Birth and the First Three Months

Class Handouts & Resources

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Weekly Rituals

Week One: Sanctuary/Altar & Foot Washing/Massage

Week Two: Loving Touch Guided Relaxation

Week Three: Relaxation Induction & Guided Visualization

Rainbow Script

Cathy Daub’s Birth Visualization (Audio file – 32.5 MB)

Week Four: Bringing Meaning to Nursing Mother’s Yoga

Week Five: Letter to Baby

Week Six: Class Reflection

Pregnancy Health & Wellbeing

Work with your vision for your pregnancy and beyond.  This worksheet will help you determine actions that will help you create an optimal pregnancy.  These additional resources may be helpful as you answer the worksheet questions:

  • Here is a list of character strengths.  When we experience these characteristics in ourselves it strengthens our spirit.  A strong spirit is perfect preparation for birth and parenting.
  • You may look over the list and identify your strengths, or take the VIA Survey.  It is a free online character survey you can take to identify your core character strengths.  (Registration is required and the survey takes about 30-40 minutes.)
  • Pregnancy can be both a catalyst and an obstacle for great communication as a couple. This handout includes a story illustrating how the feelings and demands of pregnancy can lead to communication challenges, as well as many ideas (verbal and non-verbal) for increasing communication and a richer understanding of how each person experiences pregnancy.  Safety resources for anyone experiencing or at risk for domestic violence are also included.
    Communication Story, Exercises & Safety Resources
  • This quick worksheet will help you identify specific sources of stress, positive or otherwise, common to pregnancy, as well as some of the effects you may be experiencing and ideas for positive stress relief.
    Effects of Stress

In class I mentioned deep relaxation practice at home.  This is the unfinished article that lists several suggestions for how to practice.  As you will be able to see, I have not yet written a relaxation script to finish the article, however you will find a link to instructions for writing your own.
Practicing Relaxation

Singing is a fabulous way to connect with the full range of human emotions and communicate with your baby, born or unborn.  Studies indicate that their mother’s singing voice is one of the first sounds babies respond to as they develop, most likely because of the vibration singing creates in the body.  Singing fills your lungs during the final months of pregnancy when lungs are constricted and connects you to inner and outer spirit – the source of our strength in birth.  And as Michael Odent says, “Above all it is a pleasure to sing and dance, and pleasure must not be underrated; it can only enhance pregnancy.”  I encourage you to sing all types of songs in pregnancy.  Here are three lullabies for the quiet reflective moments.
Sing for Birth Songbook

A quick impressive list of some of the incredible changes that mom’s body goes through during pregnancy.  This will increase your awe and respect and for the great miracle at hand!
http://www.rnceus.com/hormone/estrogen.html

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Labor & Birth

First

Here are some reference handouts I will discuss in class:

While not comprehensive of all of the variation possible in birth, this one-page summary of the stages of labor and tips for coping with contractions may be useful as a review as birth draws near, a reference during labor, or to facilitate conversation about how you imagine each stage and what you could do or what would be helpful.
Deb’s Ultra-Simplified Guide to Labor

Worksheets:  What works best for me in Labor?
Optimizing Labor Physiology
Optimizing Labor Physiology for Partners

A written birth plan is not necessary for all people. It is important if you have specific wishes for how nurses and others interact with you during your birth. Your written preferences help to communicate what you believe will be most helpful to you in case you arrive in labor at a time when your are deeply focused on laboring, and they give your nurses and others a picture of the values and choices you prefer. Writing a birth plan is a great exercise in clarifying for yourself what matters most to you. This can help you understand the ways you can prepare for an experience you will consider positive. Including your doctor or midwife in the process by asking questions about your options and their insight is a very valuable tool for learning more about their style of care. If you’re wondering if you need a birth plan, read Should I Write A Birth Plan. To learn how to go about writing one, read How To Write A Birth Plan. To make the most of your birth plan during pregnancy, read Using A Birth Plan For Birth Preparation.

