“Doula Unto Others…”

Posted on 23 October, 2013 by Judith Halek

Yoga

This is Judith Elaine Halek’s response to:
“Doula unto others – Forget the trendy labor coaches and
midwives – give me doctors and drugs,” an article written
by Martha Brockenbrough at Women Central.
The original article has since been removed from the web.

Martha:

Tribal conditioning has been a powerful imprint for you. It’s obvious you have been indoctrinated into the medical model mentality from utero.

I can’t tell you how many times in the past 14 years I have walked into a hospital and found pubic hair in the showers, (someone’s other than the woman I am with), dried blood under the beds, dry, caked, diarrhea under the toilet lid…sterile? Hairy back seats of cars? I would rather birth my baby in an environment and bacteria my body was USE TO being around.

“..back in the days when hospitals treated pregnancy and childbirth like a disease.”

What century are you living in? THEY STILL TREAT pregnancy and childbirth like a disease!!! As one of the largest industrial nations on this planet, we have one of the HIGHEST c-section rates, 31.5% in the world. This is because women are allowing the “medical experts” to tell them whether their bodies WORK or not.

That’s why so many hospitals have created comfortable birthing rooms (I refuse to call them suites) that simulate a homey environment. Just because a hospital rooms had facelifts…it doesn’t mean there is inner beauty. If the medical model philosophy of “delivering” vs. “birthing,” “drugs” vs. “alternatives such as: water, trust or assistance,” then it doesn’t matter what the room looks like, the treatment will continue to be the same.

“…mother who charges money for their services.”

I am a certified hypnotherapist, childbirth educator, certified labor support specialist, certified bodyworker, herbologist and nutritionist.

As an editor of the world’s third largest web site on waterbirth and labor support doula’s, I must say, like the television program “ER,” your lack of research reflects ‘pontification journalism’ as opposed to ‘legitimate, journalism that indicates intelligence and integrity.

My advice to someone who has such an overt disdain for ANYTHING on the level you do with Doulas is, if you haven’t experienced it, don’t knock it…you speak with false authority on the subject other than your own opinion which for me, as stated above lacks credibility.

In favor of respecting choice that is well informed.

Judith Halek
Director of Birth Balance
NYC, NY

Hospital Comparisons- Manhattan

Posted on 7 August, 2013 by Judith Halek

This information came from the website: http://www.health.ny.gov/statistics/facilities/hospital/maternity/new_york.htm

Thank you so much for putting this together for the community. To see about Bronx, Brooklyn, Nassau, Queens, Staten Island or Suffolk, go to the website mentioned above.

New York County Hospitals Maternity Information

Select a Hospital

Pica: Chalk Craving in Pregnant Women

Posted on 30 June, 2013 by Judith Halek

~ pica2 pica-31 pica-1 ~

When a woman, pregnant or NOT desires or craves chalk, for taste or the sensation of crunching, there is an iron deficiency in the woman and she is anemic (more tired, need energy building foods). Once she gets the iron balanced in her system, she will NO LONGER have the craving for the chalk.

When one supplement’s their diet with iron pills, it is important to take the iron pills with something acidic, like orange juice, BECAUSE it helps to ENHANCE the absorption of iron in your body.

rolaids1 When one takes rolaids, it is COUNTER PRODUCTIVE to the absorption of the iron in the body. Rolaids is an ANTACID, (not acidic) and you NEED acid to absorb the iron in your body. So, you are just canceling out the iron supplement each time a rolaid is taken. It doesn’t matter if one takes one or ten…IT IS NOT GOOD! Research shows if a pregnant woman has to choose between chalk and rolaids, the more favorable choice is the chalk. It doesn’t have the antacid element to it. STOP rolaids immediately if your doctor has suggested this as a solution away from the chalk.

Eating iron rich foods is imperative. If one needs to find foods that will satisfy a need to CRUNCH try something like ALMONDS or other kinds of seeds or nuts rich in iron. Leafy green veggies are high in iron and so are dried apricots which are ALSO high in Vitamin C, (an acidic source).

_____________________________________

Floradix is a liquid formula that will help to enhance the iron absorbtion in one’s body when eating iron rich foods.

Floradix Formula Iron (250mL) Brand: Flora

http://www.amazon.com/Floradix-Formula-Iron-250mLBrand/dp/B0002DUFKU/ref=sr_1_3?ie=UTF8&s=hpc&qid=1254578184&sr=8-3

Uses: Energy, Anemia etc. The absorption rate of Floradix (liquid iron gluconate) is twenty-five per cent compared solid iron tablets that have an absorption rate of two to ten per cent. Floradix provides maximum absorption by using the most highly absorbable form of iron, iron gluconate. Floradix also contains B vitamins and vitamin C to enhance absorption, herbal extracts to increase digestion, and fruit juices to ensure proper stomach acidity. A twenty milligram dose of Floradix satisfies the Recommended Daily Allowance (RDA) of fifteen milligrams of iron for women of child-bearing age.

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Homeopathic remedies to help get your minerals balanced in one’s body are:

1. Ferrous Phosphate: 6X or 12X strength, take 1-4 times per day, 4 pellets. This very useful cell salt is known as the “oxygen carrier”. It has the ability to carry oxygen to all the cells of the body for use in conversion to energy.

2, Bio-chemic Tissue Salts: take 5/6 of these COMBINATION 3-4X’s per day.

The 12 Tissue/Cell Salt Combination As the name implies, this is a combination of all 12 salts in a single tablet. This combination can be used daily in much the same way as you would take a vitamin or supplement. To treat specific conditions, however, select one of the single salts listed above. RECOMMENDED POTENCY – 6X is the most widely used potency. These are all the different MINERALS combined into the 12 Tissue/Cell Salts.Calcarea Fluoricum Calcarea Phosphoricum Calcarea Sulphuricum Ferrum Phosphoricum Kali Muriaticum Kali Phosphoricum Kali Sulphuricum Magnesia Phosphoricum Natrum Muriaticum Natrum Phosphoricum Natrum Sulphuricum Silicea (Silica)

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How Much Iron?
The recommendation increases to 27 mg for pregnant women.

http://www.healthcastle.com/iron.shtml
Iron Rich Foods containing Heme Iron (Iron found in animal protein):
Excellent Sources               Good Sources
Clams                                       Beef
Pork Liver                                Shrimp
Oysters                                     Sardines
Chicken Liver                           Turkey
Mussels
Beef Liver

Excellent and Good Sources of Iron Rich Foods containing Non-Heme Iron:

Enriched breakfast cereals
Canned beans
Cooked beans and lentils
Baked potato with skin
Pumpkin seeds
Enriched pasta
Blackstrap Molasses
Canned asparagus

Warning: Pregnant women should not eat liver because of its very high Vitamin A content. Large amounts of Vitamin A can be harmful to the baby.

