The Maternity & Learning Centre Team at the birth center in Uganda where Sarah Longacre traveled to last year!

This time last year, Blooma founder Sarah Longacre was preparing for her month-long trip to Africa. As part of the Off the Mat, Into the World SEVA Challenge team, Sarah and 20 others raised a total of $574,000 (thanks in large part to each of you!) and traveled to Uganda to help build a birth center.

It’s unbelievable to us that almost a full year has passed since Sarah’s trip. We thought you’d like an update on what’s happening with the birth center since each of you were so integral to raising funds for it to be built!

Sarah helping to make bricks to build the birth center. Such hard work to make one brick!

“The maternity centre has been running in full swing and getting busy and we’re very excited to have our first baby born at the centre in January,” reports Shanti Uganda. You can click here to learn about the midwives who work at the center.

If you would like to stay involved with the work that Shanti Uganda does, you can! Much help continues to be needed.

Yoga mat bags, made by the Shanti Uganda Woman's Group and available online for just $30!

There is a sponsor a midwife program (helping to pay her salary) or you can shop online for fair-trade jewelry, handmade yoga mat bags, and more, all lovingly made by the Shanti Uganda women’s group. Yet another option: purchase a $15 birth kit, which includes everything a woman needs to have  safe, sterile, and supported birth.

Sarah and Blooma continue to be eternally grateful for your help in raising funds to build the birth center. As we reflect on how lucky we are to have so many birthing options available to us here in the Twin Cities, we are especially grateful for all the ways you make Blooma shine and for your help and dedication to help women in Uganda have safer births.

Love,

Alisa, Sarah & the women of Blooma

My pregnancy has been so brilliant, I have loved every minute of it.

We are ready for you now Jelly Bean.  So excited about meeting you.

Although there is no evidence to show that non-medically indicated inductions improve outcomes for babies, inductions for non-medical reasons have been on the rise in the U.S. Increasingly, labors are being induced for psychosocial reasons and for medical convenience. What’s more, the majority of expectant mothers are not aware of the risks of elective induction when they request one or when their caregiver schedules it.

We are learning, however, that with a healthy pregnancy, not waiting until labor starts on its own may have far greater health consequences for babies than we knew. Research shows that when births are induced or cesarean sections are scheduled — especially before the 39th week of pregnancy — newborns may appear mature, but they are at greater risk for short- and long-term complications.

Labor Induction: Alarming Statistics

In 2005, 22.3 percent of all U.S. births were induced — a 50 percent increase since 1990. A national survey by Childbirth Connection showed that 21 percent of U.S. women who gave birth in 2005 tried to self-induce labor because they were tired of being pregnant. They wanted to induce to avoid a medical induction, to control the timing of their birth, or because their caregivers were concerned about the size of the baby.

Elective induction rates vary widely among hospitals (12 percent to 55 percent) and among individual physicians (3 percent to 76 percent). But more than four out of 10 mothers (41 percent) reported that their caregiver tried to induce labor. For some women, an elective induction can almost double the risk for a cesarean, depending on the individual physician’s practice style and medical specialty. And all of these statistics are even more frightening when compared to the World Health Organization’s recommendation that appropriate induction rates in any geographic region should not exceed 10 percent.

Labor Induction: The Risks

With an elective induction, babies are more likely to suffer from hypoglycemia, to be admitted to a special care nursery, and to need ventilator support. A recent study of a U.S. healthcare system showed that babies born at 37 weeks were 22.5 times more likely to need a ventilator at birth, and babies born at 38 weeks 7.5 times more likely, when compared to babies born at 39 weeks. Babies born too soon are also more likely to experience serious complications, including fever, infection, respiratory distress syndrome (RDS), and transient tachypnea of the newborn (TTN).

These babies may look normal, but have an increased risk of difficulties with vision and hearing, feeding and digesting their food, regulating their body temperature, and are more likely to need phototherapy to treat jaundice.

The newest research on babies born before term indicates the potential for neurological problems and learning difficulties that may not show up for years. The March of Dimes is educating healthcare professionals and mothers alike about the important brain growth and fetal neurological developments that take place in the very last weeks of pregnancy. At 35 weeks, a baby’s brain weighs two-thirds what it will weigh at 39-40 weeks. At 37 weeks, the brain weighs only 80 percent of its weight at 40 weeks. The cerebral cortex — the part of the brain that controls functions such as cognition, perception, reason and motor control — is the last to develop. Researchers have found that babies born pre-term are more likely to have learning difficulties at school age. It’s essential for baby’s brain development that the pregnancy goes to full-term.