Options for labor management has a nice list of options you may want to communicate on a birth plan, and also some insight into what to consider as you are making your choices.

Here is a fillable birth plan template you are welcome to use.  It simply outlines the subjects that you may want to cover, though you can feel free to skip any areas that are not super important to you.

This pdf reviews the questions that you may need to ask in order to gather full information before giving yourconsent or refusal for recommended procedures.  You may want to consider printing this and bringing it with you to your prenatal appointments and/or birth to serve as a helpful guide if the need to make hard decisions arises.
Informed Consent

In class we talked about many actions or changes you can make physically, mentally, or emotionally/spiritually to help soften and open your body for birthing. Here is a summary of those body, mind and spirit tools for your reference.
Yes! Energy

Here is a link to a nice article about labor positions, and other supports, that includes good illustrations.

Second

In this handout I introduce some of the hormones involved in birth and parenting – very informative for understanding how to facilitate the optimal function of labor, and a fascinating look into the biological drive behind parenting.
Meet Your Parenting Hormones

Writing your own relaxation script provides you with a wonderful, personalized tool to induce visualization and deep relaxation during birth.  It can be read to you, or you can simply recall the images in your own mind at times when the calming affects of visualization help you work through contractions or take a deeper more nourishing rest in between.  Share your script with your spouse, partner or doula so that they can offer the suggestion of the images most helpful to you during the midst of your labor.  Here are instructions for writing your own relaxation script.
Write Your Own Relaxation Script

The Surrender Quote: Letting Go Into Love

Here is a web site that will facilitate a deeper understanding of your baby’s position in the womband the impact of his or her positions during birth.
SpinningBabies.com

An awareness of oxytocin is an important aspect of childbirth education.  Oxytocin is so implicit to the function of labor and birth, as well as in your relationship to each other and to your baby.  You want to know how to encourage an abundant release of natural oxytocin during your birth (not be mention throughout pregnancy!)  Love, caring, safety, non-judgement… these are all essential.  Nipple stimulation and foreplay are effective as well.  Blogs on Oxytocin abound!  People love to write about this hormone.  Here’s one I enjoyed, or you can also search for your own.  Each one reveals a bit more understanding.  I believe an understanding of Oxytocin is foundational to understanding birth.
The Big ‘O’ Isn’t Orgasm (This link is sometimes up, sometimes down.)

There is peripheral research on the effects of birth practices, such as induction and augmentation with Pitocin (synthetic oxytocin) and Cesarean birth, on oxytocin release.  This abstract reporting that vaginal vs Cesarean delivery, and age at first breastfeeding, impact the pulsatility of oxytocin and the release of prolactin during breastfeeding is one example http://www.ncbi.nlm.nih.gov/pubmed/8842644. This is the type of finding that is causing researchers to consider a link between synthetic oxytocin at birth and autism.  Autistic children sometimes have an altered oxytocin system. While this possible link between induction and autism has made it into popular press, there is no conclusive evidence for a causal link at this time.

Induction, or other procedures, are sometimes the best choice for your immediate physical health and safety, or for your baby’s!  When reading information about the potential long-term or subtle harm of this, or any, procedure I encourage you to allow it to inform your choices (for example, avoid unnecessary induction), but caution against allowing fear of the procedure to brew in your heart and mind.  If induction appears to be the best choice for you or your baby, make it with confidence!  First things first.  However an awareness of the possibility of long-term side effects informs our understanding of how to promote healing in the postpartum period when all are once again stable. Humans have a huge capacity for healing and an innate drive towards health.  If this, or any other unwanted procedure, becomes part of your birth story you are always welcome to contact me for insight into how to promote healing for yourself or your baby through skin-to-skin contact, alternative and complimentary medicine and more.
Primal Health Essays by Michel Odent, M.D.

