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Why is the C-section rate so high? A podcast interview with the author of Cut It Out

Cut-it-Out-coverWhat are the key factors driving recent record high cesarean section rates in the U.S.?  And what are the consequences for the health of mothers and babies?

In our new podcast interview we spoke with Dr. Theresa Morris, author of Cut It Out: The C-Section Epidemic in America about the reasons behind the current c-section rate, why VBAC is inaccessible for many women, new trends in cesarean birth, and the paradox of the cesarean birth rate.  Dr. Morris also shared her top tips for avoiding a c-section.

You can listen to this podcast using the player below, with Quicktime, or download it from our free iTunes store.

 

Can I use herbs during labor? Yes!

products_birthWe’re pleased to share the following information on herbs for labor and postpartum care, written by Motherlove founder Kathryn Higgins:

Can I use herbs during labor?

Yes, herbs can be very useful during labor and after birth to ease pain, calm emotions, and help speed recovery.  The following herbs have been used by midwives and birthing women.  See our section on plants for photos and more detailed information on several of these herbs.  Many products using these herbs are available through Motherlove.

  • Blue and black cohosh are two herbs that work synergistically to bring on labor (but do not use before the 39th week of pregnancy).  During labor they can make contractions more efficient in a long, stalled labor, and help the uterus clamp down after birth.
  • Raspberry leaf (tea or tincture) is one of the best uterine tonic herbs to prepare uterine muscles for an efficient labor.  Its astringent action slows bleeding and helps to expel the placenta.  Have the tea on hand or make raspberry tea ice cubes to suck on during labor.

Many herbs can help ease the pain of contractions:

  • Take crampbark for uterine cramping during labor, and after birth to eliminate after birth cramping pains.
  • Scullcap and catnip relieve pain, as well as calm and relax the body.
  • Chamomile helps control pain during labor by relieving tension.

Other herbs help with emotional balance during labor:

  • Motherwort is one of the best herbs to give immediate emotional balance during the ups and downs of labor, but it may increase uterine bleeding.
  • Rescue Remedy, a Bach flower remedy, is excellent for bringing one quickly into focus when under stress or shock during a difficult labor.  It can also be put on the baby’s forehead or wrist after a stressful birth.
  • A massage oil, enhanced with herbs, will relax the muscles and ease back labor pain.  Use relaxing, aromatic herbs such as chamomile, rose, and lavender.  Rubbed on the perineum, it helps prevent tearing as the baby crowns and ease swelling and burning.
  • Essential oils in a massage oil or mister can give clarity and focus.  Clary sage gives a sense of well being and combats mental fatigue.  During birth it helps focus breathing and calm anxiety.  Geranium essential oil balances emotions  and works well for perineal massage, as it stimulates circulation.  Lavender is calming and strengthening, relieving depression and irritability, and ideal in any blend for all skin types. Be sure that essential oils are used in a carrier oil or mister and not directly on the skin.
  • After the birth, use a sitz bath to soak the perineum, heal any tears, shrink swelling, and slow bleeding.  It helps the perineum to heal quickly, makes walking more comfortable, and feels so good!  Herbs to use include comfrey, yarrow, uva ursi, witch hazel, shepherds purse, and garlic.
  • Fill a plastic squirt bottle with a strong comfrey tea (or add calendula) to squirt on your perineum as you urinate to lessen any burning and heal tears.
  • Homeopathic arnica pills, taken every few hours for several days after the birth, help reduce bruising and swelling of the perineal tissue.  Be sure you are taking arnica internally only in homeopathic form, as arnica tincture prevents clotting and should not be taken internally.

Writing a family-centered cesarean birth plan

DSCN0342Family-centered cesarean  is an emerging trend in cesarean birth, which sometimes goes by the names “gentle cesarean” or “natural cesarean.”  It’s an effort to make cesarean birth more respectful of families’ emotional and physical needs, and elements of it are catching on in may hospitals.

Whether you’re expecting a planned cesarean or want a back up plan you’re comfortable with, it’s worth exploring how family centered cesarean might fit into your plans.

We recently posted a podcast interview on family-centered cesarean, and thought we’d share some ideas for how to write a birth plan which reflects these ideas.

Below is a sort of menu, with statements you may or may not want to include in your birth plan.  Pick and choose what sounds good to you!

Of course, not all providers and hospitals will be comfortable or even familiar with these modifications to the traditional cesarean birth.  So plan ahead if these things are important to you, and discuss these ideas well in advance of your birth.

Introductory statement:  “I respectfully request the following procedures during my planned cesarean birth/should a cesarean be necessary, assuming that my baby and I are healthy at the time of delivery and are not experiencing any unforseen complications.”

