From Morning Sickness to Hypermesis Gravidarum

Many women in our society today suffer from Morning Sickness. There are a lot of theories as to its cause, most of them relating to the hormone levels that the body is suddenly producing (namely Human Chorionic Gonadotropin or HCG). Whatever is causing it, however, we suffer from it. Sometimes it is as mild as a mild nausea in the mornings, but no vomiting, in what is considered by many to be classic morning sickness. Unfortunately classic doesn’t mean it is the only form, because it comes in many stages, symptoms, and severity. It also lasts longer for some than for others.
There are women who suffer from nausea throughout the day, but are free of the vomiting their sisters wind up doing. Others, as said, find themselves at the throne of porcelain at least once a day. And then there are others who, sadly, cannot stop throwing up and find themselves living in the bathroom attempting to eat crackers and keep some liquids down to abate the dry heaves. All of these are types of morning sickness, with only the latter having a name to differentiate itself from the rest.
It is known as Hypermesis Gravidarum and thankfully, is not common. Unfortunately, women do suffer from it and usually if they do they have also likely tried almost everything out there. The first thing they will have tried is crackers first thing on waking up, so probably best to just skip suggesting that. One of the most important things everyone needs to understand that this isn’t just someone who can’t handle nausea. This is a true problem that can arise, and usually leads to being hospitalized to be rehydrated because they cannot keep anything down. It’s important for us to learn more about this, and not just wave someone’s grave complaints of nausea in pregnancy off as nothing. A woman can become dehydrated and malnourished, and many do because friends and family members simply don’t believe it is ‘That Bad’.
So what can we do about it? What can we do about all kinds of morning sickness? There are quite a few remedies and suggestions out there. I’ve listed them below, but as always with anything in pregnancy check with your doctor first. Most of them may seem or even be harmless, but it is better to be safe than sorry.

* Drink plenty of liquids
* Keep electrolytes up: EmergenC or similar products are great for this
* Small and frequent meals
* Preggie Pops: These are new and work well for some people, not at all for others. But they are cheap and worth
checking to see if they do.
* Ginger in a variety of forms: Ginger ale with real ginger, ginger tea, candied ginger, etc
* Homeopathics: Nux Vomica, Chamomilla, Belladonna
* Acupuncture/Pressure: There are points on the wrists and elsewhere that can be utilized. You can get what are
known as Seabands that rest over the points on the wrists.
* Herbs: Chamomile helps some as does mint. Try to drink with honey rather than sugar. The honey provides a little bit
of protein and a healthier blood sugar boost than refined sugar.
* Hypnosis: There are a variety of techniques. Hypnobabies offers a cd for Nausea.
* B6: You can get this in a variety of forms. It comes as a pill, a liquid, and even an injection. Some people respond
only to one kind of B6 infusion.
* Medication: For over the counter stuff Unisom and B6 is often combined and effective. Benadryl has also been known
to work…though whether simply by knocking you out so you are not longer aware you are sick or not I can’t
comment on.
* Prescription: There are a variety of prescription medications for nausea. The most common are: Phenergan, Zofran
and Reglan.

Sometimes nothing you do will help. If it is severe try and gather friends and family to help you around the house, especially if you have younger children. While meal trains usually only happen after a baby is born, this is another time they can be very useful. Often in pregnancy our sense of smell is heightened, which can make cooking nigh on impossible.