This article provides lots of information on how epidurals can affect your body and your experience, as well as your baby, during labor and postpartum.  It also provides some guidance regarding how to make a personal decision to use or not use an epidural.
Epidurals, by Deb Rhizal

This is a link to DONA International’s position paper on birth doulas.  DONA International is the largest certifier of doulas.  This paper summarizes some of the research available on the impact of doula care during birth.
DONA Position Paper

In my experience immersion in a tub of water is incredibly helpful to many women during labor.  It is best to fill the tub high before entering so that the water covers must of your belly as soon as you get in.  Getting in when the level is lower and allowing the water to continue to fill is less effective.  Water should be around 98 degrees, and the best time to get in the tub is when labor is very active and mom feels like she needs to find a new technique or get some relief.

Occasionally women don’t like the tub, and occasionally the relaxation seems to make labor slow down.  Both of these are the exception. If they occur simply get out, and consider using the tub again at a later point in labor.

Typically women settle into deep relaxation almost immediately after getting in the tub and find labor much more manageable.  Research shows that laboring in water does not increase your risk of infection, and is safe for GBS positive women.

This brief article explains some of the ways water works to benefit mom’s during labor.
Water Immersion and Pain Control in Labor

Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation by Pam England has some fabulous sections on pain coping techniques. She explains different types of focused and non-focus attention, breathing, and reframing – and provides instructions for how to “test out” the techniques using a piece of ice to create a painful situation to practice through. Pam’s book also gives many suggestions for releasing fears and building your confidence for birth.

Ina May’s Guide to Childbirth by Ina May Gaskin is another fabulous book.  The first half is full or empowering birth stories that will broaden your ideas of how to cope and increase your confidence that women can do this!

When to cut the cord? Common practice is to clamp and cut the cord within seconds after birth.  Some parents and care providers are choosing to allow the cord to stop pulsing naturally on its own before clamping – usually within 2-20 minutes after birth.  If a baby is born depressed and does not breathe, common practice is to immediately clamp and cut the cord before resuscitation.  Medical obstetrical care providers have research-based reasons for this management, and are working to reduce brain injury and other potential complications.  There are others, within the obstetrical community and without, who question this practice on the basis that placental function and blood transfusion from the placenta to the baby are physiologically protective.  They dismiss much of the accepted research because all babies in the studies have their cords clamped and cut and there is not a control group of unclamped cord management.  They advocate for delayed cord management, especially in situations where the baby requires resuscitation.  Many parents feel most comfortable leaving decisions to the medical staff in a high stakes situation such as lack of breathing at birth.  Others have a strong desire to research the available evidence and discuss the management with their doctor or midwife.

There are also parents who prefer to leave the cord in tact for physiological reasons related to the baby’s energy body or due to spiritual beliefs.  Often referred to as “Lotus Birth,” the practice is to allow the placenta to dry and separate on it’s own a few days to a week after birth.  Some parents practice partial lotus birthing, cutting the cord after 12-24 hours.

If you feel strongly that your baby’s cord is left intact for any reason, you must educate yourself and then have extensive conversations with your doctor or midwife about carrying out your decision.  It may necessitate that you choose out-of-hospital birth or go through a process of informed refusal of care.

This article explains the physiological reasoning and techniques for delaying cord clamping, especially when resuscitation is necessary.
Basics of the Cord Clamping / Brain Damage Issue

Here is a link to one of several web sites dedicated to Lotus Birth.
Common Questions about Umbilical Nonseverance (Lotus Birth)

The Scientification of Love by Michel Odent is one of my favorite books to recommend to parents interested in physiology and research-informed decision making in birth.  The book claims to be about a review of the scientific understanding of how the ability to love develops.  As such, it’s not written distinctly to expectant parents.  That being true, within the covers you will find many discussions about the impact of epidurals, disruption of the labor process, separation of mothers and babies, and experiences of trauma around the time of birth; and their impact on life-long capacity for attachment, relationship and self-love.  The books discusses animal studies, ethnographic studies, and more.  The author sets out to make a strong case, which at times I find is short-sighted of the subtleties, resilience, and complexity of human socialization… but the information is provocative and fascinating all the same.

