Archive | November 2011

“Laborland” and the art of letting go of resistance to contractions

“Laborland” is a place doulas, midwives and mothers talk about when they refer to the mental and emotional state of labor. It is a state unlike anything in normal, everyday life. It was the journey to this state of mind that I found so fascinating when reflecting on the birth of my children.

It felt like a journey to a place deep inside myself. That was one of the reasons for the name “The Prenatal Journey”. It seemed that labor felt very irritating when people were disturbing me, talking to me, taking blood pressure and so on. When I closed myself off from everyone and went inside myself, I found the stillness in the eye of the storm. I didn’t feel much “pain” anymore. The further into labor I went, the deeper into the state I was.

I was inspired to write this post after reading an article by Nancy Salgueiro called Getting To Labor Land.

“In labor the mother needs to be in control of what is happening around her, who is there and what they are doing.  This needs to be dictated before she goes into labor and she needs to know that she can trust her desires are going to be respected so that she can completely let go of that control while in labor.

If she feels safe and knows the people around her will honor her requests and desires she will be able to let go of those things outside herself.

She needs to be able to completely surrender to her body and the sensations without conscious thinking.  This is how she will be able to go to what is called “labor land”.

Labor land is like a deep meditative state. It is like an out of body experience except that it occurs so internally, totally within your body and in the meditative part of your mind.  Being in this state allows the mom to get into the rhythm of her contractions and to develop a routine of what works for her to stay on top of the intensity of her labor.

It is important that no one tries to talk to her or pull her into her conscious mind when she is in labor land.  This can take her out of her zone and make it more difficult for her to deal with the sensations she is experiencing.”

To read the rest of the article go to Getting to Labor Land.

I noticed that when I was in laborland, my sense perception was different. I couldn’t actually hear or see very well. If someone was more than a meter away talking to me, I couldn’t quite focus on what they were saying. I also couldn’t hear most of the music or see the candles by the time I got to active labor. That’s why the doula who was so fantastic at my birth spoke to me right next to my ear. I could focus on that.

Another thing I noticed was that I had a heightened perception of other people’s emotions. Even though I couldn’t see or hear them clearly, I could sense what people in the room were feeling even if they were far away. It was helpful when they were feeling caring, supportive and believing in my ability. But when they were worried on my behalf or focused on mundane discussions with other people, it shook my confidence and focus.

The reason for this shift in mental/emotional states

There is a reason for this shift in awareness. Birth, like other instinctive functions, is programmed into the lower mammalian brain. There are different parts of the human brain, some of which we share with other animals. The highly developed neo-cortex is where all the conscious thinking, speech, language, sight and sound is processed. But birth requires the use of the mammalian part of the brain. All mammals instinctively know how to give birth. they don’t have to read books, attend prenatal classes or watch other females of their species to learn. It is instinctive. Human females have the same part of the brain and the sooner they leave the neo-cortex the sooner they will labor from their primitive brain.

It can be difficult to do that sometimes, especially with a lot of distractions pulling us back into conscious thought. And also our own lack of trust in our instincts and natural abilities.

It may be easier to understand if we think about the emotional / mental state of a similarly instinctively programmed function – sex. Sex is very similar to birth in more reasons than just one being the beginning and the other the end product. Sex is a function that is programmed into our mammalian brains for the survival of the species. But we can probably remember times when we had sex with our attention in the conscious, cerebral part of the brain. Compare that with how it feels the times we have sex while not in our conscious thoughts, but acting from pure animal instinct. That’s very similar to birth. You can birth from the neo-cortex and think your way through, and probably have a harder and more painful time, or you can surrender to your natural instinctual self and know that it knows what to do and it will do it well. Deep within you, you are programmed to give birth and know exactly what to do at every point in the journey.

 

 

 

Latest research on delayed cord clamping

I read the latest research today from the British Medical Journal with regards to the time of cord clamping. Here’s a summary :

November 15, 2011 — Allowing placental blood to flow into the neonate for 3 minutes, rather than cutting the umbilical cord within the first 10 seconds, as is common, increases blood volume sufficiently to elevate ferritin at 4 months, finds a study published online November 16 in the British Medical Journal.

Adequate iron stores are essential for brain neuron myelination, dendritic growth, neurotransmission, and energy metabolism in neurons and glia. Because iron demands are high in the young, iron-deficiency anemia and subclinical iron deficiency are associated with long-lasting cognitive and behavioral problems. Past studies that support a delay in cord cutting were conducted in developing or middle-income populations that have a high prevalence of iron deficiency anemia (ie, in Guatemala, India, Mexico, and Zambia), but did not follow up children past the neonatal period. Iron deficiency is less prevalent, yet still fairly common, in other nations.

Ola Andersson, MD, a neonatologist at the Hospital of Halland in Sweden, and colleagues enrolled 400 full-term infants born after low-risk pregnancies between April 2008 and September 2009, and randomized the time of cord cutting to either 10 seconds or 3 minutes. When a birth was imminent, the midwife would open an envelope assigning either cord-cut time. Midwives held the neonates 20 cm below the level of the mothers’ vulvas for 30 seconds and then placed the infants on the mothers’ abdomens to facilitate blood transfer.

The researchers assessed infant blood sampled on the second day for CBC (hemoglobin, packed cell volume, mean cell volume, mean cell hemoglobin concentration, reticulocyte count, and reticulocyte hemoglobin), iron status (serum iron, transferrin, serum ferritin, transferrin saturation, and soluble transferrin receptors), C reactive protein, and bilirubin and repeated all but the bilirubin test on 4-month samples.

