Friday, October 30, 2009

Walk, Move and Change positions. Lamaze Step 2 of 6

Note the pink skirt that one of these beautiful Mamas is wearing! That's a PrimaMama Original BINSI skirt!

Thursday, October 29, 2009

Wednesday, October 28, 2009

Walk, Move and Change positions

Posted by Kim:

I found this blog post on the Aruban Breastfeeding Mamas website. I have added some of my own commentary as well.

This blog will discuss walking,moving around and changing positions throughout labor and why this is so beneficial.

Many women do not realize that they do have a say in choosing the position that eases the pain and facilitates the baby's birth.

Many times women assume that all babies are born in the Lithotomy position. While at times this may be the best position, there are other choices and many other advantages to these other positions. What is most important in birth is that women are empowered to listen to their bodies and do what their baby is telling them to do.

Moving around during labor is important and beneficial because

* When you walk around or move around in labor, your uterus works more efficiently
* Changing positions moves the bones of the pelvis to help the baby find the best fit through your birth canal
* Upright, side-lying, and forward-leaning positions allow plenty of blood flow to your baby, so he may be less likely to show signs of distress
* Actively responding to labor may help you feel more confident and less afraid. By feeling in control of your birthing process, you may be empowered and experience less pain due to less anxiety because of not being a "by-stander", so to speak, during childbirth.
* Research shows that moving freely in labor improves a woman's sense of control,may decrease her need for pain medication, and reduced the length of labor

Lithotomy Positions



* Some women say they like the security of stirrups for their legs, particularly if they have used them previously


* Easy to listen to Fetal heart rate

Birth Attendant:

* More control of birth situation
* Obstetric intervention easiest should it be necessary : forceps episiotomy, repair of lacerations, anesthesia
* More comfortable, less back strain
* Asepsis



* Adverse affects on blood flow : The weight of the uterus compresses large blood vessels so as to decrease blood flow to the uterus and ultimately decrease oxygen to the baby.
* Less active participation with baby and birth attendant
* Stirrups can promote blood clots if legs are in them for a long time
* Decreased ability to push
* Sense of vulnerability
* Possible inhalation of vomit


* Changes in mother's blood flow can cause fetal distress or a depressed baby at birth
* Difficult for mother to see or hold baby after birth

Birth Attendant:

* Cannot easily interact with woman and is less able to elicit her cooperation

Standing Position



* Reported improved uterine contractibility for First Stage of labor
* Avoidance of negative hemodynamic changes
* Can watch Birth
* May increase help of gravity


* Uknown

Birth Attendant:

* Ease in interacting with women



* Fatigue
* Needs two supporters
* Hypothesized increased blood loss, uterine prolapse, edema of cervix and vulva


* May fall to the ground unless "caught"

Birth Attendant:

* Difficult to control baby's head and watch perineum
* Difficult to assist with delivery

Sitting Position



* Shorter second "pushing" stage
* Most efficient for expulsive efforts
* Maintains some advantages from squatting ; increases pelvic diameter
* Easy to interact with baby and others
* Grunting may aid delivery


* Probably less negative hemodynamic effects than lithotomy thus less fetal distress
* Easy to listen to fetal heart rate

Birth Attendant:

* Good access to perineum for control of delivery
* Able to use interventions should it become necessary, such as episiotomy, forceps or pudenal anesthesia easily should it become necessary



* Needs back support
* Might induce edema of vulva or cervix


* None

Birth Attendant:

* Some attendants may not want the mother's active participation in the birth

Hands and Knees



* No weight on Inferior Vena Cava; thus probably less fetal distress
* Advocated for aiding delivery of shoulder
* Useful for relieving pressure on umbilical cord if trapped or prolapsed


* May be useful in rotating occiput posterior positions or in delivery of shoulders when they are "tight"

Birth Attendant:

* Good visualization of perineum and control of expulsion of presenting part
* Optimal control for breech delivery, according to some practitioners.



