Birthing with confidence

Witness to an UNNECESAREAN

noreply@blogger.com (Deepa) — Fri, 18 Sep 2009 16:34:00 +0000

Hi Everybody

I want to share my agony with you as I was a witness to an unnecesarean (unnecessary C-section) yesterday. I supported a couple from yesterday 6 am to 11 in the night. They wanted a home birth kind of experience, read up everything on pregancy & natural childbirth, chose a doc recommended to them as a non intervention doc, attended my classes and wanted me as their labor coach.

As they discussed their Birth Plan with their doc , She promised

will wait 3 - 4 days after due date and then monitor and decide
no routine interventions, definitely no Pit , AROM

Due date Sept 15th, the couple went to their doc and before that discussed with on negotiating time. I told them that they could easily wait 4 - 5 days as she had nothing wrong with the pregnancy and the baby was doing excellent. I asked them to assure their doc that they would do maybe 2 fetal doppler / day and monitor movements etc. But ultimately she insisted they get induced the next day itself, however the couple pushed and got ONE day more. She was scheduled for an induction on 17th Sept.

The Procedure: Woken up at 4 am , administered enema and moved her to a dingy waiting room near the labor room. Inserted Cervix Gel at 6.30 am and refused to let her go back to her room (10 steps away) saying that anything could happen at anytime!!!! She had not even begun dilating. She was upset and could even take a nap there as the nurses were gossiping so loudly outside with duty docs and cleaning staff. Finally I asked her husband to request the doc to let her move to her room for a short for her to have some sleep. She said " you are putting me in a tight spot" and then agreed. Thankfully when she moved to her room , she was more relaxed and slept for an hour and half.

AT 12 pm , she was moved to the labor waiting room and given one more gel. Finally around 1 pm she started feeling contractions. We started working on positions and also massages and the contractions were coming at 3-4 min interval lasting 1 min. At the internal exam at 2.30 pm , she was 3 cm dilated and the doc said she would be assessed again in 2 hrs and then given one more dose or start Pitocin.

The day before , the Doc had told the couple that she would give her Cx gels 2 or 3 times and wait even Overnight if the situation demanded and would not use Pitocin and the couple trusted her completely. But from nowhere came the Pit in 2 hours diagnosis.

We decided that we will work with positions during the next 2 hrs and used squatting, lunging, birth ball and rest in between . Mean while as they had restricted food intake after 9 am , we kept her well hydrated with glucose drinks, juices.

She kept getting good contractions and required a lot of support and got it from me , her husband and her mother. At around 5 pm her contractions were getting reduced in intensity and were slowing down. She was re-assessed at 5.30 pm and she had dilated 5 cm but her Cx was still think and was not effacing. She was moved to the delivery room and a drip of saline started. At this point they administered epidocin, a drug that will help in softening Cx and also bring in contractions.

They also started continous electronic monitoring as they were using induction agents. She did not quit elike ENtonox and was handling her ctx with support from us and just holding the entonox mask in her hand for moral support.

Vag exams happening every 1 hour and 3 doses (6.30 pm , 7.30pm) of epidocin , 2 more cervix gel, 1 rectum gel and Pitocin. She was writhing in pain, threw up, legs shaking , feeling cold and unwilling to go further. So we were hopeful that she moved to 7 cm dilation but could work any more positions as she was strapped and hooked. Did not even allow her to use the toilet, used a catheter that was painful and when she was hurting , Doc tells her the nurse is not doign it on purpose but bcox it was difficult to put it in with the baby's head there. They could have just let use the toilet by disconnecting things for 5 min.

A drama happened when the fetal monitoring sensor moved from position bcoz she turn sideways. The alarm rang on the machine, doc ran in and stopped pit. Then realised sensor was misplaced and immediatelt heart beat got corrected , jumped back right on. But the imression created was lets watch closely and be careful.

Pit started again and at 8.30 pm she was still at 5cm. Performed AROM and then walks a nurse who says starting pushing and also refused to let her have semi incline which was asked for in the first place. Made the mother push and push , telling her she was not putting effort and doing things the right way. Finally I told her that she is awake from 4 am , show some consideration. I told the mother to switch her off and observed her contractions. They were only happening for 30 secs and not at all intense and were almost 5 - 7 min paced out. I told her not to push and waste her energy bcoz these contracttions were not strong enough. Duty doc examined , she was still at 5 cm and she broke down completely. It was so traumatic fro her and us also and told her vent her feelings. Let it all out and then muster courage from inside you and support her baby to come out as we were supporting her. But by then I knew where all this was heading.

