Deaconess Women's Clinic midwives Lauren Armstrong, Kathleen Bentley and Catherine Shields.

How is the care you provide different from an OB?
CS: “I’m so grateful that Deaconess will allow us to have the kind of schedule that we do, so that we can practice the midwifery model. We are with the mother from the time she goes into labor until the time the baby comes. Therefore, we’re not the kind of midwives that have to leave the office and leave everybody unattended to run to the hospital for a birth. We always have one midwife in the clinic, one midwife on call catching babies and the third is off duty. We just rotate. If you work for an obstetrician’s office, you usually don’t have that option—at least, I’ve never seen it in this community. I think we have a really unique practice where, as nurse midwives, we practice independently in our own clinic and collaborate with obstetricians if necessary.

We can offer patients the time, the education and our presence, not only when they’re in the clinic but also when labor begins.

“We can offer patients the time, the education and our presence, not only when they’re in the clinic but also when labor begins. It offers them a familiar face, something they can’t be guaranteed by most OB practices. I don’t want to slam their medical model. They provide many other services for women: surgeries and taking care of complicated problems that nurse-midwives do not. That’s what they’re there for. We believe that we’re specialists in the normal.”

What do you do to prevent medical intervention?
CS: “I promise to honor what our patient’s want and do the best I can to prevent intervention. Actually, I wouldn’t even consider doing it if we didn’t see that it was necessary. There are times when it does become necessary, but before we do anything we have a discussion. And because we’re with our patients the whole time we don’t try to plant seeds of intervention or caesarean section, but we just keep them aware of what’s going on—from the beginning to the end—so that they’re informed. It may be a disappointment, but it’s not a total surprise.”

What is the birth culture like at Deaconess?
CS: “We do what you say. We don’t tell you what to do. The nurses have seen us sit down at the bedside, and explain in detail what is happening, exploring options instead of saying “you definitely need an epidural because you’ve been in labor too long.” No matter what, even it I don’t feel like they are many viable options, I try to lay as many on the table as possible so that parents don’t feel stuck in a box with no choices.

The birth plan is part of the registration process. When you come in as a patient the nurses want to see your birth plan. I just love that! The parent’s present their birth plan, the nurses go, ‘This is what she wants. Catherine’s on her way.’ And they just hang with it.”

How safe are your methods?
CS: “There’s a competency about the way we do our practice, which I like to flaunt: we’ve never had any poor outcomes in the over 5,000 births that we’ve had at Deaconess Hospital. I think that has a lot to do with our presence at the bedside. Things don’t happen—they don’t go to pot—without us knowing about it, dealing with it and getting help as we see fit.”

How does your practice holistically support women?
CS: “I have had mothers, grandmothers, sisters, neighbors, best friends and cousins in tears. Not even maybe at the birth, but at the prenatal visit because they realize, ‘Oh my God, is that the way it could be? Is that the way it really is? No one ever told me any of that.’

We talk about more than just how the baby was and how the heart rate sounded, but really address the well-being of the mother.

One time, a intensive care nurse came to help out temporarily at our clinic and was so amazed at the environment, the comfortableness of it. We sit down at the bedside of the mother and introduce ourselves to the whole family. We talk about more than just how the baby was and how the heart rate sounded, but really address the well-being of the mother—how things were going at home, how things were going with the toddler, how you’re doing with daddy gone to war or on the job out of town, with grandma being sick. It’s an encompassing attitude and energy that we put into a mother-to-be because we consider it to be the most important event in a human beings life.

Why is it important for women to really experience birth?
CS: “It has so much to do with how you move into the future as a parent, as a wife, a mother—a breastfeeding mother. It’s something that a mother who goes through birth, where she feels like she’s heard, her questions are answered and that her concerns are concerned about, she can move forward in her life always being able to call on that experience. She can say, “Oh my God. I did that! And if I can do that, then I can do this.” And it doesn’t matter whether it’s a sick toddler, a 16-year-old that’s going out with the car for the first time, saying goodbye to your teenager as they go to college or as your children are giving birth themselves.