* Very tiring : Bean bags and pillows useful for maintaining position or for rest between contractions
* Difficult to interact with baby and birth attendant, but can turn immediately after delivery and hold baby
* Cramps in arms and legs


* Difficult to monitor baby unless one uses fetal scalp electrode ( which will leave a beautiful bald spot for ever on your baby's scalp)

Birth Attendant:

* Must reorient landmarks and adapt hand maneuvers for delivery
* Usually turn woman to recumbent position for delivery of placenta, repair of lacerations and rest

Dorsal Recumbent



* Less tension on perineum
* Less pressure on legs
* No stirrups, thus less likely to develop thrombosis


* Easy to listen to fetal heart rate

Birth Attendant:

* Easy access to perineum
* Able to do pudendal anesthesia or episiotomy easily should these become necessary



* Same blood flow changes as lithotomy
* Difficult to participate in birth
* decreased ability to push


* Fetal distress can occur because of restricted blood flow

Birth Attendant:

* Cannot easily interact with woman
* Forceps delivery more difficult to do since there is less counter pressure on fetus

Lateral Recumbent



* Corrects or avoids adverse hemodynamic effects of lithotomy position
* May prevents some perineal tearing because of less tension on perineum
* May help to rotate occiput posterior presentations
* May be helpful in relieving a Shoulder dystocia
* Comfortable for many mothers and conducive to resting in between contractions


* Promotes maximum uterine blood flow and thus fetal oxygenation

Birth Attendant:

* Conducive for controlled delivery
* Preferred by some British practitioners



* Least efficient for expulsive efforts, this may be desirable to avoid a precipitous delivery (delivering in an unusually quick amount of time) for a repeat mother
* Needs someone to hold leg up for the delivery


* More difficult to listen to fetal heart tones

Birth Attendant:

* Some practitioners consider this position akward
* Unable to see and interact with mother as easily, cannot see her face directly
* Difficult to repair episiotomy or use forceps in the event that these would become necessary

Squatting Position



* Good expulsive effort: shorter second "pushing" stage
* Pressure of the thighs against the abdomen may aid in expulsion by increasing intra-abdominal pressure and promoting longtitudinal alignment of the fetus with the birth canal
* Improves pelvic bone diameter. Anteroposterior diameter of outlet increased by 0.5-2 cm :Transverse diameter is also increased ( opening of vagina made wider with less perineal trauma and tears as a result)
* Avoids adverse hemodynamic effect of lithotomy
* Facilitates interaction with birth attendant and baby and others present


* Promotes fetal descent and rotation

Birth Attendant:

* Some visibility of perineum
* Maternal effort is maximized in accomplishing the birth



* Legs can become fatigued, especially if woman is not supported
* Uterine prolapse may be more likely due to strenuous bearing down effort
* May promote increased perineal and cervical edema (swelling)
* Rapid descent and expulsion of fetus may be accompanied by vaginal and perineal lacerations
* Increased blood loss possible


* Rapid expulsion may result in sudden reduction in intracervical pressure and cause cerebral bleeding in the brain of a premature infant whose skull bones are not yet firm.

Birth Attendant:

* Cannot intervene easily in this position to help control the expulsion of the baby or to administer an episiotomy or pudenal nerve block should these become necessary

Tuesday, October 27, 2009

Pre-Pregnancy - I'm Tired of Hearing That

Written by Tink, friend of BINSI

I know you all haven't heard from me in a while. It's been a rough go lately. I haven't had much to say. Just started Cycle 11. I look back on that very first blog I wrote and that woman seems so far away. The dream of being a mother seems like just that right now; a dream. Guess these blog entries of "Pre-pregnancy" have brought quite the journey. Wouldn't be much fun if I'd gotten pregnant right away then there wouldn't be any more pre-pregnancy perspective. Fans would be asking for more drama and I'm happy to oblige.

Before you go all sappy on me and tell me, "It'll be ok. Just relax. It'll happen for you. Don't stress out too much..." I'm butting in to say ZIP IT! I'm sick of hearing that and tired of saying, "I feel.....blah blah." On to more important business...I got things to take care of.

10/26/09 brings an HSG test. Hysterosalpingogram. This test was recommended a few months ago but I thought Ah, it's only been 6 months. I'll wait a bit." Not to mention my insurance really doesn't cover much for this test and it ranks around $280. My grandmother had a blocked fallopian tube, had it diagnosed then cleared after 7 years of trying. Shortly after, she got pregnant with my aunt. Could I have one too?

