Sign up for our newsletter!

pregnant

Singing and Dancing My Way to Natural Birth With Pre-Eclampsia

 
IMG_5274.jpg

My heartfelt thanks for reading my story. I'm so blessed and honored that you will post my birth story on your blog and social media.  I hope and pray that this would inspire more women to try birthing naturally and perhaps encourage them also to sing and dance their way through labor! 

I was diagnosed with Pre-Eclampsia with severe features due to the extremely high amount of protein in my urine. My blood pressure remained normal, below 120/80, all throughout my labor, delivery & recovery. This is my 5th pregnancy. My first pregnancy was with twins.  The 1st twin, Annalise, was born naturally (no anesthesia, IV, oxygen, pain meds) in our church's birthing clinic.  The 2nd twin, Therese, was born via CS in a hospital. I was transferred because Therese went transverse when Annalise came out and it was Therese's hand that first came out.  My midwife put her hand back twice before transferring us to the hospital.  

In most hospitals, 24 hour monitoring is only done in the High Risk unit, so when my fluid was low, I had to be monitored for a full 24 hours before I transferred to a regular room.  I went back to the High Risk unit again for the Magnesium sulfate, to counter possible seizure or convulsions, according to my OB.  They also don't allow the natural birthing suite for high-risk cases like mine, because I already underwent Caesarean in a previous pregnancy, even though I've already had 3 VBACs.

Valentine’s Day, Thursday, Feb. 14, 2019, I was looking forward to a lovely dinner that night with my husband of 13 years, Ritche, to celebrate our 15th year of being together, when we received news that my husband’s 98-year old maternal grandmother “Lola Auring,” whom he was very close to, had just passed away peacefully in her sleep.  He regretted not being able to visit her sooner when she was still alive but looked forward to flying out from our home in Metro Manila (Philippines) to their province to be with her for the last time.  

But, first things first… I had to go to St. Luke’s Medical Center in Bonifacio Global City, for my routine 36th week checkup & ultrasound.  My OB did a Biophysical Score of our baby and told me that my fluid was low.  In my mind, I thought, “Okay, I’ll just have to drink up at home then.” But, my OB had another plan... I needed to be admitted to the High Risk Pregnancy Unit and hydrate via IV. I called Ritche and he agreed for me to be confined, thinking we’ll just stay overnight until my fluid goes up in 24 hours.  

So, aside from the IV drip, I tripled my water intake to 3 liters in the morning, 3 liters in the afternoon and 2 liters at night, which equated peeing almost every hour! AND I had to be hooked to several machines so my heart rate, blood pressure, baby’s heart rate and my contractions will be monitored for 24 hours. It was super uncomfortable but I thought, “No problem! As long as baby’s fluid will go up right away.”  We then asked our churchmates and close family & friends to pray with us.  I also prayed that I would be discharged as soon as possible so that Ritche could still travel the next day to be with Lola Auring.

IMG_4861.jpg

24 hours later, Friday afternoon, my fluid just increased a tiny bit so my OB double checked the protein-creatinine ratio in my urine. While waiting for the results, we got a regular room and waited another 24 hours.  My husband already cancelled his trip and let my mother-in-law, Mama Tess, go ahead to their home in the province.  My UPC ratio was still extremely high, which made me a candidate for severe pre-eclampsia. We couldn’t believe it.  Even my OB couldn’t believe it, either. I’ve always been careful with my diet, preferring veggies & fruits. I always made sure I had regular exercise.  My blood pressure has always been normal.  How could I have pre-eclampsia?   

We’ve been praying for Baby Abe to come out at least on his 38th week so, imagine our surprise when she advised us on Saturday afternoon that we’ll both be safer if he came out as soon as I reach my 37th week, which was the following day, Sunday!  Questions ran through my mind.  We knew 38 weeks is the ideal.  How do I induce labor?  We’ve always just waited for me to labor naturally.  With Agatha, our 5th child, we had to keep her in as long as possible.  With Abe, it seems, we now had to bring him out as soon as possible! We hadn’t even packed our hospital bag! We were just supposed to buy baby boy stuff this week!

I had my Birth Plan printed out for the doctors and nurses and went back to the High Risk unit so that I can be given magnesium sulfate to counter possible seizure/convulsions.  I was also given 4000 mg of Evening Primrose Oil every 4 hours to soften my cervix. It just seemed so foreign and unnatural to me that we had to naturally induce labor.  How do we do that?  

My husband comforted me and reminded me that we have a great and awesome God and that so many people are praying for us.  He had been diligently communicating with and updating our close friends.  My dearest friend Kartika from Singapore visited me twice. My best friend and sister, Lala and her husband, Solomon, came all the way from Carmona, Cavite, to encourage me with their love and presence.  Our dear godparents, Fr. Dino and Sis. Anj, braved the 3-hour traffic to show their support and pray with us. When they mentioned the words “total trust” and “perfect peace” in their prayers, I was inspired by the Holy Spirit to write down the alliterations the Lord revealed to me as they were born in my heart so I can meditate on them:

“Total Trust in Thee”  “Perfect Peace in the Prince of Peace”  “Sweet Surrender to My Savior”  “Calm and Courageous in Christ”  “Blissfully Blessed and Brave to Birth our Baby Boy”  “Relaxed, Rested and Ready”

Most importantly, my mother, Mama Lou, my father-in-law, Papa Adelo, and our 5 beautiful and wonderful children, gave me so much encouragement that I knew that we can bring Baby Abe out in God’s perfect timing.  The Holy Spirit will lead me and guide our baby out.