Labor Induction: Consider This

An induction of labor is a complex process that often requires additional medical interventions to keep the mother and baby safe from successive potential complications. Inducing labor with pitocin when the cervix is unripe (long and closed) sometimes causes the mother to labor for long hours with little progress. Subsequently, confining the mother to bed, using continuous fetal monitoring and IVs, and administering an epidural for pain are commonplace with an induction. Shoulder dystocia (when the baby’s shoulders cannot fit through the pelvis), and the use of forceps or a vacuum extractor are also increased with induction. All of these interventions and complications can lead to higher risk of cesarean section — failed inductions are not uncommon.

Labor Induction: When it’s Helpful

Regardless of all the risks, there are several medical indications for inducing labor — when the mother or the baby’s health would benefit more from the induction than from continuing the pregnancy. These may include diabetes, pre-eclampsia (high blood pressure), or a uterine infection in the mother. Or when a baby in utero is not growing at a normal rate (small for gestational age) or the pregnancy is post-term (more than 42 weeks). Induction may also be favorable when the bag of waters breaks prematurely (also known as PROM, premature rupture of the membranes).

Labor Induction: Questions to Ask Your Provider if it’s Suggested

• Why are you scheduling an induction of labor?
• What are the risks of inducing my labor?
• I know that my due date is only an estimate. What precautions will you take to make sure my baby is not born too early?
• How do you plan to induce my labor?
• How will an induction affect my labor and the health of my baby?
• I know that compared to waiting for labor to begin on its own, an induction is more likely to lead to a cesarean section. What measures would you take to reduce my odds for a cesarean?

If both you and your baby are healthy and stable, don’t hesitate to take time to consider your caregiver’s recommendations and explanations. Feel free to leave the appointment, with a follow-up scheduled — or to get a second opinion. After all, this is your birth.

The last week or two of pregnancy may be difficult. Priorities at work, or scheduling maternity leave to accommodate childcare or family needs may be a priority. However, waiting for labor to begin on its own is safer for you and your baby — and safety is of the utmost importance!

Nicette Jukelevics, MA, ICCE is a childbirth educator, researcher and author of “Understanding the Dangers of Cesarean Birth: Making Informed Decisions.” She is also the founder and publisher of VBAC.com. Nicette is past-chair of CIMS, and now serves as chair of the CIMS Coalition Building Committee. She has also served on the Board of the International Childbirth Education Association and DONA International. For more than 25 years, Nicette had the privilege of helping thousands of expectant families prepare for childbirth, VBAC and early parenting. She has presented on cesarean and VBAC issues at national conferences, and for advanced doula trainings across the U.S. With co-author, Henci Goer, Nicette recently published “The Risks of Cesarean Section & Expectant Mother’s Checklist,” a Coalition For Improving Maternity Services (CIMS) Fact Sheet.

Other resources: California Maternal Quality Care Collaborative

Tell us about your labor. Did (or will you let) your labor begin naturally? Was (or are you planning on having) your labor induced? We’re looking forward to hearing about your experiences!

You have done everything possible to ensure a smooth, healthy pregnancy — but what about labor and birth? Mary Oscategui, baby planner, birthing options advocate and mother herself, joins us this week to share ways pregnant women can cope with the stresses of an approaching birth. She encourages mothers to acknowledge their fears — for the health and well-being of both themselves and their babies.

As a health practitioner, baby planner and single mom, I understand the challenges and stressors that can affect an expectant mom in preparation for birth — trust me, I’ve been there! Your baby is soon to arrive and the excitement is present, but along with that excitement can come many different emotions — some easy to cope with, and some not. You may be feeling anxious and stressed with a lot of questions and uncertainties weighing on your mind. Will I feel pain? How long will my labor last? Will my baby be OK? What if he/she is not breathing? What if the cord is wrapped around his/her neck? What if I have complications? Will I be able to handle motherhood?

As an expectant mom, your first reaction may be to hide these uncomfortable feelings — you may feel ashamed or embarrassed to share them. Giving birth is our natural birthright, however, that does not mean we also don’t have the freedom to experience some fears or doubts. Suppressing such feelings of anxiety and stress can not only take a toll on your body, but on your baby as well. It’s important to be aware of your fears, anxieties and stressors — and to address them. Doing so will only improve the health of you and your baby, and the outcome of your birth.

How do stress and anxiety affect a pregnant woman and her baby?

