12/15/10

New Chapters

"Far and away the best prize that life offers is the chance to work hard at work worth doing." - Theodore Roosevelt
Over the last few years I've spent working as a doula I've been part of some amazing things and I've learned quite a bit about myself and about birth...
  • It never fails, I always cry or tear up as I watch these slippery babies slide out of their mothers bodies in nature's perfect rhythm. It never fails to amaze me.
  • I've held the hands of mothers in cesarean births and helped their babies latch to the breast for the 1st time as they greet their new babies with gratitude.
  • I've welcomed many phone calls from clients, and every time my birth client ringtone goes off I wonder who could it be? I get a twinge of excitement knowing the next baby is getting ready to join us.
  • I've smiled with mothers as they exclaim "I can't believe I did it!" as they had their 1st VBAC (vaginal birth after c-section).
  • I've been at homebirths and watched siblings act as doulas, offering massages and reassuring words to their mothers, these children almost always seem wise and willing to help, despite the birth sounds coming from their laboring moms. 
  • Many times I've happily rolled out of bed in the wee hours of the night to a labor call, and dressed myself in a daze rushing out the door to meet a laboring family.
  • I've been so busy at births that I survived on coffee and a few handfuls of almonds for more than 20 hours.
  • I've witnessed fathers provide un-wavering emotional support through labor and bond with their partners in unmeasurable amounts. I've seen how transformative birth can be for a relationship.
  • I've learned that satisfying birth isn't defined by the method of the babies arrival (natural vs. medicated) as much as it is in the quality of the experience and the support from the birth team.
  • I've learned that birth work is just as much emotional as it is physical.
  • I've learned that the most powerful tool in my "bag of tricks" is faith. Every mom needs someone in the room who believes in them more than they believe in themselves.
  • I've learned that I have a limit, although I don't enjoy saying no I can't take every client that contacts me. My family must come first and then my doula work.
  • I've learned to rely on others in the birth community for support, encouragement, advice and most of all - an opportunity to vent when I'm feeling low. I'm grateful to all you wonderful friends who have offered this support time and time again, you know who you are.
  • I've learned to be more open minded.
  • I've learned to trust myself more.
  • I've learned that I still have a lot of learning to do, and the day that I stop learning is the day that I stop growing.
And lastly, over the last few years I have learned that outside of the time I dedicate to my family, birth is where I'm supposed to be.

Everyone has been made for some particular work, and the desire for that work has been put in every heart. - Rumi

I have decided to pursue monitrice training to further my knowledge of birth and build some clinical skills that I can use to assist homebirth midwives in our area.  A monitrice is similar to a doula, but a doula does not preform clinical skills. A monitrice does certain clinical skills (such as fetal heart tone checks, check dilation, takes blood pressure, etc.) and is especially helpful to homebirth mothers as they can use the monitrice for the same comfort measures that a doula provides along with the clinical assistance they provide to the midwife (who is responsible for monitoring the safety of you and your baby). A monitrice can also be hired by private clients who wish to stay home as long as possible and want to have their dilation checked before going to the hospital.

The program I am going through will be rigorous. It will involve 15-20 hours of work each week and will require constant motivation. I will admit that I am a bit nervous about it, and my fear of failure creeps in every now and then. When I am doubting myself, I stop to think about the passion behind the desire to learn. It's true that we retain knowledge better when it is topics that we are passionate about. Hey, never in a million years would I have thought that I'd be creating and giving presentations on endocrine system function in pregnancy and postpartum as it relates to theories on placenta encapsulation! The drive to do this research came effortlessly because I love the subject matter.

I am looking forward to this new chapter in my journey and am excited that I am starting my trek down the seemingly eventual path of homebirth midwifery.

Blessings and much love to you all.

12/6/10

The Essential Ingredient: Doula

I received an e-mail from DONA International (Doulas of North America) about a new documentary that they have released that features commentary by all of DONA International's esteemed founders and some of our past presidents speaking on the origin and rationale of doula support. Their words are complemented by inspiring visuals of treasured birth and postpartum moments.

You can view this documentary below:


DONA members can request a free** copy of this DVD to promote their doula services by ordering it through the DONA Boutique. Details will soon be posted on the DONA International web site.

DONA encourages you to use this documentary in your doula practice. Embed it on your web site and share it with potential clients, friends and family so they can help spread the word about doulas: the essential ingredient in birth and postpartum, rediscovered!

10/7/10

Compassionate Intactivists: Let's help make it right!

“The value of compassion cannot be over-emphasized. Anyone can criticize. It takes a true believer to be compassionate. No greater burden can be borne by an individual than to know no one who cares or understands.” -Arthur H. Stainback


First off, let me say that I am a mother. Above all the things I advocate for (breastfeeding, natural birth and leaving boys intact) I remain a mother, first and foremost.


Which Is why I am so heartbroken at the negative comments from some people on Jill Haskin's blog and on message boards after her son passed away today from Hypoplastic Left Heart Syndrome after having circumcision complications.

Don't get me wrong, initially when I saw Jill's blog come up on my facebook newsfeed after being posted by several other "intactivists" who were all claiming that this death was related to the circumcision, I read her blog post called "I almost killed my baby" and I thought assumed the death was related to the post circumcision hemorrhage. So, I re-posted the mother's blog on facebook, hoping simply to inform mothers of the risks of the procedure. Later, I deleted the post because I didn't want to be lumped into the same category of people that spewed the hate on this women's blog.


Even though I didn't post any comments to her blog I feel horrified and ashamed to be associated with anyone that could spread so much hate when they claim to be devoted to preventing harm. This way of "advocating" does not help our cause, it harms it in irreversible ways because when you are hateful, you are closing minds that might have listened to you had you had the decency to be compassionate.

I had copied the the ridiculously insensitive comments into my blog, but have removed them recently in an effort to remove all negativity from this post.


In honor of baby Joshua and his mother Jill Haskin I have set up a donation fund for the Haskin family for those of us that want to redirect this into something positive for the family.

Jill, I deeply apologize on behalf of all the intactivists I know who would never say such hurtful things to you or your family. May your son rest in peace and your love for him carry you through this difficult time.

If you would like to leave a comment, this blog is a place for us to lift Jill and her family up in whatever way we can. This is NOT the time or place to come to "inform or "educate" about circumcision. We will do more harm than good and we risk loosing even more credibility as advocates. I am just asking for love and compassion, people! I will not hesitate to delete comments I find offensive to Jill's family.


UPDATE 10/8/2010: I am amazed at our readers support! Your comments have shown me what true compassion is about by reaching out to lend a hand, even when our beliefs differ! I have received some negative feedback from a few of you who think that I am drawing more attention to the negative things that were said, and that blanket blame doesn't need to be placed on the whole intactivist community. Some of you think that I am trying to "silence" you. This couldn't be further from the truth. I want the truth out. I want people to know that more infant deaths are related to circumcision than chocking, I DO want parents to question what they are told if their baby dies following this procedure. However, I don not agree with attacking grieving mothers to make a point. Believe me, we have other work we can do! Share your message with those who are expecting and write letters to the AAP Task Force and to your elected officials asking to end routine circumcision.

