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These are some of the many issues we talk about in both the HypnoBirthing and Lamaze classes.
This page will change frequently, so check back to see what’s new.
Caffeine increases miscarriage risk
Clinicians have suggested that women consider avoiding caffeine during pregnancy after finding consistently consuming 200 mg, equivalent to two cups of coffee, a day or more can double the risk for miscarriage.
The Food Standards Agency currently sets an upper limit during pregnancy of 300 mg, but De-Kun Li and colleagues' findings suggest this may be too high.
The researchers note that the relationship between caffeine consumption and miscarriage risk is independent of potential confounders including pregnancy-related symptoms such as nausea and vomiting, and aversion to caffeine consumption.
They conclude: "It may be prudent to stop or reduce caffeine intake during pregnancy."
All figures are approximate, especially with coffee. Different varietals can have different caffeine content, and the way the coffee is roasted can also change the values.
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Double espresso (2oz)
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45-100 mg
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Brewed coffee (8 oz)
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60-120 mg
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Instant coffee (8 oz)
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70 mg
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Decaf coffee (8 oz)
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1-5 mg
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Tea - black (8 oz)
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45 mg
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Tea - green (8 oz)
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20 mg
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Tea - white (8 oz)
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15 mg
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Coca Cola (12 oz can)
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34 mg
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Pepsi (12 oz can)
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38 mg
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Barq's Root Beer (12 oz can)
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22 mg
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7-up (12 oz)
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0 mg
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Chocolate milk (8 oz)
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4 mg
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Dark chocolate (1 oz)
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20 mg
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Milk chocolate (1 oz)
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6 mg
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Ben & Jerry's Coffee Fudge Frozen Yogurt (8 oz)
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85 mg
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Clamping umbilical cord after 2 minutes gives baby a leg up: study
Tuesday, March 20, 2007 | 6:08 PM ET The Canadian Press
Delaying clamping the umbilical cord at birth by roughly two minutes can give newborns a health boost that carries through the early months of their lives, a new study suggests.
Late clamping, as it is called, allows more blood from the cord and the placenta to flow into the infant, raising iron levels and decreasing the risk of anemia in the first weeks and months of life, McMaster University researchers suggested in the article, published Wednesday in the Journal of the American Medical Association.
'You can imagine it's giving your baby a better start.' — Lead author Eileen Hutton on delaying clamping
But late clamping isn't widely practised in developed countries, where doctors are taught the extra blood raises the baby's risk of developing jaundice or polycythemia — a condition considered to be the opposite of anemia, where too many red blood cells can cause circulatory problems.
In many delivery rooms, cord clamping occurs at lightning speed.
"It's very immediate," explained lead author Eileen Hutton, assistant dean of midwifery at McMaster University in Hamilton.
"For somebody who isn't involved in births, you think: 'Why are they even discussing two minutes? It seems a little bit silly.' But in that two minutes, there is a lot of change that happens physiologically."
Lower anemia rates for babies
An editorial that accompanied the article suggests this study is worth looking at, but may not change practice.
"A stronger and universal endorsement of delayed clamping will require a well-designed and preferably multi-centre (to factor in centre effects) randomized controlled trial with a sample size that is powered to address both benefits and potential adverse effects of this intervention," wrote Dr. William Oh of Women and Infants Hospital in Providence, R.I.
That's because the article by the McMaster team isn't an account of a clinical trial; it is an analysis of a series of 15 mostly small studies looking at the benefits and risks of late clamping.
Individually they present conflicting evidence for the debate. But pooled together, Hutton said, the data show a statistically significant lowering of anemia rates in babies who were clamped late, but no real increased risk of serious side-effects in those same babies.
"And the significance is not just at the time the baby's born; it lasts quite a long period of time," she said from Hamilton.
"The iron stores were increased [up] to six months of age. Basically you can imagine it's giving your baby a better start."
Clearer picture
Dr. Susan Harris, head of family practice at Vancouver's B.C. Women's Hospital, said it's useful to have this kind of analysis of the scientific evidence on the clamping timing issue, because the picture hasn't been clear in the past.
"It wasn't because people were doing the wrong thing. I think they thought they were doing the right thing," Harris said. "And I think the fact that this has now been studied in a way that suggests that we should change our practice, I think that's excellent."
A reduction in the amount of cord blood available for storage as a source for stem cell treatments is a potential downside of a widescale move to late clamping, Hutton acknowledged.
But she said the science on stem cells is advancing and other possible sources could soon replace cord blood.
© The Canadian Press, 2007
Maternity Care Analysis Finds Danger of Routine Birth Interventions
WASHINGTON (March 8, 2007) - Findings from a two-year review of the science behind maternity care indicate that the common and costly use of many routine birth interventions, such as continuous electronic fetal monitoring, labor induction for low-risk women and cesarean surgery, fail to improve health outcomes for mothers and their babies and may cause harm.
The review entitled, the Evidence Basis for the Ten Steps to Mother-Friendly Care, will be published in The Journal of Perinatal Education and the results will be premiered at the Coalition for Improving Maternity Services (CIMS) Forum today.