The absorption of Non-heme iron can be improved when a source of heme iron is consumed in the same meal. In addition, the iron absorption-enhancing foods can also increase the absorption of non-heme iron. While some food items can enhance iron absorption, some can inhibit or interfere iron absorption. Avoid eating them with the iron-rich foods to maximize iron absorption.

Iron Absorption Enhancers (GOOD to eat)
Meat/fish/poultry
Fruits: Orange, Orange Juice, cantaloupe, strawberries, grapefruit etc
Vegetables: Broccoli, brussels sprouts, tomato, tomato juice, potato, green & red peppers
White wine

Iron Absorption Inhibitors (BAD to eat)
Red Wine, Coffee & Tea
Vegetables: Spinach, chard, beet greens, rhubarb and sweet potato
Whole grains and bran
Soy products

Is Spinach a good source of Iron? Written by Gloria Tsang, RD Published in May 2006 (HealthCastle.com)

Spinach and Iron has been a highly discussed topic in our free nutrition forum. Many readers know that spinach is a source of iron. However they are confused that spinach is said to contain an iron absorption inhibitor as mentioned in our Iron Rich Foods article.

Spinach – a source of Iron
Spinach is a source of non-heme iron, which is usually found in vegetable sources. Unlike heme iron found in animal products, non-heme iron is not as bioavailable to the body.

According to the USDA National Nutrient Database, one cup of cooked spinach provides ~3.5mg of iron whereas a cup of raw spinach only contains 1 mg of iron.

Spinach – also inhibits (stops) iron absorption.
Spinach also contains oxalic acid (sometimes referred as oxalate). Oxalic acid binds with iron, hence inhibiting its absorption.

Spinach is not the only food containing high levels of oxalic acid. Whole grains such as buckwheat and amaranth, other vegetables such as chard and rhubarb, as well as beans and nuts all contain significant levels of oxalic acid.

So Should you or Should you not eat Spinach?
You do not need to give it up if you are a spinach lover! Simply eat spinach with any foods containing iron absorption enhancers. Here are some examples:

Iron Absorption Enhancers (Good to eat)
Meat, fish, or poultry
Fruits: Orange, Orange Juice, cantaloupe, strawberries, grapefruit and other Vitamin-C rich fruits
Vegetables: Broccoli, brussels sprouts, tomato, tomato juice, potato, green & red peppers
White wine

Pelvic Bone Commentary

Posted on 30 June, 2013 by Judith Halek

~ pelvis3-150x150 pelvis_birth-150x150 pelvis4-150x150 ~

Pelvises I Have Known and Loved – by Gloria Lemay (Midwife)

(© 2003 Midwifery Today, Inc. All rights reserved. If you enjoyed this article, you’ll enjoy Midwifery Today magazine! Subscribe now! [Editor’s note: This article first appeared in Midwifery Today Issue 50, Summer 1999 and is also available online in Spanish.])

What if there were no pelvis? What if it were as insignificant to how a child is born as how big the nose is on the mother’s face? After twenty years of watching birth, this is what I have come to. Pelvises open at three stretch points—the symphisis pubis and the two sacroiliac joints. These points are full of relaxin hormones—the pelvis literally begins falling apart at about thirty-four weeks of pregnancy. In addition to this mobile, loose, stretchy pelvis, nature has given human beings the added bonus of having a moldable, pliable, shrinkable baby head. Like a steamer tray for a cooking pot has folding plates that adjust it to any size pot, so do these four overlapping plates that form the infant’s skull adjust to fit the mother’s body.

Every woman who is alive today is the result of millions of years of natural selection. Today’s women are the end result of evolution. We are the ones with the bones that made it all the way here. With the exception of those born in the last thirty years, we almost all go back through our maternal lineage generation after generation having smooth, normal vaginal births. Prior to thirty years ago, major problems in large groups were always attributable to maternal malnutrition (starvation) or sepsis in hospitals.

Twenty years ago, physicians were known to tell women that the reason they had a cesarean was that the child’s head was just too big for the size of the pelvis. The trouble began when these same women would stay at home for their next child’s birth and give birth to a bigger baby through that same pelvis. This became very embarrassing, and it curtailed this reason being put forward for doing cesareans. What replaced this reason was the post-cesarean statement: “Well, it’s a good thing we did the cesarean because the cord was twice around the baby’s neck.” This is what I’ve heard a lot of in the past ten years. Doctors must come up with a very good reason for every operation because the family will have such a dreadful time with the new baby and mother when they get home that, without a convincing reason, the fathers would be on the warpath. Just imagine if the doctor said honestly, “Well, Joe, this was one of those times when we jumped the gun—there was actually not a thing wrong with either your baby or your wife. I’m sorry she’ll have a six week recovery to go through for nothing.” We do know that at least 15 percent of cesareans are unnecessary but the parents are never told. There is a conspiracy among hospital staff to keep this information from families for obvious reasons.

In a similar vein, I find it interesting that in 1999, doctors now advocate discontinuing the use of the electronic fetal monitor. This is something natural birth advocates have campaigned hard for and have not been able to accomplish in the past twenty years. The natural-types were concerned about possible harm to the baby from the Doppler ultrasound radiation as well as discomfort for the mother from the two tight belts around her belly. Now in l999, the doctors have joined the campaign to rid maternity wards of these expensive pieces of technology. Why, you ask? Because it has just dawned on the doctors that the very strip of paper recording fetal heart tones that they thought proved how careful and conscientious they were, and which they thought was their protection, has actually been their worst enemy in a court of law. A good lawyer can take any piece of “evidence” and find an expert to interpret it to his own ends. After a baby dies or is damaged, the hindsight people come in and go over these strips, and the doctors are left with huge legal settlements to make. What the literature indicates now is that when a nurse with a stethoscope listens to the “real” heartbeat through a fetoscope (not the bounced back and recorded beat shown on a monitor read-out) the cesarean rate goes down by 50 percent with no adverse effects on fetal mortality rates.

pelvis5 Of course, I am in favour of the abolition of electronic fetal monitoring but it would be far more uplifting if this was being done for some sort of health improvement and not just more ways to cover butt in court.

