Breech Birth

Here is a short article related to a vaginal breech birth with links to the scientific studies showing it can be safe. Many doctors don't offer vaginal breech births-- not because they aren't safe, but because they aren't trained. You can click on the title to find the original source of the article.

I Would Do Anything For My Babies, But I Won’t Do That…

Oct 30th 2012

© arztsamui

Last week, Kimberly Van Der Beek (yes, “Dawson’s” wife) posted a story about having a breech vaginal birth for her second child. As she explains, her original obstetrician offered her no option except a cesarean delivery of that child. But upon seeking a second opinion from another highly qualified obstetrician (not a witch doctor, mind you, but an actual OB) who’s skilled in breech vaginal delivery, she decided to transfer care so she could have her baby the old-fashioned way.

Some of the commentors on the article were outraged:

“How DARE you put your “experience” ahead of the safety of your baby!”

“Why are you so selfish??? I would do ANYTHING for my babies!”

“I would never risk my baby’s life that way!”

“Why wouldn’t you just listen to your doctor? You’re so stupid!”

But I guess those commentors missed the part where Kimberly DID listen to a doctor who recommended, and attended, her breech vaginal home birth. And Kimberly’s homebirth doctor, Dr. Stuart Fishbein, is no quack. In fact, The Society for Obstetricians and Gynecologists of Canada has been pushing more toward the option of breech vaginal delivery for years and has called for OBs and midwives to become trained in this lost art. The Royal College of Obstetricians & Gynaecologists also lists breech vaginal birth as an option for mothers based on certain criteria. Numerous scientific studies (like this one, this one) support vaginal breech delivery as a safe option for many mothers. Physicians supporting breech birth are coming from all over the world to the “Heads Up! Breech Conference” to discuss the topic in Washington, DC next week.

Unfortunately in the US, vaginal breech births can be difficult, or almost impossible, to come by. One of the main reasons OBs and midwives in the US do not, or cannot, offer the option of breech vaginal delivery is not necessarily because it’s not safe, but because they are not trained at all in how to deliver these babies. If a provider does not know how to attend a breech vaginal birth, then, yes, I would argue that a cesarean, which OBs are specifically trained for, may be safer for both mom and baby.

But Kimberly’s obstetrician is skilled in breech delivery and found Kimberly to be an ideal candidate. Her birth went perfectly and she was able to avoid a major abdominal surgery.

Yet some of those outraged commentors continued to insist that Kimberly didn’t love her baby if she didn’t have that cesarean. Kimberly’s decision not to expose herself and her baby to the risks of, what would have turned out to be, a completely unnecessary surgery, confounded many people. The comments section became filled with folks who proudly asserted they would have had a cesarean because they would do “anything” for their babies.

Well, I’m sorry. I love my babies and I’d do anything for them, but I will not have an unnecessary surgery just to please the ignorant masses. I won’t do that.

I would have done exactly what Kimberly did. She found herself in a difficult position, so she carefully weighed her options, consulted the most experienced and skilled providers she could find, and made a decision that felt right for her family.

That, to me, is the hallmark of a wonderful mother.

C-Section Options

During the 12 weeks of instruction students get in my Bradley classes, we cover choices and options they have regarding their birth. During the week we cover variations and complications, couples are often surprised to know that just because their birth veers from their natural birth plan, doesn't mean they stop having a say in how things go! Parents should be able to give informed consent to all aspects of the birth. In class, we learn how to do that and cover many of the options parents have. I'm sharing on the blog an article that helps parents who have learned they must have a planned cesarean section. It may be disappointing, and a little scary, but when done for the mother's or baby's safety know that you have done what was necessary.

Here are tips for having The Best Cesarean Possible

Don't forget that the American College of Obstetricians and Gynecologists (ACOG) now states, "Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including some women who have had two previous cesareans."

Epidural Risk

This is an older Dateline article (2006), of a  new mom who died shortly after giving birth after contracting menangitis most likely  through her epidural site.   I haven't found the outcome of the lawsuit or new info on this particular case, but I show it for FYI.  Obviously there are many who have epidurals with no complications whatsoever, and many who only have mild complications. However anyone who has ever had an epidural is already aware of the possible side effects and complications associated with one- you have to sign a waiver that you release liability in case of such risks (I have a copy I took home from the hospital after my son was born to show students).

As the Bradley method teaches, thank God for medical discoveries and medicine available for emergencies. Many lives have been saved because of it. However, in the case of normality and uncomplicated birth, natural childbirth is the safest route.

A routine epidural turns deadly

Post Baby Body

There is a lot of talk about post-baby bodies with Hollywood celebs bouncing back faster than seems humanly possible! Jessica Simpson is the latest to reveal her trim body that she admits working very hard to get. Dieting, excercise, who has time for it (at the intense level celebs go to) when you are nursing round the clock, changing diapers, and barely keeping your eyes open.  I found this article that is a great perspective at things to expect -and not to expect- of your post-partum bod.