This article provides a detailed review of fetal monitoring, including information regarding reassuring, non-reassuring and ominous fetal heart rate patterns.  Clearly the interpretation of fetal heart rate patterns is a medical skill.  Some parents may feel comfortable entering their birth without detailed knowledge about what heart rate variations may mean for the safety of their baby knowing that they will rely on their nurse, midwife and/or doctor’s knowledge and skill.  Others may want to be informed so that they can actively participate in decisions during their birth.  Knowing the language and the possibilities helps parents have meaningful discussions with their care providers.  Some birth professionals believe that continuous fetal monitoring is over-used in the United States, and there is evidence that this over-use leads to a small number of unnecessary cesareans.  These trends are also discussed in the article.   Other draw-back of continuous fetal monitoring are the impediment of movement, and a negative impact on feelings of autonomy, strength, and confidence.  Given the physical and hormonal nature of birth these impacts can be significantly  detrimental to labor progress.  These draw-backs can be overcome or reduced through education and personal preparation, giving you the tools to keep active and remain confident.
Interpretation of the Electronic Fetal Heart Rate During Labor

This YouTube video shares a positive experience utilizing epidural pain relief.  Watching it and thinking about the contrasts in the experience of childbirth in comparison with the unmedicated birth we watched in class is helpful for making decisions about your wishes for pain management.  It also provides a glimpse at electronic fetal monitoring – both on the mother and the screen showing the contractions and heart rate.
YouTube – Perfect Labor and Delivery

Did you know fetus’s can hear ultrasound?  Ultrasound is also used to listen to the baby’s heart rate in labor.
Fetuses can hear ultrasound examinations

Here is a link to Lamaze International’s web page that outlines six evidence-based healthy birth practices:

  • Let labor begin on its own.
  • Walk, move around, and change positions throughout labor.
  • Bring a loved one, friend or doula for continuous support.
  • Avoid interventions that are not medically necessary.
  • Avoid giving birth on your back and follow your body’s urges to push.
  • Keep mother and baby together – It’s best for mother, baby, and breastfeeding.

Wondering what to take with you to the hospital?

Packing for the Hospital

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Infant Development, Baby Care & Breastfeeding

Understanding how to create a secure attachment with your baby is one of the most important aspects of new parent education.  In this article I summarize the topic as explained by Doulas Davies in his book Child Development: A Practitioner’s Guide (Social Work Practice with Children and Families).
Attachment Parenting 101

Informative paper from the Center for the Developing Child at Harvard University about the importance of relationships in your baby’s life, both their relationship with you, and with significant additional caregivers.
Young Children Develop in an Environment of Relationships: Working Paper No. 1

This is a PDF of the adult attachment interview protocol intended for practitioner’s use. I find it a powerful self-insight tool. You and your partner can interview one another using these questions, or alternatively you could journal your responses.  Greater awareness of your own early attachment experiences and their influence on your personality will increase your ability to consciously form the type of relationship with your child that you desire.

Adult Attachment Interview Protocol

This handout gives a very short overview of some of the fields of science that shed light on the sensitive nature of labor and the hours after birth, and how experiences during this time can effect bonding and behavior.
The Sensitive Nature of Birth and Early Experience

The more you understand about your baby the more amazing they are! Increased understanding also helps you parent intentionally.  Knowing more is fascinating.  It’s easier to be attentive to signs you expect to be able to see, and connecting your knowledge with your experiences will involve your adult mind and increase the enjoyment of parenting a newborn.  In this handout I offer a collection of information bits, also from Davies’ book, related to baby’s development from birth through 3 months.
Interesting About Babies

In addition to this article I recommend Your Baby Is Speaking to You: A Visual Guide to the Amazing Behaviors of Your Newborn and Growing Baby by Kevin Nugent.  See my book review here.

Another popular book is Your Amazing Newborn by Kennel and Klaus.  Amazing Baby is a lovely coffee-table style book by Desmond Morris.

You can read about the benefits of skin-to-skin contact on many many web sites.  Here is a brief summary: The Importance of Skin to Skin Contact.  And it works with dads too: Paternal Skin to Skin Offers Baby Same Benefits

Colostrum is wonderful!
What is Colostrum?  How Does it Benefit my Baby?

