birth to a baby thrives when she's at the center of a circle of love.

This prompted me to do a google search and discovered that there are actually places where women give birth in the water "assisted" by dolphins.

A Russian male midwife, Igor Charkovsky, says this about the practice: "Dolphins have an affinity with the baby in the womb and are automatically attracted to pregnant women. They sense when a woman is about to give birth and gather round. They give both the mother and child a sense of protection and safety" (source).

I've been mulling over the topic of birth partners in preparation for writing something for the book, so this dolphin stuff feels relevant. And it has reminded me, yet again, how crucial it is for women to have supportive people around them as they give birth. The people we invite or allow to be with us can make or break our birth experiences. I recently encountered a 2005 study indicating that there is a strong correlation between patient satisfaction with care provider and lower cesarean rates. And Penny Simkin's research has demonstrated that the women with the highest long-term levels of satisfaction with their birth experiences were the women who had positive memories of the way they were treated by their care providers. Which brings me back to birth plans.

I think writing a birth plan is a helpful exercise. But I think most women do it too late in the game. A birth plan will do little to help you if the care provider and place of birth you have chosen have a practice style totally incompatible with it. In my opinion, the time to write your birth plan is before you ever choose a doctor or midwife (which is why I toyed with giving my sister-in-law Marsden Wagner's book now). I can't stress enough how important it is to choose the right provider--someone who will support and respect your birth preferences and shares your personal philosophy of birthing. You'll know you've found the right provider when you know you don't need to give them a copy of your birth plan when they arrive to catch your baby. Birth plans, at their best, aren't for labor day, they're for doctor/midwife interviews. Unfortunately, most women don't approach the doctor/midwife selection process this way. Hence, there are far too many battles in the labor room where peace and joy should prevail and far too many cruel jokes among doctors and nurses about "those women" with birth plans. Alas.

Given how protective I feel of my pregnant and laboring loved ones, I suppose it's no surprise I grew up with such an affinity for dolphins. I wish I could circle protectively around them throughout their pregnancies and births as the dolphins do. Maybe if I ever start an official doula business, I'll have a dolphin logo? That would be cool.

Re-post: Defining Female Empowerment

The feminism chatter on CJane's blog has got my head spinning. Now I'm all befuddled and not really sure where I stand, but it brought my mind back to this post from last August, so here it is again in case you missed it...

The whole battle between the two camps is due to the faiure [sic] of women in the country to fight for real empowerment. They take up an 'easy' cause, child birth and child raising, to fight for with the enemy that does not exist, other women. Rather than fight men for equal pay (the ERA is STILL not ratified in this country!), equal opportunity, fight sexism, fight discrimination, they pick easy 'battles' with no true winners. My partner calls the breast-home birth-epidural-vaccination battles 'Hen Chatter'. No real substance or results. These arguments do nothing to better the lives and livelihoods of women or our daughters. Filled with hystrionics [sic] and personal anecdotes they are just busy work, like darning once was, for women. Keeps the little women busy and from tackling the real fights. Keep it up ladies and we will remain in the 1960's for another half century. Empowering women is not about how you have a baby!

-Ali (excerpt from her comment in response to "Pushing Back: Has the natural childbirth movement gone too far?" by Lisa Selin Davis)

I linked over to Lisa Selin Davis' essay from the Citizens for Midwifery blog. Initially I expected the article itself to get me riled up. But it turned out to be fairly balanced. Just a few painful jabs. Then I started reading the comments. Why do I let myself read the comments? The essay's title is quite fitting, in fact. Except Jennifer Block's title was making reference to the way women as a whole are "pushed" into less than ideal maternity care. This essay refers to the way women "push" each other. And, after reading the comment by "Ali" above, I certainly did feel as though I had been violently shoved to the ground.

My immediate reaction was... I have to write a blogpost! So I opened-up this window, poised to spill my reaction on the blank screen with gusto. But I stopped myself. I knew I needed to take a breather so I could express myself with a level head.

