Monday, August 27, 2012

TV or No TV? The guide to being a lazy parent... ;)

There were certain things I said I would “never” do once I had a child. This list includes many things, but 2 of them were brought to the forefront this past weekend. One of them was to give her the basic jarred baby food. Well since Charley is a little over 4 months old now and local produce is becoming ripe, my sister in-law and I decided we were going to make some baby food this past weekend. Here’s a picture of our successes! In a little over 2 hours, we made carrots, zucchini, apple, and beet cubes that we froze and will be ready for her in a couple months when she’s ready for food.

Now this blog isn’t and never has been about how awesome of an organic mother I am. So this post isn’t about how to be all “hippy-dippy” and make your own baby food. This is about the 2nd thing I said I would “never” do- let my baby watch tv.

Somewhere in the back of my head I can hear a voice from my pediatric training saying that kids under the age of 2 shouldn’t be exposed to any television because of the constant flashing of images. It was explained as this… as adults, if we’re exposed to a strobe light- it’s very distracting and can have a neurological effect on us (people susceptible to seizures respond strongly to strobe lights). If you ever take the time to count how many seconds a television is focused on 1 shot, you’ll notice quickly that it isn’t very long at all- and commercials are the worst. So although we have been desensitized to this and it doesn’t appear to have a blatant neurological effect on us adults- it is similar to a strobe light to a child. As a practitioner that knows a lot about the neurological system, this theory makes perfect sense.

For the past 4 ½ months, I’ve been lecturing my husband, sister, mom, dad, baby sitter, etc. anytime Charley is pointed at a tv and she is clearly watching it. I’ll simply reposition her so she can’t turn her head to look at it and stare at the tv. So far so good. I may have been a little annoying to my family- but I felt as though I was sticking to my guns in the sense that I wasn’t taking the easy way out. Because let me tell you, Charley would stare at a tv for only God knows how long self-entertained.

So last night my husband and I put some real effort into making a nice dinner and it became quite apparent as we started plating, that Charley was not in a mood to let us enjoy ourselves. So I did what I feel every exhausted and overly committed mother would do. I put on the tv, positioned her swing so she could stare right at it, strapped her in and turned the swing on. (Now in my defense- I put it on baseball because I feel the cut shots are much less in the slow moving sport). The girl laughed and stared at the tv, self-entertained for the entire time we ate peacefully. The whole 6 minutes I was eating, though, I was torturing myself, convinced I was ruining our child’s rapidly growing developmental system.

This guilt sent me deep into some research to find out if I’m actually ruining our child by letting her look at tv. Although the concept of the “strobe light effect” makes sense to me, I can’t say I’ve seen it backed up by any research anywhere. Maybe I made up this theory in my own head.  

I started doing some research and found over and over, repeatedly that the American Academy of Pediatrics recommends absolutely no tv until 2 years old. The WHY is the important part, though. They claim it increases their chance of obesity and can decrease their cognitive development and language scores by 1/3 compared to 14 month old babies who had never been exposed to tv.

So at this point, I was ready to go back to my original statement of never letting her watch tv, but I looked a little deeper. Everything I read said that the reason is to do with time is better spent engaging your child and they will become smarter little people if you don’t just stick them in front of a tv to educate them- well duh.

One study is quoted, “Pediatricians widely believe the first two years of a child's life are a critical time because the brain isn't fully developed at birth. A majority of brain development is completed in response to the child's environment during the first 18 or 24 months of life. Time spent watching television takes away from activities such as playing, talking with caregivers and exploring the world around them, all of which have been proven to help development, says Dr. Donald Shifrin, past chair of the committee on communications at the American Academy of Pediatrics, which represents 63,000 pediatricians nationwide.”

Another one states, “Babies who watched 60 minutes of TV daily had developmental scores one-third lower at 14 months than babies who weren't watching that much TV. Though their developmental scores were still in the normal range, the discrepancy may be due to the fact that when kids and parents are watching TV, they're missing out on talking, playing, and interactions that are essential to learning and development.

When it comes to older kids, that’s a whole other can of worms that has negative side effects like brain washing from commercials, exposure to violence, decreased physical activity, etc…. but my baby is watching baseball, and only for a couple minutes.

I couldn’t find anywhere, any proof that the flashing of images is why television is bad. Study after study supports that it’s more an issue of the “type” of parent who would allow their child to watch tv at such a young age, is also the “type” of parent who won’t engage them and will let them be lazy and eat junk food. Since I know I’m not that “type” of parent, I feel that if I can get 5-10minutes of a peaceful dinner, or loading the dishwasher while my child giggles at the baseball game on the glowing box 10 feet away… I think I’m in the clear.

a few of my references...

Tuesday, June 5, 2012

Birth Plan- What is it, and do you need it?

