v = variable decels = c = cord compression = bad
e = early decels = h = head compression = normal
a = acels = o = ok if w/in 120- 160
l = late decels = p = placental deterioration = bad
So variable decels are when the heart rate goes UP above baseline during a contraction then down then Up again above baseline and then returns to normal. If you look on a strip it will look like "shoulders"
Early decels are when the heart rate goes down DURING a contraction. This is totally normal.
Late decels are when the heart rate goes down AFTER a contraction.
quoted from mdc thread linked in title
rixa delivers as always....
i'll add my 2 cents in my "official" follow up friday post, but you've done an awesome job of getting the whole story....
in fact heres an article from sara buckley (who i heard speak at the ican conference and she was so awesome....gave so much info my hand was sore from taking notes) this is about the risks involved in choosong epidural pain relief.
http://www.sarahjbuckley.com/articles/epidural-risks.htm i'll just quote the last paragraph here but ireally encourage you to read the full article
Epidurals have possible benefits but also significant risks for the laboring mother and her baby. These risks are well documented in the medical literature, but may not be disclosed to the laboring woman. Women who wish to avoid the use of epidurals are advised to choose carers and models of care that promote, support, and understand the principles and practice of natural and undisturbed birth."
the best book i've read about pain in l&d is grantley dick-read's "Childbirth w/o fear" http://www.amazon.com/Childbirth-Without-Fear-Original-Approach/dp/0061092487/ref=sr_1_2?ie=UTF8&s=books&qid=1247773081&sr=1-2 in it dick-read describes the Fear-Tension-Pain cycle that leads to pain.
Basically women these days having not seen normal birth (or often any actual birth...only the highly dramatized tv variety) tend to fear what they don't know. Fear leads to tension which leads to pain.
The solution is to learn about normal birth.
One of the important things to realize is that not every birth is painful. About 20% of births are actually painless. A film i highly reccomend is "Orgasmic Birth". http://www.orgasmicbirth.com/ I saw it last summer and it is so, I just can't even describe it.... inspiring, educational, just a fantastic film!
For births that do include pain, it's usually managable. My last birth never felt worse than bad menstrual cramps. Actually what surprised me most about that birth was the leg cramps I got while pushing :lol I didn't even feel the "ring of fire" during crowning. (although i did have a very intense sensation at my clitoris....not orgasmic, but not painful either just intense)
Highly effective non-medical techniques are available for pain managment during l&d. Heres a sampling:
Freedom of Movement: laboring and pushing and delivering in the position that is most comfortable for you will significantly reduce your pain sensations.
Freedom of movement is one of the 6 Lamaze Care Practices that supports Normal Birth http://www.lamaze.org/ChildbirthEducators/ResourcesforEducators/CarePracticePapers/FreedomofMovement/tabid/484/Default.aspx
Now for freedom of movement to be the most helpful you should familiarize yourself with common labor and delivery positions.
heres a slideshow from the mayo clinic with some ides http://www.mayoclinic.com/health/labor/PR00141
and heres some others from about.com http://pregnancy.about.com/od/laborbasics/ss/laborpositions.htm
Other pain management options include
You don't have to have a full water birth to take advantage of the pain relieving properties of water. Most hospital rooms have at least a shower if not a full tub. If a tub is available you can relax in the tub and if a shower is your only option you can let the spray hit your belly or your back and get some relief that way. This is an option you'll have to work out in advance with your dr or midwife but well worth it.
A word of caution: I have read that laboring in water can slow your labor so this is an option you may want to hold off on until you feel you need it. Of course if things seem slow you can always get out too.
I think the Bradley Method and the Hypnobirthing Methods offer a great deal of insight into the use of relaxation during labor and delivery.
i have this book at home and it has some good relaxation exercises http://www.amazon.com/Natural-Childbirth-Bradley-Way-Revised/dp/0452276594/ref=sr_1_1?ie=UTF8&s=books&qid=1247801922&sr=1-1
and if you can take a bradley class they'll do lots of practicing too http://www.bradleybirth.com/
hypnobirthing involves relaxation via a self induced state of hypnosis http://www.hypnobirthing.com/ i don't have any personal experience w/ it but lots of mamas swear by it
and of course there are plenty of stand-alone methods of relaxation.
this blog post from women giving birth naturally covers a few of the most popular
and heres a different site that gives more tips on different techniques http://www.womenshealthmatters.ca/centres/pregnancy/childbirth/relaxation.html
things like deep breathing (you don't have to learn anything complicated just in through the nose out through the mouth), progressive muscle relaxation where you tense then release muscle groups starting either at the toes, the fingers or sometimes the head/neck shoulders, visualization techniques, etc can all be useful helps to achieving a relaxed state.
okay well the kiddo wants the computer now so i guess i'll have to add more next thursday.....
