Tuesday, July 6, 2010

Eating while in Labor

Nutrition and Nourishment During Labor
by Dorinda Mitchell

Anytime you are with a group of women who are sharing stories of birth you will hear at least one woman complain of how hungry she was! Some women will even say, " I would not have gotten sick if I could just have had something to eat!" As you think of the choices you have or your upcoming labor and birth have you thought about how you should nourish yourself? Did you know the research indicates withholding food and drink during labor is not beneficial? If this is the case, what should you be eating and drinking?

Let's look at nourishment just before labor and during early labor. During the last days of pregnancy a shift to a high carbohydrate diet can be beneficial. This is because our body needs something called glycogen. Carbohydrates increase glycogen levels. If we don't have these stored our body will convert fat into glycogen. When our body converts fat into glycogen we also produce a by-product called ketones. The production of ketones can result in slowing labor and fetal distress. To prevent ketosis IV's are administered. As you can see what you eat sets the beginning course for your labor. Some suggestions for foods that help build stores of glycogen are breads, cereal, crackers, corn, pasta, potatoes, rice, and fresh fruit. During early labor you want to be sure to drink plenty of water, fruit juices, and Gatorade or sports drinks. These will help to replace electrolytes and keep you hydrated. You want to continue eating high-carbohydrate foods that will digest easily. This will help to prevent excessive fatigue. It is important also to avoid products such as dairy, spicy foods, and heavy amounts of protein.

As your labor progresses you will want to switch to more simple carbohydrates that will give you bursts of energy but will leave your body quickly. Some suggestions of these are juices, honey, and fruits. You may want to make up some juice-sickles to have. Even if you are at the hospital at this point most hospitals have a nourishment room with a freezer where they can be stored. During this period you will want to eat smaller amounts more frequently.

During your labor you may come to a time when your body may tell you to "stop!" If you don't feel like eating now then don't. Your digestive system will slow down, and it is okay to trust your body and what it is telling you.

Some of you may be thinking "This sounds great, but is my care-provider going to go for this? He/she said 'No eating once labor begins!'" I can't make promises as to how your care-provider will respond, but I can give you some factual research behind why staying nourished in labor is important.

The thought behind withholding food and drink is that if a woman has to have general anesthesia and vomits she could aspirate. However, the level of this risk is and always has been low. The other problem with this line of thinking is that even if there is no food in our stomach we still have gastric fluids. Anesthesiologists are trained to prevent the aspiration of fluids or food particles. In a Guide to Effective Care in Pregnancy and Childbirth the routine withholding of food and drink from women in labor is classified as a form of care unlikely to be beneficial. At North Central Bronx Hospital the policy is to allow self-regulation of nourishment during a normal labor. This is what they have found in doing this. "Those women who nourished themselves at home during labor were likely to come to the hospital in more active labor than women who did not take nourishment. Women who do self-regulate their nourishment know what, or if, they need to eat and drink during labor."

This, as with all issues concerning labor and birth, is something you will have to discuss with your care-provider. They may or may not be very open to this initially. You are the captain of your ship, though. Come armed with factual, evidence-based research and discuss what can be done. While some may say no eating once you are at the hospital, others may be very open. If your care-provider is not so open maybe you can plan to stay home until labor is well underway. Remember this, as with everything, there is a middle ground. So, happy eating!

* A Guide to Effective Care in Pregnancy and Childbirth, Enkin, Murray, MD, Keirse, Marc, MD, Renfrew, Mary, CNM, Neilson, James, MD. Oxford University Press, Oxford England. Second Edition, 1996.

* A Good Birth, A Safe Birth. Choosing and Having the Childbirth Experience You Want. Korte, Diana, Scaer, Roberta. The Harvard Common Press, Boston, Massachusetts, 1992.

GH’s portryal of birth

AHHHHHHHHHHHHHHH!!!!!!!!!!!!! THIS is why women are afraid of natural birth:( Stupid producers. She gets kidnapped, gets in an accident, finds an abandoned cabin, kidnapper shows, up...fine, it's a soap opera, I've seen dumber. But the Shoulder Dystocia?! She's sitting there on the couch having the other woman "push the baby's shoulders down as she pushes" to get her unstuck?! IDIOTS! Have her get on her hands-and-knees, the baby will pop out!

