2014 Informed Pregnancy Guide by Informed Pregnancy Magazine

Informed Pregnancy Guide

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InformedPregnancy.com

In this issue: Empowering Birth Stories p.16/44/58

Baby Name Fun Facts p.33 Guide to Non-Maternity Pregnancy Clothes p.36 The Real Cost of Childbirth p.52 Birth Center Directory p.77 Sleep for New Babies (and parents!) p.86

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A Note From The Editor:

Welcome to our Empowerment Issue By Dr. Elliot Berlin If I’ve learned anything from the past ten years working in the world of pregnancy and birth (and as a husband and father of four!), it’s that pregnancy brings out a lot of emotions. Two of those emotions, although conflicting, very often co-exist: excitement and fear. Excitement is only natural. A new family member is on the way! Many times I hear “I’ve dreamed about being a mother since I was a little girl,” or “our neighbors probably heard us screaming when that test came back positive!” Excitement leads to enthusiasm, and a keen interest in learning everything about the process of pregnancy and birth. Fear is a very different emotion, but one that is partly natural - after all, we humans are no different from many of our relatives in the natural world in our instinct to protect our young - but more often, the fear I see is clearly the result of outside influences. Those influences tell us that pregnancy is riddled with risks, complications and discomforts, and birth is so dangerous and painful that women would be crazy to attempt it without help from modern technology and highly skilled surgeons. In today’s culture, women don’t deliver their babies; doctors deliver babies. Watch the average TV show or movie about birth and you’re in for some serious drama - what’s a birth without a water breaking in a public place, a panicked rush to the hospital, and a woman screaming in complete and utter agony? What’s a birth without a decelerating fetal heart rate, and a team of surgeons declaring “we need to get this baby out, and NOW”? I’ll tell you what it is: normal. There’s a reason the average birth doesn’t make it to TV or the movies while it may be the single most incredible moment in the life of the new parent or parents, there’s usually not nearly enough drama involved to keep an audience watching. Women have been birthing without a room full of machines, a drawerful of drugs and surgeons sharpening their scalpels for thousands of years. Women still birth today without those things. It’s great to have these tools when they are necessary, but the evidence suggests they are harmful when overused. In my experience, women who feel more fear than excitement trend towards having birth “done for them,” resulting in a higher number of interventions and often less euphoria after birth; women with more excitement than fear appear to be in the driver’s seat, usually birthing their baby in an environment where they feel the most safe, the most free, and encouraged by the people they have carefully selected to support them. For some women, that safe environment is a hospital, while for others, it’s home. These empowered women know the facts, and trust the ability of their minds and bodies to deliver the healthy child they have grown and nurtured from conception, on their own. Empowered women investigate all their options before deciding where they feel most comfortable birthing; they seek out care providers who instill them with courage and positivity, and they prepare for birth knowing the journey will be intense, but also knowing they are up for the challenge. p.6

Hailey Murray, the Managing Editor of this year’s guide, is no hippie - if only you could see how ruthlessly she fact-checks every sentence in the guide! We met when she was a patient of mine, expecting her first son, and she had infinitely more excitement than fear - she was firmly in the driver’s seat. As Hailey puts it, “I know I have modern medicine to thank for my life. I had multiple cutting-edge heart surgeries in my late teens and early twenties to correct a heart condition that could easily have killed me, and when it’s allergy season, I’m popping a pill almost every day! My husband wasn’t comfortable with me birthing outside a hospital because of my medical history, but it never even occurred to me to birth any way but completely naturally unless there was a true emergency - I labored in the hospital for sixteen hours with a doula for support, and there was pain, but it was pain with a purpose. It was pain that signified progress. I even have photographic proof that I was smiling, cracking jokes and kissing my husband in between pushes - I was high as a kite, but it was all 100% natural. My body and my baby worked together exactly as they were designed to do.” All over Los Angeles, women like Hailey are reclaiming their power to birth how they want to birth. They are frustrated with the high rates of intervention that have led to one-third of babies arriving via cesarean. And the market has responded; today you have more choices than ever, including multiple top-notch hospitals, an explosion of freestanding birth centers, and a resurgence in the number of home births. We have “traditional” obstetricians who deliver in hospitals and midwives who deliver in homes, but we also have obstetricians who’ll attend home births and midwives who practice in hospitals. In order to be empowered, you need accurate information; not information skewed to instill fear. With accurate information you can make informed choices, and find providers and birth spaces that will put you on the path to your idea of success. Our mission at Informed Pregnancy® is to compile and deliver that information in print, online and through other media including documentaries, podcasts, childbirth education workshops and classes and live events. One of those projects, a documentary called Heads Up: the Disappearing art of Vaginal Breech Delivery, will hopefully be available online as you read this. One of the many real-life mothers featured in Heads Up is Kimberly Van Der Beek. At 37 weeks, Kimberly and her husband James discovered her second baby, Joshua, was breech, and also learned that her obstetrician would not attempt a vaginal breech delivery under any circumstances. Kimberly came to me, and I tried my best to restore maximal pelvic function to give her baby space to turn naturally, but Joshua had his own ideas about how he wanted to be born. Kimberly went with her instincts, and did all the research she could to become truly informed about the safety of vaginal breech delivery. She also sought out an obstetrician who routinely delivers breech babies, who confirmed that she was a good candidate. With all the ‘boxes checked,’ Kimberley changed her birth plan completely - she hired the new obstetrician and delivered Joshua breech, at home, with no “emergency” involved. Her words are so true to our ‘Empowerment Issue’ that I won’t even try to substitute my own- “when Joshua was born, that wasn’t the triumphant moment for me. That was just magic and peace. I think my triumphant moment was when I decided to do something I believed in.” I hope as you read the pages of this magazine, you’ll find yourself feeling more knowledgeable, empowered, excited, and ready to face any mountain you have to climb to have your own triumphant moment - and much, much less afraid. For more information on the documentaries, podcasts and live events visit InformedPregnancy.com or “like” Informed Pregnancy on Facebook.

Yours In Health,

p.7

Table of

Contents Understanding Breech Babies

Berlin, DC By Dr. Elliot

pg. 66

nt Stylist’s The Pregna -Maternity on N Guide to Clothes Pregnancy yxbee By Kacy B

pg. 36

Strong, Sexy, Fun: Lo ving and Mov ing Your Pregnant Body

Pregnancy, Mental Health and Medications: Questions and Answers

By Sara Haley

Dr. Emily Dossett, MD

pg. 46

pg. 40

features 16

Two New Lives

The Real Cost of Childbirth

Baby Name Fun Facts

Healthy Babies, Healthy Mothers

The Pregnant Stylist’s Guide to Non-Maternity Pregnancy Clothes

Understanding Breech Babies

It’s Not Your Mother-in-Law’s Birth: Speak Up and Stand Firm!

A VBAC Journey By Allison Sowers

Compiled By Hailey Murray and Sarah Selva

By Kacy Byxbee

Pregnancy, Mental Health and Medications: Questions and Answers with Dr. Emily Dossett, MD

A Second Chance and a New Beginning A VBAC Journey By Kate Eales

Strong, Sexy, Fun: Loving and Moving Your Pregnant Body By Sara Haley

p.8

By Rhondda Evans Hartman, RN

A VBAC Journey by Beth Townsend

By Dr. Elliot Berlin, DC

By Hailey Murray

The Truth about “The Latch”

Know Your Options: Birth Center Directory

Our Lives as Dads

By Jessica Martin-Weber

By Robert Nickell

For a directory listing of OBs, Midwives, Pediatricians and more visit DoctorBerlin.com

Sleep for New Parents and New Babies

The Truth about “The Latch”

By Shannon Hernandez

By Jessica Martin-Weber

pg. 86

pg. 74

ost of The Real C Childbirth

da Evans By Rhond , RN an tm Har

Our Lives as Da

pg. 78

pg. 52

features

tiny tips

6 11

Head Down: Breech Babies and Hypnosis By Alisha Tamburri, CCHT, MH

Keys to the Mother-Baby Bond

By Laurel Wilson, IBCLC CCCE CLD CLE and Tracy Wilson Peters, CCCE CLD CLE

By Robert Ni ckell

A Note From the Editor Behind the Scenes Directory Index

Sleep for New Parents and New Babies By Shannon Hernandez

modalities

Prenatal Chiropractic Prenatal Massage Prenatal Acupuncture Craniosacral Therapy Birth Counseling

On the cover: Kristin Prosser Photo by: Canary Lane Photography

Pediatric Chiropractic Labor Preparation p.9

PODCAST

Get informed. Get empowered. Roadside Delivery - What would you do if you had to deliver with no medical assistance? A new mom shares what happened when she got stuck in rush hour on the way to her birth and couldn’t make it to the hospital, and midwife Aleksandra Evanguelidi helps an imminently due couple feel confident knowing what to do should same happen to them. Pregnancy Taboos - Pregnancy can feel like big fat book of restrictive no no’s. Obstetrician Dr. Jay Goldberg stops by to help sort through truths and myths and better understand the core issues behind pregnancy recommendations. Sushi? Wine? Coffee? Cheese? Eggs? Juice? Exercise? Sex? Tanning? Hair Color? Nail Salon? Sleep Position? Lots more; listen and learn. Green Pregnancy - there are chemicals and toxins hiding all over our homes. Dr. Berlin chats with Pregnancy Awareness founder Anna Getty about easy and sensible steps for cleansing ‘the nest’ for your new baby. Learn about the materials that go into a crib mattress and how to select a mattress that is safe for your baby and the environment with environmental engineer Barry Cik. The Vaccine Debate - in this heated multi-episode series, Dr. Berlin explores what vaccines are, how they work and the current United States vaccine schedule. Get honest information about the risks and benefits of each vaccine and the diseases they are meant to protect us from. Pediatricians Dr. Marina Burstein and Dr. Jay Gordon candidly share their differing opinions in a powerfully sincere discussion. Vaginal Birth After Cesarean - After having a c-section, women in subsequent pregnancies can either delivery by repeat c-section, or a Vaginal Birth After Cesarean (VBAC). Jen Kamel, founder of VBACFACTS.com, joins Dr. Berlin to discuss the latest research and facts about the risks and benefits of each option and some of the obstacles women have to overcome should they choose a VBAC.

Dont miss an episode! Listen and subscribe at:

InformedPregnancy.com

Behind the

Scenes Publisher & Editor-In-Chief Dr. Elliot Berlin, DC 323-549-0070 info@DoctorBerlin.com

Editorial

Art & Production

Managing Editor

Art Director

Hailey Murray hmurray@DoctorBerlin.com

Michael Fujitani Graphics 310-266-5578 itsfuji@gmail.com

Director of Marketing & Ad Sales

Photography

Joseph Berman 323-834-9131 jberman@DoctorBerlin.com

Canary Lane Photography 951-378-8714 Canarylanephotography.com

Contributing writers

Circulation

Elliot Berlin Kacy Byxbee Emily Dossett Kate Eales Sara Haley Rhondda Evans Hartman Shannon Hernandez Robert Nickell Hailey Murray Allison Sowers Alisha Tamburri Jessica Martin-Weber Laurel Wilson Tracy Wilson-Peters

If you would like copies of The Guide please contact our office. 323-549-0070 info@DoctorBerlin.com

Business Office Website InformedPregnancy.com Berlin, LLC 6221 Wilshire Blvd., Suite 518 Los Angeles CA 90048 info@DoctorBerlin.com

AD SPACE AVAILABLE! If you would like to advertise in the next issue of Informed PregnancyÂŽ Guide, please contact Berlin, LLC at 323-549-0070

**Please note: The materials and information in this guide are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a licensed healthcare professional. Consult with your licensed healthcare professional before implementing changes to your diet, exercise or routine or before adding or stopping new modalities. Nothing contained in this guide should be construed as an endorsement by Berlin Chiropractic Corp. or Berlin, LLC. ÂŠ2014-2015 Berlin, LLC. All rights reserved. Reproduction of this guide, in whole or part, is forbidden without permission of the publisher. Volume 7, July, 2014.