Printable Breastfeeding Log for tracking pee’s, poo’s and more: assuring your baby is getting Printable Breastfeeding Log.

Breastfeeding goes best when it’s a family endeavor.  A partner’s strong belief in its importance and, when possible, practical support makes a big difference. Here are some tips on how to help a breastfeeding mom.
How Partners Can Help With Breastfeeding

Breastfeeding resources abound.  Where to start?

  • kellymom.com: A great web site when looking for your own answers to basic questions.
  • Call Deb to discuss questions, (734) 604-1841 or email me
  • Barbara at the Breastfeeding Center of Ann Arbor is a fantastic lactation consultant when complications arise, and also offers a free support group on Friday’s and a boutique for nursing supplies.
  • Indigo Forest is a tucked away treasure of warmth, encouragement and great products for breastfeeding and far more.  They also have a free mom’s group, breastfeeding support and a scale for moments of concern about weight gain.

CDC Growth Charts: Your doctor will be tracking your child’s growth, but keeping your own chart  may be reassuring during the early months of breastfeeding. It also provides you with a source of long-term information that may become useful if you have questions between visits or if you move or switch to a new doctor.  Different growth charts sometimes tell a different story, and having your own growth chart is useful if you ever find yourself researching alternative approaches to a health concern your child is facing because you are uncomfortable with the recommendation of your doctor.
Individual Growth Charts (CDC)

This pdf from March of Dimes explains the six states characteristic of newborns, and what to do for your baby in each state.
States of Term Newborn

Helpful breastfeeding video clips – I highly recommend watching the nutritive vs non-nutritive pattern clip.
Breastfeeding Comprehensive

The Happiest Baby on the Block is a book (or dvd) that promotes the “Five S’s to Calm Babies”: swaddle, shhh, swinging, sidelying, and sucking.  It’s practical and works for a lot of babies!  This link takes you to a page that shares the table of contents in detail, which is just about as good as reading the book.  It’s not complicated to learn – just takes a lot of work to carry it out around the clock!

There are so many great reasons to carry your baby often in a sling or baby carrier. You can try different baby carriers locally at The Little Seedling or Elephant Ears.  The folks at Elephant Ears will be happy to extend a 10% discount if you mention that I sent you.

What is body awareness, and what does proprioception have to do with it?  This article discusses what difficulties with proprioception look like in a preschooler.  That may seem a long way off at this point, but I share it with you to encourage you to keep your baby moving and to affirm that all that bouncing, rocking, and carrying you will fill the hours with is valuable indeed!  Problems with proprioception are a growing issue in our culture which encourages over-use of helpful parenting aids such as baby swings, click and go car seats, videos for entertainment and so on.  We all need an extra pair of hands often when caring for a baby, and the extended family, which may have provided those hands in the past, no longer lives in our house.  Parenting aids are great and a sanity saver – but limiting their use is important.
Movement and Body Awareness

What do I do with a baby all day? Playing with your baby is a joy if you clear your mind’s agenda of other activities and responsibilities.  But even then it can be mind-numbing to fill hours staring at your baby or walking around the neighborhood once again.  Babies need nothing more than diverse experience.  If they are in your arms as you go through life they will have all of the stimulation necessary to promote optimal development.  However, if YOU need game ideas to keep it interesting and fun, they abound… and your baby will love them.  Here is one list of games to play:  Many others can be found by googling “play with your baby” or picking up a book from the parenting or early childhood education section of your favorite book store or library.