At 9.45 pm, her Doc called her husband out and said she has been struggling for too long and the cervix was not thining out and did not want to lose the opportunity of baby's heart beat being strong and perform a C-section when things were good. We were worried how the mother would react but she was up from 4 am and it was almost 16 to 18 hrs.

After being probed and poked from every direction She just said "do whatever and deliver me" and then started the procedure for epidural(thankfully) and she delivered by 10.30 ish, her daughter was fine and I had to leave as it was 11 pm and I was going to drop from exhaustion. I think we also need strength training to handle long labors!!!

SO many questions in my head:

Why could the doc not wait even a day from due date ? Does a switch turn on inside on due date. I am begining to feel that only if a woman goes on a spontaneous labor before her due date will she have a normal delivery, with the hype around EDD as a deadline, docs will perform inductions on all women who go even a day beyond due date and there is atleast a 50% chance of failure.

What about Bishop's score for induction? In this case, the mother would have got 3 points or less thereby indicating failure

She said she will only use gels and WAIT overnight but then decides in Pit and nobody has a chance to re-negotiate.

Interventions one on top of the other , gels, epidocin, pit, AROM - What else was she going to "avoid"

How did a doc who won the trust of the couple of being non interventionistic suddendly do a flip flop ON the due date and still assured them she will wait and wait.

I was feeling rotten, like I had let the couple down, But they called me an angel:-) it was traumatic for me and I dont even want to imagine how bad it was for the mother. And the father said Lets get your birthing center plan going please.....God Grant me that wish.

Do give me your inputs and your feelings and experiences , so we can continue to learn....

Deepa

The Experience of Birth

noreply@blogger.com (Deepa) — Fri, 18 Sep 2009 16:29:00 +0000

For all you women who want to know and experience birth

http://http://www.youtube.com/watch?v=BuM8dzDcraI

A Father gives birth!!!!

noreply@blogger.com (Deepa) — Wed, 16 Sep 2009 15:12:00 +0000

I received a call on 5th Sept at 3.30 am and one of my expectant father's told me " She's in labor and we are at the hospital". I assured him that I would be there shortly. At the hospital after spending couple of hours I see that he is completely in charge and coaxing her to breathe and massaging her back through every contraction.

The expectant mother seeks his presence and he is with her all the time, everywhere. When she needs his strong hands, as she rocks on the birth ball, when she throws up, in the labor room, as she pushes her baby and as she gets stiched up and then when establishing breastfeeding.

I felt I was seeing my own birthing experience in front of me. I had completely surrendered myself into my husband's hands and he steered me with all his might through 2 most beautiful journeys in our lives.

This to-be father's voice never faltered, never showed the pain or tension. He was calm and in control and kept saying Relax ma , dont clench. He would say " Breathe" and show her and she would follow his cue. At a point when she was really down, he told her one contraction at a time, you can do it and She did it. She had lost all energy but somehow she pushed with all her might and soon enough she saw her baby being born and put on her abdomen.

The doctor announced " Congratulations Baby Girl. She held her baby and looked at her husband not believing that she had birthed. When the baby was put near her face, the tiny little one's eyes dart between amma and appa making straight eye contact with her parents. It was simply amazing and this intimate bonding between the 3 of them was the greatest reward for the excellent team effort that they had put in.

When their immediate family heard of the baby girl, their eyes poured out with immense happiness emotions on welcoming this beautiful princess into their lives.

This is how every couple should give birth and that's why the title which recognises the father to be a very important contributor not only to create this baby but also the need for him to be there with the mother during birth.

I think I have the best job in the world when I support a couple during pregnancy and birth!!!!

P.S I have one more labor support happening tomorrow and I am praying for the couple to have a beautiful birthing experience.

My Dream launched on March 8th,2009 Women's Day

noreply@blogger.com (Deepa) — Thu, 26 Mar 2009 06:04:00 +0000

Launched PreggyJoy - Childbirth Education Center
on March 8th, Women's Day. Its the begining of a new journey, a dream that began one year ago. Its a conscious decision to be an independent childbirth educator as I do not want to be biased by hospital policy and want to provide information and skills for couples on evidence based practices and help make wise decisions through informed consent.