Now let’s get back to pelvises I have known and loved. When I was a keen beginner midwife, I took many workshops in which I measured pelvises of my classmates. Bi-spinous diameters, sacral promontories, narrow arches—all very important and serious. Gynecoid, android, anthropoid and the dreaded platypelloid all had to be measured, assessed and agonized over. I worried that babies would get “hung up” on spikes and bone spurs that could, according to the folklore, appear out of nowhere. Then one day I heard the head of obstetrics at our local hospital say, “The best pelvimeter is the baby’s head.” In other words, a head passing through the pelvis would tell you more about the size of it than all the calipers and X-rays in the world. He did not advocate taking pelvic measurements at all. Of course, doing pelvimetry in early pregnancy before the hormones have started relaxing the pelvis is ridiculous.

pelvis11 One of the midwife “tricks” that we were taught was to ask the mother’s shoe size. If the mother wore size five or more shoes, the theory went that her pelvis would be ample. Well, 98 percent of women take over size five shoes so this was a good theory that gave me confidence in women’s bodies for a number of years. Then I had a client who came to me at eight months pregnant seeking a home waterbirth. She had, up till that time, been under the care of a hospital nurse-midwifery practise. She was Greek and loved doing gymnastics. Her eighteen-year-old body glowed with good health, and I felt lucky to have her in my practise until I asked the shoe size question. She took size two shoes. She had to buy her shoes in Chinatown to get them small enough—oh dear. I thought briefly of refreshing my rusting pelvimetry skills, but then I reconsidered. I would not lay this small pelvis trip on her. I would be vigilant at her birth and act if the birth seemed obstructed in an unusual way, but I would not make it a self-fulfilling prophecy. She gave birth to a seven-pound girl and only pushed about twelve times. She gave birth in a water tub sitting on the lap of her young lover and the scene reminded me of “Blue Lagoon” with Brooke Shields—it was so sexy. So that pelvis ended the shoe size theory forever.

Another pelvis that came my way a few years ago stands out in my mind. This young woman had had a cesarean for her first childbirth experience. She had been induced, and it sounded like the usual cascade of interventions. When she was being stitched up after the surgery her husband said to her, “Never mind, Carol, next baby you can have vaginally.” The surgeon made the comment back to him, “Not unless she has a two pound baby.” When I met her she was having mild, early birth sensations. Her doula had called me to consult on her birth. She really had a strangely shaped body. She was only about five feet, one inch tall, and most of that was legs. Her pregnant belly looked huge because it just went forward—she had very little space between the crest of her hip and her rib cage. Luckily her own mother was present in the house when I first arrived there. I took her into the kitchen and asked her about her own birth experiences. She had had her first baby vaginally. With her second, there had been a malpresentation and she had undergone a cesarean. Since the grandmother had the same body-type as her daughter, I was heartened by the fact that at least she had had one baby vaginally. Again, this woman dilated in the water tub. It was a planned hospital birth, so at advanced dilation they moved to the hospital. She was pushing when she got there and proceeded to birth a seven-pound girl. She used a squatting bar and was thrilled with her completely spontaneous birth experience. I asked her to write to the surgeon who had made the remark that she couldn’t birth a baby over two pounds and let him know that this unscientific, unkind remark had caused her much unneeded worry.

Another group of pelvises that inspire me are those of the pygmy women of Africa. I have an article in my files by an anthropologist who reports that these women have a height of four feet, on average. The average weight of their infants is eight pounds! In relative terms, this is like a woman five feet six giving birth to a fourteen-pound baby. The custom in their villages is that the woman stays alone in her hut for birth until her membranes rupture. At that time, she strolls through the village and finds her midwives. The midwives and the woman hold hands and sing as they walk down to the river. At the edge of the river is a flat, well-worn rock on which all the babies are born. The two midwives squat at the mother’s side while she pushes her baby out. One midwife scoops up river water to splash on the newborn to stimulate the first breath. After the placenta is birthed the other midwife finds a narrow place in the cord and chews it to separate the infant. Then, the three walk back to join the people. This article has been a teaching and inspiration for me.

pelvis21

That’s the bottom line on pelvises—they don’t exist in real midwifery. Any baby can slide through any pelvis with a powerful uterus pistoning down on him/her.

Gloria Lemay is a private birth attendant in Vancouver, B.C., Canada.

Maternity Mortality In USA

Posted on 30 June, 2013 by Judith Halek

Maternal Mortality in the USA

A Fact Sheet

• The World Health Organization reported in 2007 that 40 other countries have lower maternal death rates than the United States.

• The Centers for Disease Control (CDC) report that there has been no improvement in the maternal death rate in the United States since 1982.

• The CDC estimated in 1998 that the US maternal death rate is actually 1.3 to three times that reported in vital statistics records because of underreporting of such deaths. (1)

• The CDC reported in 1995 that the “magnitude of the pregnancy-related mortality problem is grossly understated.” (2)

• The rate of maternal death directly related to pregnancy or birth appears to be rising in the United States. In 1982, the rate was approximately 7.5 deaths per 100,000 live births. By 2004, that rate had risen to 13.1 deaths per 100,000 births. By 2005, the rate was 15.1 deaths.

• The CDC estimates that more than half of the reported maternal deaths in the United States could have been prevented by early diagnosis and treatment. (1)

• Autopsies should be performed on all women of childbearing age who die if there is to be complete ascertainment of maternal deaths.

• Numerous studies have found that in 25 to 40 percent of cases in which an autopsy is done, it reveals an undiagnosed cause of death.

• In the 1960s, autopsies were performed on almost half of deaths.

• The United States now does autopsies on fewer than 5 percent of hospital deaths.

• Reporting of maternal deaths in the United States is done via an honor system. There are no statutes providing for penalties for misreporting or failing to report maternal deaths.

• In the United States, the risk of maternal death among black women is about 4 times higher than among white women. For 2005, the rate was 36.5 deaths per 100,000 live births.

• Most countries with lower maternal death rates than the United States use a different definition of “maternal death”, which, unlike the United States’ definition, includes those deaths directly related to pregnancy or birth which take place during the period between six weeks postpartum and one year after the end of pregnancy.

