informed-choice

Homebirth Videos

Sun, 29 Aug 2010 08:06:24 +0100

Home Birth Gathering

Sun, 25 Jul 2010 17:13:09 +0100

For those:

who have had a home birth
who have wanted a home birth
who are planning a home birth
whose home birth didn't go according to plan
who are thinking about having a home birth
who have ‘caught’ babies born at home
who have supported mothers giving birth at home
who are interested in home birth...

R30 per person,

R50 if there's two of you

Visit the website for upcoming dates - www.homebirth.org.za

Contact:

Ruth

021 780 9510

078 557 9070

ruth@homebirth.org.za

Lana

021 703 4291

073 514 9754

doulalana@vodamail.co.za

Home Birth is a valid and safe yet overlooked birthing option.

Here in South Africa, we have one of the highest caesarean rates in the world (on average 70% in private hospitals). Women are realising that in a hospital environment their options and freedom to give birth as they wish,are often limited through hospital routine protocol and intervention.

This gathering is a support group for those who have given birth at home, for those who have wanted home births, for those who are planning a home birth or are thinking about it or are just curious. It also for those whose home births did not go as they had wished. We welcome midwives who attend home births and those who have supported mothers giving birth at home (partners, family, friends and doulas).

There will be a guest speaker, a short film on home birth and the opportunity to meet and speak to midwives, doulas and others who have had home births or are planning to. There will be opportunity for discussion.

Refreshments will be served.

Venue: The Forge, 12 Windsor road, Kalk Bay

Date: Sunday, 22nd August 2010

Time: 2pm - 4pm

Price: R30 per person, R50 if there’s two of you

Contact: Ruth ruth@homebirth.org.za or 021 780 9510 or 078 557 9070

Lana doulalana@vodamail.co.za or 021 703 4291 or 073 514 9754

Website: www.homebirth.org.za

VBAC & the myth of "once a c-section, always a c-section"

Sun, 25 Jul 2010 17:16:17 +0100

VBAC is an acronym for Vaginal Birth After Cesarean and is pronounced "vee-back".

In the 1980's when medical interference with birth was at it's very highest and c-sections were being overwhelmingly common, there was no real research on the safety of having vaginal birth after the uterus had a scar on it. It was then that the saying "once a cesarean, always a cesarean" became known.

Today things are a little different. During the 1990's began the start of a movement where women started re-exploring natural childbirth options and many who had had previous c-sections went on to give birth naturally. These days we now have the information available showing that having a vaginal birth after 1 or more previous c-sections is a safe choice, although it is not without risk.

So what is it that people are worried about with a VBAC?

The big concern is something called "Uterine Rupture" which can have devastating results if it is not detected and dealt with quickly. Due to the previous surgery there is now scar tissue left on the uterus from where it was cut into. In some cases the scar can be weaker than the rest of the uterus and a powerful contraction can cause the muscle tissue to separate.

While this sounds scary and unnerving for mothers wanting to achieve a VBAC it is important to consider the following:

The chances of it happening are less than 1% and have been reported to be as low as 0.09%. To put this further into perspective, the chance of have non-VBAC related complications (for any pregnancy) such as placental abruptia and umbilical prolapse are actually higher than the chance of uterine rupture
The risks and complications associated with a repeat c-section are higher than that of VBAC. A repeat c-section will also influence future pregnancies as they can cause placental malformations, increase risk of miscarriage and even reduce fertility
Induction of Labour should never ever be done with a mother who is having a VBAC. The medication used to induce labour can bring on very strong contractions and has been shown to increase the chances of a rupture occurring by a significant amount

FAQ's about VBAC

My doctor won't support a VBAC. What can I do?

Change your doctor. The safety of VBAC has been proven and even the notoriously conservative American Congress of Obstetricians and Gynecologists (ACOG) is in support of it. There is no reason for your doctor not to support VBAC other than it is not something they have knowledge of and are therefore not capable of caring for women having a VBAC. It is more than possible for find a more fully qualified doctor who will support your choices for your body, your baby and your family.

Can I have a VBAC at home?

Otherwise known as a HBAC (pronounced "H-back"), and yes, it is possible to have an HBAC in South Africa. The problem is though, that for those wanting it, it is a very difficult thing to find support for. While this option is more readily supported in places like the UK it is very difficult to find a midwife who feels comfortable supporting a HBAC as in most cases it needs to be carefully arranged. Midwives need to practice with the backing of an Obstetrician but there are virutally no Obstetricians who will be willing to back a midwife who takes on such cases. However, there are a small number of midwives who will support women in their choices, it's just a matter of finding them. Your best way to locate an HBAC midwife is to contact local Doulas, especially those who support homebirths and to ask them if they know someone you could speak to about your plans.