p.11

Two New Lives A VBAC Journey by Allison Sowers When I became pregnant for the first time, I knew from very early on that I wanted to bring my baby into the world naturally. I loved learning about birth, and couldn’t get enough of the stories and videos. My husband Josh and I took a natural childbirth class, and I remember thinking I wouldn’t need any of the medical interventions we were being warned about; my sister had all three of her kids naturally (including twins!) and my mother had accepted drugs with us, but still had fast, uneventful vaginal deliveries. I assumed I would experience the same. I didn’t think too much about the journey of labor, I just fantasized about the end result – the birth of my baby. I couldn’t wait for that big cinematic moment where I would give one last push and we would hear the baby’s sex shouted out. I couldn’t wait to nurse and feel my baby in my arms. I had it all staged perfectly in my mind. That was not what happened. At around 7am a few days before my due date, my water broke. My husband Josh and I drove to the hospital, and a check confirmed that my water had broken, but I was only dilated 1cm. I still felt really positive; we settled into our room and were laughing and having a good time. After taking a walk to try and get things moving, we returned to our room, where our nurse informed us that because my water had p.16

broken I needed to progress and have my baby within 24 hours, and I was already running out of time. That was when the party ended. I began feeling deflated and didn’t feel like doing anything I had learned in my birth class. The day passed by in a blur. That evening, they checked me again, and I was only at 1.5cm. My heart sank. Even though my birth plan said NO DRUGS, my nurse gave her best pitch for Pitocin – she said it would help me progress and get me to my vaginal delivery before my 24-hour deadline. I remember her saying something about not wanting me to lose the chance of a vaginal delivery altogether. Until that moment, I had never considered a caesarean as a real possibility. I gave in and said yes. As the Pitocin dripped away, strong labor contractions finally made their appearance. It didn’t take long for them to take over my body, and each contraction felt like it was happening right on top of the next. I felt scared and then guilty, but I needed help. I needed the epidural. Josh was kind and supportive, but I couldn’t shake the feeling that I’d let him down. I was horrified and in tears as they placed it in my back, but grateful once it began to give my body some relief. I was even more grateful when the next few checks revealed I was dilating – soon I was at 5-6cm, then 7, then 8. But then everything stopped. I remained at 8cm

for hours and hours. I spent the next day working on progressing those last centimeters (My OB overruled the 24-hour ‘deadline’ because our vitals looked great.) My epidural wasn’t giving me relief on both sides of my body so they kept turning it up. At around 2pm, I reached 10cm and was ready to push. Yes! Finally! So I pushed, and pushed, and pushed… I couldn’t believe it when someone told me I’d been pushing for almost four hours. Somewhere in that fourth hour I got the baby down so far that her head was right there, but she just wouldn’t come out. My OB tried the vacuum twice, but with no luck. By this point the room was crowded with a NICU team and people were saying things like “shoulder dystocia.” My OB decided to call the head physician from her practice, the one doctor I did not like and did NOT want attending my delivery. From the first touch I was reminded why I did not want him near my body. He was so hard on me I couldn’t help but scream. Then he declared that the baby would pass vaginally, and turned off my epidural in favor of a local anesthetic; my birth was now his show. The local was terrible. I could no longer connect my brain with my body to push effectively. When he said, “I was wrong, the baby won’t pass, these pushes aren’t getting us there,” I began to cry. Then he told me I couldn’t try squatting or another position, because I had the epidural. He said I needed a cesarean. I felt completely scared and helpless, exhausted from two days of labor. Everyone in the room was working to convince me to have the cesarean. I remember my mother looking at me and tearfully saying, “We

need to get this baby out safely honey, take the c-section.” Josh was also crying and terrified. I remember thinking ‘I failed… It’s over.’ So into the operating room I went. They doped me up and laid me out and cut my baby out. Exhaustion and morphine meant I was in and out of consciousness and have zero recollection of my baby’s birth. I did not hear my baby’s first cry. I did not hear the sex announced. I missed my precious daughter Quinn D’arasay being born. I missed it. I woke up alone in recovery, and when they finally brought Quinn to me for skin-to-skin, I was still so out of it from morphine that I couldn’t see straight, and was terrified that she would fall off my chest. I didn’t get to nurse her; I could barely hold her. Later, I was told she had an infection and needed NICU time. I had failed her. Every time I think about all this I cry. I feel so horrible that Quinn came into the world the way she did. No one understands what the whole experience did to me – everyone just says, “at least you had a healthy baby.” Of course I feel grateful my daughter is healthy and beautiful, but those comments don’t help. They make me feel worse, like my emotions were wrong or selfish. I still don’t understand why it all happened. I tried so hard. I felt so cheated. I felt like I let everyone down – Josh, myself, but especially Quinn. And then came Levi. Quinn’s birth had left me feeling empty and scared. I felt very torn in the beginning of my pregnancy with Levi, because while I p.17

wanted a healthy baby first and foremost, I also wanted to rewrite my birthing history. Two obstetricians told me that I was an “undesirable candidate for a VBAC,” because of Quinn’s “failure to descend.” I initially went with an OB who claimed to be VBAC-friendly, but only made me feel more anxious and confused with how he spoke about the risk of uterine rupture. Since Quinn was 9 lbs 6 oz at birth, he wanted a late-term ultrasound to detect size, and then wanted to discuss a repeat cesarean if the baby was “too big for my pelvis.” It became clear the stars were going to have to align perfectly if I was going to birth Levi vaginally. How in the world could I guarantee that? I didn’t want a repeat cesarean, but I also didn’t want another traumatic birth. Then I found www.vbacfacts. com, and everything began falling into place; finally I had real information at my fingertips. Thanks to the members of the www.vbacfacts.com Facebook community, I became convinced I needed a doula to attend my next birth. That doula search led me to the Sanctuary webpage, and then to a free Q&A for expecting parents. That night that I met members of the Sanctuary birth community, and it changed everything. Listening to Dr. Stuart Fischbein and midwife Aleks Evangueldi speak about birth compelled me to share my story, and everyone who listened echoed the same words: “Of course you can do it! You are a great candidate for a VBAC. You are not broken.” I finally understood that I needed to take control of this birth, and manually align the stars myself. I left my supposedly ‘VBACfriendly’ doctor who had only filled me with doubt for a team of hospital midwives, who welcomed my pregnancy and cheered on my VBAC hopes from day one. I hired a p.18

homebirth midwife to act as a monitrice, instead of a doula – I needed her support and wisdom to help me labor at home as long as possible. I took a birth class that taught me new ways to connect with my body and trust in the birth process. I began seeing Dr. Berlin for weekly chiropractic adjustments and massage. I found ICAN. I took spin classes and did yoga twice each week, and even put myself on a low-carb diet to try to keep the baby’s size down! I was a woman on a mission... For a few weeks before my son Levi was born, I experienced prodromal labor nightly. I’d go to bed hoping to be awoken by ‘the real thing,’ only to wake up the next morning still pregnant and disappointed. Our due date came and went like any other day and before I knew it, I was officially a week ‘overdue’. I found myself battling old anxieties about my body’s ability to give birth naturally. Was there something wrong with me? Once I hit 41 weeks, I began to undergo Non Stress Tests (NST’s) with fluid checks and membrane sweeps at the hospital. When I went in for my second NST and membrane sweep, my midwife told me she was comfortable letting me go until 42 weeks as long as the baby and I were fine, but once I hit that magic number we’d need to introduce something to get labor going – hospital policy. Fortunately, after my second sweep things began to get moving! That night, under the light of a blue moon, I began to contract regularly. My contractions kept me up through that evening and into the next day, and when I went to the bathroom at around 8am, I saw bright red blood. It kept coming, so much that I started to feel anxious – my husband and I drove to the hospital, even though I was in constant contact with my monitrice and she was confident it was just my ‘bloody show.’

My monitrice was right, but I was grateful to know the bleeding was normal. We also found out that I was 4cm dilated! The hospital was willing to admit me, but we declined the offer. Back at home, my contractions petered out. I just wanted to be alone in our bedroom with Josh. My monitrice hung out with my family, staying close in case I needed her. I was feeling low, and needed space. I felt like this baby was never going to come out. But then came sunset, and my labor returned, only this time with more intensity. I felt strong back pain and knew my baby was moving lower. It was only a few hours before I began to feel shaky. My monitrice offered to check me, and suggested we should head to the hospital – it was time to have this baby. HURRAH! I kissed now two-year-old Quinn, and off we went. We were greeted by the midwife on call, and settled into our labor and delivery room. A check revealed I was 5-6cm dilated. I labored for a while on my yoga ball, until my midwife offered to break my water. I was torn; with Quinn, my water broke before labor began, which led to a flood of interventions and eventually my traumatic caesarean. My midwife and monitrice both assured me this was a new baby, a new labor, and I was already almost 6cm – I couldn’t let Quinn’s journey decide what journey was best for Levi. I agreed, and they broke my bag. My midwife suggested heading into the shower, but as I walked I felt a huge gush of fluid and my labor took off like a speeding freight

train! I could barely walk. I could actually feel my pelvis widening. Within minutes I climbed onto the bed completely naked, and squatted facing backward so I could hold onto the back of the bed for support, breathing through each contraction with Josh by my side. One more check – I was 9cm dilated! From there my body completely took over. I had to push. There was no controlling it. I turned around on the bed and sunk down into my squat, leaning my back against the bed as I pushed. Never in my life had I felt such a sensation. I didn’t think I’d be able to make it through the pain, but I had my support team surrounding me, pouring their love and energy into my labor and my body. I can still hear my amazing husband shouting in my ear as Levi was crowning. “He’s being born RIGHT NOW! Our son, he’s coming, I can SEE him, you’re doing it, Allison, YOU ARE DOING IT!” as I pushed out my sweet baby boy – all 9lbs, 2oz of him – in only 20 minutes! Immediately after his birth, he was placed on my chest, warm and slippery and beyond beautiful, as my husband huddled beside us. Levi’s size at birth was almost identical to his sister’s, the size I was told I was physically unable to birth myself. I had proven them all wrong. I really wasn’t broken. Actually, I was a freaking rock star! I carry this new confidence with me daily. It’s in everything I do - the way I walk, talk, and love, the way I mother and the example I set for my own daughter. Two lives came into the world that morning – both that of my precious son Levi Zephyr, and a new life of my own as a stronger and more selfassured mother-of-two. p.19

Modalities

prenatal chiropractic What Does Prenatal Chiropractic Care Do For Pregnancy? Chiropractic care in pregnancy is an essential ingredient to well-rounded prenatal care. Many pregnant women experience back discomfort or pain during pregnancy. A healthy spine and pelvis will reduce or eliminate pain and accommodate the rapid growth of the baby with little or no discomfort.

Benefits of Prenatal Chiropractic Care 1

Relieves back, neck, rib, hip or joint pain

May reduce the time in labor

Prevents or eliminates sciatica

Promotes proper pre-birth positioning

p.23

Modalities Continued

prenatal massage Why is Prenatal Massage So Important? Carrying a developing baby changes your center of gravity, creating more stress on your neck, shoulders, back and abdomen. These changes, together with new sleep positions and destabilizing hormone changes, may cause you to end up feeling achy and stiff. Prenatal massage offers a safe and effective way to relieve muscle aches, joint pains, and improve posture and function of your body.

Benefits of Prenatal Massage

p.24

Reduces fatigue and swelling

Improves digestion, lymphatic and blood circulation

Improves sleep

Reduces anxiety

Decreases symptoms of depression

Relieves muscle and joint pain

prenatal acupuncture Why Consider Acupuncture & Chinese Herbs During Pregnancy? Incorporating regular acupuncture treatments before and during pregnancy can build the foundation for a healthy mother and baby. Many women who receive acupuncture during pregnancy enjoy a shorter and easier birth experience. Chinese herbs are often recommended after an acupuncture treatment as they amplify and prolong the overall benefits. Without the use of herbs, conditions may take longer to resolve.

Benefits of Acupuncture & Chinese Herbs 1

Reduces the symptoms of morning sickness

Improves digestion

Relieves heartburn

Reduces insomnia

May improve fetal position

Helps promote labor if post-due

Assists in pain management

Improves lactation production

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Modalities Continued

craniosacral therapy What Is CranioSacral Therapy? CranioSacral Therapy is a gentle, soothing, non-invasive hands-on therapy that works with the bones of the head, pelvis and spine, the connective tissue and fluid surrounding the brain and spinal cord and the nervous system. This wonderful modality helps to ensure the childâ&#x20AC;&#x2122;s skeletal, nervous, endocrine, muscular, circulatory, and digestive systems are working optimally.

Benefits of CranioSacral Therapy CranioSacral Therapy helps with a variety of discomforts such as:

p.26

Colic

Feeding and latching issues

Facial Asymmetry

Difficulty sleeping

Torticollis

Gastrointestinal disturbances

Sinus and vision problems

Fussy baby

birth counseling What Is Birth Counseling? Birth Counseling is a short term model of psychotherapy focused specifically on helping to navigate and embrace prenatal and postpartum concerns or issues. Women and couples learn valuable tools to strengthen their relationships and communication skills, so the transition to parenthood is easier and more comfortable.

Benefits of Birth Counseling 1

Evaluate emotional readiness for labor and delivery

Strengthen partner-to-partner friendship and improve intimacy

Explore the unexpected along the road to parenthood

Enhance the quality parent-infant bond

Improve conflict regulation skills and decrease potential relationship hostility

Learn to recognize normal baby blues vs. postpartum depression

the

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Protocals

pediatric chiropractic Why Is Chiropractic For Kids So Important? Chiropractic care for kids ensures that the spine is free from any misalignments or restrictions which may cause interference within the nervous system. A safe and gentle preventative care option, chiropractic treatments are designed to meet the needs of your child’s size and growth stage. By detecting musculoskeletal and nerve problems early, we work to prevent more serious improvements later in life.

Benefits of Pediatric Chiropractic 1

Improves sleep and feeding

Enhances immune system function

Common conditions complemented through chiropractic care include:

• ADD/ADHD

• Scoliosis

• Bed wetting • Colic

• Sinus/ Respiratory function disorders

• Digestive disorders

• Speech disorders

• Ear infections

• Torticollis

• Birth trauma

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labor preparation Sometimes labor is naturally smooth and sometimes it can be more complicated. However, there are some key steps that can be taken to help prepare your mind and body for an uncomplicated, healthy delivery. Our labor preparation program is designed to shorten labor and delivery time, reduce the need for medical intervention and improve your overall birthing experience. Labor Preparation begins as early as 32 weeks.

At Berlin Wellness Group we recommend incorporating a combination of the following modalities based on your particular needs. 1 Chiropractic Adjustments Ensure the full range of motion of pelvic bones creating the widest physiological door for delivery. 2 Chiropractic Massage Loosen the muscles around the pelvic region to promote unrestricted downward movement for your baby during the final stages of pregnancy and labor. 3 Traditional Chinese Medicine Promote effacement and dilation before contractions begin as well as increase the effectiveness of contractions once they begin.

4 3rd Tri Wellness Check Making sure the mind and body are equally relaxed and tension free in preparation for an uninhibited delivery.

