Healthy Mother Blog

Many of our customers ask us “What is Birth Energy” that midwives talk about?

The answer to the question is both easy and extremely difficult. Birth energy is felt, and seldom seen. As nature’s narcotics, the powerful Endorphins hormones transport the mother to a different different world during the active stage of labor, she goes into a state which is similar to a trance, time stops for her and she is engulfed by a powerful, primordial and all-pervading energy that is euphoric. This energy is so powerful that it also affects others who are present at that moment – fathers, midwives, and care providers.

This Birth Energy can only be experienced if mother is allowed unlimited privacy, support and freedom to become in tune with her body. Her baby also feels this energy and starts responding to mother’s state and moves down the birth canal. Some folks liken birth energy to the same state of sexual energy that pervades during lovemaking. We have been told by mothers after they have given birth that they felt an incredible rush when they experienced this energy. They could feel images, events and thoughts in a state of trance, with periods of deep coherence in between. We advise mothers to give themselves completely to their birthing energy with the knowledge that our team is always present to help, support and protect them. The energy is still present when the mother gives birth, in the pulsating of the umbilical cord and gradually leaves the mother in a state of exhilaration and wide-eyed so that she is awake, eager and able to nurse and bond with her new born baby. Some of our mothers tell us that they felt this birth energy as if they have been reborn themselves.

Whatever may be the final outcome (i.e., normal birth or a medically necessary c-section) it is essential that mothers are allowed a full trial of labor, provided unlimited, individual and continuous support and a team which has only the mother’s welfare in mind. That is what underpins our mission at Healthy Mother.

What has been your experience with Birth Energy? We would love to hear from you……

This headline screamed in Page 2 of today’s Times of India, Hyderabad edition. While many readers may be surprised, this news has been a common fact for many years now. Since the time when Healthy Mother was founded we ourselves have seen c-section rates around 70% in most hospitals, including some of the large corporate hospitals.

The percentage of cesarean deliveries at private hospitals stands at 70%….

Many doctors ascribe silliest of reasons to recommend (and in many cases force) c-sections on mothers. Some of these are “You are too short”, or “Your baby is too big”. While in the extremes these may be adequate reasons for intervention, in the vast majority of cases, it requires patience, support and encouragement for a mother to deliver normally. Hospitals and medical staff do not have patience, nor do they provide empathy and support to mothers during labor, which may last even 48 to 72 hours. Similar is the case with mothers who have had a previous c-section. Doctors instinctively decide that such mothers will have a c-section for their next baby, though medical science does not say that it is automatic.

Most of our mothers who have given birth normally at Healthy Mother are living proofs that if you allow mothers privacy and support to labor on their own, outcomes are overwhelmingly towards empowering normal births. We have had VBACs (vaginal birth after c-section) at our birthing center, among them mothers whose original care providers had written them off as candidates for another c-section.

Having said that, we believe that other states in India are no better. This is an increasing urban malaise that threatens to deprive mothers of the knowledge of what it is to give birth normally and to trust their own bodies to do something that nature has been helping women to do for thousands of years.

The article cites astrological preferences among women (or their parents / in laws) for going in for an elective c-section. Some hospitals even charge extra for “Muhurat C-Sections”. We believe that 99.9% of women who end up with an elective c-section do so because hospitals feed on mother’s natural apprehension and fear about the health of her baby, by recommending unnecessary procedures such as Induction, Epidurals and C-Sections.

Today, most women are being told that they or their baby has some risk or the other. Odd positions are not an anomaly. We have seen breech babies turning on their own or as a result of mother doing some exercises or adopting some positions. Even mothers with reasonable diabetes or reasonable levels of blood pressure can deliver normally. The problem is that many medical staff are always looking for problems when there is none or when they can be managed with close monitoring and without intervention such as c-sections.

Women (and their partners) need to empower themselves by educating themselves about pregnancy, childbirth and newborn care so that they can become informed customers. Only then can they actively participate in the birth of their child, the experience of which is awe inspiring and a once in a lifetime one.