THIS is why women are scared of natural birth. THIS is why they go to the hospital when it isn't needed. THIS is why they let doctors pull their babies out with forceps and vacuums (I was one of them) without trying anything else. THIS is why they agree to c-sections for "big babies" when there's no evidence it's safer than to attempt vaginal birth. Jesus...can't we see one normal birth on TV? Have her take control, squat or get on hands-and-knees and pop that sucker out!

STUPID STUPID STUPID:( And those of us who believe that crap are more stupid...

And yes...I understand it's just a show, but it's like anything else, the more you watch the more you start to buy into it all, violence, sex, birth, it's all the same. Watch natural birth? Believe it works. Watch crazy birth drama, believe it's normal.

Why Jordan is intact

This might be more explanation than you were looking for...We had our first circ'ed because I didn't know any better and basically left it up to my husband and figured "everyone does it, there's no reason not to". He's done and wanted his son(s) to be like him. I also believed all those assumptions that it's more hygienic and healthier. At our hospital, the OB does it, not a pediatrician. We did ask that he was numbed and my doc said she won't do it otherwise, she doesn't believe they can't feel it. From the beginning we had trouble. She didn't take off enough skin which has led to adhesions and constant redness and puffiness. Most of the adhesions have let go and I'm told that the others may or may not. If not, I will have to decide if we want them cut or left and if they are left, they could cause him pain later on then have to be cut, or they could aid him in regrowing his foreskin if he wanted to (yes, I guess this is possible!).

It wasn't until I met other moms who don't circ and I got pregnant again that I really looked in to it and found that there is no reason to circ and that there is no medical association on earth that recommends it! Some insurance companies won't even pay for it because it's considered cosmetic. I wish I had known that. I also didn't know that 1/3 of sexual pleasure is stolen with that skin:( I now agree with most non-circ activists and consider it genital mutilation. It doesn't matter that it's common, it's no different than cutting a clitoris off just because it's common in a tribe. If there is no reason to do it, and we force it on babies, it's' mutilation. If my second son decides he doesn't like his non-circ'ed penis later on, he can always have it done, but it takes a lot of time and effort to regrow the foreskin (I will be getting all the info I can in case my first son wants to rectify our mistake). People claim that it's "cleaner" or "more hygienic" and that they do it "just in case". That's like taking out every baby's appendix at birth just so it doesn't have to be done later in case they get appendicitis.

My husband didn't agree, but when I asked him a few months ago said that he wasn't mad that I wouldn't let it be done again. But no matter who wants it and who doesn't, in the end both parents have to sign off on it and if the anti-circ parent cares enough, s/he can just refuse the surgery. That is what it came down to with my husband. In the end, I told him that I was the one going through pregnancy and labor and birth and if it was a boy (we didn't find out either time) he would be perfect the way he came out. I apologized to him for not being able to come to an agreement, but it was going to be my choice. I did want to make him watch a video on circ but my friend who owns it was out of town and I went in to labor before I could get it. I asked him later if it bothered him and he said it didn't. I think after you see your perfect baby and change diapers for a week, you forget that it looks different than some penises.

NoCirc.org, notjustskin.org and noharmm.org have some of the best information. Or go to YouTube and search for Penn & Teller's "BullShit" episode on Circumcision. It's go so much great information!

One last thought...I have come to look at it this way: It's not needed. So, let's compare it to a nose job. You had a nose job and now you want your baby girl to look like you, so you have her nose altered to match yours at birth. Unneeded? Yup. Crazy? Sure. Why is circumcision any different? It's an unnecessary, painful surgery that we do because dad had it done. I feel so much regret every time I change my son's diaper and I wish just one person had told me that I shouldn't do it and given me the facts...At least I saved my second son from it:)

"Born in the USA" by Marsden Wagner, MD

I read this wonderful book a couple years ago. I think it should be mandatory reading for women and doctors (especially if you are contemplating kids in the near future).
Born in the USA: How a Broken Maternity System Must Be Fixed to Put Women and Children First
by Marsden Wagner


