Archive | September 2012

Healing Emotionally and Physically From a Cesarean at 29 Weeks | Birth Without Fear

Healing Emotionally and Physically From a Cesarean at 29 Weeks

by Svea Boyda-Vikander on September 24, 2012

This picture isn’t one from the hospital, as we don’t particularly want to share those. Our baby was born prematurely and it was quite traumatic for us. Here is the story…

My waters broke at 26 weeks’ gestation and I spent 10 days in hospital, where I was told that she was lying sideways, I had no amniotic fluid (was constantly losing it – like being incontinent!) and had placenta previa, which meant that I would need to have a ‘classical’ cesarean, vertical, which is the kind that means no natural birth ever again, apparently! However, I was eventually discharged from hospital because I didn’t go into labour.

At 29 weeks’ gestation (on my husband’s birthday) I finally went into labour. Ava had moved into a breech position (although you still can’t give birth to a pre-termer in breech, as their heads risk getting stuck). I was in light labour for a couple of days (we were trying to stop it) when on Friday evening I had heavy bleeding due to the placenta coming away and had to have a ‘crash cesarean. I had general anesthetic and woke up later not pregnant anymore, but with a tiny, healthy little girl!

It was all extremely traumatic, made more so because I had planned a home birth, all natural – and ended up with the opposite. However, the good news is that my placenta moved enough to allow a normal horizontal cesarean. Ava was in hospital for seven weeks, but never had any health concerns. We were the only people in the Special Care Baby Unit to exclusively breastfeed their pre-termer – and it was hard work! She was so young, and she had tongue tie, which got snipped. Eventually she got there, when we were close to just introducing a bottle as we wanted her home, and it was the only thing keeping her in hospital at the end (she was fed my milk through a nasal tube).

Recovering from the cesarean was difficult, but probably made easier by the fact that I didn’t actually have a baby to look after – as much as I wished I did! So I got plenty of rest. The second day was probably the hardest, as I came down off the morphine and the reality of the situation hit me and the grief of losing my planned beautiful birth kicked in. I also felt guilty that Ava had been born early, though it wasn’t exactly my fault. And the speed of the crash cesarean left me kind of reeling, trying to come to grips with suddenly not being pregnant.

For a long while, though I loved Ava, I almost felt like she was someone else’s baby. I didn’t have the connection of seeing her come out of me, seeing her born, and in fact it was about 14 hours between the cesarean and meeting her. However, it really only took six weeks for me to feel normal again, and now I’ve built my stamina and fitness back up, nice and slowly. The key is to take it easy and trust that time heals! Now Ava is still exclusively breastfeeding and she is six months old and lovely!

This picture was taken in the south of France this summer, six months after a crash cesarean. I just want to remind women that we do recover; we do feel great again!

Rachel Lockwood (United Kingdom)

via Healing Emotionally and Physically From a Cesarean at 29 Weeks | Birth Without Fear.

Body Image | Samantha Thrall

Body Image

Posted on September 14, 2012 by samthrall

On September 10th I created an image as a response to another I had seen about stretch marks. I had my little sister photograph my idea and added the message and sent it out into the interwebs without a watermark or name or any identifying marks. I sent it to the moderator of “the Guggie Daily” who uploaded it from her account with just my first name. Four days and thousands of shares and comments later, it found its way back to me somehow and I was contacted to speak out about my photo. The Internet is a crazy place.

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“For every woman unhappy with her postpartum marks, is another who wishes she had them.”

It was a scary thing putting such a revealing photo out there which is why I had chosen to leave it anonymous, but it has received such amazing positive comments and has touched the hearts of so many people! I am so shocked and in awe by it all.

Much love to all of you beautiful Mommas out there ❤

via Body Image | Samantha Thrall.

Why The World Needs a Parenting Revolution « www.babycalm.co.uk

 

All around the world a birth revolution is beginning, next week sees the launch of the new Freedom for Birth Film. Birth workers are metaphorically holding hands around the world to help raise awareness of the dire need for change in the way we view birth. New campaigns begin each day fighting for the rights of parents, from their place of birth to their rights to choose their care providers. The earth is beginning to awaken, awareness is rising and more and more are beginning to realise how desperately we need to make a change.