Monday, after the magnesium sulfate treatment, I had another ultrasound.  Baby’s fluid had significantly increased from 7.89 to 13!  Praise God!  We could really feel the prayers of everyone.  We were ready to induce natural labor.  My OB mentioned that Baby Abe could even be born on Thursday, which was her birthday!  But I thought to myself that I didn’t want to labor that long.  Our churchmates, Dcn. Jojo and Sis. Evelyn, brought homebaked muffins along with much laughter and prayed over us before leaving.

We finally finished my IV (Yay!) and I drank my red raspberry leaf tea, walked about our windowless room, slow danced, bounced on a birthing ball. Contractions were very mild at 3-5 minutes apart, but they weren’t “painful.”  Mama Chato, our midwife who helped me naturally birth our other children, taught us that we must reframe contractions as “good pain” because it helps bring the baby down.  The more you welcome each “good pain” and embrace the sensation, the more relaxed you will be and fear will leave you.  So, everytime I felt a contraction coming, I relaxed my facial muscles, my jaw, my shoulders and let the tightening sensation do its work on my belly. The uterus is a very powerful muscle and I looked forward to the pressure, imagining that every contraction brought Baby Abe closer to being in my arms.

The resident doctor did my first internal examination and said I’m only 2cm dilated.  Well, at least it’s not totally closed, right?  However, at 530pm, I had an unexplainable occurrence of “chills” where I suddenly felt like I was freezing.  I couldn’t stop my teeth from chattering and my body from shaking violently. My mom wrapped me in thick blankets, wore socks on me, rubbed my legs. I called my husband to hurry, as he was getting some documents for our hospital stay. I placed my cold hands in my armpits and prayed that the nurse won’t peek in and report that I’m having some kind of seizure.  The chills passed after 20 minutes.  My husband warmed me with his embrace.  However, I couldn’t sleep a wink that night.  My husband decided we transfer again to a normal room with windows so I could be more comfortable.  I searched online “how to dilate cervix fast” and visualized my cervix opening and prayed constantly to the Lord to give me thoughts of peace and not anxiety.  The baby knows when to be born.

Tuesday, I had a prenatal massage to relax and press those labor-inducing points, drank more red raspberry leaf tea, bounced on the ball and did more than walking, I did some dancing, too!  Contractions were still mild at 3-5 minutes apart. I had another bout of “chills” at 530pm so my mother wrapped me again and I rebuked every thought of convulsion or seizure.  I kept telling myself that this will pass and Baby Abe is safe in my womb. The chills stopped at 6pm. By 8pm, I was so tired from the lack of sleep that I was able to sleep very well, even with the regular rhythm of my belly tightening.  We continued to entrust everything into the Father’s hands. 

The next day, Wednesday, February 20, I was determined to up my natural induction techniques.  My OB was pleased with the progress of my labor but reminded me not to wait until my water broke.  She reminded me to let her residents know when I’m already 4cm dilated, because I gave birth so quickly to our last child, she almost didn’t make it.  

My Mama Lou and I danced belly, hip hop, Zumba to the jiggiest songs I could find (Think “Trolls” soundtrack, “Walking on Sunshine” “Moves Like Jagger” “Waka Waka” you get the picture) and I sang my heart out to our Hillsong & Bethel favorites (Oceans, What a Beautiful Name, O Praise the Name, Open Heaven/River Wild, It Is Well, No Longer Slaves, etc.) when I rested. The doctors and nurses were amazed I could still sing and dance through my contractions.  Haha!  It actually took my mind away from the pressure.  By 530pm, I thought my water was leaking so I called a resident to examine me.  No water, just the EvePrim Oil melting but I was 3-4cm dilated.  Yay! She then asked me to go down to continue laboring in the High Risk unit.   Labor progressed very quickly and I did feel more and more pressure every minute!  

Shout out to the doctors and nurses of St. Luke’s BGC for honoring my Birth Plan as much as possible and I agreed that I will only be hooked to the monitor for 20-30 mins every 2 hours.. No pitocin, no IV, no oxygen and no pain meds.  By 8pm, I was 5cm dilated.  Hooray! That pushed me to do even more dancing, bouncing, marching, swaying & singing during contractions, with my husband playing every song I requested.  The pressure was already immense at this time, and I had a tugging feeling I was very close to transition, although it’s only been a couple of hours.  I was thankful that my husband was just right there to tell me I’m doing great, and my mother was also with us, cheering me on.  Whenever I felt the tremendous pressure, I would say, “Baby’s going down, down, down!  Yes, yes, yes! Go, go, go!” and I knew that they both agreed with me and believed with me.  

I was already speaking in tongues, asking the Holy Spirit to be my Comforter, my Teacher, my Guide.  I envisioned Mama Mary giving birth to our Lord and Savior Jesus Christ.  I remembered all our children who are happily awaiting their baby brother at home. They’re counting on me to give birth to Baby Abe soon.  I wanted to birth this beautiful being in my womb without fear, only love and joy and peace... Feelings of indescribable bliss welled up in my heart for this boy whom Ritche and I had so conceived in love.  I was determined to confidently bring him out in that same love that conceived him. 

At 1030pm, I asked the resident to check my cervix, which had already dilated to 7cm, with a “bursting” effacement.  I had to be strapped again so I lay down waiting for the nurse when, a minute after, the nurse relays the message from the doctor to tell them right away if my water bag ruptures. She hadn’t left the room yet when my water bag burst!  It felt like a water balloon popped out of me. 

I excitedly told everyone, “Baby’s coming out!”

 They wheeled me out our room into the delivery room right away.  I felt the head of Baby Abe crowning.. I thought I couldn’t hold him in anymore.. but I tried to relax, as the doctors were still preparing, I had to be moved from my bed to the delivery bed and my husband, Ritche, was also getting into scrubs. I requested that I be more upright and not lying down.  Our OB was nowhere to be found but already gave instructions to her three resident OBs present in the room.  I already felt like pushing but was holding Baby Abe in.. I was so excited.. I called my husband.. “Daddy!” and told the nurse, “The cellphone!” Haha!  I didn’t want the nurse to miss taking Daddy Ritche’s picture catching Baby Abe.

