Healthy Mother Sanctum®

Routine Ultrasounds in Pregnancy: Is there evidence for long term effects on the baby?

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Getting an ultrasound during pregnancy is such a routine practice these days. So many mothers in India, start having a first transvaginal ultrasound as early as week 5 or 6, when neural organization is taking place in the baby. Thereafter, most mothers in routine practices, get a quick ultrasound check almost at each antenatal checkup, and then at least one big scan every trimester, if not more!

While we at Healthy Mother, are not against scans, we counsel every mother about the pros and cons of each scan that is available, and let them make an informed decision after they do their due diligence. We believe that while the technology of prenatal ultrasound can be life-saving , as well as aid in clinical decision-making in some instances, especially in women with history of multiple miscarriages, women who have had a baby previously with a congenital defect, etc., overuse of it in otherwise healthy, low-risk women should give us a reason to pause and reevaluate: Is it doing more harm than good?

Here is a small study done as early as 1993 – this was done when scans were not as prevalent and routine as they are now. In this retrospective study of children with speech delay, it was found that they were twice as likely to have been exposed to ultrasound in pregnancy, as compared to babies with normal speech development.

Conclusion from this study? “An association between prenatal ultrasonography exposure and delayed speech was found. If there is no obvious clinical indication for diagnostic in-utero ultrasonography, physicians might be wise to caution their patients about the vulnerability of the fetus to noxious agents.”

Here is the link to the article.

This mother came to us all the way from Vizag, to have a VBAC birth at 41weeks and 1 day

Yes, the birth was long with pre-labour contractions for more than a week, almost 2 days of bag of waters being broken, labor stalling out at 6cms for almost 14 hours. But, the body is smart, when the baby needs to move into a better position.

The contractions are sometimes strong and sometimes not, so that the mom (and her uterus) can get some rest. And, her midwives are smart enough to let that happen and not push her body. We also tried every position to help her reposition her baby better, and then labor picked up again.

Then it gets hard. Mom says, “It is bloody painful”.. Yes, it is Mom.. Let’s focus and breathe into the pain, and breathe out the discomfort. Let’s move gently. Let’s help you take a warm shower.. Let’s do this together. Then she starts to push..

She pushes beautifully and instinctively. But, she is tired and says, “Maybe I am not strong enough to do this”. No, we say – You are strong, your baby is strong, your body knows just what to do. And, an hour later, she welcomes a beautiful 3.75 kg baby boy into her circle of love.

This baby was born with the cord wrapped twice around his neck, which probably explains why he took a while to descend. Babies are smart, they know how to be born!

Congratulations, strong Mama!

How to Prepare for Natural Birth

Make a birth plan
Try and educate yourself as much as possible about birth and all related aspects. Device a birth plan that suits your preferences and conveys it to your team. The professionals will counter advice you and will help you conduct your plan with full expertise.

Choose the right practitioner
Choose the right practitioner for the birth experience, ask your friends or other mothers who experienced natural birth to learn more about the qualities to look for in a midwife. Also check the experience they have and talk to them about your expectations.

Use a labor partner
Find and use a labor partner or a Doula to assist with pain management and effective positions while giving birth. An effective labor partner can reduce the requirement of medicines and epidurals during your labor.

Select a proper birth place
Selecting a proper birth place will help in improving your comfort level and chance of a good birth experience. You can have a natural birth in a birth center, home or even a hospital, depending on your preference and comfort. However, you will still need to ensure that you pick a are provider who believes in the process of natural birth, and is attuned to your needs.

Managing pain
Managing pain is perhaps the most scary part of giving birth, but many clichés can be broken if proper support groups and classes are joined and various methods of pain relief are practiced regularly at home.Read books and watch videos to help yourself understand the different techniques that can reduce pain and relax your body during child birth.

Use a birth ball
These balls are specifically designed to help you maintain birth positions, which are most comfortable and least painful. These can be used with relaxing sessions such as using aromatherapy or breathing exercises.

Read good books
Books help you with issues which you cannot discuss with others or maybe embarrassed to ask if you’re a first time mother.

Get support
Get psychological support by talking to friends and relatives who are experienced. This can help a great deal in controlling fear and getting rid of misconceptions about natural birth.

Labor positions
Watching different videos and consulting your mid wife for most effective and productive positions also help a great deal.

Focus
Keep your primary focus on the birth of your child. Many women benefit from using visual imagery, hypnobirthing techniques, breathing techniques and positive affirmations in conjunction with use of focal points in their birth room to help manage the sensations of labor. This also reduces stress associated with labor and birth.

Stay hydrated
Labor can be a very energy consuming process, not only is it necessary that mothers consume healthy and high-energy diet during the course of pregnancy, but they should also keep themselves hydrated over the entire tiresome experience of natural childbirth.