It doesn’t end there though, the problem is bigger than birth – we are in desperate need of a parenting revolution, we need to change the way we view the formative years, in particular the first three, otherwise we are in grave danger of losing the very essence of what it is to be human. If  we continue to play God by deciding when babies should be born, forcing them out with chemicals and surgical implements and making mothers birth in environments that inhibit oxytocin we will only see more problems and need these interventions even more. If we continue to tell mothers to ignore their baby’s cries, to not ‘spoil’ their infants or let their babies manipulate them, if we continue to force toddlers to retain anger and fear by training them to be quiet and withhold their emotions we are putting our future at risk, because what future is there for a race who have forgotten what it is to be empathic? What future is there for a society of individuals unable to express their emotions unless through acts of violence and anger?

Am I being over dramatic? I honestly don’t think so, I can feel the urgency to make a change as loudly as I can feel my heartbeat when I write of it, I can hear the drums beating in an ever-increasing tempo, I can feel the energy building and I’m scared it’s going to go the wrong way.

This film is only one of many that highlight the need for urgent change and a new understanding of parenting. Science is increasingly agreeing, yet science is partly responsible for the mess we are in now, the more intelligent man becomes the more he loses grip on his instinctual self, not believing what he feels unless it is validated by the relevant ‘expert’.

How to make this change? The birth and parenting workers can only do so much, I believe our key is to create awareness, the real change though – that has to come from the parents. Once they are aware, once their eyes are open and they learn to trust in themselves, in their  bodies and their babies then it is time for them to make a stand, they are the only ones who can really make the change.  As David Chamberlain says:

“Parents themselves may be the ones to lead us into a new age of birth by setting new standards for how babies are treated. After all, whose babies are they? Parents always have the advantage of making the first move-as consumer they decide where to have their babies and what practitioners to employ. The current situation is a test of whether parents or professionals can react more quickly to new information.”

So who will win this race of reaction? whose team are you on? Me? I’m rooting for the parents.

Sarah Ockwell-Smith – Mum to Four, Parenting Author and Founder of BabyCalm Ltd

http://www.babycalm.co.uk

http://www.facebook.com/babycalm

http://www.twitter.com/babycalmclasses

BabyCalm: A guide for calmer babies and happier parents released October 4th –pre-order your copy HERE with FREE worldwide postage

via Why The World Needs a Parenting Revolution « www.babycalm.co.uk.

 

Breaking News: New Study does NOT show ‘Sleep Training Babies Causes no Lasting Damage’ « www.babycalm.co.uk

 

Breaking News: New Study does NOT show ‘Sleep Training Babies Causes no Lasting Damage’ « www.babycalm.co.uk.

Yesterday a new study appeared in the AAP’s journal Pediatrics which effectively declared controlled crying to have no ill effects for babies (or parents for that matter). The study was understandably pounced on by the mainstream media and my email hasn’t stopped pinging for the last 24hrs!

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I have spent the last day trying to get hold of the full paper, not least because I have confidently announced in my imminently to be published book that I don’t believe controlled crying (and other sleep training) is consistent with the needs of babies and that to date no (good quality) research has (in my opinion) proven its lack of lasting damage, talk about timing hey?! More than that though I genuinely cannot understand how any research worth its weight can confidently say that there are no lasting effects of this form of detachment parenting. So anyway I’d like to say a big thank you to Cathy for sending me the full paper today.

I’d like to get this blog up as quickly as possible, so bear with me as in all likelihood this means it will be incredibly badly written and read like a bit of a stream of my thoughts as I read through the paper. I’ll do my best to sum up at the end.

The study opens with this paragraph:

“Behavioral techniques effectively reduce infant sleep problems and associated maternal depression in the short- to medium-term (4–16 months’ postintervention). Despite their effectiveness, theoretical concerns persist about long-term harm on children’s emotional development, stress regulation, mental health, and the child-parent relationship. “

Behavioral sleep techniques did not cause long-lasting harms or benefits to child, child-parent, or maternal outcomes. Parents and health professionals can feel comfortable about using these techniques to reduce the population burden of infant sleep problems and maternal depression.”