I wish that every woman could have that experience [of being present during birth] because their whole life would be so enlarged.

It’s an experience unlike anything we do every day as humans. You know, we pay the bills, go to work, fill up the car with gas, scrub out the toilet. I wish that every woman could have that experience [of being present during birth] because their whole life would be so enlarged. The bigger picture would seem easier had they had the strength to call on what they did during birth and to appreciate and honor their body for what it does. It’s huge.”

What is the biggest misconception about nurse-midwives?
CS: “I had a new patient yesterday who said, ‘I have a friend who is leery of me going to midwives because they don’t give you any medicine. You have to go totally natural.’ And that’s probably the hugest myth or misconception about nurse-midwives who work in hospitals. The bottom line is it’s not about us and our desires. It’s about the mother and her goals and wishes.

They can be like you [Tine] and sit on the birth ball, labor in the bathtub and walk around the whole time which we totally love. They can receive any medication that we have to offer should they desire or need that.”

What happens when a patient does need a c-section?
CS: “We’ll never leave our patients no matter what happens. If they have to go to the OR for a caesarean section, we’re right there.”

What’s the biggest obstacle to women trying to have a natural birth at Deaconess?
CS: “I think its the societal view that women can’t do it without drugs. You spend your whole life hearing that you need medication and interventions because it’s the safe way to do it. There are attitudes that say if you don’t give women medication that you’re being cruel. I was criticized by a doctor one time who said, ‘Give her what she wants. She doesn’t have to be a martyr for you, Catherine.’ It was horrible. It was just a slap in the face. But it’s easier for doctors to do their work when the patient has anesthesia.

We try to do nothing. Because we know we don’t have to and if we leave it alone it will unfold. It’s really an awesome process. If a woman’s attitude is ‘I need an epidural,’ then that is exactly what they’ll get. I’m not there to talk them into something. I’m there to honor what they want. We try to inform them, but sometimes they are defensive about it. They don’t want to hear it.”

Why are nurse-midwives a good choice for women pursuing natural birth?
CS: “Our specialty is being able to sit by the bedside, the rocking chair or the bath tub and help the mother through it. And not be afraid of her sounds or her pain. And encourage them to know that they’re doing an awseome job, their bodies are working fine, their baby is safe and that it won’t be long. It won’t be long.”

As we covered this topic, student midwife Tonia Baker who is in training at Deaconess shared a recent experience of sitting in a rocking chair in the labor room while a mother was laboring in the bath tub. The patient could see her in the chair, just sitting there listening to her. She said, “The mother was using HypnoBirthing techniques. She said she could see me sitting in the other room, wathcing and listening to her. When she began faltering during transition, thinking she couldn’t do it, my presence was enough to make her say to herself, ‘OK. I can do this.’ And she did. She did beautifully.”

CS: “It is so important to be with them. We walk in the door and see our patients sigh with relief. They may be in the middle of a contraction, but there’s that peace that comes to them when a familiar face walks in the room. That’s what makes the stress and the long hours of our job worthwhile. It’s physical. It’s emotional. It’s spiritual. It’s everything! There just could not be anything more rewarding than the art and skill of being a midwife.”

If you missed it, read Deaconess Women’s Clinic: Part 1.

Deaconess Women's Clinic midwife Catherine Shields (right) and student midwife Tonia Baker (left).

In my ongoing effort to bring Bloom readers insights and expertise from our local natural birth professionals, I am thrilled to have had the opportunity to speak with Catherine Shields, one of the certified nurse midwives at the Deaconess Women’s Clinic in Spokane. It’s no secret that I had my second baby under the care of the Clinic’s midwives and so I know how passionately devoted Catherine is to the care of pregnant women and babies. To hear her speak about birth is a transformative experience—just as birth itself should be!

When we first sat down, Catherine and I began talking about the “cow sounds” both of us naturally discovered ourselves making during our own labors. It’s amazing that all women possess an innate ability to birth if they are properly prepared and supported. I quickly discovered that Catherine’s passion for her work is closely tied to her own birth experiences. “In fact,” she says “they are the reason I am who I am today.”