This book is written by an obstetrician who has been in practice as well as research. He worked for the WHO in London and still consults on cases when needed. Keep in mind that this is a book by a doctor who believes that his place is ONLY in high-risk pregnancy - a far different opinion than most OB/GYNs these days. An OB is a specialized surgeon. Having an OB attend your low-risk birth is the equivalent of having a brain surgeon check out your head when you bump it or a heart surgeon do your yearly physical.
It was one of the scariest things I've read and if you had an "emergency c-section" I suggest you do read it for information on VBACs but you will probably want to skip over all the facts regarding c-sections because you may quickly come to realize that your surgery was pre-emptive and not truly needed, had the doctor just slowed down, stepped back, and let the laboring woman's body do its job.
He answers the question "Are Epidurals Safe?" Though your doctor may lead you to think otherwise, they can hardly be considered safe when 23% of women receiving one have complications. There is a longer excerpt at the end about how unsafe an epidural block is if you are interested.
Following are some facts for the book and a few excerpts you may be interested in. It's sad that SOOOOO many women are scared about something that women have done for tens of thousands of years. Only in the last 100 years has giving birth become a medical process needing "treatment". The question is, when statistics show that women don't need medical help, why do we seek it? This book gives the information on pregnancy and birthing that so many doctors don't tell you and many don't even know.
I only wish I had read this before having Eli. Feel free to comment based on your own experience, but until you have read the book, know that you don't have all the facts!
Just keep in mind, if my friend could go through 17 hours of labor, 5 hours of pushing, and have a 10-pound baby with a 15-inch head all the in comfort and safety of home with no complications, then you, too, can have an average-weight baby without the need for medical intervention.

Quick facts (pgs. 242-246):
There are twenty-two industrialized countries with lower infant mortality rates than the US. All 22 provide universal prenatal care.

25% of US women receive little or no prenatal care. 1 in 2 of these women with give birth to a low-birth-weight baby (less than 5.5 pounds) or a premature baby (less than 37 weeks of gestation).

60% of infant death is linked to low birth weight. It costs 2.5-times as much to raise a low-birth-weight baby to the age of 35 than a baby of average birth-weight.

Intensive care for one infant: $20,000-100,000. This amount would cover prenatal care for 30 women.

Percentage of births attended principally by midwives:
US: 10%
European nations: 75%
Percentage of countries with lower infant mortality rates than the US in which midwives are principal birth attendants: 100%

Average cost of a mid-wife-attended birth in the US: $1,200
Average cost of a physician-attended vaginal birth in the US: $4,200

Number of scientific studies in which routine electronic fetal monitoring during every birth has been proven more effective than the use of a simple stethoscope to monitor the fetal heart: ZERO
Cost per year of using routine electronic fetal monitoring during every childbirth: $750 million

US C-section rate:
1965: 5%
2004: 29.1%
C-section rate targeted by the WHO and the U.S. Department of Health and Human services: 12%

Percentage of women in the US with C-sections who undergo repeat C-section: 91% (totally unneeded in eight-nine out of ten births).

Ratio of women dying from C-section to women dying from vaginal birth: 4 to 1

Average cost of C-section: $7,826

Evidence shows that when the c-section rate goes over 15%, the maternal mortality rate increases.
Evidence shows that midwives are safer than doctors to attend low-risk births.
Evidence shows that planned home birth for women with low-risk pregnancies is as safe as hospital birth.



"The key issue in the question of where to give birth, however, is who is in control. Physicians, hospitals, electronic fetal monitors, and drugs do not have babies - only the mother of the child can do that. . .All maternity services should reflect this fundamental fact and should be designed to assist and support the woman. Most of the present care system for birthing women in the US is designed not to assist the mother but rather to control her.
"Doctors control women with fear. They have succeeded in convincing the great majority of American women that they cannot safely give birth outside the hospital; that nearly half of them have uteruses that are non-starters and need to have labor induced or augmented with powerful drugs; that up to two-thirds of them cannot tolerate labor pain and must be made numb from the waist down with an epidural block so they cannot feel the birth of their babies; that one-third of them cannot push out their babies but must have it pulled out with forceps or a vacuum or cut out by c-section. When we try to make women believe that they can't give birth without the help of men, machines, and hospitals, we take away their confidence and their belief in their own bodies - and with their confidence gone, any feelings of power and autonomy also disappear..." (pg. 190)