So I folded our (massive) piles of laundry while my husband and kids scrubbed the toilets and cleaned the bathrooms. Then we all put our piles of clothes away. And we put more loads of laundry in the washer. Now, with my sweet babe napping, and my husband getting lunch ready, I think I'm ready to say what's on my mind. I do my best thinking while completing seemingly brainless tasks, I think--showering, housework, etc. Multi-tasking is fun, no?

Here's what I've been thinking about today...

4.3 million births were registered in the United States in 2006 (source). And the vast majority of women worldwide will give birth at some point in their lifetimes. That translates to a mind-boggling number of births. So, in my view, what happens to women in childbirth is an issue that should matter to all women everywhere.

But, of course, we are all in different stages of life. The issues that matter to each of us are usually those most pertinent to our circumstances. I happen to be in my childbearing years. I have spent the past six+ years totally immersed in childbirth and childrearing. That is where my head is. So I am well-versed in the abuses toward women (and babies) occurring within that sphere. On the flip side, most of my female age-mates have spent the last six years in graduate school and the workforce, building their careers. They would be well-versed in the abuses toward women within their spheres.

Doesn't it make sense for all women to work within their own spheres of influence? What good would I do championing the cause of females in the corporate world if I have absolutely no idea what it's like to be in their shoes? What good does it do for any woman to say, in essence, "What matters to you is meaningless! My crusade is so much better than yours!" It reminds me of the similar sentiment that my work as a "stay-at-home" mother is menial or pointless, or that my career choice is somehow harming the progress of womankind. It is attitudes such as these that have led me to eschew the "feminist" label.

"Ali" accuses me and other birth advocates of fighting with "the enemy that does not exist, other women." But what has she just done? Is she not attacking me and women like me? I have always tried to make it clear that I do what I do to educate, inspire, and empower other women. Not ever to attack them. And, yes, I said empower.

Let's talk about empowerment. I can't tell you how many times I've heard women say, following the birth of their child, "That was the most empowering experience of my life!" I would love to see the day that childbirth is empowering for every woman, and never disempowering, as it is for too many. "Ali" may not be aware just yet, but women across the country are abused daily by their maternity care providers (many of them males). Can't we agree that needs to change?

Women can be empowered in a multitude of ways. Having a salary equivalent to a male executive is only one of them. Shouldn't "feminism" be about what matters to all women, not just about what matters to one small niche of them? Who is Ali to decide what ought to be empowering to other women? Aren't we all entitled to decide that for ourselves?

The fact of the matter is that the childbirth experience is a huge, often life-changing rite of passage for women. And what happens during that special experience matters deeply to many women, and rightly so. How does it harm the progress of womankind for us childbirth advocates to focus our efforts on maximizing the empowerment of that pivotal, life-changing experience? Can "Ali" and her partner really believe these issues are "hen chatter" or "histrionics"? Or that our efforts "do nothing to better the lives and livelihoods of women or our daughters." It is, in large part, because of my love for my daughters that I continue my crusade.

Furthermore, I happen to believe that darning is a valuable lost art--one I very much wish I had. Oh how many hole-filled socks I could have made wearable again!

So, "Ali" wants to get women away from their "needlework" and out fighting the "real fights" in the feminist agenda. I'm glad there are women like her fighting for equality in their realm of experience. But if you imagine all of womankind as a whole, perched on a tabletop, doesn't it make sense that we can't just raise one corner? Shouldn't we all "stand close together and lift where we stand" and improve every aspect of women's lives simultaneously, each exerting our efforts in the areas most suited to us? You work over there, I'll work over here, and together we'll all make a difference? Isn't that how it should be?

Eye-opening little nugget

I was googling "rhombus of michaelis" to see what else was out there on the web and found an archive link apparently documenting a letter written by a chiropractor, Todd Gastaldo, to Jean Sutton. I guess they were in some disagreement about what happens to the pelvis when the rhombus of michaelis moves, but that's not my reason for posting.

