Choosing Home Birth: A Guide to Safe and Personalized Care

Choosing Home Birth with a midwife

The decision to bring a child into the world is a deeply personal and transformative journey. With the evolving landscape of maternity care, many expectant parents are choosing midwives who specialize in home birth to guide them through this sacred experience. Home birth midwives offer a unique blend of medical expertise and personalized care, ensuring a safe and empowering birth experience.

Types of Midwives

Certified Nurse Midwives (CNMs): These midwives are registered nurses with specialized training in midwifery. They have completed advanced education and hold a master's or doctoral degree in nursing. CNMs are licensed to provide care across various settings, including hospitals, birth centers, and homes.

Certified Midwives (CMs): These midwives earn a graduate degree in midwifery from a program accredited by the Accreditation Commission for Midwifery Education (ACME). CMs differ from Certified Nurse-Midwives (CNMs) only in that they are not also licensed as nurses. Only a few states recognize the CM credential.

Certified Professional Midwives (CPMs): CPMs are trained specifically in out-of-hospital settings, making them a popular choice for home births. They acquire education through accredited midwifery programs and gain hands-on experience through apprenticeships. CPMs focus on providing holistic and family-centered care.

Direct-Entry Midwives (DEMs): Direct-entry midwives have typically not undergone nursing training. They receive education and training directly in midwifery. Regulations and requirements for DEMs vary by region, which can affect their scope of practice and legality.

Traditional Midwives: Traditional Midwives may have studied midwifery through an apprenticeship, but they often do not have additional formal schooling. They have not gone through any skills testing and are often unregulated and/or practice illegally.

Checking Credentials and Qualifications

Certification: Regardless of the type of midwife, it's crucial to ensure they hold a valid certification from a reputable organization. CNMs are certified by the American Midwifery Certification Board (AMCB), CPMs are certified by the North American Registry of Midwives (NARM), and DEMs may have certification from other organizations. CMs are certified through the American Midwifery Certification Board (AMCB).

Licensing and Regulation: Research the licensing and regulatory requirements for midwives in your state or region.
In SC, CNMs can practice under the supervision of a physician. CPMs are able to obtain a license to become a LM and practice independently.
In GA, CNMs can practice independently. GA does not offer licensure for non-nurse midwives.

Experience: Inquire about the midwife's experience; this may include asking about the number of births attended and the specific settings they have worked in.

Continuing Education: A commitment to staying up-to-date with the latest advancements in midwifery and childbirth care is essential. Ask about the midwife's participation in continuing education programs and workshops. All credentialed midwives are required to attend a minimum amount of continuing education each certification/licensure cycle.

Choosing the Right Midwife

Interview Midwives: Many midwives offer free or low-cost consultation appointments to help you find the one who aligns with your values, preferences, and birthing goals. Ask about their approach to childbirth, emergency protocols, and postpartum care.

Collaboration with Healthcare Providers: A midwife should have a network of collaborative relationships with medical professionals and/or hospitals. This ensures a smooth transition in case of emergencies or the need for a higher level of medical intervention.

Open Communication: Choose a midwife who actively listens to your concerns, answers your questions, and involves you in the decision-making process. A strong sense of trust and communication is vital throughout your journey.

Choosing a midwife is a significant decision that directly impacts your birth experience and the well-being of both you and your baby. By understanding the different types of midwives, checking their credentials, and carefully evaluating their qualifications, you can confidently select a midwife who will provide safe, personalized, and empowering care. Remember, your midwife is not just a healthcare provider but a partner in your journey to welcoming a new life into the world.

Group B Strep in Pregnancy

Group B Strep (GBS) in Pregnancy

Pregnancy is a time of anticipation and preparation, but it's also a period when healthcare considerations are of utmost importance. Group B Streptococcus (GBS) is a common bacterium that can affect pregnant individuals and their newborns. In this blog post, we'll delve into the significance of GBS testing during pregnancy, the standard treatments available, potential complications for newborns, and the implications of GBS disease.

The Importance of Testing

Group B Streptococcus is a naturally occurring bacterium that can be present in the genital or gastrointestinal tracts of adults. While it doesn't usually cause problems in healthy adults, it can pose a risk to newborns during childbirth. GBS testing during pregnancy, typically conducted between weeks 35 and 37, helps identify whether the bacterium is present in the mother's body. This information is crucial in determining the best course of action to prevent its transmission to the newborn.

Standard Treatments and Interventions

Intravenous Antibiotics During Labor: If GBS is detected, the standard approach is to administer intravenous antibiotics to the pregnant individual during labor. This treatment helps prevent the transmission of GBS to the baby during birth.

Risk Factors and Considerations: The decision to administer antibiotics also takes into account risk factors, such as preterm labor, prolonged rupture of membranes, and fever during labor.

Possible Complications for the Newborn

GBS infection in newborns can lead to serious health complications, including:

Early-Onset GBS Disease: This occurs within the first week of life and can lead to sepsis, pneumonia, and other life-threatening conditions.