Research findings include:
Women whose labors are induced for non-medical reasons are more likely to suffer from intrapartum fever and more likely to end up needing forceps, vacuum extraction and a cesarean surgery. Inductions add to the risk of poor outcomes for the health of the baby. Artificially-induced labors increase the rate of fetal distress and a serious complication of labor called shoulder dystocia (when the baby's shoulders have difficulty passing through the mother's pelvic bones). Elective induction babies are also more likely to need phototherapy to treat jaundice after birth, and are at higher risk for breathing difficulties and admission to neonatal intensive care. Use of electronic fetal monitors is more than 85 percent on low-risk women. They fail to reduce the number of perinatal deaths, the incidence of cerebral palsy or the number of admissions to the neonatal intensive care unit. Continuous fetal monitoring puts women at increased risk for an instrumental delivery, cesarean section and infection. Overall 1 in 3 U.S. women give birth by cesarean surgery. The majority of the operations are repeat procedures with no medical indication. When compared to women who have a vaginal birth, cesarean surgeries put women at risk for infections, hemorrhage requiring transfusion, surgical injuries, and complications from anesthesia, chronic pain, adhesions, hysterectomy, pulmonary embolism, placental problems with future pregnancies and death. Babies born by cesarean surgery are more likely to suffer from surgical lacerations, respiratory complications, and to require neonatal intensive care.
There are more than 4.1 million U.S. births a year with a cesarean surgery rate more than 30 percent. The health and economic impact of high tech birth is significant. In 2004, hospital costs for deliveries were more than $30 billion. The record high cesarean surgery rate contradicts the national goals of Healthy People 2010 to reduce cesarean surgeries for first time mothers to 15 percent and to increase VBAC (Vaginal Birth After Cesarean) rates to 63 percent. The research also found that harm is caused by routine use of intravenous fluids (IVs), amniotomy (breaking the bag of waters), withholding food and water from women in labor and episiotomy.
To learn more about reducing the chances of having interventions during your birthing, developing confidence, finding comfort and easing pain in labour, contact me - I would love to talk with you.
Read more Lamaze press releases. The topics are varied and although the statistics are from the USA the topics concern childbearing families in Canada too.
How to have a sensual, drug-free birth
20 March 2007 http://news.independent.co.uk/uk/health_medical/article2374970.ece
Forget epidurals. Midwives say they can train women to have births that are not only drug-free, but pleasurable - and even orgasmic. Anastasia Stephens reports.
For Katrina Caslake, giving birth was not the terrifying, painful ordeal most women experience. Far from it. The midwife, from Wallington, south London, says she found it blissful, even orgasmic. "I found giving birth very sensual," says Caslake, 44, who didn't take painkillers for the birth of either of her sons, Aaron and Tomas, now 18 and 17.
"All my erogenous zones were stimulated. I was making sounds very similar to a sexual climax. And it was a very definite climax. I was doing the most feminine thing a woman can do and it felt fantastic."
It's a sentiment with which Frederika Deera, a PR officer at John Lewis in London, would agree. She had a similar experience giving birth to her two-year-old daughter Delphine.
"Giving birth filled me with the most indescribable euphoria," says Deera, who gave birth at a midwife-led unit in Portsmouth. "Of course there was pain, but my overall sense was of peace and happiness. I was on a complete high, so much that even having a major suturing afterwards did not bother me at all."
It was her "pleasurable experience" that led Caslake to train as a midwife. "I knew I wasn't unique," says Caslake, who helps run Yours Maternally, an independent midwifery service. "By encouraging other women to trust and relax in their bodies, I felt I could help them experience less painful, more pleasurable births."
It's an approach that's also encouraged at the Birth Centre in south London where midwife Nathalie Mottershead actively encourages sensual birth.
"If couples are willing, nipple and clitoral massage can be used to bring on labour contractions, open the cervix and vagina and help with pain relief," she says.
More to the point, the approach is capable of transforming birth – perceived by most women to be terrifyingly painful - into a pleasurable, even, ecstatic experience. "We work closely with women so they can give birth at home, in intimate surroundings. If mothers-to-be are open to feeling sexy, labour can be pleasurable, not painful, and it sometimes builds up to a crescendo at birth."
It's not as if the techniques used at the Birth Centre are isolated or rare. "If a woman is comfortable enough to do nipple or clitoral stimulation during birth, it's a useful trick for pain relief and inducing labour," says Andrya Prescott, spokesperson for the Independent Midwives Association.
A visit to the Unassisted Childbirth Organisation's US website confirms just how erotic childbirth can be. The site describes in graphic detail women's fantasies in which romantic and sexual union leads to "blissful waves of pleasure", and "cosmic orgasms" at the point of birth. More women, it seems, get turned on by birth than you'd think. When Ina May Gaskin, a US midwife, conducted a poll of 151 women, 32 reported experiencing at least one orgasmic birth. Admittedly, these were home births by women who were "open" to the experience. The plus points are pretty significant - a single orgasm is thought to be 22 times as relaxing as the average tranquilliser, while sexual arousal widens the vagina significantly.