Lastly are some foods I would avoid eating until the vomiting has passed…I’ve learned the hard way.
Ramen
Spaghetti or tomato bases
Vegetable soups (beef broth seems to be especially harsh)
Flavored rice (This is a texture thing more than anything)
Pasta (Trust me, spaghetti noodles are no fun. This is a texture thing again.)
Blue cheese (And probably other similar kinds of cheese)
Italian Sausage
Spicy things

If you’re reading this post because you are suffering from morning sickness in whatever variety, I wish you well soon!
Here are some resources for morning sickness and HG.
The HER Foundation, A Hyperemesis Education & Research Foundation provides education & support for mothers suffering from hyperemesis gravidarum and those who care for them.
American Pregnancy Association article on HG
Morning Sickness Help

Birth Trauma: One Reason I Became a Doula

A recent article on The Fword, a contemporary UK online site, really hit home. Here is the link if you are curious: http://www.thefword.org.uk/features/2008/03/not_a_happy_bir.Before I had read it I knew one of the reasons I started doing this work was to help mothers be fully informed about their decisions. To know that they had options that weren’t just the hospital, and that those options were just as safe. To talk about the common interventions, to explain how very easy it is to get lost in the system of the hospital and how to avoid becoming another mom on the conveyor belt of the machine.

When I had my son I was very lucky. I had a midwife who had done homebirths for years in her native country. She was revered for her knowledge and ability by both homebirth midwives in the area and other CNMs. Not only that but she trusted me and my body. I believe it is that trust that is lacking in many of the providers in modern day hospitals that lends greatly to Birth Trauma. All too often a woman cannot just be left to labor on her own, to let her body move, stretch, dilate, efface, and more on it’s own time. In a hospital everything has to be routine, has to be on the nose, ‘has to’ this and that. But birth doesn’t follow any hard and fast rule except that for most every birth, the baby comes out of the mother’s vagina eventually.

One way to avoid birth trauma is to hire a doula. For many a doula is not exactly a guardian, but a witness outside the family and the medical community who can speak up. They are a voice and eyes that belongs to neither patient, nor provider, who can put a pause in the machinery of hospital birth. That isn’t to say that birth trauma can’t still happen with a doula. I know that it can because some providers actually despise doulas and will kick them from the room if they get the chance. Or the doula will be utterly ignored as well as the mother. But thankfully, those providers are not common and most women who hire a doula find themselves with providers who are more trusting.

Still there are women out there who don’t have the resources or don’t even know about doulas who have horrible things happen to them on a daily basis. I’ve seen people say Birth Rape does not exist, how can it? There’s no sexual intent involved. But as the article linked about lays out, it doesn’t have to be about sex. Usually it is about power. And our providers, especially in a hospital, hold a lot of power…or at least that is what we have grown up thinking, feeling, and believing. And for many, that is all it takes to give in to order after order; “Hold your legs, don’t push like that!”, “You’re not dilating, I’m going to have to dilate you. Lay back now. Oh stop being a big baby.”, “This is what you get for trying to have a natural birth.”.

Food for thought…

Ultrasounds: Being Fully Informed

When I was pregnant with my son I first heard someone question the safety of Ultrasound. At that time I didn’t exactly ignore the words, but put them to the back of my mind. With my second pregnancy I fell into the excitement that was the 3D ultrasound, but at that time any warnings I had heard were far away echoes. Today as I face a pregnancy filled with ultrasounds due to it’s nature (IVF) the old words come back to me.

In the past few months I’ve seen quite a few blog posts, reports, and studies being published about Ultrasound. About it’s potential for danger, and how health experts are warning against it’s over use in pregnancy. As a result I’ve embarked on a dig for more information to both educate myself, and to have the information for future and current clients. What I have found does make me pause to wonder if having those ‘cute’ first photos are really worth it.

There are many articles out now about the possible dangers of Ultrasound, how its use and safety have not really been studied. Something similar happened in the 1930s for antenatal care and that was X-rays. It only later came out that they were linked to childhood cancer. We all know the dangers of x-rays. We encounter their careful use of lead aprons when we go to the dentist, or are worried our child has broken a bone. But what about ultrasounds? What danger could they pose to a develloping fetus?