Share your experiences that you may have……

Wikipedia defines Meconium as the “earliest stools of an infant”. As opposed to later feces, Meconium has no odor, and is sterile. According to studies, babies pass Meconium during their 12th to 41st weeks in mother’s uterus, with most occuring between the 15th and 41st weeks. Typically, it is thick, sticky and green/black in color. While in the uterus, the baby swallows amniotic fluid along with any other particles that are present in it. The amniotic fluid mixed with other particles passes through the intestines which absorbs the water and leaves behind a thick and sticky substance called Meconium.

Many studies have come to the conclusion that passage of Meconium in most babies is a normal physiological process. However, it is also true that when there is evidence of Meconium staining and birth is not imminent, it should be taken as a “red flag” and care givers should monitor baby more carefully and frequently. At our Healthy Mother Birthing Center, we have seen a couple of mothers’ bag of waters break with the water stained with green color. But in our experience we have found that in many cases, the mere presence of Meconium does not indicate that the baby is in fetal distress, as our heightened monitoring proved that fetal heart rates were within normal range. Once we notice Meconium stained amniotic fluid, we check for fetal heart rate more frequently.

Many healthcare providers view the presence of Meconium as a necessary and sufficient condition to perform c-sections. While thick Meconium accompanied by less amniotic fluid does indicate fetal distress in most cases, it should be noted that meconium by itself does not indicate that the baby is currently having a problem and that intervention is required.

Today, in most hospitals in India, the presence of even slight amounts of Meconium in the amniotic fluid is taken as a clearance for performing c-sections, without looking at the big picture. Continuous monitoring requires lots of patience, which is a rarity in many of today’s hospitals.

For nine months the baby experiences life in the mother’s womb and gradually becomes tuned to happenings surrounding it. His mother and father’s voices, sounds of various “things” outside the womb, emotions of his mother, effects of mother’s diet or medications, all are experienced by the baby. As he gets ready to leave the familiar “home” which is his mother’s womb, the baby makes the journey down the birth canal, supported by mother’s hormones and contractions of her uterine muscles. Nature’s helpers, Oxytocin and other hormones are on hand helping baby make this journey, and if mother and baby are well supported by care givers, in most cases birth happens naturally, and spontaneously.

But what about after birth? Studies have shown us that baby is wide awake for a few moments after birth, taking in the sights and smells of its new surroundings. Typical hospitals immediately whisk the baby away and subject it to a variety of procedures such as suctioning of fluids, cleaning, etc. This in itself is traumatic for a baby which has just experienced stress of leaving its mother’s womb which was its home for nine months. Babies need to be handled ever so gently immediately after birth, so that they can ease into their unfamiliar surroundings. Subjecting them to rough handling may make their birth traumatic, which may also have long term implications on their psychological and physical well being. Rough handling of newborns may shock them into crying even before their lungs are clear, which may lead to respiratory distress. Some hospitals even cut the newborn’s nails immediately after birth, as if they are presenting a pristine and well groomed baby to their families. Such actions only serve to harm the baby.

So what should care givers do immediately after the baby’s birth? The Midwifery Model of Care (that we practice at Healthy Mother) recommends that babies need to be handled with great gentleness after birth so that their transition to outside world be made with as little stress as possible. The birthing room ligths should be dimmed, and people should be silent or talk in whispers so that baby can only hear his mother or father’s voices – something that he has been hearing for many months. Babies should be guided into their mothers arms and should be left on mother’s chest so that there is skin-to-skin contact. Mother’s body is the best temperature regulator for the baby, and babies should not be dried, especially the palm of their hands. This is because the palm still has traces of the amniotic fluid, and helps baby to seek out mother’s breast to suckle. Many babies do not cry after birth, which is perfectly fine. Many care providers hold the mistaken belief that newborn babies need to be spanked in order to make them cry. If baby is breathing well, then there is no need for any intervention. The umbilical cord should be kept intact for as long as it is pulsating. Transition to full lung breathing takes place over a few minutes, with the darkish color at birth giving way to normal pink color. It is not necessary to wrap the baby in blankets or put a cap or other clothing as it is only counter productive. As long as baby is with mother and is in skin-to-skin contact it is experiencing the best “warmer” there possibly is. He will be able to regulate his breathing better, and will stabilize his temperature better and have higher blood sugar than babies who are kept on their own or are wrapped in clothing or blankets.

