Songsofheart's Weblog

Giving birth, doctors say it’s just a natural incident, yes indeed it is.

But some times nature of a human body and its function … you could say ‘unpredictable’… one would never know what lies ahead towards the delivery of a baby … each and every pregnancy is different … if an expectant mother faces complications towards the end of her pregnancy … then no matter how much she wants a natural birth she has to go for an alternative.

Before deciding which method you prefer; I say … an expectant mother and her care givers need to know every alternative ways and procedures to save both lives … need to know which one s the best method of all for you because the method one might prefers may not be the best when the time s up.

 

Natural Childbirth

A natural birth (also known as an unmedicated birth) is just that – it is the delivery of a baby without using drugs or surgery during birth. A common phrase heard when talking with people about natural birthing practices is, “birth is a natural process, not a medical procedure.” In today’s society this is definitely a radical concept for most doctors, but it is true nonetheless. You really can have a beautiful, drug-free experience in childbirth even if you have your baby in a hospital. You simply need to know it is possible, you need to find a doctor (or midwife) who will support you in your point of view, and you need some training to help you prepare yourself so you can let nature take its course.

The advantages of a natural childbirth are huge. You learn about all of the advantages when you take a natural childbirth class such as those offered under the Bradley method. Here are the three big advantages:

1. Natural childbirth is much better for the mother. The mother has a completely different experience during birth if she is not drugged – a significantly more fulfilling and beautiful experience. She also feels much more in control of her body and the health of her baby.
2. Natural childbirth is much better for the baby. The baby arrives in an undrugged and therefore much more active and alert state. It is amazing to see videotapes showing the differences between drugged and undrugged babies immediately after birth. Undrugged babies are active and responsive. Drugged babies can barely move.
3. Natural childbirth is much better for the family. When an alert and active (undrugged) baby is placed on the abdomen of an alert and undrugged mother, an amazing thing happens: the baby and mother bond in a significant and real way. The baby will naturally find the breast and begin feeding. The baby will make significant eye contact with the mother and father and respond to them. This simply does not happen when mother and child are drugged, and as a result breastfeeding starts off on a much rockier road.

Make no mistake about it – you cannot have a natural childbirth in today’s society unless you take active steps to make it happen. You and your spouse must decide in your own minds that you want a natural birth. You must find a doctor or midwife who supports that decision. You and your spouse must train for the birth so you know what to expect, how to manage pain and what to do at different stages of the birth. You also need to prepare a birth plan so that you can state your desires about a host of variables including: drugs, fetal monitoring, episiotomies, IVs, birth positions, etc. The first time you look into birth plans, the number of options is bewildering. It is amazing how all of these options actually make sense once you have done the research into the type of birth you want.

There are a number of different ways for you to have a natural birth. Here are the five most common:

• With an “enlightened” doctor at a hospital
• With a midwife at a hospital
• With a midwife at a birthing center
• With a midwife at home
• Unassisted at home

You can look at these options, weigh the risks and benefits, and choose the style that works best for you.

If you are considering a natural childbirth, you should definitely start reading up on the subject, and you should consider taking a Bradley class or similar natural childbirth class

 Very common questions: am I to go through a natural child birth after a C section Birth; I too was not sure until I read this …

Vaginal Birth after Cesarean (VBAC) is becoming more and more common. The once true adage of “Once a cesarean, always a cesarean” has been discarded. Vaginal Birth after Cesarean is what VBAC stands for. It is a vaginal birth after one or more cesareans. More than 80% of women will be able to have a VBAC.

There are many reasons that you may want a vaginal birth after a cesarean. Some may be medical and some may be emotional. Others may be financial or in terms of recovery. Here are some brief lists of the benefits to the mother and baby of a vaginal birth.