I am ready to enjoy this roller coaster ride!!!

Back again!!!

noreply@blogger.com (Deepa) — Thu, 22 Jan 2009 08:41:00 +0000

OK I am beginning to understand how difficult it is to maintain a blog along side all the other things one has to do. But I still can't resist. WHat have I been doing all this while professionally....

I supported one woman through her delivery infact I did not plan to but eventually made it during the final 2 hours before birth. It was an intense experience ad all the while i just held her hand and spoke to her, getting her to breathe, calm her and just had her focus while pushing and delivering her baby. Her husband was there by her side massaging her and comforting her and telling her what was happening. I did quite a balancing act between the couple who wanted a completely natural birth and the doctor who is a very compassionate person but really believes that interventions like episiotomy would help and must be a routine. Finally the baby boy was born and everybody was thrilled and thanking everyone else!!!

I also supported a woman who was hoping for a normal delivery after her first C-section (VBAC). We succeeded in negotiating with the doctor to wait for 40 weeks but when she crossed that date her doctor decided on a C-section. The VBAC woman did not have too many options because there is absolutely no way of finding a medical practioner who wold have wanted to wait and let her labor start normally. She was very dissappointed but she was atleast felt consoled that she tried her best.

I am hunting for a space to start my classes and that is becoming a tough cookie to crack too. Meanwhile Birth India has revamped its website www.birthindia.org and its looking beautiful and is a major resource for expectant couples looking for a more natural birth. I have a page in the services directory...So have a look.

Hope to become more regular with my blog and post atleast twice a month!

Ladies : Its important to watch your weight

noreply@blogger.com (Deepa) — Sat, 30 Aug 2008 07:06:00 +0000

I was seeing Dr.Sun News a few days back and there was the eminent paediatrician Dr.Deepa Hariharan talking about a lot of subjects. She also was saying that it is important for a woman to be at an ideal weight when planning a pregnancy. As it is many women gain atleast 12 kgs during their pregnancy so if the woman is already overweight it could lead to occurence of certain conditions like gestational diabetes and Hypertension ( high BP) leading to complications for mother and baby. So if you are planning a pregnancy eat the right way and control weight gain as it can also come in the way of conceiving.

I used the Hi protein high fibre low carb diet coupled with bare min physical exercise and it worked. I lost about 7 - 8 kilos in 3 months but unfortunately I did not continue and I thnk I might have gained half of it back.

My diet used to be :

Breakfast - Normal south Indian breakfast like 3 dosas or 3 idlis with sambar or chutney. Can also have adai , pesarattu. No fried items like puri.
1 cup of coffee

Drink lots of water and when hungry in between have spiced sprouts , grated carrot salad, diffrent pulses salads.

Lunch : Eat before you feel hungry. Start with a big bowl of thick soup. Then fill your plate with all the vegetables except for potato or yam . You can eat all the curries prepared at home for a normal meal without filling rice in your plate. Have 2 Rotis , dal and very rarely a small cup of rice. You can also have Chicken and Fish but not fried just grilled or cooked or just plain egg whites boiled.

Have fruits, nuts , dates for the evening hunger pangs.

Dinner can be the same but avoid rice.

This way you will lose weight but not at the cost of your health. This is only till you plan a pregnancy. Good Luck to you and me . I better start the practice again and get the fat of my body. My dream weight is 55Kgs and I am 5' 3" but that is a far dream!!!!!!

Finally some action!!!!

noreply@blogger.com (Deepa) — Sat, 02 Aug 2008 17:56:00 +0000

Well finally you have decided to start the roller coaster ride, so lets first do the slow climb up......You know, after having tried NOT to get to pregnant all along, remember pills and condoms and have freaky "missed a day" moments, its actually quite funny initially when you get to do it and do it without the need for protection. Now you are hoping and trying for the sperm to swim all the way in!!!!

You may hit bullseye immediately or like me get hyper because you have been trying for 3 months and nothing much has happened. It might get very mechanical on the days you are hoping to conceive and your hubby would be wondering " OK so long I had to pull her to bed now she marches me to the bedroom on those 3 days every month!!!!