Ultrasound is exactly as it name would imply. Ultra sound waves. They create various echoes against different kinds of tissue and this is what allows us to see our babies as they grow and develop. But at the same time, though high frequency sound waves could be doing damage and we wouldn’t even know it. If you think about it, people out on the airways dealing with jets have to wear protective coverings for their ears. Why? Because the sound is so intense and so loud that it can be damaging. Sound is vibrational and vibrations can cause damage. Could that high ultra sonic sound in utero cause problems with cells as they grow and develop? Certainly it is something to think about and that every parent should research more. Oh sure, we all love seeing numerous pictures of our babies as they grow and develop…but what if?

Below you will find a collection of informative and thought provoking links on the subject of ultrasounds. They are all worth reading and can help you form an opinion on whether going for that extra U/S at your doctor’s office, just to see how chubby baby is this month, is worth taking a chance.

http://www.birthinternational.com/articles/wagner02.html
http://midwiferytoday.com/articles/ultrasoundrodgers.asp
http://www.joyousbirth.info/forums/showthread.php?t=71
http://www.ehow.com/about_5347776_dangers-fetal-doppler.html
https://www.asrt.org/content/News/IndustryNewsBriefs/Sono/studyshows062408.aspx
http://www.aims.org.uk/Journal/Vol17No1/ultrasound.htm

The Price of Birth

So many times I have heard variations on these words, “I would have a homebirth, but my insurance won’t cover it and I can’t afford one.” In our day and age money has become the only thing we think of using in exchange for goods and services. However money wasn’t always the only thing used. Historically speaking a village would have a local woman, usually one past childbearing age, who served the village and surrounding areas as midwife and herbal wise woman. She helped treat ailments that afflicted all, welcomed in new life, and helped soothe the old as they passed on. Usually this woman was supplied with all she needed by the village; Food, wood, furniture, seeds and plants, etc. For the midwifes services the village traded her all she needed.

Today where money prevails and pays for our gas, our electric, our rent, and everything else the idea of trade has lost it’s value for many. However I am here to say that you should not discount the power of trade! While most midwives these days won’t take the total of a birth in trade, they still have to pay the rent, they are open to other arrangements. Cold hard cash doesn’t have to be the sole basis for getting the births we want.

While we are pregnant and before baby comes is often a good time to think about what we have to offer these amazing women who help us through one of the most important parts of our lives. Can you sew? Do you clean houses for a living? Maybe you’re an interior designer or website designer? Does your husband or partner have any special skills? Carpenters, masons, landscapers and more! Most everyone has a skill that is worth something and it NEVER hurts to ask. At worst the midwife will not have a use for your skill, but she may know someone who does or better yet have another solution to your issue coming up with the money to pay her.

Now of course it is important to note that most midwives won’t do solely trade and barter for their services. We all have rent and utilities to pay, and if we have gardens and livestock we can only give so much of that up and still have some for ourselves. So if even this is daunting to you consider the fact that you may still be able to raise that money. Small sacrifices can add up very quickly. If you drink a latte from Starbucks every day, that’s $3.50 times 30 or 31 which equals $105.00 a month. A garage sale of things you no longer use will generally bring in $100. If you ask friends and family to donate things and advertise well, you can make upwards of even $500 as a recent group Garage sale I was a part of made. You could even ask every friend and family member if they will help you in your wish for the best birth possible for you and your baby. Most people have a lot of friends, and even in this tough economic time most folks can come up with $5 to spare and some maybe more. The important thing to remember is that there is more possibilities than just your job and/or your partners job and insurance to pay for the birth you truly want.

In the Portland area there are at least a few who are open and willing to do trade for part of their services. Many more have payment plans and will work with a woman to make sure she gets the birth she wants. Being a midwife is a service of compassion and worth every cent you can raise, save, and barter for.

Midwives in the Portland Metro and Salem areas who are open to different arangements:
Pamela Hines-Powell – Circle of Life Midwifery http://www.midwifemama.com/
A Woman’s Point of View Midwifery and Woman’s Health, http://www.mydwyf.com/
Margy Porter – Sprouting Hope Midwifery, http://www.sproutinghope.com/
Lucina Armstrong – By Her Side Midwifery, www.byhersidemidwifery.com

These women were kind enough to share their insights and experience in trade with me. There are likely more who are open and willing to this, so don’t hesitate to ask if coming up with cash is hard for you.

