The topic here today is how it have a minimalist and frugal perspective on parenting.  Most of us want to keep the majority of our hard-earned money and figuring out how to do that in regular life and with a kid or two or three is easier than you may think.  Just think about it!  Here is a fun little article.

 

Also, for those looking much deeper for tips, here are 2 books: the first has great reviews for minimalist beginners, not those already practiced up….”The Minimalist Mom.”  Secondly, The “EcoFrugal Baby, How to Save 70% off baby’s first year” is written by a local Ann Arbor author.    Here is the article about the latter on Ann Arbor.com.

 

 

RESEARCH

Effect of delayed versus early umbilical cord clamping on neonatal outcomes and iron status at 4 months: a randomised controlled trial

BMJ 2011; 343 doi: 10.1136/bmj.d7157 (Published 15 November 2011)

Cite this as: BMJ 2011;343:d7157
  1. Ola Andersson, consultant in neonatology12,
  2. Lena Hellström-Westas, professor of perinatal medicine2,
  3. Dan Andersson, head of departments of paediatrics, obstetrics and gynaecology1,
  4. Magnus Domellöf, associate professor, head of paediatrics3

Abstract

Objective To investigate the effects of delayed umbilical cord clamping, compared with early clamping, on infant iron status at 4 months of age in a European setting.

Design Randomised controlled trial.

Setting Swedish county hospital.

Participants 400 full term infants born after a low risk pregnancy.

Intervention Infants were randomised to delayed umbilical cord clamping (≥180 seconds after delivery) or early clamping (≤10 seconds after delivery).

Main outcome measures Haemoglobin and iron status at 4 months of age with the power estimate based on serum ferritin levels. Secondary outcomes included neonatal anaemia, early respiratory symptoms, polycythaemia, and need for phototherapy.

Results At 4 months of age, infants showed no significant differences in haemoglobin concentration between the groups, but infants subjected to delayed cord clamping had 45% (95% confidence interval 23% to 71%) higher mean ferritin concentration (117 μg/L v 81 μg/L, P<0.001) and a lower prevalence of iron deficiency (1 (0.6%) v 10 (5.7%), P=0.01, relative risk reduction 0.90; number needed to treat=20 (17 to 67)). As for secondary outcomes, the delayed cord clamping group had lower prevalence of neonatal anaemia at 2 days of age (2 (1.2%) v 10 (6.3%), P=0.02, relative risk reduction 0.80, number needed to treat 20 (15 to 111)). There were no significant differences between groups in postnatal respiratory symptoms, polycythaemia, or hyperbilirubinaemia requiring phototherapy.

Conclusions Delayed cord clamping, compared with early clamping, resulted in improved iron status and reduced prevalence of iron deficiency at 4 months of age, and reduced prevalence of neonatal anaemia, without demonstrable adverse effects. As iron deficiency in infants even without anaemia has been associated with impaired development, delayed cord clamping seems to benefit full term infants even in regions with a relatively low prevalence of iron deficiency anaemia.

Trial registration Clinical Trials NCT01245296.

 

See full article: http://www.bmj.com/content/343/bmj.d7157#alternate

Nurturing Your Sexual Abuse Wounds During Pregnancy: Let Yourself Feel.

Dawn Bussey CD(DONA), birth doula, Ann Arbor, MI

www.mydouladawn.com

May 1, 2012

April was Sexual Assault Awareness Month and so I would like to post this article that I wrote as a wrap up to this very important month.

During the 10 months that a woman carries her child, is perhaps for some the perfect time to heal–given that she is ready to embrace her wounds.  The particular wounds that I am referring to in this article are sexual abuse wounds: childhood or adult, past, current, or continuous.  Here is the statistic that answers our question of relevancy:  1 in 4 women have disclosed being sexually assaulted at least once in her life (Mickey, S. & Julia, S., 2008).  Thus, many women are survivors of one kind of sexually traumatic incident/s or another.  Many women know that they have experienced abuse, but if the culture in which they were raised was filled with dysfunction the case may be that they did not recognize abusive behaviors as such.  In certain contexts and at maturity levels, abuse may seem normal especially if no one steps up and declares the situation a problem, but instead turns their face from the abuse, ignores, or denies it.  So, for some, the healing process cannot begin until the abuse is identified as abuse and one believes that she is a survivor.  Identifying abuse as abuse and subsequently, declaring a survivor as a survivor is step number one in the healing process.

My experience as a domestic violence and sexual abuse counselor/advocate was in the same breath heavy and satisfying work, informs my current work as a birth doula and allows me to better serve survivor moms.  Just to be clear, survivor moms are women who have a history of abuse and are mothers or becoming mothers.  The model that I embraced as a counselor was one of “empowerment”—coming alongside survivors and listening to their stories week after week and empowering them to heal in their own time and in their own way.  Often times, I spent a lot of time educating about abuse, literally helping them identify that what they experienced or were experiencing that moment was emotional, physical, and/or sexual abuse.  Emotional abuse is sometimes hard to see because most of it is so subtle and psychologically twisted.  I taught about the signs and signals of abuse, boundaries, and healthy and unhealthy relationships.  I helped normalize their experiences, feelings and pain regarding the abuse, which is something I also do for women who are in labor.  Simply saying, “yes, I know that that hurts” or “that feeling of panic is normal” can go a long way in providing effective emotional support to survivors and laboring moms.  All this to say, that I have an intimate knowledge and experience of what survivor moms need having worked with survivors and moms exclusively.