On an average it takes about 7 months to even a year before you actually conceive. So you could take a doc's appt after maybe 3 - 4 months to learn more about the right days and she may give you medication for regular ovulation etc.

So which are the right days to get into full action?

Assuming that your menstrual cycle is 28 days then day 1 is when you get your period and day 14 is when ovulation or release of egg into fallopian tube and then to uterus happens. So your best best would be from 12th day to 15th day. However it is better to observe your cycle and then find out when ovulation actually will happen for you. If your periods are very irregular then it is better to consult your Doc who will advice on medication to make your cycle regular. Thats what happened to me and I conceived on the 3rd cycle after taking medication to regularise my period. Here is a good website on ovulation cycle http://www.ovulation-calculator.com

Now to the juicer part: What is the best love making position for conception?
Well the missionary position ( Man on top) seems to win hands down. It seems to be the most popular position for couples trying to conceive.

It is important for the woman to keep lying down for atleast 20 - 30 minutes after intercourse and also raise her lower back with a couple of pillows underneath. Or she could lie on her stomach flat and take a blissful nap.

But People most importantly let it be an enjoyable period with romance leading to love making rather the " make me pregnant fast " ones. Try to take off the pressure or stress of procreation and enjoy the pleasure for the sake of it. Well now stop reading and take off to the bedroom!!!!

Getting ready before the Roller Coaster Ride

noreply@blogger.com (Deepa) — Wed, 02 Jul 2008 10:13:00 +0000

So, here you are quite excited about taking that roller coaster ride, ready to enjoy the thrills and the topsie turns. If you are planning a pregnancy in the coming few months here is a list of things that you need to do:

Get FIT and in shape : The first thing to do would be find out if you have a Healthy body weight. Check your BMI ( Body Mass Index) http://www.doctorndtv.com/calculator/bmi_calculator.asp

For below the normal range this is the best time to ignore the "diet" and eat healthy as less body weight can cause trouble for ovulation , conceiving and can increase chances of a low-birthweight baby.

However too much fat is also not desired. Being overweight at pregnancy or gaining too much weight during pregnancy will also increase the chances of gestational diabetes , delivering a baby who is above the normal birthweight and other incidents like C-section .

So start to plan healthy meals with more protein , high fibre content and go slow on carbs and sweets. Visit a nutrition consultant to design a well balanced meal - would be worth the trouble anyday.

Fitness routine is also very desirable for women planning to conceive. Most of us are very lazy to do any kind of exercise routine So, go get your husbands to play along. Go for yoga or a Salsa class or play some game ( outdoor!!!) and go walking under the moon by the seaside if you can.....

Say Hi to your doctor : Go meet your gynaec who will conduct a few tests and probably prescribe some supplements like folic acid and iron / calcium.

I know you would feel squeamish....what if the doc wants to examine me... gosh I cant expose myself....Tell you what, its what she does every day, just imagine having seen sooo many pelvises before, is yours going to stun her? So gather your courage , feel confident and go ahead. Soon you will become a pro at this.

If there is a need for a pelvic exam, lie down , relax yourself comletely which means leaving loose the pelvic muscles, your stomach, your hands and your jaw and take deep breaths. There will be just a mild discomfort and no pain. Let your doctor know if how you are feeling and she will reassure you.

You could discuss with your doctor about your contraception method and if you need to wait for a few months before trying to conceive. If you are using the pil it is better to switch to barrier method for 3 months before trying to conceive.

Your gynaec will prescribe some vitamins like :

Folic Acid : Folic acid (folate) is a vitamin and is needed to make new cells in the body. Pregnant women in particular need a good supply of folic acid which is used by the developing baby.
Many foods contain folic acid including vegetables such as spinach, sprouts, broccoli, green beans, and potatoes. You should start taking folic acid tablets before becoming pregnant (from the time you plan to become pregnant). Neural tube defects usually develop in the first 28 days of pregnancy, often before a woman even knows that she is pregnant. If the pregnancy is unplanned then start taking folic acid tablets as soon as you know that you are pregnant. Continue to take folic acid tablets for the first 12 weeks of pregnancy - even if you eat a good diet.