“I would like my (choose more than one if desired) partner/other support person/doula present in the OR during the birth.”

“I would like to have music of my choice playing during the operation (if not an emergency cesarean).”

“I would like my partner/other support person/doula to be able to take pictures and/or video during the birth.”

“I would request that the talk in the operating room among my providers focus primarily on the birth, and not traffic, sports, weekend plans, etc.  Please remember that I can hear what is being said during the birth, and will carry memories of it for many years.”

“I do not want my arms strapped down during the operation.”

“I would like the IV catheter, oximeter, and blood pressure cuff all placed on my (non-dominant) arm to give me a completely free arm to touch my baby.”

“I would like ECG leads to be placed on my back, to make my chest free for skin-to-skin contact.”

“I’d like a non-drowsy, anti-nausea med if possible (i.e. Zofran).”

“I do not want to have the surgical drape form a ‘tent’ over my head, making me feel trapped or isolated from other people and the birth.”

“I would like to use a mirror/have the drape lowered/use a clear surgical drape so that I can see my baby being born.”

“I would appreciate a warm blanket during surgery if possible.”

“I would like you to ask me ‘Are you ready to have your baby now?’ before operating.”

“Please explain the surgery to me as it happens.”

“I would like to have a slow delivery, with the intent of simulating the ‘vaginal squeeze’.”

“I would like for my partner/support person to be the one who announces the sex of the baby, even if I already know what it is.”

“If possible, please keep the umbilical cord long for my partner to cut while baby is in my arms.”

“I would like to see and touch the placenta and cord.”

“If possible I would like the cord to continue pulsing after the birth so that my baby may start breathing on his/her own while still attached to the placenta.”

“I would the baby to go  directly to my chest as quickly as possible.”

“I would like all newborn tests, measurements, and procedures performed with the baby on my chest, not in the warmer.”

“I would like to hold my baby skin-to-skin in the OR.  I may need help to do this.  If I am physically unable to hold my baby with support, I would like my partner/other support person to hold the baby.”

“Please don’t swaddle my baby or put a hat on him/her while he/she is skin-to-skin.  I’d like my baby to be able to move and I’d like to see him/her unobscured.  To keep us warm, once my baby is on my chest you can cover both of us with a warm blanket.”

“I would like to have the opportunity to breastfeed in the OR.  I may need help to do this.  If I am physically unable to hold my baby with support, I would like my partner/other support person to hold the baby.”

“Please do not give me sedatives after the birth. I want to remember my baby’s first day of life.”

“I would like to have minimal separation from my baby.  If the baby and I need to be separated for medical reasons, I would like my partner/other support person/doula to accompany our baby to the nursery.”

“I wish to delay my baby’s first bath until the second day of life so that I can get breastfeeding and bonding off to a good start.”

“I am willing to be up and walking as soon as possible.”

“I would like my catheter out early the morning after surgery.”

“I would like to eat and have the IV removed as soon as possible after surgery.”

Motherlove’s founder: How herbs helped me through three births

3131 31 31Today we’re very happy to share the birth stories of Kathryn Higgins, Motherlove’s founder.  Already an expert in the power of herbs for lifelong health by the time her daughters were born, she used a number of herbs before, during and after her labors.

I decided to have a home birth with my first child.  We lived in the mountains in Colorado, far from a hospital.  When my water broke and I went into labor, my husband and I drove to my midwife’s home in town, where we would be closer to a hospital in case of any unforeseen emergency.  An intense, 30 hour labor, gave me plenty of opportunity to use my pain relieving tinctures of crampbark and scullcap.  But I had only dilated to three centimeters, and it was time to go to the hospital.  Now, hooked up to fetal monitors and pitocin, my cervix still would not dilate. Our first daughter (Silencia Deva) was born by cesarean with her head was tilted back, and the umbilical cord wrapped around her neck three times.  I was told she would have suffocated had she ever entered the birth canal.  I was grateful for the herbs which helped me through a long labor, as well as for the medical expertise that saved our lives.  As soon as I returned home from the hospital, I put mashed comfrey leaves on the cesarean cut and today I happily have no visible scar.

I was confident that I could have a successful vaginal birth with my second child, but my husband was not willing to try a home birth again.  The local hospital had beautiful birthing rooms where I was encouraged to use my herbal tinctures during labor when I needed them.  Soon after the birth of our second daughter, I took crampbark tincture to prevent any afterbirth cramping and slow after birth bleeding. I continued to take this tincture several times a day for three days.