10 Tips to help you have a natural birth

1) Plan for continuous labor support. 
This support can come from a family member, doula or midwife. Choose someone with whom you feel like you can let go of all inhibitions during birth, and someone who will treat you with dignity & respect. Ultimately, your labor support people should know & support in your decision to birth naturally, and must have basic labor support skills.
2) Eat and Drink freely during labor
3) Move freely in labor, whenever and however you want. 
Did you know that slow dancing with your partner in labor, will not only given space to your baby to move down into your pelvis, but will also trigger the love hormone oxytocin, which in turn will speed up labor? And, that in turn will trigger another hormone Endorphin, which is nature’s narcotic to effectively manage the pain of labor?!
4) Feel free to ask to be left alone for a while, if that’s what you desire. 
Sometimes, women need the peace and quiet of non-activity, in order to rest or refocus on the immense task of labor
5) Choose a place of birth that is cozy, private and safe. 
A safe and comfortable environment allows your primitive brain to take over and complete the primal task of birthing with ease.
6) Choose a care provider, team and place of birth that follow woman-centric maternity care. 
Do your due diligence. Do not just go by how fancy a place looks. Interview at least 3 different care-
providers, find out their philosophy regarding natural childbirth, and more importantly their rates of C-sections and other interventions as well!
7) Ask that Internal Exams be minimal during labor. 
This in itself will give you confidence in your body and avoid unnecessary interventions.
8) Ask for unlimited time to labor, as long as you and your baby are doing well. 
Artificial time constraints are one of the major reasons for unnecessary interventions including C-sections
9) Be at home in early labor; 
more importantly, try to get lots of rest in early labor, and continue to rest when you can, even as labor becomes stronger. Lots of activity and too much anticipation in early labor, leads to maternal exhaustion both mentally and physically as labor progresses.
10) Believe deep in your heart that you can birth naturally! 
For too long, birth has been associated with pain, without telling mammas that this labor pain comes and goes, and most of it can be easily managed with focus, breathing, relaxation, massage, visual imagery, positive affirmations, and everyone around the mother encouraging her, and believing in her ability to given birth. Once you are able to manage each wave of pain, you will be able to surrender to the process of labor, and who knows, perhaps even enjoy it!!

What makes Sweden the second-best country in the world to become a mother in?

During a normal pregnancy without complications, just one ultrasound will be done over the whole nine months, without a single gynaecological exam.

Here your Gyneacologist wants to give you an ultrasound at almost every check. She might do an internal exam initially, she may do transvaginal ultrasounds many times in the early weeks of pregnancy, she may even put you on Progesterone tablets and HcG injections. All this is done “just to strengthen you pregnancy”, even though you have conceived naturally and your pregnancy is already “strong”!

She may then do an internal exam at 37 weeks and predict that you will have your baby soon (though the simple fact that baby is low does not mean labor will start soon). Or, she may say the baby is “too high” and ask you decide a date for the C-section you require (wholly untrue as well)!

So what can you do to get the pregnancy care that you deserve?
Do your research, attend Lamaze classes, find a careprovider/ midwife who can put back the “normal” and “gentle” in maternity care and get the best outcomes for you and your baby!!

Read more

Call the midwife ‘Dad’

In each visit, and through our classes, we try to prepare dads to be there both physically and emotionally. We try to teach them coping skills, to help the mother in her early labor, massages, the effect of different kinds of touch, and to explore what really helps mom and what doesn’t. I always say, “It is like a tool bag, you will not use everything, but then the one thing that you need may just be there!”

That said, it is also up to the dad to decide how he wants to help. For most dads, being there and witnessing the birth of their child, is priceless. However, for a few, it may just not be their cup of tea. I have had the odd dad, hang out just outside of the birth room door, and run all sorts of errands, but, not want to come inside until the birth is over. This is okay too, as long as mom is also okay about it.
Lastly, the best thing that dads say they like about being a part of the classes and the antenatal care is that they are prepared for what is to come, they know what to expect. They do not panic, and they can help mom knowing that together, they can do it. Now, isn’t that the best gift for the mom in labor to have?

In this article, Daniel Oakes narrates why being at the birth of his first child was a life-changing experience, in more ways than one: Read full article here

When her bag of waters broke, she knew exactly what to do..

This morning, after almost a day and half of labor, a sweet first time mother gave birth to her handsome 3.75 kg baby boy!

This is a couple who treated pregnancy and birth truly as normal, natural life events – reading up about birth, following a good diet, exercising daily. No fuss parents that they were, their antenatal check-ups would barely last for 15 minutes each time – no fears, no extraordinary questions. They did get mentally and physically prepared through our Lamaze classes.

And, all that preparation did pay off! When the mother’s bag of waters broke night before last, she knew just what to do. We only got a call from her much later, when her contractions started to pick up, 5-6 hours after her bag of waters broke! Through the many hours of labor, and the many more hours of pushing, mother managed her sensations of birth with a peacefulness that is hard to describe! Hats off, Momma – you were amazing!

Midwife-led care is just as safe as doctor-led hospital care for low-risk deliveries: The Birthplace study

New draft guidelines from the National Institute for Health and Care Excellence (NICE) in the UK: For healthy low-risk pregnancies, women should be encouraged to give birth in a midwife-led unit, birth center or at home. Hospital labor wards with doctors are more appropriate for pregnant women with higher risk or for difficult cases.

These recommendations were based on “The Birthplace study, the largest to be carried out into the safety of different maternity settings. It involved almost 65,000 births in England and found midwife-led care was just as safe as doctor-led hospital care for low-risk deliveries.” Read more at BBC.COM