Mother:

• Prevention of Death from surgery
• Prevention of lesser complications from surgery
• Prevention of blood loss
• Prevention of infection
• Prevention of injury (bowel, urinary tract, etc.)
• Prevention of blood clots in the legs
• Prevention of feelings of guilt or inadequacy that surgery sometimes causes
• Breastfeeding is generally easier after a vaginal birth
• The cost of a vaginal birth is about $3,000 less

Baby:

• Prevention of Iatrogenic Prematurity (meaning surgery was done, because of an error in guessing a due date)
• Reduction in the cases of Persistent Pulmonary Hypertension
• Labor prepares the baby for extrauterine life
• Prevention of surgery related fetal injuries (lacerations, broken bones)
• VBAC results in fewer fetal deaths than elective repeat cesareans

Rapture of the Uterus: This is a common fear among women who have had a previous cesarean. Most of this fear dates back to when the incisions of the original cesarean were of the classical variety (vertical incisions), nowadays most incisions are the low transverse type. There are two types of uterine rupture: complete and incomplete.

Complete uterine rupture is very unlikely today, for a variety of reasons. One is that when we use Pitocin, if needed, during a labor, we regulate the amount that goes in. In other times it was given IV to a woman and allowed to flow freely. These have also decreased due to some obstetrical practices being abandoned, like high forceps, internal version, etc. And the final reason is because of the rarity of the classical incision. A complete rupture occurs in much less than 1% of women attempting VBAC.

Incomplete rupture occurs about 1-2% of the time. However, usually these women are asymptomatic, and neither mother nor infant require any assistance.

Golan published a study in 1980, where there were 93 ruptures of the uterus. 61 of those ruptures occurred in a normal uterus (never had an incision), and 32 of them had had previous incisions. There were 9 maternal deaths from the ruptures, but they were all from the group that had not had previous cesareans.

 

You may be worried to be pregnant again, and really don’t know where to turn for information or support. You may wonder what you can do to increase your chances of a successful VBAC. There are several things you can do, they are listed below in Preparing for your VBAC. Basically, the same rules of pregnancy apply, eat well, exercise, educate yourself, and develop a good birth team. Take responsibility for your care.

The time has come. Labor has arrived!

What will it hold for you? Many women are very emotional about the labor, and rightly so. Critical times may be the place where you got “stuck” at the last birth, when your water breaks, getting to the hospital, or any other time. Support is critical, turn to those around you. Here are some questions that many women have about laboring with a VBAC.

What if I had a cesarean because my pelvic bones were too small?

Most women do not truly have pelvic bones that are too small, unless you have suffered a pelvic fracture or had polio. Women with a pelvis to small to give birth vaginally are truly few and far between. Many women go ahead to deliver vaginally the next time, and have a bigger baby than the first!

What if the baby is large?

The pelvis and the baby’s head are not rigid structures. Both mold and change shape to allow the birth to occur. There are certain postures that you can assume to help your pelvis expand (For example: Squatting opens the outlet of the pelvis by 10 %.)

The American College of OB/GYNs (ACOG) has stated that the effects of labor, with a baby of more than 4,000 grams (8 3/4 lbs), has not been substantiated. However, in one study, 67% of babies weighing more than 4,000 grams were born vaginally, even when over 50% of these mothers had had previous cesareans for failure to progress.

What if I have had Herpes?

In years past, many women were delivered by cesarean for a history of genital herpes. Doctors did cultures in the last weeks of pregnancy to determine if the infection was active. ACOG has determined and recommended that unless there is a visible lesion at the time of birth, a vaginal birth is acceptable.

What if I have had more than one cesarean?

From the Guide to Effective Care in Pregnancy and Childbirth:“The available data on outcomes after a trial of labour in women who have had more than one previous caesarean section show that the overall vaginal delivery rate is little different from that seen in women who have had only one previous caesarean section.”… and also … “the available evidence does not suggest that a woman who has had more than one previous cesarean section should be treated any differently for the woman who has had only one caesarean section”.

What if the other cesarean was for fetal distress?

True fetal distress is rare, and only a handful of cesareans are done for fetal distress. One study indicates that fetal distress only occurs in 1.5% of all VBAC attempts (Finley, Gibbs), while another showed that of mothers who had a primary cesarean for fetal distress, the second labor had 3% of those mothers with fetal distress (Paul, Phelan, Yeh).