They were in total agreement that lying on the back or semi-reclined on the tailbone prevents the birth canal from opening to its full capacity--substantially. Apparently by 20 to 30%! That's huge. Then the doc gave the following eye-opening observation, calling it "obvious OB crime" (and I would add that OBs aren't the only perpetrators--midwives are also to blame sometimes):

OBs are slicing vaginas en masse (euphemism "routine episiotomy")--surgically/FRAUDULENTLY inferring everything possible is being done to OPEN birth canals--even as they CLOSE birth canals − up to 30%.

OBs are slicing abdomens en masse ("c−section")-- surgically/fraudulently inferring everything possible has been DONE to open birth canals--even as they CLOSE birth canals − up to 30%.

Now--to be sure--allowing the birth canal to open the "extra" up to 30% is not going to prevent all caesareans and episiotomies--but it can't hurt. Incidentally, when babies' shoulders get stuck, OBs KEEP the birth canal closed--even as they say they are opening it maximally.

OBs don't charge for their mass vagina slicing--but it is known to increase severe perineal tears by 50X--and perineal tearing is the most common reason for hospitalization of women:

"The most common diagnosis for hospitalization among all women is trauma to
perineum due to childbirth" (source).

It blows my mind that we just lie down and take this... over and over and over and over and over and over again.

When will we demand that these crimes end?

Stand by me

A statement out of a recent Midwifery Today E-Newsletter reminded me of something I've been wanting to blog about ever since my doula training almost a year ago. Dutch midwife, Gre Keijzer, explained:

In my view, starting the second stage in a standing position can be seen as a preventive measure against the occurrence of shoulder dystocia. If it does occur, it can be easily corrected without having to perform all sorts of heroic manoeuvres.

I've become somewhat obsessed in the last year with giving birth in standing positions. My fascination began when my doula trainer, Mary, shared a handout adapted from an article by Jean Sutton called, "Physiological Second Stage or Birth Without Active Pushing."

Jean Sutton, my doula trainer explained, was an engineer before becoming a nurse/midwife. So she applied her understanding of engineering to the human pelvis and determined the optimal maternal stance for the baby's smooth journey through the birth canal. She argues, "Human birth is an engineering situation . . . . We have tended to ignore the way the maternal pelvis and [fetal] head are designed to interact. Parents should be given the facts about how the process works." She also says, "In a normal physiological birth, the mother has no need to deliberately push her baby into the world." Here are the particulars of achieving this apparently effortless process:

1) Optimum fetal positioning. In order for this smooth "fetal ejection reflex" to occur, the baby should be in the anterior position (facing the mother's back) before the pushing stage begins. The website Spinning Babies has excellent resources for encouraging babies to rotate into this optimal position before and during labor.

2) Supportive environment. The laboring mother needs to have freedom of movement. Jean Sutton recommends having "strongly fixed rails or bars at or above normal waist height." A sturdy support person to hold onto may also be sufficient.

3) Optimum maternal positioning. The laboring mother should be in an upright position--standing or kneeling. The mother's weight should ideally be "in front of her ischial tuberosities" (the bones in your bum)--so the upperbody leaning slightly forward. The mother's hands should be grasped onto something above waist height to release tension in the lower body. Her back arched, head thrown back. If ideally supported, her body will sag and her knees will rotate outwards, and the lower part of the woman's spine which includes the tailbone (the Rhombus of Michaelis) will move backward causing her pelvis to destabilize. Midwifery Today describes this fluid physiological process this way:

The following spontaneous actions then occur: the mother reaches upward for something stable to grasp; her body sags forward and knees roll out; her back arches and she begins to wriggle her lower body; the uterus contracts and forces the baby downward (a series of actions very similar to those during orgasm).

Jean Sutton argues that any position raising the knees above the seat, reclining, or squatting will cause the pelvis to be "splinted" and fixed. It is also important that a woman's tailbone be free to flex and move out of the way of the baby's head as it travels down.