7 days after I get a happy face on a ovulation predictor test, I go in for a progesterone test. Could be just that I have low progesterone and my uterus lining can't handle it? Luckily, it's 2009 and that little problem can be fixed quite simply.

Monday, October 26, 2009

Nipple Phobia

Tuesday, October 20, 2009

Boo Nestle - Make your Halloween Nestle-Free

Found on the Boo Nestle website

What is Boo Nestle?

Participation in a campaign as far-reaching as the Nestle Boycott can be overwhelming, especially for busy parents. But it's exactly because so many of the products we feed our families are made by Nestle that we can help protect vulnerable children and families around the world with our action.

So this Halloween take one concrete step: don't buy any Nestle candy for the ghouls and goblins knocking at your door.

Call to Action

What can you do?

Besides not buying Nestlé products yourself, here's what else you can do:

• Tell your friends and family about Boo Nestlé by forwarding them this email.
• If you use Facebook and other social networking sites, share this message as your status update: I'm not buying Nestlé candy this Halloween - here's why:é
• If you use twitter, tweet the following messages: I'm not buying #NestléFamily candy this Halloween - here's why:é #BooNestlé (Pls RT) and #BooNestlé: Brands to Avoid for a Nestlé-free Halloweené #Nestléfamily #Nestléboycott (Pls RT)
• Join in the discussion of the Nestlé Halloween boycott on Twitter by using the hashtag
• Please spread the word by forwarding this email to friends and family.

Nestle Candy Brands to Avoid

Here are the US-distributed candy brands to avoid:*
• 100 Grand
• Aero
• Baby Ruth
• Bit-O-Honey
• Butterfinger
• Carlos V
• Chunky
• Goobers
• Harry Potter Brand Candy
• Kit Kat
• Laffy Taffy
• Lik-M-Aid Fun Dip
• Nerds
• Nestlé Abuelita Chocolate
• Nestlé Crunch including Crisp, Miniature, and Buncha
• Nips
• Oh Henry!
• Orion
• Pixy Stix
• Raisinets
• Runts
• Smarties
• Sno-Caps
• Spree
• SweeTarts
• Wonka Products (Pixy Stix, Gobstoppers, Spree, Laffy Taffy, Nerds incl Nerds Rainbow Rope, Fun Dip, Runts, SweeTarts, Shockers, Mix-Ups, Wonka Bar, Tinglerz, Kazoozles, Gummies, Harry Potter-branded candy)

Also, if you’re having a Halloween party, avoid these brands that you might use for party food:

* Nestle Toll House (chocolate chips, refrigerated cookie dough)
* Juicy Juice
* Coffee-Mate
* Dreyer’s
* Haagen-Dazs
* Jamba Ready-to-Drink
* La Lechera (condensed milk)
* Nescafe
* Nestea
* Nestle Abuelita chocolate
* Nestle Crunch Ice Cream and Dibs
* Nestle Hot Cocoa
* Taster’s Choice
* YoCrunch yogurt
* Water:
o Pure Life
o Aqua Pod
o Arrowhead
o Calistoga
o Deer Park
o Ice Mountain
o Montclair
o Nestle Pure Life
o Ozarka
o Poland Springs
o Zephryhills

* The above lists the relevant brands Nestle manufactures themselves but there are many other products and brands they are involved with distributing, licensing (such as Kit-Kat) or have partial ownership of in the US and globally so there may be other products in the Halloween aisle but at least this is a start.

If you’re in Canada, visit INFACT Canada for a list of their Canadian-distributed brands.

If you'd like to avoid ALL Nestle brands, visit Crunchy Domestic Goddess for a comprehensive list.

Thursday, October 15, 2009

Light a candle on Oct. 15 for babies lost to miscarriage or stillbirth

On October 15 of every year, at 7 p.m. your time, light a candle for one hour in memory of our babies who were lost far too soon. As each time zone extinguishes their candles and the next one lights theirs, we create a continuous wave of light around the world to remember our angels.