• Complete and correct ascertainment of all maternal deaths is key to preventing maternal deaths.

• The Confidential Enquiry into Maternal Deaths in the United Kingdom (England, Scotland, Wales, Northern Ireland), which has functioned since 1952, is the system believed to have achieved the most complete ascertainment of maternal deaths while guaranteeing utmost confidentiality. See www.cemach.org.uk

• The maternal mortality rate for cesarean section is four times higher than for vaginal birth and is still twice as high when it is a routine repeat cesarean section without any emergency. (3,4)

• There is currently no federal legislation mandating maternal mortality review at a state level.

• Fewer than half of the states conduct state-wide maternal mortality review.

• Hospitals do not release reports of maternal deaths to the public; hospital employees are required to keep such information to themselves.

• The Healthy People 2010 Goal is no more than 3.3 maternal deaths per 100,000 births. This is a goal that other nations have achieved.

Notes

1. Morbidity and Mortality Weekly Report, September 4, 1998, Vol. 47, No. 34.

2. Atrash HK, Alexander S, Berg CJ. Maternal mortality in developed countries: Not just a concern of the past. Obstet Gynecol 1995;86:700-5.

3. Petitti D et al. In hospital maternal mortality in the United States. Obstet Gynecol, Vol 59, pp. 6-11, 1982.

4. Petitti D. Maternal mortality and morbidity in cesarean section. Clin Obstet Gynecol,Vol. 28, pp. 763-768, 1985.

5. The Confidential Enquiry into Maternal Deaths in the United Kingdom, www.cemach.org.uk

Prepared by Ina May Gaskin, MA, CPM, Coordinator for the Safe Motherhood Quilt Project, 149 Apple Orchard Lane, Summertown, TN 38483, www.rememberthemothers.net, www.inamay.com

Conscious Parenting

Posted on 14 June, 2013 by Judith Halek

~ “The children desire freedom! And every particle of their being from their Source says, ‘You are free. You are so free, that every thought you offer, the entire Universe jumps to respond to it.’ And so, to take that kind of knowledge and try to confine it in any way, defies the Laws of the Universe. You must allow your children to be free, because the entire Universe is set up to accommodate that. And anything you do to the contrary will only bring you regret. You cannot contain those that cannot be contained. It defies Law.” – Abraham, excerpted from the workshop in Atlanta, GA on Sunday, September 19th, 1999 #400

~ “The little ones still remember how to use the power of their imagination. They are still engaged in the utilization of their imagination — that is one of the reasons that keeps them so exhilarated.” – Abraham, excerpted from the workshop in Spokane, WA on Wednesday, July 7th, 1999 # 394.

~ “Babies Are Thinking and Attracting Before They Are Speaking… Even though you are only months old in your physical body, you are a very old and wise creator focused in that baby’s body. And you came with powerful intentions to experience contrast and to launch clear rockets of desire into your Vibrational Reality for the purpose of expansion. People often assume that because a child is not yet offering words, the child could not be the creator of its own experience, but it is our promise to you that no one else is creating your experience. Children emanate Vibrations which are the reason for what they attract – even from their time of birth.” – Excerpted from the book, The Vortex, Where the Law of Attraction Assembles All Cooperative Relationships # 333.

~ “Parents don’t want their children to make the wrong decisions, so they don’t allow them to make the decision. And then the child becomes dependent, and then the parent resents that, and it gets off into a blameful thing early on. If you are encouraging children to do all that they can do — and not squelching the natural eagerness that is within them, so that they can shine and thrive and show you and themselves how good they are at adapting to physical experience — then everyone wins.” – Abraham, excerpted from the workshop in Dallas, TX on Saturday, March 13th, 1999 # 393.

~ “If we had a child, or anyone, and we caught them doing something inappropriate, we would not amplify it with our words. We would identify what it is we do not want, and then out of it would come the rocket of desire of what we do want, and then we would just visualize, visualize, visualize, until we find peace within our vision. When you make someone and their action the heart of a vision that you’ve spent time on — your relationship improves, your experience is better, and they receive the benefit of the experience. But if you catch them, and see them, and worry about it, and put mechanisms in place to prevent it, now you have not only amplified it, you have now made a commitment that is hooking you both into that, until usually it gets big enough that you break apart, and then you attract others to fulfill that role.” – Abraham, excerpted from the workshop in Chicago, IL on Sunday, April 25th, 1999 #588.

~ “The reason the grandchildren will benefit by the launched rockets that you’ve set forth; is because they’re born with no resistance to the rockets of desires that you’ve launched forth… You’ve seen those little ones on computers? They have no problem with that. They were born with computers in their life; they’re born cable-ready. They’re already up to speed with what you’ve launched into the vibrational future. And that’s one of the reasons that it’s nice when the old ones croak and the new ones come in, because it sort of dilutes the resistance factor that’s going on on this planet.” – Abraham, excerpted from the workshop in Tarrytown, NY on Saturday, May 14th, 2005 #504.

~ “Relative to our children or any children with whom we would interact, our one dominant intention would be to give them a conscious understanding of how powerful and important and valuable and perfect they are. Every word that would come out of our mouths would be a word that would be offered with the desire to help this individual know that they are powerful. It would be a word of empowerment. We would set the Tone for upliftment and understand that everything will gravitate to that Tone if we would maintain it consistently.” – Abraham, excerpted from the workshop in Chicago, IL on Saturday, July 19th, 1997 #469.

~ “Child of mine, I will never do for you that which I know you can do for yourself. I will never rob you of an opportunity to show yourself your ability and talent. I will see you at all times as the capable, effective, powerful creator that you’ve come forth to be. And I will stand back as your most avid cheerleading section. But I will not do for you that which you have intended to do for yourself. Anything you need from me, ask. I’m always here to compliment or assist. I am here to encourage your growth, not to justify my experience through you.” – Abraham, excerpted from the workshop in Seattle, WA on Sunday, July 4th, 1999 #453.

~ “Nothing is more debilitating than to care about something you can’t do anything about. And you can’t do anything about your adult children. You can want better for them, and maybe even begin to provide something for them, but in the long run, you cannot do anything about someone else’s vibration other than hold them in the best light you can, mentally, and then project that to them. And sometimes, distance makes that much more possible than being up close to them.” – Abraham, excerpted from the workshop in Ashland, OR on Saturday, July 19th, 2003 #437.