When my patients are around 35 weeks of pregnancy, I ask them how their birth plan is going. With first time moms, the most common response includes a look of confusion, followed by, “my plan is to have the baby.” A lot of people don’t know what a birth plan is, or more importantly- why they need one.
Why you need a birth plan is to control as much of your surroundings as possible during a very vulnerable time in your life. It is not uncommon for you to feel scared or helpless during labor, and having control over small details can help. Having a birth plan is not only about small details such as mood lighting and sounds. It is also about big details like how you feel about pain medications, episiotomies, and what is done to the baby after birth.

When starting from square one, I first suggest a woman and her partner get their hands on as many birth stories and videos as possible. Whether this includes watching “A Baby Story”, reading Ina Gaskin’s “Guide to Childbirth”, or renting some educational videos, you may not know how broad the spectrum is for typical births now a day… and how are you supposed to know your options or what you prefer without witnessing/reading about it? Perhaps you prefer being able to walk around freely during contractions, or dim lights, or a waterbirth. Even if you envision giving birth to the 90s hit sensation group “Boys II Men” blasting in the background, it’s your damn birth plan and you can want whatever you want.

That being said, if you’ve decided to give birth in a hospital, you may want to discuss your ideas with your obstetrician before falling in love with any one thing, as many hospitals have rules on what is and isn’t allowed during labor. For instance, a very common “demand” by laboring women is to be able to eat and drink freely during labor to keep up their strength. This may be a black and white, “no” from the hospital as it is their policy to have you prepped for surgery at any given point during labor. But every hospital is different, so just find out the rules of yours.

Once you and your partner have established what you like and dislike about some births and then cleared what is and isn’t allowed with where you’re birthing, then you begin forming your own birth plan. The invention of the internet has made this one of the easiest steps.  There are many very helpful websites when it comes to building a birth plan that allow you to just check off boxes from a variety of options and press print. Here is a couple that I send my patients to:

When reading through some of the options provided, you may get the sense that you’re being bossy and telling the doctor or midwife what to do. Although I fully support people taking charge of their birth experience, it is important to be respectful when talking to your doctor. Some of these statements are like telling your accountant “I would like to get a big tax return this year.” Some things are just out of their control and when reality strikes- it doesn’t matter what your plan was. To be honest, I see more birth plans hit the fan once labor starts rocking and rolling- but that still doesn’t mean you shouldn’t have one.

Here are a few of my favorite items to have on a birth plan:
·                               -Laboring at home as long as comfortable/safe
·                              - Avoiding inductions at all means possible
·                              - Eating and drinking freely to keep up strength
·                              -Moving around freely
·                             - Controlling surroundings like temperature, lighting, smells, and sound (perhaps you dig aromatherapy  and want to diffuse lavender oil)
·                             -Not being offered pain medications unless the couple seeks it out
·                             -The ability to try alternative labor augmentation like nipple stimulation before Pitocin or membrane rupture is suggested
·                            -  keeping the hospital “interventions” to a minimum. Every time you need to stop your flow and get your blood pressure checked, checked for dilation, or asked a question- it interrupts what your body is trying to focus on. The more a woman can go inside her own head and tune out everything around her, the faster the body will progress. 
·                             - No episiotomy unless the baby appears to be in danger
·                            - No forceps, vacuum, or greedy little OB hands pull the baby out. The force from pushes and uterine contractions is usually more than enough to push the baby out. An OB or midwife should simply be there to guide the baby out
·                           -Baby should go directly to mom’s chest- skin to skin contact is proven to be best for the baby
·                          - Give the baby a chance to take his or her first breaths on their own without sticking a suction bulb down their throat

There are so many more options and details available to a mother, and these are just the tip of the iceberg.
The last suggestion is even if you don’t think it’s necessary, write your birth plan down and bring copies to your birth. Some people feel that just because they discussed their wishes with the doctor ahead of time, that their birth plan is communicated to everyone on their birth team. Unfortunately this is not usually true in a larger birth setting like a hospital. Over the course of a labor, you may go through numerous nurses that never sat down personally with you or your doctor to discuss your needs and wants. If you find yourself butting heads with a particular nagging nurse- feel free to hand her a birth plan and tell her where to shove it.

Ultimately, remember that a birth plan is just that- a plan. Birth is exciting and unpredictable, and never feel guilty or embarrassed if your birth doesn’t go as anticipated. 

Thursday, April 12, 2012

Planning for the Organic & Natural Nursery

If you haven’t realized yet that along with a baby comes a boat load of STUFF, then you need to check your pulse because you may not be alive and functioning. It’s not just the big stuff that fills your house with clutter, it’s all the small stuff too. And then there’s the completely non-sensible stuff that you don’t need (and never wanted) that people give you because it’s marketed as a baby product and is “cute”. What you decide is necessary or not isn’t what this blog post is about. It is about keeping all of that “stuff” safest for your baby.