IMG_4982.jpg

Finally, it was only a matter of minutes before I told them I had to push Baby’s head out.  The doctors assured me and said they won’t hinder me from pushing.  His head came out and the doctor was wise enough to remind me not to push anymore because he slid out so easily! It’s a birth phenomenon they call the “Fetal Ejection Reflex.” Pushing would have made the baby fly out.. Haha! It was amazing to see my husband “catching” our son!  As with all our other children (except Therese who underwent emergency CS), he did the ceremonial cord cutting after the cord stopped pulsating.  Baby Abe had already pooped meconium but miraculously, he didn’t ingest any and his Apgar score was 9 out of 10.  Thank God!

I delivered the placenta within 5 minutes. And our OB, Dra. Bambalan, arrived moments after to check on me.  Everything looked good.  My blood pressure stayed normal all throughout. I had a 1 mm tear that didn’t need any stitching. 

They were amazed at how easy the birth was and how fresh I still looked even after giving birth.  We all laughed at how my primary concern was to get the cellphone to the nurse and how Baby Abe didn’t want to have the same birthday as Doc.  Everyone in the room was lighthearted and Dr. De Guzman exclaimed that this was one delivery she will never ever forget!

IMG_4981.JPG
Chat & Baby Abe Selfie 1.jpg

All in all, we stayed in the delivery room for 18 minutes then I was brought out to the Recovery Room for 4 hours to check on Baby Abe and me.  By the end of the recovery period, my BP was still stable, Baby Abe and I had skin to skin contact and he latched on the breast perfectly, but there was just one problem.  The nurse said that they’d have to put a catheter on me if I didn’t urinate soon. No way!  I gently pressed on my bladder and, sure enough, I was able to pee on my own.

IMG_4984.JPG

The next 48 hours were critical for me and Baby Abe. I recently saw the diagnosis of my OB upon discharge.  It was Pre-eclampsia with Severe Features.  But, thank God, we never manifested any complications.  No headache, nausea, vomiting, seizure, swelling, convulsion, shortness of breath whatsoever.  My blood pressure never elevated all throughout.  Baby’s oxygen levels were stable.  I didn’t go into shock, stroke, had brain damage or any organ failure. I didn’t need any kind of pain medication.  

Within 48 hours of delivery, we went home to our family, carrying our 6thbundle of joy, our second boy, whom we named "Abraham Nickola."  So thankful to all our family, relatives, friends, and churchmates for keeping us in your thoughts and lifting us up in prayer.  I believe that Ritche’s grandmother, Lola Auring, was also looking down from Heaven and interceding for us, along with all the saints and angels. To God be all the glory, honor and praise!  He is a miracle-working God who faithfully keeps all His promises and grants us the desires of our hearts!

Adam & Abe 1.jpg
Lois, Adam & Abe 1.jpg
Agatha & Abe 1.jpg
Therese & Abe 1.jpg
IMG_4804.jpg
Mama Lou & 6 Grandkids 1.jpg
IMG_4909.jpg
IMG_4386.JPG

By: Chat Jandayan @chatjandayan

Most of the photos were taken by my husband and my mom.

This is why excellent childbirth education is a must, why planning for your birth and the unexpected challenges that can arise, is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years.

It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  

Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want - so you can ROCK your birth, however it unfolds!

It’s wonderful alone, a great refresher or adjunct to any other course!

 

WHAT TO DO WHEN YOUR BABY IS BREECH OR TRANSVERSE

WHAT TO DO WHEN YOUR BABY IS BREECH OR TRANSVERSE

Art by Catie Atkinson @spiritysol

Preparing for Pregnancy

 

There are so many things to consider when preparing for pregnancy

baby-birth-born-41167.jpg

Every momma wants to give her baby the best possible start in life. Preparing for pregnancy will enhance your own health for fertility success, and set yourself up to provide a healthy environment for your baby.

But, where do you start? Taking a natural, holistic approach to preparing for pregnancy includes optimizing your diet, supplements, physical movement and state-of-mind. This is a less invasive, less expensive, and much healthier approach for both momma and baby before even considering the standard fertility treatments.

Eating for a Healthy Pregnancy

avocado-1838785_1920.jpg

When preparing for pregnancy, it’s best to eat a wide variety of fresh, whole, plant-based foods and adequate protein. Your plate should be beautiful and colorful with plenty of varied vegetables, fruits, whole grains, beans, some nuts and seeds, seasoned with fresh herbs and spices. Look for:

  • Organic. Free of chemical fertilizers and pesticides that can damage fetal development, this is the best option for produce. Use the Dirty Dozen as a basic guide. These foods are to be either eaten organic or avoided.

  • Local. Choosing local typically means the food is at the peak of freshness, grown in your locality, maintaining more nutritional integrity.

  • Colorful. The various colors of fruits and vegetable provides differing nutrients. Make sure you’re eating a full spectrum of color to get a well-rounded diet.

  • Unprocessed. Chemical additives, preservatives, artificial sweeteners, food coloring and genetic modification can all negatively affect your health and your baby’s. If it comes in packaging, it’s probably not the best option.

  • Sugar-free. Sugar is damaging to you and your baby’s cells, and disrupts gut flora; it negatively impacts your pregnancy, and how you feel physically and emotionally. Sugar is found in almost all processed food. Look out for marketing tricks, like using four or five different types of sweeteners so manufacturers don’t have to list it as the first ingredient. Stick with natural sugars like in fruit, and if you must add a sweetener, a tad of pure raw honey or maple syrup is better.