Our second daughter’s (Zenna Serene) heart defect was discovered the day after she was born.  The sitz bath and homeopathic arnica were invaluable to me, as I walked and sat comfortably through three days of tests and many appointments.

I was two weeks overdue in my third pregnancy.  After consulting with my nurse midwife, I took a dose of  blue cohosh tincture.  Six hours later I went into labor.  When we arrived at the hospital, once again I was only dilated to three centimeters.  But in less than an hour of soaking in a warm tub, with my oldest daughter pushing the pressure points on my lower back, I was ready to push.  The birth of our third daughter (Jasmin Jencine) went very quickly.  I walked and squatted as we waited for the placenta to expel. But unknown to us at this time, the placenta had adhered to the uterine wall at my previous cesarean scar, and I was hemorrhaging internally. The warm blood came gushing out as the doctor on call prepared to do an emergency hysterectomy.  My husband squeezed a dropperful of fresh shepherds purse tincture into my mouth.  Almost instantly the bleeding “miraculously” stopped, and an incredulous doctor removed the placenta with a D&C, instead of the planned hysterectomy.

So remember to call on herbs to help you, as they did me, minimize the pain, promote rapid healing after the birth, and reduce the need for any unnecessary drug intervention, as you go through this joyous time of transformation.

Preparing for a VBAC

Preventing and treating hemorrhoids during pregnancyConsidering or committed to having a hospital VBAC birth?

If so, you might be wondering how to prepare, both logistically and emotionally, to give yourself the best odds of having the outcome you want.  The VBAC rate has fallen dramatically in recent years, making preparation and planning very important.

So we assembled this list of steps you can take in preparing for a VBAC.  Consider it a starting point, and feel free to add to it in the comments!

Choose providers carefully, and don’t be afraid to shop around.  Probably the most important decision you’ll need to make is your choice of provider.  Obstetrical and midwifery practices can have widely varying VBAC success rates, so it’s important to shop around.  This might lead you to change providers, which you can do even in the final weeks of pregnancy.  You may feel uncomfortable switching practices or shopping around, but a provider’s VBAC history is the factor most likely to determine a birth outcome.  Concerned about having to drive a little longer to get to the hospital?  One mom we know puts it this way:  Would you drive an extra 15 minutes to get to a good hairdresser?  (And in a true emergency you’ll end up at the closest hospital anyway).

How should you judge the best place for a trial of labor?  Look at the practices’ VBAC rates, including the number of women who have had a trial of labor and the percentage of those labors which ended in VBACs.  If this isn’t available online, call and ask the practice for their rates in the last year or two.  If they are unwilling to share this, consider that important information.  Also check the hospital’s rates, which are more likely available online, but understand that most hospitals host several practices, so this number is a combination of the practices’ rates.  When interviewing providers, try to learn as much as possible about practices’ VBAC policies:  How long can you go “post dates” and still try for a VBAC?  What kind of monitoring do they do?  Can you labor in water?  If you end up with a CBAC, can your doula be present in the operating room?  What do they think makes someone a “good candidate” for a trial of labor?  In your search, remember that, while there are many wonderful obstetricians, certified nurse midwives in general have lower cesarean rates.

An important tool in researching your options is the International Cesarean Awareness Network (ICAN) website’s VBAC policy database.  ICAN members contacted every maternity hospital in the U.S. to determine which had bans on VBAC – both outright and “de facto” (those without an official policy but in which no practice would attend a VBAC) – and found that roughly half of all hospitals do not allow a trial of labor.  So you may want to begin here in your research.

Hire a doula.  Labors with the trained support of a doula are less likely to send in cesarean births, so be sure to have a doula or other trained labor support person present.  When looking for a doula, try to find one who has experience with VBAC labors and who is knowledgeable about providers’ VBAC practices and policies.  If you can’t afford one, see our post on ways of finding good labor support when a doula isn’t in the budget.

Get peer support from other mothers who are in your position.  Even when mothers get great support from their providers and partners, it can be isolating to try for a VBAC and it’s often very powerful to have peer support from people who understand how you feel.  ICAN is one such organization, and you can find a group here.    If there isn’t a group near you, you can find support in their closed Facebook page, and the forums of a number of other websites.  You may also want to read VBAC birth stories, and there are many on the ICAN website.

Learn non-medication based methods of reducing discomfort in labor.  As with birth generally, the longer you can relieve pain without using medication during a trial of labor, the better your chances of having a vaginal birth.  That’s because medication-based means of pain relief often trigger a “cascade of interventions” which leads to a cesarean.  So learn about ways of relieving pain, such as movement, deep relaxation, partner massage, visualization, breathing, water, and others.  Of course, it’s definitely possible to have a VBAC with medication, so if your labor ends up going in that direction all is not lost!