It is our responsibility as parents and health care providers to make the newborn’s transition to outside world in as humane manner as possible. A simple act of mother just holding her baby close to her and gently touching or stroking him and talking to him will leave a lasting positive impact on him for the rest of his life. Birth should be gentle, serene, and holistic. After all, even most mamals have this ingrained in them. By treating birth as a medical procedure we humans are depriving babies of the humanity that they deserve.

Over the past several years, I have had the opportunity to talk to several moms who have had a previous C-section, and want to try for a natural birth the second time around. In fact, we have helped some of these women birth their second baby naturally at our Healthy Mother Birthing Center. One of the primary concerns, in trying for a natural birth the second time around is “scar rupture”. But, as we put up a recent consensus document from the NIH, VBACs (vaginal birth after c-section) are safe, and the revised figures for scar rupture during trial of labor is at 0.3% vis-a-vis a 1% risk for scar rupture during a repeat C-section.

Currently, we have a mother who has had two previous C-sections, wants to try for a natural birth at our Center. As with all VBACs, the mother’s history and her health during this pregnancy become important indicators of how her labor and birth will unfold. However, I firmly believe that with good antenatal care, counseling about the risks and benefits of VBAC, physical and emotional preparation, as well as constant support and vigilant monitoring during labor, every mom stands a chance to labor and birth her child naturally.

Now, a new study has been published in the British Journal of Obstetrics and Gyneacology (BJOG), which validates this approach, and finds that even with two previous C-sections, eligible women should be counseled, and offered the option to a trial of labor, in order to birth their babies naturally. We hope expectant mothers who have had one or more previous c-sections benefit from this article about options available for them.

Here is a synopsis which has been published by Childbirth Connection –

What does the best available evidence tell us about vaginal birth after two cesareans?

The practice of vaginal birth after cesarean (VBAC) has swung widely over the past two decades, declining considerably since 1997 due in large part to concern about increased risk of uterine rupture. A recent consensus conference convened by the National Institutes of Health to study the evidence and provide guidance on VBAC concluded that “trial of labor is a reasonable option for many pregnant women with one prior low transverse uterine incision.”

In this study, the authors conducted a careful meta-analysis to pool all available observational data on the success rate and risks associated with vaginal birth after two cesareans, comparing this to vaginal birth after only one cesarean and also with elective repeat cesarean. The pooled successful VBAC rate among 5666 women who had a trial of labor after two or more cesareans was 71.7% (compared to 76.5% after one cesarean). The pooled uterine rupture rate after more than one cesarean was 1.36%, which represents a statistically significant increase in relative risk, but a very small increase in absolute risk for this rare complication. Importantly, the study did not indicate a significant difference in risk of neonatal death, asphyxia, or admission to the neonatal intensive care unit among VBAC after one cesarean, VBAC after more than one cesarean, or elective repeat cesarean. In addition, the rate of other serious maternal complications such as hysterectomy, blood transfusion, or fever was not significantly greater for VBAC after more than one cesarean than for elective repeat surgery.

The take-away:

The authors conclude that this analysis of best available data does not suggest excessive risk associated with VBAC after two prior cesarean births, and therefore eligible women should be appropriately counseled and offered the option to undergo a trial of labor.

Here is a reference to the abstract of the original article:
Tahseen S, Griffiths M. Vaginal birth after two caesarean sections (VBAC-2) – A systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. BJOG 2010;117(1):5 -19.

This is a long post…..

Exactly 12 days back at 11:30 pm on 1/6/2010, a baby boy was born to one of our moms at our Healthy Mother Birthing Center, the Sanctum. That he was born after almost 15 hours after mom’s bag of waters (BOW) broke, or that he was born with a nuchal hand (hand placed near his neck and face as he was born), seem to be a part of any routine labor and birth.