"Women might think twice about having an epidural if they knew that, but nobody talk about these things," points out Gaskin, a natural childbirth pioneer who was the first midwife to openly acknowledge that women could climax at birth.
It almost sounds too good to be true: a touchy-feely labour followed by an earth-shattering orgasm at the moment of birth. Unfortunately, this is very far removed from most women's description of childbirth. A major hitch is that, as with any sexual activity, the amount of pleasure gained - for women at least - is closely related to the degree of relaxation, trust and safety she feels.
Most women anticipate with dread the "birth ordeal", a state of mind that will make muscles contract and adrenalin levels rise before it even begins. And then, most women can only feel sexy in intimate surroundings, with people they know well. Hospitals and doctors don't really do the trick.
"Adrenalin inhibits sex drive and labour contractions," says midwife Andrya Prescott. "You become tense and are more prone to feeling pain. It's why women can have trouble with labour and birth at hospital. Surrounded by strangers, their adrenalin levels are high. They can't relax. Even if they were open to getting aroused, at a hospital, they may as well forget it."
Part of the problem, it seems, is the way sexuality around childbirth has been denied. In her book, Ina May's Guide To Childbirth, Gaskin points out that doctors had to downplay female sexuality for medical men to be admitted to the birth chambers of women in the 18th and 19th centuries. This "denial" was later institutionalised when hospital births became routine.
Even today, it's a pretty taboo subject. "Lots of women would worry they'd be seen as abnormal or deviant if they admitted to feeling sexual at birth," says Carolyn Cowan, a yoga teacher and doula based in south London, who herself had an ecstatic birth. "It's something lots of women feel ashamed to talk about," she adds. "I run erotic dance classes for pregnant women to try to get rid of these inhibitions. I should know a thing or two - it took giving birth to my son to discover my G-spot."
The tide is clearly turning. A growing number of obstetricians and midwives point out what seems pretty obvious, yet has been somehow forgotten – that since sex leads to pregnancy and birth, they're pretty closely linked.
"When you look at sex, birth and lactation, the same hormones are involved," says Michel Odent, the obstetrician who pioneered the use of birthing pools in the Seventies. "It seems obvious that childbirth is a part of a woman's sexuality."
Many parents-to-be, for example, find that making love and nipple stimulation are one of the best ways to get labour going. That's because sexual arousal releases oxytocin, a love and bonding hormone, which triggers orgasmic and labour contractions in the uterus. Conveniently, this hormone is an endorphin, meaning it has an opiate-like effect - inducing pleasure while acting as a highly effective painkiller.
Aside from the pleasure and pain relief, the advantage of a sensual birth is less physical damage. "Women who are relaxed and feel good, undergo easier, smoother births, so suffer less tearing and bruising," says Caslake. "Fear makes a woman more tense and this holds the baby back."
The baby gets a pleasure hit too - bathed in "feel-good" hormones, they're more likely to come out feeling relaxed and content.
www.michelodent.com (for more info on love hormones);
www.unassistedchildbirth.com (for more info on sensual birth);
www.birthcentre.com (020-7820 6661); www.independentmidwives.org.uk; for
sensual prenatal exercises contact Carolyn Cowan (020-7701 3845;
www.mooncycles.co.uk); Yours Maternally Independent Midwives, Wallington,
south London ( www.yoursmaternally.co.uk; 020-8401 9501)
How to have a pleasurable birth:
Why some women achieve a "birth climax" while others endure excruciating pain is likely to be due to differences in environment, genetics, expectations, and psychological factors. Trust and the level of emotional support you feel from your partner or midwife is critical in inducing a feeling of safety and relaxation needed to get the "pleasure hormones" going.
Women are generally more likely to have sensual birth experiences during home deliveries in an intimate environment. Midwives who have witnessed women who've been physically aroused during childbirth believe the following techniques could make the experience more likely:
* Before and during childbirth, become intimate with your body. Look at yourself naked in the mirror, noticing any areas that trigger uncomfortable emotions. Send loving thoughts to that area until the difficult feelings pass. Ask your partner to look at your body and compliment you.
* If you feel comfortable with it, aim for a home birth.
* Work closely with a doula or midwife to build up a sense of trust with her, in your body and in the birth process.
* Ask yourself if you can believe that your body will be doing the right thing, to the best of its ability, to give birth successfully. The more you can believe this, the more you'll be able to trust yourself and relax.
* Pick a special room or area where you want to give birth. Light candles to create atmosphere and evaporate lavender essential oil in an oil burner to induce relaxation.
* Learn a relaxation method such as abdominal breathing or self-hypnosis to use during childbirth to curb the release of stress hormones.
* Create the expectation that childbirth could be pleasurable, even if there is pain: while pregnant, spend time imagining how it could trigger warm tingling sensations in your body along with feelings of love.
* If you feel it is appropriate, ask your partner to kiss you, stroke you gently or even caress your nipples as labour contractions come on.
I look forward to talking with you - call me or e-mail now
Mary Hebden (250) 748-8493
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