This brings us to fetal monitoring. In a normal, low risk pregnancy, fetal monitoring has not been shown to improve maternal or fetal outcomes, rather it only serves to increase the cesarean rates. Some care providers insist on continuous electronic fetal monitoring for VBAC clients. This is something that you need to research beforehand, and decide if it is something you want and can live with.

 

Who is a candidate for VBAC?

The general guidelines for VBAC are:

• Low transverse incisions on both the abdomen and uterus
• Adequate pelvis (See Above)
• Willingness to prepare for VBAC

Preparing:  

• There are many things that you should do to prepare yourself for a VBAC. Some are mental, emotional, physical and general preparations for your VBAC.
• Information. Get as much of it as you can. Obtain a copy of your medical records from the previous birth(s) for yourself. Ask your current careprovider to explain anything that you don’t understand. Talk to your careprovider, make plans with them (See Birth Plan FAQ). Talk to other people who have been there. Read a lot of books and journals.
• Physically you need to prepare your body. Being in good physical condition can help your labor move more quickly as well as speed healing. Regular exercise and special birth exercises are good ways of doing this.
• For more information on how to prepare yourself, check out the VBAC Checklist

 

 

 

Birth Alternatives:

Can I use a midwife?

You certainly can. As we have discussed before, with a few exceptions, VBAC is actually safer than an elective repeat cesarean. Midwives are trained to detect problems and can refer you to their back-up physician, should you need that type of care.

Can I give birth at a birth center?

Once again, this goes back to you and your careprovider.

Can I still have a homebirth?

This is up to you and your careprovider. Most practitioners of homebirth do not see any reason why you cannot have a homebirth VBAC.

What about medications?

Medication is labor and birth is fairly controversial, even without VBAC. When you are talking pain relief medications, you need to think some things through. Unless you do not want them or have a medical reason for not having them, pain relief medications can be used with a VBAC. However, it is important to use them wisely. We know that epidurals can increase the cesarean rate. You may want to consider delaying medications and using non-pharmacological methods of pain relief as long as you possibly can. Some studies indicate that if you delay an epidural past 5 cms then you lose the risk of increased cesarean.

Narcotics are also sometimes used in labor. While these do not have a direct effect on your chances of cesarean, they do have an effect on your mobility and your mind. Some women feel that their minds were clouded when they used narcotics. Often, once you receive a narcotic you are confined to bed, limiting your mobility, which can hinder labor. There are also effects of these drugs on babies that are much more apparent.

Pitocin, used to induce or speed labor, was once controversial in VBAC births. However, in the American College of OB/GYNs VBAC Guidelines it states that pitocin is safe for use with VBAC births, because the risk of uterine rupture is so small.

 

The Picture shows my father and his siblings, he’s the second from the left; at an occasion where he met with the president of the country.

This Post is a Tribute to my father (1945, Sep 11 – 2009, Feb 08)

 

God took the strength of a mountain, The majesty of a tree,
The warmth of a summer sun, The calm of a quiet sea,
The generous soul of nature, The comforting arm of night,
The wisdom of the ages, The power of the eagle’s flight,
The joy of a morning in spring, The faith of a mustard seed,
The patience of eternity, The depth of a family need,
Then God combined these qualities, When there was nothing more to add,
He knew His masterpiece was complete,
And so, He called it … Dad

~Author Unknown~

 

 

I would never be able to picture his face how it looked like when he held his first born, me.

I’d never truly know how he felt on the first day I took my first steps, the first day I attended school.

But I know a lot about how he’d have felt on different occasions in my life; because I still have vivid memories, of how happy and sad (to leave me) he was on my Wedding day, how ecstatic he was to hold the only grand child he knew.

Did I know my dad well? I knew him well; yet I feel sometimes I didn’t know him quite completely, as he was a person who showed rare emotions, expressed a little.

I loved my father at all times and I still do, even he’s no more (ah now this‘s something I’m still trying to convince my self; that he’s no more) yet I feel I didn’t show enough (hope he knew that I do love him always).