Wednesday, October 14, 2009

5 Reasons to Avoid Induction of Labor

Posted by the Denver Doula on Facebook
Written by By Robin Elise Weiss, LCCE,

The induction of labor can be done for many reasons, including many valid medical reasons. However, the rise in the rate of social inductions, or elective inductions is on the rise. As the induction rate rises there are more babies and mothers placed at risk for certain complications. Here are five risks of induction that you may not know about:

1. Increased risk of abnormal fetal heart rate, shoulder dystocia and other problems with the baby in labor.

Labor induction is done by intervening in the body's natural process, typically with powerful drugs to bring on contractions or devices that are used to break the water before labor starts. Both of these types of induction can cause the baby to react in a manner that is called fetal distress as seen by fetal monitoring.

The nature of induction like contractions may also be more forceful than natural labor. This can cause your baby to assume or stay in an unfavorable position for labor making labor longer and more painful for the mother. It can also increase the need for other interventions as well.

2. Increased risk of your baby being admitted to the neonatal intensive care unit (NICU).

Babies who are born via induction have not yet sent signals to the mother to start labor. This means that they simply aren't yet ready to be born. This risk is worth it if the baby or mother's lives are in danger, but simply to take this risk for elective reasons may not be well advised.

When a baby is in the intensive care unit there is less ability for you to be with your baby or to hold your baby. Breastfeeding usually gets off to a rocky start as well. This can usually be avoided by giving birth when your body and baby say it is time.

3. Increased risk of forceps or vacuum extraction used for birth.

When labor is induced babies tend to stay in unfavorable positions, the use of epidural anesthesia is increased and therefore the need to assist the baby's birth via the use of forceps and vacuum extraction is also increased.

4. Increased risk of cesarean section.

Sometimes labor inductions don't take, but it's too late to send you home, the baby must be born. The most common cause of this is that the bags of waters has been broken, either naturally or via an amniotomy. Since the risk of infection is greater, your baby will need to be born via c-section.

A cesarean in an induced labor is also more likely for reasons of malpresentation (posterior, etc.) as well as fetal distress.

5. Increased risks to the baby of prematurity and jaundice.

Induction can be done before your baby is ready to be born, because your due date is off or because your baby simply needed more time in the womb to grow and mature their lungs. Your baby may also be more likely to suffer from jaundice at or near birth because of the induction. This can lead to other medical treatments as well as stays in the hospital for your baby.

Being born even a week or two early can result in your baby being a near term or late preterm infant. This means that your baby is likely to have more trouble breathing, eating and maintaining temperature.

Sunday, October 11, 2009


Thank you Danelle Frisbie for posting this on Facebook

Rebecca Griffin's forthcoming book, 'Why Didn't Anyone Tell Me?' is due for international publication in early 2010 by one of Australia's leading and most credible educational publishers - ACER Press (Australian Council for Educational Research).

The book weaves together parents’ stories, witty anecdotes, words of wisdom and handy tips with evidence-based research, so that new parents have access to a range of information at their fingertips. Topics range from conception, pregnancy and birth, right through to the transition to parenthood, making the book helpful not only to the new parent but also to parents who want to feel supported, informed and connected.

Because this book relies on stories from everyday mums and dads, Rebecca is now calling for contributions. Contributing is easy. All you need to do is contact Rebecca and she will explain the process to you and help you put your story together.


You don't have to be a great writer to contribute to this book. Rebecca has many years of editing experience and there are a number of ways you can share your story. For example, Rebecca can set up an interview with you and, using your words, create your story. It's that simple!


Every contribution remains strictly confidential. That is, only Rebecca Griffin will have access to your details. Parenting can often be an intimate topic, so it is important that each contributor feels confident in sharing their story in the knowledge that their privacy will be maintained.


Not only will you be helping others, your stories will be valuable for birth professionals in training, from obstetricians and paediatricians, to midwives, doulas, childbirth educators and other related professionals.


Rebecca wants this book to be as representative as possible, both in culture and experience. So please invite your friends today!