You may even feel that the mean people should just be ignored, not be made the focus with this blog post. While I agree that only a handful of people were spreading these hateful comments, I felt that It was important to provide a place for us to show Jill and her family the other side of our hearts and a solace for us to apologize, if we felt the need. Many of you have probably thought "Compassionate Intactivism" is a oxymoron, we are compassionate people by nature. We love and want to protect these little boys from unnecessary surgery. This is true. We are compassionate towards little boys. However, sometimes that is all we see... In order to reach the parents, I believe we must get our message out with polite arguments and facts rather than by being confrontational.


Thank you again for your support!!! We raised $579.00 for the family! I have sent the money (along with the link to read  your comments) to the family and am closing this donation fund, for those of you who would like to donate, you can directly at Jill's blog.

Here is a list of all those who have donated through 10/16:

P.U.S.H. doula services
Amy Townsend
Michelle Ellinger
Virginia Dauz
My Postpartum Voice
Kristie Little
Beth Ritzman
Kuliaikanuu Petzoldt
Shannon Church
Gary Ehrheart
Zoe Kennedy
Dimitra Vourliotou
Katherine Lane
Denise Tourelle
Birthing Babes Childbirth & Parenting Education Studio
Joy Szabo
Keely Shaw
Valerie Smith
Kyra Sewell
Shelly Alberti
Ashley Hill
Katie Seelinger
Heather Randolph
Leah Faleer
Michael C Robertson
Elizabeth Storm
Daniel Nelson
Christine Smith
Erin Denison-Wise
Brooke Smith
Mollie Firkins
Birth Matters
Agnes Zurek
Jeffery & Sami Havard
Brandi Hefner
Lauren Jenkins (On behalf of the Whole Network)
Divini Fong
Heather Reddout


THANK YOU!!!

Here is the screen shot of the confirmation from paypal that I have sent the funds:
(You'll have to click to enlarge so you can view)

10/6/10

The Continuum of Normal Birth: Doulas discussing circumcision?

The Continuum of Normal Birth: An Intact Penis
Anna Marie Nelson, CD(DONA), LCCE, LMT

September 24, 2008
Published in: International Doula, Volume 17, Issue 1, March 2009


ABSTRACT

Oftentimes doulas are asked for information concerning circumcision. Doulas should be educated on this subject and be able to provide information based on scientific evidence without the influence of social biases. The American Academy of Pediatrics does not endorse circumcision. A doula should be educated on the physiology of a normal penis, so she is able to provide the facts associated with the benefits of not performing a cosmetic surgery on a newborn infant. A number of anti-circumcision facts will be presented, so the doula can be informed with evidence-based information on why a penis should be left intact.


_______________________________________________________________


As doulas we discuss many personal subjects with parents, but it seems as though one area is not getting much airtime--circumcision. Perhaps doulas are not mentioning it due to embarrassment; perhaps because they think the decision is too personal and should only be addressed by the parents; perhaps we have a personal bias for or against circumcision; or maybe we think that discussing circumcision is beyond the scope of a doula.

Because circumcision is such a personal and sometimes even embarrassing subject, oftentimes parents will not ask about it during group childbirth classes. Sometimes a doula is the only person parents will ask about it. We should be prepared to give factual information.

Approximately one-half of our clients will be giving birth to boys, and one of the first major decisions parents are faced with is whether or not to circumcise. The decision is a personal one, but if we are asked for information concerning circumcision, we have the responsibility of providing the facts concerning the advantages of leaving a penis intact, and the disadvantages of having a circumcision performed. Parents should at least make an informed decision based on facts, rather than on tradition and social bias.

To effectively teach about circumcision, we must first let go of our own personal biases, especially if we have a male child and chose to circumcise him. As a parent did you make the decision based on facts, or did you do it because ‘everyone else does it’, or perhaps because, ‘he should look like his dad’? Neither of these reasons is evidence-based. They are simply opinions and traditions.

Consider the following scenarios concerning circumcision from a young boy’s point of view: A woman had two sons, one she circumcised because she ‘followed the crowd’, and one she did not because she knew more about it and decided there was no medical reason to have her newborn son undergo surgery. As her two young sons were bathing together they noticed they were not exactly the same. The mom was asked why. She answered that for the older son she and Daddy had decided to cut off a little bit of his penis, but for the younger son they decided not to. The older, circumcised son started crying and asked his mother, “Why did you let someone cut off part of my penis?!”

In another instance, the father was circumcised, but the mother and father chose not to circumcise their son. As their son got older the son noticed that he and his father were different, and the son asked his dad why. The dad answered, “Well, when I was a little baby people thought it was a good thing to cut off a little piece of a baby boy’s pee-pee, but your mom and I read a lot about it and we decided that it wasn’t really a good thing so we didn’t have a little piece of your pee-pee cut off.” The young boy heaved a huge sigh of relief and said, “Thanks, Dad!” Then the son very quietly added, “Daddy, I’m very sorry that you got part of your pee-pee cut off.”

As doulas we seem to constantly struggle with the dilemma of knowing evidence-based facts, yet we observe obstetrical practices performed based on antiquated traditions. To combat that we educate our clients so they can make educated choices. Circumcision should not be the exception. We should give concrete facts, just as we would with any other topic concerning childbirth.
If a doula has a male child that she has circumcised, it is especially hard to teach evidence-based facts concerning circumcision. It is similar to when a nurse almost unknowingly promotes bottle feeding because she bottle fed her own children, and, “…they turned out just fine.” Oftentimes the nurse does not truly embrace breastfeeding because then she would have to admit to herself that she did not do the best thing possible for her own children. That is a bitter pill to swallow.

As professionals we need to keep our own biases out of our discussions with clients. We cannot undo the past, but we can teach the facts so other parents do not blindly follow the crowd simply due to ignorance and a lack of information.

There is also the argument that circumcision is not a part of childbirth. Technically breastfeeding is not a part of birth either, but we certainly talk about that. We also talk about postpartum depression and many other topics that are not technically a part of birth, but they are so closely related that it seems unwise not to educate parents about the subjects.

There is also an argument that Jews must circumcise their sons for religious reasons, thus the subject should not be discussed. However, there are Jews that do not circumcise and instead perform a ceremony which ‘draws blood’ and some Jews feel that it fulfills the religious covenant. A doula should always be respectful of her clients’ personal and religious beliefs, but if asked for information, she should be able and willing to give factual information.

In childbirth education classes is it not appropriate to ‘skip over’ breastfeeding because a woman in the class may have had breast cancer and would not be able to breastfeed, so out of respect for her situation the subject of breastfeeding is completely avoided because the educator does not want to make her feel guilty or uncomfortable. So just as a childbirth educator should not skip over breastfeeding in order not to hurt someone’s feelings, neither is it appropriate for a doula to skip over the subject of circumcision. It is our responsibility to teach the facts in a nonjudgmental manner, and then let the parents make their own educated decisions based on their own set of circumstances.

If asked for information on circumcision, we should answer accurately without ‘playing’ to our audience. We should assume our clients want an accurate, scientifically sound answer without deciding for them what information we think they should have based on our perception of the answer we think they want to hear.
One of the main arguments for circumcision is that a male uncircumcised penis needs to be cleaned. That is true, but not until the foreskin is retractable, which normally does not happen until about the time of puberty. We all brush our teeth, we wash our hair, we wash our hands, we wash our faces, our armpits, and our bottoms. Girls also wash their vaginas. The decision to amputate a body part because it will have to be washed is not based on sound judgment.