  • Gluten-Free &/or Dairy-Free. Most women feel best when they are gluten-free. Try removing it from your diet for a week and see if you feel better in your mind and body, gain more energy or clarity. Many also feel better off cow dairy, but tolerate goat or sheep dairy products. Try a different week without it and note how you feel.

  • Hormone & Antibiotic-Free. Whenever possible, select the highest-quality organic meats and animal products, including wild fish from non polluted waters. If the animal food you’re eating was treated with hormones and antibiotics, your body and baby will be affected by that. And consider that most farm animals are fed genetically modified (GMO) corn and feed that is highly sprayed with pesticides. Animals who are free to move in the sunshine and graze in the green pastures, as they did for thousands of years before the modernization of the farming industry, produce the healthiest meat, diary and eggs for human consumption.

  • Healthy fats. Your body needs plenty of high-quality fat, especially when preparing for pregnancy. Ideally, you should be eating wild Alaskan or Norwegian salmon at least twice per week as well as healthy oils. Use extra virgin olive oil on cold foods (like for salad dressing) and light sautéing, and coconut oil or organic grass-fed butter for cooking at higher temperatures.

  • Hydration. Don’t forget to drink plenty of fresh spring or filtered water throughout the day. Work your way up to half your body weight in ounces. For example, if you weigh 150 pounds drink 75 ounces of water daily.

Preparing for Pregnancy with Supplements

In a perfect world, we would get all the nutrients we need from our food. But, with today’s industrialization of food and depleted soils, that has become virtually impossible. Additionally, the standard American diet is really empty of needed nutrition and even those of us with the best intentions do not eat all of what is needed for the health of ourselves or our pregnancies. The supplements you need when preparing for pregnancy will depend on your specific situation. Chat with me to find the best supplements for your body.

However, there are a few supplements that every woman should take daily. I take them myself and recommend them to all my clients. Following this supplement protocol has blessed me with feeling wonderfully vital and rarely getting sick - even when a bug is going around my house.

So what’s my supplement magic? I take whole food organic supplements from trusted, high quality, professional grade companies, including:

  • A multivitamin/mineral combination

  • Methylated folate in B complex

  • Calcium, magnesium, and D complex

  • Omega three fatty acids

  • Herbal iron depending on your iron stores

  • Mega-Probiotics that are colon and urogenital specific for women

adult-daylight-exercise-1533886.jpg

My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple by category (listed in the prenatal section), and the products will be shipped directly to your home or work within a few days.

For more details on food and supplements for pregnancy check out my Natural Birth Secrets book, and in even greater depth, my online course.

Exercise for a Healthy Pregnancy and Beyond

Movement is another important aspect of preparing for pregnancy. Not only will a strong, agile and flexible body provide a safer prenatal home for baby, it will help you avoid aches and pains along the way, reduce inner stress, help in labor and even postpartum recovery. The right exercise can also get your body ready to ease your baby into a perfect birthing position.

Ultimately, the best exercise is that which you enjoy, so you stick with it. Vary activities that you love, and incorporate it into your life so it doesn’t feel stressful. Here are some types of movement to consider:

  • Walking. This is a great place to start if you’re someone who currently isn’t getting much exercise. Begin with a leisurely 15-minute walk every day, and build up to 45-60 minutes at a faster pace.

  • Yoga. Yoga will not only strengthen your body and make you more flexible, it’s been known to decrease stress and enhance your overall well-being as well. There are tremendous health benefits to regular yoga practice. There are even fertility yoga classes out there, designed with just this topic in mind! I teach private yoga classes, including yoga workshops for pregnancy and labor, as well as postpartum - which can be done locally or on Skype.

  • Dance. Dancing is such a great way to keep healthy and active! It is so much fun, and is a direct path to feeling awesome without realizing you are also getting a fabulous workout. It relieves stress, helps you feel and move emotions, and creates happy for you, and for your baby; your stress hormones as well as your happy love hormones pass through the placenta to baby....and both are contagious to those around you. Dancing also helps you tap into your sensual or sassy sexy, which is beneficial in pregnancy, labor and life! Dancing in labor uses gravity and asymmetrical movements to ease baby down and out through a wider birth canal. Start by taking dance classes, but you can also just turn on the music regularly and dance like no one is watching. I give group and private healing movement workshops - called Femme!, which is a wonderful experience for both men and women.

  • Weight-training. If you are not called to yoga or dance, back, arm, leg and core exercises help align your body and are great preparation for the uneven weight of pregnancy. Squatting helps prepare for delivery.

  • Pilates. Pilates has a strong emphasis on core conditioning and is also great for mommas-to-be.

  • Swim. It gets you outside, connected to nature and immersed in healing waters that soothes the soul. Swimming and water aerobics are also great ways to be active. In advancing pregnancy, it relieves common aches and discomforts, and pregnant women love the sense of weightlessness they feel in water.

If you’re someone who currently has an intense workout regimen and are having trouble conceiving, consider dialing it back to a lower intensity. Otherwise, moderately moving your body and being active each day is the way to go.

Tapping into Mindfulness and Joy

zumba-2382200_1920.jpg

Reducing inner stress and living in joy are central to preparing for pregnancy. Inner stress can actually prevent pregnancy. Many of us recognize that we have grown out of alignment with our true natural being and it's time to get back to our original design.... get back in touch with the cyclic nature of our human bodies, our minds, our hearts and our spirits. The thoughts we think and the perspective we carry while preparing for pregnancy are incredibly influential.