Because past rationale for cutting the cord immediately after birth was increased risk for adverse events resulting from excess blood, the researchers also assessed the late-cord-cut infants for respiratory symptoms, polycythemia, and need for phototherapy to treat neonatal jaundice. Blood was drained from the placenta and volume measured, which explained the higher average weight of the babies with later-cut cords.

At 4 months, the infants in both groups had similar hemoglobin concentration, but the infants whose cords were cut later had 45% (95% confidence interval, 23% – 71%) higher mean ferritin concentration (117 μg/L vs 81 μg/L; P < .001) and lower prevalence of iron deficiency (1 [0.6%] vs 10 [5.7%] infants; P = .01). The delayed group also had lower prevalence of neonatal anemia (2 [1.2%] vs 10 [6.3%] infants; P = .02). The groups did not differ in respiratory symptoms, polycythemia, or hyperbilirubinemia.

Every 20 babies having delayed clamping could prevent 1 case of iron deficiency, the researchers estimate. They conclude that delayed clamping “should be considered as standard care for full term deliveries after uncomplicated pregnancies.”

Patrick van Rheenen, MD, a consultant pediatrician at the University of Groningen in the Netherlands, agrees in an accompanying editorial that “enough evidence exists to encourage a routine change in practice.”

The study was supported by grants from the Regional Scientific Council of Halland; the HASNA Foundation, Halmstad; HRH Crown Princess Lovisa’s Foundation for Child Care, Stockholm; and the Framework of Positive Scientific Culture, Hospital of Halland, Halmstad The authors and the editorialist, Dr. van Rheenen, have disclosed no relevant financial relationships.

BMJ. Published online November 16, 2011. Full text

Medscape Medical News © 2011 WebMD, LLC
Send comments and news tips tonews@medscape.net

 

The evidence is overwhelmingly in favor of waiting to clamp the cord. Yet, the majority of doctors continue to cut immediately after birth. Even the language we use is biased – “Delayed” cord clamping suggests that clamping immediately is the norm while delaying is the odd behavior. In the wider perspective, it is the other way around. In nature, animals and humans don’t rush to cut the cord. They tend to their infants first and concern themselves with the cord after everything else is fine. The terminology should be changed to “Rushed cord clamping”.

The question is not ‘Is early or late cord clamping better for mom and baby?’ The question is : “What are the reasons that cause caregivers to clamp early?” Is it lack of information? Not seeing a need to change the way they practice? Wanting to move the baby to the warmer  or oxygen mask instead of the other way around? Just following convention? Not seeing it as an important enough reason to change?

How do moms and dads feel about the issue? Those who understand the benefits of waiting for the blood to completely flow to the baby before clamping are vocal advocates for their babies. Those who don’t understand would rather have the baby with them as long as possible while they bond, but put up with the cord being cut and baby being taken to the warmer because they believe it is necessary. It may be necessary in certain emergency situations, but certainly not in normal situations.

What are your thoughts?

 

 

Weekend Prenatal Classes in Langley Dec 2011

Halloween is over and the holidays are around the corner. We know how busy this time can be, so we’re offering Weekend Prenatal Classes in December 2011.

The classes for first-time parents will be on two Saturdays-  Dec 3rd and Dec 10th from 10am to 4pm with a lunch break. Classes will be in Willoughby, Langley, BC. We’ve decided on a class series on two Saturdays instead of a Saturday and Sunday so parents-to-be have a week in between to integrate what they’ve learnt, and come back the next week with more questions and insights.

A lot of busy parents love the weekend format. We recommend parents-to-be take classes in their last trimester so they can attend the reunion class after all the babies in the class are born. If you are pregnant but are in your first or second trimester, you can still register for an early pregnancy class, and get a free 30 minute consultation with either Kaurina Danu or Jamie Taylor.

Refresher Classes for expecting parents who already have kids will be just one Saturday, Dec 17th from 10am – 4pm. Many expecting parents who are having their second, third or even fourth child ask if the prenatal refresher course will be useful for them. And our answer to that is, we guarantee it will be useful. Even if you’ve taken another prenatal class for your first pregnancy, you’ll get so much more depth out of our classes that will enable you to make more informed choices and have a more positive experience for you next birth. A lot of parents hope for a natural birth, but don’t really have enough understanding of what causes difficulties or excessive pain in labor, and what you can do to reduce pain without meds, and make informed decisions to help birth go more smoothly. And of course sometimes, unexpected things happen in labor so we teach parents-to-be tools to make the best decisions for themselves in partnership with their caregivers in whatever situation they may find themselves in. It’s great to know what to expect when you’re expecting, but’s it’s even better to know what to DO!

Participants love our classes because we don’t teach classes like a biology lecture. Classes are totally interactive, and tailored to the individual needs and preferences of the participants in each class. We know that Pregnancy, Birth and Parenting are affected by the social, physical, emotional and psychological aspects of our lives so we take a wholistic approach to Childbirth Education. We understand what preparing for birth and early parenting involves, and believe us when we say it’s not just memorizing a bunch of facts.

If you are expecting, you need to check out our classes. You won’t regret it. And if you know anyone who is expecting, let them know about The Prenatal Journey’s classes. This holiday season, save time with the weekend prenatal series in langley, while still getting prepared for the birth of you baby.

Call 604 809 3288 to register, or if you have any questions. Have an awesome day!