Both males and females produce smegma, the lubricating substance a foreskin or clitoral hood and produces. But baby girls do not have their clitoral hood amputated a day or two after birth, we would call that genital mutilation and be highly outraged. There is no difference in amputating an anatomically normal body part of the male body.
In many cultures little girls undergo genital mutilation, and the women that have had the same thing done to them are oftentimes the ones that perform the amputation, while the mother and other women that love the little girl the most are the ones that usually restrain the girl during the amputation. We shudder at the thought and wonder what could possess another woman to not only let it happen, but to act in helping it happen. But in some cultures there is a social bias to do it, it is accepted as a normal part of life for a female, it is perceived as normal and necessary.

Fathers that have undergone circumcision as a baby oftentimes give no thought to their son being circumcised, because just like the mothers of the girls undergoing genital mutilation, circumcision is perceived as normal and necessary. But the practice is based on antiquated tradition, social bias, and myths. There is no logic in that rationale.
Another argument for circumcision is, “I don’t want my son to be the ‘different kid’ in the locker room.” Of course parents are sensitive to their child possibly being ridiculed, but circumcision rates have steadily declined during the past 30 years from about 90% in 1971 to about 60% in 2002, which is the most recent statistics available. However, the downward trend is expected to continue, and currently the circumcision rate in the U.S. is thought to be about 50%. In 2002 the west coast circumcision rate was about 35%.

Although it is highly unethical for profit to be made from unnecessary surgery on a newborn, there are still some doctors and hospitals that promote circumcision. Circumcision is a multi-million dollar industry in the U.S. Parents need to be educated about circumcision well before the birth of their child so they do not fall prey to the many myths surrounding the benefits of circumcision.



Here are the facts concerning circumcision:
Circumcision Information: (Please feel free to reproduce and circulate)
1) In 1999 the American Academy of Pediatrics stated that there is not sufficient data to recommend routine neonatal circumcision (Lannon, 1999).

2) The circumcision rate in the U.S. has steadily dropped from a high of about 90% in 1971 to about 60% in 2002 (Bollinger, 2004).

3) The foreskin is adhered to the glans (the head of the penis) at birth. Retracting the foreskin tears the adhesion of the foreskin to the glans. It is extremely painful, and is comparable to tearing a fingernail away from the finger (Spock, 1998).

4) The foreskin is a useful part of the male anatomy. It protects the glans, and also produces lubrication, sub-preputial moisture containing lytic material, which has anti-bacterial and anti-viral properties. The natural oils lubricate, moisturize, and protect the mucosal covering of the glans and inner foreskin (Cold, 1999).

5) Circumcised male infants are 12 times more likely to get MRSA, (Methecillin-resistant Staphylococcus aureus) an extremely serious antibiotic resistant staph infection, than intact male infants (Klevens, 2007).

6) Circumcision is traumatic to the baby, even if anesthesia is used. If a child stops crying during the procedure it is possibly due to shock, not because it does not hurt. (Wallerstein, 1990).

7) When a child is circumcised, he loses about 240 feet of nerves and between 10,000 and 20,000 specialized erotogenic nerve endings, which decreases his sexual sensitivity. The average size of an adult foreskin is about 15 square inches or more than the size of a 3 x 5 inch index card. The foreskin is the most sexually sensitive part of the penis (Taylor, 1996).

8) Circumcision does not decrease a male’s chances of developing penile cancer. In fact, although penile cancer is rare, in most cases, when it does occur it starts at the circumcision site (Maden, et al, 1993).

9) Circumcision does not decrease the risk of a male’s female sexual partner from developing cervical cancer (Shingleton, 1996).

10) The foreskin contains Langerhans cells, which may provide resistance to HIV infection. (Fleiss, 1998).

11) Circumcision may contribute to erectile dysfunction by destroying blood conduits (Taylor et al, 1996).

12) The foreskin protects the corona (rim of the glans) from direct stimulation during intercourse and helps to prevent premature ejaculation (Zwang, 1997).

13) An uncircumcised penis does not cause the friction that a circumcised penis causes, so it helps in the comfort of sexual intercourse (O’Hara, 1999).

14) Of 138 women who had experience with both circumcised and intact male partners, 85.5% preferred intact male partners (O’Hara, 1999).

15) Circumcision does not prevent a male child from masturbating (Wallerstein, 1990).

16) Circumcision does not prevent sexually transmitted diseases (England, 1998).

17) Circumcision is surgery and carries with it all of the risks of any surgery, including hemorrhage, infection, gangrene, septicemia, ulceration of the exposed urinary meatus, skin grafting, disfigurement, loss of the penis, and albeit a small risk, even death (England, 1998).

18) Although some studies have shown an increased risk for urinary tract infections in uncircumcised males, it is difficult to summarize and compare the results due to many confounders, including: methodology, samples of infants studied, method of urine collection, and urinary tract infection definition. In some studies methods for determining the reliability of the data were not described (Lannon, et al, 1999).

19) While breastfeeding is known to protect against urinary tract infections (Pisacane,1992), the trauma of circumcision often disrupts successful breastfeeding (Howard,1994).

20) Circumcision costs $150-270 million annually, not including complications. And the additional cost of an extra 1/2 day hospital stay, on average, is estimated to be well over $200 million annually (Bollinger, 2004).


Certainly the decision to circumcise or not to circumcise is still a very personal decision, and many couples will decide to circumcise their child. But perhaps when presented with evidence-based facts, some couples that have never really given it any thought will begin to consider the risks of circumcision and the benefits of letting their baby boy stay intact.

As doulas we should be teaching facts, including the often overlooked facts concerning circumcision, because with circumcision, just like birth, there are no ‘do-overs’ and the consequences last a lifetime.

We all want to promote ‘Normal Birth’. It is time we also promote ‘normal’ male anatomy.



REFERENCES

Bollinger D. (2004). Normal versus Circumcised: U.S. Neonatal Male Genital Ratio, white paper. An original publication by the Circumcision Information Resource Pages.

Cold, C.J., Taylor, J.R. (1999). The prepuce. BJU International 83, Suppl. 1:34-44.

England, P., Horowitz, R. (1998). Birthing from Within. Partera Press: 188, 295.

Fleiss, P.M., Hodges, F.M., Van Howe, R.S. (1998). Immunological functions of the human prepuce. Sexually Transmitted Infections, 74:364-367.

Gellis, S.S., (1978). Circumcision. American Journal of Diseases of Children, 132:1168-1169.

Howard CR, Howard FM, and Weitzman ML. (1994) Acetaminophen analgesia in neonatal circumcision: the effect on pain. Pediatrics 1994;93(4):641-646.

Klevens, R.M., Morrison, M.A., Nadle, J., et al. (2007) Invasive Methicillin-resistant Staphylococcus aureus infections in the United States. JAMA 2007; 298(15);1763-71.

Lannon, C.M., Bailey, A.G.D., Fleischman, A.R., Kaplan, G.W., Shoemaker, C.T., Swanson,

J.T., Coustin, D., (1999). Circumcision Policy Statement. Pediatrics: Official Journal of the American Academy of Pediatrics. 103:689.

Maden, C., Sherman, K.J., Beckmann, A.M., Hislop, T.G., Teh, C.Z., Ashley, R.L., Daling, J.R. (1993). History of Circumcision, Medical Conditions, and Sexual Activity and Risk of Penile Cancer. Journal of the National Cancer Institute: Vol. 85, 1:19-24

O’Hara, K., O’Hara, J., (1999). The effect of male circumcision on the sexual enjoyment of the female partner. British Journal of Urology: 83, Suppl. 1:79-84

Pisacane A, Graziano L, Mazzarella G, et al. (1992) Breast-feeding and urinary tract infection.