Who can't have a VBAC?

This is a difficult thing to answer as it really just depends on your own circumstances. Women who have been diagnosed with TRUE CPD (a proven small pelvis) may be advised against VBAC, especially if the reasons for the CPD diagnosis were to do with damage to the pelvis (eg. fractures, breaks, malformations). That being said, unless it is completely obvious as to why your pelvic outlet (the space between the pelvic bones) is particularly small, it may be worth your time visiting a chiropractor or cranio-sacral therapist to help you with your alignment.

VBAC Resources for South Africa

The South African VBAC Website has discussion forums, information on doctors, midwives, doulas who all support VBAC

Good Reasons to hire a Private Midwife

Fri, 25 Jun 2010 15:17:47 +0100

1. Continuity of Care

Obstetricians/Gynecologists often work in teams. While you might still get to see your doctor for each of your prenatal visits, when you go into labour you will see whoever is on call at the time (which might be anywhere between 1 other, to 3 or 4 other doctors). In some cases, where a woman would like to guarantee that her doctor is the one delivering the baby an elective c-section will often be encouraged.

It's completely understandable that you would want the same person who has seen you during your pregnancy to be there during the birth. You build up trust, and therefore a relationship, with that person and it can be a daunting idea that s/he will not be there for the most important part - the birth.

A private midwife will be the person you see for each pre-natal visit and she'll also be with you for the duration of your labour. If you choose an OB/Gyn then s/he will only see you if s/he is "on duty", but also during your labour it will be the hospital midwives who care for you until birth is imminent at which point the doctor will be called to oversee the birth. Some doctors may periodically call in to check on you, but if they run a busy practice then the first time you see him or her might be as you are pushing. In some cases the doctor may not even get there on time and it will be the hospital midwives who deliver the baby.

With a private midwife she not only stays with you throughout labour and is there to catch the baby, but she will also be at your side for a few hours after the birth to monitor you and to help you begin breastfeeding.

2. Post-natal care

Following the birth, you will only see your OB/Gyn around 6-8 weeks following the birth. A midwife will instead be very involved with you following the birth of your baby. She'll return a number of times to check on you while in hospital and she'll come and visit you in your home as well. This is a highly important service that she performs because she will be available to help you with any problems you might be having with feeding your baby, or if you are feeling particularly depressed after the birth. For most new mothers this kind of post-natal home visit is invaluable!

3. Hire the expert you need

There is a terrible misconception that midwives are somehow less qualified to deal with childbirth than a doctor. The thing that people often forget is that a pregnant woman is young, in good health and simply going through a natural process. She is not ill and should not be treated as such. In their training, doctors are specifically taught to pick up illness and how to treat it. This training, and their subsequent practical experience in hospitals where they see many women experiencing complications often lead them to treat a pregnant woman as if she has a potentially life-threatening illness.

Midwives come from a different perspective. They are taught how to support a healthy woman through a natural process and how to pick up problems if they should arise. A midwife is the expert in a normal, healthy pregnancy and an OB/Gyn is the expert in complications. However, women feel that they would prefer to have an OB/Gyn "just in case" which, while understandable, is a bit like hiring a Paediatrician to babysit your child "just in case".

Midwives don't work alone though. While your primary care giver is a midwife, you will still have an OB/Gyn as a backup and your midwife will ensure that your doctor is kept informed of your progress and together they will ensure that everything is going smoothly. If at any stage there is a question about the health of you or your baby, your OB/Gyn will be consulted for input.

4. Studies-based medical practice

Midwives are known for practicing medicine that is studies-based. This means that they are more likely to keep up to date on the latest methods which have been scientifically studied, tested and shown to be the best way of caring for a pregnant woman.

Due Dates

Fri, 01 Jan 2010 18:27:47 +0100

The Due Date - That special date when you get to meet your precious new born child!

This will often be one of the very first things you will found out following a positive pregnancy test and it's the first thing people want to know when they discover you are pregnant.

It's a date that women think of with great excitement in the beginning, and towards the end of the pregnancy it torments them because it either feels like they'll never reach it or they have to deal with disappointment when they go past that date and are still pregnant. It's a date even other people put a lot of stock in, and harass the poor mother with phonecalls and sms's asking if she's had the baby yet once that day draws close or passes!

So what is a due date?

