I have recently been made aware how true this really is. My three year old daughter only cries when she is hungry, tired or hurt. HTH (Hungry Tired Hurt)
Once I figured this out, I told my daughter that I noticed this was the case. Now when when she cries, I ask her what are the 3 reasons why you cry? I can see relief in her face as she realizes what it is. She will tell me right away, “I am hungry!”
I handle promptly….usually a protein as I find that restores a great attitude immediately but some kind of veggie or snack will do in a crunch.
So remember, HTH… maybe there is nothing more wrong with your child than HTH. ( Hungry Tired or Hurt).
When you are interviewing midwives for your home birth, here some questions to ask in no particular order.
1 Are you licensed and how long have you been practicing?
2 Do you know how to administer an IV?
3 What drugs do you bring? (For example, you want to make sure the midwife has Pitocin if mother was hemorrhaging after birth.)
4 Do you have a back up hospital or doctor?
5 Do you bring oxygen tanks?
6 Do you bring a fetal heart monitor?
7 Do you perform a complete newborn baby exam?
8 How do you handle posterior labors? (if she says by walking or using a birthing ball…run!)
9 Do you bring an assistent?
10 What is your transfer rate? What was the reason? Outcome?
11 Do you stay with me at hospital if I was a transfer?
12 Are you in a lawsuit or have you ever had a lawsuit? Why? What was outcome?
13 How many births have you attended where you were the primary caregiver?
14 Have you ever resuscitated a baby?
Of course there are several other questions as well but this is a basic guideline to start from.
Highly recommend you check out Tonya Brooks as your midwife if you are in Los Angeles area and are considering a birthing center or home birth. I have been to a birth with her and would recommend her to anyone attempting to deliver naturally.
Tonya Brooks has been a midwife for almost 35 years and has delivered over 6000 babies at home, in birth centers and hospitals. She was director of the Natural Birth and Women’s Center for 28 years. She is a research scientist and has ongoing research to prevent brain injury, obstetric hemorrhage, and gestational diabetes She also uses alternative approaches to help all women with nutrition and hormone problems. She is Founder of the Association for Childbirth at Home International (ACHI).
This article was written by Tonya Brooks and I admire her courage for reporting the side that isn’t being told.
FOR LABOR: SHORT TERM BENEFITS AND LONG TERM QUESTION
Most women who have experienced the pain relief of epidural anesthesia swear by them. One email stated, “My experience with an epidural was very positive. It did slow down labor however, requiring the use of Pitocin. Once the Pitocin was administered labor went quite quickly. The epidural did not inhibit the baby’s progress down the birth canal. When it came time for me to push, I was numb but I could do it. To my knowledge neither I nor the baby suffered any adverse effects.”
However, long-term outcomes are not measured by Apgar scores or how alert babies are at birth. There are fourteen studies in child development journals, pediatric and maternal/child nursing, and obstetric journals which link specifically epidural drugs to long-term learning disabilities such as hyperactivity. Mounting evidence suggests epidural anesthesia – including the drugs, doses and combinations – should be studied from a point of view of long-term outcomes. Many physicians are reluctant to discuss the ramifications of epidurals because they feel women must have access to pain relief in labor. For mothers who need them, for reasons related to cesarean sections, epidurals are far safer than general anesthesia and spinals (epidurals given deeper). But studies we do have compare the effectiveness of one drug against another rather than compare medicated birth against those births that are drug free.
When a mother’s blood pressure is lowered by the epidural, a fetus with poor placenta reserves receives lower oxygen levels causing a reflex that shunts blood from the gut to the vital organs: the brain, heart and adrenals. Occasionally that safety mechanism is severe enough to deprive the intestines of enough oxygen to damage them. The long-term consequences are complex but this can cause digestive disorders in the infant. The problem with a baby that does not digest well is that the infant is developing the top lobe of the brain until he is nine months old. It is critical for the brain development that infants properly digest food. Brain injury is often minimal but cumulative. So before one settles for the pain relief of an epidural anesthesia, it is worth understanding and investigating benefits versus the risks.
Statistics show the use of epidural anesthesia for pain relief in labor is on the rise. It has reached up to 90% in some hospitals, depending on the city in the U.S. It is touted as safe and in fact mothers are told that drugs given in this fashion as an epidural does not reach the baby at all. This has been translated by the public at large to mean that epidurals are without risk to the mother and the baby and there is no need to labor the natural way. Nothing could be further from the truth.
The use of epidural in labor does the following:
(1) It interferes with contractions and thus the progress of labor.
(2) By decreasing the strength of contractions, epidural anesthesia may require the use of Pitocin – a synthetic version of one’s own hormone, which causes the uterus to make stronger contractions than it normally would. The stronger contractions do two things: first, they squeeze the blood vessels feeding oxygen blood to the placenta that is already compromised by the decrease in maternal internal blood pressure and, second, Pitocin can make a uterine contraction strong enough to push the baby into the pelvis in a poor position. This raises the cesarean rate for failure to descend through the pelvis.