Journal of Pediatrics ;120:87-89.

Shingleton, H., Heath, Jr., C.W., (1996). Letter to Peter Rappo, M.D., February 16, 1996

Spock B., Parker S.J., (1998). Baby and Child Care (7th Edition) New York, Pocket Books, p. 94

Taylor, J.R., Lockwood, A.P., Taylor, A.J., (1996). The prepuce: Specialized mucosa of the penis and its loss to circumcision. British Journal of Urology: 77:291-295.

Wallerstein, E., (1990). The Circumcision Decision. International Childbirth Education Association, Inc.

Zwang, G., (1997). Functional and erotic consequences of sexual mutilations. In: Denniston,

G.C., Milos, M.F., eds. Sexual Mutilations: A Human Tragedy. New York and London: Plenum Press




ANNA MARIE NELSON is a doula and childbirth educator in the Dallas, TX area. She has three teenaged daughters--who all would have been circumcised if they had been males, so she understands the psyche of “following the crowd.” But she is older and wiser now and is trying to spread the word!

9/28/10

Mother Nature’s hormonal blueprint


Ecstatic birth - nature’s hormonal blueprint for labor
by Dr Sarah J Buckley 2005: http://www.sarahjbuckley.com/

This article has been previously published in Mothering Magazine, issue 111, March-April 2002, and in Byron Child, issue 5, March 2003. This version updated March 2005.

This material has been further expanded as“Undisturbed Birth: Mother Nature’s hormonal blueprint for safety, ease and ecstasy” available in Sarah’s book, Gentle Birth, Gentle Mothering: The wisdom and science of gentle choices in pregnancy, birth, and parenting.


Giving birth in ecstasy: This is our birthright and our body’s intent. Mother Nature, in her wisdom, prescribes birthing hormones that take us outside (ec) our usual state (stasis), so that we can be transformed on every level as we enter motherhood.

This exquisite hormonal orchestration unfolds optimally when birth is undisturbed, enhancing safety for both mother and baby. Science is also increasingly discovering what we realise as mothers - that our way of birth affects us life-long, both mother and baby, and that an ecstatic birth -- a birth that takes us beyond our self -- is the gift of a life-time.
Four major hormonal systems are active during labor and birth. These involve oxytocin, the hormone of love; endorphins, hormones of pleasure and transcendence; adrenaline and noradrenaline (epinephrine and norepinephrine), hormones of excitement; and prolactin, the mothering hormone. These systems are common to all mammals and originate deep in our mammalian or middle brain.

For birth to proceed optimally, this part of the brain must take precedence over the neocortex, or rational brain. This shift can be helped by an atmosphere of quiet and privacy with, for example, dim lighting and little conversation, and no expectation of rationality from the laboring woman. Under such conditions a woman intuitively will choose the movements, sounds, breathing, and positions that will birth her baby most easily. This is her genetic and hormonal blueprint.

All of these systems are adversely affected by current birth practices. Hospital environments and routines are not generally conducive to the shift in consciousness that giving birth naturally requires. A woman’s hormonal physiology is further disturbed by practices such as induction, the use of pain killers and epidurals, cesarean surgery, and separation of mother and baby after birth.

Hormones in Birth:

Oxytocin

Perhaps the best-known birth hormone is oxytocin, the hormone of love, which is secreted during sexual activity, male and female orgasm, birth, and breastfeeding. Oxytocin engenders feelings of love and altruism; as Michel Odent says, “Whatever the facet of love we consider, oxytocin is involved.”1

Oxytocin is made in the hypothalamus, deep in our brains, and stored in the posterior pituitary, the master gland, from where it is released in pulses. It is a crucial hormone in reproduction and mediates what have been called the ejection reflexes: the sperm ejection reflex with male orgasm (and the corresponding sperm introjection reflex with female orgasm); the fetal ejection reflex at birth (a phrase coined by Odent for the powerful contractions at the end of an undisturbed labor, which birth the baby quickly and easily2); and, postpartum, the placental ejection reflex and the milk ejection, or let-down reflex, in breastfeeding.

As well as reaching peak levels in each of these situations, oxytocin is secreted in large amounts in pregnancy, when it acts to enhance nutrient absorption, reduce stress, and conserve energy by making us more sleepy.3 Oxytocin also causes the rhythmic uterine contractions of labor, and levels peak at birth through stimulation of stretch receptors in a woman’s lower vagina as the baby descends.4The high levels continue after birth, culminating with the birth of the placenta, and then gradually subside.5

The baby also has been producing increasing amounts of oxytocin during labor;6 7 so, in the minutes after birth, both mother and baby are bathed in an ecstatic cocktail of hormones. At this time ongoing oxytocin production is enhanced by skin-to-skin and eye-to-eye contact and by the baby’s first attempts at suckling.8 Good levels of oxytocin will also protect against postpartum hemorrhage by ensuring good uterine contractions.

In breastfeeding, oxytocin mediates the let-down reflex and is released in pulses as the baby suckles. During the months and years of lactation, oxytocin continues to act to keep the mother relaxed and well nourished. Oxytocin expert and researcher Professor Kerstin Uvnas Moberg calls it ‘…a very efficient anti-stress system, which prevents a lot of disease later on.’3 In her study, mothers who breastfed for more than seven weeks were calmer,when their babies were six months old, than mothers who did not breastfeed.

Outside its role in reproduction, oxytocin is secreted in other situations of love and altruism, for example, sharing a meal.9 Researchers have implicated malfunctions of the oxytocin system in conditions such as schizophrenia,10 autism,11 cardiovascular disease,12 and drug dependency,13 and have suggested that oxytocin may mediate the antidepressant effect of drugs such as Prozac.14

Beta-endorphin

As a naturally occurring opiate, beta-endorphin has properties similar to pethidine (meperidine, Demerol), morphine, and heroin, and has been shown to work on the same receptors of the brain. Like oxytocin, beta-endorphin is secreted from the pituitary gland, and high levels are present during sex, pregnancy, birth, and breastfeeding.

Beta-endorphin is also a stress hormone, released under conditions of duress and pain, when it acts as an analgesic and, like other stress hormones, suppresses the immune system. This effect may be important in preventing a pregnant mother’s immune system from acting against her baby, whose genetic material is foreign to hers.

Like the addictive opiates, beta-endorphin induces feelings of pleasure, euphoria, and dependency or, with a partner, mutual dependency. Beta-endorphin levels are high in pregnancy and increase throughout labor,15 when levels of beta-endorphin and corticotrophin (another stress hormone) reach those found in male endurance athletes during maximal exercise on a treadmill.16 Such high levels help the laboring woman to transmute pain and enter the altered state of consciousness that characterizes an undisturbed birth.

Beta-endorphin has complex and incompletely understood relationships with other hormonal systems.17 In labor, high levels will inhibit oxytocin release. It makes sense that when pain or stress levels are very high, contractions will slow, thus ‘…rationing labor according to both physiological and psychological stress.’18

Beta-endorphin also facilitates the release of prolactin during labor;19 prolactin prepares the mother’s breasts for lactation and is thought to be important in preparing the baby’s lungs and heat-regulating systems for life outside the womb.20 21

Beta-endorphin is also important in breastfeeding. Levels peak in the mother at 20 minutes,22 and beta-endorphin is also present in breast milk,23 inducing a pleasurable mutual dependency for both mother and baby in their ongoing relationship.