Learn about fetal positioning.  If your cesarean birth was due at least in part to fetal positioning (having a posterior or “sunnyside up” baby), learn more about that topic and choose providers (including doulas) who are skilled at helping babies settle into optimal position for vaginal birth, including during labor.  The Spinning Babies website and chiropractic care from someone trained in Webster’s Technique can be helpful.  Be sure to listen to our podcast on posterior babies and what can be done to change their positions, including the “belly lift” and “sifting” with a rebozo.

Prepare for the possibility of another cesarean birth.  Even moms who are completely focused on having a VBAC need to have a back-up plan they’re comfortable with.  Explore the possibility of family-centered cesarean, which may include options such as doing skin-to-skin and/or breastfeeding in the operating room, having your arms free to touch the baby, a slower birth through the incision, lowering the drape so you can see the baby being born (if you want), and other less frequently used practices.  Meet with the obstetrician who would be performing the cesarean to work out your backup plan.  And you may want to listen to our podcast on family-centered cesarean.

Work on processing past experience.  If the prior cesarean was traumatic and strong feelings are affecting emotional preparation for your next birth, do the hard work of processing it.  EMDR and other therapies can be very useful for this.  Discuss your prior experience with your providers and briefly explain it in your birth plan.  Other emotional preparation, such as visualizing a repeat cesarean or peering into the OR, may be useful.  You may also want to read our post on getting help for traumatic birth experiences or listen to our podcast on traumatic birth.

Stay active.  Exercising reduces your risk of gestational diabetes and having a large baby, both of which can affect your chances of having a VBAC.  You’ll also be in better shape for the workout that is labor and birth.

Finally, you may want to listen to Motherlove’s podcast on VBAC – an interview with he president of ICAN.

U.S. maternity leave policy and its effect on families: A podcast interview with Moms Rising

Businesswoman Holding a BabyDid you know that the U.S. is one of only a handful of countries that does not offer new mothers paid family leave?   The other countries:  Papua New Guinea, Lesotho, and Swaziland.

In this podcast interview we spoke with Charlie Rose, associate campaign director for MomsRising.org, a national organization with over a million members advocating for family economic security.

Charlie spoke about how few moms have paid parental leave, how much leave moms actually take, the health and economic costs of our current policy, how current policy affects the role of partners, and what Moms Rising is doing to advocate for better policies.

You can listen to this podcast with the player below, listen with Quicktime, or download the podcast from our free iTunes store.

Family-Centered Cesarean: A podcast interview with Robin Elise Weiss

Newborn baby girlHave you heard about a new trend in cesarean birth?  It goes by a number of different names:  family centered cesarean, natural cesarean, gentle cesarean.

Whatever you call it, if you’re pregnant and want a more satisfying cesarean experience should one be necessary, you’ll want to learn more about it.

In this podcast interview we talked with Robin Elise Weiss, author, childbirth and postpartum educator, certified doula, doula trainer, and lactation counselor.  Robin is the Pregnancy and Childbirth expert on About.com and is the author of numerous books, including The About.com Guides to Having a Baby and Baby Care, The Everything New Mother’s guides to The First Year, Pregnancy Fitness, and Getting Pregnant.

We discussed what a family-centered cesarean looks like, what it means to moms and for birth outcomes, how moms can advocate for a family-centered cesarean, and whether this new trend will harm efforts to reduce the historic high cesarean rates of recent years.

You can listen to this interview using the player below, listen with Quicktime, or download it from our free iTunes store.

Podcast: Birth and breastfeeding in prison

Prison-Birth-Project85% of women in prison are mothers, and the same percentage of women in prison are pregnant as on the outside.

What is birth like for them?  How long do they have with their babies before they’re separated?  Why do some birth in shackles?  And is it possible for incarcerated mothers to breastfeed?

To answer these questions we spoke with Marianne Bullock, co-founder of The Prison Birth Project, a non profit organization providing support, education, advocacy, and activism training to women at the intersection of the criminal justice system and motherhood.

You can listen to this podcast using the player below, through Quicktime, or download it from our free iTunes store.

Trauma from childbirth? Listen to our podcast interview.

iStock_000000105626XSmallDid you have intrusive thoughts about your birth?  Flashbacks?  Do you steer clear of hospitals, or try to avoid talking about your birth?

We’re very happy to share a podcast interview on trauma from childbirth, with Dr. Kathleen Kendall-Tackett, health psychologist and trauma expert.

