Holistic Mama Guide Part 2: The Birth Plan
This is a continuation from the Holistic Mama Guide Part 1, Pregnancy and Prep.
Many women wait until the third trimester to create a birth plan, but I recommend researching as much as possible to create your “dream” birth plan prior to choosing your OB/midwife, hospital, and/or doula to ensure they are willing to help you achieve your wishes.
Additionally, be aware of for-profit hospitals that are likely to refuse or make it difficult to work with your midwife and/or doula during the labor and birthing process and/or even reject some of the items on your birth plan. In fact, for-profit hospitals c-section rates are higher than non-profit hospitals.
Once you select an OB, Midwife and/or Doula and ask them for their recommendations on which hospitals are likely to give the least amount of resistance to your birth plan. Fighting at the hospital is the last thing you want during labor.
Here is an example birth plan which can be edited to fit your needs:
I recommend putting an alternative “C-section” birth plan together in the event it becomes unavoidable. Approximately 30% of births are done via c-section, so it doesn’t hurt to be prepared and ensure your practitioner is willing to oblige to those wishes as well.
If you are rushed in for an emergency c-section, chances are you’ll have to kiss the majority of your birth plan goodbye. Your birth plan should include your wishes for what happens during and after the birth, but isn’t guaranteed, depending on the severity or complications with mother and/or baby.
In the event of a scheduled c-section, even if it's scheduled for a few hours out on the same day, you may still be able to request a “gentle” or “natural” caesarian, which could consist of some of all of these steps:
Viewing the operating room prior to delivery to lessen intimidation of the room
Allowing for an extra person in the room (doula and/or photographer)
Have choice of music playing
Attach IV and straps on mother’s non-dominant arm in order to hold baby after birth
No drape or a clear drape to allow mother to watch the birth
Allowing baby to “walk” itself out of the uterine incision or providing gentle assistance
Placing the baby directly onto the mother’s chest immediately after birth with the cord intact
Cord is left to finish pulsating before cutting
Swabbing the baby in mother’s vaginal fluids/bacteria (more on this below)
See this video of a baby “crawling” out of the mother’s womb via c-section incision or this one of a breech baby receiving help out of the womb and being placed on the mother’s chest. WARNING: May be graphic content for some. Both videos make me cry with awe and joy every time I see them.
1/3 of a baby’s total blood volume is still in the cord at the time of birth so allowing the blood to flow to the baby over the course of 5-10 minutes, or until it stops pulsating is encouraged. In some cases it may seem as though they are slower to initiate breathing, but the placenta is still oxygenating blood for the baby to help them make the transition. Experts would know how to assist with gentle stimulation.
Some opt for a Lotus Birth which keeps the placenta attached to the baby until it separates naturally.
Cutting the cord early can result in anemia, cerebral palsy, learning disorders, respiratory distress, and more.
Of course, there are reasons immediate cord clamping may be necessary, such as the cord being wrapped around a baby’s neck or if there is a plan to bank the stem cells. Note: Stem cell banking is recommended by the AAP only when there is knowledge of a full sibling in the family with a medical condition (malignant or genetic) that could potentially benefit from cord blood transplantation…not for later personal use.
Vaginal Bacteria (Even in a C-section)
A babies first exposure to good (GREAT) bacteria is during birth on their way through the mother’s vaginal canal. The microbes picked up by the baby during this process can be essential for the development of a healthy gut/immune system.
Unfortunately, because c-section babies bypass the birth canal, “some epidemiological studies have suggested C-section babies may have an elevated risk for developing immune and metabolic disorders, including Type 1 diabetes, allergies, asthma and obesity.”
However, for some cases of an unavoidable c-section, hope is not lost! Prior to the c-section, doctors may be able to use gauze to absorb fluid from the mother’s vagina and then wipe the baby’s entire body with it immediately after birth. The results of a study showed this step partially restored and normalized the microbial assembly that takes place naturally in babies!!
This obviously shouldn’t be done if the mother has tested positive for group B strep or STD’s, so this should be discussed thoroughly with the doctors.
My c-section was called an “emergency” although it was scheduled for 8 hours later that day after many hours of labor. In these cases, your chances of having a gentle c-section and getting the vaginal microbes to baby are greatly increased.
Depending on your type of birth, you may spend 0-4 (or more) nights in the hospital. Tempting as it may be to allow nurses to care for the baby, say for just a few hours of solid sleep, some insist the baby never leave their side or sight unless accompanied by a trusted family member or friend. This may or may not be necessary, but some feel when the baby is unaccompanied, the hospital may administer unwanted tests or procedures. If this is the case, your birth plan should include your preferred sleeping arrangements, including a family member or friend sleeping overnight.