Late-Onset GBS Disease: This occurs between the first week and the third month of life and might result in sepsis, meningitis, and related complications.

Signs and Symptoms: Newborns with GBS disease might exhibit symptoms such as fever, difficulty feeding, breathing problems, and lethargy.

GBS Disease and its Implications

While GBS disease in newborns is relatively rare thanks to effective testing and preventive measures, it underscores the importance of early detection and treatment. Left untreated, GBS infection can lead to severe health consequences, making timely testing and administration of antibiotics during labor vital.

Group B Streptococcus is a prime example of the critical role that prenatal testing plays in ensuring the well-being of both pregnant individuals and their newborns. Testing for GBS during pregnancy, along with standard antibiotic treatments during labor when necessary, can significantly reduce the risk of GBS transmission and associated complications in newborns. By staying informed, seeking regular prenatal care, and discussing GBS testing with your healthcare provider, you're taking proactive steps to ensure a healthy start for both you and your baby.

Safe and Supported: The Role of Midwives in Modern Maternity Care

Safe and Supported: The Role of Midwives in Modern Maternity Care

The landscape of maternity care is evolving, with an increasing number of expectant parents seeking alternative options that align with their desires for a personalized and empowering birth experience. In this context, the role of midwives has gained increasing recognition as a choice that provides both safety and emotional support.

Ensuring Safety Through Expertise

Comprehensive Prenatal Care: Midwives are trained healthcare professionals who provide thorough prenatal care to monitor the health and progress of both the mother and the baby. Through regular check-ups, we identify potential risks and complications early on, ensuring appropriate interventions are taken when needed.

Continuous Monitoring: During labor, midwives closely monitor the progress of labor and the well-being of the mother and baby. We are skilled at recognizing signs of complications and are equipped to handle emergencies or to make the decision to transfer to a hospital if necessary.

Emergency Preparedness: Home birth midwives undergo rigorous training to handle emergencies that might arise during childbirth. We carry medical supplies and equipment to manage common complications, and we will communicate directly with the hospital if a transfer becomes necessary. We renew our Neonatal Resuscitation certifications at least every two years.

Risk Assessment and Transparency: Midwives conduct thorough risk assessments to determine if a home birth is a safe option for each individual. We maintain open and honest communication with each client, discussing potential risks and benefits and ensuring that everyone is well-informed before making decisions.

Providing Unwavering Emotional Support

Creating a Trusting Relationship: Home birth midwives focus on building strong relationships with expectant parents. We invest time in getting to know our clients, understanding their values, fears, and aspirations for childbirth. This relationship of trust fosters a sense of emotional security during the birth process.

Empowerment Through Education: Midwives are educators as well as caregivers. We provide comprehensive information about the birthing process, available options, and potential interventions. This empowers parents to actively participate in decision-making, contributing to a more positive and confident birth experience.

Holistic and Family-Centered Approach: Midwives consider the emotional and psychological aspects of childbirth. They create a supportive environment that includes partners, family members, and even older siblings, fostering a sense of unity and comfort during labor and delivery.

Emotional Well-being: We are attuned to the emotional needs of expectant parents. We offer reassurance, encouragement, and personalized comfort measures, helping to alleviate anxiety and promoting a more relaxed birthing atmosphere.

The resurgence of interest in home birth with midwives reflects a growing desire for a birth experience that values both safety and emotional support. These skilled professionals bridge the gap between medical expertise and compassionate care, ensuring that expectant parents are well-prepared for the transformative journey of childbirth and the first several weeks postpartum. By embracing the holistic approach of certified and licensed midwives, modern maternity care melds with the importance of personalized care, informed decision-making, and the emotional well-being of both parents and newborns. As the trend of pursuing a home birth continues to gain momentum, more families are discovering the profound impact that the partnership with a midwife can have on their birthing experience.

Empowering Your Birth Experience: How Home Birth Midwives Can Make a Difference

Empowering Your Birth Experience: How Midwives Can Make a Difference

Bringing a new life into the world is a transformative journey that holds immense significance for expectant parents. As the birthing landscape evolves, more individuals are seeking ways to take control of their birth experiences, embracing options that align with their values and desires. Midwives have emerged as key figures in this movement, offering a unique approach to childbirth that empowers parents and celebrates the natural process of bringing a child into the world. Let’s explore how home birth midwives can make a profound difference in empowering your birth experience.

Personalized Care and Relationship Building

Home birth midwives prioritize building strong relationships with their clients, cultivating an environment of trust, comfort, and respect. Unlike the often impersonal setting of a hospital, midwives take the time to understand your personal preferences, concerns, and aspirations for your birth journey. This personalized approach ensures that you are an active participant in every decision, fostering a deep sense of empowerment.

Education and Informed Choices

One of the remarkable aspects of home birth midwives is their commitment to education. Throughout your prenatal care, midwives provide comprehensive information about various birthing options, potential interventions, and the natural progression of labor. Armed with this knowledge, you are empowered to make informed choices that resonate with your values and wishes. This educational aspect of midwifery care enables you to approach childbirth with confidence and a clear understanding of what to expect.

