My Reflections On Labor And Birth

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Photos and Article Copyright @ 2000 Judith Elaine Halek

I was sitting at a dinner table with a group of women in their late thirties and forties. I, myself, am in my early forty’s, not married, been working in the birth modalities for the past twelve years and at present, am not seeing anyone in particular. I commented, “I don’t think it’s in the cards for me to have a baby this lifetime.””Really!” exclaimed a couple of the women. “How old are you?” inquired one woman. “Close to my mid forties.” I responded. “Oh, that won’t be a problem,” she said matter of factly, “You can always do invitro, or donor insemination.” I looked at her and then to other women around the table as all eyes were set on my response. I was surprised and disappointed that conception has become a casual ‘technocratic procedure’ in the minds of the public. I began to explain IVF and donor insemination requires massive douses of antibiotics, a large bank account, arranging one’s work schedule around clinic visits, undergoing countless invasive, often painful, always emotionally charged procedures, all for the chance that I might be the one of ten to be blessed with the news of a cyborg conception. Please understand, I am not judging anyone who chooses this path of conception. It is not my preference of choice and thank goodness, we still have a choice.

Or do we? When I reflect back on my experiences the past twelve years as a labor support specialist, childbirth educator, birth counselor, massage therapist, yoga instructor I’ve found far too many women who did not exercise their options of choice and gave their power away to the medical caregivers, especially in hospitals. After attending over 100 births in hospitals, birth centers and homes, I have had the opportunity to experience a variety of possibilities. It is my vision, that all labor and delivery nurses and obstetricians witness 30 home births or birth center births as part of their medical training.

I remember at one hospital, a nurse commented, “Having a baby at home is one of the most dangerous experiences a mother could put her baby and herself through.” I asked if she had ever attended a home birth, or studied the statistics of home birth practices. She admitted she had not attended a one or knew anything about recent studies on home birthwith midwife practices. I asked her, as I’ve asked many people who make blanket statements without any information to back up their claims, “How can you make such a definitive comment when you’ve not any experience with what you are judging?”

It’s rather ironic that we in our intellectual aspects, read, watch videos, attend classes, surf the internet, express our gathering feminine nature, becoming an ‘informed consumer’, yet when it all comes down to the real deal, one of my favorite mentors, Dr. Michel Odent states, “Forget the books, tapes, videos. Go to a quiet, dark place, private and safe, trust the process, surrender to your bodies and have your babies.”

I believe women have forgotten how to birth, trust, listen, go deep inside and communicate with their bodies and their babies. I also believe women can remember.

What are the choices, options, for non-technocratic pregnancies, labors and births? I have treeoflife been an advocate of midwifery for the past 12 years. After researching international statistical outcomes regarding midwifery vs. obstetrical care, midwives have far exceeded the lower infant mortality rates, fewer medical interventions and higher results in more empowering births.

Having a baby with an obstetrition in a hospital? Create a birth plan, a “guide line,” toward the ideal birth you would like to create. Birth plans are generally discussed in your childbirth classes. Look in various childbirth books early on in your pregnancy and begin to educated yourself. A few favorites are, “The Birth Book” by Sears and Sears, MD, “The Complete Book for Pregnancy and Childbirth,” by Sheila Kitzinger and “New Active Birth, a Complete Guide to Natural Childbirth,” by Janet Balaskas. To find out about midwifery based practices in your area, call American College of Nurse Midwives, (ACNM,): 202-728-9860 (general number), 1-888-643-9433, (toll free locator number). Or contact Midwives Alliance of North America, (MANA): 1-888-923-6262.

Bring questions to your medical caregivers, be attentive how they respond. If you experience not being heard or rushed through prenatal visits, go over in your mind and with your partner why you don’t feel supported. If you do your work early on, talking further or switching medical caregivers will not be as problematic.

Over and over I have encouraged women to trust your highly sensitized instincts, do research and own this birth. This labor and birth will only happen once and it’s vital to be with people you feel safe, listened to and trust. I believe, the only way change will take place among the obstetrical practices is through the public. By asking for what you deserve, you educate and introduce the medical profession to another possibility.

Another alternative is a labor support doula. A ‘doula’ is a Greek word for ‘woman assistant.’ She meets with a couple and gathers information prentally. She’s on call before and after the due date, attending to the parents needs during early and later stages of labor and birth, following up with a post-natal visit after the birth. Doulas have statistically proven to lower cesarean sections by 50%, length of labor down 25%, oxytocin use, down 40%, pain medications (narcotics) down 30%, forceps down 30%, and epidurals down 60%. A labor doula is by no means to replace the partner of the mother. No one can replace the relationship or connection of a woman’s partner. The doula helps to relieve the pressure and enhance the experience.