What makes his birth special is that he was the first of the twins to be born. His sister (now we know that the second twin is a baby girl) was still happy to be inside mom’s belly, and she waited happily there for the next 23 hours to be born. She was finally born on 2/6/2010, at 10:15 pm, to much joy and awe of both parents and our team.

Between 11:30 pm on 1/6/10 and 10:15 pm on 2/6/10, we waited, watched, monitored, occasionally examined, discussed various options and scenarios, helped the first twin breast feed (several times!), believed that the mom’s body and the baby inside had the wisdom and knew what to do, tried a few different things to get labor started again, and waited .. and waited … and waited … for mom to start her contractions, so that her second baby could be born.

Through this time, initially after the first twin’s birth, mom rested a bit. Then our OB, who had been present for the birth of the first twin, in case her expertise was needed, did an intrapartum ultrasound, to determine the position of the second twin. We knew from antenatal check-ups that the second twin was in breech position. We were hoping that with the birth of the first baby, she would turn head down with the additional space now available to her. However, she continued to remain in breech position till her birth. The parents had already been counseled and given full information on the pros and cons, and the risks involved in a vaginal breech birth, and they had opted to try for it. This made it easy for us to wait, watch and monitor.

In the early morning hours of 2/6/10, mom wanted to move around and walk to see if she could help get labor started again. Though we (Rinn, me and her husband) took turns walking with her, helping her with pelvic rocks and tilts, and many trips to the restroom – no labor. Baby was such a trooper and happy as a clam that Mom was joking – “This baby did not have enough space inside me before; now she is enjoying her share of time and space!”

By mid-morning, mom had her breakfast. I suggested more walking, and some small sideways lunges with pelvic tilts and some mini-squats to see if we could move things along, which mom did. We also started some herbs. Mom was slightly anxious about labor not getting re-started, and I found myself singing the Gayatri Mantra to her, and her husband joined in, and I think this helped her relax a bit. As Rinn slept a bit, I started some pressure points and homeopathics, which in addition to the upright postures, seemed to help get a few more contractions – but still, no labor rhythm. We discussed with our OB about the option of starting a slow Pitocin drip to see if we could give a gentle push to get the contractions more into a labor rhythm. At this point, though none of us were wanting to do anything major, it was still unchartered territory for all of us – 12 hours had elapsed since the birth of the first twin and still no contractions! Parents chose to go with the slow drip; but mom’s body was still not ready. Some stronger contractions, but no labor. After a couple of hours of the drip, we decided to turn off the drip and let mom sleep for few hours, as sometimes a few hours of sleep will rest the body and signal the uterus to start contractions again. Mom slept soundly for the next 4 hours, while Udaya, our doula, monitored baby periodically. I wanted to sleep, but could not – anxiety?!? But, I did get a much needed break.

Early afternoon saw a well rested mom, but no signs of labor still. My OB partner (and friend!) was by now being tested with all our “patience”, “baby is well”, “mom wants to wait” approach. She consulted several of her colleagues, all of whom were skeptical about the whole process, and were telling her that the best course of action after so long would be to do a C-section to minimize risks to the baby. She did another intrapartum ultrasound, which showed that the baby was still in breech, and was still doing well. Rinn did an internal exam, which showed that the cervix was 7-8 cms, but very stretchy, and bulging bag of waters.

So, we had a long round of discussion with the parents and talked to them about their options:

1) No interventions. Baby is doing well. Let mom start labor when she does. This could be a few hours or a few days – who knows?!? Risk – If infection sets in, or baby does not do well – then, emergency c-section would be the only option.

2) Re-start a Pitocin drip, get a complete team scrubbed and ready, break the bulging BOW, hope that the contractions pick up, baby descends and complete a breech vaginal birth. Risks – those associated with cord compression and any vaginal breech birth. May need to go in for an emergency C- section if things did not go well.

3) Go for an elective C-section. Risks – those associated with the surgery.