Iron : It is a very well known fact that iron is very important for a pregnant woman or when one who is planning to conceive. Iron is essential for making hemoglobin, the protein in red blood cells that carries oxygen to other cells. During pregnancy, your iron requirements go up significantly. First of all, your blood volume expands until you have almost 50 percent more blood than usual, so you need more iron to make more haemoglobin. You also need extra iron for your growing baby and placenta.

Sometimes some iron supplements can cause constipation ot stomach upsets which usually settle down. To counter this you can increase your fluid intake and also have a high fibre diet. If it is still troublesome ask your doctor to change to a different brand , a more slow -release or paediatric supplement.

Calcium : It is important to have an adequate supply of this mineral for the awaiting pregnancy and also the baby. So you may have to take a calcium supplement along with a healthy diet . If you are taking Iron and calcium , it is better to take iron in the night and calcium in the morning as iron tends to reduce the body's absorption of calcium .

If you are already pregnant and did not plan on it like most of us , just ensure that you start on your antenatal vitamins immediately!!!

Cut down on the caffeine: I love coffee and chocolates and cola and lot of other beverages. I cant live without them but hey I am done with having babies!!!! Have only about 1 or 2 cups (about 100ml ) of coffee in a day ( no refills at work). Why do we need to do this ...read here:

Caffeine is a diuretic that means it removes fluids more your body as well as calcium. It also interferes with the absorption of iron that means may lead to anaemia. It is also known to heighten mood swings and insomnia.

A BIG ABSOLUTE NO to :

1. Smoking : Quit it whether you want to become pregnant or not and yeah applies to your partner and there are no two ways about this.

Smoking can make you less fertile and also cause birth defects and other problems if you are pregnant. See here:

http://www.netdoctor.co.uk/health_advice/facts/pregnantsmoking.htm

Well if your partner then you will have to deal with the same effects . Read below on how to handle this:

http://www.bbc.co.uk/health/ask_the_doctor/pregnancypassivesmoking.shtml

2. ALCOHOL :

Settle for " orange juice on the rocks" when planning a baby as there is no safe level of alcohol consumption during pregnancy. Women consuming large levels of alcohol can lead to Foetal Alcohol Syndrome ( FAS) which is condition for the fortus or baby having malformations, dysfunctions and abnormalities.

Having said that dont worry too much about the couple of pegs or wine you had before you knew you were pregnant. Forget it and make sure you stick to juice.

3. DRUGS

Illicit drugs are a big NO when planning to conceive and after you are pregnant and it applies to both the partners.

Be careful about Prescription and over the counter(OTC) medicines. Let your doctor know you are planning to conceive or if you doubt you are pregnant before taking any medicines and the same goes for even simple OTC medicines.

That does it for the do's and dont's and lets await with bated breath for the juicy post on " How to make babies"!!!!

To be or not to be - A Mommy and Daddy

noreply@blogger.com (Deepa) — Wed, 18 Jun 2008 16:36:00 +0000

When a couple get married in India , the next question from everybody is "When are you going to have a baby?" Really because well according to many thats the next duty to complete!!! Awesome amount of pressure on the couple before they can even begin to know each other as a husband and wife ( oh yeah thats a lot different from lovers or fiance). Well I know because San and I decide to give ourselves time to enjoy each other in every respect before moving to the next phase.

We really freaked out in our "DINKS" days but by the time we finished 4 years of marriage we had everybody breathing down our necks with a well meant " Start trying"!!!. 2 hilarious(now, not then) incidents ...one a neighbour aunty putting her head thru our car window and saying with so much sadness - " What not pregnant yet" @#&!@#Two, a very old 70+ man ( some acquaintance) meeting us for the first time said in front of the whole family "4 years no baby, better go see a doc immdtly". Oh man I was really psyched.

However it is a good idea to ignore the pressure and take it easy for atleast 4 years after marriage. Learn about each other and enjoy that period for it will never come back. Take short vacations often and try to explore different places together. Dont take risks on contraception. Remember the safe period is never safe.

The right time for a woman to have her first baby as everyone knows is around 26 - 29 yrs depending on when you get married and how much time you want for yourselves before you think of a baby. Having said that, being mentally prepared for a baby is equally or much more important than being physically prepared. And it applies both for the man and the woman.

We had our son when I was 27 and yeah we were ready.