Fight-or-Flight Hormones

The hormones adrenaline and noradrenaline (epinephrine and norepinephrine) are also known as the fight-or-flight hormones, or, collectively, as catecholamines (CAs). They are secreted from the adrenal gland above the kidney in response to stresses such as fright, anxiety, hunger or cold, as well as excitement, when they activate the sympathetic nervous system for fight or flight.

In the first stage of labor, high CA levels inhibit oxytocin production, therefore slowing or inhibiting labor. CAs also act to reduce blood flow to the uterus and placenta, and therefore to the baby. This makes sense for mammals birthing in the wild, where the presence of danger would activate this fight or flight response, inhibiting labor and diverting blood to the major muscle groups so that the mother can flee to safety. In humans, high levels of CAs have been associated with longer labor and adverse fetal heart rate patterns (an indication of stress to the baby).24

After an undisturbed labor, however, when the moment of birth is imminent, these hormones act in a different way. There is a sudden increase in CA levels, especially noradrenaline, which activates the fetal ejection reflex. The mother experiences a sudden rush of energy; she will be upright and alert, with a dry mouth and shallow breathing and perhaps the urge to grasp something. She may express fear, anger, or excitement, and the CA rush will cause several very strong contractions, which will birth the baby quickly and easily.25

Some birth attendants have made good use of this reflex when a woman is having difficulties in the second stage of labor. For example, one anthropologist working with an indigenous Canadian tribe recorded that when a woman was having difficulty in birth, the young people of the village would gather together to help. They would suddenly and unexpectedly shout out close to her, with the shock triggering her fetal ejection reflex and a quick birth.2

After the birth, the mother’s CA levels drop steeply. A warm atmosphere is important; a new mother is very sensitive to temperature and if she cools down significantly, the cold stress will keep her CA levels high, inhibiting her natural oxytocin release and therefore increasing her risk of postpartum hemorrhage.26

Noradrenaline, as part of the ecstatic cocktail, is also implicated in instinctive mothering behavior. Mice bred to be deficient in noradrenaline will not care for their young after birth unless noradrenaline is injected back into their system.27

For the baby also, birth is an exciting and stressful event, reflected in high CA levels. These assist the baby during birth by protecting against the effects of hypoxia (lack of oxygen) and subsequent acidosis.28 High CA levels at birth ensure that the baby is wide-eyed and alert at first contact with the mother. The baby’s CA levels also drop rapidly after an undisturbed birth, being soothed by contact with the mother.

Prolactin

Known as the mothering hormone, prolactin is the major hormone of breast milk synthesis and breastfeeding. Levels of prolactin increase in pregnancy, although milk production is inhibited hormonally until the placenta is delivered. Levels decrease during labor but then rise steeply at the end of labor and peak with birth.

Prolactin is a hormone of submission or surrender--in primate troops, the dominant male has the lowest prolactin level--and produces some degree of anxiety. In the breastfeeding relationship these effects activate the mother’s vigilance and help her to put her baby’s needs first.29

Prolactin has been associated with nurturance from fathers as well as mothers, earning the additional label “The hormone of paternity”30. New fathers with higher prolactin levels more responsive to their babies’ cries.31 Animal studies show that prolactin release is also increased by carrying infants32.

The baby also produces prolactin in pregnancy, and high levels are found in amniotic fluid, secreted by the baby’s membranes as well as the mother’s uterine lining.33 Prolactin is also secreted into breastmilk, at least in the rat. 34 According to one researcher,“… there is evidence that prolactin plays an important role in the development and maturation of the neonatal [newborn] neuroendocrine [brain-hormone] system.”35

Undisturbed Birth

Undisturbed birth is exceedingly rare in our culture, which reflects our ignorance of its importance. Two factors that disturb birth in all mammals are firstly being in an unfamiliar place and secondly the presence of an observer. Feelings of safety and privacy thus seem to be fundamental. Yet the entire system of Western obstetrics is devoted to observing pregnant and birthing women, by both people and machines, and when birth isn’t going smoothly, obstetricians respond with yet more intense observation. It is indeed amazing that any woman can give birth under such conditions.

Some writers have observed that, for a laboring woman,having a babyhas a lot of parallels with making a baby: the same hormones, the same parts of the body, the same sounds, and the same needs for feelings of safety and privacy. How would it be to attempt to make love in the conditions under which we expect women to give birth?

When I gave birth to my fourth baby, Maia Rose, I arranged a situation where I felt very private, safe and undisturbed, and had my easiest and most ecstatic labor and birth: one-and-a half hours with an unexpectedly breech baby. I believe that this birth proceeded optimally because of this lack of disturbance, and because of my freedom to follow my own instincts.

Undisturbed birth is possible in a variety of settings, but must always involve a feeling of emotional security for the birthing woman. A familiar and supportive companion, such as a midwife or doula, can play an important role in creating and protecting a private space for the laboring woman, especially in a hospital setting.

Impact of Drugs and Procedures

Induction and Augmentation

In Australia in 2002, approximately 26 percent of women had an induction of labor, and another 19 percent have an augmentation--stimulation or speeding up of labor—through either artificial rupture of membranes or with synthetic oxytocin (Pitocin, Syntocinon).In the US in 2004, 53 percent of women reported that they had Pitocin administered in labor to strengthen or speed up contractions.36

Synthetic oxytocin administered in labor does not act like the body’s own oxytocin. First, Pitocin-induced contractions are different from natural contractions, and these differences can have significant effects on the baby. For example, waves can occur almost on top of each other when too high a dose of Pitocin is given, and it also causes the resting tone of the uterus to increase.37

Such over-stimulation (hyperstimulation) can deprive the baby from the necessary supplies of blood and oxygen, and so produce abnormal FHR patterns, fetal distress (leading to caesarean section), and even uterine rupture.38

Birth activist Doris Haire describes the effects of Pitocin on the baby:

The situation is analogous to holding an infant under the surface of the water, allowing the infant to come to the surface to gasp for air, but not to breathe.39

These effects may be partly due to the high blood levels of oxytocin that are reached when a woman labors with Pitocin. Theobald calculated that, at average levels used for induction or augmentation/acceleration, a woman’s oxytocin levels will be 130 to 570 times higher than she would naturally produce in labor.40 Direct measurements do not concur, but blood oxytocin levels are difficult to measure.41 Other researchers have suggested that continuous administration of this drug by iv infusion, which is very different to its natural pulsatile release, may also account for some of these problems.42

Second, oxytocin, synthetic or not, cannot cross from the body to the brain through the blood-brain barrier. This means that Pitocin, introduced into the body by injection or drip, does not act as the hormone of love. However, it can interfere with oxytocin’s natural effects. For example, we know that women with Pitocin infusions are at higher risk of major bleeding after the birth43 44 and that, in this situation, the uterus actually loses oxytocin receptors and so becomes unresponsive to the postpartum oxytocin peak that prevents bleeding.45 But we do not know the psychological effects of interference with the natural oxytocin that nature prescribes for all mammalian species.