When an expectant mom feels anxious and stressed, her nervous system causes physiological changes in her body. Adrenaline and the stress hormone, cortisol, release into her bloodstream, causing her body to react in a fight-or-flight response. As a result, her digestive system slows down, which prevents essential nutrients from being absorbed into her body and passed on to her baby. Her muscles become very tense, making it difficult to think clearly and relax. These physiological changes can lead to premature labor, or even complications during labor.

Babies exposed to a variety of stress hormones, toxins and malnutrition inside the womb may develop a host of problems during their fetal growth and after they are born. Their bodies have to undergo certain biological changes in order to cope with a high-stress environment. In October of 2009, The UK Times reported new research that shows exactly how stress can harm a baby’s development, and how that stress can lead to long-term problems.

According to research by Vivette Glover, a professor of perinatal psychobiology, maternal anxiety affects the placenta by reducing the activity of the main barrier enzyme that hinders the hormone cortisol from reaching the fetus. The babies of women who were stressed during pregnancy had lower birth weights, lower IQs, slower cognitive development, and more anxiety than those born to the other women in the study.

How can women cope, and prevent stress and anxiety?

When I was pregnant, I found a few things essential to my (and my baby’s) well-being.

Acceptance

I had to accept and feel comfortable with my feelings, and not to try to resist them. It is perfectly normal to have some doubts or fears surrounding labor, especially if you are a first-time parent. Once you allow and invite your feelings to be present, you will be able to take the steps you need to take care of yourself and your baby, while reducing — if not eliminating — stress all together.

Support

I sought support. This could be through an expectant mom’s group, a childbirth education class, or a qualified professional — such as a birth doula. By working with a birth doula, or attending a birth education class or expectant mom’s group, you can prevent or reduce stress levels dramatically. Birth doulas are trained to provide expectant moms emotional and physical support in preparation for labor, and are also present during labor for support. Childbirth education classes are designed to inform expectant mothers of their options for labor and birth, and prepare them for the journey. An expectant mom’s group can also be another great resource, as you will be able to relate to and share all the uncertainties and fears you are going through with other women who are going through the same process.

Sleep and Relaxation

I made it a priority to rest. It is so important to make sure you are getting as much sleep as your body needs, as well as taking some down time throughout the day. Your body repairs itself during sleep, and also works to restore any imbalances that are occurring. When you compromise sleep, you become more susceptible to stress, as your immune system has to work harder to maintain proper levels of functioning throughout the day. Also consider taking some down time through a yoga or meditation class, a brisk walk, bubble bath, or even by lightening your workload.

Nutrition

I found that nutrition played a very powerful role in both coping with and the prevention of stress while I was pregnant. Caffeine, sugar and processed foods can trigger stress, so it is best to avoid them. Eat whole, fresh organic foods: fruits, vegetables, protein, and healthy fats that are easy to digest, and contain bio-available nutrients that are especially high in B vitamins and minerals. Exposure to sunshine for a few minutes of day will help your body absorb these nutrients. Of course, be sure to consult your midwife, doctor or nutritionist for your specific dietary needs.

Should you seek medical help?

If you have tried everything and find yourself helpless or depressed, it’s always best to seek medical attention. There are many professionals who are dedicated and committed to supporting you through your journey, and can provide you and your little one on board with the necessary help.

Mary Oscategui, CBP [IABPP], CPT, is the founder and CEO of The International Academy of Baby Planner Professionals (IABPP). She is an international business consultant and educator specializing in maternal health, fitness and going green. She is also the founder of TheBabyPlanner.com, EcoFit Mom and Physical Awakening. Mary is a writer, speaker, coach, author and birthing options advocate. She enjoys empowering, educating and supporting expectant and new parents to know all their options, so they may confidently make the best decisions for themselves and their baby in the most objective, healthy, safe way. Through IABPP, Mary introduced a new approach to the baby planning industry by focusing on the needs of her clients through parental education and emotional support.

How did you cope with the stresses of anticipating labor? Did you utilize a support group or birth professional? What tips do you have for other expectant moms?

We have been busy this weekend – preparing the house for your arrival.  It’s been so lovely doing things for you already.

We are also going for our 20 week scan next week and don’t think we are going to find out if you are a girl or boy – it’s very tempting!!

This is your Dad – this evening your mother and I attended our first antenatal class to learn a little bit about what we will go through with pregnancy.  The experience was rather funny and weird although quite comfortable after a while, cos she made me wear it for some time.