Honoring the Natural Process

Home birth midwives have a profound respect for the natural process of childbirth. They believe that birth is not just a medical event but a deeply transformative and emotional experience. Midwives work with your body's innate wisdom, allowing labor to unfold naturally whenever possible. This approach minimizes unnecessary interventions and medical procedures, allowing you to embrace the innate strength and capability of your body.

Creating a Supportive Environment

The familiar surroundings of your own home can significantly contribute to a positive birth experience. Home birth midwives curate a calming and supportive environment that promotes relaxation and confidence. You have the freedom to move, eat, and labor in ways that feel most comfortable to you, enhancing the natural progression of labor. Additionally, having your loved ones close by can provide invaluable emotional support, further enriching the experience.

Empowerment Through Active Participation

Home birth midwives encourage active participation in the birthing process. They guide you through the stages of labor, offering encouragement, comfort measures, and various positions that can facilitate labor progression. This hands-on approach empowers you to be an integral part of your birth story, creating a lasting sense of accomplishment and pride.

The role of home birth midwives goes far beyond providing medical care; they are champions of empowerment, education, and holistic experiences. By choosing a home birth attended by a skilled midwife, you are embracing an approach that values your unique needs and desires, while celebrating the beauty of childbirth. The empowerment you gain from actively participating in your birth journey, supported by the expertise of a midwife, can set the tone for your parenting journey ahead. As this trend continues to grow, more individuals are discovering the transformative impact that home birth midwives can have on the sacred journey of bringing new life into the world.

Bringing Birth Back Home: The Rising Trend of Home Birth Midwives

Bringing Birth Back Home: The Rising Trend of Home Birth

In recent years, there has been a noticeable shift in the way many individuals approach childbirth. With a desire for a more personalized and holistic birthing experience, the trend of home births attended by midwives has been steadily gaining momentum. This movement signifies a departure from the traditional hospital setting, highlighting a return to the roots of childbirth.

The Role of Midwives

Home birth midwives play a crucial role in ensuring a safe and supportive environment for expecting mothers who choose to give birth at home. These skilled professionals bring a wealth of knowledge and experience in providing prenatal care, assisting with labor and delivery, and offering postpartum support. Their primary goal is to empower and educate mothers, promoting a sense of ownership and confidence in the birth process.

Benefits of Home Birth with Midwives

1. Personalized Care: One of the standout advantages of home birth midwives is the individualized attention they offer. Unlike the often fast-paced hospital environment, midwives take the time to build strong relationships with their clients, tailoring their care to the specific needs and preferences of each mother.

2. Comfort and Familiarity: Giving birth at home provides a comfortable and familiar setting for the mother, reducing anxiety and stress. This can contribute positively to the progression of labor and the overall birth experience.

3. Reduced Medical Interventions: Home births with midwives tend to have lower rates of medical interventions such as cesarean sections, epidurals, and induced labor. Midwives emphasize natural birthing processes and intervene only when medically necessary, promoting a more holistic approach.

4. Family Inclusion: Home births allow for greater involvement of family members, partners, and even older children in the birthing process. This can foster a stronger family bond and a more inclusive experience for everyone involved.

Challenges and Considerations

While the trend of home birth midwives is on the rise, there are certain challenges and considerations to keep in mind:

1. Safety Concerns: Critics argue that home births might carry increased risks in cases of emergencies or complications. However, trained midwives are well-prepared to identify potential issues and take appropriate actions. If medical concerns arise, the midwife will facilitate transfer to the hospital for continued care.

2. Legal and Regulatory Factors: The legality and regulation of home births vary from region to region. Some areas have well-defined guidelines and support for home birth midwives, while others have stricter regulations or even outright bans. In SC, midwives are eligible for licensure after earning the Certified Professional Midwife (CPM) credential. On the other hand, GA does not license midwives unless they are Certified Nurse Midwives (CNMs), who are nurses with additional training in pregnancy and birth.

3. Access to Resources: Availability of resources such as emergency services can be a concern in remote or rural areas, affecting the feasibility of home births.

4. Client Choice: It's essential to remember that home birth is a personal choice. Not all individuals are suitable candidates for home births, and some might prefer the controlled environment of a hospital setting.

The rising trend of home birth reflects a growing desire for a more personalized, natural, and family-centered approach to childbirth. These skilled professionals offer individualized care, emphasizing the importance of empowering mothers and promoting a sense of agency during the birthing process. While challenges exist, the increasing popularity of home birth midwives underscores the need for a diverse range of options that cater to the diverse preferences and needs of expectant parents. As this trend continues to gain traction, it will be interesting to observe how healthcare systems and policies adapt to accommodate and support this evolving approach to childbirth.

Debunking Pregnancy Myths

Debunking Common Pregnancy Myths: Separating Fact from Fiction

Pregnancy is often a wonderful journey filled with excitement and anticipation, but it's also accompanied by a plethora of information, some of which might not be entirely accurate. In this post, we'll take a closer look at some common pregnancy myths and provide evidence-based insights to help you navigate this special time with confidence.