For most people, this post will send you into a fear induced tirade through your baby’s nursery, looking to throw out everything considered harmful. Until you realize that EVERYTHING is considered harmful and then you’ll just find yourself overwhelmed, frustrated and angry, and not knowing what to do, or where to start. As parents, protecting your child is the number one priority in life, but realizing you can’t protect them from everything is a lesson in itself. They say knowledge is power, but I think it can cause insanity and obsession. Yet here we go, on another attempt at creating the safest, most natural and organic world for my little baby to live in.

Here is a general guideline of the toxic chemicals that are most prevalent in all of our baby’s “stuff” and why you want to avoid it whenever possible:
Flame Retardants- Many flame retardants have gone through a “trial by error” period in time. In the past we’ve coated everything from mattresses to pajamas in flame retardants in attempts to keep a baby safe when surrounded by fire- to later find out they caused serious health effects and make them illegal to be used. Chlorinated Tris (aka TDCPP) is the most popular one used today and is known to be carcinogenic, cause nervous system harm, damage brain cells and hormone disruption.
VOCs (volatile organic compounds)- found in many paints and finishes. Benzene, styrene, toluene, xylene, and formaldehyde. Some of these are known to be carcinogenic or neurotoxins, causing symptoms such as headaches, fatigue, difficulty breathing, and eye, skin, and airway irritation.
Phthalates- class of chemicals used as softeners in plastics like PVC or vinyl products. Can disrupt hormone activity, reduce sperm count, and cause liver or breast cancer.
BPA (bisphenol-A)-  used in many hard plastics and is a known endocrine disrupter. This can damage male reproductive organs, causing enlarged prostates, shrunken epididymides (sperm carrying ducts), and decreased sperm counts. This can also cause early puberty, miscarriages, and birth defects with long term exposure.
Parabens- synthetic preservatives found in cosmetics and personal care products. Can cause skin irritation, rashes, or dermatitis. It has also been found in breast tumors, and is a suspected endocrine disrupter.

Things to consider when registering/buying for your nursery

1. Padded Products
This includes things like changing pads, car seats, bassinet pads, co-sleepers, nursing pillows, and mattresses. The most common flame retardant used in many of these (about 80% of products) is chlorinated Tris. This chemical escapes easily from the padding it is located in and can contaminate and toxify the air around it.
-Choose products that use more organic ways of being fire safe, such as wool, or look for manufacturers that use safer, less toxic chemicals. Baby bjorn, Orbit Baby, and Boppy all report producing baby products without chemical flame retardants.
-Also because of the increased “off gassing” that occurs closest to time of manufacturing, looking for gently used products that may be a couple years old will decrease your off gassing. Or you can let your newly purchased padded products sit outside or in your garage for a few days or weeks so it doesn’t off gas in your nursery.
-Avoid products that contain polyurethane with the label TB117 that indicates it has been made with toxic flame retardants

2. Paints & Finishes
Look for paints that claim to be “VOC free”, natural or organic, or natural milk paints. These all have little to no fumes. If you are going to be polyurethaning or staining any items in your nursery, look for more organic stains and finishes that use things like tree resin or citrus oils. There are many products like this available for purchase online. If you’re in a pinch and going to your local Menards is all you have time for, choose water based stains or finishes. Water based stains dry faster and release less chemicals into the air. Spray paint also contains chemicals such as dicholormethane, trichloromethane, 1,4-dioxane, xylenes, toluenes and other toxins that can have both short and long term health effects like asthma.
Although you don’t have to worry about buying lead paint anymore- keep in mind that only a few decades ago, using lead paint on furniture and toys was not known to be hazardous. There are cheap test kits at hardware stores that you can use to test old pieces of furniture to determine if it has lead paint.

3. Mattresses & Furniture
The safest mattresses are those made with wool, cotton, or natural latex without vinyl cover or stain resistant coatings. You should avoid polyurethane foam mattresses treated with flame retardants. Some highly rated, safer choices include the “Naturepedic no compromise” mattress or “natural home simply affordable organic baby crib mattress”. Many of the symptoms associated with the chemicals used inside crib mattresses are scarily similar to those of SIDS. Cardiac or respiratory failure being the key health hazards.

Most of the baby furniture found in stores like Target, Babies R’ Us, etc use pressed wood. What this means is that many small bits of cheap wood were glued together into one larger piece of wood. Many of the glues and chemicals they use to do this are very toxic- one of the most popular being formaldehyde. Try finding furniture that is made from “real woods” like oak or maple. Since often these are more expensive and less available, keep an eye out at garage sales or antique shops. A special report done by Good Morning America found that a new rocker in a nursery was off gassing 5 times the legal limit of formaldehyde. So keep in mind that although sometimes more expensive, and less available, they will last much longer.