~ “Children coming forth today have a greater capacity to deal with the greater variety of information that is coming forward than you did. They deliberately are coming forth into this environment where there is more to contemplate. This generation gap that you are talking about, it has ever been thus. Each new generation, every new individual, that comes forth, is coming with you having prepared a different platform for them to proceed from. There is this thing that gets in the way of that that says, ‘I’m the parent. I got here first. I know more than you do.’ From the children’s perspective, and from the purity of their Nonphysical Perspective, what they are saying is, ‘You’re the parent. You got here first. You prepared a platform that I am leaping off from — and my leap will be beyond anything that you have ever known.'” – Abraham, excerpted from the workshop in San Rafael, CA on Saturday, February 27th, 1999 #395.

~ “The child is thinking, and receiving vibrational thought from you on the day that he enters your environment. That is the reason that beliefs are transmitted so easily from parent to child, from parent to child, from parent to child. The child is vibrationally receiving your fears, your beliefs, even without your spoken word… If you want to do that which is of greatest value for your child, give thought only to that which you want, and your child will receive only those wanted thoughts.” Abraham, excerpted from “The Law of Attraction, The Basics of the Teachings of Abraham” #385.

~ “The most important thing that you can teach your children is that wWell-being abounds. And that Well-being is naturally flowing to them. And that if they will relax and reach for thoughts that feel good, and do their best to appreciate, then they will be less likely to keep the Well-being away, and more likely to allow it to flow into their experience. Teach them the Art of allowing.” – Abraham, excerpted from the workshop in Milwaukee, WI on Wednesday, July 5th, 2000 #363.

~ “Parents can’t choose the mates of their children or the behavior of their children. You actually can’t choose anything for your children without disempowering them.” – Abraham, excerpted from the workshop in Syracuse, NY on Thursday, October 17th, 1996 #347.

~ “When a child has a dream and a parent says, “It’s not financially feasible; you can’t make a living at that; don’t do it,” we say to the child, run away from home… You must follow your dream. You will never be joyful if you don’t. Your dream may change, but you’ve got to stay after your dreams. You have to.” – Abraham, excerpted from the workshop in Asheville, NC on Sunday, May 1st, 2005 #330.”Most people don’t think that new-born children could be the Creator of their own reality because they are not even talking yet. But the Universe is not responding to your language, anyway. The Universe is responding to your vibration — and your vibration is about the way you feel.” – Excerpted from the workshop in Seattle, WA on Saturday, June 20th, 1998. Jerry and Esther Hicks (Abraham).

~ “Your child is naturally joyful. Your child is naturally tuned in to Source Energy. And as he is diving through and digging through contrast, it is natural that there would be some things that might disconnect him. Just don’t let his disconnection then inflame your disconnection. Many parents have discovered that their children, for the most part, feel good when they do — and the ornerier you are, usually the ornerier your children are. They are a strong reflection of the way you are feeling much of the time.” – Excerpted from the workshop in San Antonio, TX on Saturday, January 26th, 2002. Jerry and Esther Hicks (Abraham).

~ “If you encourage your children to stay connected to Source Energy, they will remain clear-minded; they will remain optimistic; they will remain enthusiastic. They will remain balanced; they will remain flexible. They will remain in a state of grace. They will remain in a state of Well-Being. And they will make wonderful choices.” – Excerpted from the workshop in Philadelphia, PA on Thursday, May 12th, 2005. Jerry and Esther Hicks (Abraham).

~ “The little ones still remember how to use the power of their imagination. They are still engaged in the utilization of their imagination — that is one of the reasons that keeps them so exhilarated.” – Excerpted from the workshop in Spokane, WA on Wednesday, July 7th, 1999. Jerry and Esther Hicks (Abraham).

~ “The most significant thing for a parent to contribute to anyone, is their own Connection and their own stability. An effective parent is a happy parent. An effective parent is a parent who laughs easily and often, and who doesn’t take things so seriously.” – Excerpted from the workshop in Albany, NY on Monday, October 1st, 2001. Jerry and Esther Hicks (Abraham).

~ “Life is a flame that is always burning itself out, but it catches fire again every time a child is born.” – George Bernard Shaw

~ “The question is, ‘Well, what about the little ones? What about the (unhealthy) babies?’ And we say they’ve been exposed to a vibration, even in the womb, that caused them to disallow the Well-being that would have been there otherwise. But once they are born, no matter what their disability, if they could be encouraged to the thought that would allow it, then, even after the body is fully formed, it could be regenerated into something that is well.” – Abraham, excerpted from the workshop in Ashland, OR on Tuesday, May 16th, 2000).

~ “There are three reasons for breast-feeding: the milk is always at the right temperature; it comes in attractive containers; and the cat can’t get it.” – Irena Chalmers

~ “Parents often think that they are here to guide the little ones. When – in reality – the little ones come forth with clarity to guide you.” – Abraham, excerpted from the workshop in Orlando, FL on Saturday, February 15th, 1997.

~ “A baby is something you carry inside you for nine months, in your arms for three years and in your heart till the day you die.” – Mary Mason

~ ”A woman in harmony with her spirit is like a river flowing. She goes where she will without pretense and arrives at her destination, prepared to be herself and only herself.” – Maya Angelou

~ “Who you are and what you know when you are born is everything that you need to know to thrive. You are born with a sense of self and a sense of wanting self to feel good, and the mechanisms to bring it about.” Abraham, excerpted from the workshop in Kansas City, KS on Wednesday, September 17th, 2003.

Delayed Cord Clamping

Posted on 25 January, 2013 by Judith Halek

I have always believed the delayed cord clamping would be beneficial for the baby as well as the mother. The paper below presents control studies indicating the BENEFITS of delayed cord clamping for the baby. IF you are going to proceed with cord blood storage, you will NEED to cut the cord IMMEDIATELY in order to preserve the precious stem cells into the vial for potential future use. It is ONLY as a result of this preservation that the cord be cut immediately. We have YET to see controlled studies about the benefits for the mother as well. Enjoy!

Academic OB/GYN December 3, 2009 Nicholas Fogelson

Delayed Cord Clamping Should Be Standard Practice in Obstetrics

There are times in our medical careers where we see a shift in thought that leads to a completely different way of doing things. This happened with episiotomy in the last few decades. Most recently trained physicians cannot imagine doing routine episiotomy with every delivery, yet it was not so long ago that this was common practice.