Find ways to slow down, unplug and enjoy the journey. Make sure you are well rested, and getting 7-8 hours of sleep each night. Practice saying “no” to anything that doesn’t bring you calm and pleasure during this time. Explore ways to bring joy back into the things that aren’t optional. Stay as much as possible in the present moment, one moment, one breath at a time; practicing mindfulness - anchoring into what is going on around you and the sensations within you in the now transforms your life and will benefit your labor immensely. Consider a daily practice of mediation, journaling, and creating any form of art to help your body keep in a calm and joyful state. Decide to live a glorious life; dress and treat yourself like the goddess you are. Focus on what you have to be grateful for and all the blessings in your life. Connect more in community with those you love, and those who inspire you. Clear your body of trapped emotional pain, trauma and internal stress, and transform self limiting beliefs and thought patterns with Clarity Breathwork. Turn negative thoughts into positive affirmations, for example: My body is strong and healthy for pregnancy or I am the perfect age to become a mother; empowering uplifting thoughts are usually the opposite of, and more true than the false stories we typically tell ourselves.

smile-1485850_1920.jpg

Acupuncture is a great way to relax and has the added bonus of hormone regulation and improved ovarian function. Many women who had some initial trouble conceiving often get pregnant after receiving acupuncture by a practitioner with expertise in fertility; I have seen it used in conjunction with routine infertility treatments, and have seen successful pregnancies even after several IVF attempts failed.

We’ve discussed a lot of lifestyle factors here. Some might be big changes for you. Don’t let them overwhelm you. I’m a huge fan of the 80-20 rule. Spend 80% of your efforts on achieving optimal habits and allow yourself the freedom to enjoy the other 20% without guilt.

Fertility Awareness

sperm-806391_1920.jpg

Learn the signs of fertility so you can make sure you have intercourse during the small window of time when you are likely to conceive, you get the most accurate estimation of pregnancy dating, and you will even know when you are pregnant before you can take a pregnancy test. This is key, and will also provide helpful information as to causes of difficulties should you need professional guidance. I cover this in more detail in my Natural Birth Secrets book.

For further inspiration and optimal health during, birth and after pregnancy, please make sure to click here to take my online Love Your Birth course, so you can ROCK your journey wherever and however you plan to give birth.

 

RhoGam Shot in Pregnancy

 

Risks and Benefits of RhoGAM

adult-bed-bedroom-590487.jpg

Many expecting parents have questions about whether or not to get the Rh immune globulin (RhoGAM) shot if the momma to-be is Rh-negative. This applies to a small number of women, but it is extremely important for them to be armed with all the information prior to making a decision.

If you are among the roughly 10 - 15% of people who are Rh negative, your pregnancy could be affected if your baby is Rh positive.  In this situation, obstetric providers often recommend RhoGAM.


However, it’s not always that simple. If you’re not sure you have all the information for an informed decision, you’re in the right place. Below are some frequently asked questions and points to consider.

What is the Rh factor?

The Rh factor is a protein that can be found on the surface of red blood cells. If your blood cells have this protein, you are Rh positive. If they do not have this protein, you are Rh negative. This is the negative or positive after your blood type: A, B, O or AB. It is simply about different normal variations in red blood cells. For example, you can be A positive or O negative. The negative or positive is your Rh factor. A pregnant woman will get a blood type, Rh and antibody screen as part of the routine prenatal blood tests; if she is Rh-negative, her antibody response will get tested several times as indicated throughout the pregnancy to check for Rh sensitization.

What is Rh incompatibility and sensitization?

Rh incompatibility is when the blood of a fetus is Rh-positive but the momma’s is Rh-negative. In this situation, if baby’s blood gets into mom’s bloodstream, the mother creates a defense system against the different type of blood; it is perceived as foreign by her body, even though it belongs to her baby. She will react against it by making anti-Rh antibodies. When a pregnant mother makes antibodies against the Rh factor on her baby’s red blood cells, it is called sensitization. Once a mom is sensitized, it stays with her forever.

This rarely causes complications in a first pregnancy, as the primary immune response takes time to develop and initially produces IgM antibodies that are too large to cross the placenta. However, it could be dangerous in future pregnancies for the fetus or newborn baby, when the secondary immune response is more rapid and the body has made smaller IgG antibodies that easily cross the placenta. Once these antibodies can cross the placenta, they try to destroy the fetus’s red blood cells.

blood-1813410_1920.jpg

How can Rh problems affect the fetus during subsequent pregnancies?  

Rh sensitization can lead to a wide variety of mild to serious health issues in a fetus or newborn of the next pregnancy. The main concern is a severe type of anemia in the fetus, in which red blood cells are destroyed faster than baby can replace them. Red blood cells carry oxygen to all parts of the body. Without sufficient red blood cells, the fetus will not get enough oxygen, and this can result in hemolytic disease of the fetus and newborn causing jaundice, brain damage, heart failure and death.

How can my fetus’s blood get into my bloodstream?

During healthy pregnancy, a mom and her fetus usually do not share blood, thanks to the placenta that keeps the fetal and maternal blood circulation separate. But sometimes a small amount of blood from the fetus can mix with the mother’s blood. Typically, there is no mixing sufficient enough to risk sensitization unless there is are complications like miscarriage, placental abruption or previa, abdominal trauma, or an invasive medical/surgical procedure like chorionic villus sampling or amniocentesis, abdominal surgery and even ultrasound. 

Sensitization is usually associated with a rapid and large volume of fetal-maternal blood mixing. The most common time for Rh-positive fetal red blood cells to enter mother’s bloodstream, is during childbirth, though it can occur at other points during pregnancy - mainly in the third trimester.

Traumatic and difficult births with a high level of invasive procedures increase the likelihood for baby’s blood to mix with mom’s. So can certain routine interventions including use of the synthetic drug Pitocin to induce or augment labor, local or regional anesthesia, forced directed pushing, clamping the umbilical cord too early, pulling on the cord and putting pressure on the fundus to hasten delivery of the placenta.