You could say that the story of the Deaconess Women’s Clinic begins with the birth of Catherine’s first child back in 1972. With noticeable sadness in her voice, she told the story of having her son in a hospital, knocked completely unconscious, her baby delivered with forceps. She was left with 4th-degree tears and gauze inside of her birth canal which she didn’t discover for days. It was a painful, heartbreaking and horrific experience about which she says, “I can still cry about it today.” With the lingering trauma of the birth and no professional breastfeeding support, she nearly fell apart when her mother went back home two weeks after her son was born. It was in that dark period that Catherine decided birth MUST be different for her—for all women.

Determined not to repeat the experience of her first hospital birth, Catherine prepared herself for the kind of birth she wanted and went on to have her second child in a quick, unmedicated hospital birth. Her third and fourth babies were born at home with no tears and no stitches. Unfortunately, there weren’t any nurse midwives working in hospitals when she had her babies and she knew the majority of women in our community stood little chance of receiving education about birth or the loving care they deserved from hospital staff. During her experience as a labor and delivery nurse, Catherine was a first-hand witness to the conservative culture that brought about the highly medicalized model of birth in Spokane. She said, “Nurses used to make fun of a woman who walked in with a birth plan. They would say, ’she’s bound to end up with a c-section.’ There was a perception that people who were educated about birth would be difficult to work with.”

Catherine wanted others to experience the kind of gentle, natural birth that she knew was possible. She began to pursue midwife training with her mentor Sister Marie Ladd, the first certified nurse midwife in Spokane. Following her training, Catherine was the second midwife hired by the Deaconess Women’s Clinic when it opened in 1993. She quickly became the clinic’s visionary leader, devoted to ensuring that the midwifery model of care would grow and thrive within the hospital setting. That model of care includes:

• Time: Spending more time with prenatal patients than is typical in most medical practices, monitoring the physical, psychological, and social well-being of the mother
• Education: Providing the mother with individualized education, counseling, and prenatal care to support her wishes and needs
• Presence: Continuous hands-on assistance during labor and delivery, as well as postpartum support

When I asked her why she isn’t a homebirth midwife after having two of her own children at home, she answered, “The homebirth midwives…they are like God to me because they are on their own. They are on their own! To me, I appreciate the support that I get if I have a problem. I’ve got an in-house doctor that will come and help me get a baby out, help me repair a difficult laceration or take me to the OR and I’m just standing beside my patient while they are there to do the work that I’m not trained to do because I’m not a surgeon. And I am so grateful for that support as well as the intensive care nurses that can help get a baby out of trouble in two seconds while I’m at the perineum helping get the placenta out. You know, I had 2 babies at home. I’m totally supportive of the homebirth midwives. I give them so much credit for having the ability, the skills and THE GUTS to do that. I can’t offer my patients the homebirth environment. There’s not going to be lasagne cooking in the oven for after the birth is done, but I promise to honor what they want and do the best I can to prevent intervention.”

PART 2
As I sat down to write this article, I realized that I had so much valuable information to share with you that it couldn’t possibly be contained in one article. Check back later this week to read the rest of my interview with Catherine Shields as we discuss the current practice at Deaconess Women’s Clinic and why it is different from any other hospital/OB practice in town.

You can sign up to be notified by email when the next article comes out.

• Do we want him to look like his father?
• Do we have a religious or cultural reason to circumcise?
• Will he be teased by other boys for looking different?
• What are the health benefits and risks of being circumcised?
• What are the health benefits and risks of NOT being circumcised?

After thinking through all of these issues, and consulting our pediatrician (who said she didn’t recommend it for any health reasons), we came to the conclusion that we didn’t want to make this HUGE decision for our son. And I definitely didn’t want to think about my tiny, hours-old baby boy suffering an unnecessary surgical procedure when he could be cuddling in the safety of my arms.