 

How might one go about nurturing their sexual abuse wounds during pregnancy?

Since pregnancy is a major trigger for survivors, a survivor mom may very well be confronted with the challenge to deal with her wounds during this time (Mickey, S. & Julia, S., 2008).  It is, of course okay, if she is not ready to start or continue the healing process during the pregnancy—the empowerment model stresses that change and effective healing will happen only when she is ready to move forward.  The decision must come from within.  However, we could all guess that the manifestations of PTSD–re-experiencing, dreams, recollections, flashbacks, high alert mentality, fear–that a survivor mom may experience are not healthy for the mom or baby.  So, if she is experiencing PTSD while pregnant then she might do well to not ignore it for hers and the baby’s sake (Mickey, S & Julia S, 2008).

Ideas about how to reach out and heal: journaling, talking to a counselor, opening up to a trusted friend, drawing or sketching, writing a song or poem, envisioning and how to respond and cope with your particular vulnerabilities for the next birth and getting the emotional support you need (i.e. a doula or something similar), and these are just a few ideas that have worked for many women.  Some women have written out a specific list of things that they need in labor for their caregivers to know.  For example, “when doing vaginal exams, I need you to ask permission, move slowly, explain to me exactly what you are doing and why, and allow me to stop the exam at any given second, and offering me validation at every step.  Caregivers found this very useful in providing sensitive care to their patients.

 

Resources

*Book: When Survivors Give Birth: Understanding and Healing the Effects of Early Sexual Abuse on the Childbearing Woman by Penny Simkin

–When Survivors Give Birth provides survivors and their maternity caregivers with extensive information on the prevalence and short- and long-term effects of childhood sexual abuse, emphasizing its possible impact on childbearing women. Challenges in the client-caregiver relationship are thoroughly portrayed, with much practical advice for improving trust and communication as well as self-help techniques to handle abuse-related distress. Chapters on birth counseling, psychotherapy, and clinical care of survivors make this book a useful resource for survivors and all who work with them (450 pages).  http://www.pennysimkin.com/products.htm

*Book: Survivor Moms by Mickey Sperlich, MA, CPM, and Julia S. Seng, Ph.D., CNM http://www.storycirclebookreviews.org/reviews/survivormoms.shtml

*WomanSafe Health: http://www.womansafehealth.com/  Getting the safe, informed, sensitive OB/GYN care that pregnant survivors need.  Dr. Elizabeth Shandigian and her team’s practice is integrated with understanding the particular sensitivities needed to empower survivors through and during medical care.

*Melissa Schuster is a Psychotherapist for the Childbearing Year in Ann Arbor, MI: http://www.melisaschuster.com/about.html

*SafeHouse Center, Ann Arbor, MI:  http://www.safehousecenter.org/  They offer 6 months of free counseling to all survivors of sexual or domestic violence whether it happened during childhood, adulthood, or is current.  They also have groups were women can come together and share on a weekly bases their healing journeys.

*Local doulas–birth and postpartum:  http://center4cby.com/birth-doulas.html or http://center4cby.com/postpartum-doulas.html

References

Mickey, S. & Julia, S., 2008. Survivor Moms: Women’s Stories of Birthing, Mothering and Healing After Sexual Abuse. Motherbaby Press: Eugene, OR.

This article will help guide expecting parents towards the best products for them and their new baby or babies.  There is so much out there and we always want the buy the best, greenest, perhaps most affordable products and this guide will help you get started and maybe even finish your registries and shopping.  Happy preparation and nesting!  Doula Dawn

I ran into one of my old professors from the Univ. of Michigan last week and we got to chatting about birth….this should not be surprising.  I have guest lectured for her about doulas.  She told me about this recent article that was written by The Atlantic.

Less is MORE is the name of the game if you are a low risk mama.  One important concept that comes to my mind with this article is the Cascade of Interventions–once you get some of the seemingly routine ones in the beginning, maybe in triage, you open yourself up to the risk automatically of having more interventions.  For example, other research shows that low risk moms who get the routine 20 minute heart rate strip upon admission actually increase their chances of a C-section by 20%.  Is it helping you?

You can read the article here……

http://www.theatlantic.com/health/archive/2012/03/the-most-scientific-birth-is-often-the-least-technological-birth/254420/#.T2yziR1NrBa.email

This was part of a blog entry written by my client Rachel Hinz:

“One major accomplishment of many has been the meeting and hiring of our doula, Dawn! (For some reason I like to refer to her as “Doula Dawn” while saying it with a southern accent, although she is not from the south). Throughout this pregnancy I have discovered how little I know about this experience (nothing in my history has prepared me for this) and I think Seth and I together have realized that nothing in either of our experiences has prepared us for labor and the delivery of a child. For us and for our birth plan, a doula makes sense. And one thing that she said that really made me confident of our decision was when she spoke about what happens in the whirlwind of “when it all goes down.” Basically, my instincts are going to kick in. God has designed women for labor. Giving birth to a child is not the time for me (or Seth) to be flipping through a manual, reading what is supposed to happen. She is there to support us, so that if we have questions or need help in naturally dealing with the pain or whatever- that can be her job. We can just do it.”