A gentle birth process with minimal intervention and time allowance for the placenta to separate provides a reduced risk of significant mixing of blood between mother and baby.

While not a guarantee, planning for a natural undisturbed physiologic pregnancy and birth may certainly help prevent the mixing of fetal and maternal blood that leads to sensitization and hemolytic disease.

Can you tell if the baby is Rh-positive?

There is a new noninvasive blood test, which can detect fetal blood type using a blood sample of the pregnant mom. It is said to be highly accurate, almost as reliable as the conventional test, that uses a blood sample of the newborn after birth. It is almost, but not 100% accurate; and it is not available everywhere or covered by all insurances.

I recommend dad getting his blood type and Rh factor tested. If the father is Rh-positive and the mother is Rh-negative, there is about a 75% chance baby is Rh-positive, and providers will probably recommend RhoGAM. But if both parents are Rh-negative, baby will also be Rh-negative; in that case, there is no risk of Rh sensitization, and no need for RhoGAM.

What is RhoGAM?

RhoGAM is a drug made from human blood plasma, that prevents the mother from making antibodies against the positive Rh factor in baby’s blood. It is given via intramuscular injection, to prevent the immune response of sensitization against baby’s Rh positive blood, and subsequent hemolytic disease of the fetus or newborn in future pregnancies.

 
What are the benefits of RhoGAM?


RhoGAM’s effectiveness has been demonstrated in multiple studies around the globe. According to Dr. Murray Enkin et.al of A Guide To Effective Care in Pregnancy and Childbirth , one of the widely respected and authoritative founders of evidence based care, RhoGAM given after birth reduces the rate of hemolytic disease from 15% down to 1.6%.  RhoGAM administration prenatally in the third trimester has been shown in studies to further decrease the incidence to 0.06%.

The administration of RhoGAM medication to Rh-negative mothers is thought to be a major achievement of modern obstetrics by many in the medical profession. Before RhoGam’s introduction into routine practice in the 1970s, hemolytic disease of the newborn was a major cause of serious illness, death and long term disability in babies.

RhoGAM does not typically benefit firstborn babies unless the mom who is Rh negative has previously experienced a reaction to a mismatched blood transfusion, an abortion, miscarriage or ectopic pregnancy untreated with RhoGam.  

antibiotic-black-and-white-bw-1537009.jpg

When is RhoGAM recommended, and why?

For women who are Rh-negative, health care providers routinely recommend a shot of RhoGAM around 28 weeks of pregnancy and then again within 72 hours after birth, in order to protect the baby of a subsequent pregnancy.

Providers must decide about the RhoGAM shot and its dose based on how likely it is for the baby to have Rh-positive blood, as well as how likely it is for the baby and mother’s blood to significantly mix during pregnancy and birth.

Is there controversy around RhoGAM?

This standard approach is not without its critics, especially regarding its routine use during pregnancy, in which only about 1.5% of Rh negative moms with Rh positive fetuses develop antibodies and become sensitized against the baby’s positive Rh factor. Risk of sensitization is significantly higher after birth. Administration of RhoGAM postpartum is much less controversial, where benefits of the medication more clearly outweigh potential risks.

“The problem with routine prescription of prenatal RhoGAM is that many babies who are Rh negative like their mothers will be exposed to the drug, and there has been no systematic study of the long term effects of this product in babies.” - Ina May Gaskin

 “RhIG is not given for the direct benefit of the recipient or even her current fetus. The only beneficiary will be an RhD-positive fetus during a subsequent pregnancy (although the woman would also benefit in the event of a wrongly typed transfusion during the time of birth). Furthermore, prenatal prophylaxis unnecessarily exposes the 35% of fetuses who are RhD-negative to RhIG. These babies are at no risk of RhD sensitization. RhIG is completely unnecessary when a baby is the last child in the family. In the absence of clear answers to these pressing questions, the routine use of RhIG assumes that the birth process for RhD-negative women is inherently flawed.” - Anne Frye

Reliable research and meta analysis of the studies on benefit and harm of routine use of RhoGam in pregnancy are still limited, especially as it relates to who, when and which dose is needed, as well as its cost effectiveness.

Some argue that there may be other factors that contributed to the marked decline in severity and prevalence of perinatal morbidity and mortality associated with Rh incompatibility and sensitization, and medicating healthy pregnant women undermines those who trust the inherent wisdom in the natural process of childbearing. That being said, the issue remains an issue which, still today, impacts babies of pregnant women who are Rh negative.

What are the risks of RhoGAM?

Despite excellent results, the medication retains an FDA Pregnancy Category C: “Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.”

The known possible side-effects to RhoGAM include local swelling inflammation at the site, skin rash, body aches and sometimes hives. Infection from the blood product of modern preparation is rare, but still a possibility.

Expecting mommas should also keep in mind that standard RhoGAM preparation in many countries contains the mercury compound known as thimerosal, which has a litany of health risks.  However, pregnant mommas can request the use the mercury-free RhoGAM, if it is available where they live. In the United States, RhoGam is said to be mercury-free, although it may still contain traces.

So, is the RhoGAM shot absolutely necessary during pregnancy? 

baby-668235_1920.jpg

This is a hard question to answer for each individual person, on a blog.  Although much of the research is compelling, it is dated, was largely funded by the pharmaceutical companies and it is not without bias, flaws and some conflicting conclusions. For an eye opening text analysis of the data though 2001 and guidance from a traditional midwifery perspective, check out “Anti-D in Midwifery: Panacea or Paradox? 2nd Edition”, by Sara Wickham.

As always, pregnant mommas should empower themselves with knowledge and talk with their provider to fully understand the benefits and risks of all medications unique to their situation. 