4. Personal Care Products
From morning til night, we coat our skin in many different products that can contribute to toxic inhalation and direct absorption through the skin. Items like shampoos, lotions, bath soaps, butt balms, diaper wipes, sunscreens, insect repellants, laundry soaps, and perfumes contain a long list of chemicals in the ingredient list to preserve them and make them effective at “cleaning” or “deodorizing”.

-Look for certified organic products and those with the fewest ingredients.

-Avoid care products that contain parabens, phthalates, DMDM hydantoin, fragrance, triclosan, sodium lauryl sulfate, DEA, TEA, formaldehyde, PEGs, or anything with glycol or methyl.

-If price or availability leaves you few options, try making your own. There are many helpful    resources online that use everyday household products like olive oil, baking soda, and essential oils. Here’s a quick link for making your own diaper wipes:

5. Plastics, plastics, plastics
By now most people know that BPA (bisphenol A) is a bad thing and they choose products that claim to be “BPA free”. BPA is often found in baby bottles, plastic kitchenware, and canned food. This becomes a larger health hazard when heated. Look for plastic #7 to indicate that BPA is in a product.
In addition to looking for BPA free products, also avoid plastic #3. #3 indicates that the product contains PVCs. PVCs contain phthalates and are found in food packaging, cling wraps, and children’s toys including teethers and “soft squeeze toys” like beach balls, and bath toys.
Plastics may be unavoidable in your nursery, but look for products with #2 and #5, as they are accepted as the safest and most recyclable.

If by now you’re not freaking out about all the potential health hazards surrounding your baby, here’s a video to push you over the edge:

More Helpful Tips

1. Allowing things time to off gas before putting them in your nursery is essential. It may take days or weeks for some products to fully air out before it would be safe to put them into the nursery. If done too quickly, it will greatly affect the air quality.

2. Open a window. Air quality is what is largely affected by many of these products. Simply airing the nursery out whenever possible is going to help eliminate exposure. If the time of year doesn’t allow you to open a window, take things you’re most concerned about out of the nursery and let them off gas in your garage or outside.

3. Get rid of dust. Get an air purifier with a HEPA filter- this will help eliminate dust that has been found to be loaded with chemicals. Also be sure to wash drapes, rugs, and bedding often.

4. Cut clutter. Although this seems impossible with all of the stuff “necessary” to care for a baby, the less you have- the less the risk of items containing many of the aforementioned toxic chemicals. Go through your nursery and get rid of any stuffed animals or toys your baby never uses and donate them.

5. Don’t add more fuel to the fire with cleaning products. Remember that over doing it with harsh cleaning products will only add more chemicals and problems to what you’re trying to eliminate. The Pinesol smell? Not actually from pine needles believe it or not. There is so much information on the internet now for more natural solutions to cleaning. Here’s a start

6. Start learning more. It’s never too late to have an impact on future purchases, no matter how old your child is. Many of the chemicals listed are dangerous because of their long term exposure. One of my favorite resources is book “Healthy Child Healthy World” by Christopher Gavigan.

My Nursery Story
In my idealistic state prior to creating the nursery, I envisioned a beautifully organic nursery full of organic fabrics, simplicity, and handmade products surrounding my baby. My end result was something far from it.
Sometimes being “crafty” or “thrifty” backfires. For instance… my mom had this beautiful antique dresser she found in an ally a few years ago. It had great architectural lines with great chipped paint, giving it that shabby chic feel I wanted. It was going to be the perfect changing table- and FREE. When my mom brought it up from La Crosse to my house, the possibility of it being lead paint was brought up. So we tested it and of course- my beautiful dresser was completely covered in lead paint.

Now I don’t know if it was just the lead paint, or the culmination of my organic idealistic collapse so far, but this pushed me over the edge and I started crying... crying really really hard. I had such high hopes for this damn nursery, and by now I had spray painted picture frames, bleached non-organic fabric everywhere, and had a cheap cushiony rocker- almost guaranteed to be filled with flame retardants and chemical filled stuffing. How can you possibly start with such good intentions and end up here? But I wasn’t about to start over, so after I stopped crying, I slapped 4 coats of polyurethane (water based of course!) on that dresser, painted the knobs pink and threw it in the nursery.

That wasn’t even the end of it. While doing research for this blog, I discovered that one of the most toxic car seats with chlorinated Tris in it was the Graco Snugride…. Which happens to be the car seat so beautifully waiting in my back seat right now for me to put my little angel in- awesome.