(3) Pitocin has also been implicated as a contributing factor in increased neonatal jaundice.
(4) Pitocin in conjunction with anesthesia must be monitored internally so that the dose given does not cause contractions strong enough to rupture the uterus. Also internal monitoring increases the risk for maternal and infant infections. Internal monitoring decreases the mobility of the mother in labor and she must remain in bed.
(5) Because epidural anesthesia lowers maternal blood pressure, it cannot be used without IV fluids that assist in keeping maternal blood pressure up to safe levels. Lower blood pressure in the mother can cause a condition called “utero-placental insufficiency”. Utero-placental insufficiency can cause fetal distress and cesareans for rescue.
(6) The kind of drugs used in the epidural is usually a local anesthetic and a narcotic combo. Women are told that because these drugs are a local anesthetic they “do not reach the baby”. We have known since 1972 from Harvard studies that the “caine” drugs cross the placenta in 18 seconds in 40-60% of the maternal load. In other words, fast acting drugs will be in a higher concentration in the maternal blood stream quicker. The narcotics with which they are mixed cross the placenta with ever beat of the mother’s heart. These drugs are categorized as central nervous system depressants and may cause a decrease of the baby to breathe at birth. If this occurs, the baby must be given a drug called Narcan to block the effect of maternal anesthesia and breathing is established by resuscitation.
(7) Because the epidural interferes with uterine contractions, it can interfere with fetal rotation and descent (the ability of the baby to rotate in and come through the maternal pelvis). This increases the likelihood of “failure to progress” by decreasing descent, dilation or both and markedly increases the chance of a cesarean section. A cesarean section puts the mother’s future births (even pregnancies) at risk for uterine rupture, but that will be dealt with elsewhere.
(8) Because epidural anesthesia causes relaxation of deep muscle, little to no feeling and decreased sensation of pressure, it is difficult for many – not most – mothers to push; and prolonged pushing increases the risk for operative deliveries such as out forceps or vacuum extractions. This lack of ability to push can be corrected if the epidural is turned off. But the effect of the anesthetic on the baby is still there. The second stage of labor (pushing) is important to the infant’s well-being and long-term outcomes. Uterine contractions peak faster and maintain their peak longer causing decreased blood flow to the placenta, while maternal cardiovascular output decreased in the second stage of labor. Moreover the maternal anesthetic decreases the fetal neurological response to oxygen deprivation. In the “at risk” fetus such as premature or growth retarded babies or babies with infection, this can cause significantly low oxygen levels.
(9) In addition, the drugs used in epidurals carry the risk as a neurotoxin; however, this is rarely studied because many physicians believe pain relief to be necessary to any woman in labor. If one assumes all women need pain relief then the increased risk of cesarean sections, fetal distress, post-partum hemorrhage, and maternal deaths are acceptable risks. In fact, the safety studies for the last several years DO NOT state if the drugs reach the baby or their effects instead they study one form of anesthesia against another for effectiveness. Again, they DO NOT focus on what the drugs actually do to the mother or baby. One of the few exceptions is the study done by Yvonnne Brackbill, MD and Sam Broman.
In summary, epidurals are not without long-term risk to mother and baby. Lowering maternal blood pressure in a fetus whose placental reserves are poor is likely to produce oxygen starvation depending on the underlying condition of the baby and it is related to future behavioral problems. This is certainly enough to produce long-term problems for the child.
No researcher is saying “never have anesthesia” but the long-term effects are not being adequately studied and the physical consequences are quite real, so the best approach depends on the physical circumstances.
And still the best way to protect one’s baby in a normal vaginal delivery is to have an unmedicated birth or “natural childbirth”. Good childbirth classes should give mothers and coaches a wealth of information to cope with labor without drugs. One of the biggest purposes for midwives is to help mothers create births where pain is minimized by laboring in water and with the loving support of family and friends. This article has not focused on the incredibly empowering experience that childbirth without drugs can bestow but the emotion of birth is profound and lifelong. I hope all women will get trained and rethink their plans. With natural childbirth, most women will experience the joy of conquering pain, and child development specialists will see fewer cases of hyperactivity and all that goes with it.
I found a helpful article that sums up what foods to avoid during pregnancy. The only thing I would add to this list is donuts! Ladies, don’t use pregnancy as an excuse to chow down on junk. You will regret it later. The sugar is not good for you or your baby and the weight post pregnancy is harder to lose when you have gained unnecessary pounds.
Also remember for those of you committed to natural child birth the more discipline you practice now the stronger you will be in those last 24 hours of birth.
Here is the short list of foods to avoid.
Mexican-style cheeses, such as queso blanco, queso fresco and panela
Raw fish and shellfish.
Refrigerated smoked seafood, such as lox.