As with all topics I discuss on this blog, I advocate that parents be informed so they can make the right decision for their families. It is your choice and not something that anyone else—much less the fashion of our times—should dictate for your son.

Here are a few things you might not previously have know about circumcision.

No national or international medical association recommends routine circumcision.
The Expectant Mother Guide says, “The American Academy of Pediatrics could offer no significant medical benefits to advocate routine circumcision. Their policy is against routine circumcision. Why, then, do the majority of American newborn boys get circumcised? The answer is because of social reasons. Most parents who choose to have their son circumcised do so because they ‘want him to look like his dad’ or brother.”

The circumcision rate is dropping in the U.S.
The National Health and Life Survey reports that “circumcision rates in the United States are now down to 57% among males born. That number is low compared to a whopping 90% circumcision rate in the 1960’s. Some states have an even lower amount of routine circumcisions done at the rate of less than 50% of males are circumcised after birth. California has the least amount of newborns circumcised and reported 21% in 2004.”

Medicalized circumcision began during the 1800s to prevent masturbation, which was believed to cause disease.
The History of Circumcision website says, “In the United States circumcision emerged at the same time as in Britain and for much the same reasons: hostility to masturbation, delusions about congenital phimosis, fear of diseases like syphilis and cancer. But it got its biggest boosts from the two world wars and from the medicalisation of childbirth. The importance of both the obstetricians/gynecologists and the the military in the promotion of circumcision in the USA cannot be overestimated.”

Circumcision denies a male’s right to genital integrity and choice for his own body.
The Peaceful Parenting website says it best. “Even if circumcision was entirely PAIN FREE — to amputate the prepuce would still be removing a healthy, vital, fully functioning organ from a non-consenting person. We forever change the sexuality of this future adult man and his partner. All human beings - male and female - have the basic human right of genital integrity. They have a right to ALL their functioning, healthy body parts. A man (even as a newborn) has a right to his whole, intact penis, to do with as he pleases.”

The practice of circumcision is beginning to be questioned by many in the Jewish community.
The Jewish Circumcision Resource Center website says, “Bound by this burden to comply with social expectations, most Jewish parents do not recognize that circumcision is a choice. Since open communication about circumcision is discouraged, there is virtually no awareness of others who feel similar conflicts and doubts around circumcision. Moreover, if a Jewish parent does decide not to circumcise a male child, it is not generally known to the rest of the community. As a result, many parents submit to the pressure and then discover only too late, perhaps after witnessing the circumcision of their son, that they wish they had chosen differently. Some parents report that if they could take back one decision, it would be their son’s circumcision.”

Circumcision - Just say NO! Part 1

Circumcision - Just say NO! Part 2

FOR MORE INFORMATION
National Organization of Circumcision Information Resource Centers
Doctors Opposing Circumcision
Circumcision Resource Center
Jewish Circumcision Resource Center
Mothering: The Case Against Circumcision

Sarita’s slings will work for newborns as well as older children up to 35 lbs. This picture shows Sarita with her 3-year-old daughter Rajani who still fits comfortably in the sling. Each one comes with a hidden storage pocket on the underside of the front flap and an instructional brochure illustrating multiple carrying positions and how to put the sling on. The fabrics she uses are carefully selected for quality and durability. Slings should be hand- or spot-washed as needed.

Sarita began sewing slings on her mom’s old sewing machine after the birth of her first child in 2002. She wasn’t crazy about the other slings she had tried, but was passionate about wearing her baby. She began experimenting with different patterns and developing her own artistic style, eventually making slings for others and finally launching her own business. Initial success came when her slings were a hot topic on thebabywearer.com. She has previously sold them online, but now makes her slings exclusively available at Anemone in the River Park Square mall in downtown Spokane.

