Family Planning

Mamas on Bedrest: Vermont is the Best State in Which to Have Your Baby!

February 28th, 2017

According to WalletHub.com “2016 Best and Worst Places to Have a Baby”. Wallethub.com is a virtual financial planning company that helps individuals track their spending and saving, help repair credit and help individuals protect their credit history including protecting identity. Wallethub.com tracks people and money and in their opinion, if you cannot afford to have a baby, you shouldn’t. When the parameters of delivery budget (cost to have a baby, cost of living and cost/availability of health insurance), overall health care ranking (maternal and infant mortality, rates of prematurity, availability of professionals such as midwives and pediatricians, etc.. ) and baby friendliness (i.e. parental leave, available childcare, support for new moms, etc..) were analyzed for the 50 states and the District of Columbia, Vermont ranked number 1 as best place to have a baby by wallethub.com.

It is important to plan for children as unintended pregnancies can cause huge financial strains on families and can have serious health implications for mothers and infants if pregnancies occur too close together. But there are other, equally important issues to consider before becoming pregnant; availability of and access to quality prenatal care, adequate food resources, housing, how will the mama/family fare without mama’s income, childcare and availability and accessibility of resources such as transportation that may pose potential roadblocks to a healthy pregnancy and birth.

The article in question alluded to the fact that if a couple cannot afford a child, they should not have a child. Well, I live in Texas where availability of and access to family planning information and resources is extremely and increasingly limited. So what is a couple to do? Perhaps they cannot afford a child but in Texas, there is not readily available contraception and virtually no access to abortion. Should people simply stop having sex? That won’t happen!

I agree, finances should factor into the decision of whether or not to have a child. The reality is that conception is happening regardless of financial status (or even couple status!!). In my opinion, the best states or more pointedly, the best places to have a baby (because there are little oases within what I will call “maternity deserts”, areas that are fairly void of any sort of maternity support or reproductive health care) are places with the following:

  • obstetricians and midwives, and facilities that allow both to perform deliveries
  • birthing facilities that use the least amount of intervention that is safely possible
  • birthing facilities that allow fathers and doulas to be present to support mama during labor and delivery
  • birthing facilities that allow mama to freely move during labor
  • birthing facilities that believe in immediate skin to skin bonding between mother and baby (even before wiping off the vernix, provided there are no health complications in either mother or baby!)
  • birthing facilities that promote breastfeeding and provide immediate and readily available lactation support to new mothers

These characteristics should define whether or not a provider, a hospital or birthing center, a city or town or a state is “best for mama and baby.” The worst state in which to have a baby according to Wallethub.com is Mississippi and yet I would bet that within that state there are a few hospitals or birthing centers that are supportive of childbearing women and offer quality care and support. In addition to financial considerations, prior to pregnancy (or at least prior to birth) mamas and their partners should research health care providers and the health care facilities available to them in their states, cities and communities. For sure some cities will have more resources than others, and some states will have more resources than others. But that doesn’t mean that having an uncomplicated, normal healthy birth is absolutely impossible. It just means that mamas will have to be savvy, do research about what is available and collect as many resources for themselves as possible.

Mamas, be careful what you read. The headline “Vermont is the best place to have a baby” is misleading alone, may have had many mamas ready to relocate and truly doesn’t give mamas and their families tools and tips to evaluate birthing resources and facilities in their area that may in fact be “Mama and Baby Friendly”. I believe that every woman can have a healthy, uncomplicated pregnancy and birth a healthy full term normal weight infant. This is much easier to do in some areas where resources are more readily available than in others, but it is possible none the less. Use the aforementioned list as a guide to evaluating resources and with a bit of research, you too can make your pregnancy, labor and delivery mama and baby friendly-no matter where you live in the United States!

Mamas on Bedrest & Beyond is committed to helping mamas have safe, healthy pregnancies, labors & deliveries and healthy full term babies. If you need help finding resources in your area, e-mail info@mamasonbedrest.com.

References:

Wallethub.com

The US Centers for Disease Control and Prevention

The Guttmacher Institute

 

Mamas on Bedrest: To end the bedrest debate, we need more healthy mamas!

September 22nd, 2015

Greetings Mamas!!

The bedrest debate continues as more and more studies are advocating treatment of the causes of bedrest in lieu of activity restriction. However, there are those that are convinced that bedrest is an effective treatment for preterm labor and prolongs pregnancy. Let’s take a look at the evidence.

For over 25 years, Judith Maloni, RN, PhD researched bedrest and found that the practice has no apparent benefit and has been shown to be harmful to pregnant women. Her publication, “AntepartumBed Rest for Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth”(1), Maloni denounced the bedrest prescription because there was no evidence to support the practice.

In 2007. NASA released an article which showed that female astronauts in space lost bone mass and muscle mass and strength in as little as 2 weeks of inactivity, and the effects were even more pronounced at 60 days.(2) They recommended that if women do have to be on limited activity for an extended period of time, they should engage in a modified exercise program to maintain bone and muscle integrity.