Episiotomy was supported in Medline indexed publications as early as the 1920s(1), and many publications followed in support of this procedure. But by as early as the 1940s, publications began to appear that argued that episiotomy was not such a good thing(2). Over the years the mix of publications changed, now the vast majority of recent publications on episiotomy focus on the problems with the procedure, and lament why older physicians are still doing them (3) (4). And over all this time, practice began to change.

It took a long time for this change to occur, and a lot of data had to accumulate and be absorbed by young inquisitive minds before we got to where we are today, with the majority of recently trained OBs and midwives now reserving episiotomy only for rare indicated situations.

Though this change in episiotomy seems behind us, there are many changes that are ahead of us. One of these changes, I believe, is in the way obstetricians handle the timing of cord clamping.

For the majority of my career, I routinely clamped and cut the umbilical cord as soon as it was reasonable. Occasionally a patient would want me to wait to clamp and cut for some arbitrary amount of time, and I would wait, but in my mind this was just humoring the patient and keeping good relations. After all, I had seen all my attendings and upper level residents clamp and cut right away, so it must be the right thing, right?

Later in my career I was exposed to enough other-thinking minds to consider that maybe this practice was not right. And after some research I found that there was some pretty compelling evidence that indeed, early clamping is harmful for the baby. So much evidence in fact, that I am a bit surprised that as a community, OBs in the US have not developed a culture of delayed routine cord clamping for neonatal benefit.

I think that this is a part of our culture that should change. This evidence is compelling enough that I feel like a real effort should be made in this regard. So to do my part in this, I am blogging about it.

As this is Academic OB/GYN, of course I am going to lay out this evidence I speak of. But before I do that, I want to present some logical ideas under which this evidence ought to be considered.

Prior to the advent of medical delivery, and for all time in animals, it has been the natural way of things for a baby to stay on the umbilical cord for a significant period of time after delivery. Depending on culture and situation, the delay in cord separation could be a few minutes or even a few hours. In some cultures the placenta is left on for days, which of course I find excessive and gross (5). But whatever the culture and time on cord, the absence of immediate cord clamping allows fetal blood that was previously in the placenta to transfuse back into the baby. Studies have demonstrated that a delay of as little as thirty seconds between delivery and cord clamping can result in 20-40 ml*kg-1 of blood entering the fetus from the placenta (6).

Considering this data, I have to think about evolution and function. I am a strong believer in evolution, but even under creationist thinking I have to believe that if the system meant for babies to have been phlebotomized of 50-100 cc of blood at birth, we would have been born with higher hemoglobins. Clearly the natural way of things is for this not to happen.

So does this mean that early cord clamping is necessarily harmful? Absolutely not. But what it means is that the burden of proof is on us to prove that early cord clamping, which amounts to planned fetal phlebotomy, is a beneficial thing. Otherwise, all things being equal we ought to give the tykes a few minutes to soak up what blood they can from the placenta before we cut’em off.

Check out this video by Dr. Stuart Fischbein: Delayed Cord Clamping: http://www.metacafe.com/watch/yt-WWCOzkSe85M/dr_stuart_fischbein_delayed_cord_clamping/

So the question is whether or not there is strong data either way.

It is easy to imagine a randomized study of immediate vs. delayed cord clamping, with quantitative analysis of fetal lab values and clinical outcomes. So easy in fact, that it has been done many times – and in just about every study, there is a clear benefit to delaying cord clamping, even if it is just for 30 seconds after delivery. These benefits include important outcomes such as decreased rates of intraventricular hemorrhage and necrotizing enterocolitis in preterm neonates. Furthermore, aside from some intermittent reports of clinically insignificant polycythemia and hyperbilirubinemia in term infants, there appears to be no harm that can be linked to delayed cord clamping. It feels like being a doctor 10-15 years ago looking to see if there is any data about episiotomy, and finding that there’s a lot, and it says we’ve been doing it wrong for awhile now.

So here’s the data:

Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial(7)

Randomized 72 VLBW infants (< 1500 grams) to immediate or delayed cord clamping (5-10 vs. 30-45 seconds). Delayed cord clamp infants had significantly less IVH (5/36 in delayed group vs. 13/36 in immediate group, p = 0.03) and less late onset sepsis (1/36 vs. 8/36, p = 0.03).

The Inﬂuence of the Timing of Cord Clamping on Postnatal Cerebral Oxygenation in Preterm Neonates: A Randomized, Controlled Trial (8)

Randomized 39 preterm infants to immediate clamping vs. 60-90 second delay, and examined fetal brain blood flow and tissue oxygenation. Results showed similar blood flow between groups, but increased tissue oxygenation in the delayed group and 4 and 24 hours after birth.

Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomized controlled trial(9)

Randomized 476 infants to immediate or 2 minute delayed clamping and followed them for 6 months. Delayed clamped babies had higher MCVs (81 vs. 79.5), higher ferritins (50.7 vs. 34.4), and higher total body iron. Effects were greater in infants born to iron deficient mothers. Delayed clamping increased total iron stores by 27-47mg. A follow up study showed that lead exposed infants with delayed clamping also had lower serum lead levels than immediate clamped infants, likely due to iron mediates changes in lead absorption.

A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints(10)

Infants delivering at 30 to 36 weeks gestation randomized to immediate vs. 1 minute delay. Delayed group had higher RBC volumes (p = 0.04) and hematocrits (p < 0.005), though there was no difference in RBC transfusions. There was a small increase in babies requiring phototherapy in the delayed group (p = 0.03) but no difference in bilirubin levels between groups.

Immediate versus delayed umbilical cord clamping in premature neonates born < 35 weeks: a prospective, randomized, controlled study (11)

Randomized 60 infants to clamping at 5-10 seconds vs. 30-45 seconds. Delayed clamping infants had higher BPs and hematocrits. Infants < 1500 grams with delayed clamping needed less mechanical ventilation and surfactant. Trend towards more polycythemia in delayed group, but not statistically significant.

And that’s just some of it. I’ll be happy to send you an Endnote file with a pile more of you’d like it. If the burden of proof is on us to prove that immediate clamping is good, that burden is clearly not met. And furthermore, there is strong evidence that delaying clamping as little as 30 seconds has measurable benefits for the infant, especially in premature babies and babies born to iron deficient mothers.