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Fun Facts about Baby Names

Fun Facts

Compiled by Hailey Murray and Sarah Selva The United States Social Security Administration maintains a publicly-accessible list of the most popular names given to babies each year, beginning from 1880! Today, with approximately four million new babies being born in the US each year, compiling the list is no simple task. The most recent year for which complete data is available is 2012. Here’s a comparison of the top baby names in 2012 compared to 1912, as well as the most popular names for babies born in California in 2012: Top 10 girls names (US) 1912 1. Mary 5. Ruth 2. Helen 6. Mildred 3. Dorothy 7. Anna 4. Margaret 8. Elizabeth Top 10 girls names (US) 2012 1. Sophia 5. Ava 2. Emma 6. Emily 3. Isabella 7. Abigail 4. Olivia 8. Mia Top 10 girls names (CA) 2012 5. Mia 1. Sophia 6. Olivia 2. Isabella 7. Sofia 3. Emma 8. Abigail 4. Emily Top 10 boys names (US) 1912 1. John 5. Joseph 2. William 6. George 3. James 7. Charles 4. Robert 8. Edward Top 10 boys names (US) 2012 5. William 1. Jacob 6. Liam 2. Mason 7. Jayden 3. Ethan 8. Michael 4. Noah

9. Frances 10. Marie

9. Madison 10. Elizabeth

9. Samantha 10. Camila

9. Frank 10. Thomas

9. Alexander 10. Aiden

Top 10 boys names (CA) 2012 5. William 9. Alexander 1. Jacob 6. Liam 10. Aiden 2. Jayden 7. Jayden 3. Daniel 8. Michael 4. Ethan Names that held the #1 position most often in the 100 years from 1913-2012: Girls: 43 years - Mary (1913-1946 and 1953-1961) 14 years - Jennifer (1970-1984) 12 years - Emily (1996-2007) 9 years - Jessica (1985-1990; 1993-1995)

8 years - Lisa (1962-1969) 6 years - Linda (1947-1952) Boys: 44 years- Michael (1954-1959 and 1961-1998) 17 years - Robert (1924-1939 and 1953) 14 years - Jacob (1999-2012) 13 years - James (1940-1952) 11 years - John (1913-1923) Baby Naming Tips If you’re still haunted by years of being “Jennifer S.” and you want to give your child a unique name, it pays to take a very close look at the SSA database. For example, if you love the name Jaiden, you’ll probably feel happy to know it only ranked 207th in the list of 2012 boy’s names, with just 1,813 Jaidens born across the US. But if you count alternative spellings of “Jaiden” that also made the top 1000 (in 2012, they included Jayden, Jaden, Jaeden, Jaydon, and Jadon) that 1,813 becomes 21,532! If you then add names in the top 1000 that rhyme with Jaiden (meet Aiden, Ayden, Aidan, Aden, Adan, Aaden, Aydan, Brayden, Braden, Braydon, Braeden, Braiden, Kayden, Kaden, Kaiden, Kaedan, Caden, Cayden, Caiden, Hayden, Zayden, Zaiden, Raiden and Rayden) the number explodes to 81,742. That’s not even counting the sound-alikes that don’t exactly rhyme with Jaiden (Jason, Jayson, Jalen, Jaxton and Jaylin, among others…) or the three rhyming names that made the top 1000 for girls – Jayden, Kayden and Hayden – or are sound-alikes (Jazlyn, Jaelyn, Jaelynn, Jaylee, Jaylynn, Jaylin, Jazzlyn and more...) The good news? While the trend towards “creative” naming might make it harder to gauge the true popularity of a name without taking a very close look at the full SSA “top 1000,” it has also resulted in a much greater pool of names for parents to choose from – even all the variations of “-ayden” names combined don’t come close, percentage-wise, to the popularity of Mary, Jennifer, John or Robert in earlier generations. That said, if you feel strongly about giving your child a name that they won’t have to share with a classmate, it’s now a safer bet to go with Robert (#61 in 2012) over the more popular Jayden, Aiden, Landon, Carter, Brayden, Hunter or Jordan, or Jennifer (#163!) over the more popular Addison, Harper, Taylor, Serenity, Genesis, London, Payton, Rylee, Jordyn, Hadley or Brooklynn. p.33

The Pregnant Stylist’s Guide to Non-Maternity Pregnancy Clothes By Kacy Byxbee Shopping for great pregnancy clothes is almost laughable, and somehow we still don’t have as many fabulous maternity options as we should. While we don’t want to spend copious amounts of money on clothes we will only wear for nine months, we also want to be comfortable during this beautiful time. Here are some of the best maternity basics and must-have’s to make your nine months of the ever-growing belly more enjoyable, comfortable, and fun! 1. Dresses, dresses, dresses, did I say dresses? Perhaps the greatest go-to item for all of pregnancy: the dress. You may want to size up from your normal size when purchasing these non-maternity dresses, but not necessarily. Both form and loose fitting can work on the pregnant body, and it just depends on what you are most comfortable in. The more comfortable you are, the better you look. Also, remember that fabulous, less expensive options can always be found at Topshop and Forever21! Alasdair Twist Dress www.stevenalan.com *optional belt makes this even more wearable pre, during and post pregnancy

Acne Avedon printed oversized sweatshirt dress www.bergdorfgoodman. com

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James Perse Skinny Tank Dress www.jamesperse.com

Tracy Reese Waverly Cocoon Tunic Dress www.anthropologie.com

2. Pants with room If you want to wear jeans, the hair tie through the belt loop trick only lasts most of us so long. Your best bets are maternity jeans like the J Brand below or my personal favorite, sweatpants disguised as proper day wear (you can get away with a lot when you’re pregnant!) The key to buying any pant is make sure they are LOW on the waist. J Brand Maternity Jean www.jbrandjeans.com

James Perse Skinny Sweatpant www.jamesperse.com

3. Comfortable shoes The key to pregnancy footwear is COMFORTABLE and easy to get on-especially as we head into our third trimesters where bending over is no small feat. We still want to feel and look great though, so a small heel is absolutely not out of the question! We are also beyond fortunate to be pregnant during the Revival of the Birkenstock! Check out the collaborations with J.Crew and Barneyâ&#x20AC;&#x2122;s as well as different designersâ&#x20AC;&#x2122; take on the sandal. And one last tip, go see your podiatrist for a custom-made insole. They usually take about two weeks to arrive, and will be a blessing to those tired feet.

Isabel Marant Suede Dicker Boot www.barneys.com *these are available in an array of colors and go with absolutely everything

Converse Classic Chuck Taylor Hi Tops www.converse.com *if tying up your high tops is getting way too tricky, take them to your local shoe repairman and have him add a zipper!

4. Small, easy purse Lugging around any extra weight (besides your belly) is best to be avoided. Its time to downsize your purse; there are several fantastic and chic options like this A.P.C Half Moon Bag.

A.P.C. Half Moon Bag www.usonline.apc.fr

5. Going to the office? Do not fret if you are working a corporate job and needing to be in business attire whilst pregnant! Though most of the aforementioned pieces are for casual dressing, both Vince and Theory have put out some great maternity collections, available at Pea in the Pod.

Isabel Marant sandal www.barneys.com

Vince blouse + dress www.vince.com

Happy pregnancies and happy shopping! xx, Birkenstock Stripe-print Arizona Sandal www.barneys.com

Kacy Based in Los Angeles, Kacy Byxbee is a brand new mother, costume designer, stylist, and owner of online retail boutique Byxbee Atelier. http://byxbeeatelier.bigcartel.com p.37

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Pregnancy, Mental Health and Medications: Questions and Answers with Dr. Emily Dossett, MD As told to Hailey Murray Many women take medications for depression, anxiety and other mental health conditions. In your experience, what happens when those women become pregnant? If a woman has depression or anxiety to the point that she needs to be on medication, when the time comes to get pregnant the typical message she hears is “you should stop the medication.” Sometimes that message comes from the media, often she’ll hear it from her care providers, and she may also hear it from her family and friends. It’s enough to make many women terrified and think “If I stay on my medication, I’m a bad mother. I’m hurting my baby from the very beginning,” and that’s a hard feeling to counter. Of course, the last thing any woman wants to do is hurt their baby! But so much of that fear is based on stigma and misinformation. How difficult is it for women to find care providers who are up-to-date and informed regarding mental illness and pregnancy? It can be very difficult. Many women have problems accessing good information even if they’re already seeing a psychiatrist. Unfortunately, the way that psychiatric training and residency programs are carried out right now, most psychiatrists have very little training in reproductive psychiatry. A lot of psychiatrists will advise women to “just go off” their medication(s) if they’re p.40

pregnant or they want to get pregnant. When you combine that with OBs who’ve had even less training in reproductive psychiatry and just managing mental illnesses in general, it becomes very hard for women to find care providers who can help them feel comfortable making informed choices about their medications. Thankfully, there is a growing acknowledgement and comfort level with mental illness in perinatal women among health care providers, though we have a long way to go. That sounds like a chorus of voices saying “stop taking your medication.” Yes. Combine it all and it’s easy to see why many women feel they have no choice but to stop. They hear so much well-intentioned advice – it is well-intentioned, no one wants to hurt a baby – telling them “just stop.” And there’s their own voice; their own fears that they could hurt their baby in some way. Then there’s a simple lack of access to providers who feel comfortable giving women options. I also see a generally held belief that when you get pregnant, you should stop your antidepressant. I believe many women internalize that belief well before pregnancy is even on their radar. Let’s move on to pregnancy. Do you believe it’s challenging for a pregnant woman to voice that she’s struggling? Absolutely. When we do trainings on this

we talk about ‘the myth of pregnancy.’ As a culture, we have this expectation that a pregnant woman is supposed to be happy, glowing, feeling fabulous, joyfully preparing the nursery… but no pregnant woman feels that way 100% of the time, even if they’re not depressed or anxious. For women who do struggle with depression or anxiety, that myth just makes them feel that much more ashamed. I think we’re also in a culture now where mothers are expected to do everything perfectly – to be a good mother, you have to eat all-organic, you have to exercise five times a week… those ideas can be helpful, but they can also backfire when a woman feels so much pressure to do everything perfectly that if she can’t, she then feels like she’s failed. What postpartum?

about

I think ‘the myth of pregnancy’ also carries over into ‘the myth of new motherhood.’ You’re supposed to be happy and cheery and breastfeed exclusively and from the very beginning, and then make your own baby food… all these ideas about ‘the right way.’ And again, even for a woman who is not depressed or not anxious, it’s not that way all the time, and for a woman who is depressed or anxious the shame is just tremendous. It’s hard to speak up. Even the people who are around a new mother and notice that she’s struggling often say things like “this is normal, this is how it is for everybody.” Most women do experience the baby blues, that’s a very normal phenomenon. But there are a significant number of women who have feelings postpartum that are not normal, and they’re almost made to feel that their feelings are not significant. They’re

just given this message that it’s normal and think “I shouldn’t complain, I should just get through it.” But “getting through” depression is not easy…

postpartum

No. It’s a really scary time for women. And it’s a really scary time for husbands, and partners, and friends, and everyone around a new mother. I see a lot of confusion in families about what’s going on – is it just the baby blues or is this not normal? – and then about what they should do. That’s an interesting point about family confusion. I’m often struck by how quickly the media brands a mother as “evil” because she did something that could have or did harm herself or her children, when so often the people close to that mother report that they’d seen multiple warning signs that she was struggling or “wasn’t herself.” That’s very true. It’s tragic when a woman acts because of her mental illness in ways that have harm for herself or her children. What is really unfortunate about those media reports is that they only add to the stigma around postpartum depression and mental illness. I see women in my office who say, “I’m worried I’m going to go crazy like…,” and they’ll name someone who has been in the news. It feeds on that fear. You’re on the front lines in this battle, so to speak. How do you work to reduce that fear? I do a lot of pregnancy and pre-pregnancy consultations. Either way, reproductive psychiatry is like any other kind of psychiatry, there’s no single answer that p.41

fits everybody. It’s important to understand each woman’s history and what they’re dealing with, and we talk about whatever they’re taking – Prozac, lithium, lamotrigine, whatever it is – and have a conversation about what to do, whether they are already pregnant or, ideally, pre-pregnancy. I try to emphasize that yes, there are risks with medications, and I break those risks down medication by medication, but I also talk about the risks of going off those medications. This is the risk of relapse, and if you do relapse, these are the risks of untreated illness for yourself, for your fetus, for postpartum, and for the ongoing development of your child… I think it’s that risk of untreated illness that is not brought up for the most part when women are getting prenatal care. Everyone is very frightened of the medications, but the reality is untreated illness has very well documented negative effects. I think we best serve women by giving them all the information we have that’s up-to-date, and then really let her make her own choice. And I’ve seen it – I’ve seen women in very similar situations make completely different decisions about what to do. I also try to emphasize that there are many strategies for managing mood or anxiety disorders beyond medications, including psychotherapy, increased social support, and moderate exercise. Given that this is the “Empowerment Issue” of the Informed Pregnancy® Guide, what would you say a woman needs to do to be informed and empowered regarding mental illness and pregnancy? The best thing she can do is try to get all the information she can. And she should try to get it from sources that are going to give her a valid, up-to-date perspective. I’d also encourage her to seek out this information as soon as she can – ideally before pregnancy. I’d like every woman who has struggled p.42

with a mood or anxiety disorder, or worries that she will, to make a plan that she and her partner feel comfortable with that can carry her through pregnancy, into delivery, and through the postpartum. That road map might include medication, therapy, physical support, social support… And I’d really want her to know and to feel confident that with the right planning, women with even the most serious mental illnesses can do really well in pregnancy and as parents. I like that you said every woman should have a plan. Yes. Every woman would be ideal. Of course if you have a history of mental illness or there’s a history in your family, it’s especially important to have a plan. But every woman needs to be informed. She needs to know, for example, that postpartum depression can happen to anyone, but with the right knowledge and support, it can be prevented or treated. Just opening up the conversation helps remove the stigma, and there shouldn’t be a stigma any longer. Emily Dossett, MD, is a psychiatrist focused on helping women with anxiety, depression and other mental health challenges achieve happy and healthy pregnancy and postpartum periods. She is a professor of Psychiatry and Obstetrics and Gynecology at the Keck School of Medicine at the Los Angeles County and University of Southern California Medical Center. She is also the Medical Director of the Los Angeles County Perinatal Mental Health Task Force, a non-profit consortium dedicated to championing perinatal mental health for all women in the region. Dr. Dossett also works with women and families in her private practice in Pasadena. She can be reached at edossett@edossetmd.com. For more information on mental health during and after pregnancy and to connect with other new moms for community support visit InformedPregnancy.com

A Second Chance and a New Beginning A VBAC Journey by Kate Eales My VBAC journey began, as many do, with an unwanted cesarean. It wasn’t that the labor and delivery of my first child were terribly traumatic. But for five hours after my son’s birth - time I had hoped to spend bonding with my new baby - I was alone in a recovery room, my sense of failure growing by the minute. All of the messages of empowerment that I’d received before labor now haunted me instead: Women are built for natural childbirth. Your body knows what to do. You and your baby will work together to make it happen. What did it mean about me as a woman, and as a mother, that I hadn’t done it? I worried that I’d never be able to breastfeed, that my baby and I would never bond, that I had failed him in his first moments of life. These worries faded as we met, and bonded, and breastfed without trouble, but the seeds of doubt about my birth experience had been sown deep. Was it my fault for getting an epidural at 4cm? Had I not been moving enough in labor? Had the clock really run out, or was my midwife (who’d been at the hospital for four straight days with deliveries) just exhausted? During my second pregnancy, I resolved to do as much as I could to avoid feeling so much self-judgment and doubt after the baby’s arrival. I ruled out a home birth, just as I had the first time, but I knew that the first change to make was also the most p.44

important: I needed a new care provider whose opinion and experience I trusted completely. I was thrilled when I found Dr. Jessica Schneider, partly because I knew she was supportive of VBAC, and partly because our communication was so open and easy. I remember coming home from one of our first appointments and saying to my husband, “I’m going for a vaginal birth, but whatever happens, I know I’m in good hands. If she says I need a cesarean, I’ll trust her.” As my pregnancy progressed, I did everything that I felt comfortable doing to increase my odds of VBAC success. I found a wonderful doula, took hypnobirthing and VBAC prep classes, and started regular acupuncture and chiropractic visits. At every ultrasound, I was told that my daughter was measuring big, but my doctor assured me that we could still try for a VBAC. As I sailed past weeks 37, 38, and 39, I took steps at home to avoid an induction, which I knew counter-indicated VBAC success. Herbal teas, nipple stimulation, scrubbing the floor, sex… I tried them all. I remained hopeful for a long time, but as I passed 40 weeks with no sign that labor was near, I realized I was starting to panic. My first baby had been late, and big, and arrived via cesarean, and here I was, past my due date again, with another big baby… I shared my mounting anxieties with Dr. Schneider and she assured me that yes, we could still try.