Kangaroo Care and Delaying the Bath
Forgoing the immediate weighing, bath and APGAR test, Kangaroo Care provides mother and baby with an immediate skin-to-skin bonding during the sensitive first 2-hour window of baby’s life. This can be requested even after the baby is born via c-section provided the baby does not require emergency care and the mother is able to hold the baby. If the mother is unable to immediately hold the baby, another party can hold the baby skin to skin or even hold the baby near or against the mother.
Outside of emergency medical intervention, I'm aware of no downside to kangaroo care. Here are some reasons you may want to do it:
Holding the baby skin-to-skin has been shown to regulate their temperature and create a bond of sight and smell to their mother or father
Most babies intuitively crawl to the breast and latch for breastfeeding within 75 minutes
Distracts mothers from pain of episiotomy or laceration repair discomfort
This same study showed nurses did not report a change in workload, though lately, it was widely shared that a family was charged an additional $40 to hold the baby skin-to-skin for the nurse's added duty of handing the baby to the father
Request APGAR be performed on baby while in the mother’s arms
If indicated on your birth plan, your baby can come directly from your womb to kangaroo care, which means they skip the routine bodily wipe-down. A newborn baby is covered in a vernix which contains powerful and essential antimicrobial proteins effective in inhibiting the growth of common perinatal pathogens, including group B. Strep, K. pneumoniae, L. monocytogenes, C. albicans, and E. coli. Delaying the bath and keeping the baby with the mother until breastfeeding may prevent cases of infection.
This study goes on to say pre-term babies tend to have more vernix than babies born at or after 40 weeks and derive even greater benefit from staying with their mother.
Eye Goop, Shots and Vaccination
Obviously, this is a sensitive subject. But, as with everything else, it deserves, at the very least, research of scientific, peer reviewed studies for every shot. We challenge our doctors on things like baby formula and lotions/creams, we owe it to our children to double and triple check the effect and safety.
The recommended medical interventions at birth are:
Why it’s given: The eye ointment is an antibiotic (erythromycin or tetracycline) smeared over newborns eyes within the first hour of birth to prevent blindness from the mother’s Sexually Transmitted Disease(s) (STD), such as gonorrhea, chlamydia or herpes.
Questioning the reasoning: If the mother has been properly screened for STDs, the procedure should not be required. Additionally, babies born via c-section shouldn’t be at risk for exposure.
Concerns about the product:
Wide spread use may contribute to the development of antibiotic resistant bacteria
Erythromycin has been shown to have a 20% failure rate
Some feel the blurred vision caused by the ointment interferes with parent-bonding during the crucial window right after birth
Alternatives: Receive STD screenings during the third trimester and research your State’s laws and penalties for refusal of the eye ointment. You can also request to delay the ointment in order to ensure no interference with parent-bonding
Vitamin K Shot
Why it’s given: Physicians state newborns are born deficient in Vitamin K and need it to prevent hemorrhaging caused by Vitamin K Deficiency Bleeding (VKDB), a rare, but serious condition
Questioning the reasoning: It would seem all newborns have low Vitamin K levels compared to adults because Vitamin K doesn’t pass through the placenta well, but during the immediate days of breastfeeding after birth, the body begins to produce Vitamin K in the gut, given no complications with the delivery or health of the child
Concerns about the injection:
Adverse reactions according to the package insert: Many including anaphylactoid reactions and death
The ingredient Benzyl Alcohol (preservative) associated with jaundice and fatal Gasping Syndrome in premature babies
The ingredient Aluminum is associated with neurotoxicity and bone toxicity. The package insert further issues this warning: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk. The Association of American Physicians and Surgeons state aluminum should be removed from vaccines (currently used in Hep B, DTaP, PCV, HiB, Hep A.)
Read/Watch more about the shot and concerns here
Vitamin K Mulsion drops orally during last trimester and administered to baby during nursing or feeding. Additionally, delayed cord may help while Colostrum and Breastmilk naturally contain vitamin K
The Netherlands eliminated the Vitamin K shot and began administering the vitamin orally instead and there has been no cases of VKDB
Hepatitis B Shot
Why it’s given: If the mother has hepatitis B, it can be passed on to the baby during birth
Questioning the reasoning: Unless the mother has hepatitis B, which is a routine test during pregnancy, the injection wouldn’t be necessary unless the baby needs a blood transfusion, is having sex or will be around needle sharing in the home. Studies show that babies born via c-section are at a significantly lower risk of contracting Hepatitis B from the mother.
Concerns about the injection:
The ingredient Aluminum is associated with neurotoxicity and bone toxicity. The Association of American Physicians and Surgeons state aluminum should be removed from vaccines (currently used in Hep B, DTaP, PCV, HiB, Hep A.