Since 1993, when Doulas of North America, (DONA,) began a certification program there are now over 8,000 certified. For referrals call, 206-324-5440. Book referrals for becoming a doula: “The Birth Partner,” by Penny Simkin, PT, “Mothering The Mother,” by M. Klaus, MD , J. Kennel, MD and Phyllis Klaus, M.Ed., CSW. If someone would be interested in setting up a doula program read, “Doula Programs: How to Start and Run Private or Hospital-Based Programs with Success!,” by Paulina Perez and Deaun Thelen.

An aquatic analgesic alternative to medical pain medication or an epidural is water labor or water birth. As the east coast resource center for water birth, my organization, Birth Balance, has educated countless couples on this unique and growing approach. A shower is great during labor, yet, it can’t compare to submerging half to three quarters of your body in a tub of water. Advantages to water birth for the mother are: easier coping during dilatation of the cervix and the pushing stage, softening of the perennial tissues, bones, muscles so lacerations are minimal, ability to move in whatever position her body organically discovers, less interventions, faster labors and births. Advantages to the baby: a medium which softens the baby’s bones and tissues thus creating a softer birth experience, babies appear to be less traumatized, a drug free beginning and more immediate bonding with mother.

wavecave A concern regarding water labor or birth is infection. When in the water, bacteria is diluted. Unless someone enters the water with an infection of some sort offering foreign bacteria, there wouldn’t be problems with the mothers infecting herself or the baby. A study in 1996 of 1385 women with prelabor rupture of the membranes after 34 weeks gestation concluded a tub bath did not increase the risk of maternal or neonatal infection after premature rupture of the membranes and prolonged latency. (1)

Another randomized, controlled trial was with 785 women. The results were as follows: tub group required fewer pharmacological agents, fewer deliveries by forceps and vacuum, more likely to have intact perineum and an overall positive effect on analgesic requirements, instrumentation rates, condition of the perineum and personal satisfaction. (2)

Another concern people have is the drowning of the baby at birth. The baby is in a womb of water from conception and is born into an extended womb of water later. The baby receives oxygen from the umbilical cord which is attached to the placenta. As the baby is born, the placenta is detaching from the mother, thus the supply of oxygen becomes depleted and bringing the baby up to the surface as soon as possible is imperative. Another atmospheric pressure, such as air or gravity is what stimulates the babies chemoreceptors to take a breath. That is why, in water, the baby will not take a breath.

Water birth has been around for centuries. In the contemporary times the concept began in Russia in the 60’s,, spread to France, England in the 70’s and come to the United States in the 80’s. For further reading on the subject check out: (book and video) “Gentle Birth Choices,” by Barbara Harper, RN, “Water Birth, A Midwife’s Perspective,” by Susanna Napierala and “The Waterbirth Handbook, ” by Dr. Roger Lichy and Eileen Herzberg.

No matter what choices you make for this birth or future, each pregnancy, labor and birth will teach you what to do differently or the same the next time. Remember, everything is an opportunity for learning. Keep an open mind and heart and learn.

(1), (2): MIDIRS Midwifery Digest, (Mar 1997) 7:1.

Fathers Take The Plunge: A Look At Waterbirth

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek

Photos and Article Copyright @ 2013 Judith Elaine Halek

Being a good dad is like being a good husband–learn as you go and do the best you can. One thing prospective fathers should keep in mind is this: a couple-focused pregnancy provides both a healthier pregnancy and birth experience and is a time when all three parties bond. Although fatherhood is probably the most important role a man will play in his lifetime, many men have been culturally and emotionally separated from pregnancy and the childbearing process.

As an observer at many births, my grandest observation is the remarkable change that takes place in men (whether the actual father or partner, a friend, brother or family member) while assisting the labor and birth. One father commented, “I have a newfound respect for my wife. I don’t think I could have ever done what she did, go through what she went through to have our child.”

During a baby’s birth, the father’s presence can markedly alleviate a mother’s pain and anxiety, and it certainly enhances his experience of the birth. It is crucial the mother not feel alone during this strenuous time. Many studies have shown that infants recognize and respond to voices they hear in the womb, therefore it is important to maintain a modicum of peace, tranquility and communication at all times.

One father who acted distant and angry during the labor and birth of his child finally let go of most of his defenses when I challenged, “Can we put the weapons down and let the egos go so we can help your child enter a place of welcome and peace?” By the time the baby was actually out daddy had softened immeasurably.