Myth 1: "You Should Eat for Two"

One of the most prevalent myths is the idea that pregnant women should eat twice as much to support their growing baby. In reality, an increase in caloric intake is required, but it's nowhere near double the amount. The emphasis should be on nutrient-dense foods to provide essential vitamins, minerals, and energy for both mom and baby. For most women, 1/2 of a PB&J sandwich would fill the small calorie increase needed during pregnancy.

Myth 2: Morning Sickness Only Happens in the Morning

While the term "morning sickness" suggests that it only occurs in the early morning hours, many women experience nausea and vomiting at any time of day. It's essential to understand that this symptom varies widely and can affect women differently.

Myth 3: You Should Avoid Physical Exercise

Pregnant women are often advised to rest and avoid physical activity, but moderate exercise is actually beneficial for both the mother and the baby. Staying active can help manage weight gain, improve mood, and enhance overall well-being. Of course, it's important to consult your healthcare provider before starting any exercise routine during pregnancy.

Myth 4: Caffeine Must Be Completely Eliminated

While excessive caffeine intake should be avoided during pregnancy, moderate consumption is generally considered safe. The key is moderation—limiting caffeine to around 200 milligrams per day, which is roughly equivalent to one 12-ounce cup of coffee.

Myth 5: You Shouldn't Travel During Pregnancy

Traveling during pregnancy is possible, but it's important to plan ahead and prioritize comfort and safety. Consult your doctor before embarking on any trips, especially if they involve long flights or remote destinations. Adequate hydration and regular stretching during travel are essential.

Myth 6: Heartburn Means Baby Has Hair

The idea that heartburn during pregnancy is linked to the amount of hair the baby will have is just an old wives' tale. While there may be some anecdotal correlations, scientific research doesn't support a direct connection between the two.

Myth 7: Pregnant Women Shouldn't Eat Fish

Fish is an excellent source of omega-3 fatty acids, which are vital for the baby's brain and eye development. While some types of fish should be limited due to their mercury content, incorporating low-mercury options like salmon, sardines, and shrimp can be highly beneficial.

Ultimately, pregnancy myths often stem from well-meaning advice, but it's crucial to separate fact from fiction. Rely on evidence-based information, consult your healthcare provider, and trust your instincts. Every pregnancy is unique, and by debunking these common myths, you can make informed choices that contribute to a healthy and joyful pregnancy journey.

What's the Difference Between a Doula and Midwife?

While doulas and midwives both assist parents during childbirth, both fulfill different roles.

Midwives are healthcare professionals who offer comprehensive prenatal care, oversee the birth, and provide postpartum care for both parent and baby. They possess the necessary expertise to manage the medical aspects of childbirth, such as conducting vaginal examinations, monitoring vitals, and addressing complications if necessary. While doulas focus primarily on emotional support, midwives provide vital medical care, ensuring a positive and safe birth experience for parents.

Benefits of Hiring a Midwife:

1. Personalized and Holistic Care: One of the key advantages of hiring a midwife is the personalized and holistic care they provide. Midwives prioritize building a strong relationship with the expectant parents and offer individualized care based on their specific needs and desires. They focus not only on the physical aspects of childbirth but also the emotional, mental, and spiritual well-being of the mother.
2. Continuity of Care: When you hire a midwife, you can expect to receive continuous care throughout your pregnancy, labor, birth, and postpartum period. Midwives are present during the entirety of the childbirth journey, providing ongoing support and guidance to ensure a seamless, integrated experience. This continuity can foster a deeper sense of trust, comfort, and security for the expectant parents.
3. A Natural Approach to Birth: For those who desire a natural childbirth experience, midwives specialize in supporting and promoting natural, unmedicated births. They use various techniques like water birth, massage, breathing techniques, and position changes to manage pain and facilitate a positive birthing experience. Midwives also tend to have lower intervention rates, including lower cesarean section rates, compared to traditional medical settings.
4. Focus on Informed Decision Making: Midwives prioritize informed decision making and strive to empower expectant parents to make choices based on their preferences and values. They provide information and education about different options and interventions, allowing the parents to actively participate in their birth plan. Midwives believe in the importance of the birthing person's autonomy and work collaboratively with them as partners in the decision-making process.
5. Postpartum Support: Hiring a midwife means not only having support during labor and birth but also receiving care and guidance during the postpartum period. Midwives typically visit the postpartum family at home during the first week, providing assistance with breastfeeding, newborn care, emotional support, and overall recovery. Ongoing support continues through at least the first six weeks after birth. Their focus extends beyond just the physical aspects of the postpartum period and includes emotional well-being and adjustment to parenthood.
6. Cost-effective: In many situations, hiring a midwife is less expensive compared to hospital-based care, making it an attractive option for those seeking more affordable childbirth services.