A woman reclined in a bed cannot experience this spontaneous, fluid process. She also can't experience it with an epidural. Jean says:

I think we need to get women to understand that, although epidurals are great for pain relief, they actually get in the way of a spontaneous second stage and vaginal birth. In many cases, the reason they've got an epidural is that the baby wasn't in the best position when it started, and the baby in the less suitable positions needs all the space he can get to turn around in.(Source)

Jean Sutton also emphasizes that it is crucial to resist the temptation to "help" a woman through this process: "Women may be left with permanent damage if the legs or pelvis are moved at the wrong time or at the wrong angle. It must be understood that the spine has no support once the Rhombus moves."

I've given birth three times. Every time I have been squarely on my tailbone with my knees up... like so...And pushing took a great deal of effort every time. It's my dream to someday experience this spontaneous physiological process as God and nature intended--standing upright!

You may also enjoy this article about the Rhombus of Michaelis and physiological birth by Sara Wickham and Jean Sutton.

(Re)birth

Giving birth for the first time is life-changing. I was reminded of this, once again, a few moments ago as I was reading through my maternal grandmother's life history. A couple of years ago I started typing her hand-written life story so it could be compiled with other family histories in a book for our families and future generations. Tonight I was thinking about her, feeling a need to refresh my memories of her past, and began reading the portions of her story I had previously typed. Then I came upon the section where she describes her feelings after giving birth for the first time. She says:

[T]here is absolutely nothing like that first-born baby. For me, that first birth, of our daughter Judy, represented a sort of “rebirth” for me, not withstanding my having assisted at a number of births in my nursing profession. I had this peculiar “psyche” that I couldn’t really actually give birth to a baby--I felt that I was a sort of unreal bystander or spectator in this big game of life, so when I did really actually give birth to a baby, I was brought to realize that I was first as real and able a player in this game of life as anyone else. When her daddy came into the room following her birth, I exclaimed “We did it!” (We have a baby).

I do not know the details of her birth experience. My mother was born in 1947, so it was during the horrific "twilight sleep" era, but I get the sense that my grandmother was aware during the birth process because of the way it changed her from feeling like a spectator to feeling like a "real and able player." I wish she were still alive so I could ask her. And I wish every woman's first time could be a beautiful, joyful memory and (re)birth just as my grandmother's was.

Divine Design

Back in October, I posed this question on the Birth Faith facebook fanpage: "Do you believe the birth process was divinely designed?" I got some great responses and decided that I'd write a full blogpost on that very topic soon. Well, "soon" came and went. Then a couple of weeks ago I took a poll of my facebook fans asking what they'd prefer to see next, and "spiritual roots" won. So here it is. At the risk of opening myself up too much, I'm going to share some of my most cherished and personal beliefs (interspersed with relevant quotations I like). Whether you agree or not, I ask that you please be respectful.

I believe the human body is a sacred temple, a masterpiece patterned after the divine. I believe the functions and processes of the human body, particularly the birth process, are magnificent.

I marvel at the miracle of the human mind and body. . . . No camera ever built can compare with the human eye. No method of communication ever devised can compare with the voice and the ear. No pump ever built will run as long or as efficiently as the human heart. No computer or other creation of science can equal the human brain. What a remarkable thing you are. . . . Look at your finger. The most skillful attempt to reproduce it mechanically has resulted in only a crude approximation. The next time you use your finger, watch it, look at it, and sense the wonder of it.

-Gordon B. Hinckley (“The Body Is Sacred)

I believe my female body was created in the image of my Heavenly Mother's body. I believe we are all spirit daughters of a divine Mother--the eternal companion and equal of our divine Father.

God is your father. He loves you. He and your mother in heaven value you beyond any measure. They gave your eternal intelligence spirit form, just as your earthly mother and father have given you a mortal body.