The first article on this page has a couple fantastic tips for how fathers can be involved in breastfeeding – an involvement that studies have shown to have a large impact on the duration of breastfeeding.  The many other links on this page will take you to other articles written by fathers about their thoughts and feelings and experiences with breastfeeding.
Fathers and Breastfeeding

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Postpartum Health & Transitions

This fun article from USA today reports on some research findings that show the hormonal changes dad’s experience during pregnancy and postpartum.
Dads’ hormones change, too, during pregnancy – USA Today.com

This lengthy article provides a paragraph or two on many aspects of health and healing after the baby is born.  It includes topics such as nutrition, relief for hemorrhoids, and sexuality changes.  It has a basic level of information that both mothers and fathers should know before having a baby.
Postpartum Health and Healing

Postpartum Herbs, Oils, & More: This article describes some of the ways postpartum herbs are used in birth centers and by midwives to offer care to new mothers and speed healing after birth.

Breastfeeding Pain Remedies: If you are experiencing breastfeeding pain, early intervention can help a great deal. Learn some remedies and tips for avoiding and dealing with this pain.

Helpful websites for the postpartum family:

  • kellymom.com:  This is a great site for practical, thorough and evidence-based information on breastfeeding, sleeping and parenting.  I find her resources to be to-the-point and supportive of the real needs of parents and babies.
  • WorkAndPump.com:  A great site for questions related to returning to work as a breastfeeding mom — including the question of whether to try pumping and working or not.  The site includes sample schedules of what a day would look like while pumping and working, lots of practical information like storage times and temperatures, and resources for the personal questions you may have about the work and impacts of pumping on your career.
  • Dad’s Adventure:  Practical tips on how to play with your baby, how to become a team as parents, and what changes you may navigate as a couple.  Great information on dad’s role and impact.

A Time magazine article looking at collaborative parenting and the impacts of gatekeeping, socialization, and gender identity.
When Moms are Gatekeepers

This link provides instructions for some gentle exercises that you can begin just after birth.  Doing so will bring tone to your abdominal and pelvic floor muscles even as they are slack from the stretch of pregnancy and birth.  This prevents atrophy, cell death that leads to muscle weakness and a slower recovery.  Doing gentle exercises and stretching daily will make your return to pre-pregnancy strength and posture faster once your body is ready, and will also enhance positive emotions, deep sleep, and mental wellbeing during the first few weeks after your baby is born.  Save more vigorous exercise for after your bleeding stops and your energy returns fully.
How to Exercise After Giving Birth

A long-winded and candid blog about how and why to take it easy after birth.
A Time to Heal

Placenta’s contain many nutrients and hormones, and there is a rich history of their use in medicine in diverse cultures.  To the best of my knowledge there have been no controlled studies researching the impact of eating your own placenta, but testimonials of the benefits abound from women who have given it a try.  Here is a web site with more information from two women who will come to your home and prepare capsules from your placenta that can be taken just like any other supplement.  I include this information because of the very positive experiences a few of my clients have had after taking placenta capsules, particularly in reducing postpartum blues/depression and in increased milk supply.
After Birth Service

This links to an article from an extremely practical web site for new parents.  The site is targeted to new dad’s, but the advice is equally relevant to moms and dads if you can take their stereotypes with a grain of salt.  It provides some of the most realistic, practical, proactive and positive tips I’ve come across, and does a great job of providing a picture of what to expect after your baby is born.  This particular article gives you seven goals for new dads in the first three months.  The site is easily perused for other helpful advice by clicking the articles tab.
7 Goals for your First 3 Months as a Father – dadsadventure.com

This PDF is a two page summary of the results of a national survey of 1,573 women regarding their experience in the 18 months following birth.  It provides a snap shot of the many challenges facing postpartum women in the US, which is helpful in preparing for your own postpartum.  Knowing what challenges you could face gives you greater insight into how to prevent them.
New Mothers Speak Out – childbirthconnection.org

Health complications after birth are a possibility. It is estimated that about 15% of new moms may experience one of the following: urinary or fecal incontinence, painful intercourse, 3rd or 4th degree laceration, ineffective healing of episiotomy. If you experience any of these, or any other complication, The Health and Healing After Delivery Clinic at U of M is a wonderful resource no matter where you gave birth.

 

Wheel of Needs

Postpartum Worksheet

A Financial Planner’s Notes for Expecting Parents

 

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For Healthy, Happy, Families