Mamas on Bedrest: What We can Learn From Elephant Births!

June 25th, 2014

safe_imageGreetings Mamas!

This video showing the birth of a baby elephant is all over Facebook, and I even posted it to the Mamas on Bedrest & Beyond Page. Now I have been known to post all things mamas and babies on this page, so it probably was no surprise when this video appeared. However, I want to call your attention to some very specific details in this video that should be mandatory for any birthing female-of any species! I truly believe that if we practiced the habits exhibited by the elephants in this video, birth outcomes in humans (especially in the US) may very well improve!

1. Allow Mama to labor in whatever position is most comfortable for her. Throughout this video, the laboring mama elephant is moving about the elephant pen and doing what she can to find comfortable positions while her baby makes its way through her birth canal. This mama is not placed in the lithotomy (on her back, legs up in the air) position! And mama is not being given any medications to “speed up the labor” or to dull the pain. This mama elephant’s birth is following nature’s course and in due time, this mama elephant gives birth to a healthy baby elephant.

2. Mama should make whatever sounds she needs to make while laboring and delivering. This mama elephant cries out when she needs to and in a way that is natural to her. No one is telling her to “Get mad” and push her baby out! She is using sound and movements natural to her to manage her labor and delivery.

3. Mamas may snack while in labor. At one point during the video, another elephant offers the laboring mama a branch to snack on as she labors. This is in stark contrast to laboring women her in the US who are not given food and water but instead are hooked up to an IV fluid bag “In case a c-section is necessary”.

4. Mama took all the time she needed to labor. No one told mama elephant that her labor was taking too long, she wasn’t given pitocin and she wasn’t told she’d need a c-section if her labor went beyond a certain time. Mama Elephant simply kept roaming the pen and moving about until finally her body pushed her baby out “at the perfect time”.

5. Other female elephants were there at the birth. African Elephants are known to be very tribal and when a female is giving birth, the other females of the herd care for her and support her during her pregnancy, are present and assist as needed during labor and delivery and help the new mama raise her young one. African Elephants have a 22 month gestation and only get pregnant once every 5 years, so supporting the growth and development of the babies is critical to the survival of the herd. As seen in this video, when a mama elephant is laboring, the other females of the herd offer her food (tree branches), keep her cool (throw sand on her body), check the birth progress (sniff and lick her bottom) and help clean and care for the new baby when it was born.

In many cultures and species, birthing is considered to be “women’s work”. If we look throughout history, women traditionally attended births; be it the mom, aunties, cousins, or other women in the community. In this way, the wisdom of childbearing and childrearing was passed down. Modern day obstetrics severely hinders this passage of information from woman to woman and generation to generation. It has in many ways thwarted the knowledge many new mamas have at childbirth and the shared commitment to the mother and infant from families and communities. In Elephants, once the elephants mate, the male moves on to another herd while the newly pregnant mama elephant is now cared for and supported by the mamas, aunties, sisters and cousins in her herd. A pregnant elephant is never left on her own because her herd recognizes that the survival of the entire herd depends upon everyone being healthy and well. So mama is nurtured throughout her pregnancy, labor and delivery and once the baby is born, the entire herd raises the baby.

We could learn a lot from elephants and quite possibly improve our human birth outcomes!!

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.