Now we did do some things right. My parents made a beautiful oak crib, and we found a gently used organic mattress for it. I’ve been able to have the windows open for the past 3 weeks, and have an air purifier running around the clock. Many of our clothes are second hand, meaning that all of the original dyes and bleaches have been sent through the washer an extra few times before my baby will wear it. We also purposely didn't get a rug because of all the glues used to keep them together. The nursery still has that “new plastic” smell, but maybe I’m just being overly sensitive.

Putting together a natural and organic nursery has been hard, and some might say impossible. When you add in that you only have control over what you buy, and not what is bought for you- it only gets worse. Although lovingly gifted to me, I’ve had to return many diapers, bath soaps, clothes and toys. Of course you feel like a complete a** doing this, but that’s just a part of what makes all of this difficult. You have to figure out what you want, strive for it, and then be ok with falling very short. If you’re anything like me, no matter how hard you try, you’ll still only compare yourself to that idealistic organic nursery and find everything you’ve done not good enough.

Good luck, and may the odds be ever in your favor.

Tuesday, April 3, 2012

Prenatal Nutrition and Exercise

So I already admitted in the intro to this series that I didn’t get a chance to do a pre pregnancy cleanse like I had always hoped and planned. Pregnancy snuck up on me and I all of a sudden one Sunday afternoon had to start treating my body like a “temple” rather than a collective pit for margaritas, hot dogs, cheese curds, and beer that I had been treating it like.

I feel it’s important to preface any information I give out on nutrition, that I had these grandiose ideas of how I would eat and exercise when pregnant. I imagined eating healthier than I ever had, giving up caffeine completely, buying many more organic products than I already did, and eating a lot of protein and nutrient packed smoothies. I would finally figure out how to consume those “hippy” things like wheat grass, chia seeds, spirulina, and coconut oil. The following section is a compilation of the ideal and my reality during the last 9 months of my life.

The most basic of prenatal nutrition is the importance of taking a prenatal vitamin. The biggest difference between your average “one a day” and prenatal vitamin is going to be folic acid (B6) content, calcium content, and iron. Folic acid is the big deal that everyone talks about because of its proven effectiveness at preventing neural tube defects with the baby.

Through my research and training, I feel that the mother’s diet or supplement should incorporate more protein, calcium, omega 3s, choline, and vitamin D as well. Consumption of all of this seem to be the number one issue with pregnancy, as many women don’t exactly feel like eating as nutritious as they had hoped.

If you are one of those lucky women who has no problem blending up some spinach in your morning smoothie, getting 9-11 servings of organic produce, 80gms of protein daily, or chomping down on a huge organic greens salad for dinner- good for you! More than likely the typical “one a day” prenatal is good enough for you because of the quality of nutrients you are getting from your food.

Or you may be one of those women who can’t stand to even look at a vegetable in the first trimester and has to rely on getting nutrients from your vitamins. This was my category. Luckily for me, I didn’t have much nausea associated with my produce revulsion and was able to swallow a hefty amount of vitamins to make up for what I ate, or more importantly what I didn’t eat. Below is a picture of the pile of pills I took daily… well almost daily.

I realize that this may look very different than many of your “one a day” vitamin, but here’s what’s in that pile o’nutrients: 2 multivitamins, 2 calcium, 1 choline, 2 fish oil, and 2 vitamin D. Choline and fish oil are very beneficial in the growth and development of the baby’s nervous system, and vitamin D is a very strong immune system support. This is more important for women living in areas with moderate to severe winters and are more likely to have decreased levels of vitamin D. What your “pile o’nutrients” looks like is going to vary from pregnancy to pregnancy depending on what additional issues have arisen for you-  whether it is heart burn, high blood pressure, sleeping problems, low energy, nausea… etc.

So we’ve covered category 1-the woman who actually eats as healthy as you’re supposed to and doesn’t crave doritos and ice cream; category 2- the woman who gets sick thinking of eating nutritious food, but is able to swallow a hand full of pills; and now we’ve got category 3- the stage 5 mess of nausea, puking, and a nasty gag reflex. A couple of my most nutritious conscious friends fell into this category during pregnancy and resorted a taking a one a day gummy or Flintstone vitamin. I am not going to lie to you, this is barely better than nothing at all. But you have to work with what you can while pregnant, and at least you’re going to be getting more folic acid. But please realize that this is not enough if you are able to take more. Get yourself on the most nutritious diet you can and take the highest quality of supplements that you can.

As far as ideal nutrition goes, there are plenty of books and online resources that will give you chapters and chapters of information on what to eat. There’s no way to cover everything in this short blog, so here were a few of my general guidelines.

-When it comes to produce, I am a big fan of following the “dirty dozen”. These are the 12 fruits and vegetables if bought organically, will reduce your pesticide intake by 95%! They include: apples, celery, strawberries, peaches, spinach, nectarines, grapes, sweet bell peppers, potatoes, blueberries, lettuce, and kale/collard greens.