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Doulas play a crucial role by offering emotional, physical, and informational support throughout the entire journey, from pregnancy to postpartum. They provide reassurance, advocate for the parents' preferences, and help them navigate the challenges of childbirth.

Benefits of Hiring a Doula:

1. Emotional Support: A doula offers continuous emotional support to both the birthing person and their partner. They provide reassurance, encouragement, and a calming presence during the labor process. This support can alleviate anxiety and help create a positive birthing experience.
2. Continuous Presence: Doulas are available to support you throughout your entire labor, regardless of its duration. They offer uninterrupted care, ensuring that you never feel alone or neglected during this transformative moment.
3. Advocate and Mediator: Doulas help navigate the intricacies of the healthcare system, ensuring that your voice is heard and your desires are respected. They can help facilitate communication between you and medical staff, empowering you to make informed decisions.
4. Comfort Measures: Doulas are well-versed in various comfort measures such as breathing techniques, massage, and positioning, effectively easing discomfort during labor. They can suggest alternative pain management techniques before resorting to medical interventions.
5. Postpartum Support: Doulas often provide postpartum care, offering guidance on breastfeeding, newborn care, and emotional well-being. Their presence can help ease the transition into parenthood, reducing feelings of overwhelm.
6. Reduced Medical Interventions and Better Birth Outcomes: Studies show that having a doula as a part of the birthing team can lower the need for medical intervention and improve birth outcomes.

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So can you hire both a midwife and doula? Absolutely! Midwives and doulas often work well together, forming a strong team to cocoon you in support during your transition into parenthood. Each has their own role throughout your journey, and both would be happy to guide and support you.

Did you have a doula and/or midwife for your birth? Tell us about it in the comments.

Prenatal Infections

Navigating Prenatal Infections: Understanding Risks and Common Treatment Options

Bringing a new life into the world is a beautiful journey, but it's essential to be aware of potential risks along the way. Prenatal infections are a concern for expectant mothers, as they can pose risks to both the mother and the developing baby. In this blog post, we'll delve into the risks associated with common prenatal infections and explore treatment options to ensure a healthy pregnancy.

Understanding Prenatal Infections

Prenatal infections are caused by various bacteria, viruses, and parasites that can be transmitted to the baby during pregnancy or childbirth. These infections can lead to complications such as preterm birth, birth defects, developmental delays, and even miscarriage. Being informed about the risks can empower mothers to take proactive measures.

Common Prenatal Infections:

1. Cytomegalovirus (CMV): This virus can be passed to the baby through contact with body fluids, such as urine or saliva. CMV infection during pregnancy may result in hearing and vision problems, as well as developmental delays.

2. Rubella (German Measles): If a pregnant woman contracts rubella, it can lead to severe birth defects, including deafness, heart defects, and intellectual disabilities.

3. Toxoplasmosis: Caused by a parasite found in undercooked meat, cat feces, and contaminated water, toxoplasmosis can lead to serious health issues in the baby, including vision and hearing problems.

4. Group B Streptococcus (GBS): This bacterium is commonly present in the birth canal. While it doesn't usually harm the mother, it can cause severe infections in newborns, including pneumonia, sepsis, and meningitis.

Prevention and Treatments:

1. Hygiene and Food Safety: Practicing good hygiene, such as washing hands regularly, and following proper food safety guidelines can reduce the risk of infections like CMV and toxoplasmosis.

2. Regular Prenatal Care: Attending regular prenatal check-ups allows healthcare providers to monitor your health and the baby's development. Routine screenings can detect infections early and guide appropriate treatment.

3. Antibiotics and Antiviral Medications: In cases where prenatal infections are detected, healthcare providers may prescribe antibiotics or antiviral medications to manage or minimize the impact of the infection on both mother and baby.

4. Counseling and Support: It's important to receive emotional support if diagnosed with a prenatal infection. Health professionals can provide guidance on managing stress and anxiety associated with the condition.

Conclusion:

Knowledge is a powerful tool when it comes to ensuring a healthy pregnancy. By understanding the risks associated with common prenatal infections and familiarizing yourself with preventive measures and treatment options, you can take proactive steps to protect yourself and your baby. Regular prenatal care, open communication with your healthcare provider, and practicing good hygiene can contribute to a smoother and healthier pregnancy journey. Remember, you're not alone—there's a network of support available to guide you every step of the way.

Do WHAT With My Placenta??

So you're expecting a baby, and everyone is giving you advice. 
"You need this stroller; it's a lifesaver!" 
"Make sure baby eats every 2 hours!"
"Don't use that brand of diaper! You'll have poop explosions; they leak!"
"You have to encapsulate your placenta! I did, and it was wonderful!"

Wait, what was that about a placenta? 

Placenta Encapsulation is a way of ingesting the placenta, and it's a decision that's gaining popularity. It may sound bizarre, but the placenta is filled with hormones that many people believe may benefit new mothers. 

Generally, Placenta Encapsulation involves processing the placenta into a dry, fine powder. The powder is then put into empty capsules so that the client can take the capsules just like a vitamin. There are also other ingestion options which may include taking the placenta as a tincture or in raw smoothies. 