Unwashed fruits and vegetables
Large quantities of vitamin A
Home birth is far less painful than a hospital birth even with an epidural. This is what “they” are not telling you. If you think that just because you have an epidural at a hospital the birth will be easier and less painful, you couldn’t be further from the truth.
At a hospital, a woman is hooked up to machines and confined to lying in a hospital bed. She is encouraged to have an epidural and keep quiet. Her birthing process is interrupted by doctors and nurses coming and going. She is not allowed to have whomever she wishes in the room. She is not allowed to eat or drink. The room is bright and often noisy with disregard to mother’s wishes for dim lights and quiet. Her body tenses and the natural child birth process is cut off or stopped and thus the door is opened for doctors to intervene further. From this point on, it is pitocin to speed up labor which usually, inevitably, leads to caesarean. Baby is born, pulled away from mother. When mother is finally allowed to hold the baby, she is so doped up from all the medications. She has to stay several days in the hospital and then she will have a long recovery time from the operation.
What is painless and easier about a home birth is that a woman is allowed to labor on her own time in the comfort of her own home. She is the master of ceremonies and can control her environment. She is the golden goddess who runs the show and is surrounded by her team of love and support. She is encouraged to move around allowing her body to naturally open. She applies techniques and uses her birthing partner to get through her contractions. Each contraction brings her closer and more connected to partner and baby. She is able to reclaim her deepest power. The muscles designed to give birth actually relax and her body is able through a wondrous process give birth creating a beautiful birth experience for her, her team and baby.
Once the baby is born, she has the luxury of having her baby placed directly on her chest. Mom and baby have that immediate bonding and comfort of each others embrace. Baby is encouraged to nurse. Baby isn’t washed or taken away until mother and baby are ready. Mother has endorphins which are present during and immediately after child birth that induces feelings of pleasure and euphoria which can help reduce the risk of maternal depression for the weeks following delivery.
In short, generally speaking, hospital births are a nightmare which are far from painless and have fear and anxiety around child birth whereas, home births are a beautiful empowering experience which bond and unite not only mother and baby but the whole family in the process.
There are some very simple steps a new mom can take to alleviate the intensity of postpartum depression. First and foremost, a new mother needs to not panic when she finds herself feeling depressed. There are several things happening that contribute to this. One being that her body was carrying and sustaining life to her unborn child for the past nine months an now her womb is empty. The hormones have to adjust to the new change as well as all the organs that have to go back in place. Remember, the organs were pushed and pressed on during pregnancy and now they must move back into their proper place or shrink back.
Once she has had her new born baby, she may get trapped inside the house for days on end. It is very important that she go outside and get some fresh air. If not a walk, go on a ride around the block. If she is unable to go outside for a medical reason, it is important to sit by a window and look outside and really have a look at the trees, birds, sky and flowers etc. This will get her “out of her head” and place her attention on outward thoughts versus being stuck on her “unhappiness.”
It is equally important to take her prenatal vitamins as recommended by her doctor. Her body needs to recover and supply milk so it is important that she gets the right nutrients. While I was pregnant and still now that I am nursing, in addition to my prenatal, I take Omega oils, folic acid and Cal Mag but you may want to ask your doctor what is right for you. It is extremely important for new mom to not use her depression as an excuse to eat a pint (or gallon) of ice cream. This will only make her feel more helpless and depressed! When new mom is feeling depression, this is the most crucial point to eat healthy and avoid caffeine and sugars! Eating healthy will make mom feel in control of her life and better about herself.
New moms need to make sure they are drinking lots of water. Water I am convinced is a miracle. This will keep mom hydrated, producing milk and believe it or not, help her loose that extra baby weight. Water flushes the toxins from the system, helps maintain digestive health, reduce fluid retention and provide more energy.
Lastly, she needs to sleep. It is tempting to get caught up on emails or other “important” activities while baby is sleeping but really sleep is so valuable to heeling a body and depression that it should take priority! New mom needs to take care of themselves and sleep is the best gift a new mom can give herself. I say Happy mom makes for even happier babies!!
On June 7, I had the absolutely privilege to assist Amber and Troy as they delivered their daughter (drug free) at their beautiful home in the company of their 2 year old son also named Troy.
Amber made natural home birth look like a walk in the park. She was strong and courageous, a true warrior. I am so proud of her! Her husband Troy was her hero. He was right by her side the whole time offering his love and support. He held her, looked in her eyes and softly whispered words of encouragement to get her through a tough contraction. It was a beautiful moment of intense love and admiration that I felt very privy to witness.
The final moment when Baby Indigo popped her little head out was so magical. The midwife put Amber’s hands on Indigo and Amber was able to pull her out from there. Amber gently placed her on her chest and held her close. The room was filled with joy. We all started crying and hugging. We all held hands as Troy led us in a sweet prayer welcoming and blessing their new baby daughter. She was 8lbs 3oz and looked into her mother’s eyes as she nursed on her breast. Proud Papa with tears in his eyes kissed both baby and Mama.