Those of you who have witnessed a birth know what I’m talking about. A sacred transformation takes place that crosses beyond the boundary of mere words.

My extensive work assisting people make the informed choice to birth babies in water and/or use water labor instead of the traditional “drug the mother” syndrome has brought both myself and the clients’ experience to newer, loftier heights. I have become very curious about fathers’ reactions and level of participation. I began to keep data–who initiated the idea and when the decision was made, were fathers able to support their partners during preparation, and did they clean up after the event?

It was important for me to know exactly what these new fathers would say about their waterbirth experience to other prospective dads. I set about doing this by interviewing six waterbirth fathers. They ranged from thirty to sixty years old with Indian, Italian, Hispanic and African American backgrounds.

Heads Bowed - Copyright 2004 Birth Balance When I asked the father why he chose to attend the labor and birth of his partner, the responses were uplifting. “Why not?” said a new daddy, “It’s my child as well. To me it was a moment getting to know and get closer to my wife. I can assure you, it did. It took the relationship to another level. Relationships are a collection of experiences and it’s brought us closer together. Forget the candlelight dinners guys, you can’t compare it and it may happen only once or twice in your life. Don’t miss it.”

Another father told me,” I felt it would be a good thing to see a baby born into this world. Doctors see this all the time, why can’t I?”

One man said, “I wanted to be part of it. We are a team. I was also curious to see the whole process. I’m in my thirties. Most of the guys in my generation are really into supporting their partners as opposed to older generations who might not be so interested in seeing the whole experience.”

When asked whose idea it was to have the waterbirth, most men responded, “both partners.” One father commented, “We were unhappy with conventional births. When we heard there was a more gentle, drugless approach to having a baby we went to a waterbirth educator and realized it was more normal to have the baby in water than the air. My wife’s obstetrician told us about a waterbirth educator. When we saw the videos I was really more supportive of doing the birth this way. At first I had to talk my wife into it. But that didn’t take too long.”

Another father told me, “The midwife suggested it. My wife was very open to it so I had no objections. We’d had three babies the traditional air birth. My second wife and I were having our fourth when we saw pictures of water babies. They looked so much calmer and happier. That’s when we decided to have our next child underwater.”

When asked about concerns or fears regarding this alternative method, one father replied, “No concerns. The water looked less traumatic and more comfortable for my wife and baby. It was something completely new to us.” Another dad added, “We had only heard of it two to three weeks prior to the birth of our child. It was a little nerve-racking, but I had no specific concerns.”

It was the father’s choice to enter or not enter the birth pool. One dad had a cold and didn’t think going in was a wise decision; others just felt a little overwhelmed. One excited father who did enter the pool said, “This goes to show how things can change. I thought I wouldn’t go in, but I was in the water ten minutes before my wife. I didn’t want to miss a moment of the birth. It was OK. I was behind my wife. I could hear the doula and the documentarian say, ‘Here comes the head.’ When the moment came, I was crying like a baby. I was totally overwhelmed!”

When queried about how important a part the water played, one father responded, “Vital–the only thing that prevented her from getting drugs!” Another stated, “The water was like a lifeline for her, something she could hold onto even if she didn’t use it very much until the birth. Just having it was her security.”

Preparation for a waterbirth means going to a waterbirth educator, getting an OK from the medical caregivers and institutions, looking at videos and pictures, ordering a tub, and lots and lots of talking to each other. If your facility does not supply a tub, you’ll need to rent one. Once done you must make contact with the hospital or birth center maintenance staff to ensure that the hot water hose adapters match the water faucets. Prior to the labor you will want to actually set up the tub.

Filling up the tub is optional but timing is everything, so get an idea from the staff how long your tub might take to fill. Knowing this relieves both parents of undue stress.

One of the most important elements mentioned by all six men was the hiring of a labor support specialist or labor doula. This is a person specializing and certified in assisting couples during their labor and birth. The doula attends the mother and baby while the father is busy with the tub before and after the birth. It is an added bonus if the doula is experienced in the waterbirth arena. She can give helpful tips on when to utilize the water and when it’s unnecessary.

One father advised, “Let the midwife and doula, if there is one, do their job. This is the best way to go if you don’t want to see your wife suffer.”

If you are considering the unique joy of waterbirth, make sure you employ a doula who is a team player. She should be open to allowing your full participation. Knowing and trusting her methods can really relieve the pressure. Though it may take some time, get the medical establishment to support you in your choice. Next, seek out a waterbirth educator or a labor specialist interested in waterbirth. Watch as many videos as possible and above all, be patient. Talk to people who have had this experience. Remember, knowledge is power. Make a choice to become intimately involved in one of life’s greatest moments. You won’t regret it.