Sarita and a few of her friends are also busy plotting the resurgence of a local baby wearing group. Right now you can join their Yahoo Spokane Babywearers Group to be connected with them. I’m excited that there will be a place for local parents-to-be interested in baby wearing to connect with other moms and dads who are old pros. If you’re interested in more information on the benefits of baby wearing, check out these websites:

• thebabywearer.com
• Ask Dr. Sears
• Babywearing International
• Ten Reasons to Wear Your Baby

Pregnant women and their husbands/coaches attend a series of 12 classes, beginning around the 5th month of pregnancy. Class sizes are always small and couples are taught how they can work with their bodies to reduce pain and make their labors more efficient. I don’t think I can describe it any better than the Bradley website does: “When you take a class in the Bradley Method® you don’t need most “extra” classes that are commonly offered. Bradley® classes cover it all: nutrition, exercise, being more comfortable during pregnancy, the coaches role, introductory information about labor and birth, advanced techniques for labor and birth, complications, cesarean sections, postpartum care, breastfeeding (we do recommend La Leche League meetings) and caring for your new baby. Our classes cover a few topics that are rarely discussed in other classes like: how to reduce the need for an episiotomy and the likelihood of a tear, how to avoid needing a cesarean, how to make the best of it if a cesarean is necessary, and what the coach should do if the baby is accidentally born in the car.”

WHAT IS A CLASS LIKE?
Melinda Mardon, a Bradley Method teacher in Spokane Valley, invited me to attend one of her “Week 5″ classes this past Monday evening which she teaches out of her home. Both Melinda and the classroom environment are warm and inviting. She is a wealth of knowledge on all aspects of pregnancy and birth and has props to illustrate so many of the complex concepts that are typically difficult to explain about the birth process.

PREGNANCY NUTRITION
The class begins with the couples sitting on nests of pillows, husbands giving hand massages to their wives. The nutrition topic of the week is grain—namely identifying the differences between whole grains and the refined, vitamin-deficient products that are largely available to us in stores. Even the snacks provided that evening were tied into the theme of whole grains to further illustrate the point. During the week, couples keep detailed food journals to ensure they are eating the proper foods to “build a baby.” The journals are shared with Melinda, who also encourages the couples to discuss them with their health care providers.

THE FIRST STAGE OF LABOR
Next we move onto discussing the first stage of labor. Everything is covered, from what happens physically when labor begins to identifying mom’s emotional state and how that changes moving into active labor. We talked about Braxton-Hicks contractions, mucous plugs, the bag of waters and something I’d never heard of before…the Natural Alignment Plateau. Have you ever heard someone say, “My labor stalled and the doctor wanted to speed things up by giving me Pitocin?” Well, it turns out that this Plateau is often misunderstood to be “stalled labor” and what we should do is give women’s bodies the time they need to better position the baby, finish producing antibodies in breast milk or address any number of physical and emotional issues at play. Besides, most of the women who experience this Plateau (stuck at 5 or 6 cm for hours) will transition suddenly and rapidly without the use of drugs, reaching the final pushing stage very quickly. This is exactly what happened during the birth of my first child!

THE EFFECTS OF EPIDURALS ON BABIES
The class watched a video showing how unmedicated newborns, who are given immediately to their mothers, use the crawling reflex to reach the breast and begin suckling only moments after birth. Then we see how babies whose mothers received epidurals and spent time away from them right after birth often fail to suckle, even when placed directly on the nipple. This is an eye-opening video for many in the room and brings our attention back to one of the basic reasons many of us are preparing for natural birth—it is best for our babies.

LABOR REHEARSAL
Finally, we get to what is called Labor Rehearsal. The women start by doing pelvic rocking exercises, kegel exercises and squatting. These movements are known to help babies get into more ideal birthing positions and prepare the mom physically for the work she will do in labor and birth. Then the moms lie on their sides and prepare to use the techniques they’ve been taught to relax through pain, including abdominal breathing and visualization. In these “simulated contractions,” the husbands apply increasing pressure by squeezing or pinching the mom’s arm or leg over the course of one minute, while reminding them to relax and breathe, gently massaging another part of their body and giving words of encouragement. It sounds a little barbaric to the uninitiated, but I can tell you from first-hand experience that using these natural techniques to cope with pain is something that must be practiced to be effective in labor.