The decision to go for a VBAC was going to stay in my hands. During those final days, though, Dr. Schneider asked me one question that gave me pause: Why did I want a VBAC so much? Even after all I’d done to try for a successful VBAC, it was a difficult question to answer. For me, having a VBAC certainly didn’t matter more than having a healthy child. Sitting inside that exam room, it was incredibly hard to say out loud that I worried I would feel like less of a woman if I never had a vaginal birth. Hearing myself say it, I knew it was absurd – but once I said it, I cried, and that emotional release felt better than anything else I’d done in the preceding few weeks. After that cathartic moment of letting go, I decided to schedule my induction, and I stopped scrubbing the floor at home. Labor would start before my induction, or it wouldn’t. I spent those last few days relaxing. At the end of my 42nd week, I went in for my induction. I had a mental list of targets for my labor and delivery, and to my joy, everything starting humming along as I’d hoped. After an initial small dose of Pitocin, I labored naturally for hours, and this experience was completely different from my first. At 8cm, I asked for a walking epidural, after which I was able to keep moving: squatting, doing yoga, resting, and then moving again, doing everything I could to make my baby come down. As it turned out, my baby was not coming down. About 24 hours after my induction began, my dilation had stalled and the baby had been stuck at zero station for several hours. Dr. Schneider came in and gently said, “I think it’s time to talk about a

c-section.” And there we were. I won’t deny that I was disappointed. But once my husband and I were alone, discussing our options, we both came back to what I’d said before about trusting Dr. Schneider. She was leaving the door open for me to wait if I wanted to, but she didn’t advise it, or think it would help. What would I be fighting for if I said no, and for how long? My mantra for labor (and the name of at least three tracks on my music playlist!) was “Let Go.” It felt clear to me now that the best way for me to bring my daughter into the world was to let go of my vision for how it would happen. That is how my VBAC journey came to end with a repeat cesarean. But this time, after my (healthy, 10-pound!) daughter was born, my doctor made sure we weren’t separated at all. I held her and nursed her in recovery, and in the days that followed, our bonding and my recovery went beautifully. Before we said yes to the second cesarean, my husband and I talked about how having another cesarean would mean leaving certain questions unanswered forever. Would our daughter have come down if I’d kept on squatting and walking for a few more hours? Maybe. Might I have had a VBAC if I’d had a home birth? Perhaps. Was there anything I could have done differently to end with the VBAC I’d hoped for? It’s possible. But in leaving these “what if” scenarios unanswered, I feel peace knowing there’s another question that will remain unanswered: what if I will never Continued on Page 90 p.45

Strong, Sexy, Fun: Loving and Moving Your Pregnant Body By Sara Haley I for it!) For me, exercise means waking my body up, keeping my muscles alive and enjoying the ability to move.

‘‘Empowerment’ is not just a buzzword. It feeds our self-esteem, our confidence, and our identities. I think that’s why motherhood changes so many of us for the better. While parenting always has its challenges, it can also make us feel strong, feminine and joyful, all at the same time. Another thing that has always given me a feeling of empowerment is exercise. I would never say that exercise is equally empowering as bringing new life into the world, but working out does fulfill my desire to feel strong, sexy and happy. Before you roll your eyes and turn the page, let me define what I mean by exercise. I’m not insinuating grueling hours at the gym (unless that’s your thing, in which case, go p.46

I’m a pre and postnatal exercise specialist and as I write this, I’m 35 weeks pregnant with my second child. I’ve always preached that every pregnancy is different, and now I know that for sure. With my son, I had no pain, no bothersome symptoms, and was still doing jumping jacks on the day he was due (he made his debut ten days later.) This pregnancy has been a different ride in many ways, and no, I don’t think that necessarily means I’m having a girl. I just think I’m three years older and my body is coming from a different place, or perhaps this baby simply has his or her own unique needs, just like all of us! Despite the differences in my pregnancies, one need has not changed for me; I’m still determined to keep my body fit and healthy so that I can have the best possible pregnancy, labor and birth, as well as an easier postnatal recovery. When I created a DVD fitness program for pregnant women, I had three main goals in mind. The first was to include exercises that allowed expecting moms to feel and be strong. Secondly, I wanted to inspire and motivate pregnant women with movements that made them feel womanly and sexy. Finally, I wanted to create fun routines so moms-to-be would smile, laugh and enjoy their workouts. I believe the combination of these three powerful elements – strong, sexy and fun – is the perfect recipe for an empowered workout, body, and life.

HAVE FUN

FEEL STRONG A strong body and mind are essential for a successful labor. I’m sure all expectant mothers would love to feel the strongest and healthiest they’ve ever been when they go into labor. Lunging to keep your legs and butt strong, stretching your back and chest to release tension and stay limber, and elongating your limbs to work your balance and core are some of the best ways to keep your body safe and strong through your pregnancy.

As you progress through your pregnancy, movements that once seemed fun and enjoyable may start to feel awkward and uncomfortable. Rather than getting frustrated, I’ve found the best way to handle this challenge is to work on changing your state of mind. Working out during pregnancy should not be about burning calories, looking a certain way, or sweating your butt off. Instead, focus on just moving your body each day and finding ways to stay active and have fun. If traditional workouts aren’t for you, just do something active that makes you smile – head to the beach, run and play with your older children or the family dog, hold hands with your spouse or partner, and enjoy being fully present in the moment. After all, no matter how many children you already have, a new arrival changes everything!

FEEL SEXY When I refer to feeling ‘sexy’ during pregnancy, what I mean is accepting and enjoying your pregnant body. Not only are you undergoing the amazing task of growing a child, but you have the opportunity to flaunt and move the most womanly assets you have – your breasts, belly, hips and butt. Instead of ignoring them or hiding them away, get off the couch and find ways to make those body parts look and feel good. Freedom to move without any inhibitions is sexy. Why not put on your favorite maternity dress and go for a walk outdoors somewhere that you love? Feel the sand or the soft grass between your toes, enjoy the breeze blowing through your hair, and hold your baby bump close. Be proud of your amazing body!

I wish you a healthy and fit pregnancy and a joyful introduction (or re-introduction!) into motherhood. Sara Haley is a fitness expert who specializes in pre- and postnatal exercise. Drawing on more than twenty years of fitness and dance training, Sara has developed her own brand of fitness DVDs, The Daily Sweat®, which includes her award-winning prenatal workout program, Expecting More®. Follow @SaraHaleyFit on Facebook, Twitter and Instagram.

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The Real Cost of Childbirth By Rhondda Evans Hartman

I RN

Birth is a normal, natural function of your female body. Knowing this is the first step towards taking power over your body during pregnancy, labor and delivery, and post-partum. When we allow someone else, even someone with good intentions, to take that power, we are no longer in charge of our bodies or our births. When we allow our birth experience to become a medical event – one controlled by doctors, hospital policies and insurance companies – we are the ones who lose. These losses come in many unwanted forms. Many women feel physical losses – the difficult and painful healing process after a caesarean is one example. Others feel emotional losses; they grieve the loss of their ideal birth, or feel a deep loss in self-esteem believing that they “couldn’t do it,” often because someone else decided it was so. Another loss affects not only individual women, but our entire society – the increasing monetary cost of maternal care. In The Cost of Having a Baby in the United States, a 2013 report issued by Childbirth Connection, Catalyst for Payment Reform, and the Center for Healthcare Quality and Payment Reform, these costs are made clear: improved maternity care in the US could save billions of dollars each year. Improved? But doesn’t the US have the most advanced medical care in the world? Yes – in terms of technology. In terms of p.52

pregnancy and childbirth, a normal, natural function of your female body, not at all. As The Cost of Having a Baby report stated, “Most childbearing women are healthy, have healthy fetuses, and have reason to expect an uncomplicated birth, yet routine maternity care is technology-intensive and expensive: combined maternal and newborn care is the most common and costly type of hospital care.” Have you ever wondered why more than one-third of babies in the US are now born via cesarean, a 50% increase in just ten years? It’s not because women have suddenly forgotten how to give birth. Here’s a hint from the study: the average total payments for maternal and newborn care with cesarean births were about 50% higher than average payments with vaginal births. Maureen Corry, the Executive Director of Childbirth Connection, put it simply: “If the rate of c-sections were reduced from 33% to 15% (the World Health Organization recommends a c-section rate of 15% or less), national spending on maternity care would decline by more than $5 billion.” In any medical procedure, there is a profit involved. The expensive equipment needed for rare and unusual medical emergencies in birth must be available. It also must be paid for. It follows logically that if birthing women do not use that equipment, how can buying

and maintaining it be cost-effective for a hospital? It becomes financially necessary for the hospital to encourage its use. Hospitals set their own protocols. These “rules” can require that staff use expensive techniques and equipment when there is only the slightest suggestion of risk to baby or mother. As mothers, we are terribly vulnerable during the birthing process. Would any one of us want to jeopardize the life or safety of our babies? Of course not! When a doctor declares that an intervention “must” be done, would any parent disagree? Who is responsible for the number of cesarean births today? Ask around and you’ll hear blame put on doctors, hospitals, insurance companies, mothers… all we know for certain is that the increased cesarean rate increases the costs of childbirth dramatically, and not just childbirth via cesarean – even mothers who have normal, natural vaginal births in hospitals pay more in “facility expenses” because hospitals today need multiple operating rooms to keep up with the exploding cesarean rate. Between 2006 and 2010, the out-of-pocket expenses for mothers who birthed via cesarean or vaginally both increased fourfold. Medical costs should never be the deciding factor in how our babies are born – but it could easily happen that way if we stay uninvolved in our own births. As a motherto-be, you have the responsibility of planning your birth. Your best defense is to choose your health care provider with great care. Find one who believes you are the

primary participant in your birth. Find one who will happily explain the reason for all birth procedures, and shows flexibility when it comes to your wishes. Find one who does not think of an epidural as a “routine” birth procedure (Epidurals are very common, but they are still an intervention.) Find one who will listen to you and discuss a birth plan with you. If a care provider’s eyes roll when you say the words “birth plan,” walk out and keep looking for someone who will include you in your own birth experience! All interventions carry some kind of risk. Unless interventions are truly necessary, the fewer procedures and interventions used during your birth, the better for you and your baby – and the lower the cost of birthing. It’s up to you to be informed and educate yourself enough to feel confident saying “yes” or “no” when an intervention is discussed. S o m e t i m e s interventions are necessary, but you should still be included in making the decision to go ahead. You have the power. Use it! Rhondda Evans Hartman is a Registered Nurse with a BS in Nursing and an MA in Sociology. Rhondda taught classes and trained and supervised other teachers in husbandcoached childbirth with the world-renowned Dr. Robert A. Bradley for twenty-five years, and frequently spoke alongside Dr. Bradley at major conferences. She is also the author of two books: Exercises for True Natural ChildBirth and the newly-released Natural Childbirth Exercises. Rhondda is a proud mother of five and grandmother of nine. Her website is www. naturalchildbirthexercises.com.

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Healthy Babies, Healthy Mothers A VBAC journey by Beth Townsend My journey into motherhood began in late 2010, when my husband and I found out we were expecting our first child. We felt so excited; we’d waited a long time to have children, wanting to get school, travel and all of that ‘out of our systems,’ but now we both felt sure we were ready. For the most part, the beginning of my pregnancy was fairly uneventful. We really thought a lot about our desires for bringing our son into the world. We took some birth classes at a local birth center, and shortly after we hired a doula, because once we started the classes we realized we’d like someone there to help us through labor. We also decided to take the Bradley Method approach to natural childbirth, although we still planned to deliver in our local hospital with an OB.

I was already being closely monitored as a high risk pregnancy, because although I was only 34 at the time, my husband is a twin and his twin brother had a congenital heart defect and died at twenty-three years old. We were seeing a perinatologist often and they did quite a few ultrasounds, mostly to check the baby’s heart, and then also because I started having these strange episodes. At one ultrasound, it turned out that he (by now, we knew we were having a boy!) was breech. Everyone said “don’t worry, it’s still early,” but he stayed in pretty much the same position at every ultrasound, and soon I was on a mission to get him to turn.