-Spencer W. Kimball, “Privileges and Responsibilities of Sisters”

I believe our Heavenly Mother can and does lend us her uniquely feminine help, strength, wisdom, and love.

[K]nowing how profoundly our mortal mothers have shaped us here, do we suppose [our Heavenly Mother's] influence on us as individuals to be less?

-Spencer W. Kimball

I believe the male-female pair has been the pattern for eternity. There could not have been a man without a woman to complement him. I do not believe the creation of Mother Eve was an afterthought. She was part of the picture before her physical body was ever brought into being.

Having looked over all of this, He declared it to be good. He then created man in His own likeness and image. Then as His final creation, the crowning of His glorious work, He created woman. I like to regard Eve as His masterpiece after all that had gone before, the final work before He rested from His labors.

-Gordon B. Hinckley, "Daughters of God"

I honor our glorious Mother Eve, for her courageous choice to bring about the conditions necessary for humankind to procreate through conception, pregnancy, and childbirth.

We all owe a great debt of gratitude to Eve. In the Garden of Eden, she and Adam were instructed not to eat of the tree of the knowledge of good and evil. However, they were also reminded, “Thou mayest choose for thyself.” The choice was really between a continuation of their comfortable existence in Eden, where they would never progress, or a momentous exit into mortality with its opposites: pain, trials, and physical death in contrast to joy, growth, and the potential for eternal life. In contemplating this choice, we are told, “And when the woman saw that the tree was good for food, … and a tree to be desired to make her wise, she took of the fruit thereof, and did eat, and also gave unto her husband with her, and he did eat.” And thus began their earthly probation and parenthood. . . . If it hadn’t been for Eve, none of us would be here.

-James E. Faust, "What It Means to Be a Daughter of God"

I do not believe the sensations of childbirth are a punishment inflicted on women.

The Hebrew word for “multiply” is rabah (raw-bah), meaning to repeat over and over. It does not suggest greater sorrow, but rather repeated sorrow. The Hebrew word for “sorrow” in the Genesis account (Genesis 3:16) is from atsab (aw-tsab), which means “labor” or “pain.” While these words suggest that toil and suffering would be a part of Eve’s life, Eve did not view the conditions that came upon her through the Fall to be a curse (see Moses 5:11). Moses 4:22 “is a great revelation to women. Eve and her daughters can become cocreators with God by preparing bodies for his spirit children . . . . Mothering would entail inconvenience, suffering, travail, and sorrow; these the Lord foretold as natural consequences and not as a curse" (Ellis T. Rasmussen, A Latter-day Saint Commentary on the Old Testament [1993],17). . . .

“If Eve must labor to bring forth, so too must Adam labor . . . to quicken the earth so it shall bring forth. Both of them bring forth life with sweat and tears" (Hugh Nibley, Old Testament and Related Studies, John W. Welch, Gary P. Gillum, and Don E. Norton, eds. [1986], 90).

-Moses 4:20–32, The Consequences of the Fall

Rather than a curse, I believe the travail of childbirth is a blessing for our own and our babies' benefit.

* Pain in childbirth serves a physiological purpose. When a woman feels her labor, she can allow it to prompt her movements and changes of position. Women who can be mobile in labor will almost always move their bodies and adopt positions that will facilitate and speed-up the birth process.

* It facilitates the release of hormones which prime mother and baby for smoother delivery, bonding, and breastfeeding.

* It instills confidence and self-worth in a woman. Women who have given birth without drugs often describe the experience as life-changing. I believe God knew that new mothers would benefit from the trial of labor because it would allow them to see the strength and power within them. What better way to begin motherhood than on a springboard of power and strength?

-Me, "Nobody thinks you're a hero"

I believe our heavenly parents care a great deal about how (and even where) their spirit children are born into this world, and I believe they are eager for us to pray for guidance as we make those pivotal personal decisions.

Counsel with the Lord in all thy doings, and he will direct thee for good.