As for the baby, ‘Many experts believe that through participating in this initiation of his own birth, the fetus may be training himself to secrete his own love hormone.’29 Michel Odent speaks passionately about our society’s deficits in our capacity to love self and others, and he traces these problems back to the time around birth, particularly to interference with the oxytocin system.

Read The Rest of the Article Here: http://www.sarahjbuckley.com/articles/ecstatic-birth.htm

9/13/10

Beautiful Vernix Caseosa

vernix
















The vernix caseosa is the waxy looking white substance that covers your newborn baby. When you see videos of a birth on television, you may see the doctors wiping off the “dirty” looking baby. Don't rush to rub off this wonderful stuff off your brand new baby... it has been found to have some fantastic properties...
STUDY: ANTIMICROBIAL PROPERTIES OF AMNIOTIC FLUID AND VERNIX CASEOSA ARE SIMILAR TO THOSE FOUND IN BREAST MILK


Akinbi, H. T., Narendran, V., Pass, A. K., Markart, P., & Hoath, S. B. (2004). Host defense proteins in vernix caseosa and amniotic fluid. American Journal of Obstetrics and Gynecology, 191(6), 2090–2096.

Summary
In this study, researchers analyzed samples of amniotic fluid and vernix caseosa (vernix) from healthy, term gestations to determine the immune properties of these substances. Participants were pregnant women admitted for elective cesarean section after 37 weeks gestation with no prior labor and no signs of chorioamnionitis (intrauterine infection). Women with a history of prenatal fever or premature rupture of membranes, or who received steroids prenatally or antibiotics while giving birth were excluded, as were women whose babies passed meconium in utero, had congenital malformations, or required prolonged resuscitation after birth. Amniotic fluid was obtained by amniocentesis to determine fetal lung maturity prior to elective birth. Vernix was gently scraped from the newborn's skin with a sterile implement immediately following birth. The researchers obtained 10 samples of amniotic fluid and 25 samples of vernix.

Tests (Western analysis and immunochemistry) revealed that lysozyme, lactoferrin, human neutrophil peptides 1–3, and secretory leukocyte protease inhibitor were present in the amniotic fluid samples and in organized granules embedded in the vernix samples. These immune substances were tested using antimicrobial growth inhibition assays and found to be effective in inhibiting the growth of common perinatal pathogens, including group B. StreptococcusK. pneumoniaeL. monocytogenesC. albicans, and E. coli.

The authors point out that the innate immune proteins found in vernix and amniotic fluid are similar to those found in breast milk. As the baby prepares for extrauterine life, pulmonary surfactant (a substance produced by the maturing fetal lungs) increases in the amniotic fluid, resulting in the detachment of vernix from the skin. The vernix mixes with the amniotic fluid and is swallowed by the growing fetus. Given the antimicrobial properties of this mixture, the authors conclude that there is “considerable functional and structural synergism between the prenatal biology of vernix caseosa and the postnatal biology of breast milk” (p. 2095). They also suggest that better understanding of these innate host defenses may prove useful in preventing and treating intrauterine infection.

Significance for Normal Birth

Routine artificial rupture of membranes increases the likelihood of intrauterine infection because it eliminates the physical barrier (the amniotic sac) between the baby and the mother's vaginal flora. This study suggests an additional mechanism for the prevention of infection when the membranes remain intact: A baby bathed in amniotic fluid benefits from antimicrobial proteins that are found in the fluid and in vernix caseosa.

The results of this study also call into question the routine use of some newborn procedures. Early bathing of the baby removes vernix, which contains antimicrobial proteins that are active against group B. streptococcus and E. coli. Delaying the bath and keeping the newborn together with his or her mother until breastfeeding is established may prevent some cases of devastating infections caused by these bacteria. The fact that preterm babies tend to have more vernix than babies born at or after 40 weeks might mean that healthy, stable preterm babies derive even greater benefit from staying with their mothers during the immediate newborn period.

Finally, this study illustrates how the normal physiology of pregnancy and fetal development is part of a continuum that extends beyond birth to the newborn period. The immunologic similarities between amniotic fluid, vernix, and breast milk provide further evidence that successful initiation of breastfeeding is a critical part of the process of normal birth.


So mamas, rub that vernix in instead of rubbing it off!



Sources:

Wonderful Vernix & Amniotic Fluid: http://sheffieldhypnobirthing.co.uk

9/3/10

A Guide to Extended Rear-Facing Safety

Last Tuesday around 5:30pm my husband was driving our son home after picking him up from daycare. It had been raining lightly and he was passing through an intersection when a driver failed to stop at a stop sign and hit him almost head on, the impact sliding his car across the road. John quickly checked on Jude to see that he was okay. They will both be receiving chiropractic care but thankfully weren't critically injured.


When I met John on the scene of the accident I unbuckled Jude out of his car seat and as I was pulling him out of the seat I noticed that his legs were locked together, he wouldn't or couldn't open them for several minutes. It was as if his legs had taken the force of the collision. This force that would have been felt in the neck and spinal cord had he been in a forward facing car seat. These sorts of injuries can lead to paralysis and death. In fact, in the US, motor vehicle crashes are the number one cause of death for children. The extra protection offered by rear-facing seats is something that parents should take advantage of as long as possible.

I am so grateful that my boys are okay and I wanted to share this guide for families that may not be aware of the significant safety benefits when a child remains rear-facing as long as the seat allows. For most children, rear-facing can and should continue well into the second or third year of life.

Some of the articles below are from CPS Safety

Why should your child rear-face past 1 year and 20 lbs?



Every milestone in a child's life is exciting! First steps, first word, first day of school. Even car seat milestones seem exciting. The truth is, they should be looked at with a certain sense of dread, not longing. Every step in car seat "advancement" is actually a step down in your child's protection.

Rear-facing is much, much safer than forward-facing. Child safety seats: Rear-face until at least one year discusses the reasons why children should remain rear-facing for a FULL year and 20 lbs. In it, Kathleen Weber states, "In the research and accident review that I did a few years ago, the data seemed to break at about 12 months between severe consequences and more moderate consequences..." This does not mean that there are NO consequences. The consequences may no longer be death from a completely severed spinal cord, but simply life-long injury, including complete paralysis. Research studies suggest that until children are at least four, they are incapable of withstanding crash forces as well as adults - and should remain rear-facing. In a crash, life-threatening or fatal injuries are generally limited to the head and neck, assuming a child is in a harnessed seat.

When a child is in a forward-facing seat, there is tremendous stress put on the child's neck, which must hold the large head back. The mass of the head of a small child is about 25% of the body mass whereas the mass of the adult head is only 6%! A small child's neck sustains massive amounts of force in a crash. The body is held back by the straps while the head is thrown forward - stressing, stretching or even breaking the spinal cord. The child's head is at greater risk in a forward-facing seat as well. In a crash, the head is thrown outside the confines of the seat and can make dangerous contact with other occupants, vehicle structures, and even intruding objects, like trees or other vehicles. 


Rear-facing seats do a phenomenal job of protecting children because there is little or no force applied to the head, neck and spine. When a child is in a rear-facing seat, the head, neck and spine are all kept fully aligned and the child is allowed to "ride down" the crash while the back of the child restraint absorbs the bulk of the crash force. The head is contained within the restraint, and the child is much less likely to come into contact with anything that might cause head injury.