Why would someone eat their placenta? 
Many new moms report benefits from ingesting their placentas. Benefits can vary person to person, but some of the most common reported include an increase in energy levels, balanced mood, increased milk supply, and lower incidents of postpartum depression. It is important to note that there have been little to no scientific studies into these benefits; most of the information available is anecdotal. One of the main theories is that since the placenta is partially the mother's hormones, these can help balance her hormone levels after the sudden drop that occurs after the birth. Again, results may vary, and the FDA has not researched or approved placenta encapsulation as a way to treat or prevent anything. 

Are there any negatives or side effects?
The majority of our clients never have any issues. In the general population of people who try placenta encapsulation, a small percentage do report that they have a decrease in milk supply. It is also possible that one may experience a burst of shaky energy (similar to caffeine jitters) if they are taking too much placenta at once. Again, this is not common and can normally be eliminated by taking fewer capsules at once. 

Raw Prep, Heated Capsules, Traditional Chinese Method...What's the difference?
There are multiple ways to prepare the placenta prior to making it into capsules. Each has their own pros and cons, and preparation methods may vary encapsulator to encapsulator. 
Raw preparation means dehydrating the placenta at temperatures between 115-118F. Heating at these lower temps is thought to preserve more of the nutrients since heat can denature some of the beneficial nutrients, but these temperatures are not high enough to kill off potentially harmful bacteria. Because of the bacteria risk, Little Orchids does not offer raw preparation. 
The Traditional Chinese Method (TCM) involves steaming the placenta prior to dehydration. Adding more heat by steaming is thought to add hot "yang energy" to help balance the cold "Yin energy" thought to be prevalent postpartum. Depending on the practitioner, some will add herbs to the steaming placenta thought to help promote postpartum healing. The placenta is then dehydrated at temperatures that vary by practitioner. Steaming can help kill more of the surface bacteria on the placenta. Steaming the placenta may produce fewer capsules since the processing loses additional mass. At Little Orchids, we do not add anything to your placenta, and we dehydrate at 160F to maintain food safety guidelines. 
Heated preparation means that the placenta is dehydrated at temperatures high enough to kill off any bacteria. This is normally done for a longer period of time than other preparations - usually 12-24hours. This can produce a safer product, but the additional heat can very slightly lower the nutritional benefits. This is the default preparation method at Little Orchids unless TCM is requested. 

How do I plan to encapsulate my placenta? 
The first step would be to locate a local placenta encapsulator. It is beneficial to do your research; placenta encapsulation is completely unregulated, so training and processing standards vary wildly. At Little Orchids, our encapsulator is a Certified Postpartum Placenta Encapsulation Specialist who maintains ServSafe Foodhandler certifications as well as Bloodbourne Pathogens certification. Safety is our number one consideration, and we want to ensure a safe product for our clients. 
Once you've chosen your encapsulator and confirmed they're available for your due date, you can start their booking process. At Little Orchids we offer the options of meeting for a consultation or just directly booking online through our website. 
After you've booked, your encapsulator will follow their specific procedures for pick up and processing of your placenta. At Little Orchids, we give clients a handout of instructions for safely storing the placenta until pickup as well as how and when to contact us for pickup. Placenta products are completed promptly and are returned directly to you.

Placenta Encapsulation can be beneficial for many mothers, and it can be a great thing to consider. If you do choose to ingest your placenta, it is important to find an encapsulator you're comfortable with who provides the processing options you want, so begin your search in advance whenever possible. Have any questions for our encapsulator? Contact us today! 

BRAINED: Decision Making for Labor (and Life)

Labor can be an intense, stressful time. Many people go into the birth process with a "birth plan," or a list of ideals they wish to stick to. These are often well researched ideas the family is comfortable with. But what happens when suddenly your doctor comes in and says those ideas need to change? Whether the doctor suggests additional interventions or even talks about changing the type of delivery, sometimes births do not go as planned. How can you make such a potentially huge decision during a high-stress, vulnerable time? 

We like to use the BRAINED pneumonic to talk through these situations. It can be helpful to have a neutral third party (like a doula) to help walk through these steps, but it can be a handy tool for anyone to use for any decision.

So what is BRAINED?

B: Benefits

What are the benefits of the suggested choice? Are there more benefits than there would be with the current plan? Are the potential benefits worth changing plans?

R: Risks

What are the risks of the suggested choice? Does the risk level increase or decrease with the new choice? Do the benefits outweigh the risks? How severe are the potential risks?

A: Alternatives

Are there any other alternatives to consider? What are the alternatives? How do the alternatives compare to the current options?

I: Intuition

What does your gut feeling say? Intuition can be a powerful thing, and it is there for a reason.

N: Nothing

What happens if we decide to do nothing or stick with the original plan?

E: Evaluate

Evaluate these considerations as well as any other questions you have.

D: Decide

Decide what is the best option for you.