-I also tried to start choosing products that had the fewest of ingredients possible. We picked dairy products with less preservatives like butter that only had 2 ingredients: cream and salt.

-We bought grass fed beef because of its lack of antibiotics, hormones, and increase in omega 3s.

-We bought organic grass fed milk for me only, and my husband still had to drink the normal stuff because organic milk is so expensive where I live! We’re talking $5 for half a gallon.

-Drink half your body weight in ounces of water a day

-We also found local eggs because of the higher nutrient quality, and much lower risk of salmonella.

-I also tried to increase my protein content to at least 80g a day. I got a lot of it through milk, chicken, beef, bacon, nuts, eggs, greek yogurt, and lots of cheese.

-We started getting the creamer for my coffee that only had 3 ingredients: milk, sugar, and natural flavoring.
Oops…. The cat’s out of the bag. I drink coffee…. Every day. According to research, a pregnant woman can have 300mg of caffeine a day. If you are able to give up caffeine while pregnant, that is the healthiest thing for your baby. But just in case you can’t- here are some very loose numbers to give you an idea of what 300mg looks like:
     8oz medium roast coffee- 130mg
     1 shot of espresso- 70-80mg
     Coke- 50-60mg
     Tea- 50-100mg
     Hershey’s Chocolate bar (1.5 oz)- 9mg

So I’d love to tell you that I also avoided fast food and heavily processed white flour and sugar, but that just wouldn’t be the truth. Although I knew I shouldn’t, I’ve eaten more McDonalds and dairy queen in the past 9 months than I have in the last few years. Don’t judge me… look at the picture of my vitamins again!

Again, high hopes here that fell drastically short. I had planned on becoming a runner prior to pregnancy.  This I had actually planned as part of my “pre pregnancy cleanse” or work out. I never have considered myself a runner but always wanted to be. Oh… to be one of those people who goes for a 10 mile jog because it’s such a gorgeous day. I did occasionally go for a couple mile run (usually 2, but at brief moments in my life was at good enough condition to do 4 or 5). But I knew that in order to run during pregnancy, the obstetricians always say, “if you were already a runner prior to pregnancy, then you’re fine to continue running.” Well what was I? I sure as hell wasn’t a runner

I did my best to keep working out at least as much as I was prior to finding out I was pregnant, but that didn’t really happen. I was so tired, that sleeping seemed like way more important than going to the gym. When we got a treadmill, it did help eliminate one hurdle in getting exercise and I resumed at least walking 2 or 3 times a week for 20-30min. I firmly believe that the time of year you’re pregnant makes a big difference here.  The majority of my pregnancy was over the winter, when going for after work walks wasn’t really an option. It was dark by 5pm, I was tired from work, and all I wanted to do was eat a bacon cheeseburger, watch tv on my couch, and pass out by 8:30.

And although I recommend to all of my pregnant patients the importance of yoga, lifting weights, doing squats, strengthening the core and pelvic floor- I barely did any of it myself. THIS DOES NOT MEAN YOU SHOULDN’T- it just means I’m lazier than I expect you to be :o)

For those of you with more motivation and will power than me, here are some helpful links:

Just in case any of you were wondering, I remain an optimist and plan on eating healthier than ever and working out more than ever after the baby is out in order to lose the 45 pounds that McDonalds and not exercising has built up on my body. Haha… another reality check post for another day.

Next blog will be on the nursery and collecting all the baby essentials. 

Tuesday, March 27, 2012

Home Birth, Birthing Center, or Hospital?

This was one decision we had already talked about and planned on. Living in Rice Lake, WI, there are limited birthing options- but more than one would expect. Although I work with many of the obstetricians in the area on a professional level and I respect them greatly, my husband and I knew from research that your chances of an unmedicated and natural birth are much higher at home or in a birthing center. (I was not a fan of having my first child at home for purely opinion reasons and no evidence against it. For now I like the idea of going somewhere to have the baby and coming home with her. We’ll see how I feel about baby #2).

Both the mother and father must be very comfortable with where they’ve decided to give birth. It is very well known amongst midwives and obstetricians that fear can stall or create problems with a labor. If a mother decides to homebirth but is scared that she’s going to need medical interventions- it could very well be what causes a transfer to happen. But likewise, if a mother decides on a hospital birth, but is very scared of getting a c-section, she is increasing her chances just through that fear. A mother and father must be truly comfortable with their decision and be confident that they are at the location that will best reflect their birth plan.

