Labor and Delivery

Mamas on Bedrest: Who should be at your side when you deliver?

June 11th, 2014

Greetings Mamas!

Mamas, “Who should be at your side when you deliver?”

Current wisdom is that it should be the baby’s father. But what if the baby’s father is unavailable? The birth of your baby is one of the most monumental moments of your life! You need to be completely comfortable, able to freely express yourself and receive nothing but support. You must choose a birth partner who is not only completely supportive of how you are birthing, but they must be able to advocate on your behalf if you are unable to advocate for yourself. With those parameters in mind, who will be at their birth of your baby as YOUR support? Share who you chose to be in the delivery room with you and why in the comments section below.

Mamas on Bedrest: How pregnancy triggers physiologic and emotional responses in women

May 9th, 2014

Hey Mamas!

PregnantwomanonballI’m bringing you Part II of Kathy Morelli’s series on physical and hormonal influences on women’s mental health. In Part II she focuses on the changes that occur during pregnancy. Kathy breaks down the emotional responses to pregnancy this way:

Emotional. What if the pregnancy was unplanned? What if this pregnancy follows a stillbirth or miscarriage? What if her primary relationship with the baby’s father is not going well? There is also job stress, financial factors and a whole host of other life stressors that combined can make the news of a pregnancy hard to take and All of these emotional considerations require attention and adjustment. We clinicians and birth workers must be aware of these potential life stressors and be sure that we are as vigilant in addressing these emotional needs of the women that we serve as we are addressing their physical needs.

Physiologic/Hormonal. By the first six weeks of pregnancy, estrogen levels rise to three times more than during the menstrual cycle! Progesterone levels also rise quickly and Progesterone is also implicated in depressive moods. As the pregnancy progresses through the second and third trimester, along with elevated estrogen and progesterone levels, the hormones cortisol, prolactin and oxytocin rise. Cortisol is a strong player in the HPA feedback loop. High levels of cortisol are also associated with depression. And prolactin is also associated with anxiety, anger and irritability. Oxytocin is known as the bonding and happiness hormone. Natural oxytocin causes nutrition absorption, uterine contractions, pair-bonding, mother-infant bonding, pain amnesia, calmness and feelings of belonging and happiness. Now add in bed rest! Mamas on Bedrest are at increased risk of developing perinatal mood disorders because in addition to the normal hormonal fluctuations of pregnancy, the stress of being on bed rest and the unsurety of the pregnancy stimulate the “fight or flight” response, releasing additional cortisol and neurotransmitters that will affect Mamas’ mood.

During an uninterrupted birth, there is a surge of oxytocin, beta-endorphin, adrenaline, noradrenaline and prolactin. These hormones all combine to orchestrate the event of birth and positive emotional outcome. Oxytocin for uterine contractions, calmness, love.  Beta-endorphins for a protective emotional high during a peak physical activity.  Adrenaline rush for energy and the final push of the fetal ejection reflex.  And high prolactin levels to consolidate breast milk production and breastfeeding. However, if there is medical intervention of any sort during labor and delivery; an epidural, episiotiomy, forceps/vacuum extraction or cesarean section, this natural hormonal protection and mood enhancement is disrupted and often lost resulting in birth trauma, post tramautic stress disorder and post partum depression. The extent of the trauma is different for every woman and typically correlates to the level of intervention. Researchers are just beginning to understand the delicate interaction between hormones, labor and deliver and a women’s mental health, and as more research is done, we will have better understanding of this complex interaction and how best to care for women during pregnancy labor and delivery to protect their mental and as much as possible, minimize negative emotional effects.

In Part III, Kathy looks at hormones and post partum! 


Mamas on Bedrest: Don’t Lose Sight of What’s Truly Important!

April 30th, 2014

Happy Wednesday, Mamas!

In this video blog I want to encourage you to partner with your health care provider-not contradict or become adversarial-for best birth and health outcomes for you and your baby.

I was on one of my birthing professional sites and happened to read a disturbing account written by a woman who had hired a doula for her birth. The Doula essentially told this woman to do the opposite of whatever her OB advised, telling her that the OB was just trying to control her birth and give her a c-section. I was really moved by this account and got into a deep online discussion with some other workers on the site. Some wanted to blame the mama for listening to the doula, but I countered with “If you are unsure and has hired someone to help, it is natural to defer to their “expertise”.

That sparked this vlog. While I am a wholehearted proponent of doulas, THEY ARE NOT MEDICALLY TRAINED PROFESSIONALS! I really want to re-emphasizes the importance of having complete trust and confidence in your provider, being able to ask questions and have them answered fully to your satisfaction and being able to have the ancillary support that you need. Enjoy the post and please share your comments and experiences in the comments section below.