My tears; it has a weight that some times I cannot bare. One would say ‘if you share your pain with others around, you’d be ok’, is it really? I wonder now. A person has one mother and one father; how could one bare the pain of loosing either?

The only possible way to heal myself is to face the reality; the reality of life and death, there’s a story and the story goes like this and it happened in Buddha s time:

 

“Kisagotami, a young woman, was married to the only son of a rich man and they had a male child. The child died when he was two years old. Kisagotami had intense attachment for the child. She clasped the dead child to her bossom, refused to part with it, and went from house to house, to her friends and relatives, asking them to give some medicine to bring the child back to life. A Buddhist monk said to her: “O good girl! I have no medicine. But go to Lord Buddha. He can surely give you a very good medicine. He is an ocean of mercy and love. The child will come back to life. Be not troubled”. She at once ran to Buddha and said, “O venerable sir! Can you give any medicine to this child?”. Buddha replied, “Yes. I will give you a very good medicine. Bring some mustard seed from some house where no child or husband or wife or father or mother or servant had died”. She said, “Very good, sir, I shall bring it in a short time”.

Carrying her dead child in her bossom, Kisagotami went to a house and asked for some mustard seed. The people of the house said, “O lady, here is mustard seed. Take it”. Kisagotami asked, “In your house, has any son or husband or wife, father or mother or servant died ?”. They replied, “O lady! You ask a very strange question. Many have died in our house”. Kisagotami went to another house and asked the same. The owner of the house said, “I have lost my eldest son and my wife”. She went to a third house. People of the house answered, “We have lost our parents”. She went to another house. The lady of the house said, “I lost my husband last year”. Ultimately Kisagotami was not able to find a single house where no one had died. Viveka and Vairagya dawned in her mind. She buried the dead body of her child. She began to reflect seriously on the problem of life and death in this world.

Kisagotami then went to Lord Buddha and prostrated at his lotus feet. Buddha said to her, “O good girl! Have you brought the mustard seed?” Kisagotami answered, “I am not able to find a single house where no one has died”. Then Buddha said, “All the objects of this world are perishable and impermanent. This world is full of miseries, troubles and tribulations. Man or woman is troubled by birth, death, disease, old age and pain. We should gain wisdom from experience. We should not expect for things that do not and will not happen. This expectation leads us to unnecessary misery and suffering. One should obtain Nirvana. Then only all sorrows will come to an end. One will attain immortality and eternal peace”. Kisagotami then became a disciple of Buddha and entered the Order of Nuns”

 

Lord Buddha preached: “We will have to find out the cause of sorrow and the way to escape from it. The desire for sensual enjoyment and clinging to earthly life is the cause of sorrow. If we can eradicate desire, all sorrows and pains will come to an end. We will enjoy Nirvana or eternal peace. Those who follow the Noble Eightfold Path strictly, viz., right opinion, right resolve, right speech, right conduct, right employment, right exertion, right thought and right self-concentration will be free from sorrow. This indeed, O mendicants, is that middle course which the Tathagata has thoroughly comprehended, which produces insight, which produces knowledge, which leads to calmness or serenity, to supernatural knowledge, to perfect Buddhahood, to Nirvana.

“This again, indeed, O mendicants, is the noble truth of suffering. Birth is painful, old age is painful, sickness is painful, association with unloved objects is painful, separation from loved objects is painful, the desire which one does not obtain, this is too painful – in short, the five elements of attachment to existence are painful. The five elements of attachment to earthly existence are form, sensation, perception, components and consciousness.

“This again, indeed, O mendicants, is the truth of the cause of suffering. It is that thirst which leads to renewed existence, connected with joy and passion, finding joy here and there, namely, thirst for sensual pleasure, and the instinctive thirst for existence. This again, indeed, O mendicants, is the noble truth of cessation of suffering, which is the cessation and total absence of desire for that very thirst, its abandonment, surrender, release from it and non-attachment to it. This again, indeed, O mendicants, is the noble truth of the course which leads to the cessation of suffering. This is verily the Noble Eightfold Path, viz., right opinion, etc.”

What am I to do … Just leaving a message, thaaththa I Miss You!