Human females have a gestational period of anywhere between 38 to 42 weeks. When you are given a "due date" this is actually whatever date you will reach 40 weeks of gestation on. Most people think that going past this date is considered being "overdue" when it is perfectly normal to continue growing your baby until 42 weeks. Going past 42 weeks is therefore overdue - and the closer you get to 42 weeks, and if you go past it, the number of risks to the baby increase.

How accurate is a due date?

There are a number of ways to determine a due date. It is calculated from the first day of your last period, as this is when the egg that is eventually fertilised about two weeks later starts to form. If you have a regular cycle and know exactly when you ovulated and even when the ovum may have been fertilised then your due date may be a fairly accurate calculation. However, every woman grows a baby at her own speed which is why you may go into labour any time between 38 to 42 weeks.

Another way of determining the due date of a baby is by assessing it's grown through an ultrasound scan. During the scan various measurements are taken, such as diameter of the skull, length of the femur etc and a calculation is made which predicts the stage of development of the fetus. From this stage of development the number of weeks until fully developed is calculated and a due date is given. Although the technology can be good predictor, it's interesting to note that twins are often given different due dates based on scan information.

Midwives often measure the size of your bump from the public bone. Each centimeter is equal to one week of gestation eg. 30cm from pubic bone to top of your bump would equal 30 weeks. This isn't really used to determine a due date, but instead it is relied upon to ensure that the baby is growing continuously.

What happens if I'm overdue?

The risks of going beyond 42 weeks are that the placenta will not be working as effectively and the baby will have grown quite large, possibly making a vaginal delivery more difficult. If you have reached 42 weeks and have not gone into labour you will need to discus your options with your care provider. Some Doctors will refuse to allow you to go past 40 weeks in some cases, and those that allow you to go as far as 42 weeks will almost definitely insist on induction or a c-section at that point.

If you go past the magical due date, try to remember that only 3% of women actually go into labour on that date, and that in most first pregnancy's you are more likely to deliver closer to 42 weeks. It can be really frustrating for the mother, and especially so when people start wanting to know why the baby hasn't arrived yet. There is a very simply solution that can help the mother keep people from nagging her, and also help her psychologically if she goes beyond the due date. The trick is, right from the start, to consider your due date to be 42 weeks. So whatever date your doctor or midwife gives you, just add two weeks to that and give that as your due date to friends and family, and focus on that yourself to help avoid disappointment. :)

Birth Plans

Wed, 21 Oct 2009 13:23:46 +0100

Birth Plans have, over the years, been highly promoted by birth activists as a way the pregnant mother can take control of her birth and have her needs heard, instead of just being treated as a sick patient. While the intention of creating a birth plan is great, when it comes to the practical application of this, the plan generally gets thrown out the window.

As a Birthing From Within mentor we do not generally advocate the use of a birth plan, as we know just how unpredictable birth can be and that what is most important is that you be able to cope with whatever happens. Having researched various birth plans I have only ever found one that echo's what Birthing From Within's philosophy is when it comes to them.

The Blooming Birth plan also offers you an online tool that helps you delve into your fears and also doesn't focus on a specific outcome. Instead it helps you to plan for how you will deal with the good and the bad, so that you don't get left being overwhelmed by the situation.

Click this link to visit blooming birth

Vrksasana - The Tree Pose

Wed, 21 Oct 2009 13:12:30 +0100

This is a pose used in Yoga and it is called “The Tree Pose” or in Sanskrit “Vrksasana”.

When using this pose, a person should be like a tree, with roots holding them firmly to the earth but still able to bend and sway in harmony with the breeze or mighty gale.

A similar mindset is needed to face childbirth, where you are firmly grounded and can have a sense of inner peace and calm while being able to adjust and accept any obstacles that may arise.

By empowering yourself with knowledge you will be able to make choices easily, should situations arise, and be able to “go with the flow” of labour and birth which hardly ever goes according to plan!

Info on Umbilical Cord Clamping

Wed, 21 Oct 2009 13:03:05 +0100

According to this article:

"If a blood pressure gauge is placed on an unclamped umbilical cord, it will pick up pressure rises as high as 60 mm Hg with each uterine contraction. This indicates that these contractions are intimately involved in the transfer of placental blood through the cord. A striking pressure rise, which persists through the first few hours of life, is also evident in the baby's vena cava and right atrium of the heart. All studies on this indicate a significantly higher systemic pressure in infants who have been clamped late (90% in the first nine hours) and conversely, a significant drop in those early clamped infants (70% of systemic by the second hour, and almost 50% of systemic by the fourth hour). [Moss, Arthur J, MD "Placental Transfusion", PEDS 40:1 ^V July 1967]"