So basically, we should be doing this. I’m going to try to effect some change in my department, but there are a lot of things that need to happen for us to change as a general culture. It can’t just be the OBs. L and D nurses and pediatricians need to buy in as well.

Some people will argue that premature babies need to be brought to the warmer right away for resucitation. I don’t know the answer to this, but it’s worth study. One might think that it is important to intubate a very premature baby right away, but I have to wonder if that intact cord will be better at delivering oxygen to the baby for 30-60 seconds than the premature lungs. Particularly in cases of fetal respiratory acidosis, there is strong logical argument that a baby might be better resuscitated by unwrapping the cord and letting it flow a bit than trying to oxygenate it through its lungs. Until that placenta is detached, you have a natural ECMO system. Why not use it? Certainly there are exceptions to this logical argument, abruption being the biggest one, and perhaps even severe pre-eclampsia and other poor feto-maternal circulation states.

I wonder at times why delayed cord clamping has not become the standard already; why by and large we have not heeded the literature. It is sad to say that I believe it is because the champions of this practice have not been doctors, but midwives, and sometimes we are influenced by prejudice. Clearly, midwives and doctors tend to have some different ideas about how labor should be managed, but in the end data is data. We championed evidence based medicine, but tend to ignore evidence when it comes from the wrong source, which is unfair. It is fair to critique the research and the methods used to write it, but it shouldn’t matter who the author is. In this case, Mercer and other midwives have done the world a favor by scientifically addressing this issue, and their data deserves serious consideration.

To quote Levy et al (12) “Although a tailored approach is required in the case of cord clamping, the balance of available data suggests that delayed cord clamping should be the method of choice.” We ought to heed this advice better. Like episiotomy, this change in practice may take awhile, but we should get it started. I’m going to work on it myself. How about you?

1. Martin DL. The Protection of the Perineum by Episiotomy in Delivery at Term. Cal State J Med 1921 Jun;19(6):229-31.

2. Barrett CW. Errors and evils of episiotomy. Am J Surg 1948 Sep;76(3):284.

3. Rodriguez A, Arenas EA, Osorio AL, Mendez O, Zuleta JJ. Selective vs routine midline episiotomy for the prevention of third- or fourth-degree lacerations in nulliparous women. Am J Obstet Gynecol 2008 Mar;198(3):285 e1-4.

4. Gossett DR, Su RD. Episiotomy practice in a community hospital setting. J Reprod Med 2008 Oct;53(10):803-8.

5. Westfall R. An ethnographic account of lotus birth. Midwifery Today Int Midwife 2003 Summer(66):34-6.

6. Weeks A. Umbilical cord clamping after birth. Bmj 2007 Aug 18;335(7615):312-3.

7. Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W. Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics 2006 Apr;117(4):1235-42.

8. Baenziger O, Stolkin F, Keel M, von Siebenthal K, Fauchere JC, Das Kundu S, et al. The influence of the timing of cord clamping on postnatal cerebral oxygenation in preterm neonates: a randomized, controlled trial. Pediatrics 2007 Mar;119(3):455-9.

9. Chaparro CM, Neufeld LM, Tena Alavez G, Eguia-Liz Cedillo R, Dewey KG. Effect of timing of umbilical cord clamping on iron status in Mexican infants: a randomised controlled trial. Lancet 2006 Jun 17;367(9527):1997-2004.

10. Strauss RG, Mock DM, Johnson KJ, Cress GA, Burmeister LF, Zimmerman MB, et al. A randomized clinical trial comparing immediate versus delayed clamping of the umbilical cord in preterm infants: short-term clinical and laboratory endpoints. Transfusion 2008 Apr;48(4):658-65.

11. Kugelman A, Borenstein-Levin L, Riskin A, Chistyakov I, Ohel G, Gonen R, et al. Immediate versus delayed umbilical cord clamping in premature neonates born < 35 weeks: a prospective, randomized, controlled study. Am J Perinatol 2007 May;24(5):307-15.

12. Levy T, Blickstein I. Timing of cord clamping revisited. J Perinat Med 2006;34(4):293-7.

Possibly related posts: (automatically generated)

Grassroots Network: Delayed Cord Clamping

Where To Have A Baby: Home – Hospital – Birth Center?

Posted on 23 January, 2013 by Judith Halek

When making a decision of where to have your baby there are a score of questions to consider:

1. Measure of Risk vs. Control.

2. Pain Management vs. Natural Coping Tools (How do you personally view medicine: do you trust or mistrust the medical model medicine or would prefer the alternative coping tools?)

3. Baby-Centered ASPECT: considering what’s important:

a. Separation of the baby at birth.

b. Potential Medications going into your Baby. (These could be allopathic or alternative medicines.)

4. Where do you feel SAFE / SUPPORTED? Most important question to ask yourself.

5. What are your greatest FEARS with birth?

6. Why are you choosing the place to have your baby?

7. Have you ever SEEN a birth? TV, internet, film, live?

8. What was YOUR BIRTH like? What about your siblings? Grandmothers?

9. Were you breastfed? How long?

10. What is an image of an IDEAL BIRTH?

11. AUTHORITY, what does that mean to you? You may need to let someone else make decisions for you and your baby. If this is your preference, labor doulas/assistants, will give you information regarding personal choices and you will either assume that power or give the power away be it to a medical caregiver, doula, childbirth educator, sister, friend, or a mother.

Homebirth and Hospital environments are at one end of the spectrum and a Birth Center is a happy medium whether it is located in hospital or free standing out of hospital.
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When I interviewed a mother of two, planning a Home Birth, the following were MOST important to her:

1. EMPOWERMENT: Feeling like she had some sort of say/power/control/connection with what was happening during her pregnancy, labor and birth. Surrounding herself with a TEAM of women to support HER NEEDS, not their agenda’s.

2. READING: two favorite books:

a. Nurturing Your Unborn Child, By Thomas Verny, Pam Weintraub

b. Continuum Concept, Jean Liedloff

3. MEDICAL PERSON: Visits with the MIDWIFE, even though the midwife was not warm and fuzzy, she was supportive to the mother’s wishes and did not ‘yes’ her at the prenatals.

a. She had a NUTRITIONIST on staff who had the mother write down one week’s diet. The nutritionist went over it with her to make sure she was getting all the appropriate nutrients included in her diet.