It has made me be more sympathetic toward how your mum will feel and the difficulties in moving during the pregnancy.  I will need to keep that in mind.   Take a look at me in the pregnancy/jelly bean suit!

Sometimes even I can’t believe that I really had a non-medicated, in-hospital, water birth VBAC. This experience had been a dream of mine for so long that I often have to remind myself that the actual experience of a natural birth was not a dream. But it was real, and it was empowering, and it was a dream come true. I had to fight (hard) for my VBAC, and would like to help other women avoid the struggles that I, myself faced.

Just last month, the National Institutes of Health (NIH) held a Consensus Development Conference on VBAC (vaginal birth after cesarean). It was refreshing to hear from the NIH panel that VBAC is a “reasonable option for many pregnant women.”  This is a very significant finding in the current birth climate in which:

• Nearly one-third of babies are delivered by cesarean section.
• The VBAC rate decreased dramatically from approximately 23 percent in 1996 to just 8.5 percent in 2007.
• Many OB/GYNs and midwives often refuse to attend VBACs because of medico-legal concerns.
• Approximately 30 percent of hospitals have written policies banning VBACs.

After attending the conference and fully absorbing the gravity of this consensus, I asked myself, What could I do to help facilitate self-advocacy? I was sure that the NIH statement could be just the tool that women seeking a VBAC in the U.S. have been looking for — to fight a local VBAC ban, discuss their natural birthing options with care providers, or even simply decide for themselves between a VBAC and a repeat cesarean section. Thus, the “NIH Consensus Statement Primer” emerged.

I am now partnering with Amy Romano (certified nurse-midwife and blogger for Lamaze International’s Science and Sensibility) and some other amazing birth organizations, advocates and bloggers, and the work for this primer is well underway! We hope for it to be accessible, informative and empowering — a real tool that women can use to help advocate for themselves, their babies and their birthing choices. The panel has yet to release its final statement on VBAC.  (The current consensus statement is only a draft version.) After the final statement is released in late April or early May, we hope to have an online version of the primer available four to six weeks later.

Our primer will include:

• Risks and benefits of VBAC and elective repeat cesarean
• An analysis of the “critical gaps” that the NIH panel found in the research on VBAC
• Ideas for pushing care providers and hospitals to publicize their VBAC rates
• Tips for discussing VBAC and the consensus statement with care providers.

What do you think about VBACs and the current resistance of the medical community to provide them? Do hospitals in your area do VBACs? Have you heard of any VBAC success stories?  Do you think that this primer could help you or another birthing mama you know?

We’d love to hear from you. Please share your feedback, questions and ideas in the “comment” field below!

Kristen is a feminist mother. A doula and future lactation educator who’s working on a PhD in philosophy. She’s a birth and breastfeeding advocate, a lover of good food and wine, an obsessive fan of various books and television shows, and the wife of a wonderful man who happens to be an attorney.

Finding a care provider who supports your decision to have a VBAC is essential for success. Check out these PDFs for helpful tips on choosing and changing your care provider:

Choosing a Care Provider

Changing Your Care Provider

Also, watch this video on avoiding unnecessary birth interventions:

She will go to the ends of the earth, not just for me, but for her grand-daughter too. I must say that I don’t wait for Mother’s Day to thank her for all she does or remind her how much we love her, but I do feel I should make a special effort on this particular day.

Last year I did sponsor a safe birth in Ethiopia for her as well as getting her some flowers. I’m sure I’ll do it again, but it seems a bit of a cop-out to do it two years running. So, I think I’m going to get out my sewing machine and make her a personalised something .(Wheat bag? Cushion cover? Who knows!) It’s not going to damage the environment and, I hope, says I love you more effectively than an icky Mother’s Day compilation CD.

Have you got a better idea? Please let me know! She really is the best mum I know (though my ‘second’ mum Patsie  – actually my best friend’s mum – does come close) and one year I hope to adequately express my admiration, affection and thankfulness.

Is Chiropractic Care safe during pregnancy?

Chiropractic care during pregnancy is not only safe for the mom and fetus, but essential.  There are no contra-indications for Chiropractic care during pregnancy.  Chiropractor’s have specific training to help women who are pregnant.  Many even take it a step further and get a certification in helping women who are pregnant and children.

• DACCP – Diplomate with ICPA reflecting highest level of advanced training
• CACCP – Certified with the ICPA reflecting advanced training
• Webster Certified – trained to specifically work with breech positions

Why see a Chiropractor during pregnancy?