The BRAINED tool is most often used for labor decisions, but it's also great for really any life choice. Using this tool helps prevent making quick, emotional decisions by breaking down different considerations logically. 

Labor Inductions: What to Expect

Your doctor may recommend scheduling an induction of labor for many reasons. For some this can be a welcome suggestion; you get to know more definitively when you will meet your new baby! For others, induction can be a scary or unwanted option. No matter how you come to the decision to induce, there are a few things to consider.

1. Methods of induction

There is no one-size-fits-all approach to induction. Multiple different methods may be used based on your personal history, any medical concerns, and your doctor's preference. There can be pros and cons for each method, so it can be helpful to talk through your options in advance with your doctor. Here are some of the most common methods:

Pitocin
Pitocin is the synthetic form of the hormone Oxytocin, which helps trigger contractions during spontaneous labor. Pitocin is given through an IV line in labor, and the hospital staff may adjust the dose as needed throughout the induction. Sometimes Pitocin can cause contractions longer and stronger than spontaneous contractions would be, but it is often an effective method of induction. 

Cervidil
Cervidil is a medication that helps soften the cervix. This preparatory softening can help stronger induction medications be more productive, so many doctors will recommend Cervidil overnight the night before an induction is officially set to start. Cervidil is applied right by the cervix on a cloth tape and can be left in for many hours. Many people find this no more uncomfortable than a regular cervical check. One of the good things about Cervidil is that if the contractions are too strong or if there is a problem, the tape can be removed, limiting further effects. 

Cytotec/Misoprostil
Cytotec is a brand name of the drug Misoprostil. This medication can help soften the cervix and bring contractions, so it is often used during labor inductions. Use for inductions is actually an off-label use not recommended by the FDA, but it is often very effective. Cytotec is packaged in tablets that can be given multiple ways, but it is most often placed internally by the cervix for induction. Although it is effective, Cytotec can be a bit controversial when used for labor induction since it can produce contractions so long and strong that baby becomes distressed. Unlike Cervedil or Pitocin, Cytotec cannot just be removed or turned off if there are complications; once it has dissolved, it's gone. 

Foley Bulb/Cook Catheter
Foley Bulb Catheters and Cook Catheters are very similar options that both function the same way. Both of these options can be used to manually dilate the cervix without the use of medications. These work like balloons; a long balloon-like tube is inserted into the tip of the cervix. Saline is then used to inflate the end, which begins to wedge open the cervix. You do need to be at least 1cm. dilated for this to work, and it may not work for everyone if your cervix isn't ready. The level of discomfort this procedure causes varies person to person, but it may not be comfortable to have the cervix physically stretched. Some providers will require the patient to remain in hospital once a bulb is placed. Others will place the bulb and ask the patient to come back when it falls out, which would mean they should be 3-5cm dilated. If there are problems, the bulb can be deflated and removed quickly and easily. 

Homeopathy and Natural Induction Methods
Homeopathic remedies and herbs are not frequently recommended by OB/GYNs, but they may be a good option for some. There are multiple homeopathic remedies that may be effective to nudge someone into labor. As with any other intervention, we always recommend you speak with your doctor or midwife about what options may be best for you. 

Acupuncture is a centuries-old practice that may be used to start labor. There are specific pressure points a knowledgeable acupuncturist may use if the goal is induction, although it may not work for everyone. Sometimes multiple treatments are needed, but acupuncture can be a good option to try if one wishes to avoid a more medicalized induction. 

Chiropractic care from a Webster-certified provider does not directly start labor, but it can help align the pelvis properly so that baby can find the best position. Sometimes labor doesn't start because a misalignment doesn't allow baby to drop or sit properly; a good adjustment may help with that. 

Breast pump and/or nipple stimulation can be used to naturally produce oxytocin that may trigger contractions. It can be possible to overstimulate the uterus if this is done too frequently, so it is often recommended to stop the stimulation once contractions are established. As with anything else, it's best to check with your provider if there are concerns. 

2. What are the chances an induction will be successful?

The Bishop score is a test that looks at multiple aspects of your history to estimate if an induction would be successful. This scoring system looks at cervical position, cervical consistency (softness), cervical dilation, cervical effacement (thinning), and fetal station (how high baby is in the pelvis). These aspects are rated on a scale of 0-3, and a score of 8 or above is believed to mean that either the body will begin labor spontaneously or that an induction would be successful. Low scores often correlate with unsuccessful inductions, and the doctor may move to recommending a Cesarean birth. 

3. We've started an induction; now what?

There is no hard and fast rule about how an induction will proceed. A lot depends on how ready your body was at the beginning. For some people, a little nudge is all that's needed to push them into full blown labor. For others, the body needs a bit more coaxing, and the induction may take a bit more time. Sometimes an induction can be a lengthy process; some inductions may actually take multiple days. 

It's normal to not feel much at the beginning; depending on your personal tolerance, it can take hours for the medications used to produce uncomfortable contractions. If this is true for you, that can be a good time to rest while you can. Inductions can become very intense suddenly, so taking every chance you have to just rest and take it easy can pay off in the long run. 