-Alma 37:37

Other posts you might enjoy:
Birth in the Bible
The Curse of Eve
Eve's "Curse"?

No medals here

Wow. Huge thanks to Jill (The Unnecesarean) for sharing this fabulous post by Arwyn: "Just like athletics: exploring a childbirth analogy." Jill described it as her "favorite breakdown of the childbirth-athletics analogy," and I have to agree that it is definitely my new favorite as well.

Arwyn eloquently discusses how our culture is quick and eager to praise, admire, and encourage those engaged in athletic feats--marathons, sporting events, and even local 5Ks, but when a woman attempts natural childbirth (a likewise challenging physical feat), she is lucky if she finds one or two supporters to cheer her on. Instead, far too often, it is those on the sidelines who should be her loudest cheerleaders who tell her she "can't do it."

I am personally saddened and disheartened when I (frequently) hear women tell me that it is their husbands who say, "You're definitely not tough enough for a natural birth," or who "can't bear to see her in pain," and thus push her toward an epidural. Would they also suggest that she's not tough enough for a marathon, if that was her goal, or stop her in the last grueling miles of the race and say, "You need to stop... I can't stand seeing you in so much pain"? I certainly hope they wouldn't. All this stuff has brought to mind this post from last June--"Nobody thinks you're a hero."

Here are a couple of teasers from Arwyn's post:

Everyone has heard of and no one doubts the existence of “runner’s high”, so why do we start plugging our ears and rolling our eyes and flapping our tongues when we speak of “birthing high”? Just as in athletics, in the absence of intolerable pain and unnecessary interferences (the latter of which is all too often responsible for the former), birthing has the potential to produce the most delicious chemical cocktail which feels good. (Divine even: I certainly felt like a birthing goddess afterward.) Even discounting that, or in its absence, there is potential for pride and a sense of accomplishment: something we value so much in athletics, yet scoff at in childbirth, where our effort benefits both us and another. We deny women that pride in accomplishment (for which support of athletics is so vital to girls’ sense of self and women’s equality), that boost in self-esteem and feeling of competency, right when we need it most: at the start of parenting, one of the most demanding journeys a person can undertake. . . .

But the current cultural construction of birth must change: not by moving backward to a time when women had no options in childbirth, and were expected — even encouraged — to suffer, and in which there were no medical interventions for when they were truly needed; but forward, to a time when our bodies are valued, our spirits are supported, and the work of birth is seen as hard, yes, and even sometimes painful, but within reach of most of us, and oh so worth it: just like athletics.

And some pics, for fun...

My dad (in the blue hat) finishing the Boston Marathon as a 50th birthday gift to himself, with his friend, and my (now deceased) brother, Steven, running the last 5 miles with him (behind my dad)...Me and my husband with his Boston Marathon finisher's medal (April '08)...My husband helping me run my first 10K, the longest race I've ever run...And then again, helping me through one of the most difficult (and best) experiences of my life (with my doula as another cheerleader)...So much better than a medal...

Ask Busca: Vitamin K?

Ali asked:

My first question is about Vitamin K injection given at birth. I had two [nursing] teachers tell me they are necessary to jump start the blood coagulation. They also said the dose given in 20,000 times the amount you need. This seems way out of control to me, and also unnecessary. so I was just wondering what you thought about it.

Busca's babble:

I should start off by saying that all three of my children have received a vitamin K injection at birth. I should also admit that except for the brief handout/consent form I received on from my midwives during my last pregnancy, I did zero research on the subject before my children were born. Sad, I know. I guess my only excuse is that I was so busy educating myself about other things that I just never got around to it. So I'm really glad you asked this question because it gave me a chance to do some digging.

The medical establishment's explanation for routine administration of vitamin K is that all babies are born with "low levels" of vitamin K. This begs the question: If all babies are born with "low levels," then aren't their levels of vitamin K "normal" for newborns?