Notice the difference in stress on the child's body in the videos below:

Forward Facing


Rear Facing


The American Academy of Pediatrics (AAP) recommends that all infants should ride rear-facing starting with their first ride home from the hospital. They should remain rear-facing until they reach the highest weight or height allowed by their car safety seat’s manufacturer. At a minimum, children should ride rear-facing until they have reached at least 1 year of age and weigh at least 20 pounds. However, AAP News April 2009 recommends keeping car seats rear facing until 2 years of age (if they car seats are designed for such use).

Children can also comfortably ride rear facing up to 3 and 4 years of age!

Aaron, still happily rear-facing at 3 years old (36 months)

Won't my child be uncomfortable? Where do his legs go?



Many parents have the misconception that children are uncomfortable or at risk for leg injury by having their legs up on the vehicle seat or bent when kept rear-facing. These concepts are completely incorrect. First, children are more flexible than adults so what we perceive as uncomfortable is not for children. Think about how your child sits in everyday play. Do they sit with their legs straight out in front of them? When they sit on the couch, do they purposely sit so their legs dangle out over the edge? No. In real, everyday life, toddlers and preschoolers CHOSE to sit with their legs folded up - that IS comfort to them.


Second, there is not a single documented case of children's legs, hips, etc. breaking or being injured in a crash due to longer rear-facing. There are plenty of cases of head and neck injury in forward-facing children that could have been prevented if the child had remained rear-facing. However, even if a leg or hip were broken or injured, it can be fixed. A damaged spinal cord (from forward-facing too soon) cannot be repaired and subjects the child to lifelong disability or death.


What if I am hit from behind? Won't my child be safer facing forward?

Frontal and side impacts are the most common type of crashes. They account for 96% of all crashes. They are also the most deadly type of crashes (especially side impacts) and rear-facing children have MUCH more protection in both types of crashes than forward-facing. In the 4% of rear impact crashes that a rear-facing child would be in, they have at least the same amount of protection that a FF child would have in a frontal impact, with the added benefit of less crash energy being transferred to them, and the fact that the rear impact is usually not as severe.


The forces in a rear impact crash are much different from the forces in a frontal impact crash. In a frontal impact, the forces are much greater because the vehicles are usually traveling in opposite directions. Experts suggest that a frontal crash is the same as hitting a concrete barrier and the vehicle and all occupants come to a dead stop within less than 1 second.

When you are struck in a rear impact, the vehicles involved are traveling in the same direction, and the vehicle that is hit in the back has room to move forward. The crash force on the occupants is much less than in a frontal impact. The movement of the impacted vehicle, in addition to the crush zone, absorbs a lot of the crash energy, so it is not transferred to the child. Additionally, the majority of rear impacts are at low speeds.


In short, if your child is rear-facing, he has optimal protection in the types of crashes you are most likely to be in. If he is forward-facing, he may have optimal protection in a rear-end crash, but statistically, that is the least likely to happen and he is 60% more likely to be injured or killed in the types of crashes (frontal, side impact) you are most likely to be in.


You can learn more about the physics of rear-facing at http://www.car-safety.org/rearface.html

Different types of Infant Safety seats:
There are 2 types of rear-facing car safety seats: infant-only seats and convertible seats.
When children reach the highest weight or length allowed by the manufacturer of their infant-only seat, they should continue to ride rear-facing in a convertible seat.

Infant-only seats
  • Are small and have carrying handles (and sometimes come as part of a stroller system).
  • Are used only for travel (not for positioning outside the vehicle).
  • Are used for infants up to 22 to 35 pounds, depending on the model.
  • May come with a base that can be left in the car. The seat clicks into and out of the base so you don’t have to install the seat each time you use it. Parents can buy more than one base for additional vehicles.
Infant-Only Car Safety Seats


Convertible seats (used rear-facing)






  • Can be used rear-facing, then "converted" to forward-facing for older children. This means the seat can be used longer by your child. They are bulkier than infant seats, however, and do not come with carrying handles or a separate base.
  • Have higher rear-facing weight and height limits than infant-only seats, which make them ideal for bigger babies.
  • 5-point harness is ideal-attach at the shoulders, at the hips, and between the legs.
The Basics of Rear-Facing Seats - A correct use checklist created by CPS Safety

The seat must be designed for use rear-facing and must actually face the rear of the vehicle.
  • Be sure you check the labels and manual for the seat to find out whether the seat can be used in the rear-facing position. If the seat can face backward and forward, be sure you locate the belt path that is required for rear-facing and use it. Infant seats, those that double as carriers, can ONLY be used in the rear-facing position and should never be used forward-facing. For infant seats with a base, the vehicle's seat belt must thread through the belt path on the base, not the belt path on the infant seat. Only use the belt path on the infant seat if you are using the seat without the base. All rear-facing seats should have a label indicating that it meets motor vehicle safety standards.
The seat must be tightly installed in the vehicle.
  • After installation, grab the seat at or near where the car's seat belt threads through the car seat belt path. Give a firm tug, not a yank, from side to side, and from the back of the car towards the front. The seat should not move more than 1 inch in either direction, and preferably as little as possible, or not at all. The same policy that is the foundation of Aviva and all other insurance providers holds true: better safe than sorry! It only takes a minute to check. A rear-facing seat will have normal movement throughout the top of the seat - towards the back of the car and from side to side. This movement is part of the seat's safety design, and should not be a concern.
The seat must be reclined at no more than 45 degrees
  • For newborns, a 45 degree angle is necessary to keep their air passage open. For older babies that are able to maintain head control, a more upright position is okay. Although some seats come with "level indicators", these are not always accurate due to any incline the vehicle may be on. If you use the built-in level indicator, be sure the vehicle is parked on a flat surface (even your garage floor has a slight incline). An easy way to check for a 45 degree angle is to take a piece of paper and fold the shorter top edge over to meet the longer side edge. You'll get a triangle with one long side. Place the longest side of the triangle against the seat where baby's back normally rests. The top of the paper should be parallel to the floor of the car.
The safety harness must fit the child snugly.
  • "As snug as a hug" is a good guideline. You don't want your child to have problems breathing, but a too loose harness could have devastating results. Many instruction manuals suggest that only one or two fingers fit under the harness at collarbone level, but this could be too loose, depending on the size of the fingers. Instead, use the pinch test: grabbing the harness at shoulder level, try to "pinch" the harness together from top to bottom. You should not be able to pinch a vertical fold on a snug harness.
The safety harness must be in the slots that are at or below the child's shoulders.
  • In a rear-facing seat, the harness will hold the child down and in the seat in a crash. The harness must be at or below the shoulders to do this properly. If the harness is above the shoulders, the child can "ramp up" or rotate toward the top of the seat, exposing the head and neck to possible injury. For newborns and very young babies, the bottom harness slot may still be above the shoulders. As long as the harness is in the bottom slots, and the harness is snug, this will protect the baby.
Chest clip must be at armpit level.
  • The chest clip is designed to keep the harness straps properly positioned on the shoulders before a crash. This clip is ONLY for pre-crash positioning. A chest clip that is too high may interfere with the child's ability to breathe. A chest clip that is too low could allow the straps to slip off the shoulders before a crash, leaving the child free to slip out of the seat.
The carry handle must be in the correct position, usually either curved around the top of the seat or under the seat.
  • Many people mistakenly think that the carrying handle will perform as a "roll bar" in a crash, but in reality, most handles are not designed to withstand the force of a crash. Upon impact, the handle can shatter or break, sending sharp, jagged pieces towards baby or other occupants in the car. CHECK THE INSTRUCTIONS. Most seats require the handle to either be around the top of the seat or underneath it. Only a few seats allow the handle to up over the baby during travel.
NEVER place a rear-facing seat in front of an active airbag.
  • The airbag is protection designed for adults, not children and especially not babies. The rear-facing seat sits too close to the airbag, and when it inflates, it does so rapidly and violently, causing massive head and neck injury. EVERY REAR-FACING CHILD WHO HAS BEEN IN FRONT OF AN ACTIVE AIRBAG IN A CRASH HAS BEEN SERIOUSLY INJURED OR KILLED!!!
The back seat is the safest place.
  • This doesn't just apply to rear-facing seats. Everyone would be safer in the backseat - in the middle, if possible. The back seat is safest because it is farther from any point of impact. A front seat passenger is 30% more likely to be injured or killed than a rear-seat passenger. Use the back seat position that offers the best installation. A good fit in an outboard position is safer than a poor fit in the middle. *NOTE* In mini-vans, the safest position may be in the MIDDLE seat, as the rear has less "cargo space" to absorb a rear impact.
Avoid using add-on products
  • Anything that did not come in the box with the seat could potentially put your child at risk. Adding strap covers could cause the chest clip to be positioned incorrectly. An added head support cushion could compress in a crash, introducing slack in the harness and allowing the child to be ejected from the seat. In general, you want nothing under baby or between baby and the straps that is any thicker than a placemat. Adding NOTHING under, behind or between baby and the straps is the best. Also, keep in mind that any product you add that is not included with the seat can release the manufacturer from being responsible for any injuries your child may suffer in their seat.
The child must fit properly in the seat
  • There are several conditions that must be met for a child to fit correctly in the seat.
A child is too small for the seat if:
  • The child weighs less than the seat's lower weight limit.
  • The harness can not be adjusted to snugly fit.
A child is too large for the seat if:
  • The child weighs more than the seat's upper weight limit.
  • The top of the child's head is less than one inch from the top of the hard plastic shell of the seat.
  • Some manufacturers used to state that the child must use a forward-facing seat when the child's feet are touching the vehicle seat back. All manufacturers have now removed these instructions, as there is no real-life data to suggest that the feet touching the seat back would cause injury, but there are cases of children who have been turned forward-facing too soon and suffered life-threatening or fatal head, neck and spinal cord injuries.
Used seats may be dangerous
  • Never use seat that is damaged, under recall*, over 5-6 years old, or has an unknown history. Check out Not New? for more information on any seat that is not brand new before using it.
  • *Some recalls do not affect the safety of the seat (for instance, a recall on the handle of the seat when used as a carrier), and the seat may safely be used to transport your child until the problem is fixed. You will need to contact the manufacturer to find out whether any recalls on your seat must be fixed before using it for transporting your child.