Home Birth
Home birth is going to be a great option for the right candidates. If you are not considered a high risk pregnancy and know of a midwife who can attend your birth at home, then it is likely that home birth is an incredibly safe and rewarding option for you. In 1900, nearly half of births were done at home. By the mid 1900’s it was down to less than 25%, and currently is less than 1%. It is important to know that this shift has been largely due to a fear mentality that has arisen with birth, and not attributed to any studies that show it is unsafe. It is actually the contrary. Your chances of having a c-section go from about 30% in the hospital to less than 5% at home. Studies even show less chance of injury, death, or infection when birthing at home. Now that one shocked me and I had to re-read it when I learned that. How is it possible that birthing at home has less chance of infection and a lower rate of infant death? Yet after looking around at multiple sources, it appears to be true. The infant mortality rate at home is approximately between 1.1-2.2/1000 births. At a hospital the infant mortality rate is 5.7/ 1000 births. You are also not exposed to as many dangerous strains of bacteria at home that exist in hospitals despite their best attempts at being sterile. Respiratory resuscitation is 17 times more likely in the hospital than at home as well.

As the wife of an unofficial statistician, I should point out a very large “flaw” in most stats supporting home births. Much of the time, only women who do not have a high risk pregnancy are recommended to birth at home. If you are a “high risk pregnancy” or become one during the labor process- you are transferred to the hospital and are now included in the hospital’s stats. It could be concluded from that that the hospital has an “unfair” pool of women since they have many more high risk candidates than home births…. Just sayin.

If your wish is to have as natural and unmedicated birth as possible, and you are a healthy candidate, you should seriously consider looking into a home birth. It goes without saying that you are free to wear what you are comfortable in, eat or drink whatever you want, and do as you please at home. There are very few distractions that will occur at home that are likely to stall labor as well. One last note on home births… this can be a great option if you have no insurance as it is usually thousands of dollars less than a hospital birth.

Birthing Center
Birthing centers are wonderful for people who may be a little weary of the home birth idea, yet know they don’t want the “typical hospital birth”. This option may feel a lot safer to some than home birth because although many of the statistics of better mortality rate, less infection, and less interventions still apply, there are some medical interventions available at a birth center that wouldn’t be at home. Each birth center is going to be different on what they offer for medical advancements, but it is probably safe to say that none of them do major surgeries such as c-sections. If something unpredicted or more serious arises during birth, then you would transfer to a hospital at that time. Again with birth centers, you need to “qualify” to be a candidate for an out of hospital birth. Many of the benefits of a homebirth and birthing center birth are that you can cater your birth plan to your wants and needs. It is much easier to assure an environment that limits interventions like constant fetal monitoring, allows the mother to eat and drink during labor, walk around, and get into whatever position is most comfortable for her.

What should also be noted about midwife care versus many ob appointments is the amount of time they spend with you. Personally, I have an obstetrician who “signed off” on me being a safe out of hospital candidate, and she was amazing and wonderful- yet still my appointments were at best 15 minutes long. All of my prenatal appointments with the midwife have been between 40min to an hour and a half. During these appointments we discuss everything from nutrition, to the pros and cons of certain tests/interventions, to my emotional status.

Having a midwife so far in my pregnancy has been wonderful as she has also suggested many more natural approaches to “conditions” that have arisen during my pregnancy. Initially, I had higher blood pressure than ideal at my first few prenatal appointments. My midwife had 5-10 various suggestions for diet and lifestyle that were natural and noninvasive to me and my baby. Over the course of the next two months, my blood pressure dropped to a safe level. (Please note that many hospitals in the country have midwives available- there are none in my area, though.)

Well this is obviously the much more common choice in America. This is a wonderful option for those that feel uncomfortable with the idea of birthing at home or in a center, or for some reason are considered a “high risk pregnancy”. If you are wondering if you are a high risk pregnancy, see this link by the National Institute of Child Health & Human Development.

This is a good option for those that do not plan on “opting out” of any/many of the typical procedures and tests done around pregnancy, labor, and birth. Some of the procedures that may be standard at your hospital are: multiple ultrasounds, pelvic examination, STD testing, blood and urine testing, gestational diabetes test, use of the Doppler, triple screening, and group B strep test. There are also many things that are considered “standard” during labor, delivery, and neonatal care that will be discussed in the future birth plan blog.

In general, most people don’t need to be “talked into” a hospital birth, they just assume that is the safest and best place for them. If part of your birth plan is an epidural, then being at a hospital is kinda your only option. This blog is not to shame anyone for choices they make about their birth- so no one be offended if you raised your hand and said, “yes please!” to an epidural. This is not the “whether to get an epidural” blog… again that is in the future birth plan blog.