There are a lot of changes that go on in the body during pregnancy both structurally and biomechanically.  These changes in the body respond well to gentle chiropractic adjustments.  The changes that occur in the body during pregnancy include:

• Release of hormones, especially ‘Relaxin’ which causes muscles and ligaments to relax – allowing more joint movement
• Increased weight gain – increases stress on joints
• Change in weight distribution – causing changes in posture and biomechanics

Changes to the body’s structure and biomechanics often leads to fatigue and discomfort.  Also, these changes can lead to undo stress on the nervous system which is the master control center for maintaining the body.

What is the benefit of seeing a Chiropractor during pregnancy?

The potential benefits of getting your spine examined and adjusted by a Chiropractor include:

• Healthier Pregnancy
• Nausea Control
• Decreases Labor and Delivery Time
• Back, Neck and Joint Pain Relief
• C-Section Prevention

What can Chiropractic do about a breech presentation?

Many Chiropractor’s are trained in the “Webster Technique” which was developed by the founder of the International Chiropractic Pediatric Association (ICPA), Larry Webster, D.C..  This analysis and adjusting technique establishes a balance in the pregnant pelvis, reducing stress on the nervous system, the mom and the fetus.  The balancing of the pelvis and its connecting structures allows for the breech child to reposition naturally for a safer birthing process.

“The Journal of Manipulative and Physiological Therapeutics reported in the July/August 2002 issue an 82% success rate of babies turning vertex when doctors of chiropractic used the Webster Technique. Further, the results from the study suggest that it may be beneficial to perform the Webster Technique as soon as the 8th month of pregnancy when a woman has a breech presentation.”(1)

It is most beneficial for women to receive chiropractic care throughout pregnancy to maximize the benefits and results.  A balanced pelvis not only allows the baby a better delivery presentation for a safer birth, it also creates a decreased potential for C-Sections by reducing pelvic constraints due to misalignments.

(1)  Pregnancy and Chiropractic Care,  American Pregnancy Association

Pregnancy is simply one piece of healthcare and care involves nothing less than what is given to all others in all other health care fields regardless of gravity of the situation. I want to know why you feel a need to TELL women not to birth at home. I don’t TELL women not to birth in hospitals. I do what they ask of me: share what I know, point them to resources and let them choose for themselves.

Women who have been my birth clients have chosen from among hospital with OBs, hospital with MW/OB, free standing birth center with MW, homebirth with CPMs and Traditional Birth Attendants, homebirth with CNMs and unassisted childbirth. They made their own choices and collectively they represent a c/s rate right around 10% (the WHO guideline recommendations) and of the almost 90% vaginal birth rate a little over 80% of those were without drugs ~ pain medication ~ and only a few with augmentation.

The reasons for cesareans were breech and less than textbook labor patterns. I don’t believe everyone is either at your end of the “birth is not safe” spectrum or at my end of the “birth is safe” spectrum” rather I believe the greater majority is somewhere in the middle. Certainly statistics show that less than 10% of births take place at home. I wonder that such a small group with healthy birth outcomes would take up so much of your time.

I wish that you devoted the same amount of energy to asking careproviders to give all the facts about every procedure and protecting the right to make our own health care decisions. What exactly is it about homebirth that is so dangerous? I know I can pinpoint the abuse of oxytocin, the abuse of medical privileges in prescribing drugs off label and the untold risks of cesareans, such as putting your future children’s lives at risk, for specifics about medicalized birth that is dangerous.

I’m not alone in that aspect. There are doctors out there who agree these practices bear scrutiny and are unethical. They question America’s maternity health care system in whole. I really am very interested to know exactly what aspects of homebirth are dangerous in your opinion and why you feel a need to use fear to quell an individual’s right to explore and educate themselves, invade a person’s home, privacy, body and right to choose for themselves. I notice that most of what is posted between you and others on the internet is lost in rants.

I don’t need the stats. I can find stats myself and I fully understand anyone can interpret stats however they’d like. I’m interested in hearing what YOU KNOW about birth, your experience with birth.

As a matter of interest, in my case it wasn’t homebirth advocates who advised me to VBAC spontaneously, without medications and especially with my premature son.  My skilled homebirth midwives advised me to birth in a hospital with the underlying medical conditions I had.  It wasn’t the homebirth advocates that encouraged me to VBAC telling me I could do it and I would be fine.   It was two different obstetricians in two different hospitals.  It was obstetricians who weren’t just trained in VBAC and complications of birth, they were SKILLED.