One of the things that sticks out from those classes was that there were three other couples - so four of us total - and someone, I don’t remember if it was the instructor or the doula, said “well, statistically, one of you is going to have a c-section.” I remember looking around the room and thinking ‘that’s not going to be, I’m not going to have a c-section.’

That’s when Dr. Berlin first came in. I’d had my driver’s license suspended, because I’d fainted while driving and ended up in hospital for four days, and obviously it wasn’t safe for me to drive while I was having these episodes. So my doula and anyone else who could was driving me to my chiropractic sessions with Dr. Berlin, and I also tried swimming, walking on all fours, moxibustion, acupuncture, hot packs, cold packs - everything they suggest to turn a breech baby, you name it, I tried it - but as the weeks went by he still wouldn’t budge.

As time went by, complications appeared - I started passing out randomly and fainting, and eventually I had to go out on disability.

I desperately did not want to have a c-section, but as we went past thirtysomething weeks my OB was quite

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insistent that the baby wasn’t going to turn and was ready to schedule my c-section. I was still holding out hope, and when he started talking about choosing the actual date I begged him to hold off a little bit and broke down in tears. He reluctantly agreed, so I went to see the perinatologist again, and that’s when they brought up my lastditch option: an external cephalic version (ECV.) I was still determined to do anything to avoid a c-section, so I went to the hospital and attempted the version. It was very uncomfortable. After each session with Dr. Berlin, I would feel my baby move and turn just a little, but soon after he’d just pop right back. The perinatologist didn’t have any more luck, even though he tried so hard I remember that at one point in the whole ordeal he said he had to stop for a while because his wrist was starting to hurt. I remember thinking ‘well, if your wrist is hurting a little bit imagine how uncomfortable I’m feeling right now!’ So the version failed, but I was still determined to get him to turn or somehow birth him naturally – I called a doctor in Glendale who will deliver breech babies, but by then I was already 38 weeks, and they wouldn’t accept me as a new patient. Reluctantly, I let my OB put my c-section on his schedule. At 39 weeks, I woke very early in the morning to my water breaking, five days before my scheduled c-section. That was a small silver lining for me, because at least my son chose his own birthday; I’d been having a really hard time mentally wrapping my head around the idea that we

were choosing the time for him to come, it just didn’t seem right. It felt so unnatural. I started having contractions, but they were very mild, so I dilly-dallied at home for several hours because I knew once we got to the hospital I was going to be prepped and taken in for the surgery. We eventually got to the hospital around noon. They did another ultrasound - yes, he was still breech - and I was told my OB would arrive around 4pm and my surgery would begin at 4:30pm. So I sat there and labored until the doctor came with my husband and doula, and they consented me, and I bawled my eyes out all the way into the operating room. I couldn’t stop the tears flowing, even as I lay there and they did my spinal, and my OB was actually very compassionate in that moment, and held me and wiped tears from my eyes and said it was going to be okay, but the tears didn’t stop. Once everything was ready, they brought my husband in, I had my section, and it was the complete opposite of everything I had imagined ‘birth’ would be. I was thrilled to pieces to have our son, Brycen, here, but they took him right away, he was screaming and I couldn’t even see him. My husband even had to plead to bring Brycen in to me in recovery to let me see him and try to at least breastfeed him a little. The hospital staff didn’t want to allow it, because there might have been other patients in recovery, but eventually I got to see him for about twenty minutes and then they took him back. Thus began my journey into new motherhood and trying to breastfeed, with that awful incision, feeling a lot of pain and delirious from what had p.59

just happened. I had a really rough five days in the hospital – they actually said I could leave a day earlier, but I looked at my OB and started crying and said I couldn’t go home yet, so I was allowed to stay another day. But that was it - we had to go home, and somehow I had to get through the healing process and take care of my newborn. In many ways, my emotional recovery was harder (and took much longer) than the physical recovery, although that was extremely painful and difficult. It was hard to accept that after everything I’d tried, I’d still ended up with the last thing I’d wanted. For at least the year after Brycen’s birth, probably longer, I couldn’t think about it without crying. Whenever I heard that someone we knew had delivered their new baby the ‘old-fashioned-way,’ ugly feelings would surface - of course I was happy for them, but I was jealous, and envious, and I felt sad for myself and what was taken away from me and my son. I didn’t know why my body had failed me and couldn’t do what it was supposed to do, and although I’m sure I didn’t always know the whole story, it felt unfair every time another woman seemed to have her baby naturally so easily when I’d wanted it so much, and so passionately, and I’d educated myself, I’d had a doula... I’d tried so, so hard. My husband eventually got used to it whenever someone we knew had a baby, I had to know: did they have a c-section, or did they deliver vaginally? Was it painful? Did they take medications? I couldn’t stop thinking about my birth plan, what I’d wanted and didn’t get. It was painful every

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time someone else went through it and succeeded where I’d failed. I also felt like - I still feel like - I constantly had to explain why I had the c-section. I needed people to know it wasn’t my choice, he was breech, my choice was taken away from me. Usually people responded with “at least you had a healthy baby,” or “thank god we have such advanced hospitals these days,” and while I know they were intended to be comforting words, really they just served to devalue my feelings, like I was selfish for wanting more from my birth. I’d even do it to myself, thinking ‘why can’t you shake this? Are you mental, are you crazy?’ The one thing that gives me just a little bit of solace was that the OB told me that Brycen had quite a short umbilical cord, so I try to tell myself perhaps it was the right birth for him, because although the risk was low, it could have been very tragic if the umbilical cord had come apart before he was born. As hard as my birth and recovery had been, as soon as Brycen was born I couldn’t imagine having just one child. And I was only getting older, so we didn’t have a lot of time to waste… within 15 months we were expecting our second child. Brycen’s first year proved to be challenging in many ways and after everything we’d been through, when we told our pediatrician we definitely got some accolades for being brave enough to move on to number two! This time around, I was about to be 36 and therefore of “advanced maternal age” and we still had the congenital heart defect to

worry about, so from the beginning we were again monitored closely by a perinatologist. But this time I immediately began my quest to find a physician or provider who was going to allow me to VBAC; I knew the minute Brycen was born that if we ever had another child, I was going to be determined to VBAC that baby. Thus began my research. I joined all the support groups and Facebook groups I could, I found the International Cesarean Awareness Network (ICAN), and interviewed doctors and midwives and all kinds of people, trying to find someone who would be able to give us the birth we wanted. Somewhere around 18-20 weeks we finally found an OB near where we lived who told us that provided everything went as planned and this next baby was not breech, we would be able to have a VBAC at a local hospital. But as the pregnancy went on, I started to feel more anxiety whenever I went in and the baby was not in an ideal position, and eventually I found out that the back-up doctors for the OB I had chosen did not support VBAC. When I spoke to him about it he said, “don’t worry, I’ll be there, there’s no reason I shouldn’t be there, I’ll run it past them anyway, don’t worry.” As much as I wanted to believe him and trust him, in the end it just wasn’t enough - I couldn’t feel confident about what would happen if my OB wasn’t the doctor on call when I went into labor, and I wasn’t willing to leave so much to chance. Then I went to the perinatologist – I was around 28 weeks by then - and my baby was breech. Although I knew it was early

and she (yes, this time we were expecting a girl!) had plenty of time to turn, I still asked “if she stays breech, would you attempt a version again?” He said no, because Brycen’s version had failed, and I’d also had an early bleed with complete placenta previa in this pregnancy. He basically told me that in his opinion, I was going to have a c-section again. I walked out in tears. That was when I told my husband that the only person I trusted, the only person I would believe 100%, was Dr. Stuart Fischbein – one of the few doctors in the greater Los Angeles area who frequently delivers breech babies vaginally. We had talked about Dr. Fischbein during my first pregnancy, but my husband wasn’t comfortable with the idea, because he doesn’t deliver in hospitals - our only options with Dr. Fischbein would be a home birth or a birth center. But after all my research, I knew more about his safety and success record, and I told my husband “I just want to hear it from him. If he tells me I need to have another c-section, it’s too dangerous to do it any other way, I’ll believe him, and I’ll accept it.” My husband heard me out and understood, and we made an appointment to see him when I was 30 weeks along. In person, Dr. Fischbein was much like I’d heard - very warm, and very, very thorough. We had a long conversation about our medical histories, and he went through all the risks and benefits of VBAC and vaginal breech deliveries in great detail; he also explained that the risks of VBAC and the risks of breech are separate and not cumulative, which already made me feel a lot better. Finally he said, “There’s no p.61

reason I can see that you need a repeat c-section. To me you’re a good candidate for a VBAC.” It was the verdict I had been hoping so desperately to hear, but for some reason I didn’t really know what to feel in that moment. I wanted that VBAC so badly, but now we were talking about an out-ofhospital birth, and paying what was, for us, a lot of money out of pocket. Was I being too selfish? We’d been saving for a new house. Now I was thinking about taking that money from my family just to get the birth I wanted… was my VBAC that important? We took a couple of days to talk about it and think it over, and in the end it was my husband that put me over the edge. He knew how hard Brycen’s birth had been for me, and how deeply it had affected me and our little family since. He looked at me and said “I give you a 10-15% chance of delivering vaginally if we stay where we are. I think our best bet is Dr. Fischbein.” He’d never been comfortable with the idea of me delivering outside of a hospital, so to see him make this huge shift, and not only feel at peace with it but believe it was what we needed to do, made it easier to stop feeling I was being “selfish.” At 34 weeks, we made the switch, and at that first appointment our daughter had turned, so breech was no longer a factor. At around 38 weeks I’d been having a week of prodromal labor - I’d be up all night every night. The funny thing was that Dr. Fischbein was out of town that week, so as annoying (and exhausting) as the prodromal labor was, I wanted my baby to stay in! Although the new midwife at the birth center we’d chosen had told me I no p.62

longer needed to see the perinatologist, I had an appointment booked, and I’m a people-pleaser, I follow the rules… he did an ultrasound and said she was occiput posterior (“sunny side up”), and that babies in that position are very hard and painful to deliver vaginally and, yes, I’d probably end up with a c-section. More doubt. More second-guessing. The next few sleepless nights were even harder. Had I done all this for nothing? Two days after that deflating appointment, my husband and I spent the day out with my son. We went to the mall and walked around, and although I was contracting all day, I didn’t think anything of it because by then that wasn’t unusual. That night I took a Tylenol PM because I needed to sleep so badly, but as soon as I got into bed I had two strong contractions and I felt a pop and a gush of fluid. My water had broken. We called Dr. Fischbein, and he was on his way home from the airport - perfect timing! - but he told us to relax and call again when my contractions were consistently 2-3 minutes apart. About 20 minutes later I told my husband “you need to call him back,” because this was happening - it was as if my body went into ‘game on’ mode as soon as my water broke. Within an hour my contractions were 2-3 minutes apart, and within a few hours they were basically on top of each other, and with the back labor because of her position everything was more intense. We got to the birth center, my doula met us there, and soon after Dr. Fischbein appeared. I labored most of the time in the tub, but then after some time, Dr. Fischbein

did a check and said he thought he could help me out and I could start to push down if I wanted. It soon became clear it was too hard for him to help much while I was in the tub, so I got up on the bed and started pushing there. It took a little time to get the hang of pushing effectively, but then Dr. Fischbein looked at me, grabbed my hand and said “Beth, you are having this baby, vaginally, today.” Finally, for the first time in my entire pregnancy, I really believed it was going to happen. It all became very real in that moment. It was like the holy grail. It was the moment I had been waiting for since they wheeled me into the operating room to deliver Brycen. I got chills. I started to tear up. I believed him. I believed it. I believed in myself. He was right. We were there. We were at the finish line! I’m a runner; I do distance races. The best analogy I can think of is that I’d been at that point where you think you can’t possibly go any further, you’re wondering what you got yourself into and how you’re possibly going to finish the race, and your body hurts and you’re exhausted - but then you see the finish line and the people cheering and they have no doubt you’re going to finish, and somehow you find that final surge of energy you didn’t think you had, that part that was locked up inside… that’s what his words meant to me. That was the feeling I had, that final surge of adrenaline. It took one more push. Then I heard “reach down and pull your baby out” - was this real? It was. I was really experiencing that

moment I thought I would never be able to have - only it was even better, because I did reach down, and I delivered my daughter Maiya myself. No one else touched her, the first skin she touched was mine. I pulled her to me still saying “ I did it!” and “I can’t believe it,” but she was there, and we kept her attached until the cord stopped pulsing. It was all so gentle and peaceful and exactly how I had envisioned, how I hoped my baby could come into this world, the way that nature intended. There was nobody poking her and prodding her, she wasn’t screaming her little lungs out, she was just at peace laying on me, she nursed right away, and just four hours later we were home. In the end, I was in active labor for nine hours and pushed for thirty-five minutes. My husband said later, “There was no one in that entire birth center that was going to let you go to the hospital. You were going to have this baby vaginally and naturally and you were going to have it there. I knew you were doubting, but no one else was doubting it.” It was overwhelming to hear that. Choosing to switch to Dr. Fischbein was the hardest decision of my life, but I truly believe that it was the best decision, too. I am certain that had I stayed in the hospital system, I would have had another c-section. The recovery after Maiya’s birth was nothing compared to the recovery after Brycen’s. Emotionally, I felt so high, and so much more even-keeled. I thought having two children to care for was going to be so hard, and yes, it was challenging, but I felt great. I was out and p.63

about around town with both my kids within the time period I was still in the hospital recovering after my c-section! It was a healing birth in all the ways you can imagine. I needed it so badly in order to feel “normal.” It wasn’t until I gave birth to Maiya that I felt I could say those three words - I gave birth. I gave birth to my child. I can even say with a little more conviction that I gave birth to both my children now. I don’t know where I’d be today without Maiya’s birth, or even if I’d had a repeat c-section without hiring Dr. Fischbein, without knowing I had done everything I possibly could to have a VBAC. For me, without doubt, there is more to a successful birth than “healthy baby, healthy mother.” Birthing is a process, a journey to experience. It’s all the benefits for the mother AND baby, the hormones, the oxytocin, the experience of the child… there are studies now suggesting that how a child is born may affect them in the future much more than we think. You can’t just say birth is a means to an end. There’s so much in between - let’s say birth ends with a mother who is not emotionally healthy. That’s a “successful” birth to an OB, because she’s alive and physically well, but to me it’s not a completely successful birth. I was not emotionally healthy after my c-section and I believe it affected me, Brycen, and my husband in negative ways, how is that success? You need a truly healthy mother to take the best care of a child. After my experiences, I would tell women to follow their hearts and their guts, because they’re usually right. I would tell them to

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educate themselves, learn the facts, and I don’t just mean talk to your doctor - read the guidelines of the American College of Obstetricians and Gynecologists (ACOG), read and dissect the research, join support groups, talk to other mothers, because not every practitioner gives you complete unbiased information about your choices. I do believe they want to do the right thing and have the best outcomes, but sometimes they are torn in different directions by factors that may sway their judgment. Research for yourself. Learn as much as you can. Empower yourself with that information and then work with your doctor or midwife to get the birth that is best for you and your family. For me, my best birth was delivering my baby vaginally with hardly any ‘intervention’ besides encouragement and care. And to everyone who said “you’re just going to have another c-section,” you were wrong. I told you I could do it. In that amazing moment - you are having your baby, vaginally, today - I finally knew I could do it. My body is not broken. It was never broken. The only thing that was broken, for two difficult years, was my belief in myself, and thanks to the people who did believe in me, now that is healed too. I am a healthy mother with two healthy children, and now I feel like a success.