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Potential Methodology Issues Not addressed in the Study:

  • Sleep problems were ‘parent reported’, at 7mths a questionnaire was given with the question “Over the last 2 weeks has your child’s sleep generally been a problem for you?” 47% of respondents answered ‘yes’ and thus became eligible for trial inclusion. The ‘problem’ was not elaborated upon and I would have liked to have seen more questioning to ascertain exactly what the problems were, what had been tried until that point, what information the parents had received and what support had they received up until that point in those first important 7months as this time period could have a big effect.
  • The sample (out of those reported sleep problems) was selected by the researchers, I can find no mention of how they were selected and what other criteria was looked into in terms of the infant’s/family history/psychological wellbeing until that point.
  • Parents must have been open to the idea of sleep training to agree enrollment in the study, would this therefore mean that their opinions/beliefs were reflected in other parenting practices?
  • Training was carried out on babies 8-10months of age so cannot be applied to any infants younger than this. It also does not tell us the effects of training on older children/toddlers.
  • Parents were able to choose the type of sleep training used – either gradual extinction (what you and I know as controlled crying) or gradual withdrawal (parent starting out sitting with child and moving further away but involving no crying) – though no distinction was made between the type of sleep training used and later impact in the results.
  • Control/Intervention group allocation was blinded only to researchers not parents (understandably it would be tricky to be blinded to parents – but I wonder how knowledge that they were in the intervention group affected parental perception).
  • The control group visited the same nurses and were free to ask for sleep advice, but the nurses in these control groups were not trained to offer specific sleep training advice, however what advice did they give? Pretty much any parent I know could give controlled crying instructions without special training, do we know that they didn’t give similar advice to the intervention group? I cannot find this information out and to me from this point in the study loses all credibility for me – Do we know what the control group did sleep wise? We know they reported that they had had a problem with their child’s sleep in order to enter the study, so it’s pretty likely that they would want to do *something* – were they followed up and questioned and asked exactly what they did do? Again I can find no mention – How do we know that a large majority of the control group DIDN’T sleep train?
  • Outcomes were measure by cortisol samples, taken at 6yrs of age (why on earth would they take them at 6year of age?! I find this very confusing and not at all relevant? From what I can see the first follow up – and potential cortisol testing was at 10 months, yet the concerns over stress to infants from sleep training is during and in the immediate aftermath of the training, a sample taken 2 months up to 5 years later seems bizarre? Where is the cortisol sample DURING and IMMEDIATELY after the training? This is the one that matters IMO).
  • Child emotional questionnaires and ‘quality of life’ questionnaires were parent reported (and occasionally child reported) – meaning that parents filled in the questionnaires giving their own opinions. We know questionnaire reporting is notoriously unreliable with two main factors – 1) wanting to tell the investigator what they want to hear and 2) sticking to ‘middle of the road’ answers, i will add in 3) here – what parent will want to report that they feel their child has an emotional/behavioural difficulty? Especially not when they have been enrolled into a trial looking into the effects their early parenting may have had upon these. I find it very hard to determine whether the measures of psychological wellbeing were all parent reported as the results are very vague, but if I were to make an assumption I would guess that the majority were parent reported. Child reporting surely would include bias – what child would say negative things about their parents in front of said parents?
  • In terms of parenting style (and thus I presume eluding to bonding too?) the researchers appear to feel that “authoritative parenting” (high warmth, high control) is optimal parenting whereas what they call permissive parenting (high warmth, low control) is sub-optimal. I would argue that having “high control” over children is NOT optimal parenting, or indeed respectful parenting and am not convinced at all that highly controlling parents are those exhibiting the most healthy parenting style. I would like to see how they define “high and low control” and look to see how many initial “permissive parents” morphed into “authoritative parents” from the intervention group as a result of the training undertaken, this information though is not provided.
  • Nearly a third of the sample were lost to follow up (31%) – that’s a BIG number and a major limitation – what if they didn’t agree/respond to follow up because they found the intervention traumatic/it didn’t work for them/it went against their instinct?

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Perhaps the most interesting part of this research to me those is this:

“There was no evidence that a population based targeted intervention that effectively reduced parent-reported sleep problems and maternal depression during infancy had long-lasting harmful or beneficial effects on child, childparent, or maternal outcomes by 6 years of age. Thus, this trial indicates that behavioral techniques are safe to use in the long-term to at least 5 years.”