A Labor of Love

Posted on 25 October, 2013 by Judith Halek

By Judith Elaine Halek
Photographs © Judith Elaine Halek

Women In Photography debuts an photographs and an article on
photographing water labors and births in the No. 8, Fall Issue,
October 1, 2001 Issue. The following is a rendition of the
article written by Judith Halek that appeared in this issue.

To view the website of Women in Photography, click here.

Archive 8 – WIPI News Article 3

Documenting births has been an obsession of mine since 1987 when
I assisted the first homebirth, waterbirth in New York City. Over the past fourteen years
I have slipped in and out of one of the most intimate experiences known to life.
I’ve had the privilege of documenting three separate environments;
homes, hospitals and birth centers. My specialty is underwater birth.

Waterbirth takes place when the baby is actually born from the womb of water inside the mother, to an extended womb of water, which could be a bathtub, a portable birthing pool, a jacuzzi, a water trough, or an ocean.

On my first contact with a couple, I give them a package of information and refer them to my website. After they have received the package and reviewed the site, we discuss what they like, what more they want and if whether there is a preference for a specific format, i.e., transparencies, and negatives, black/white, color.

Personally, I prefer to shoot with color negative because it offers more advanced emulsions. The additional color layers give better control in Photoshop. Black and white is the heart of photography, and from the purists point of view, film is superior to digital, yet, in the last three years technology has changed this. Today printing from a digital file with the special small gamut or monochrome black and white inks, creates a cutting edge print as acute as the traditional print from a darkroom.

The first thing to establish is the due date. One can be on call
approximately three weeks before the due date and two weeks after, unless it will be a home birth where the post dates could last up to four or five weeks. We discuss whether the couple wants me to be at their home before they go to the hospital or birth center.

It’s imperative to have permission to photograph from the hospital or birth center. Put something in writing and submit it to the medical facility before hand. One doesn’t want to become an intruder and sometimes medical personnel can be security conscious. When parents create their birth plan, photographic permission ought to be included as part of the labor/birth.

I work with the available light. Because of its invasive nature, I rarely use a strobe. I find available lighting creates a truer, softer,
journalistic reflection. I work with the fastest film for the camera:
Ilford and T-Max 400 and 800 for black and white and Fuji color (I find the skin tones are truer with Fuji). Sometimes I’ll be creative and shoot 1600 and 3200 when I’m at a home where candles are the only light source. I then utilize a monopod.I take anywhere between 5-8 rolls of film. I participate quietly in the labor and birth dance by making myself as inconspicuous as possible and shoot further away rather than close up. I work with the Canon EOS, SLR system; two cameras at a time with the Canon Elf as a third back up if we are transferring to the hospital or birth center. I use a EF 50mm f1:4 and EF 70-200 f1.2.8 lenses. I advise taking along a wide-angle lens such as a
21mm or 28mm for the confined areas.
When shooting, it1s important to focus on the details. Focus on becoming a Zen photographer and capture tender moments of father comforting mother, a gentle touch on a belly, a reflection in a mirror, a flower floating in water.If you are fortunate enough to be invited into the OR in a hospital,
you’ll wear their sterile gowns. Pay attention to where you can and cannot be, and don’t touch anything! Take a small fanny pack for your film. In a birth center you can wear comfortable clothing to move around in, climb on top of tables, beds, chairs, or edges of the tub. A home birth environment is the most relaxed. Wear clean clothes, shoes that slip on and off easily, take time to use the bathroom, eat and hydrate yourself with something other than caffeine.Labors and births can take from 25 minutes to 18-20 hours. Patience and vigilance are the keys. It’s like covering a sporting event. You have no idea what’s going to happen minute to minute. Conserve your energy by breathing in such a way as to stay in a calm, neutral state, both mentally and physically. Most importantly, enjoy… the miraculous experience.

Judith Halek is the director of Birth Balance, the east coast resource center for under water birth. Judith is now in the process of moving her 15 years of photography out to the public. She has been published in numerous birth journals such as Midwifery Today, The Journal of Perinatal Education an ASPO/LAMAZE Publication as well as New York Magazine. She will be debuting her first solo show at a prestigious birth center in New York City this winter.

Her website is www.birthbalance.com
Her email is Judith@BirthBalance.com
Phone and Fax: 212-222-4349

*Judith Halek is among the photographers of
WIPI’s 20th Anniversary International Tea Time exhibit

“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

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.

By Judith Elaine Halek Photographs © Judith Elaine Halek

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By Judith Elaine Halek
Photographs © Judith Elaine Halek