The World Health Organization and Amnesty International have both denounced the bed rest prescription and have had sharp criticism of the United States-which boasts the highest costs of maternity care than any other country in the world, yet has some of the highest rates of complications, bed rest, interventions, cesarean sections and maternal and infant morbidity and mortality-to rethink their maternity care practices and to bring their maternity statistics in line with the rest of the world.

In 2013, physicians in the American Congress of Obstetricians and Gynecologists began questioning the practice of prescribed bedrest and Christina McCall, MD (3) and Joseph Biggio, Jr., MD (4) both called on their ACOG colleagues to stop the practice of bedrest citing the harm that is poses to pregnant women.

However, bedrest remains a mainstay in obstetrical practice. Here in Austin, the 2 major hospital systems each have large antepartum units which cater to women experiencing pregnancy complications. My colleague Angela Davids, founder of Keepemcookin.com, recently blogged about an article by Drs. Christine Piette Durrance and Melanie Guldi (5) in which the authors concluded after an extensive review of PRAMS (Pregnancy Risk Assessment Monitoring System) data of some 200,000 women, that limited inactivity does reduce preterm birth before 33 weeks by 7.7% and low birth weight infants (weighing less that 1500 grams) by 15.4%.

So what are mamas to think? Should they abandon bedrest? Remain on bedrest? Is there a way to not have to go on bedrest, to not encounter the complications that lead to the bedrest prescription?

At this juncture if you are a mama on bedrest, I WOULD NOT recommend abandoning the care plan that your provider has put into place for you. If you have questions about whether or not bedrest is necessary in your case, speak with your provider and voice your concerns. I am a firm believer that if you have hired (chosen) a provider for services, then you should follow their directions. Now if you are having reservations about being on bed rest, its efficacy and whether or not it is doing harm to you, you must have a candid conversation with your OB and get your questions answered so that you can make an informed decision.

I myself am a proponent of mamas getting off bedrest. I believe the way to do it is to help women to be in the best shape BEFORE they ever think about getting pregnant so that when they are pregnant they are strong and healthy. Many of you reading this may be saying, “Well fat lot of good that does me now!” I sense your frustration. There is nothing we mamas on bedrest do better than second guess ourselves! But what you did in the past (no matter how recent) is of no consequence. As Dr. Maya Angelou eloquently said, “When you know better, you do better.” You know better right now, so begin taking exquisite care of yourself right now! As much as possible,

  • Eat healthy, nutrient dense foods.
  • Drink lots of water (1/2 your current body weight but in ounces).
  • Rest (I know that sounds ridiculous, but many mamas on bedrest are so stressed out they don’t sleep well and don’t rest. Your body is not only maintaining you, it is also growing another fully complete human being. That most certainly deserves a nap!
  • Do stretches t keep your muscles supple and limber. (BedrestFitness!)
  • Keep your spirits up

I don’t know what is to become of bedrest and the bedrest prescription. I do know for the nearly 1 million women who will experience bedrest, you have to take care of yourself. If you are in the Austin, TX area, look me up! I always enjoy mixing with mamas and would be happy to serve you.

How are you surviving bedrest? Share your tips and comments section below.

 

References

Judith Maloni, Ph.D.  AntepartumBed Rest for Pregnancy Complications: Efficacy and Safety for Preventing Preterm Birth (Biological Research for Nursing 12(2) 106-124)

Mark Ransford. NASA-Funded Study finds Exercise Could Help Women on Bedrest November 15, 2007

Christina McCall, MD, “Therapeutic” Bed Rest in Pregnancy, Unethical and Unsupported by Data”, vol 121, No.6 June 2013, 1305-1308

Joseph Biggio, Jr., MD.“Bed Rest in Pregnancy, Time to Put the Issue to Rest!” vol 121 No. 6, June 2013, 1158-1160

Christine Piette Durrance and Melanie Guldi. Maternal Bedrest and Infant Health.

Mamas on Bedrest: Let’s Talk About Sex (after) Baby!

April 23rd, 2014

Greetings Mamas,

It’s Video Wednesday April 23, 2014. Today’s topic-SEX!!! The topic was raised by a mama in our community and it’s a topic we’ve not discussed much, so I decided to address it here.

The reality is that many women aren’t interested in sex post partum. The research estimates that as many as 80% of women experience a change in their sex drives (usually a drop) immediately following the birth of a baby. When you stop to think about it, it makes a lot of sense. Women have been pregnant, and have experienced extreme physical as well as emotional and hormonal changes. In our case, mamas have been on bed rest and been inactive. If a woman had a vaginal delivery, there was a lot of force against the perineum and possibly a tear or episiotomy with stitches so she may still be sore. If mama had a c-section her belly may be sore from that. Then she is breastfeeding, she’s tired, she’s adjusting….There are just so many issues that it’s hard for many women to even think about sex.

In this video, I offer some things to think about to “get the sexual wheels turning” and so sex will actually take place. While sex may not be on the top of a new mama’s priority list, it is very important for the couple to reconnect. So I hope this video is helpful. If it is, say so in the comments section below. If you have information to share, please do!