GET YOUR SEAT CHECKED! Find a certified CPS Technician. Lists of certified CPS Technicians and Child Seat Fitting Stations are available on the NHTSA Web site at www.nhtsa.gov or at www.seatcheck.org.You can also get this information by calling 866/SEATCHECK (866/732-8243) or the NHTSA Vehicle Safety Hotline at 888/327-4236.





Car Seat Shopping Guides

The following Convertible Models for Extended Rear-Facing have above average height and/or weight limits for rear-facing use. These may allow children to face the rear for safety longer than many other models. Also listed are the rear-facing weight limits according to the manufacturer. Most of these models are taller than average, with the possible exception of the Cosco Scenera that is listed primarily as a value option. Please verify these yourself in case of errors. Please note that nearly all convertibles can be used for extended rear-facing beyond 20 pounds and models not listed may have ratings similar to the examples below.
  • Britax Marathon/Decathlon/Boulevard/Advocate (33 or 35 lbs)
  • Learning Curve / Compass True Fit (35 lbs)
  • Cosco Alpha Omega Elite (35 lbs)
  • Sunshine Kids Radian XTSL (45 lbs)
  • Graco MyRide 65 (40 lbs)
  • Evenflo Triumph Advance (35lbs)
  • Evenflo Titan Elite (35 lbs)
  • Cosco Scenera (35 lbs)

6/30/10

Happy Birth Day Owen!

Birth Notes from the Doula’s Perspective
Pictures posted with permission

It was April 22ndth and you were 40 weeks and 2 days pregnant. This birth would be a planned homebirth. You called me around 9:30am to let me know contractions had started a few hours earlier and were about 5 minutes apart and mild. You decide to try and rest a bit because you weren’t sure that you were in active labor. You’d thought maybe you had been having contractions the night before but you thought it may have been a dream so you went back to sleep. It wasn’t long before your husband called me at 10:30am to let me know that contractions were getting closer and he said that you were focusing through them; I assured you I would be at your home shortly. I arrive at your home at about 11:00am and the homebirth midwife arrives shortly after. I come in the house to see you standing in the bathroom; your face rosy and warm as you close your eyes during contractions. You mention that you don’t know what is going on with your body, that you were not expecting labor to progress this quickly. I hug you and remind you that no matter how much we prepare, we still have to be open to the unique labor we are given. I also remind you how amazing you are doing! Shortly after, you are assessed by the midwife and found to be 7-8cm! You can’t believe it! Your body naturally relaxes with each contraction and you rest in the bed for several contractions. Your family arrives and your daughter  greets the room with love and curiosity when she asks “What’s mommy doing?” I smile and say “She’s having a baby!”

As the birth pool is being filled with water, you walk around the house for a few contractions. You rotate between rocking your hips and leaning on me. You breathe with purpose; each breath is long and smooth as you take in plenty of oxygen for your baby.  Because you hadn’t had much to eat you snack on some orange jello and water. Upon entering the birth pool you quickly respond with “Why didn’t I get in here sooner?” and we all giggle because we had been encouraging you to try the tub for a while. You were able to relax even deeper in the birth pool, allowing your body’s natural painkillers to do their job. Your husband and I take turns sitting behind you supporting your arms; I get you cold washcloths for your forehead and massage your hand.

You mention more pressure and start bearing down a bit, pushing softly with contractions. You aren’t sure that you really have the urge to push so you decide to relax for several contractions to see if the pressure intensifies. An hour or so later, the midwife encourages you to stand for a while and let gravity help you, you do that and then you sit on the birth stool to push on a few contractions. You start a feel a little doubt creep in; you say “It feels like I am not doing something right?” The midwife and I assure you that you are doing everything right because you are listening to your body! You push for a while longer and get back in the birth pool on your knees leaning over the edge, where your water breaks. Immediately, you feel a stronger urge to push and within a few contractions your baby emerges into the water as you reach down to catch your baby on your own.

You put your baby on your chest and say with the proudest joy “I did!” With your husband at your side, both of you overwhelmed with joyful tears, you both can’t take your eyes of your baby. You didn’t know if you were having a boy or a girl (although your daughter Orianna seemed to think it was a boy) So you reach down and look to see, and you both say with delight “It’s a boy!”  Owen weighed 10lbs 4oz!

“Happy Birth Day Owen!”

This birth was filled with so much faith and strength! Congratulations! You did amazing! I'm sure I left something out, as birth brings so many magical moments. The official birth story belongs to you.  Thank you for inviting me to be part of something so sacred.

With love,
Taryn Goodwin, CD(DONA)




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