Parents chose to go in for the second option. So, a Pitocin drip was re-started. This time around, the contractions were longer, stronger and rhythmic, but to our surprise, mom had very little pain. There was slow build –up of contractions, rhythm and intensity over the next 4 hours. Mom was having more lower abdominal discomfort and some mild back pain with the contractions. After monitoring mom and baby through several contractions, an entire team was assembled, an epidural was put in place, in case we needed to go in for an emergency LSCS, and Rinn broke the BOW. The contractions increased in strength, the baby started to descend buttocks first; Mom was encouraged to push, which she did beautifully. And finally with some assistance from both Rinn and the OB, the baby was born. A beautiful 2.3 kg baby girl had finally made her journey earthside!

There would be more events thereafter – manual removal of two placentas, which were slightly adherant, postpartum hemorrhage that needed some controlling and such – so, it was a complete team effort. All credit to the OB and her team for not only waiting patiently with us, but helping us at the birth as well as managing the immediate post-partum so well. In the meantime the baby girl was hungry and latched on to mother’s breast with ease, and we could all only wonder at the miracle of birth!

I have waited a while to process the whole experience and write about these births, simply because I did not want to come across as if we were doing something out of norms, or weird, or extraordinary – depending on whose perspective you look at it from!! People in birthing circles and care providers have asked me – “How long would you wait for the second twin to be born?” Honestly, I have no answer. In this birth, the birthing energies were right. Mom and the second twin were doing well. The first twin had been born without too much difficulty. The mother (who is really the key and integral part ot any birthing process) was confident and had a gut feeling that her body would start laboring, and that she would have her baby naturally. Dad and family members were very supportive of the process. We had a very supportive OB and an entire medical team on call at all times; this was our safety net. We were monitoring closely and very cautious at all times, even though we were confident and hopeful for a natural birth for the second twin as well. Had any of the above factors been absent, we would have probably had to intervene sooner.

In the end, all of us marveled at nature’s own way of preparing and enabling the mother to give birth to her twins. We were happy to be part of this family’s incredible journey to parenthood.

An recent study conducted by Professor Patricia Conway of the School of Biotechnology and Biomolecular Sciences at the University of New South Wales, said babies born naturally received protective bacteria as they passed through mother’s birth canal during delivery.

Numerous studies before this one have proven this fact. The study reinforces the importance of good practice of waiting for labor to begin and progress on its own without external intervention when both mother and baby are healthy.

One of the most frequent causes of infections in newborns is bugs in hospitals where they are born. If babies are allowed to be born naturally, as they pass through their mother’s birth canal, the good bacteria lining the walls of the birth canal are transfered to babies’ skin. From there the bacteria colonize the intestine and inoculate babies against hospital bugs. This “Gut Flora”, the study says, is essential for development of baby’s immune system.

Whether mother ultimately gives birth naturally or not, it is essential that in order for babies to get the benefit of this good bacteria, mother should be allowed a full trial of labor, especially after the bag of waters has broken. Sadly most Indian hospitals fail in this respect.

Other ways for the good bacteria to be absorbed by babies are if mother and baby are allowed “skin-to-skin” contact after birth and very importantly, when babies are breastfed.

The study also quotes a European study done in 2008 which reviewed 20 previous studies for a relationship between cesarean and diabetes, and found that babies who were born surgically without mothers undergoing a trial of labor were 20% more prone to develop Type 1 diabetes in their later years.

This is yet another scientific study that reinforces the power of laboring without interventions and giving birth naturally. Here is the link to the article that describes the study.

All our mothers at Healthy Mother understand this power and are given full chance to labor on their own without any time pressure.

A couple of days ago I received an email from Kathy Petersen about an article that appeared here.

