Hiding The Truth Of Third Stage

A few weeks ago I was chatting to an expecting mum and during this conversation she had told me that her obstetrician had told her in regard to third stage (placenta deliver) she would need a shot, to help birth the placenta and stop the bleeding. She was told everyone has it, she would have little choice – it was what was done and when she asked about it, the options given to her as a reason why it was done – where for pure convenience.

She went home and researched and asked her friends and what she found was that it was something most women had done, that it was common practice! I wanted to hold her hand as she went to discuss things with her obstetrician, I wanted to be there and support her when she told them “NO”.

The medical management of the third stage of labour- the time between the baby’s birth, and the emergence of the placenta it very common. We have injections, examinations, and clamping and pulling on the cord. Instead of skin-to-skin contact, bonding and body heat, we have separation, inspections and wrapping, and then we have haste to deliver the placenta and clean up for the next ‘case’.

As Sarah Buckley of Gentle Birth, Gentle Mothering has also written “Medical management of the third stage, which has been taken even further in the last decade, with the popularity of ‘active management of the third stage’ which has its own risks for mother and baby. While much of the activity is designed to reduce the risk of maternal bleeding, or postpartum haemorrhage (PPH), which can be a serious event, it seems that, as with the active management of labour, the medical approach to labour and birth may actually lead to many of the problems that active management is designed to address.”

The use of active management also creates specific problems for mother and baby. In particular, the use of active management leads to a newborn baby being deprived of up to half of his or her expected blood volume. This extra blood, which is intended to help the newly functioning lungs and other vital organs, is discarded along with the placenta when active management is used.

Synthetic oxytocin has also been linked to an increased risk of postpartum depression. In a recent study, it was found that women with a history of depression or anxiety disorder prior to pregnancy, exposure to peripartum oxytocin increased the risk of postpartum depression or anxiety disorder by 36%. Women with no history of prepregnancy depressive or anxiety disorder, exposure to peripartum oxytocin increased the risk of postpartum depressive or anxiety disorder by 32% compared to those not exposed.

Sarah also speaks of the hormones that occur during the third stage of labour, so when we inject a synthetic into the workings of our natural hormones those connections change and ultimately will affect mother and baby. What naturally occurs during the third stage of labour is strong uterine contractions continue at regular intervals, under the continuing influence of oxytocin. The uterine muscle fibres shorten, or retract, with each contraction, leading to a gradual decrease in the size of the uterus, which helps the placenta pull away from its attachment site on the mother’s uterine wall. Third stage is complete when the mother delivers her baby’s placenta.

During this time the Mothers has peak levels of oxytocin, the hormone of love, and endorphins, hormones of pleasure for both mother and baby. Skin-to-skin contact and the baby’s first attempts to breast-feed further augment maternal oxytocin levels, strengthening the uterine contractions that will help the placenta to separate, and the uterus to contract down. In this way, oxytocin acts to prevent haemorrhage, as well as to establish, in concert with the other hormones, the close bond that will ensure a mother’s care and protection, and thus her baby’s survival. (Buckley, 2005)

So why is this being ignored, knowing what we know about delayed cord clamping and the effects synthetic oxytocin can have on a mother postpartum, why are we not giving women a choice and a say in having a managed third stage and when do we say enough!

For me this is where childbirth education becomes highly important, where knowing the pros and cons of a managed third stage labour are taught, where being informed and being able to communicate with your care provider are vital – these are only just a few of the things expecting parents are taught in a Lamaze class.

Care professionals need to think about the birthing woman. Whilst most things are simply “routine” for them, they are not for a first time mother and full information and consent need to be given. Instead, most care professionals seem convinced that they know best, that mother’s do not know how to give birth and that birth is a medical emergency – when most births are not! They skim over information or just expect the mother to be a mind reader or get frustrated when she will not comply, when she will not do what they have told her.

All over the world, women are repeatedly forced to undergo procedures and interventions during labour and birth that they would not necessarily agree to. Had they been given all of the information and been able to make an informed decision, their choice would have been ‘no’. The decisions you make about your birth options can ultimately have long lasting effects on the health and wellbeing of yourself, your baby and your family.

Women who feel satisfied and in control of their birth experience are less likely to experience traumatic stress after birth. Ideally, women should be valued as the key decision maker in their own care by all caregivers.

In Birth, Gem.

References

Buckley, S., 2005. Leaving Well Alone: A Natural Approach to the Third Stage of labour. [Online]
Available at: http://sarahbuckley.com/leaving-well-alone-a-natural-approach-to-the-third-stage-of-labour

Kroll-Desrosiers A, N. B. B. J. G.-W. Y. M. S. T. D. K., 2017. Wiley Periodicals - Association of peripartum synthetic oxytocin administration and depressive and anxiety disorders within the first postpartum year.. [Online]
Available at: https://www.ncbi.nlm.nih.gov/pubmed/28133901

Rabe H, D. J. D. L. D. T., 2012. Effect of timing of umbilical cord clamping and other strategies to influence placental transfusion at preterm birth on maternal and infant outcomes.- Cochrane Database of Systematic Reviews. [Online]
Available at: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003248.pub3/abstract;jsessionid=3EE451A363B32133121955277B02EA9F.f02t01

Ruta Nonacs, M. P., 2017. Synthetic Oxytocin and Its Effect on Postpartum Mood and Anxiety - Womens Mental Health. [Online]
Available at: https://womensmentalhealth.org/posts/synthetic-oxytocin-effect-postpartum-mood-anxiety/

Healthy Birth Practice # 6

"Keep Mother and Baby Together: It's Best for Mother, Baby and Breastfeeding."