Trial of Labor A powerful documentary about modern childbirth from the mother’s perspective. Visit: TrialOfLabor.com.

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Understanding Breech Babies By Dr. Elliot Berlin I Prenatal Chiropractor Early in pregnancy, your baby has plenty of room to move, as you’re probably well aware – my patients often share that it’s not unusual for them to feel a sharp elbow jabbing into their ribs, some swift kicks to their belly, and even complete somersaults going on in there! Usually, by week 34, the combined forces of gravity and the decreased “room to move” in your uterus leads your baby to settle head-down (in a vertex presentation) in preparation for birth. At term, around 3-5% of babies are not vertex, and those babies are said to be in a breech presentation. There are three common breech presentations; frank breech, complete breech, and footling breech. If you ask a midwife, you are likely to hear that a breech presentation is just another variation of normal; ask most OBs, and you’ll hear that a breech presentation is abnormal. You’re also likely to hear that if your baby doesn’t turn before your “guess date,” you’ll be delivering via cesarean – and you have no other choice. It wasn’t always this way. Breech babies can be a little more difficult to deliver vaginally than babies in a vertex position; as Jennifer Block writes in her book Pushed: The Painful Truth about Childbirth and Modern Maternity Care: “The breech baby demands patience; she rejects active management; she demands normal, physiological birth.” Many midwives talk about a “hands off the p.66

breech” approach for delivering breech babies vaginally. From years of observation and sharing their collective wisdom, midwives know that the more a woman and her baby are free to do their own thing, the more successful the outcome is likely to be. The perceived ‘dangers’ of vaginal breech delivery had their roots in the first half of the 20th century; the ‘assisted breech’ techniques of the day, which often combined heavy anesthesia, manual pressure on the uterus, and the routine use of forceps to force the delivery of the baby’s head, could not be further away from the normal, physiological birth that Block describes. One 1953 study found that “the more manipulation is performed and the earlier this manipulation is instituted, the greater is the fetal mortality and morbidity, to say nothing of maternal injuries.” But even in 1953, Europe was already far ahead of the US in their understanding of breech birthing – a full fifteen years earlier, in 1938, the German obstetrician Erich Bracht presented an analysis of 206 successful vaginal breech deliveries, without one fetal injury or death. Interest in the “Bracht maneuver,” essentially another version of “hands off the breech,” led to more than 30 trials in Europe and South America, all resulting in dramatically better outcomes for babies and mothers. Not one of those studies was translated into English. The result? In Europe, breech birthing

techniques continued to improve, while in the US, doctors increasingly turned to surgery. By 1978, 60% of breech babies were born via cesarean in the US, and by 1990, that number was 85%. Andrew Kotaska, MD, a strong critic of the “breech = automatic cesarean” attitude of most American OBs, had to travel to Germany to gain experience in vaginal breech delivery; not one North American program existed to accommodate him. As Dr. Paul Crane, one of the few doctors in the greater Los Angeles area who will (very rarely) attend a planned breech delivery within a hospital, explains, “The problem is… there’s nobody who’s going to get enough training to do vaginal breech deliveries in the modern world. Ask people who are my vintage and perhaps ten years younger, they’ve all stopped practice. There won’t be anybody really willing to do vaginal breeches.” Dr. Ronald Wu, another LA-area doctor who stills attends planned breech births vaginally within a hospital, concurs: “There’s no more knowledge, the skill level is being lost. Not too many people will do a vaginal birth any longer, so the experience of seeing one is not available. And if it’s not available, how can you train anyone? It [vaginal breech delivery] is a dying art.” It’s a dying art for one particular reason: the Term Breech Trial. Mary Hannah MD, a well-respected obstetric researcher, led a randomized controlled trial involving more than 2000 women carrying in breech presentation in 121 hospitals and birthing facilities around the world. The study, published in 2000 in the medical journal The Lancet, seemed to show a significantly higher chance of “serious neonatal morbidity” in breech babies who were born vaginally. In the wake of the study, The American College of Obstetricians

and Gynecologists (ACOG) recommended that planned vaginal delivery of a breech baby at term was no longer appropriate. The standard of care changed practically overnight. Hospitals, insurance companies, and collective practices would no longer allow OBs to deliver a breech baby vaginally unless a woman arrived at the hospital with her baby already virtually out of the birth canal. Universities and teaching hospitals stopped training students in vaginal breech delivery altogether. As Dr. Crane explains, “In 2001, [ACOG] came out with a position paper… and that paper said that unless the baby just was falling out upon arrival, we should section all breeches.” The problems with the Term Breech Trial became apparent almost immediately. Professor Marek Glazerman, a researcher from Israel, re-analyzed all of the data from the term breech trial, and he was the first to say ‘we made a mistake here.’ As Dr. Stuart Fischbein explains, “they took a critical look at that study and found that they included a lot of things in there that shouldn’t be included, like unplanned breech deliveries, preemie breech deliveries, breeches with congenital abnormalities, and once they had corrected for those things they found that… this isn’t the way it should be.” In 2006, ACOG renounced their original opinion and declared that vaginal breech delivery was safe in the care of an experienced physician. “But by then the damage was done,” Fischbein says. “I don’t think anyone coming out of a residency program now has certainly done or necessarily even seen a breech.” Only ‘renegade’ doctors and midwives were left to attend planned vaginal breech deliveries, which today almost always occur at home. As Jennifer Block puts it, “it is independent homep.67

birth midwives, some of whom practice illegally, who are left attending these higherrisk vaginal births. And they are surpassing physicians in experience and expertise in the delicate matter of vaginal breech delivery. What has become a lost art in the delivery room is kept alive in women’s homes by care providers who are largely unrecognized by the obstetric profession and even criminalized in several states.” Dr. Fischbein gave up his privileges to attend hospital births and quickly became a leading force in the underground movement to keep options available for women. “All things being equal,” he says, “breeches should be born in a hospital setting because you have the ability to have general anesthesia should you have an emergency. The problem is all things aren’t equal.” He acknowledges that “there are risks to breech delivery, but the risks are minimal if you follow tight protocols. We all know that planes fly safely most of the time, but we only talk about planes that crash. It’s the same thing here. When there’s a tragedy in any birth it’s sad, but they can happen just as easily from a cesarean section in the hospital or a breech birth in the hospital, or at home for that matter.” Dr. Fischbein is clear in his mission: “Ultimately whatever a doctor feels, or whatever a hospital committee or administrations feels, the decision really doesn’t belong to them. It belongs to the individual patient… and [in the future] people in labor are going to be coming into the hospital breech and not knowing it, and no one is going to know what to do, and that’s going to be a real tragedy.” If you are late in pregnancy and your baby is in a breech presentation, you do have options. You can seek chiropractic care, acupuncture or moxibustion (offered at Berlin Wellness, of course!) to try to gently p.68

turn your baby. You can attempt “spinning babies.” You can ask for an external cephalic version (ECV), which should only ever be attempted by a highly trained doctor and assistants in a hospital setting; it is often painful, but the commonly referenced success rate is around 50%. If your baby will not turn, you can also seek out care from doctors willing to attend a vaginal breech delivery. Dr. Wu and Dr. Fischbein are your best options in Los Angeles. Homeland star Morena Baccarin hired Dr. Wu 39 weeks into her pregnancy, and she delivered her healthy, breech baby vaginally with his assistance. You do have choices. They are not always easy or cheap, and nothing is guaranteed – but at least for now, you still have some choices. I hope that the demand for vaginal breech deliveries will lead more care providers to offer them to women. There are a lot of benefits and reasons why the birth process is the way it is, and when we bypass them, we lose a lot of the benefits. I’ve been busy recently creating a documentary film about what went awry with vaginal breech delivery in the US, and I consider that film part of my contribution to keeping the choice alive. But here’s the real truth: I’m a man. I have worked with many, many women who are carrying breech, but I will never be in that position myself (actually, that’s not entirely true - I was a breech baby, and my mother delivered me naturally!) It is up to you to stand up for choice. It is up to you to demand more, and better, if you discover your baby is breech late in pregnancy. I hope that if you find yourself in that situation, you will speak up and make yourself heard – you want options. You demand options. Only a united chorus of women will bring the option of vaginal breech back, and I ask you to join that chorus –

even if you do not want to birth your breech baby vaginally, or you are not carrying breech, stand up for choice. Be heard. Make it just a little easier for the next mother who finds herself with a breech baby in late pregnancy… you can do that! You, mothers and mothers-to-be, can do anything. In all my years working with pregnant women, I am inspired over and over by what my clients achieve. You humble me every day. So stand up for choices. Stand up for heads up!

Dr. Elliot Berlin is a Prenatal Chiropractor and founder of Berlin Wellness Group which offers Prenatal, Pediatric and Family chiropractic, acupuncture, massage, counseling and other wellness services. He is a male birth doula and innovator of bodywork techniques during childbirth to help ensure a smooth and comfortable labor and delivery. Dr. Berlin founded The Informed Pregnancy® project to help educate and empower new and expectant parents to make informed pregnancy and parenting choices.

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It’s Not Your Mother-in-Law’s Birth: Speak Up and Stand Firm! By Hailey Murray It used to be that women labored alone while their husbands stood in waiting rooms smoking cigars; boy, have things changed! Today hospitals and birth centers often allow multiple supporters with you as you labor and even during delivery (our hospital allowed four – I chose my husband, our doula and a very brave male friend who took beautiful photographs of our son’s arrival). Some hospitals are even offering stadium-style seating, allowing up to 15 people in the room with you as you labor. If you plan to birth at home, there’s no limit to how many people can join the party! But is that what you want? Think carefully, and early, about who you might want beside you as you labor. If you have a spouse or partner they’re almost certainly going to make the guest list, but would you also appreciate the support of your mother? Your sister? Your best friend? If you plan to deliver in a hospital or birth center, call well before your ‘guess date’ to find out how many people can join you during labor, and don’t forget to make sure you have approval from your spouse or partner before extending invitations. My own father still talks about how my aunt (my mother’s sister) “grabbed” my older brother from the doctor and announced “it’s a boy” before dad could even get a glimpse of his firstborn son, and that was thirty-one years ago! There are other potential ramifications you should consider, too - if you invite your mother to witness her grandchild’s birth,

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will your mother-in-law expect the same privilege? If you definitely don’t want mom or dad or your in-laws watching you moaning and sweating in labor, let them know as early as possible so they aren’t disappointed – and have a speech prepared if they beg you to change your mind (try “the hospital’s policy is that I can only have my husband there.” If there’s one time you can be forgiven for a little white lie, it’s now.) When I was pregnant, my husband and I let our friends and family know that we didn’t want anyone hanging out in the waiting room, but we promised to call our family with the good news and the baby’s name as soon as we were settled after delivery. We even registered as anonymous at the hospital, so anyone ringing to ask if we were there would be told that we weren’t. If there’s conflict in your relationship or your extended family, don’t be afraid to confide in your nurses and make sure they know who can receive information about you or visit and who can’t. If it comes down to it, the hospital staff will even help you remove an invited guest from your room if you’re no longer comfortable with their presence. Don’t feel embarrassed if you have family drama – labor and delivery nurses have seen it all, and they’re used to playing gatekeeper! My husband and I welcomed our parents to visit us in our recovery room after we’d had

several precious hours as a couple to bond with our new baby, and our siblings soon after. We didn’t invite friends for a “meet and greet” for more than a week after we came home from the hospital – my husband and I both wanted (and needed) time to settle into our new lives as parents. Because we’d detailed our wishes and explained the reasons for them well before our son’s arrival, everyone understood. Our (very big, and very excited) family even waited a whole day for us to make the allimportant Facebook announcement to the world before sharing the news more widely themselves. Even my friends, who were thrilled to become my son’s “aunties,” gracefully accepted that only his actual aunts and uncles would become “Uncle Sean” or “Auntie Troian.” It wasn’t a difficult case to argue; with my two brothers and my husband’s huge blended family, our newborn already had twentythree official aunts and uncles to remember!

