The Mom Crowd

We got this email from a reader:

I had my second child without medication. Not by choice but because I didn’t make it to the hospital in time. It was painful but I liked that the recovery was so much easier. I am considering going natural when we get pregnant with our third child. I like the concept of childbirthing centers. Is natural childbirth safe in a childbirthing facility? What if something unpredictable happens during the birth? How are the midwifes prepared for emergencies?

Amelia responds:

Since I have only had unmedicated births, I don’t have anything to compare it to, but my friends that have had a natural birth after a medicated one have also said that the recovery time is easier and faster. I would love to hear your birth story!

Free standing birth centers are a great place to have a baby and yes they are safe. I would venture to say that natural childbirth is safer at a birth center than in a hospital. They are a great alternative for people who want a more home-like facility but don’t feel comfortable having a home birth. Some moms prefer a birth center experience after having a disappointing experience at a hospital or want a natural birth and don’t want to hassle with routine hospital procedures. Birth Centers are usually run by Certified Nurse Midwives (CNMs) which means that they have a nursing degree and have also completed a degree and training in midwifery at an accredited school. Birth centers typically have lower c-section rates, episiotomies, inductions, infections, and the list goes on. For example, the birth center I had Graham in has a 7.5% C-section rate, compared to a 30% national rate. Midwives are often better trained to help women cope with the pain of labor and are available to help support the woman throughout the labor. Birth centers also let women eat and drink throughout labor. Hydration and food for nourishment are important factors for allowing a woman’s body to flourish during labor. No matter where a woman chooses to give birth, the most important thing is to feel confident and comfortable with your birth provider and the birth facility.

A word about midwives:
Most midwives have a different perspective when it comes to birth. Midwives are trained to look at birth as a normal, natural event. Obstetricians are trained surgeons and are trained to scoping out problems. As a result OBs tend to do a lot more testing and intervention during pregnancy and birth and have a much higher c-section rate. Many midwives also spend more time with their patients and take time to answer questions.

In my own experience with midwives, I have left appointments feeling like they have taken the time to get to know ME as a whole person. The midwife group for my last pregnancy was amazing. I felt like they were looking out for me during and after the pregnancy. The midwife who caught Graham called me this past Monday, seven weeks after the birth, to check up on me and the baby. They knew that I had struggled with postpartum depression after my second birth and have been very proactive about making sure I have the support network I need.

To answer your question about emergencies, birth centers are often close to a hospital so that if a transfer is needed it is easy to get there in an emergency. Birth centers also screen their patients throughout the pregnancy to make sure they are low risk. Most births will proceed with little problem and usually when a problem develops it shows up over a period of time. A woman that falls into a high risk category (i.e. pre-eclampsia, diabetes requiring insulin) will be asked to birth in the hospital. Women who need to be induced with Pitocin will be asked to birth in the hospital as well. In my last birth, I had shoulder dystocia, which is where the baby’s shoulders get stuck under the pubic bone. Graham’s head was out and we had to get the rest of him out quickly. Our midwife was calm and instructed me how to help her get the baby out. It was a serious situation. After Graham came out he was floppy and needed oxygen. The midwife and nurse knew exactly what to do and did it well.

Midwives are required to be trained in infant and adult resuscitation. They also have local anesthesia available for any tissue repairs after the birth. They have medications available for things like postpartum hemorrhage and will transfer to the hospital should a need arise during or after the birth.

I would encourage you to find a birth center in your area and ask to take a tour. I would also encourage you to take an independent childbirth class or do some additional reading to help you prepare for your next birth.

Some great books are:

Creating Your Birth Plan: A Definitive Guide to a Safe and Empowering Birth by Marsden Wagner

Thinking Woman’s Guide to a Better Birth by Henci Goer

Natural Birth the Bradley Way by Susan McCutcheon

Amelia,

I need mom advice… How do you know if your breast milk is not working for the baby? My baby is totally having gas problems. The Dr. wants to put him on Prevacid. He had a ultrasound yesterday to check for reflux, but it came back fine. He gained almost another pound …10.15 now.

He has this terrible cry and painful look in his face like he needs to pass gas several times through out the day. It’s hit and miss when he gets fussy. I tried gripe water but it is not helping.

My husband’s grandma thinks it’s my milk. She keeps telling me my milk isn’t rich enough or something is wrong with it. If that is true, I will be totally sad. I guess I dont want to think that it could be it…I’m having a hard time with grandma being here. I’m a total emotional roller coaster. I love her, BUT she is driving me nutzzzzzz. She has toooo much to say and tooo much advice and talks too loud….

I would like your opinion about the breast milk. Not sure what to do. Your advice is needed my friend.

My response:

First let me start off by saying that you are doing a great job as a mamma! I’m glad the reflux ultrasound came back negative.

It sounds like hubby’s grandma has some old information. She is telling you things she heard back in her time of breastfeeding. Your milk is the best thing for your baby and the fact that he has gained over 2 pounds since his birth a month ago is a great sign! His pain might be worse if he were on formula instead of your milk, which is more easily digested.

I can understand how difficult it can be when your baby is crying as if he is in pain. It is hard for a mother to see her child in pain and as moms we try to do what we can to minimize our children’s pain. Try to remember that his digestive tract is young and immature and that he will eventually grow out of it.

There are a few things you can do in the meantime. Check your diet and make sure you aren’t eating a lot of the common foods that are known to bother babies like dairy, broccoli, garlic, onions, and chocolate. Sometimes babies are sensitive to what a mother eats. You can eliminate one kind of food at a time and see if there is an improvement in his gassiness/fussiness.

Also, you could try feeding the baby from only one side. Some babies become less gassy and fussy when they eat from one side at a time. Research has shown this to be true for some babies. When babies eat from one side they get more hindmilk and that seems to improve the problem. If your baby has bowel movements that are green and frothy it can be a sign of hindmilk/foremilk imbalance. When mothers produce large amounts of milk sometimes the baby gets full on too much foremilk and don’t get enough hindmilk. One way to remedy that, especially when feeding from both sides, is to pump a little or manually extract some milk from the first side before the baby eats to make sure the baby gets more hindmilk. Also feeding from one side per feeding can help too.

Having family to help after you have a baby can be wonderful but it can be difficult too. As hard as it may be, I would encourage you to tell grandma, “Thanks for your input, but I don’t think my milk is the problem. The doctor doesn’t either and I would appreciate it if we could agree to disagree and not talk about it anymore.” Or something like that. You could also ask your husband to talk to grandma and have him tell her that her negative comments are hurting your feelings and that it would be better for her to say positive things about your decision to nurse your baby. It might be better coming from him since it is his grandma. It sounds like she is a direct person, and often times direct people need to be spoken to directly.

Breastfeeding is such an intimate experience and it is common for mammas to be very vulnerable to negative comments. It is so important for you to have others around that support your decision to breastfeed. Hang in there and try to ignore grandma’s negativity.