Some interesting statistics:

1. "The placental blood normally belongs to the infant, and his/her failure to get this blood is equivalent to submitting the newborn to a severe hemorrhage at birth. [De Marsh, QB, et al "The Effect of Depriving the Infant of its Placental Blood", JOUR AMA ^V 7 June 1941]"

2. "Deprivation of placental blood results in a relatively large loss of iron to the infant. [De Marsh, QB, et al "The Effect of Depriving the Infant of its Placental Blood", JOUR AMA ^V 7 June 1941]"

3. "The time of cord clamping may be involved in the pathogenesis of idiopathic respiratory distress syndrome (the earlier clamped, the more respiratory distress). [Saigat, Saroj, et al. "Placental Transfusion and Hyperbilirubinemia in the Premature" PEDS 49:3 ^V march 1972]"

4. "Placental blood acts as a source of nourishment that protects infants against the breakdown of body protein. [De Marsh, QB, et al "The Effect of Depriving the Infant of its Placental Blood", JOUR AMA ^V 7 June 1941]"

5. "Studies have shown that immediate cord clamping prolongs the average duration of the third stage and greatly increases maternal blood loss. [Walsh, S. Zoe "Maternal Effects of Early and Late Clamping of the Umbilical Cord" LANCET ^V 11 May 1968]"

And for the argument that delayed cord clamping will increase a babe's risk of hyperbilirubinemia (jaundice), Mothering eloquently says this:

"Among other drugs, pitocin inductions and epidurals have been conclusively linked with nonphysiological neonatal jaundice (this is not normal, breastfed jaundice). Any drug administered to mother or baby must be viewed with a "jaundiced" eye, for it is likely to compete with bilirubin sites on blood protein, causing more bilirubin to be free to contribute to jaundice.

In an all-out effort to prevent the possibility of jaundice, obstetric practitioners have reasoned against delayed cord clamping, since it increases the volume of red blood cells ^V which, in breaking down, will produce increased levels of bilirubin. True, hyperbilirubinemia may be prevented in premature and "medicated" infants by early clamping; however, in a normal delivery of a full-term, unmedicated infant, there are untold advantages to delaying cord clamping until after the placenta has delivered itself."

STUDY OF DELAYED CORD CLAMPING:

Am J Perinatol. 1984 Jan;1(2):165-9.

How to plan for your c-section

Wed, 21 Oct 2009 12:57:24 +0100

First, make sure you check out the article called "A c-section, but naturally"!

Penny Simpkin is an American author of several books and is an outspoken birth activist since 1968.

If you find yourself in place where a c-section has become the best and safest option for the birth of your child, then this is the document for you. This download is aimed at helping you take charge of your birth and offers suggestions on how to best deal with the birth by c-section. Mothers having a c-section need to have that brave birth-warrior spirit as sometimes the recovery from this surgery can be quite difficult, especially with a new baby to care for.

This wonderful article can help you decide how best to take care of yourself before, during and after the procedure.

Download "Ideas for the Best Cesarean Possible" by Penny Simpkin

A C-Section, but naturally!

Fri, 16 Oct 2009 13:15:48 +0100

This is a new term that is gaining popularity as it provides a very different approach to Ceasarean Surgery. It offers parents, and their baby, some aspects of a vaginal birth that are not normally associated with ceasarean birth.

During the traditional method of ceasarean surgery, the doctor tries to perform this as quickly as possible. The baby is pulled from the mother uterus as soon as possible after the incision is made and then whisked away to be evaluated, then swaddled and brought to the mother to see for a few moments.

A natural ceasarean follows a more gentle approach. Parents are made more involved by dropping the screen so that the mother can see what is happening. The baby’s head is gently brought out and left this way for a moment. The torso and legs are also delivered in the same way – slowly and gently. This mimics the way in which a baby is delivered vaginally.

The cord is also not immediately cut, but instead it is left until the baby is breathing on his or her own, as the plancenta will still be providing oxygen to the baby. Once it is cut, the baby is passed out of the sterile area and placed skin-to-skin on the mothers chest.

Many studies have shown the importance of immediate and uninterupted skin-to-skin contact following birth, as it helps promote bonding and the facilitation of breastfeeding. It’s generally something which is regarded only in connection to vaginal birth, but now too it can be incorporated into ceasarean birth.

If you need to have an elective ceasarean, or even in some cases where an emergency ceasarean is performed, you can ask for some aspects of the “natural” ceasarean to be incorporated. Make sure to discus your wishes with your care provider, but remember that certain emergency situations may mean they won’t be possible.