How We Birth Matters

How we birth has a lifetimes worth of impact on not only us, as mothers, but on our children. A cesarean section can save the lives of a mother, her child, or both and it is a useful tool for us to have perfected. There is no doubt in my mind that there is a place for this surgical procedure in birth such as placenta-previa, certain cases of Pre-eclampsia, vertex (side lying) position of the fetus at onset of labor, to name a few. Yet recently there is a lot of press and research going into Cesareans as well as a lot of discussions on issues of ethics in performing them electively.

Let us break down some basics in terms of birth. First we will start with the hormones involved. The main hormone of birth is Oxytocin. This hormone is also known as the love hormone. It helps to stimulate our uterus to contract and bring our child into the world with labor. It also is one of the hormones involved in orgasm. As labor progresses the levels increase and then peak shortly after our child is born. This drug is an important building block for bonding with our child, effective breastfeeding, and even for allowing us to gain more effective rest in the first few weeks with our newborn. In addition our body also releases endorphins during the birth process. Some women release more than others in response to their discomfort. It should be noted that fear and stress can cause an increase in discomfort and pain in labor. It can also cause you to produce adrenaline which can counteract the effects of oxytocin and lead to labor stalling. Luckily when the things causing the fear or stress are removed, and the mother is given enough time to relax, labor will start back up without any artificial drugs that use synthesized oxytocin, like Pitocin.

Pitocin is a synthetic drug that produces contractions in a laboring mother, but there is little information on if it really produces the same effects of bonding and breast milk production as our own natural variety. Pitocin is, according to many, one of the most abused drugs in America. During the 1980s, Dr. Roberto Caldreyo-Barcia, a former president of the International Federation of Obstetricians and Gynecologists and a renowned researcher into the effects of obstetrical interventions commented, “Pitocin is the most abused drug in the world today.” It is important to note that the FDA has no approved the use of Pitocin for elective induction. That is an induction of labor where there are no risks or needs that require delivery. In most other countries this includes going past your due date and up to 42 weeks. Here is an excerpt from the package: Antepartum: Pitocin is indicated for the initiation or improvement of uterine contractions,
where this is desirable and considered suitable for reasons of fetal or maternal concern, in order
to achieve vaginal delivery. It is indicated for (1) induction of labor in patients with a medical indication
for the initiation of labor, such as Rh problems, maternal diabetes, pre-eclampsia at or near
term, when delivery is in the best interests of mother and fetus or when membranes are prematurely
ruptured and delivery is indicated; (2) stimulation or reinforcement of labor, as in
selected cases of uterine inertia;

Cesarean section disrupts oxytocin or completely bypasses it which is why there is often increased difficulty with breastfeeding. Sometimes this is increased due to the separations, even of a short period of time, between mother and infant. In addition this disruption leads to a higher incidence of PPD and PPP (Postpartum Psychosis). Unfortunately just disrupting oxytocin isn’t the only thing this life saving procedure can do. There is a lot of evidence emerging on how severely this surgery can impact a woman and her child.

A recent, although small, study from Sweden took 36 infants and looked at DNA-Methylation in the white blood cells. DNA-Methylation is how a cell remembers where it has been, essentially, and is a vital part of our immune system. In the infants who were born via cesarean (16) had higher levels of DNA-Methylation compared to those born vaginally. The reason this study was done was because of the other research out there that shows a correlation between higher incidence of asthma, diabetes, and leukemia in those born via cesarean. These diseases are linked to the immune system and so any change beyond the norm could be the cause of these catastrophic problems, and vaginal birth is how we are supposed to normally give birth.