Once contractions are strongly established, some providers will lower or disconnect the medications. Often the body will take over and continue contractions. Others may leave the meds running throughout to make sure contractions stay strong. If you would wish to cut the medications as soon as contractions are established, we recommend you discuss this possibility with your provider in advance. 

4. Can a doula help in an induced birth?

Yes! Doulas can be wonderful support for any type of birth, including inductions. Our support in an induction changes very little and is tailored to each client. Often, we accompany you as you get settled in to start the induction. Some clients then choose to send us home until things ramp up, but that is totally up to the client. We can stay with you, or we can return whenever you're ready. From there the support is the same as any other birth; we can help with comfort measures, talking through upcoming options, and whatever else you most need. 

Throughout the whole process of induction, communication with your provider is important. A birth plan can be a great way to go over your thoughts with your provider, but it is always important to remember that nothing with labor is ever set in stone. 

If you would like to meet to discuss how we can support you through your upcoming birth, please let us know! We'd be happy to schedule a consultation or a phone call to answer all of your questions. 

Choosing a Provider

Whether you've been trying to conceive for months or you've just found out you're expecting a surprise, one of the first decisions to be made is who to go to for prenatal care. 

In many areas, the main options for maternity care providers are Obstetricians and Midwives. Sometimes Family Practitioners attend births as well. In our local area of Columbia, SC, the choice is mainly between OBs, Certified Nurse Midwives, and Licensed Midwives.

So what's the difference between them all?

Obstetricians are Medical Doctors who have specialized in pregnancy and birth. They deliver in the hospital setting and can care for anyone from low to high risk. Obstetricians also have surgical training and are able to perform Cesarean Deliveries and Circumcisions. 

Certified Nurse Midwives are Advanced Practice Nurses who have had additional specialized training specifically for prenatal care and birth. CNMs practice primarily in hospitals and birth centers and can care for low to moderate risk patients. CNMs work under the supervision of a physician (often an OB) and can transfer care to the OB if the patient becomes high risk or needs more intervention, like a Cesarean Delivery. 

Licensed Midwives are most often women who complete schooling and a clinical apprenticeship specifically focused around prenatal care and birth. Some LMs have additional medical training of some sort, although this is not required. The didactic school portion can take place in person or online, and the student finds an active LM to study and learn clinical skills. LMs only care for low risk women and deliver in home or birth centers. If a client becomes too high risk, the LM refers the client to an OB. 

Each type of providers has extensive training and experience caring for pregnant families and newborn babies. So who is best for you? Your decision will often depend on a few factors. 

1. Your medical needs
As you can see, not every type of care provider can care for every patient. Risk factors such as high blood pressure, diabetes, and any pregnancy complications may be beyond the scope a midwife can treat. If you do have a higher risk pregnancy, you're more likely to need the more advanced labor monitoring that is offered in hospitals by OBs. 

2. Where are you most comfortable?
Stress can inhibit labor in multiple ways. One of the best ways to remove some of that stress is to labor in a comfortable environment. For some people that means delivering in a hospital where baby can be constantly monitored and advanced procedures can be done nearly immediately if needed. For others they prefer to stay in their home where they are in control and can do what they want- take a bath, chill on the couch, or walk around the neighborhood. Neither of these options sound preferable to you? Birth centers can be a happy medium between the two. Birth centers provide a more home-like feel without having all of the birth equipment and messiness in your personal space. 

3. Payment/Insurance
Sometimes insurance plans only cover specific doctors delivering at specific hospitals. For many people, this can limit available options. Even if your OB is covered by insurance at your chosen hospital, sometimes the Anesthesiologist who comes for an Epidural or the Pediatrician who sees baby are not in your network, leading to more bills. At least locally, homebirth with a licensed midwife is not covered by insurance, so that would become an out of pocket expense for anyone choosing to deliver that way. Checking into who and what is covered by your insurance and thinking about covering finances if you choose to deliver out of network can be important things to look at well before you go into labor. 

4. Referrals and Recommendations
Especially if you are new to the area or are expecting your first baby, you might still have a hard time choosing who to go to for care. Asking friends, coworkers, or local social media groups who they recommend can be a good place to start.

5. OB/CNM Groups
You might find a provider that you absolutely love. Yay! But they work in a group, and you're not a fan of anyone else in the practice. Many of the local OBs and CNMs work in groups that use a rotating schedule to determine who will be on call when a patient goes into labor. Ultimately, there may only be a 1 in 5 (or however many other doctors are in the practice) of your doctor to actually be the one with you in labor! Many people are fine with this, but some are not as comfortable with that uncertainty; it's something else to consider when choosing. 

Everyone's experiences are different, and you can always change providers if you don't feel comfortable with the first (or second, third....) you choose. Many factors may lead you to seek care from any particular provider, and it is so very important that you feel comfortable with your chosen attendant. This person will be seeing you at your potentially most vulnerable time welcoming your child; that needs to be someone you are confident is up to the task.