I encourage my clients to take great care of themselves, be well-educated on their health-related issues, and to be in tune with their bodies.  While I aspire to provide evidence based information about medications and recommended treatments, I also know that there is much we do not know, and I am wary of routine medical and surgical interventions in a healthy natural process Too often they are widely used before sufficiently evaluated or harm has been identified. I feel informed and empowered moms are best able to make decisions for themselves.

Understanding that the vast majority of woman who are Rh-negative will not become sensitized during pregnancy, as it is rare that mixing happens until birth, is an important consideration when balancing the risks and benefits of using a pharmaceutical therapy while pregnant.

If you are Rh-negative and baby’s dad is Rh-negative, no, you do not need the shot. If baby’s dad is Rh-positive, and you choose to refuse the shot in pregnancy, you may still need it later if you suspect bleeding or another reason for sensitization, or if you change your mind. If you have done your research, you believe you are low-risk, and you do not feel comfortable with the shot while pregnant, do not let a provider pressure you. 

According to those who advocate a gentle birth process with minimal intervention and time allowance for the placenta to separate, there is usually less risk of significant mixing of blood between mother and baby. But mixing and sensitization can certainly still occur during healthy natural birthing. Traumatic, highly interventive and difficult births increase the likelihood for fetomaternal hemorrhage and sensitization. So can certain routine interventions including ultrasound, use of the synthetic drug Pitocin to induce or augment labor, local or regional anesthesia, forced directed pushing, clamping the umbilical cord too early, pulling on the cord and putting pressure on the fundus to hasten delivery of the placenta - anything that possibly disrupts the delicate physiology of placental separation or cause tiny fetal blood vessels to rupture and bleed. Planning for a natural undisturbed physiologic birth may certainly help prevent the mixing of fetal and maternal blood that leads to sensitization and hemolytic disease.

If you are feeling overwhelmed, or do not even know what questions to ask, I can help you! Check out my number one international best selling book Natural Birth Secrets and my online course - an online version of how I have helped thousands in my local practice. Both resources are unique, but each provide an in depth, one-of-a-kind holistic approach created by me, a seasoned nurse midwife of over two decades, who has seen everything!

ao-dai-1491063_1920.jpg

If you need more personalized guidance and help navigating these and other tough decisions, you can arrange a consultation with me, bundled with my online course. Or I invite you to choose from a variety of services I offer to the global community. Rock Your Journey To Motherhood is my most comprehensive, supportive offering for pregnant mommas anywhere in the world.  You will have personal access and guidance from me as we co-create your joyful journey from pregnancy to postpartum healthy bliss.

 

Birth Story of Redemption

 

“Redemption: Koen James

Stalking your Instagram and drooling over all things Birth!

Screen Shot 2018-12-05 at 5.37.03 PM.png

I wanted to share my story:

After experiencing a hospital birth and an at home intervention free birth I have such a deeper connection with my body and the things it is capable of. I find myself being in complete awe over what the woman’s body can accomplish by watching, scrolling, and reading stories into the wee hours into the early morning. An indescribable feeling.

Those who attended the birth of my first born would tell you it was unforgettable in the worst of ways. Two years ago, I was riding passenger on the way to the hospital to be induced. My husband and I discussed during our drive how delighted we were for our lives to change to a family of three to avoid the anxiety we felt. After a short ride we arrived to small talk and routine work: readying IV's, retrieving a catheter, sterilizing the area, the whole nine. Luckily I was contracting on my own the use of pitocin was unnecessary and went directly to breaking my water. Before leaving my room my doctor quickly questioned me about the need of an epidural. Although my pain was fear driven, I was young and naive, I insisted.

Screen Shot 2018-12-05 at 5.37.15 PM.png

Seconds after receiving the epidural I was reaping it's effects. I became so nauseated I couldn't bare to speak. I was begging for relief as they injected a dose of phenergan into my IV. Little did anyone know I was severely allergic to the medicine. I couldn't see. I couldn't talk. I began to black out. I woke up for a split second patting my chest in hopes to convey something was wrong. My nurse was frustrated unaware of the situation she got two inches from my face yelling "USE YOUR WORDS" repeatedly. All I could do was grab her arm with a frail grip before passing out again. My condition was worsening when I awoke for a second time. I remember looking up to my husband holding my hand, telling me it would be okay, as he began to tear. Everyone was being rushed out of the room as a team of doctors scrambled through the door. I didn't know it but my heart rate was dropping.

 Awake for a third and final time, it was over but now it was time to push. I was exhausted and still confused, I thought the oxygen they had me on was their attempt to put me to sleep. In between surges, with what little energy I had left, I was fighting to remove the mask. Two hours of nodding in and out, I remember asking if it was almost over. Anything that could have gone wrong, did. I was ready to be holding our baby boy. A tiny six pounds and twelve ounces, he was finally here. Relieved we're both okay, I still look back and break a little inside unable to recall the birth of my first child. 

Screen Shot 2018-12-05 at 5.37.32 PM.png

Once we became pregnant for the second time we knew, wherever we delivered, we would not opt for any interventions. It wasn't until the third trimester we started weighing out our options of where we would welcome our newest addition. I knew I didn't want to be in the same environment I was with my first, scarred from the experience we lived previously. It wasn't until then we discussed a home birth. No pokes and pricks, being in the comfort of home, I wouldn't have to find a sitter for our son, it appeared to be a dream. This is what I wanted. 

It was a day after my due date when my water broke as I was laying our son down for a nap. I immediately alerted my midwife, Rebekah, who was attending a birth of another mother. I then called out to my husband and informed him we would have a baby soon. We went about the rest of our day normally, trying to do the odds and ends in order to prep our house for birth. I continuously encouraged my husband to get as much rest as possible before going to bed myself.  