Website - Parents' Wisdom
Contact Rebecca - email

Tuesday, October 6, 2009

My Journey to a VBAC

Posted by Kim:

One of my amazing friends on Facebook posted this video and I thought it was fantastic and wanted to share it with you. What an inspirational story of a woman who used her first birth experience to charge the outcomes of many other women's birth experience. It is not only inspirational that she was able to complete a VBAC, but in fact it was amazing that she had the courage and passion to become a doula, birth educator, lactation consultant, midwife and finally the mother of a natural birth. What a blessing.......

My Journey to a VBAC from Lindsey Meehleis on Vimeo.

Monday, October 5, 2009

Midwives: A Safe, Cost-Saving Alternative

Posted by CommonHealth, Saturday, September 12th, 2009

Peggy Garland, a certified nurse-midwife and Coordinator of the Massachusetts Coalition for Midwifery, says the state acts against the interests of women and mothers by limiting access to midwifery services:

Did you know that almost a quarter of all hospital discharges involves maternity care (mother and newborn)? That six out of fifteen of the most common hospital procedures involve maternity care? That Cesarean section is the most commonly performed surgery? Why are so many procedures being performed on essentially healthy people? It’s the same reason behind sky-rocketing costs in all other sectors of health care: reimbursement is procedure-driven.

None of us would want to stint on the health of mothers and babies if all these procedures produced improved outcomes. But our outcomes are among the worst in the developed world and are not improving. The long-term health problems for women associated with Cesarean section are only now being understood. Maternal mortality is actually increasing. Some of the problem is undoubtedly due to excess interventions, especially those of unproven effectiveness.

The hallmark of midwifery is care with minimal interventions, with a focus on those that are evidence-based. Numerous studies of midwifery care involving low-risk women show lower costs and equal or better outcomes, as summarized here, in a report by the prestigious Milbank Memorial Fund.

Consider this:

In 2006, in Massachusetts there were 26,141 Cesarean sections (out of 77,670 births.) If we could reduce this surgery by 1% we would experience a cost savings of nearly $1.5 million. Boston itself provides a good example of the magnitude of the potential cost savings: the three Boston hospitals with the most midwife-attended births saved the Commonwealth nearly $3 million in Medicaid reimbursements in 2006 by reducing Cesarean sections, compared to the Boston hospitals that had few midwives. (1)

We could also allow low-risk women on Medicaid to choose out-of-hospital birth. States that have made state-licensed midwife services available to women on Medicaid have been glad they did. According to Jeffery Thompson, MD MPH, Chief Medical Officer, Washington State Department of Social and Health Services:

In 2007, the Washington State legislature commissioned a cost-benefit analysis from the Department of Health on licensed midwifery care. This independently-conducted analysis found that licensed midwives directly save the State of Washington at least $473,000 per biennium in cost-offsets to Medicaid when women give birth at home or in free-standing birth centers. It should be noted that this was a very conservative estimate which reflects only avoided costs associated with licensed midwives’ lower Cesarean section rates. When facility fees and costly medical procedures such as epidurals and continuous electronic fetal monitoring are factored into the equation, the actual savings to Medicaid biennially are approximately $3.1 million. These savings occur with licensed midwives attending just under 2% of the births in the state. (2)

Massachusetts midwives have encountered regulatory barriers that limit their availability to women. Only 60% of hospitals with obstetrical services in Massachusetts have midwives. Many of those that do have midwives have not expanded their services because they aren’t aware of the cost savings they are getting—ironically, current law causes midwives to be invisible in hospital accounting systems. Massachusetts does not regulate midwives providing homebirth services, as Washington State does (and NH and VT), therefore denying women on Medicaid a quality low-cost option.

Senator Richard Moore, Chair of the Health Care Finance Committee, recognized some of these issues several years ago when he introduced legislation to streamline and consolidate the regulation of midwives in the Commonwealth. As we move from the provision of universal coverage to the painful task of cost-savings, we can use some simple ways to lower costs, increase satisfaction and improve outcomes for our families. Increasing access to midwives (for women who want them) has just such potential.

Notes:[1] MA DPH, secondary analysis Kelly Roberts, RN, CNM[2] From letter of support submitted to the Congressional Budget Office July 2009.