cesarean section

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Many of my readers are very familiar with the work that doulas do, some of them are doulas themselves. For those of you who are not familiar, I wanted to say a few things about the role of the doula. Before the advent of technological, hospital birthing, women gave birth at home. They weren’t expected to do this alone, they were typically attended by many women, usually family members, and also a midwife. A woman’s mother, sisters, aunts, grandmother, would all assist the birthing woman in whatever way was needed. Providing emotional support and encouragement, offering water and food, gathering wet washclothes, just being there. As birthing moved into hospitals that role moved to the attending nurse, and family members were not present, including the woman’s partner. Eventually, the husband was allowed to be there for the birth of his child, but as technology advanced, the role of the nurse moved more towared monitoring the machines attached the the laboring mother, and away from a supportive role.

The need for female, non-medical support during labor needed to be filled. The doula is a woman (typically, although there may be a male doula out there that I have yet to meet) who is committed to filling that role. She is a person trained in normal labor progress, as well as the interventions that may or may not be required during the course of labor and delivery. She typically knows the risks and benefits of medical intervention as well as having a “bag of tricks” for helping a labor proceed as best as possible. During a woman’s labor she is able to offer support, encouragement, suggestions for different positions or techniques when labor stalls, or becomes rather difficult, or the laboring woman is feeling discouraged or fearful. The doula also acts as an advocate for the woman, helping her understand any medical interventions that are being offered, and any risks associated with accepting or denying those interventions.

During my own labor with my first daughter, my doula (Jennifer Hampton Head, now a midwife in Oregon) was vital. She came to my home when I felt I needed some support during early labor. She helped me to stay focused on the task and when I became scared of the pain and overwhelmed by the seemingly endless process, she took my hands, and looked me in the eye in a way that told me it was all going to be just fine. She rode with me through my entire labor, and later in the hospital, when medical intervention did become necessary, she helped my husband and I understand our options clearly. All of the decisions we made were well-informed because of her. Even the ultimate decision to have my daughter enter this world via cesarean was made from a place of empowerment, not defeat, because of the amazing support of my doula. My midwife was very instrumental in that as well, and I was fortunate that my doula was allowed to be with us during the c-section. Even more atypical, my midwife was given the honor of bringing my very poorly positioned daughter out of me, thanks to a wonderful Obstetrician. Because of the incredible work my doula did, I know that my cesarean was not one of those unnecessary surgical births, but rather the only option left after attempting every concievable option.

During my second labor, my doula was instrumental in my ability to have an unmedicated vaginal delivery. Her awe at my progress gave me faith in myself to continue, and her whispers of “this is normal, this is what it’s supposed to be like” in my ear during transition got me through. Her suggestions for better pushing positions allowed me to push my daughter out in 30 minutes. Two very contrasting labors and births, but in both instances, a doula was extremely important in both progress of the labors, and also in my perception of myself and my ability to give birth.

Doula’s fill a very important role whether women are birthing in a hospital, in a birth center, or at home. There are plenty of statistics available on the lowered intervention rate when doula’s are present. There are even statistics on shorter labors when a doula is present. Right now I want to put statistics aside and just honor what doula’s are. They are women who are passionate about helping women during quite possibly, the more transformative moment of her life, when she becomes a mother, or a mother again. They are women who understand that a woman’s view of herself and her world will be altered in some way during that process, and they are committed to having that alteration be positive. What we experience during our labors can shape how we feel for the rest of our lives. Doulas know that society as a whole is more healthy when women feel supported during their births and they are there to do it tirelessly.

Thank you to all the doula’s out there. Your work is important and I honor it. May every woman be given the opportunity to birth with a doula.

To learn more:

www.dona.org

www.palsdoulas.org

www.openarmsps.org

 

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Near the end of pregnancy, when the due date begins to loom, most babies will position themselves head down and facing the mother’s back. This is the ideal position for labor and delivery. When a baby is in this position the head descends and puts pressure on the mother’s cervix which helps initiate labor and leads to effective, productive contractions during labor. This position is also ideal for the descent of the baby through the birth canal and out into the world.

While turning head down is the norm, not all babies move into this position on their own. Giving birth to a breech baby who is butt down or feet down is possible, but it carries a higher risk to the baby and mother and most care providers are not willing to do it.

There are two choices in Western medicine when it comes to breech babies. One is to attempt a manual version from the outside. The midwife or OB will use their hands on the outside of the mother’s abdomen to try and turn the baby into the ideal position. This is done with the aid of an ultrasound machine while the heart rate of both baby and mother are monitored closely. It is not without risk and not all practitioners are willing to perform this technique. Some women find it to be painful and opt out of trying it. The second choice, when manual version is not an option, or is undesired, is to schedule a cesarean section.

Chinese medicine offers another option. 

There is a simple technique that can be quite successful if applied correctly and daily within a specific time period.

Moxibustion is applied to the point Zhiyin (BL-67) on both feet for 15 minutes every day.

A practitioner of Chinese Medicine can perform the technique once, showing the woman and a partner how it is done, and then the woman can have it done at home every day for up to 5 days. After 5 days, the pregnant woman should be checked to see if the baby has in fact turned. If not, another 5 days of moxa can be applied.

The ideal week of gestation for applying moxa is week 34, but anywhere between 30 and 38 can be done. If it is applied too early, the baby may turn back into the breech position, while attempting too late may not be successful if the baby doesn’t have enough amniotic fluid or room to make the move.

There have been several studies performed testing the efficacy of this technique. The success rates vary from 60% to 80% success, depending on the study. Most of these studies also conclude that the 34th week of pregnancy is the ideal time to perform moxibustion for turning breech babies.

I have personally seen this technique succeed and feel that it is usually worth trying when cesarean section is the only other option.

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