Throughout most of human history, mothers and babies have stayed together from the moment of birth. When a newborn is placed skin- to – skin not only is this the first time a mother and her newborn can meet and bond, but it’s helps the natural progression of breastfeeding and hormonal release.

The familiar sounds, smells, and tastes, and the perfect warmth of your skin helps your baby know they are safe and sound.

Experts now recommend that right after birth, a healthy newborn should be placed skin-to-skin on the mother’s abdomen or chest and should be dried and covered with warm blankets. Any care that needs to be done immediately after birth can be done with your baby skin-to-skin on your chest.

With Skin to skin, your baby more easily transitions to breathing, stays at just the right temperature, and learns instinctively how to nurse. In fact, scientists have discovered that unmediated babies who are held skin to skin and undisturbed in the hour after birth need no help at all to start nursing. They scoot and crawl up the mother’s belly, find the nipple by sight and smell, and latch on all on their own!

The more time spent with skin-to-skin contact in the first days after birth, the stronger the benefits. One amazing benefit is a greater mother-baby attachment. Women who hold their babies skin to skin after birth care for their babies with more confidence and recognize and respond to their babies’ needs sooner.

Research studies have compared babies who have skin-to-skin contact in the hours after birth with babies placed in a bassinet or wrapped in blankets. The studies found that babies held skin to skin do better in many ways.

Benefits for Babies Held Skin to Skin after Birth:
• They have more stable temperatures.
• They cry less.
• They have more stable blood sugar.
• They breastfeed sooner, longer, and more easily.
• They have lower levels of stress hormones.
• They are exposed to the normal bacteria on the mother’s skin, which may protect them from becoming sick due to harmful germs.

Keeping your baby close makes the early hours and days of birth safer and healthier for you and your baby. After 9 months of growing and nurturing your baby, keep them near – hold them close, gaze upon them and soak in every moment of them.

Healthy Birth Practices # 1

Let labour Begin On It's Own.

Last week I introduced you all to The Lamaze 6 Healthy Birth Practices, each and everyone is important in the role of Labour and Birth and can help improve outcomes for mother and baby.

For many women, the last days and weeks of pregnancy can be very uncomfortable and emotionally difficult. We are anxious to meet our babies and hold them in our arms. Aches and pains may become more bothersome. Sometimes, minor problems or worries arise,and mothers may feel pressure to induce their labour—even when it would be safer to wait.

Letting your body go into labour spontaneously is almost always the best way to know that your baby is ready to be born and that your body is ready for labour. In the vast majority of pregnancies, labour will start only when all the players—your baby, your uterus, your hormones, and your placenta—are ready. Naturally, labour usually goes better and mother and baby usually end up healthier when all systems are go for birth. Every day of the last weeks of pregnancy is vital to your baby's and body's preparation for birth.

If your labour is induced (started artificially), it becomes a medical event and proceeds quite differently from spontaneous labour.
It’s important to remember that induction is forcing labour to begin before the baby and mother’s body are ready.

Let Labour Start on Its Own - Here's How:

• Know that your "due" date is not an expiration date. Only about 5 percent of moms give birth on their due date. Instead of a day, think of it as your due "month."
• Take a childbirth education class such as Birthability's, Learn how to have a safe, normal and healthy labour, learn about induction and informed decision making.
• If your care provider suggests an induction, ask questions. Is it an emergency? What's the risk in waiting? What are the alternatives?
• Hire a doula who can provide resources and information on labour and local care providers and birthplaces.
• Remind yourself that every day your baby is still on the inside is one more day she needs to grow and develop. 
• If you end up needing an induction, learn how you can keep your labour as normal and healthy as possible.

The Lamaze Healthy Birth Practices

The Lamaze Healthy Birth Practices

The Lamaze 6 Healthy Birth Practices, have you heard of them?

Years ago Lamaze became widely known as a ‘method’ for birth, teaching a breathing and coping style that came to be known by its name.

Lamaze today is a ‘philosophy’ of birth, founded on 6 Healthy Birth Practices that are designed to encourage women to trust their bodies, reduce fear, and have a healthy and safe birth for mother and baby.

The Lamaze Healthy Birth Practices are the foundation of Lamaze. These Birth Practices are designed based on years of research to help simplify the birth process with an informed approach that helps alleviate fears and manage pain. Regardless of baby’s size, your labor’s length and complexity, or your confidence level, these care practices will help keep labor and your baby's birth as safe and healthy as possible.

It's a Date

It's a Date!

The humble Medjool date it seems may just have some hidden superpowers!

A study conducted in 2011 and published in the Journal of Obstetrics and Gynecology, has some really interesting results from comparing two groups of women: those who consumed six dates per day in the last four weeks of labour and those who did not.

Here are a few interesting results from the study:

- Spontaneous labour occurred in 96% of those who consumed dates, compared with 79% women in the non-date consumers.

- Use of prostin/oxytocin was significantly lower in women who consumed dates (28%), compared with the non-date consumers (47%).

- The mean latent phase of the first stage of labour was shorter in women who consumed dates compared with the non-date consumers. (Those who consumed dates had an average 8.5 hours of first stage labor while those who didn’t had an average 15.1 hours of first stage labor.)

- The women who consumed dates had significantly higher mean cervical dilatation upon admission compared with the non-date consumers.

The study concluded that the consumption of dates in the last 4 weeks before labour, significantly reduced the need for induction and augmentation of labour, and produced a more favorable, delivery outcome.

https://www.ncbi.nlm.nih.gov/pubmed/21280989

The effect of late pregnancy consumption of date fruit on labour and delivery. - PubMed - NCBI

J Obstet Gynaecol. 2011;31(1):29-31. doi: 10.3109/01443615.2010.522267.

NCBI.NLM.NIH.GOV|BY AL-KURAN O , ET AL.