We had our daughter when I was 29 and she was a total surprise!!.

Were we ready? Oh no...No way...by the time my son had his first birthday I was 3 months pregnant...Whoa its been a roller coaster ever since although the ups and downs have kind of flattend off with them growing up. The initial 2 years were very tough on both of us but looking back we are really proud and did enjoy the little bundles of joy thoroughly!!!

If you are wondering should you or shouldn't here is some encouragement
http://www.babble.com/content/articles/columns/the-babble-list/45-Reasons-To-Have-A-Baby-Right-Now-Cold-Feet-A-Few-Good-Reasons-To-Dive-Right-In/index.aspx

And if you are thinking of the changes that your life will take have a look at this
http://www.babycenter.com/0_thirty-things-that-change-when-you-have-a-baby_1452535.bc

Well hope you have decided to take the plunge ( no pun intended!!!)

Cheers
Deepa

Childbirth Education - What and Why

noreply@blogger.com (Deepa) — Tue, 10 Jun 2008 05:11:00 +0000

About 6 years back when I took these classes for my first pregnancy it was mostly some stretching and breathing exercises and some information about what happens during labor. However today it is very different and very valuable because it is more on

Knowing the natural changes happening in the body and how to cope with the challenges that come different stages of pregnancy
what to expect during labor and how the labor support person can be of tremendous support & motivation to the mother-to be
Knowing the different positions that can be adopted during labor
Knowledge of diferent pain relief methods and the pros and cons of each and how to make decisions
Different kinds of medical interventions, why they may be needed and what to do when faced with those
Communicating with the heath care provider and hospital staff
Breastfeeding - Learning the right way to breast feed and knowing what to expect during the intial few weeks
Postpartum care - Baby and mother
Relationship between the couple and the need for constant support for the mother and also time spent together

Equiped with the above information a couple and more importantly the woman will be empowered and thereby have confidence and be in control of the situations that she would face. This will pave way for her birth experience ,whether normal or surgical, to be a positive and fulfilling experience that she will remember forever.

A new journey most satisfying

noreply@blogger.com (Deepa) — Fri, 06 Jun 2008 08:42:00 +0000

I was at that juncture of my life where my kids were growing up and at school the whole day which gave me the much needed time to re-start my career. After having worked as an HR professional for close to 5 years and then taken a 6.5 yr break I did not want to get back into the corporate race and I desperately wanted to be my own boss and started rattling out business ideas and mailing them to myself. At this point Santhosh, my hubby gave me this book and told me that I would get some clarity on reading it. “ The Monk who sold his Ferrari” by Robin Sharma (www.robinsharma.com) which is about 6 years old but wow the book showed me the path on how I could figure out what I wanted to do in life and how to move ahead towards achieving it. The book came with an audio CD and we played it in our car and at home. Try it, for it brings about profound change.

I was sitting at my doctor’s clinic ( my mentor now ) and was contemplating on what career would give me complete joy and satisfaction. Then in a flash I knew it!!!! I wanted to be the link between pregnant women and the doctor and hospital. I wanted to be a positive influence and empower women and bring about change for women or infact for couples having a baby. I wanted to make that experience as a beautiful and joyous occasion than a scared and out of control one.

Both my pregnancies were quite difficult because of excessive vomiting (ugggh) but my birth experiences were beautiful because my doctor (Dr. Mallika Samuel, Apollo First Med) was very accommodating and treated me with kindness and compassion. My husband was allowed to be with me the whole time and was almost a part of the birthing team !!! Having him with me gave me tremendous confidence and strength to handle the pain and so much during and after the birth.

Ever since then Birth fascinates me and I feel each birth is a miracle even if it the most natural thing happening to mankind. So with my doctor as a mentor and some intensive research on the internet I am on my way to becoming a CERTIFIED CHILDBIRTH EDUCATOR. I am training with an organization called Childbirth International http://www.childbirthinternational.com/ and will soon head towards certification. In due course I also want to be a labor coach where I can be of support to woman during labor. My long term goal is to open a birthing center where women rather than being patients will be given a very natural and conducive atmosphere to give birth with minimum medical interventions. It will be a place for a couple to have a baby in a beautiful and peaceful manner with doctors who advocate natural birth.

My next post will be on what is - Childbirth Education and why we need it
Tchao