Midwife Sara Wickham explains:

"The risk of a baby who is not given vitamin K developing HDN [Hemorrhagic Disease of the Newborn] is between 1 in 10,000 and 1 in 25,000 (Von Kries and Hanawa 1993). We also know that the babies most at risk from HDN are those who have traumatic births (clinically, this might include babies who are delivered by forceps, ventouse or emergency caesarean section, or babies who show bruising)" (from "Vitamin K - An Alternative Perspective," AIMS Journal, Summer 2001, Vol 13 No 2)

It doesn't surprise me that birth trauma would be highly associated with newborn bleeding disorders. Midwife Ronnie Falcao's gentlebirth.org has a wealth of helpful information. She starts her vitamin K discussion with these points:

Early or "Classic" HDN (also called Vitamin K Deficiency Bleeding) occurs in the first week of life. It is an iatrogenic condition, meaning that it is caused by medical care:

* premature clamping/cutting of the umbilical cord deprives babies of up to 40% of their natural blood volume, including platelets and other clotting factors
* the use of vacuum extractor or forceps often causes bruising or internal bleeding, which uses up the baby's available clotting factors
* the use of antibiotics inhibits the baby's generation of clotting factors

I'm always quick to believe that God/nature got things right, and it's us fallible humans who got things wrong, so this information just felt right to me.

She also shares fascinating bits of articles and research on vitamin K for newborns. Among the details I found most interesting and pertinent were...

* Colonization of the newborn gut with the mother's fecal matter and microflora is essential to jumpstarting vitamin K production in the newborn. Antibiotics and efforts to make the mother's perineum "sterile" will interfere with this important transfer of beneficial bacteria. "Babies are born next to the anus for a reason!" Yet another reason to avoid a cesarean whenever possible! (More info on how the newborn gut produces vitamin K here.)

* There is little clear-cut evidence that vitamin K injections are themselves harmful, but we can't ignore the fact that an injection will always be a potential avenue of infection. When administered in a hospital, the potential for serious infection is a cause for concern.

* There are situations where a vitamin K injection would be necessary. Some medications taken by the mother may interfere with vitamin K, babies who receive antibiotics have disrupted clotting mechanisms, and an extremely rare liver disorder can inhibit vitamin K production.

* Formula-fed babies receive sufficient vitamin K through feedings to supply their bodies' reserves, so it appears there is little need for these infants to receive vitamin K injections.

* Oral doses of vitamin K are sometimes even more effective at boosting newborn vitamin K levels than injections.

* Eating lots of fresh, leafy green vegetables will boost the vitamin K content of breastmilk and further protect newborns from late-onset HDN.

When/If I have more babies, I hope to do what I can to prevent HDN by giving birth in an environment where my baby will be exposed to beneficial bacteria to jumpstart vitamin K production, avoid birth trauma, delay cord clamping/cutting, and boost my own vitamin K levels through nutrition to increase my breastmilk's vitamin K content. As long as all of these preventative measures are achieved, I think it's unlikely that my future babies' "low" vitamin K levels will be problematic, but I plan to consider oral vitamin K as opposed to an injection if I feel it is necessary.

If all babies could be born under such natural/normal circumstances, I'd wager there would only very rarely be a need for vitamin K administration. As Sara Wickham argues, perhaps newborns and breastmilk are "low" in vitamin K for a reason? Should we really be messing with nature? Ronnie Falcao aptly concludes, "Until we have the definitive answers to these questions, parents have to choose between a system that's been in place for less than a hundred years and one that's been in place for thousands of years."

Any other research, facts, tips, and/or experiences from my readers?