The article made me stop and re-read, if nothing else, for the immense implication it could potentially have on the study of Autism. While, you can read the article by following the link above, I will try to simplify it below:

Epidural is given to the laboring mother to supposedly help her manage pain during labor. It makes the body numb from the waist down and typically slows the process of labor, leading mothers unable to keep pushing, often causing the need for cesarean operation or forceps delivery. Other side effects include onset of low blood pressure, shivering, loss of bladder control, back pain after birth, spinal headache or nerve damage. In some cases mothers have been known to have convulsions, and in rare cases, brain damage has occurred. Another drug, Pitocin is very widely used in Indian hospitals to speed up labor. When administered, Pitocin is known to cross the Placenta to the baby’s body.

Typically, in hospitals, a “cocktail” of drugs Pitocin and Epidural is given to mothers in labor. The article’s author claims that this cocktail of drugs “has the potential of skewing the brain if the infant is unable genetically to process the drugs quickly through its system”. When Pitocin crosses over to the baby, adequate production of an enzyme found in the liver (CYP 3A4) is required to rid it from the baby’s body.
CYA 3A4 is found to combine with another naturally occurring hormone called Oxytocin, which together help in brain development.

When Epidural and Pitocin are given to the mother and when they cross over to the baby, Pitocin’s intensity increases, in babies which cannot produce CYP 3A4 in adequate quantities, causing brain development to shut off early. Another enzyme, MAO-A is known to control the production of Seratonin. As a result of the drug combination, as the child ages, MAO-A levels decrease, causing Seratonin levels to increase, affecting communication, speech, emotion and bonding.

The article quotes heavily from the researcher who invented Respen-A, a homeopathic medicine that claims to curb production of Seratonin, allowing for a more normal brain function. It is not clear if the article in unbiased in nature – however, the claims regarding the cause and effect of Epidural and Pitocin on Autism certainly forces parents and caregivers to sit up and take notice.

In India, Epidural and Pitocin are used very frequently, typical in 80% of cases.

What has been your experience?

One fine day I got an email from the founders of the website www.yourstory.in, a leading portal that highlights entrepreneurs and gives voice to the work that they do.

It was gratifying to be able to articulate to a wider audience about the work that we do and so thanks to all for the wonderful support and encouragement you have provided to us throughout our journey.

We rededicate ourselves towards making positive change in birth practices in India.

Here is the link to the interview.

When I initially started helping moms birth their babies, I did not believe in numbers, sequences, patterns .. etc. The more births I attend, the more I am convinced that the energies that we as practitioners bring into a birth, has a potential of making an immense difference in the family’s birth experience.

So, sometimes we see a few difficult labors clustered together … and then a few remarkably easy ones happen.

This time, we had 2 water births clustered together … Yes, we had another amazing water birth yesterday! Yes, both moms had longer labors; yes, both of them decided to go into the water towards the latter part of their labors; and, yes, and most importantly, both of them had a great resilience, attitude and total trust in their own bodies. And oh…, yes, I wore the same green outfit that I wore for the previous water birth ….. hmmmmm, superstition??

Much as I want to write more about this water birth, I will wait for the new mom to tell her story. She told me yesterday, as her contractions were getting stronger, that she has been keeping a diary, and that she wants to write a blog about her baby’s birth. So, keep watching this space for mom’s story ….

What did I learn from this labor? PATIENCE as usual was the key. After 2 days of early labor, and a day and a half of active labor, when mom was at 4 cms dilation, it would have been so easy for everyone (mom, dad and caregivers) to choose interventions/epidural. However, encouraging the mom to look at all the positives, getting her mind off the contractions and verbalizing our belief that she could do it, and that we were all present for her – I believe, helped her get through that phase of her labor. And, barely 2 hours later, she went from 4 cms to complete dilation and was ready to push!

Finally, it is always the mom who has to birth her baby … I say this again and again in our Lamaze classes. We, as caregivers, can provide as much support as the mom needs, but she is the one who is allowing life to pass through her. In that sense, how open she is to the experience (and thereby, the pain) determines the nature of her baby’s birth. For this mother, even at the peak of her contractions, “the pain” was not “pain” – it was “an altered state of consiousness” in her own words, allowing her to focus on her job of bringing her baby into this world.

I could not have put it better.

Wishing everyone wonderful birth experiences …
Dr. Vijaya