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Friday, February 22, 2013

Fetal Movement

While you are pregnant, your baby moves a lot! While the baby does sleep quite a bit, they also kick, roll, and move around (sometimes punching kidneys or ribs).

You probably won't feel the fetus move until he or she is about 16 - 22 weeks. Don't worry about how much your baby moves until the third trimester. At that point, you'll want to start paying attention to whether the fetus has decreased movement. To make sure, you can do Kick Counts.


Generally mom's movement will lull baby to sleep, and then when mom is still and trying to relax, baby will wake up and kick up a storm!

Fetal Kick Counts
- paying attention to kick counts generally starts at about 7 months pregnant (28 weeks)
- figure out a time of day when baby seems most active (perhaps after meal times)
- Make sure you relax
- Sometimes babies just need to be woken up a little - try drinking some juice!
- Count at least 10 movements in the span of 2 hours

There might be a different kind of fetal movement as you near your due date, as the baby has less room to move around in there! Just make sure to pay attention to it, and ask your doctor if you're concerned. And follow your instincts!

Decreased fetal movement may be a sign that the baby isn't getting enough oxygen. If, after doing kick counts, you're worried, schedule an appointment to have a non-stress test and a biophysical profile.

Friday, February 15, 2013

Moving Videos

I've seen a few powerful, moving videos in the past week that I'd like to share far and wide. So, for your Weekend Movie viewing pleasure...

This is My Body
or, as Upworthy called it, "These Women Are About to Tell You Some Things That Are Absolutely None of Your Business"


I wish I were as eloquent. Some of these monologues are so amazing!


Same Love


Pay attention to the lyrics, they're really good.


One Billion Rising


One Billion Rising is a worldwide movement to stop violence against women and girls, because 1 in 3 women on the planet will be raped or beaten in her lifetime. It is a celebration of the 15th anniversary of V-Day.

Enjoy!
And let me know what you think!

Friday, February 8, 2013

Optimal Fetal Positioning

In the past year, I've had some clients whose babies were malpositioned, either during pregnancy or (suprise!) during labor.

A baby who isn't positioned exactly right can make labor difficult. Ideally, a baby will be head down, occiput anterior (OA, facing mother's backside), and not get stuck in a left or right position. Not so ideally, a baby could be breech transverse (head up or laying sideways), occiput posterior (OP or 'sunny side up'), left occiput anterior/posterior, right occiput posterior/anterior. Babies can also present face-first or with their hands beside their faces!


Some postulate that our sedentary lifestyles may contribute to a baby becoming malpositioned during pregnancy - we do a lot of reclining! - and suggest trying to avoid this during late pregnancy, if possible. In a Bradley course I once heard some "tricks" to try to get or keep baby head-down: playing music down low so the baby turns toward it, same thing with heat packs, handstands in the pool, and so on.

A baby can turn in pregnancy and labor right up until the last second, especially if you employ some techniques to help the baby along. External version or Webster's Technique are two ways that professionals might try to help a breech baby turn.

Chiropractic care can open up tight abdominal ligaments, which aid in a baby's positioning through your pelvis. Spinningbabies.com is a great resource for moms who are worried about the position of their baby. As long as you don't have blood pressure issues, one can practice the Inversion daily. Prenatal yoga is also a great way to stretch everything out and get stronger at positions that will help you in labor (not to mention help you learn to breathe well for labor!)


Since the goal is often to avoid a Cesarean section or a long, painful labor, many mothers are looking for ways to promote optimal fetal positioning. 

Doulas have a lot of tricks up their sleeves for helping reposition babies who may not be in the most ideal position for birth. Signs during labor that the baby might be mis-aligned include a prolonged active labor (first stage), back labor, or a prolonged pushing stage. Use of a rebozo, the Captain Morgan stance with a lunge, open knee chest position, and the breech tilt are some that I know for repositioning babies during labor.
captain morgan pose

open knee chest
breech tilt



rebozo sifting
Many of these positions work by opening up the pelvis, lifting the baby out of a position he/she might be stuck in so that they are loose and able to move, and allowing for rotation.

Recently, someone suggested that I look into using the Miles Circuit with my doula clients.

It takes 90 minutes to complete and, like many of these techniques, are somewhat difficult and require preparation. It consists of:
1. Knee chest for 30 minutes
2. Exaggerated SIMS (side lying or semi prone with top leg bent at right angle) for 30 minutes
3. Upright movements - can be lunging, movement on a birth ball, climb stairs, for 30 minutes

It seems like this could really work! It already incorporates things that doulas already do - get mom moving, side lying for when she needs rest, and the classic open knee chest to first lift baby out of the pelvis.

Have you ever heard of this?   Used it yourself?


One question that often comes up is whether these things can put the baby in a worse position. Probably not, but just in case, I couldn't actively do something like the Miles Circuit during pregnancy or labor if the baby was already in an optimal position!

Tuesday, February 5, 2013

Short Link Roundup

A News story illustrates how Patriarchy works in Subtle ways
Florida Man Accused of Fraud After Adopting His Wife's Last Name 
"The man says he followed the same process that a woman would follow to change her last name after she got married, but was later told that that process is "only for women" and that he has to go through a much more time-consuming and expensive process if he wants to legally change his name."
The blogger says only nine states have gender-neutral marriage name change laws.


How "Personhood" Strips Mothers of their Fundamental Rights
I really liked this series on Spirt of Ilithyia blog about how "personhood" (the idea that the fetus holds equal or sometimes greater rights than the woman carrying it) issues affect birthing women's rights (not just women who want abortions).
"Stories ranged from forced c-sections to prosecution for homicide for actions a pregnant woman took during her pregnancy to murder charges for miscarriage."


There is a new study out with data on Birth Center births!

Because I'm in public health, I'm really into the data, and what it means for maternity care. 
94% of these women ended up with vaginal births (this c-section rate of 6% compares favorably to the national rate of 27% for low-risk women), and 84% of the total sample gave birth at the birth center. Of the 16% that did not, some were referred to the hospital prior to labor, some during, and some after birth. 
Less than one percent of the study sample transferred to the hospital during labor for emergency reasons. There were no maternal deaths. Rates for infants (0.047% stillbirth and 0.04% death within the first 28 days of birth) are consistent with the results of several previous studies of low-risk women that included births at hospitals, birth centers, and home. 
The “bottom line” is that birth centers offer “high-quality, family-centered care with a Cesarean rate of approximately 6% and a lower than 2% urgent transfer rate (for either mother or baby).
Rebecca Dekker wrote an 8-pg analysis of the study, and here is some additional information I find interesting: 
  • About 75% of the women were white 
  • Women were cared for by certified nurse-midwives (80%), certified professional midwives and licensed midwives (14%), or teams made up of all three types of midwives (6%)
  • 85% were between 18 and 34 years of age
  • The researchers estimated that, in this study, more than $30 million was saved because of the 15,574 women who chose to give birth in birth centers.
What this means is that birth centers provide low-risk pregnant women with safe care at a fraction of the  cost of the hospital, with a C-section rate that is 4 times lower in the same population. 


Shakira had a baby!
I admit, I love Shakira. Various news stories have said that she had a C-section and she is breastfeeding.


In personal news, I turned in my first draft of my thesis, I graduate in 3 months, I'm interviewing with some doula clients and I'm looking for jobs!

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