10 Surprising Facts About Bouncing Back

Mastitis

I'm posting this info about mastitis remedies because I keep hearing of friends dealing with it. Mastitis might be the mother of all mothering woes  and the ultimate "It's ok to cry" reason (at least in my book!). I am prone to infections (Had it 3 times with my daughter, and 3 times so far with my son), so I feel for all those who have to deal with it. I obtained this info from Lisa Marasco IBCLC , author of Making More Milk, international speaker , and personal friend (aren't I lucky??).


I've personally tried and recommend
Happy Ducts herbal tincture by Wish Garden (ordered online, tastes NASTY but seems to work)
Castor oil compress
Tumeric spice added to everything
Breastfeeding on hands and knees, or sideways (explained on bottom of the page) to use gravity to help flow.
I also had to pump after feedings, or middle of the nights when I had too much milk, and change breast pads frequently!

Hope this helps!

Mastitis and Plugged Duct Remedies

FOR MASTITIS:

Mastitis Remedy and Mastitis Compress by Wish Garden

·         http://www.wishgardenherbs.com/index.php?load=pregnancy&page=index&group_id=7

Castor oil compress

·         Warm, moist washcloth folded to appropriate  size...a "glug" of castor oil on that...lay over area...put plastic wrap over that and a heating pad on "low" over that, and let sit 20-30 minutes before nursing or pumping, with massage if possible during milk removal. I find that frequent removal, heat, massage and castor oil packs usually clear a plug in 12-24 hours...even if mom has fever and nausea and redness on the overlying skin. So I do not tend to prescribe antibiotics until trying these measures….It seems that a mom with a "stubborn" plug that has not responded to heat and massage alone will respond to this. Don't know why. -- Kathy Leeper, MD, IBCLC

·         Cold-pressed castor oil on a washable breast pad, placed it over the area, covered it with plastic wrap, and added a hot pack.  Castor oil packs are a remedy given by Edgar Cayce, and the idea is that the castor oil (cold pressed only, found in good health food stores) promotes the body's lymph system to relieve congestion. Christine Northrup, MD. (Women's Bodies, Women's Wisdom) recommends the castor oil packs, and gives detailed descriptions on how to use them.  ~Shirley Morris, RN, IBCLC, LMT

·         Soak a cloth, such as a washcloth or diaper with the oil and heat (ie, microwave) until hot through. Wait until cooled to skin tolerance and apply directly, then cover w/ saran wrap and a towel. This will stain, so wear something that you don't really care for. Jennifer Tow, IBCLC, CT, USA

Potato poultice

·         Grate raw, peeled potato and wrap in cheesecloth or another thin cotton cloth. Place over inflamed skin.  Jennifer Tow, IBCLC, CT, USA

Bromelain

·         Take bromelain capsules in between meals three times a day at a dose of 250-500 mg.  The effect is usually rapid, within 12-24 hours but sometimes as quickly as 4 hours. Bromelain (derived from pineapple) is used by the dairy industry for dairy cows that have chronic mastitis, and it helps clear… infections that are causing repeated plugged ducts and stringy milk. ~ Chris Hafner-Eaton

FOR CHRONIC MASTITIS:

"Jan's Magic Pills" homeopathic remedy

·         Hepar Sulphur 30 C  -- take 3 pellets and dissolve in mouth. 3 hours later take Phytolacca 30 C -- 3 pellets & dissolve in mouth.  3 hours later repeat the Hepar and 3 hours after that repeat the Phytolacca.

The entire process can be repeated x1 if necessary.  Generally isn't. We've used it on a number of mothers w/ intractible or repeated bouts of mastitis, and it always works. ~Jan Barger, RN, MA, IBCLC, RLC

Probiotics:

·         10 log(10) CFU of Lactobacillus salivarius CECT5713 and the same quantity of Lactobacillus gasseri CECT5714 for 4 weeks[i]   I decided that I was at the end of my rope & based on recent new studies, decided to try taking a probiotic supplement. I was able to find a capsule called Multidophilus 12 at Henry's that contains L. Salivarius.  I tried finding L. Gasseri but was unable to locate a store that carries it so I thought I'd try just the one with Salivarius.  I started taking 2 capsules each day.  Since then I have not had one bout of mastitis & it's been just about 6 weeks. I want to SHOUT IT FROM THE ROOFTOPS!  ~ a mother 

Could be MRSA- most mastitis is caused by staph aureus, but some are methicillin-resistant so don't clear up on the usual antibiotics. Get milk cultured along with baby's naro-pharynx. There are a number of antibiotics that are suitable for the treatment of MRSA infections. ..In adults, good choices for breastfeeding mothers would be clindamycin, trimethoprim-sulfamethoxazole (a little slow),  or ciprofloxacin, ofloxacin, or levofloxacin. ~ Thomas Hale

If expressed milk turns pink: Could be Serratia marcescens, also requiring different antibiotic than usual.[ii]Get milk cultured along with baby's naropharynx.