WHY IS THIS ARTICLE SO LONG?
In part, it takes this many words to tell the story of the Bradley Method and the class I attended. And if you’re still reading at this point, then perhaps you are the kind of parent-to-be who will understand the value in devoting 12 weeks to learning how to fully prepare for the birth of your baby and beyond. It is intense. It requires that you take responsibility for the well-being of your baby and your family. You will feel like a fool at times and do things you’d never be caught doing in public, but there’s no better way to immerse yourself in the traditions of natural birth and be prepared for whatever happens!

When asked why he found the Bradley Method classes to be so valuable, one of the fathers in this class answered, “I like it because we are making the choices. We believe that our baby will be fine and are preparing for a natural birth. If there’s a complication in the hospital then we are educated enough to make good decisions and won’t let anyone take the control away from us.”

Become A Birth Doula!
March 18-20, 2010
Pullman, WA
DONA International Approved | www.dona.org
Contact: Dolores Michael, CD(DONA), AAHCC
Phone: (435) 213-9053
Email: naturalbirth@hotmail.com

Birth Doulas are the latest addition to the maternity care team, assisting families to have both a safe and memorable birth. They provide physical comfort, emotional support, and information to families before, during and just after childbirth. The birth doula brings back a kind of care that’s been missing in modern childbirth.

This workshop focuses on the psychological, social and emotional aspects of childbirth, the Doula’s contribution to a positive birth experience, and providing labor support in a variety of circumstances. This course completes one step toward certification by DONA International.
Below are some of the topics we will be covering.

• Long-term Impact of childbirth
• Influence on Women’s Childbearing
• The Doula’s Role and Presence
• Physiologic Pain Management
• Labor Progress Enhancement
• Emotional Support of the Mother & Partner
• Support and Advocacy for Difficult Births
• Prenatal and Postnatal Client Contact
• Professional Issues & Scope of Practice
• Getting Started-Marketing Your Practice

Fee: $350

The only way to find out what will work for you (there is no ONE size fits all) is to know what’s out there and go try them on yourself. My friend Hannah Reasoner, a doula living in Ft. Worth, wrote a great article on her blog with tons of photos showing different slings being demonstrated. Check out her post, “Babywearing—Slings and Wraps,” to get an idea of how many different options are out there if you’ve never really looked before. She shows the Moby Wrap, Maya Wrap, Gypsy Mama, Pikkolo, Ergo Baby Carrier and Beco Baby Carrier, giving brief descriptions of each including prices and photos.

I have also found a great site with tons of information about baby wearing called TheBabyWearer.com. This site has compiled a series of articles and charts comparing different carriers to help you determine which carriers are best for hiking, wearing while pregnant, plus-sizes, multiples and anything else you could imagine.

When you’re ready to go try on a few for yourself, head out to Mother’s Haven in Coeur d’Alene where they carry many of the brands listed here.

Baby Wearing Product Sites
Moby Wrap
Maya Wrap
Gypsy Mama
Pikkolo
Ergo Baby Carrier
Beco Baby Carrier

It has long been hospital policy in many places to only allow tiny sips of water or ice during labor in case a woman has to have an emergency c-section, but anesthesia practices are much improved since the 1940s when this trend began. The doctor’s conducting the study found that “evidence showed no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.”

So, if you’re at low-risk of needing anesthesia during birth, bring a copy of the Reuter’s article to your doctor and the hospital staff and let them know you’ll be in charge of deciding if you’d like to eat during labor!

Midwives and consumers of midwifery care will be meeting with legislators to discuss this year’s legislative agenda. We will be meeting at United Churches (directions follow) for a briefing session at 8:30 am. For more information, contact Audrey Levine, MAWS President, at (360) 709-0888 or send Audrey an email at president@http://www.facebook.com/l/8c827;washingtonmidwives.org. Please join us!

Directions to United Churches: Take I-5 to exit 105A in Olympia. Go straight at the stoplight on Jefferson (under the overpass) and turn right onto Capitol Way. Go several blocks and turn right onto 11th Avenue. United Churches is at 110 Eleventh Avenue SE. Parking is available behind the church or at meters on the street. Please do not park in the numbered spaces in the lot or your car will be towed.