"Women who have epidural block for normal labor pain have risk of dying that is triple that of women who do not. . ."A woman also has a 15 to 20 percent chance of developing a fever after receiving an epidural block. When a woman in labor developed a fever, it means that a diagnostic evaluation must be done to determine if there is an infection in her body or in the baby's body. These diagnostic procedures can sometimes be invasive, including doing a spinal tap on the baby, which is a painful and risky procedure in and of itself."Another known complication of epidural block: between 15 and 35 percent of women who are given an epidural will suffer from urinary retention after the birth, a condition which, if it continues, necessitates putting a catheter in the bladder until bladder function returns.". . .Studies show that around 10 percent of epidurals don't work at all; there is no pain relief. Even when pain is blocked during labor, about one-third of the women given an epidural will trade a few hours of pain-free labor of days, weeks, or months of back pain after the birth. Studies show that 30 to 40 percent of women who receive an epidural during labor will have severe back pain after the birth, and 20 percent will still have severe back pain a year later."The fact that when an epidural block is given labor does not progress normally has consequences as well. A great deal of scientific research has shown that women who receive epidural block for normal labor pain will have a significantly longer second stage of labor, and thus the epidural block means a four times greater chance that forceps or vacuum extraction will be used to extract the baby, and at least a two time greater chance that a C-section will be performed. . ."Although many women might be willing to take risks with their own bodies for pain relief, very few women are willing to put their babies at risk. But that is what a woman does when she agrees to an epidural. One common complication when a woman has an epidural is that there will be a sudden drop in her blood pressure, leading to a sharp drop in blood flow through the placenta to the fetus. This drop in blood flow can result in mild to severe lack of oxygen getting to the fetus, which if not quickly treated can result in brain damage in the baby. . .Studies have shown that in 8 to 12 percent of cases in which a woman is given an epidural block for normal labor pain, the electronic fetal heart monitor will show a severe lack of oxygen to the baby. In a further study, after having an epidural, three-quarters of the babies of healthy women in normal labor had episodes of slowing of the fetal heart rate, a symptom of fetal distress" (pgs. 54-55).

Epidurals also lead to sleepy babies and if you want to get off to a good start in breastfeeding with as few complications as possible, a sleepy baby is the last thing you want right after birth.

What makes you mad?

The question posted in my churches' Facebook group (yes, we're that hip...we have a Facebook group) was:

Well, here's a place to start. On Sunday, I revealed that I'm pretty
angry about bottled water for environmental reasons and the fact that
there are plenty of places in this world where people literally don't
have water much less clean water... I wonder what Angry Jesus would
have to say.

What makes you angry? Seriously, what makes you angry enough to take action and affect change?

I liked my answer so much I have pasted it here to share with you all,
if you are interested. I'd love to hear what makes you angry!

You probably don't want to read all of this but you've opened a can of
worms with me...or rather one of those "can of nuts" with a snake that
jumps out at you;)

I am angry that ACOG and the media have women so afraid of pregnancy
and birth that they flock to surgeons for routine care instead of
midwives who have better statistics. How is it that we are supposedly
SO medically advanced and yet of all industrial nations we have the
highest c-section rate and perinatal death rates for both women and
babies. There are two possible answers to this. Either 1) low-risk
pregnancy and birth should never be over-seen by surgeons looking for
something to go wrong, inducing for non medical reasons and
administering drugs at the first sign of labor or 2) somehow, US women
have evolved so much that ONE THIRD of them are suddenly unable to have
healthy vaginal births. Hospitals and doctors are for sick people and
only 7-10% of women actually have something wrong with them or their
baby that requires obstetric care. But every day, ACOG and OBs lie to
women telling them that home birth is not a safe option, that birth
centers aren't as good as hospitals, that VBACs are riskier than
scheduled surgery, that slowed labor is reason for surgery when the
baby shows no signs of distress.

How can our country look at our birth statistics in relation to other
industrialized nations and think that our way is the best? How can
media make show after show like "A Baby Story" with emergency after
emergency and think they are doing anything but scaring women out of
the natural process of birth?

How can a nation that is largely religious believe that God has made
them some-how faulty in reproducing to the point that offspring must be
cut out of them more than 33% of the time?

How can 85% of women spend more time researching their next car
purchase than they do their birth options? Most of us would never walk
in to a single dealership, take the first car dealer who walked up to
me and let him tell me what car to buy with which options, but that's
exactly what women let their God-like doctors do.

People blame insurance for it. "Doctors are quick to cut because of a
fear of litigation and malpractice insurance goes up because of it."
That's because there is a huge difference between a woman who has a
midwife in a birthing center or at home and a woman who uses a doctor.
The difference is that a woman who believes her doctor is all-knowing
because s/he went to medical school can do no wrong and is solely at
fault when something goes wrong, whereas a woman who uses a midwife
knows that sometimes things happen in birth that can't be prevented.
When compared to doctors with low-risk patients, Midwives have lower
c-section rates and lower death rates and are rarely sued when
something goes wrong. Their rates are much more comparable to those of
other industrialized nations.

