Hands off my Vagina

The term episiotomy means to cut the skin between the vagina and anus in an attempt to widen the vaginal opening for childbirth. Many years ago this was done routinely on every woman giving birth under the notion that a cut would be easier to repair than a jagged laceration when a woman tore on her own. Episiotomies are no longer recommended and can even do more harm than good. Here's why:

• A cut weakens the tissue of the perineum making it easier to tear into the rectum during childbirth
• Increased risk of infection
• Some women may not tear at all, so why not give them the opportunity to not need stitches
• Studies show that women with episiotomies have a longer recovery and more long term pain with intercourse.

If your doctor reaches for the scissors during your birth, make sure you tell them "Hand's off my vagina!".

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To VBAC or Not?

VBAC is the term used to refer to a women who successfully gives birth vaginally after a previous c-section. A TOLAC (trial of labor after cesarean) is the term used for women who are trying to have a vaginal birth after cesarean.

60-80% of women attempting a VBAC will be successful (ACOG, 2010).

Benefits:
Lower risk of hemorrhage and infection
Faster recovery
Decreases risks associated with multiple cesareans such as injury to bowel, bladder, hysterectomy, and abnormal placenta placement
Less breathing problems with baby


The most common risk associated with a TOLAC is a uterine rupture, where the pressure from contractions causes the c-section scar to break open. This can rapidly cause hemorrhage or loss of oxygen to the baby and could result in a hysterectomy or death to mother, infant, or both. It sounds scary doesn't it? The actual risk of something like this happening is very low and it does depend on certain factors like how many previous c-sections you have had, whether or not your doctor is using pitocin to stimulate your contractions, etc. With one prior c-section the risk of a uterine rupture is less than 1% which means that only 1-10 out of 1000 women who are attempting a VBAC will have a uterine rupture. With high tech hospital facilities other subsequent complications such as hysterectomy and death are even more rare occurances.

There are also risks with considering an elective repeat cesarean and this may seem like a safer option but consider the risks:

Increased risk of breathing problems with baby call respiratory distress syndrome
Hemorrhage
Injury to bowel or bladder
Infection
Readmission to the hospital with complications
Increased risk of hysterectomy in future pregnancies due to abnormal placental locations
Increased risk of death compared to a vaginal delivery.

Midwives are known for low cesarean section rates and are the perfect choice for women considering TOLAC.

Great Resources: International Cesarean Awareness Network http://www.ican-online.org/

Stand and Deliver: My birth plan

Check out this edited version of a birth plan at the blog Stand and Deliver:


Stand and Deliver: My birth plan

The First Few Moments…

All of your hard work during labor has finally paid off. You hear the first cry from your newborn baby and it is the most perfect moment of your existence. Many new mothers do not know about the importance of skin to skin contact during the first hours after birth and often find themselves caught up in rigid hospital routines that enable nurses to whisk their newborn babies away to a nursery. Weighing the baby and giving medications can be postponed until after the first hour and an assessment to make sure baby is doing well can be performed with the baby on your chest. Baby can also be placed skin to skin with the mother during a cesarean section or on the father chest if the mother is unable. Placing your baby on your chest immediately after birth (also called Kangaroo care) is proven to have many benefits for both mom and baby. Most experts recommend keeping baby skin to skin with you for at least 1 hour. Skin to skin care helps to:

• Stabilize your new baby's temperature, heart rate, and blood sugar which are very important for newborns
  
• Make latching on to the breast easier for breastfeeding because baby is most awake during the first hour.
  
• Studies show that babies held skin to skin at birth breastfeed more months after going home
  
• Your baby may cry less and be soothed by the smell of your skin
  
• Promotes bonding
  
• Stimulates the uterus to contract with the release of oxytocin helping you to have less vaginal bleeding
  
• Helps distract you from pain if you will need stitches
  
• Placing your baby skin to skin during breastfeeding also helps to stimulate milk production
  

 

Favorite Birth Quotes

"Just as a woman's heart knows how and when to pump, her lungs to inhale, and her hand to pull back from fire, so she knows when and how to give birth"  --Virginia Di Orio

 

"Mothers need to know that their care and their choices won't be compromised by birth politics." --Jennifer Rosenberg

"Giving birth should be your greatest achievement not your greatest fear" -- Jane Weideman

 

"The effort to seperate the physical experience of childbirth from the mental, emotional, and spiritual aspects of this event has served to disempower and violate women" --Mary Rucklos Hamptom

A Common Reality: Postpartum Depression

Bringing home a baby is supposed to be a joyous experience. At least this is the expectation that most of us have, but what happens when the harsh reality of late night feedings, exhaustion, and a screaming baby become part of your everyday life. Instead of finding happiness in cuddling your new bundle of joy, you are tearful and overwhelmed by the experience of becoming a mother. The truth is that these types of feelings are shared by many women that are home for the first few weeks after having a new baby. Hormonal changes from pregnancy and still returning to normal making it easier to feel overwhelmed and cry at any moment. For most women this gets better within two weeks of having your baby.

Occasionally, these emotions do not get better and may last longer than two weeks. Women may continue to experience episodes of crying and of being overwhelmed. Symptoms may progress to feelings of depression such as hopelessness, loss of interest in enjoyable activities, sleeping all the time, not taking care of yourself or the baby, not eating, and withdrawing from friends and family . It may also be common for women to have feelings that they are not bonding well with the baby and even have feelings of hurting themselves or their baby. It is important to know that you are not alone. It is not something that you should feel embarrassed or ashamed about. An estimated 5-25% of women experience postpartum depression and it can start at any time during the first year after the birth of a baby. There is hope and it is important to talk to your health care provider about treatment options. Your health care provider may prescribe depression medication to help regulate your hormones until they return to pre-pregnancy levels. Mental health professionals that specialize in postpartum depression can also be a good source of hope and support.

I recently came across a new book called "Why I Jumped: My True Story of Postpartum Depression, Dramatic Rescue & Return to Hope" by Tina Zahn. This amazing story is the true story of a woman who suffered with postpartum depression after the birth of her child. Her depression became so severe that she completely isolated herself from her family, friends, and new baby. She compares her feelings during that time in her life as losing all hope. At her lowest point, Zahn drove her car to a large bridge in Green Bay, Wisconsin intending to take her own life by jumping over the edge. In a life changing moment, a state trooper held on to Zahn at the last minute after she jumped over the edge. This heroic act saved her life and she has since recovered and dedicated her life to helping other women with postpartum depression. It is a brilliant story to give women suffering with postpartum depression hope again.
Here is the video of her actual suicide attempt recorded by the state troopers camera that saved her life.