RECURRENT PLUGGED DUCTS – in addition to compresses above, can try:

Lecithin

·               2 Tablespoons per day of lecithin granules are recommended, with it taking about one week to help with  recurrent plugged ducts by Star Siegfried.  Can mix into yogurt, take 1T twice daily.

·               4 gelcaps of 21 grain lecithin. The bottle recommends 1 a day but that is just for a supplement. I have mom begin with 4. After a week or so she can see if just 3 will work for her. For some women 3 is enough.

·               For blocked ducts try lecithin 1200g 3-4 times a day.

·               Ruth Lawrence recommends 1 tablespoon or 3-4 gelcaps a day.

·               Serves as "Roto Rooter for the veins" (thanks to a Lactnet from Pat Gima).

Cranberry Capsules—Donna Walls

Tumeric Powder- Stir 1 tsp of turmeric powder into a glass of water and drink.  Seems to work very quickly! If needed, repeat the next day.  Kittie Maxwell

Combo especially useful with nipple Blebs-

·         Magnesium (not cal/mag--just magnesium), homeopathic phytolacca 30c (1 dose every half hour for 6 doses and then stop--for acute condition), lecithin (preferably granules, not capsules) and essential fatty acids (krill oil if not vegetarian, Udo's blend if veg). This is the most effective approach I know of for chronic plugged ducts (assuring, of course that latch is efficient and the baby has no structural problems causing the plugs). –Jennifer Tow

Rachel's Trick:

·         Mother lies on one side, with the problem breast UP.  Baby lies on side next to mother.  Mother rolls over until breast reaches down to baby, and feeds in this position.  This position lets the breast hang free, and straightens out ducts which may get 'kinked' or pressed on in many upright positions, or in side-lying if the affected breast is nearest the mattress. If desired, once milk is flowing, mother can apply gentle pressure over the affected area with the flat of her hand to help that particular area to drain.  It isn't always even necessary.  ~Rachel Myr, midwife, IBCLC

Celebrities do it to!

A new controversy over breastfeeding came up this past week. Two military moms were photographed breastfeeding in uniform. I'm not in the military so I don't have much to say about the "appropriateness" of it. But I hated that the military spokesperson said something to the effect of "Military moms who are still breastfeeding are encouraged to pump and bottle feed." To me that isn't fair. It is much harder to pump and bottle feed (not to mention the loss of the physical/bonding aspects of breastfeeding) and I think it is unfair that these women serving our country are being asked to do so. That's all I got to say about that.

Then today I came across another article relating to breastfeeding. The hype and controversy has reached Hollywood, and celebrities are "coming out" about breastfeeding.  The entire article and slideshow of breastfeeding mommies can be found HERE

But here is an excerpt:

After a certain national magazine rocked the world with a cover story aboutattachment parenting, singer Alanis Morissette, 37, is the most recent celebrity to announce publicly that she follows the tenets and advice of Dr. Bill Sears. Specifically, Morissette, a mother of one, is making headlines for saying she prioritizes breastfeeding, even though her son, Ever, is 16 months old.

"I breastfeed and I’ll be breastfeeding until my son is finished and he weans," she said on "The Billy Bush Show."

Morissette joins other celebrity moms who have been recognized for nursing, whether negatively for doing it longer than the public expects to see a mother put her child on the breast, positively for being a role model who abides by the advice of the American Academy of Pediatrics or just for being a mother who is -- with leaky boobs, a bigger bra size, and less sleep -- indeed, "just like us."

Things you can refuse

A couple of weeks ago, consumer reports released an article titled "What to reject when you're expecting"
Find it here:what-to-reject-when-you-re-expecting

It is lengthy, but worth the read. The points are:
1. A C-section with a low-risk first birth
2. An automatic second C-section
3. An elective early delivery

4.Inducing labor without a medical reason

5. Ultrasounds after 24 weeks

6. Continuous electronic fetal monitoring
7. Early epidurals
8. Routinely rupturing the amniotic membranes
9. Routine episiotomies
10. Sending your newborn to the nursery

I appreciate the statistics and studies they show to back up the points. As Dr. Bradley would say, "research is catching up to the Bradley method" (Husband Coached Childbirth).  The Bradley method has been saying these things since the beginning!

On the same note of things to think twice about (and possibly refuse!) is this article :10-childbirth-norms-parents-can-refuse

This article comes from a natural mom's blog and she is sharing her personal choices for pregnancy and birth.I like this article because it reminds you of things that you need to consider and make decisions about. I agree with most of her points, and encourage you to use informed consent when making your own choices. Consult with your own doctor and your own research.

Remember- you become a parent with choices to make from the time you are pregnant (and hopefully even before conception). Don't be afraid to do what feels right to you, even if that means questioning a doctor.!