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Before my pregnancy, I suspect most of my friends would have described me as a people-pleaser. But as soon as I knew I had a new life to protect, I found the strength to assert myself and defend my decisions, diplomatically but firmly. It helped me have a relatively stress-free pregnancy, labor, birth and postpartum experience, and my family and friends were all elated by our new arrival, whether they met him in the hospital or a few weeks after we brought him home. For me, the key was managing expectations early; don’t wait until you’re in labor to tell your 15 closest friends they are not coming with you into the delivery room, stadium seating or not! Hailey Murray is a writer, editor, speaker and birth doula. She is also the Managing Editor of this year’s Informed Pregnancy® Guide, and a proud mother to her two-year-old son Hugh. You can follow Hailey on Twitter @Hailey_Murray, or find her online at www.haileymurray.com

The Truth about “The Latch” By Jessica Martin-Weber “I’m really scared of breastfeeding.” Pregnant with her first child, my friend subconsciously rubbed her 34-week belly as I made dinner. I asked her why. She said she’d googled and learned that breastfeeding could be extremely painful, particularly if she didn’t achieve “the perfect latch.” She went on to explain that she had read different blogs and forums about how hard it was to get a good latch, stories of women with bleeding nipples and babies who wouldn’t gain weight. She wanted to know the secret to a good latch and what would happen if it didn’t happen for her. It’s true that many mothers experience some degree of difficulty in the early days of breastfeeding, but here she was, just weeks away from finally meeting her baby, scheduled to take a breastfeeding class and worried sick that she was facing a world of pain if she couldn’t get that elusive latch. Earlier that same day, I’d had coffee with a good friend, an IBCLC at a local hospital. When the topic of the “perfect latch” came up, she surprised me by saying that she thought everyone made too big a deal of the latch. “If mom isn’t in pain and the baby has plenty of soiled and wet diapers, why do we need to mess with anything? Sure, if there’s a problem like pain or a dehydrated baby, then we need to fix what we can. But so what if that bottom lip is curled in if it’s not p.74

causing any bother?” In other words, if it’s comfortable and it’s working, it’s a good latch. There is a wide range of normal. I love this woman; she often says exactly what I’m thinking. In general, newborn babies are ready to breastfeed and our breasts are ready to feed them. It just works, and we don’t need to mess with it – it doesn’t have to be a complicated endeavor. Yes, for some women breastfeeding is difficult, but we shouldn’t expect trouble. More often than not, moms need support simply because it isn’t all that common in our culture to see a baby at the breast – we cover up or retreat to a restroom to feed, so plenty of women don’t ever see breastfeeding “in action” until it’s their turn to try it! Many women look online or join a breastfeeding support group for guidance – proactively seeking examples of successful breastfeeding techniques that in other cultures she might have been exposed to from the day she was born. If a new mom doesn’t seek out or have access to that help, she may not even realize that difficulty with pain, bleeding nipples or ineffective milk transfer to her baby could be related to her latch, and there might be very simple way to “fix” it. After I shared a few pictures of my thennewborn daughter’s latch on Facebook, I received several emails and comments from other moms stating that they had never seen what a “good latch” looked like, and had endured pain in breastfeeding because

they didn’t realize something was wrong. If you are ever experiencing pain with breastfeeding that is more than a brief moment of discomfort or lasts beyond the initial latch, please seek out help – pain is usually an indicator of a problem that can be corrected. It doesn’t mean you’re doing something wrong, it just means you might benefit from some help. I talked with my friend Star Rodriguez, IBCLC of Lactastic Services and WIC peer counselor, for the following lists:

then longer ones as your milk starts to let down. If you’re using a nipple shield, ensure that the nipple and surrounding tissue is being pulled into the shield. What can a mom do to try to improve a painful or ineffective latch? If your baby isn’t opening their mouth wide enough, attempt to show her what to do by opening your own mouth wide. Many babies will subconsciously mimic you.

When do you need to consider latch issues and improving your nursling’s latch?

Make a “breastwich” - hold your hand in a C-shape behind the areola to help your baby get a bigger mouthful.

When breastfeeding is painful beyond the initial latching.

Get your baby as naked as possible for the inviting feeling of skin-to-skin contact.

When there is tissue damage to your nipples.

Hold your baby securely; a snug, close hold will help.

When there are weight gain issues for the baby.

Pull your baby in quickly when her mouth is open wide.

What latch ‘tips’ can moms try? Get into a comfortable position and bring your baby to your level – don’t lean down to theirs. Make sure your baby’s body is facing yours, and her arms are not pushing away at you. It is best to let the breast fall naturally if possible. If you have large breasts OR when your milk first comes in, it may be helpful to hold your breast with your hand. Aim your baby’s nose toward the nipple; if it’s necessary to encourage a wider mouth, tickle the very top of the baby’s upper lip with your nipple. Your baby’s chin should touch the breast, but her nose should be unobstructed. You should not need to push your breast away from your baby’s nose with a good latch. You should be able to hear or see your baby swallowing – short sucks/swallows at first,

It is common to experience some discomfort at latch in the first few weeks of breastfeeding. It should go away as the feeding continues. If it does not end after around 30 seconds, you may need to remove your baby from the breast and reposition her. Break the suction by placing your little finger into the corner of your baby’s mouth and trying to latch again. Some lactation consultants can show you ways to fix a latch without taking your baby off the breast, but those are easier to learn from being shown rather than told. You may need to put your baby in a different nursing hold or position. When should a lactation consultant be called? If repositioning doesn’t work. If you feel sudden soreness experiencing painless nursing.

after

Continued on page 90 p.75

Know Your Options: The Birth Center

Birthing at a freestanding birth center, often described as in between home and hospital birth, is an attractive option for many parents-to-be seeking “the best of birth worlds” – the comforts of home with the facilities, expertise (and emergency backup!) of a hospital birth. This demand has led to an incredible growth in the number of freestanding birth centers around California, especially in the greater Los Angeles area. Just a few years ago, birth centers were few and far between, and “in the know” moms-to-be reserved the few spaces available on their schedules long before the average first-time mom might have learned the option even existed. Now birth centers are popping up everywhere, offering an ever-expanding and diverse array of services and facilities – and winning over mothers seeking everything from a cozy and communal space to birth to one comparable to the privacy and luxury of an p.76

upscale spa. When evaluating a birth center, it’s important to go in with your heart and your head and think about every possibility before ‘falling in love.’ You should feel confident with the staff, the space, and the relationship between the center and local doctors and hospitals, in the unlikely event that you do need to transfer. It’s also a good idea to ask the center’s policies if you go into labor early, or pass your “guess date.” Then ask the fun questions - unlike hospitals, birth centers generally allow children into their birthing rooms - would your soon-to-be big brother or big sister want to see his or her sibling being born? Do your homework, then feel free - fall in love with your birth center! Sun, surf, sand and birth choices – what’s not to love about raising your family in California?

Birth Center Directory Ancient Paths Midwifery and Family Birth Center* (p.50)

Natural Birthing Center and Women’s Wellness

www.ancientpathsmidwifery.com

www.naturalbirthcenter.com

5849 Schaefer Avenue, Chino CA 91710. Phone (909) 464-0974.

432 S. San Vicente Boulevard, Suite 250, Los Angeles CA 90048. Phone (424) 245-4150.

The Art of Nursing Care Midwifery

9209 So Colima Road, Suite 4100, Whittier CA 90605. Phone (562) 696-2313.

www.artofnursing.net 3013 Washington Boulevard, Marina Del Rey CA 90292. Phone (424) 835-4186.

Push Midwifery and Birth Center www.pushmidwifery.com

Beach Cities Midwifery and Women’s Health Care

415 Rolling Oaks Drive, Suite 190, Thousand Oaks CA 91361. Phone (805) 494-1333.

www.beachcitiesmidwifery.com

The Sanctuary Birth and Family Wellness Center* (p.12)

24902 Moulton Parkway, Suite 120, Laguna Hills CA 92637. Phone (949) 215-7575

www.birthsanctuary.com

1224 E. Wardlow Road, Long Beach CA 90807. Phone (562) 912-4421.

11965 Venice Boulevard, Suite 307, Los Angeles CA 90066. Phone (310) 566-7690.

The Community Birth Center* (p.39)

SCV Birth Center* (p.38)

www.lacommunitybirth.com

www.scvbirthcenter.com

2422 W. Florence Avenue, Los Angeles CA 90043. Phone (323) 541-9100.

25050 Peachland Avenue, Suite 170, Newhall CA 91521. Phone (661) 254-3000.

Del Mar Birth Center

Southcoast Midwifery and Women’s Health Care

www.delmarbirthcenter.com 1416 El Centro Street, Suite 100, South Pasadena CA 91030. Phone (626) 577-2229. GraceFull Birthing www.gracefull.com 2815 W. Sunset Boulevard, Suite 105, Los Angeles CA 90026. Phone (323) 486-7134. The Natural Birth and Women’s Center www.gr8birth.com 20201 Sherman Way, Canoga Park CA 91306. Phone (818) 386-1082.

www.southcoastmidwifery.com 6817 Quail Hill Parkway, Irvine CA 92603. Phone (949) 654-2727. Sunrise Birthing Center www.venturamidwife.com 12 N. Ash Street, Ventura CA 93001. Phone (805) 648-2350. Ventura Birth Center www.venturabirthcenter.net 3458 Loma Vista Road, Ventura CA 93003. Phone (805) 667-2229.

*Featured sponsors in this guide

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Our Lives as Dads By Robert Nickell When I created Daddy & Company and our signature product, DaddyScrubs, I had a clear goal in mind: to recognize the important role of fathers in a family, and to include them in a process (pregnancy, labor, delivery, and parenthood) where almost all of the available information, resources and support are targeted towards expecting mothers. Of course, this goal wasn’t about minimizing the amazing role of mothers at all. It was about helping new fathers to feel involved, not only encouraging them to be proud of their title as ‘daddy,’ but also to feel confident supporting their partners and working as a team, sharing the joys and challenges of parenthood together. DaddyScrubs were an instant hit, but I knew there was more still to do. There aren’t many pregnancy books for dads to tell them ‘what to expect.’ There aren’t many ‘daddy n’ me’ classes, or support groups for new fathers. That’s why I created “My Life As A Dad,” a show all about helping men become better fathers. “My Life As A Dad” is part of the multichannel Parent Family Network and can be viewed online anytime. It’s entertaining, informative and educational, and I hope it will help dads from every background, in all kinds of families, to understand a little more about what makes a great father – and laugh a little as they learn! As I write this, more than 75 well-known actors, musicians, entrepreneurs, authors and professional athletes have already shared their personal stories on “My Life As A Dad.” As the host of the show, I ask each guest to talk about how they feel about being a father, what their parenting p.78

philosophies are, how they balance family life with their often demanding professional lives, and sometimes how they relate their own unique upbringing to their lives as fathers today. I’m always inspired and often surprised (and amused!) to hear celebrity dads describing their favorite ways to engage with their child, their best piece of parenting advice, and even their first thoughts following their child’s birth. It’s fascinating to learn how many feelings regarding fatherhood are universal, and how many are deeply individual and personal. I’m a father of seven, and I’m still learning from all my incredible guests! If you haven’t checked out “My Life As A Dad” yet, here’s a sneak peek into what you’re missing:

“To the young dads out there: If you’re nervous all the time, that’s normal.”

– Alimi Ballard (Actor, Numbers and CSI) “Let them [your children] find their own journey.”

– Kevin Frazier (Host, The Insider) “There were a couple times when I put the diaper on backwards!”

– JR Martinez (US Army veteran and Dancing with the Stars champion)

“It’s so unbelievably exciting!”

– Eric Christian Olsen (Actor, NCIS: Los Angeles)

“Time: that’s one thing that your kids will never forget. They may not remember something about money, but they will remember whether or not you were there when they needed you.”

“This is for real. This is a lifetime commitment. Everything is different now.”

– Tom Arnold (Film and TV actor)

“Be very supportive and loving. And try your best to be understanding.”

– Tyrone Wells (Singer/Songwriter)

– Chris Paul (NBA Player, LA Clippers)

“It’s real but surreal, because it’s something that’s beyond hitting the lottery or beyond anything I could ever want.”

– AJ Calloway (Host, Entertainment Tonight)

“I like to focus on making moments - moments that Hunter will remember.”

– James Durbin (American Idol finalist, musician) “Listen to your elders. Take advice. If a father’s telling you something - listen. You can always become a better father by listening to someone else who has been through it.”

– Delanie Walker (NFL Player)

“You should be able to freeze dry certain ages.”

– Shadoe Stevens (TV and Radio personality)

“It’s all about your child. Your son, your daughter - that’s the most important thing.”