“Dawn came highly recommended to me from a colleague who had his first child just months ago. She’s young, but experienced- relatable, yet maintains a professionalism that I want- and is Christian- which was very important to us. Of the variety of things she does (such as two prenatal visits- we’ve already had one- since, well, we are running out of time) the things that I anticipate appreciating the most will be her ability to be with me laboring at home (hopefully avoiding any unnecessary time in Triage- oh, that reminds me, we did tour the new Women’s Hospital- but more on that later), being with me at the hospital through the whole ordeal and then afterwards, and finally two post-partum visits where she can check on me, how I’m fairing, and can aid in breastfeeding. Seth and I have discovered that after our first home visit with Dawn that she really does even more than this- she’s a resource for us now. While we were going over the birthplan, I was somewhat amazed at what I didn’t know or expect- especially with questions of “what types of interventions do you want for baby?” As in, after he’s born- do we want to go ahead with the standard protocol that babies usually do or??? I hadn’t even thought of this, and that’s not to say that I won’t want to have him get all of the first vaccinations and tests or anything- it’s just the thought that (1) those exist (2) I have a right to know what they are/do and (3) I have a choice in the matter.”

New research that could help low-risk women prevent the “need” for a cesarean section delivery.  Tactfully say…no thank you for the Triage 20 min. Admission strip because you do not want to end up in a C-section.  

Birth Advocacy Tip:  In light of this research, you could ask for a 20 min. intermittent Doppler reading in Triage.  

Here’s what the research says….

“Admission Strip” increases cesarean rate by 20 percent
Continuous heart rate monitoring upon admission to a hospital (usually 20 minutes for an “admission strip”) not only shows no benefit for low-risk women, but increases the cesarean rate by 20 percent, as compared to intermittent monitoring with a Doppler. That’s according to a new review from the Cochrane Collaboration, published online February 15. The reviewers stated: “The findings of this review support recommendations that the admission CTG not be used for women who are low risk on admission in labour. Women should be informed that admission CTG is likely associated with an increase in the incidence of caesarean section without evidence of benefit.” Read the Cochrane Review, or analysis from Lamaze International’s blog Science and Sensibility.

–DONA International

 

 

 

 

Hey Ann Arbor Parents,

I thought I would post this article for you announcing several recalled items so that you could make sure your kiddies are safe!

Doula Dawn.

 

 

 

I just received another call today from a mom pregnant with twins, she was looking for a referral for a postpartum doula to help with breast-feeding and all of the adjustments at home that having twins brings with it.  No doubt, lots of help is appreciated and necessary for these families.  I gladly referred her to a colleague of mine, but then followed up with the question, “have you also considered a birth doula?”  She said that she sort of had, but not seriously because she thought that adding one more support person to her friends and family would probably not be helpful.  I added on to her comment about the amazing difference between skilled and professional doulas versus family member and friend type doulas.  Both are awesome, but both categories are quite different in terms of the level of support that can be provided.  Skilled versus unskilled, professional versus unprofessional.  She was captured.  I talked more.

After sharing about the value of having skilled, professional doula support, I went on to explain that in my experience, I have talked to many mamas who are scheduled to have a c-section or who have a condition where a c-section is on the table who believe that having a birth doula is a waste of money.  I say, just the opposite in fact.  I tell them that my very first client had gestational diabetes, a higher risk situation, where the dr. decided to schedule a c-section for an over 10 lbs baby (these can be born vaginally as well). This mom was so appreciative of the extra support during recovery and immediate postpartum.  She, at times, was in a state of panic, she was tired, she had many questions, and she missed her baby.  I would answer her questions, hold her hand, try to help her to get some rest, find out information about her baby in the NICU, and more.  Having a birth doula for even a scheduled c-section is a wonderful choice.  I met this client before she went into the operation, took some pictures of her and her best friend, and then waited until recovery to serve her.

To conclude, if you are having twins, have gestational diabetes, or any situation where a c-section may be scheduled consider hiring a birth doula to support you and your family as well.  Plus, breast-feeding can be even more of an uphill battle after a c-section, the more support the better.

Hey, Ann Arbor childbearing population…..let’s fight this increase in Gestational Diabetes incidences.  Skim this article and at the end of it, you can see the things that may put you at higher risk for being diagnosed with GD.  They are going to raise the standards soon it sounds like.

An increase in diagnoses of Gestational Diabetes to 8-9% of pregnant women is a lot.  You are at risk if you are overweight upon conception, if you gain excess pounds in first trimester, if you drink soda/pop, if you are Korean or Filipino American just to name a few.  GD can lead to Preeclampsia which is fatal.

http://www.fitpregnancy.com/pregnancy/health/sugar-shock?page=2