Bugs and Guts

I've been wanting to post about birth and healthy guts for a while now. Years ago I read an article that had a profound impact on me. It was Jeff Leach's "C-sections, breastfeeding, and bugs for your baby." His piece changed the way I viewed the birth canal. Cesareans aren't just another way to give birth. Being born through an incision bypasses an extremely important step in the birth process--being colonized by the "base population" of the mother's vaginal and fecal microflora. Following birth, breastfeeding continues the transfer of healthy microflora (probiotics) from the mother to the infant. Jeff Leach explains:

Studies have shown that at one month of age, both breast-fed and formula-fed infants possess bifidobacterium but population densities in bottle-fed infants is one-tenth that of breast-fed infants. The presence of a healthy and robust population of bifidobacterium throughout the first year or two of life contributes significantly to the child’s resistance to infection and overall development of defense systems – not to mention the physical development of the intestinal system in general. Aside from the substances secreted by these specific bacteria that are known inhibit the growth of pathogenic bacteria, they also work to make the intestinal environment of the infant more acidic, creating an additional barrier against invading pathogens. In short, breast-fed babies are sick less, are less fussy, have fewer and shorter duration of bouts of diarrhea, and have more frequent – and softer – bowel movements. (source)

Cesareans can save lives, but they also put babies at increased risk for infections, allergies, asthma, intestinal problems, skin problems (such as eczema) and future health problems. When there is an absence of breastmilk, those potential problems can become exacerbated.

What are the best ways to ensure a healthy and strong population of gut microflora for your baby?

* Give birth vaginally.
* Keep baby and mother together immediately following birth (to prevent the colonization of harmful bacteria, especially when giving birth in the hospital).
* Breastfeed as soon as possible following birth and frequently thereafter.
* Consume probiotics (in foods or supplements) yourself during pregnancy and while breastfeeding.
* Avoid giving your infant antibiotics, if possible.
* Give birth in a location far-removed from harmful bacteria, if possible.

I was delighted (not long after giving birth to my son at home) to discover a study whose results indicated: "Term infants who were born vaginally at home and were breastfed exclusively seemed to have the most 'beneficial' gut microbiota (highest numbers of bifidobacteria and lowest numbers of C difficile and E coli)" (Penders, J, et al, Factors influencing the composition of the intestinal microbiota in early infancy). I wasn't surprised by those findings one bit. It has been informative and eye-opening to see how much impact the events following birth can have.

My first daughter was born vaginally in the hospital, lifted-up briefly for me to see following her birth, taken to the other side of the room to be weighed, poked, smeared, wrapped, and finally brought to me. We were talked into giving her formula during her first night because she wasn't latching well. We did establish a good latch with the help of the lactation consultants and some contraptions. We stayed in the hospital an extra day largely because of my perineal trauma (we spent two nights there). Of all my children, she was the most irritable/fussy. She was also the only one to experience troublesome eczema and diaper rash as well as frequent bouts of croup throughout infancy and childhood. She is also the only one of my children to exhibit a possible food allergy.

My second daughter was born vaginally in the hospital, placed immediately on my chest, breastfed exclusively following birth, and spent barely over 24 hours in the hospital. She experienced only minor diaper rashes, no eczema, has never developed croup, and rarely gets sick.

My son was born vaginally at home, placed immediately on my chest, spent his first hours at my chest and breast, and never entered a hospital. He developed a skin infection a week after birth, but recovered quickly (through oral and topical antibiotics, but I chugged probiotics to prevent thrush and other problems). I have consumed more probiotics while breastfeeding him than I ever have before. He has been my least fussy baby and has never needed diaper ointment nor developed eczema.

The more I learn, the more convinced I am that what happens during and after birth matters A LOT. Do you think you baby's postpartum gut microflora had an impact on his/her behavior or health short-term or long-term?

Related links:

Allergies, Asthma, and Eczema: Response to Disturbance of the Microbiota of the Newborn Gut

The potential for probiotics to prevent bacterial vaginosis and preterm labor

Improved appetite of pregnant rats and increased birth weight of newborns (following probiotic feeding)

Probiotics may aid postpartum weight loss

Probiotics during pregnancy, postpartum, breastfeeding, and their impact on immunity

Probiotics in infants for prevention of allergic disease and food hypersensitivity