– Marcedes Lewis (NFL Player) Continued on page 90 p.79

Head Down: Breech Babies and Hypnosis Alisha Tamburri, CCHT, MH It’s late in your third trimester. You’ve been hoping and planning for a vaginal birth, and never thought much about delivering via cesarean - until your OB or midwife does a scan and tells you your baby is breech. Now what? Suddenly your plans to ‘rest and nest’ in preparation for your newborn’s arrival are pushed aside. You read everything you can find about chiropractic techniques, acupuncture, moxibustion, external cephalic version (ECV) and even standing on your head in a swimming pool (Who comes up with these ideas?), desperately searching for a way to get your baby to turn. You might not read about a method for encouraging babies to turn that I’ve used successfully in my practice for more than 30 years – hypnotherapy. Hypnosis can help loosen tight muscles in your uterus, release stress, and calm your body and your baby. An integral part of the breech turn session is fear release therapy, where moms learn to let go of their fears concerning their pregnancy, labor, parenting, and even the stress of dealing with in-laws. Of course, many mothers-to-be also have strong feelings upon learning their baby is breech – some feel angry, disappointed, depressed, nervous or scared. Some are terrified contemplating the possibility that they may have a surgical birth. Quite often mothers-to-be confide in me that they feel they must have done something ‘wrong,’ and I quickly assure them that this is NOT the truth. While the primary goal of a breech session is encouraging the baby to turn, I also work to help mothers feel more relaxed and peaceful about their upcoming birth, no p.80

matter how they eventually deliver, so they can focus on the joy of meeting and holding their newborn. The use of hypnosis to help turn breech babies was supported in a groundbreaking 1994 study presented by Dr. Lewis MehlMadrona. The study included 200 women who were carrying their babies in a breech position at 36 weeks gestation or more. The experimental group of 100 women received hypnotherapy from a trained practitioner. The comparison group of 100 did not receive hypnotherapy, although some did ECV, a procedure where the baby is manually manipulated from outside the abdomen to bring about the downward turn. While in hypnosis, the mothers in the experimental group were led through guided imagery to bring about deep relaxation. They were helped to imagine their uterus becoming pliable and relaxed in order to allow their babies sufficient room to make a move. Suggestions were then given to visualize their babies effortlessly turning into the proper vertex position for birthing. Each mother was asked to talk to her baby. The hypnotherapist verbally encouraged the baby to release from the breech position, turning downward for a gentle birth. The result? 81 of the 100 breech babies in the experimental group turned spontaneously. In the group that did not receive hypnotherapy, only 26 babies turned, and an additional 20 turned after ECV. Hypnosis is natural state of focused awareness that we all have within ourselves. All hypnosis is self-hypnosis; Continued on page 90

Keys to the Mother-Baby Bond By Laurel Wilson, IBCLC CCCE CLD CLE and Tracy Wilson Peters, CCCE CLD CLE In today’s world, it can seem exceedingly difficult for any expectant mother to truly connect with her baby during pregnancy. Instead, moms-to-be are often constantly connected to external stimuli, including the internet, social media, email, texts, phone calls, advertising and television. There’s no denying that the pace of life has sped up significantly, and what is expected of a pregnant mother – the demands on her time and energy – has increased exponentially as well. It’s easy for a pregnant woman today to feel like she’s living on autopilot; more susceptible to external messages and less able to connect with her own thoughts and feelings. But pregnant mothers who do take the time to become more aware of their thoughts, feelings and actions begin to become more conscious of their behavior – and that consciousness can help tip the balance towards a healthier relationship between the external and internal, and a stronger bond between mother and child. If you’re pregnant, you can encourage this process with a few key steps that help to foster a deeper connection with yourself and your world, and in turn, to deepen the emotional, physical and spiritual bond between you and your baby. We use a neat acronym to help mothers remember these steps – BOND. It stands for Being, Observing, Nourishing, and Deciding. Being relates to your consciousness – your awareness of your thoughts and feelings.

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Your thoughts and feelings shape your daily life, affecting your physical health, your stress levels and the development of your baby. Pregnancy is a major life event that leads many women to take action and make healthier choices, but there is more to health than eating well and exercising. Becoming emotionally healthier incorporates activities that enhance your sense of being, and may include mindfulness techniques, breath work, thought awareness, and simply taking quiet time to be ‘alone together’ with your baby. Observing is all about achieving mindfulness. Mindfulness means being purposeful, conscious and non-judgmental in thought and action. What could be a better mindset for pregnancy? Observing and practicing mindfulness provides you with the opportunity to create change where it is needed. For example, it allows you to determine which of your relationships are nourishing and healthy, and which are emotionally draining. Emotions and attitudes are contagious. Loving, supportive relationships during pregnancy change a mother’s brain, her heart patterns, and her mental and physical health, and those changes also affect her baby. Nourishing involves all of the generous and loving ways that you tend to your and your baby’s emotional and physical needs during pregnancy. Your physical health involves more than what you eat and drink and how often you exercise. It’s about how you care for your body and how you feel about it.

Pregnancy can be an opportunity to make a shift. It’s vital to let go of attitudes that make healthy choices seem burdensome (but I hate broccoli!), and begin embracing a new belief system where you see healthier choices as loving gifts to yourself and your baby. The body is always an expression of one’s internal emotional world. The keys to nourishing revolve around gratitude, mind/ body awareness, making healthy decisions and practicing stress reduction. Deciding is the experience of actively participating in creating your reality. Put simply, what we think about, we bring about. Therefore, it makes sense to move through this world intentionally, especially given that we know a mother’s experiences directly impact the health and personality of her baby. You can feel confident making decisions that are truly in your best interest by practicing a unique tool called conscious agreement. This is the act of making decisions based on deep inner listening, and coming to an intuitive agreement in mind, body and spirit. It is making decisions that feel good at a gut level. Conscious agreement occurs when you are in collaboration with your inner wisdom, and every part of you says “YES!” Before pregnancy, your level of awareness mainly affects your own life, but once you conceive, your consciousness also impacts your baby’s development and emotional health. Achieving a state of conscious agreement during pregnancy is crucial to the mother-baby bond. Here are some simple tips to help you get there: Separate from external influences. To connect within, it is necessary to remove yourself from distracting environments or people. This can be as simple as closing your eyes and taking a moment to tap in to your inner wisdom.

Get quiet and pause. Take a few deep breaths, and allow your thoughts to calm and connect to your source. Your source is whatever you feel guides you most strongly – God, the universe, your spirit, your intuition – only you know. Listen in. Think about each situation you’re presented with. What is your gut feeling? How is your body feeling? How is your body reacting? Do you feel drawn to the situation, or do you feel a sense of discomfort? How might your baby feel? Decide and commit. Honor your feelings; they are surfacing to benefit you and your baby. Make a decision that is in harmony with what your body, your baby and your intuition are telling you. This is truly honoring the mother-baby bond. All expectant mothers can experience a deep motherbaby bond by Being, Observing, Nourishing and Deciding. You have the key to unlock a deep connection with your baby by consciously tuning out the distractions of modern life, and instead tuning in to the miracle happening inside you. Yes, on “birth day,” you may be surprised that your newborn has his grandfather’s red hair or your aunt’s dimpled chin, but you will still already know each other in a deeply profound way; after all, your hearts have been beating together since the very beginning. Laurel Wilson and Tracy Wilson Peters have more than 40 years of combined experience supporting mothers and other professionals who work with new families. Their bestselling book, The Attachment Pregnancy: The Ultimate Guide to Bonding with Your Baby, unites evidencebased information with a holistic “heart and mind” approach to give mothers the tools they need to feel deeply connected to their pregnancy and their baby.

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“Your class really helped Carey feel empowered and more confident in supporting me the way I needed and wanted to be supported. I took lots of childbirth classes, and yours was the best. Britta, you are a master at what you do.” Mother, Alecia Moore (aka P!nk)

Birth transforms… Woman into mother Man into father Couple into family Preparing you and your partner for your rite of passage. • • • •

Childbirth Preparation Classes Mothers’ Groups Couples Coaching Babymoon Retreats

There is more than one way to give birth. Seek your own answers. Discover your own truth. Begin your unique journey into parenthood.

Britta Bushnell, MA Birthing From Within Certified Mentor Topanga, Pasadena, Santa Monica Britta@Embodica.com | (310) 738-7390 | www.Embodica.com

Sleep for New Parents and New Babies By Shannon Hernandez With a newborn in the house, sleep becomes a precious luxury. Even a short nap feels incredible, and it’s hard to believe you ever managed to stay awake until 3am in college. With a dull headache and an overwhelming desire for anything that might offer a quick “pick-me-up,” it’s no wonder so many new parents guzzle coffee and lunge for stale donuts (carbs!) in the office break room. Yes, your joy in welcoming a new baby outweighs the pains of exhaustion, but when can you expect some relief? How do you get your baby to sleep soundly when every ‘sleep expert,’ from the authors of the ever-growing number of sleep training books to your mother-inlaw, gives you contradictory advice? As a sleep coach for new parents and new babies, I can reassure you that you are not alone; most parents I work with share the same questions and anxieties about sleep. Here are the five questions I hear most often: When is the right time to sleep train? Some babies can sleep through the night from a very young age, but most babies are ready for sleep training when they’re around four or five months old. By this time, they’re usually taking in most of their food during the day, making night-time weaning much easier. Your baby’s fine and gross motor skills have also usually developed enough to assist them with self-soothing. p.86

How long will I need to keep feeding my baby at night? Assuming you have a healthy baby who was born at term (after your 37th week of pregnancy), you can begin feeding your baby more during the day as early as six weeks after birth. As you gradually get towards the recommended 24 ounces of milk or formula during the day, night feeds can slowly be weaned out. If you’re breastfeeding, you can estimate how much milk your baby is taking in each day by pumping one morning feed and one evening feed, and using the average to estimate your milk supply. You can also use a scale to measure how many ounces your baby is eating at the breast. Why does my baby keep waking up at night? If your baby no longer needs night feeds and doesn’t have any medical conditions like acid reflux, teething or a virus, it’s likely she has not yet fully developed her self-soothing skills. It’s normal for all of us – babies and adults – to wake in between sleep cycles. But unlike a new baby, most adults have developed the skills to self-soothe. We roll over on our side, fluff our pillow, kick off our blanket or put another one on. Helping your child learn to self-soothe will help them (and you!) to get back to sleep quickly after waking during the night, and mastering self-soothing will also help your child to feel more confident and independent as she grows.

If I co-sleep, will my baby have a harder time sleeping through the night? I’ve worked with many parents who cosleep. Some of them share a family bed for several years, while others plan to co-sleep with their new baby for a few months. Where your baby sleeps is secondary to learning to self-soothe, without interventions such as nursing or being picked up and rocked back to sleep. As your child grows older, where they sleep becomes more important; all children benefit from the security and routine of knowing where they belong when it’s time for bed. But teaching your child to self-soothe is far more vital to getting a better night’s sleep, and can be learned in bed with you. Is it bad to let my baby cry? This question always comes up as I work with parents. I believe the answer depends on whether your baby has had all her needs met before being put down to sleep. Learning how to sleep is similar to teaching a child how to ride a bicycle. It’s new and challenging, for both child and parent. As a parent, you know there’s always a risk of a spill or a scraped knee – but still, you take a deep breath, make sure your child’s helmet is firmly in place, and keep pushing forward. You run alongside your child until you feel ready to take the leap and let go as she finds her balance, and it feels amazing to see your child’s joy at riding a bike ‘all on her own.’ All children need to know that their parents or caregivers are there with them, and they are not alone in a new learning process – whether they’re learning to ride a bike or learning how to sleep. I suggest staying

with your baby as she learns to sleep, being present and quietly supportive as she learns to self-soothe. When your baby is crying, it’s not easy to resist the urge to intervene – to keep your hands on the bike. But as long as you are there with her, I’d advise you not to hold her back from her personal achievements by interfering with something she’s capable of doing herself. For me, the ultimate answer is no, it’s not ‘bad’ to let your baby cry and fuss during the learning process, but I prefer for babies not to be alone as they struggle to learn and eventually master the skills they need to self-soothe. I realize I’m yet another of the sleep ‘experts’ I mentioned earlier, and it’s simply not possible to give you personalized advice and work through trial-and-error to find what works for your family and your baby in one short article. Having a sleep coach who is welleducated in child development is key to successfully getting a new family back to sleep. The exhausting days and nights with a sleepless newborn will be over before you know it, but the healthy emotional development I promote will benefit your child throughout her entire life. Shannon Hernandez is a birth coach, postpartum doula and owner of Dream Team Doulas and has served thousands of families in Los Angeles and Orange County over the past 15 years. In 2008 Shannon started sleep coaching after researching infant sleep and child development. Shannon is known as LA’s baby whisper and she enjoys being the mother of four children that have inspired her in her work to strengthen families. For inquiries write to shernandez@doctorberlin. com

p.87

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A Second Chance continued know how lucky I am that cesareans exist? No matter the answers, I feel okay with not knowing. One thing I do know is that in no way am I less of a woman, or less of a mother, because I birthed my son and daughter via cesarean. And while I believe that “healthy baby, healthy mother” comes first, I know that they are not the only things that matter. It turns out that it mattered to feel that my birth “experience,” not just the statistical outcome, were important to my care team, and it mattered that I felt good about myself when all was said and done. I do feel good about myself. My second cesarean turned out to be a second chance, and I have no regrets about my choice to let go. ______________________________________ The Latch continued If you feel stabbing or burning pain in your breasts or when your baby latches. If you have cracked or bleeding nipples. If your latch is not painful, but your baby is not producing a good amount of wet and dirty diapers. Jessica Martin-Weber is a writer, speaker and creator of TheLeakyBoob.com. In just four years, The Leaky Boob has become the world’s largest online interactive breastfeeding resource, recommended to mothers by several major hospital networks and health agencies. Jessica is a mother to six fiercely independent daughters and also blogs with her husband, Jeremy, at BeyondMoi.com.

______________________________________ Our Lives As Dads continued “Another tip for the guys: Your wife is always right. When she’s pregnant, she’s always right.”

– Brian White (Film and TV actor and producer) “My Life As A Dad” is filmed in the Parent Family Network Studio in the South Bay. p.90

You can subscribe to “My Life As A Dad” on YouTube, or by visiting www.mylifeasadad.com. I am proud of all the fathers and fathersto-be who have shared their feelings and experiences with me and my audience on “My Life As A Dad.” It’s a show created by dads, for dads. I hope you’ll watch, learn and enjoy. Robert Nickell is the founder and CEO of Daddy & Company, the creator of DaddyScrubs, and a well-known syndicated columnist for national newspapers, parenting magazines and websites. He is also the Executive Producer and host of “My Life As A Father,” and a very proud dad to children Austin, Paige, Hayden, Kennady, Lincoln, Carter, and Tessa.

______________________________________ Head Down continued the hypnotherapist serves as a guide. The power is truly yours! It is inspiring to witness a mother become at peace with herself, her body and baby using only the incredible power of her own mind – a power they often don’t know they possess until they come into my office. I give moms a recording of their session to listen to every day. This repetition helps mothers maintain the calm state they achieved in hypnotherapy, and encourages a baby who does turn to stay head-down until birth. Whether or not your baby is breech, hypnotherapy during pregnancy can help to relax your body, mind, muscles and baby. It can also help make you feel more confident and empowered about birthing and becoming a parent – no standing on your head required! Alisha Tamburri is a clinical hypnotherapist, birth doula, HypnoFertility therapist, and childbirth educator. She has more than 30 years of experience working with expecting parents, alleviating anxieties and resolving personal and physical challenges through hypnotherapy. Alisha is a pioneer of HypnoBirthing Childbirth Education in California. She is also the proud mother of two daughters, two sons-in-law, and two grandsons. www.clearmindhypnotherapy.com

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