Dr. Kendall-Tackett is health psychologist, and Clinical Associate Professor of Pediatrics.  She is president-elect of the Trauma Division of the American Psychological Association, and the incoming editor-in-chief of the Journal of Psychological Trauma.  She has authored more than 300 articles and 24 books on maternal depression, trauma, family violence and breastfeeding, including Depression in New Mothers and Breastfeeding Made Simple.

Dr. Kendall-Tackett discussed what trauma looks like, what experiences tend to cause trauma, partners and trauma, strategies for healing from trauma, ideas for preparing for a subsequent birth, and post-traumatic growth.  She also discusses the relationship between trauma and breastfeeding, and answers your questions submitted on Facebook.

You can listen with the player below, listen with Quicktime, or download this podcast from our free iTunes store!

 

 

 

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We’ve got a salve for that!

ML_products_RGBItchy skin?  Stretch marks?  Eczema?  Diaper rash or thrush?  Sore nipples?  Hemorrhoids?  Chapped lips?  Bug bites?  New tattoo?

We’ve got a salve for that!

Motherlove’s line of protective and soothing herbal salves provides natural and effective relief to get you through many skin problems:

Motherlove’s Pregnant Belly Salve is an all natural way to prevent and soothe stretch marks.  Certified organic herbs added to a scar-healing base of shea butter do wonders to prevent, soothe, and minimize stretch marks.  You can use our Pregnant Belly Salve on dry heels, elbows, your c-section scar, even chapped lips.  The stars of this salve are marshmallow, which softens skin and soothes skin irritations; rosehips, which helps prevent scarring and hydrates the skin; calendula, an an all purpose skin healing herb; and chamomile, an anti-inflammatory herb which softens skin.

USDA_Organic_LogoMotherlove’s Green Salve is all-purpose, multi-tasking soother and healer.  This organic, all natural salve is the perfect remedy for rashes, and chapped or irritated skin, including eczema.  In winter it’s great for dry, chapped skin; in summer it’s great for taking the itch out of bug bites, bee stings, and poison ivy.  Green Salve contains extra virgin olive oil, beeswax, plantain herb, comfrey herb, marshmallow root, and calendula flower.  Plantain herb is known as “nature’s band aid” because it is excellent for healing wounds and drawing out toxins.   Comfrey herb is nicknamed “knitbone,” as it quickly heals wounds and prevents scarring.  Marshmallow and calendula soothe, heal, and soften skin.

USDA_Organic_LogoMotherlove’s Nipple Cream is made with all certified organic ingredients which heal and soothe sore, cracked nursing nipples.  Motherlove’s Nipple Cream contains extra virgin olive oil, beeswax, shea butter, marshmallow root, calendula.  All ingredients are safe for ingestion, so it does not need to be washed off prior to nursing.  Have leftover Nipple Cream?  Here are 13 more ways to use our Nipple Cream including using it on chapped lips, dry elbows, and even to tame frizzy hair!

oregon tilthMotherlove’s Diaper Rash & Thrush is an all-natural salve made with certified organic ingredients for persistent, inflamed diaper rash.  It contains healing herbs oregon grape root to clear up skin conditions, yarrow to soothe rashes, myrrh to fight bacteria and yeast overgrowth, and calendula to soothe skin.  If you’ve been treating diaper rash unsuccessfully with other products, your baby may have a yeast infection which requires a product with antifungal properties.  Our Diaper Rash & Thrush salve is diaper safe and compatible with all diapers including cloth.  This salve can also be used on nursing nipples, and does not need to be washed off nipples prior to nursing.

USDA_Organic_LogoMotherlove’s Tattoo Care is a certified organic salve which provides optimal moisturizing and healing properties for a new tattoo, yet retains a consistency that is comfortable to apply while tattooing or to a fresh tattoo.  Unlike petroleum-based products, Motherlove Tattoo Care allows the skin to breathe, and allows ink to fully penetrate the skin.  Made with calendula flowers and marshmallow root, infused in extra virgin olive oil, beeswax, and shea butter, it keeps pores from getting clogged and promotes a quicker healing time.

USDA_Organic_LogoMotherlove’s Rhoid Balm is a certified organic balm which provides immediate relief for inflamed tissues.  It contains a soothing combination of herbs including witch hazel, recommended by moms and doctors alike to reduce swelling, slow bleeding, and ease the discomfort of hemorrhoids

And of course, all of our salves have a zero rating (the cleanest rating) by EWG’s Skin Deep Cosmetic Saftey Database.  They’re free of body care ingredients to avoid.

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