BUT, if you want a natural birth at a hospital, I will forewarn you of the “slippery slope of interventions”. This usually goes as follows… the use of Pitocin, which causes stronger contractions, which may require fetal monitoring. Stronger contractions usually mean more pain with less rest time, which requires the pain relief from an epidural.  Epidurals have side effects of longer labor and maternal fever. That usually requires antibiotics for the mother and baby. Some hospitals give what they call “walking epidurals” which allows the woman to be standing for birth. If your hospital does this- great! If yours doesn’t then you are on your back for labor which is the WORST position for labor. At this point it is common for either forceps, vacuum, or episiotomy for the baby to come out vaginally, or a c-section. That is the “slippery slope of interventions” in a nutshell. There are multiple studies out there to support that the slippery slope of interventions is true and common. If studies aren’t your gig… start asking around and you will hear it over and over again from your friends and family.

This blog will not answer all of your questions on where to birth, as there are many books that are completely dedicated to this subject. There are some links at the bottom of this blog, otherwise I suggest “Ina May’s Guide to Childbirth” as a great book to get you started. Good luck in your decision process, as this is the first “hard decision” of many.

Part 3 of this blog series will be on prenatal nutrition and exercise.

Thursday, March 22, 2012

Having a Natural & Organic Birth, Labor, and Baby: The Ideal, the Plan, & the Reality (part 1)

As a chiropractor with a clinic that focuses on pediatrics and prenatal care, I was already aware of the “to dos” and “not to dos” of pregnancy and labor. When I actually got pregnant, I found out that making many of those decisions is much harder and requires more work than I sometimes cared to do. In preparing for the birth of my child, I realized that there’s the ideal, the plan, and the reality.  

Currently, I am 36 weeks pregnant and you can call it nesting, or call it whatever you want, I’ve decided that sharing this crazy journey of attempting a natural, organic pregnancy, childbirth, and eventually child rearing with my readers is a good idea. Side note - did you know that the author of “What to Expect When You’re Expecting”, Heidi Murkoff, wrote the entire first edition of her book during her first pregnancy based on frustrations with what pregnancy books were available at the time? (Now is not the time for my soap box on that book, and how I don’t recommend any of my patients read it… that will be a future post on its own).

So, although I don’t anticipate this blog series turning into a movie someday, I do hope that it can be a tongue in cheek, yet informative series for many of my patients and readers on the planning process of having the more natural -and non-assembly line pregnancy and birth.

Prior to getting pregnant, I thought I knew exactly how everything would play out once it happened. I had had a lot of advanced training on avoiding unnecessary medical interventions, what to not eat, what to be sure to eat, what special supplements to take, what products to avoid in the nursery… and on and on and on. I knew it wasn’t going to be easy but knew it was important for our future child to be protected from many of the unnecessary (and potentially harmful) hospital procedures and from many of the toxic products that surround pregnancy and infancy.

First bump in the road of “the ideal organic pregnancy and baby”… no pre-pregnancy cleanse. We found out we were already pregnant when we were already 5 weeks along.  I admit that my husband and I were very fortunate and did not have any trouble getting pregnant, and I actually got pregnant 1 month earlier than we “planned on trying”. So, my original plan to begin a more natural and less toxic diet to “prepare” my body for pregnancy changed from plan to reality. Had I been able to do the pre-pregnancy cleanse, it would have involved eliminating alcohol, tobacco (I don’t use tobacco- but for those of you who do, now is a good time to start quitting), caffeine, and all the obvious junk food offenders. I would have continued buying a lot of organic produce, and begin taking my prenatal package of vitamins, and even started to exercise/run more. Of course, much of this pre-pregnancy cleanse would have included my husband since he contributes half of the genetic makeup of this future child.

It was semi disappointing to know that I had started this process off not as planned as I will admit to being somewhat of a perfectionist and idealist in nature. But, once we learned the exciting news of our pregnancy, we immediately scheduled an appointment with our midwife, I started taking a load of prenatal vitamins, and I poured out my 7&7. (Ok… I wasn’t actually drinking a 7&7 at the time of finding out I was pregnant… but I figuratively poured it out :o).

Over the next few weeks and months, I plan on writing many blog posts on this entire process including subjects like:
-Home birth, birth center, or hospital
-Prenatal nutrition and exercise
-Prepping an “organic” nursery
-The natural birth plan
-Hard medical decisions once the baby has arrived (vaccines, circumcision, breast feeding, Vitamin K shot, gonorrhea drops, etc…)
-Natural/Organic decisions once the baby is home (cloth diapering, co sleeping, baby wearing, etc…)

This blog series is meant purely to give my journey of decision making, and although it will include many statistics, numbers, and facts, this is not meant to be a mother’s (or father’s) end all be all resource for natural and organic decisions. I will include books, dvds, and websites on the subjects for that purpose, though.

Please excuse my sarcasm and potentially offensive opinions… and try to enjoy with a grain of salt.
Part 2 will be on home birth, birth center or hospital.