The ingredient Formaldehyde, a carcinogen, causes reproductive and developmental toxicity
Conditions such as the following have been linked to the Hep B vaccine:
Alternatives: Receive proper screenings during the third pregnancy and research your State’s laws and penalties for refusal of the Hep B shot.
Additionally, the National Vaccine Advisory Committee has recently recommended adding the HPV vaccine, Gardasil, to the newborn vaccine schedule. This specific vaccine has had numerous adverse reactions, including death, recently, and being that it is meant to guard against a sexually transmitted form of cervical cancer with 3-5 year antibodies, one would wonder what the benefit is to a newborn. You can read the quick fact sheet on HPV and the vaccine here.
Please understand, this is not an instruction manual on what to do. Just a starting point to gather research to be made alongside a trusted physician. The ingredients and adverse reactions highlighted here is a partial list. There are many other ingredients that may be of particular concern to you such as egg protein, animal DNA and/or fetal tissue. You can read all of my vaccine articles here.
Neonatal circumcision is the process of removing the foreskin of the penis through an elective surgical procedure during the first week of birth. While this procedure is done worldwide for religious purposes, the United States has a high number of males circumcised at birth for non-religious reasons. While several parents believe circumcision to be a violation of human rights, others do not question it since the procedure carries a perception of low risk. Specific reasons why proponents actively choose to circumcise, may be:
Socioeconomic Status: A review found a significant association with private insurance and higher socioeconomic status in opting to elect circumcision.
Father-Son-Comparison: In the United States, Parents, particularly fathers of newborn boys state they don't want their son to look different than their father. 90% of circumcised fathers choose to circumcise their son while only 23% of uncircumcised fathers chose to circumcise their son.
Hygiene and Reduced risk of STD/STI: Mothers in the United States cite hygiene as the most important reason to choose circumcision. This study points out the bulk of the data used to justify the AAP/CDC policies [to circumcise] were derived from studies of adult circumcision carried out in sub-Sharan Africa, a geographic region whose epidemiological environments and patterns of disease transmission are dissimilar to those elsewhere in the world...the majority of the literature on circumcision is based on research that is not necessarily applicable to the North American populations."
Reduced risk of Penile Cancer: The U.S. lifetime risk of penile cancer is approximately 0.07% and occurs in the skin of the penis. When you remove 1/3-1/2 of the skin, naturally, the risk of cancer will be reduced. In David Gollaher's historical book about circumcision, he retorts "A high percentage of skin cancers eventually develop on the nose. But this has not led physicians to recommend prophylactic rhinoplasties."
Reduced Risk of Urinary Tract Infection (UTI): This study shows while newborn circumcision may reduce the chance of UTIs in the first 6 months, they don't believe there to be enough data to advocate routine neonatal circumcision.
One researcher sums it up this way: In the case of circumcision, originally a ritual practice with a long history of being dubiously medicalized, it is important to be especially skeptical. At the end of the day, it is not altogether clear that minor reduction in the absolute risk of certain infections or diseases - whose prevalence in developed nations is generally low, and whose occurrence can typically be avoided by other, less injurious means - is worth the 'trade-off' of losing a part of one's penis. What is certain, however, is that the answer to this question is likely to be highly subjective, and to depend upon numerous, unpredictable, and ultimately personal factors. Therefore, it should be up to the affected individual himself (or indeed herself, in analogous circumstances) to decide about permanent genital-modification surgeries at such a time as he or she can meaningfully factor in his or her own preferences and values. Circumcision before an age of consent is not a desirable health-promotion strategy, given more effective, and less ethically problematic, alternatives.
Placenta encapsulation is the practice of consuming your own steamed, dehydrated and ground placenta in the form of a pill shortly after giving birth. Some even consume the placenta raw by eating directly or blending into a smoothie. Most mammals eat their placenta after birth, though some argue it is to remove traces of childbirth from predators.
Those who choose to encapsulate their placenta may do so hoping to experience one or more of these benefits:
Increased milk production
Increase in oxytocin, the hormone that helps return the uterus to its original size, stimulating interferon and prolactin (hormones that boost energy and immune system) while increases baby bonding.
Decrease in PPD (postpartum depression) levels
Boost in Iron levels
Making an alcohol based placenta tincture and saving for menopause is said to help counter some of the symptoms
There is little scientific evidence to support these claims, but mainly because the practice simply hasn’t been studied enough. This study, however, was done to evaluate potentially toxic elements and minerals present in the placenta. The results showed “the recommended daily intake of encapsulated placenta may provide only a modest source of some trace micronutrients and a minimal source of toxic elements.”
That's it for now! Any other recommendations I missed, please feel free to share!
*Disclaimer: I am not a doctor. This post is not advising you to any medical action but rather promotes the reader to educate themselves and to make decisions with a licensed medical professional.