I was filled with mixed emotions as I attempted to close my eyes. Although this was my second birth it was very much my first. I didn't know what to expect as I had no previous experience other than reading what I could online. I woke up early Sunday morning with consistent contractions. I began timing them before I carefully crept out of bed trying not disrupt our son to go wake my husband on the couch. I could tell he had gotten little to no sleep. As I started to explain I needed his help timing my contractions he told me he didn't go to bed until five that morning.. it was three. Nodding in and out we averaged my contractions two minutes apart while lasting thirty five seconds. 

Keeping my midwife updated she decided it was time to head my way. They arrived just as the sun was making an appearance through the trees. She had brought along some back up, Paige a student midwife, as the rest of her team was still with laboring mother before me. As we got aquatinted my contractions stayed two minutes apart while lengthing in time. I was checked at five centimeters when Rebekah asked if I felt comfortable with her leaving to attend her previous engagement. I gave her the thumbs up as I tried to get comfortable for the labor ahead. 

Screen Shot 2018-12-05 at 5.37.47 PM.png

I was stretched across the couch when Paige encouraged me to get into a more baby friendly position to help descend him further into the birth canal. I put a pillow under each knee and squatted down while leaning over the seat cushions. I could feel my contractions intensifying as I was overcome by intolerable back pain. My husband would try massage me while Paige squeezed my hips, but it was doing more harm than good. I couldn't be touched. All I wanted to do was lay down. 

I crawled back up on the couch surrounding myself with pillows in every direction to give my body some ease. With each wave I would reach out to my husband and pull on his shirt until it passed. I had been laboring in the living room for a short couple of hours, since my midwives arrived, when I decided I wanted to try a new method of comfort and relax in a hot bath. Before stepping into the water, Paige checked me in between six and seven centimeters. She called Rebekah to inform her of my progression. Minutes away from reaching her destination she asked if she needed to turn around. Since my dilation appeared slow Rebekah continued on her drive.

My son was still asleep in the room next to me when I got into the bath. I immediately turned on the cold water. I was refreshed with the cooling sensation through the marathon my body was running. At this time my contractions were now a minute or more long. The pain I felt in my back had me paralyzed. I could do nothing but scream. I managed to wake our son from the howls I released through each surge. As much as I wanted him there I knew I couldn't comfort him like he wanted me to, so we quickly called for reinforcements. My husband attended to his side while Paige poured water over my forty week belly and reminded me that I could do this. I wasn't in the tub for ten minutes when I told her I needed to push. No one was expecting me progress the way I had. She asked me slightly confused "You need to push or feel like you want to push?" I shouted "HES HERE". 

Screen Shot 2018-12-05 at 5.38.17 PM.png

Before getting up to notify Rebekah, she wanted me to promise I wouldn't push. I knew it was no promise I could keep. Our son's ride arrived relieving my husband back to his former duty of being by my side. I had one more contraction in the tub when I demanded we make a run for it. I was caught in the hallway by another surge before reaching the couch. Rebekah was too far away. She would never make it back in time. It was just the three of us. With Rebekah absent, my husband and Paige rushed to get everything ready for the arrival of our newest baby boy.

I was already pushing as I watched them grab the rest of the necessities. I beared down against Paige who was positioned at my feet. Through all the pain I had felt that morning I was at such peace while pushing. With two more thrusts he was here. I lifted him up to my chest and rubbed my fingers across his face. He had the most perfectly round head and that beautiful burgundy after birth color. My husband cut the cord while I took everything in that I had missed the first time. I finally got the birth I had been longing for. I thanked my body for overcoming my mind and showing me what I was truly capable of.

I questioned myself on if I should write my story when I was reminded, I gave birth at home, after a traumatizing first experience, without any interventions, and that itself is a success. I could and I did and this time I remembered. 

@shelbylclowers’’ 

Screen Shot 2018-12-05 at 5.38.41 PM.png
 
Screen Shot 2018-12-05 at 5.38.54 PM.png
 

Was your birth upsetting or traumatic? Do you have more questions about processing your birth and need help healing? Arrange some time to chat with me. I’d love to answer your questions and help you heal and get yourself back - I have a program specifically got you, that can also include this revolutionary and last natural healing modality called Clarity Breathwork.  Helping women heal from birth trauma is one of my passions and areas of expertise. So is preventing it in the first place.

This is why excellent childbirth education is a must, why planning for your birth is so important today, and is a major reason why I created my Love Your Birth course. It is a comprehensive online course that teaches women what they need to know about planning and carrying out the birth that they want in all settings - the hospital, birthing center or at home. It’s a course on how to have a holistic, healthy pregnancy for the body, mind, and soul - and is how I have guided thousands of women and their families in my midwifery practice for over 21 years. It contains a rolodex of my favorite resources with over 200 of the best books, movies and supplies I use personally and professionally with my clients, family & friends. Even diving into a fraction of this list will have you feeling empowered and prepared for conception, pregnancy, postpartum and parenting...It includes resources on improving and even ensuring ensuring healthier pregnancy and birth outcomes than the status quo, and preventing and healing from birth trauma so prevalent in the modern world!  Be prepared to do some research on your own, but knowledge restores your power. I also help you prepare your mindset for such a task, to debunk myths, and to reframe any current ideas or conditioning about pregnancy and birth that can use a change in perspective or that are simply incorrect and do serve you. After finishing the course, the idea is that you are now able to create and have the healthy, beautiful and empowering pregnancy and birth that you want - so you can ROCK your birth! It is a course that is recommended by doctors, midwives, and other professionals around the globe!

You can get a free nugget from my course - all about creating your ideal birth plan here. A huge part of preventing birth trauma is getting clear your birth preferences, knowing the pros and cons about all the tests and procedures, all the interventions your may be faced with, so you can make informed decisions - rather than simply give over your body, your choice and voice to your health care providers and institution you choose.