some follow-up from salon http://www.salon.com/mwt/broadsheet/feature/2009/07/14/epidural_epidemic/index.html
and from london based delia lloyd http://www.politicsdaily.com/2009/07/16/no-pain-no-gain-the-value-of-epidurals-during-childbirth/
I posted rixa's reply seperately in the previous post. and she did an awesome job of collecting all the chatter. all i really have to say is trhat all the hoopla about him being a MAN is getting in the way of what he has to say. its sexist at the very least....i mean do we also question so strongly the pronouncements of other males dealing in birth such as the mostly male writers of obstetrical texts?
a study about bottle-feeding
the study basically says that women who choose to bottle feed are ignored by the medical profession and not given appropriate safety info. i ahve to say i agree with this. i bottlefed my daughter from about six weeks and did not get any safety info wrt formula feeding.
when i got my lactation counselor certification they suggested giving formula feeding classes as well as breastfeedig classes. it wasn't until i took that class that i learned formula isn't sterile for instance. and how many moms are told to add water to the bottle before powder to ensure accurate measurements? i wasn't. lucky for my daughter i knew that.
i thnik pediatricians would do well to pay attention to this study and to pay attention to their patients and parents as individuals....
dick morris makes claims that govn't is telling women to quit having cesareans
actually according to healthy people 2010 we do have a goal to reduce primary section rates from %18 in 1998 to %15 in 2010 and the repeat section rate from %72 to %63
however the site states
"(The targets presented here apply to the population as a whole and are not intended to be used as practice outcome objectives for individual physicians or institutions, as the medical needs of the patients in each practice will vary.) In addition to monitoring rates of cesarean births, the outcomes of these deliveries (for both the mother and the infant) should be watched closely to assure that changes in the mode of delivery do not put women or their infants at risk."
so section rate reduction is not being pushed in terms of a money saving strategy....thats really all i can find about obamas take on section rates....and of course these goals were crafted before obama took office anyway
anybody with more info? please comment....
and heres gloria lemays take on a letter posted on the american college of nurse midwives site http://www.glorialemay.com/blog/?p=147
i still don't know what i think about the situation. i'm an aspiring midwife. i'm currently thinking of going the cnm route rather than cpm because taht would allow me to bring the midwifery model of care to more women. if things were to change legally in this state to allow for legal recognition of cpms then i might go that route....
i do think the letter was unecessarily divisive, and i have not seen any research to support the conclusion that cpms are not qualified providers, BUT i do like the idea of a standardized education for cpms.
i don't see why apprenticeship couldn't be incorporated into that.
okay well this was kind of a lazy post but ithink its all i got for now....
this one is a mom comparing her epidural birth w/ her natural birth. guess which birth she prefered?
and that is ina may gaskin talking about birth.
i'm working backwards so the first few rounds are mostly going to be a few months back but hopefully it will become more current as i weed through.
1st up, an awesome resource http://www.nationalpartnership.org/site/PageServer the national partnership for women and families. they put out a daily report on women's health that you can sign up for here http://www.nationalpartnership.org/site/PageServer?pagename=daily2_fullreport (this link takes you to the days report, scroll all the way down to the bottom to subscribe)
and on to this article http://www.physorg.com/news157818920.html which is about the lack of consideration given to women's health in judical decisions the article is based on this study http://papers.ssrn.com/sol3/papers.cfm?abstract_id=1345824# heres a quote from the abstract:
" judges regularly -- and often inaccurately -- cite the theoretical availability of alternative reproductive health services as proof that women's health will not suffer even if a law curtailing reproductive rights is upheld. I label this the "availability tool." Second, when alternatives are not available, decisions may blame women for the lack of availability. I call this the "culpability tool." Application of the availability and culpability tools in reproductive health cases can result in a truncated analysis of how laws impact women's reproductive health. "
heres an article about egg donation and possible risks to donors http://www.time.com/time/health/article/0,8599,1888459-1,00.html heres a quick quote:
"Right now egg donors are treated like vendors, not as patients. Patients need to be followed up," says internist Jennifer Schneider, who has been advocating for the government to track egg donors since 2007, a few years after her daughter, a three-time egg donor, died of colon cancer at age 31. "After the first few days of being discharged from the IVF clinic and seeing that there were no immediate consequences, they are never contacted again."
here is an awesome blog entry about the cyclical nature of womanhood and the disservice we do ourself in not respecting our rites of passage http://redtenttempletn.blogspot.com/2009/04/women-and-depression.html
just found a new blog to keep up with. this one written by a cnm in training http://nursemidwifeintraining.blogspot.com/ go check it out ya'll
a new study shows that women feel ignorant and uninformed re pregnancy and childbirth: http://ec.europa.eu/research/headlines/news/article_09_04_03_en.html
attributes this to hospital birth and geographic mobility
ok so i guess thats it for this mondays edition....
Two-fer Tuesdays: when iwill post two awesome birth related videos
Wild Wednesdays: for whatever tangent i'm on lately
Topical Thursdays: devoted to topics in childbirth education to be covered on a rotating basis
Follow-up Fridays: when i'll catch up on reading my favorite birthy blogs and give my take on what everybody else is talking about
At Your Cervix: What you may (or may not) know about labor and birth