If you’re not able to come on the 21st, please review MAWS’ public policy agenda at http://www.facebook.com/l/8c827;washingtonmidwives.org/2010-legislative.shtml and then call or send an e-mail to your legislators asking them to:

1. Preserve the Midwifery Advisory Committee
2. Support HB 2435 which will give licensed midwives electronic access to the UW Health Sciences Library through HEAL-WA for a $25 annual fee
3. Maintain the budget proviso that caps the midwifery licensing fee for the 2009 – 2011 biennium
4. Support Senator Karen Fraser’s anti-shackling legislation

To find out who your legislators are and obtain their contact information, go to: Washington State Legislature Web Site - Find Your Legislator at http://www.facebook.com/l/8c827;apps.leg.wa.gov/DistrictFinder/Default.aspx and fill in address to find your “legislative” district and legislators (the “congressional” radio button is for national). This new feature brings up your district along with links to all your senators and representatives. All you have to do is click each link for their contact information!

THANKS FOR YOUR SUPPORT! - And again, please share with others!

You may be wondering how important it is to forgo coffee and other forms of caffeine during your pregnancy. I think that all doctors would tell you the safest bet is to avoid all caffeine altogether, but that having one normal-sized cup of coffee a day probably won’t harm to your baby. At least, that’s what I was told by multiple physicians during my pregnancies. But, what does medical science really know about how caffeine affects babies after all these years of uncertainty?

The Major Risk
The March of Dimes advises women to limit their caffeine intake to less than 200 mg per day. This recommendation was prompted by the results of a study published in the March 2008 issue of the American Journal of Obstetrics and Gynecology, showing that moms-to-be who consumed 200 mg or more of caffeine a day had double the risk of miscarriage compared to those who had no caffeine. However, not all studies show a link between heavy caffeine use and increased risk of miscarriage. This is why most professionals urge mothers to err on the side of caution since there isn’t definitive evidence supporting this theory.

Other Possible Risks

• Caffeine crosses the placenta, but a fetus is not able to metabolize it. Caffeine might adversely affect cell development in the fetus and decrease blood flow in the placenta.
• Caffeine is a diuretic. It may decrease blood flow to the placenta causing an increase in stress levels for the fetus.
• A study in Denmark found that the risk of stillbirth more than doubled in women who drank a great deal of coffee per day — eight cups or more — compared with non-coffee drinkers.
• Some studies have shown a slightly increased risk of low birth weight, while other studies have not.
• One study found a link between maternal caffeine consumption equal to three cups of coffee per day and an increased risk of having a son born with undescended testes.
• Other research has shown that babies whose mothers consumed more than 500 mg of caffeine a day had faster heart rates and breathing rates and spent more time awake in the first few days after birth.
• Drinking coffee may interfere with your body’s ability to keep homocysteine and cholesterol levels in check, most likely by depleting folate, B12, B6, and calcium, all crucial in neural and skeletal development in the fetus.

WHAT’S THE VERDICT?
Medical researchers are still working to figure out the exact effects of caffeine on unborn babies. Physicians are mixed on the topic—some telling patients to avoid coffee and other caffeinated beverages altogether while others urge moderation. Since about 75% of expecting mothers will drink some form of caffeine, let’s look at ways to improve the quality of your caffeine intake.

Start by brewing your coffee at home, using organic coffee and unbleached filters. Coffee is often imported from countries where the use of pesticides is unregulated, so it is best to purchase organic coffee to avoid ingesting these toxins. Bleached paper coffee filters leak small amounts of chlorine into coffee, so using unbleached coffee filters eliminates that risk.

If you can manage to give up coffee, green tea is a great alternative. It contains much less caffeine and has wonderful health benefits.

MORE INFORMATION

• USA Today: New studies, different outcomes on caffeine, pregnancy
• Baby Center: Caffeine During Pregnancy
• Pregnancy Health 101: How Much Coffee Can I Drink?