As the title of this post says, how we birth matters. Currently most of our society, and some others, view cesareans as an acceptable alternative to vaginal birth. For some they even welcome it as it allows them to escape the pain and/or fear associate with childbirth and for others it is viewed as easier. Unfortunately this mindset is harming our current and future generations. Mothers who have cesareans suffer more miscarriages and fertility problems and may be forced to endure another cesarean because there are no practitioners providing VBACs in her area. This is just the tip of the iceberg, of course, on the future problems for mothers undergoing surgical birth. But something for us to consider is that today over 1/3 of Americans are born by Cesarean Section. Cesarean Section is for when something goes wrong. Before Cesarean Sections became safe, and before births moved to medical establishments, our neonatal and maternal death rate was not near 1/3 of the population. Yes it was still higher than the home birth numbers of today, but as a species that many people are not broken and unable to function.

In the end it is about educating yourself about the risks in all that you do during your pregnancy, labor, and delivery. It all effects us and our children now and in the future. You may find yourself in the space of having to have a cesarean section for a true need, but our choices leading up to labor can effects whether or not there truly was a need.

1. http://www.accessdata.fda.gov/drugsatfda_docs/nda/2003/018261_s023_PITOCIN_LBL.pdf
2. http://www.sciencedaily.com/releases/2009/06/090629081443.htm
3. http://www.sciencedaily.com/releases/2008/06/080618114718.htm
4. http://www.sciencedaily.com/releases/2008/08/080826080810.htm
5. http://www.hencigoer.com/articles/elective_induction/

Breaking Down Post-Dates Research

A woman sits in her doctors office at 40 weeks, anxiously waiting for her doctor to come in. After 15 minutes or more in she or he comes, glancing at the chart before greeting the woman by name. “Well, baby isn’t here yet. I doubt she/he will come on his own. Shall we go ahead and schedule an induction for next Wednesday?” There may have been some mild chatting of how she is feeling, taking babies heartbeat, a vaginal exam, etc before this whopper is laid out.

Perhaps the doctor and woman talk about the risks versus the benefits, perhaps not. I hear a lot of women talking about how their doctor’s say, “Going past 41 weeks is dangerous for the baby. The placenta can degenerate and your baby can die.” And while for some women this may hold true, we and our babies are not all created from the same mold. Our nutrition during pregnancy plays a roll as does our family history, ethnicity, and other personal factors. But when a doctor says these things, they routinely are referring to this study; Crowley P. Interventions for preventing or improving the outcome of delivery at or beyond term. (Cochrane Review). In: The Cochrane Library. Issue 2. Oxford: Update Software, 2002. (Abstract)

While this does look like a great study there are sadly flaws to be found. These flaws are pointed out in fairly easy to read language by Henci Goer. What if I were to tell you that the systematic review was flawed because the original studies themselves were flawed? That sort of puts a moot point on the study. Not to mention that if we look at Europe, where the maternal and fetal outcomes are much better than our own on average, we see they wait till 42 or 43 weeks to induce. So what commentary am I referring too by Henci Goer? Why this one.

Now comes the question of what to do with the information. Often times when the word, ‘Induction’ comes up it is at a time where women can’t even imagine changing providers. This is totally understandable! This is a person you have developed a relationship with over the pregnancy and had the expectation will be present at the birth. Thankfully if you have a truly trusting and good relationship you should be able to sit down with Henci Goer’s commentary printed out and discuss it. Hopefully the two of you can come to an understanding and you and your baby will get the time to finish developing.

Breastfeeding and Stem Cells Oh My!

“Breastfeeding should never be expendable. Only under extraordinary circumstances should breastfeeding be interrupted. It is too important to the physical and mental health of the child and the mother for them to give it up the way one might give up ice cream.” The Ultimate Breastfeeding Book of Answers, Jack Newman M.D. & Teresa Pitman

Many people might disagree with this statement, but when you consider some research that came out last year there is even more power in it. Doctor Mark Cregan of the University of Western Australia is a molecular biologist who made this discovery. And it’s an exciting one for everyone, advocates of breastfeeding and those who just simply do it. What’s more is it may eventually help to explain why breastfed babies consistently have higher IQs than formula fed children. The full article was published in February of 2008 and has made the rounds since then.