How can that not make women furious? Women and babies are dying for no
reason and ACOG puts out a statement that home birth shouldn't be legal
because it's unsafe. If you want to look purely at statistics, it's
hospitals that shouldn't be allowed to deliver low-risk births. But
then OBs and ACOG don't get any money.

Truly natural birth rarely ends badly. Natural birth is a birth
unhindered by IVs, artificial induction, or pain medication. A birth
that isn't "managed" but watched over. A birth that is left to the
woman's body because that woman comes from a long, unbroken line of
childbearing women. Birth didn't become safer when it entered the
hospital, in fact, more women died because of hospital birth for many
years until germs were discovered.

Here's my favorite quote:

"There's a secret in our culture and it's not that birth is painful, it's that women are strong." -Laura Stavoe Harm

What women don't know is that OBs spend little time learning about
delivering babies in medical school and not one minute, not one written
page is spent on natural birth and its effectiveness. All the while,
midwives spend almost all their time learning how to safely deliver a
baby. How can that possibly have anything but a better outcome?

So, I have decided to go through doula training this summer in hopes
that I can help women learn about natural birth and help them through
it, even if they chose to do it in the hospital.

Oh, and routine infant circumcision...but that's an even longer post.

Like I said...you probably didn't want to read it all. But I feel better getting it out...thanks for asking:)

"Crying for Comfort"

I'm tired of the CIO crap I hear from people. I just don't think there's anything compassionate about letting a child scream himself to sleep. I'm really not looking for a debate. If you're interested read the article. If you think babies need to "learn to self-soothe" then feel free to move on. Thanks:)

http://mothering.com/parenting/crying-for-comfort

"Pregnant in America"

I liked this more than "The Business of Being Born". Here is what I took from it.

http://www.pregnantinamerica.com/

"Some of us have found that the process itself, the actual process of birth, is quite an extraordinary event, and would chose not to just miss that."

"There is not cultural valuation any more on women's bravery and courage in pushing their babies out on their own."

"A mother and baby are designed to work together during labor, and when drugs are used they both are drug-impaired so they're not working together."

"There are studies linking labor drugs to teen-age drug addiction and suicide."

"We have been brainwashing Americans about childbirth, about how dangerous it is, how all the terrible things that can go wrong, and how you need to be in the hospital where all the doctors are, all the machines are, and all the operation tables are so that we can take care of horrendous emergencies when they occurr. It's absolutely not true."

Ina May's Numbers:

* 2000 births
* 95% needed no medical intervention or hospital transfer
* <30 got a c-section (that's less than 1.5%)
* her mortality rates were still below the US documented rates for low-risk pregnancy and birth

"I don't know but one person that can have a baby and that's the mother. Mather nature knows best." - Father of a home birthing woman, also a horse breeder.

Section Stats:

* Between 1990 and 2000, induction doubled from 10-20% and the number of babies born M-F went WAY up.
* 50% of inductions end in c-section
* section rate in 1975 = 7%
* section rate in 2008 = 33%
* the infant and maternal mortality rates have not declined in response to the quadrupled section rate

"Why is our section rate high? Because surgeons are in charge of birth. To a man with a hammer, every problem looks like a nail. To a surgeon, every problem looks like surgery is the answer."

"Everywhere women are getting cut open because they are being told it's safer even though all the evidence is to the contrary."

"If I have a reason to do a section, I can be home in 30 minutes." - Ron Sancetta, OB/GYN

"Breech [birth] isn't even taught at most schools anymore. Insurance companies to hospitals they'd pull support if they taught breech anymore."

"We are victims of our insurance."

"Most Cytotec cases are settled with a gag order which is why we don't hear about it."

"It's sad that a country with the technology we have could institutionalize medicine."

Doctors play the 'dead baby' card so often women believe that it happens very often in non-medicalized births.

"We're just concerned about your baby."

"Doctors in America do not want any significant change in the present system. They have all the power, they have all the control, and they're making the big bucks."

"A loving midwife does what she does because she wants to help other women experience the miracle of childbirth."

"Thank goodness for epidurals and Pitocin when they are truly needed. But in countries where they don't use it just as a normal management of labor technique or protocol, they have much better statistics and outcomes, and we can learn a lot from that."

"[Birth is] as close to magic as human beings can know."

"There is no more empowering experience that a woman can possibly have than giving birth herself."

"It's so sad what women are missing and they don't know they are missing it."

Books that the experts in the film have written:

"Gentle Birth Choices" by Bruce Lipton, PhD

"Magical Child" by Joseph Chilton Pearce, PhD