Read that again, I’m pretty certain I dispute their claim that it has no long lasting harmful effects given the parental reporting, strange timing of cortisol testing, lack of information on what techniques the control group used, promotion of authoritative/controlling parenting as the optimum type, lack of information of life before 7 months of age (or in fact not much about life afterwards aside from financial questioning – what about childcare for a start) and lack of in-depth information about bonding (why no Ainsworth ‘Strange Situation’ type testing?). No the most interesting part to me is even with all of the above limitations in mind this research tells us there are NO LASTING BENEFITS to sleep training……Now which paper picked up on that then?! No, thought not.

So what DOES the research tell us?

  • There is still NO evidence that shows controlled crying under 8 months of age has no ill effects
  • The results did NOT differentiate between the different types of sleep training used (e.g: No Cry V Crying related options) in the results, therefore we do not know about the individual methods and their outcomes, only ‘sleep training’ as a broad label of many different types of training.
  • That sleep training does NOT have lasting positive effects on a child’s sleep behaviour
  • That nearly 50% of parents still have problems with their baby’s sleep by 7months of age (hey, perhaps that’s because it is NORMAL infant sleep and our expectations are incorrect)
  • That 31% of parents for some reason did not agree to follow up with the researchers
  • That parents tell researchers that they did not feel that sleep training affected their child negatively (tell me something new).
  • That controlled crying DOES work in the short term (I don’t think this has ever been disputed?).
  • That concerns over the effect of controlled crying on babies are still very valid, particularly in light of the recent Middlemiss study (that measured cortisol levels DURING training, not 5yrs later!) – A good summary of the concerns of sleep training can be read HERE.
  • That a whole lot more health professionals and  ’baby experts’ are going to use this as arsenal to tell parents that there are no concerns with sleep training involving baby crying, that it’s a good thing to do, even if it feels wrong to them, as parents, to do it.

Sigh………..

by:

Sarah Ockwell-Smith – Mum to Four, Parenting Author and Founder of BabyCalm Ltd

http://www.babycalm.co.uk

http://www.facebook.com/babycalm

http://www.twitter.com/babycalmclasses

BabyCalm: A guide for calmer babies and happier parents released October 4th –pre-order your copy HERE with FREE worldwide postage

Reference:

Price. A, Wake. M, Ukoumunne. O and Hiscock. H. ’Five-Year Follow-up of Harms and Benefits of Behavioral Infant Sleep Intervention: Randomized Trial’ Pediatrics;  September 10, 2012;

 

Your pregnancy: 8 weeks | BabyCenter

Decision Guide: Which prenatal tests are for you?

Your healthcare provider will offer you a range of genetic screening and diagnostic tests during your pregnancy. Some are simple blood tests, while others involve more invasive procedures — and all are optional. Before you agree to any test, ask your caregiver to explain what it is, how it’s done, whether the test itself is risky in any way, and what the results will tell you. Many prenatal tests are for screening rather than diagnostic purposes. Screening tests give you a sense of your risk for certain conditions. But only a diagnostic test can tell you for sure whether your baby has a problem. Here are your options during the first trimester:

Video

Inside pregnancy: How food reaches your baby

A 3D animated look at how the food you eat gets broken down into tiny elements, is absorbed into your bloodstream, then passes through the placenta to your baby.

First-trimester combined screening test: This relatively new screening test combines a nuchal fold scan (using ultrasound to measure the clear space in the tissue at the back of your developing baby’s neck) with a blood test to measure two proteins. The scan is performed between 11 weeks of pregnancy through the end of 13 weeks, and the blood test may be done at the same time or possibly a few weeks earlier. First-trimester combined screening gives you information about your baby’s odds of having Down syndrome and may tell you whether your baby’s at higher risk for a few other problems as well. Although it’s not diagnostic, the screening is essentially risk-free and may help you decide whether you want invasive diagnostic testing such as chorionic villus sampling (CVS) or amniocentesis, which slightly increase the risk of miscarriage.

Chorionic villus sampling (CVS): This diagnostic test involves collecting cells from the placenta, which are then sent to a lab for genetic analysis. CVS can identify whether your baby has any of hundreds of chromosomal abnormalities and other genetic disorders. It’s done in the first trimester, usually between 11 and 12 weeks, making it an earlier alternative to another diagnostic genetic test called amniocentesis, which is done between 16 and 20 weeks.

via Your pregnancy: 8 weeks | BabyCenter.