While some might consider this old news, being a year old, it is something worth thinking about when you are considering formula versus breastfeeding. No formula has, or likely will have, stem cells. The fact that breastmilk -has- stem cells leads researchers to believe that it is meant to take over development after the placenta. When you consider that humans are one of the only species born still needing to develop significantly in terms of cognitive and motor skills this is an important consideration. These stem cells could be an important link in our ability to fully realize our mental capacity.

Carol Gray’s Free Infant Craniosacral Clinics

Carol Gray is a local Portland midwife and chiropractor who does Craniosacral training for a variety of professionals in the region. What is Craniosacral therapy is a common question. Here is an excellent answer from her site:

Craniosacral Therapy (CST) is a gentle, non-invasive, yet effective type of hands-on body treatment that is helpful for infants and children as well as adults. It is an assessment tool plus corrective and preventive treatment. A newborn CST session can minimize or eliminate the repercussions of difficult births and help ensure good health for well babies. All babies should receive newborn Craniosacral evaluations and treatments as soon as possible after birth. Children should continue to receive pediatric CST periodically throughout childhood as they adapt to the process of growing up.

I have personally had numerous treatments through my life and after each one have felt so much better, and so much calmer and more settled with myself. It is an amazing treatment opportunity and there is a free infant clinic coming up on November 3rd at Nurture PDX. If your child is less than 6 months old, and even if they didn’t suffer any special incidents in their birth it can make a huge difference. Some of the things I have heard as benefits is colic disappearing, better ability to sleep soundly, happier babies, breastfeeding issues related to suck or latch improving or completely resolving. Take advantage Portland mamas! You may be amazed at the wonderful changes a single treatment can make for your baby AND for you.

Follow this link for more information:

Infant and Pregnancy Loss Awareness

Today is a day that has been picked out nationally for us to remember the losses of the smallest ones in our life, be they before we held them or soon after. At 7pm across the US light a candle for an hour in remembrance of those who have gone before, and those who may come again.

This day remind me of something from Baby Catcher. About how her son comforted her through her own miscarriage, explaining to her that she now had a spirit baby. And it would come to her again, and was waiting to come to her again. Whenever I hear of an infant or pregnancy loss, this story shines brightly to me as a light in the dark.

Mama Care Package!

I am happy to announce that I have recently put together a package for new moms. It is designed so that friends and family can buy something special for a new mom, making sure she gets some professional support and, hopefully, some sleep as well. Studies have shown that women who get one on one support post-partum suffer less from Post Partum Depression, breastfeed longer, and have an overall better sense of well-being around their birth and baby.

The Mama Care Package consists of an hour long pre-natal appointment where we will talk about any of mom’s fears, worries, or concerns about the birth and immediate post-partum. We will also focus on mom’s feeding plans, discuss strategies if there is excessive concern, and answer any general questions. If there are other children, this appointment is designed for me to meet them and them to meet me, so that if mom chooses too at her post-partum visit she can take a nap.
In addition to the pre-natal appointment and post-partum visit mom will get a handmade meal to stick in her freezer. Often new moms find they don’t have time to make a fully nutritious meal for their families or are too tired to want to think about standing and cooking. At the pre-natal appointment we will discuss what mom and family would like for their meal.
The post-partum visit is a three hour visit in which mom will have the opportunity to take a nap, shower, talk about questions and concerns involving baby and feeding, or just get out of the house for a little while. Breastfeeding help, guidance, and support will also be available if mom wishes to take advantage of these resources.

The cost for the package is $60. If the mom doesn’t want post-partum support, she can gift it to another person or use it for $60 off a Birth doula package with me. So tell your friends, hoard your pennies for expecting friends, and remember that we all deserve a little support with a new baby in the house.

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