This mother, who’d not eaten yogur,t was told by a friend, “EAT YOGURT…you need yogurt.” The midwife asked her if she even liked yogurt and the mother said NO…so the suggestion was to bone up on other protein and calcium foods she DID eat and like. She didn’t do something because someone told her to do it.

4. DOULA: Having another set of hands, a friend, a doula, someone who could communicate with her without even speaking…knowing exactly where to massage, or bring her something to drink or eat was invaluable! Chemistry was very important!!.

(THE PARENTS MAY BE INTERVIEWING THE DOULA and THE DOULA IS INTERVIEWING THE PARENTS.)

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When I interviewed a mother of three, pregnant with her fourth child, planning on a Hospital Birth, the following were MOST important to her:

1. EXERCISE: Helped labor go more smoothly, body felt more toned, strong during pregnancy and labor. Recovery was faster, more in touch with her body, and found exercising everyday was really important.

a. With one baby, she exercised more often than with the others. As a result of this, she feels her baby girl is much stronger in her body than her other children because of that.

2. MASSAGE:Towards the end of the pregnancy and even earlier stages she was having regular massage. (once a week.) It helps to release the pain in her body, the back, etc. and helped her to feel more comfortable, particularly in the last few months. It was a time for bonding with her baby and her doula. It’s important the doula bond with the baby as well.

3. DOULA: Incredible, ultimate support to have someone there with the knowledge, experience and insights as to what might happen next, or what to do when things were happening. Doula’s know what to ask and how to make her more comfortable.

4. READING: 10 books at my bedside…can’t really remember…all.

a. Week to Week book on Development: her favorite:

b. Pregnancy Week-by-Week[Spiral-Bound]Jane McDougall

c. Was reading some book on a special breathing technique from Switzerland…never really helped me…second birth pushing stage was really important what she did that time..blow instead of push hard!!.

5. OBSTETRICIAN:She chose an OB instead of a midwife. The bad thing about it was it was a group practice instead of a private practice and it was random who she would get for the birth. She felt they were all good doctors, but didn’t like the randomness.

6. HOSPITAL SETTING: She had expectations of what it would be like. Checking in was annoying, but she dealt with that. She was pleased with the nurses and staff overall and felt most safe to have her babies there.
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When I interviewed a mother with her first pregnancy, planning on a Birth Center, the following were MOST important to her:

1. CONVENIENT FOR INSURANCE: because they decided not to have a home birth, this was the best of both worlds.

2. CHOICE REASON: The husband was not comfortable to do the home birth, perfect balance in his mind. RISK FREE: to him meant being IN a birth center, close to the facilities that could help out, “just in case”.

There was no luxuriating in the Birth Center. They wanted her out within 12 hours postpartum. She wanted to be out because the nurses were mad at her she wouldn’t get out of the tub when she was pushing so in turn, they were less gentle with her baby.

3. DOULA: was key to her birth because her doula was a ‘water specialist.’ This was the most important factor for her…more than her medical caregiver who knew nothing about water birth. Her 1^st birth was on the obstetrical floor and the 1st underwater birth at that hospital. Her 2^nd child, was at the same hospital in the birth center this time, underwater.

4. PREPARATION FOR BIRTHS: Because of the desire to have a waterbirth this mother read a number of waterbirth books, articles and watched one video out at that time. This was 1993 & 1996. The father’s comments were, “laboring and birthing in water is more like making love.” The childbirth education was mandatory for them to be in the birth center but they did not find it particularly valuable.

5. BIRTH PLAN: The obstetrician suggested and encouraged the mother to have a BIRTH PLAN and to hang it in the birth room on the wall so the nurses and other staff people could see her wishes. The DOULA also supported the idea. It was more important in the preparation of doing it because it helped her be clear about what she wanted and not wanted.

6. BEFORE PG – COLONICS: With the first pregnancy, she did a lot of them in order to get ready for the pregnancy which helped her feel more balanced and clean. At 36 years old, she conceived her child on the first try. With the second child almost 3 years later, she didn’t do any colonics and it took 3 months to conceive.
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When I interviewed a father of three, pregnant with their fourth child, planning on a Hospital Birth, the following were MOST important to him:

WHY CHOSE A HOSPITAL BIRTH: He didn’t really draw a line with their decision to go to a hospital as a major decision. He realize he’d never been at a home birth and had nothing to compareit to other than, several couples he know who’d completely gone the other way and had no doctors visits with the following results:

1. delivered a stillborn at home with a midwife,

2. child almost died because the cord was tangled around its neck,

3. delivered at 27 weeks, had a C section and the baby is still in the NICU (had she not gotten there asap, it would have been disastrous).

For him,understanding the protocol in the hospital was essential notbecause he had to obey it, but because being in the hospital environment offered him options in case something went wrong. Options that might not be available quick enough when doing a home birth. Although these kinds of complications are a small possibility in childbirth, his understanding is there is little time after a complication occurs to make decisions.

2. DOULA: -Was helpful as being well educated and conveying, not everything he hospital requires HAS to be done when the hospital wants it done.

3. WIFE CARE: It was very important to this father to make sure his partner is able to feel calm and she was in good hands to focus on her “delivery.” This was achieved by the combination of having the right food, water, doctor and level of support from everyone in a relaxed manner.

4. COMMUNICATIONS WITH Obstetrician: His prior experiences with an obstetrician in a hospital was the understanding there might be times in the process when the parents are questioned. If that happens not to take it personally. This was a tough one because the parents have to haveenough self-confidence to stay centered in that situation.

5. SUMMARY: He thinks the most important thing is to understand that being well prepared requires good education, That’s where I think a doula or birth assistant invaluable!
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From MY perspective, the MOST important key elements at any birth:

BREATH / BODY / BABY

1. Stay connected to your BREATH, which is your heart coherence center.

2. Stay present by being IN your BODY as opposed to leaving or numbing your body.

3. Always keep the lines of communication and connection open with your BABY.

TRUTH AS I KNOW IT:

As a birth caregiver, I can get the word out there but ultimately, it is up to the mother and baby to integrate, assimilate and implement the information or suggestions to the best of their ability. There are no failures, there is only experience and from that experience is the potential for learning, growth and finding peace with whatever unfolds.