The Journey of Becoming a Mother

Nature intends that the physical and hormonal changes of pregnancy insure the growth and development not just of the baby but of the mother. The physical and emotional changes of pregnancy and, then, labor, birth, and breastfeeding play vital roles in guiding women on the journey of becoming a mother. Standard prenatal care and medicalized labor and birth interfere in powerful ways with nature''s plan and, consequently, women''s ability to negotiate this journey. In this column, these issues are explored, and implications for childbirth education are discussed.     

Teaching normal birth interactively

IN THIS COLUMN, THE AUTHOR PROVIDES EXAMPLES OF TEACHING STRATEGIES THAT CHILDBIRTH EDUCATORS MAY UTILIZE TO ILLUSTRATE EACH OF THE SIX CARE PRACTICES SUPPORTED BY LAMAZE INTERNATIONAL TO PROMOTE NORMAL BIRTH: labor begins on its own, freedom of movement throughout labor, continuous labor support, no routine interventions, non-supine (e.g., upright or side-lying) positions for birth, and no separation of mother and baby with unlimited opportunity for breastfeeding.     

Promoting, protecting, and supporting normal birth

In this professional paper, published by Lamaze International and reprinted here with permission, Lamaze International identifies six care practices-adapted from the work of the World Health Organization-that promote, protect, and support normal birth. The six care practices are: labor begins on its own; freedom of movement throughout labor; continuous labor support; no routine interventions; non-supine (e.g., upright or side-lying) positions for birth; and no separation of mother and baby with unlimited opportunity for breastfeeding. Evidence to support each care practice is presented. Health-care providers and places of birth are encouraged to adopt these care practices as standards of care. Additionally, women are encouraged to choose health-care providers and places of birth whose care practices promote, protect, and support normal birth.     

Another Breastfeeding Controversy

In this column, the editor of The Journal of Perinatal Education discusses the latest breastfeeding controversy—a new doll that is intended to help little girls learn to breastfeed. The goal of the doll’s manufacturers is to spread the word that breastfeeding is a normal, natural way to feed a baby. Its purpose is to raise awareness about the positive health benefits associated with breastfeeding. But not everyone seems to agree. Pros and cons are presented. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote natural, safe, and healthy birth.     

#6: no separation of mother and baby with unlimited opportunity for breastfeeding

In this position paper-one of six care practice papers published by Lamaze International and reprinted here with permission-the value of keeping mothers and their babies together from the moment of birth is discussed and presented as an evidenced-based practice that helps promote, protect, and support normal birth. The paper is written for childbearing women and their families. Babies held skin-to-skin with their mothers cry less often, breathe easier, and stay warmer than babies who are separated from their mothers. They also instinctively attach to the breast and begin breastfeeding, usually within one hour of birth. The advantages of rooming-in for mother and baby are also discussed. The accompanying commentary-written by two leading professionals in the field of maternity care and pediatrics-provides further evidence to support the practice of keeping mothers and their babies together after birth. Lamaze International encourages women to give birth in settings that do not separate mothers and babies after birth.     

Each One Unique

A young mother shares the stories of her two sons'' births. Her first birth experience was complicated by muscle spasms and changes in her baby''s heart rate during labor and, later, by medical problems with her baby in the days after birth. The mother''s strength and commitment shine through at every twist and turn during labor and the days after her son''s birth. Two years later, in contrast to her first son''s birth, the mother''s second son was born so quickly that labor presented a different set of challenges. The mother''s confidence in birth and in herself are essential facets of the stories of the births of her two sons.     

New Resources for Childbirth Educators and Parents

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and for expectant and new parents. The books, CD, and DVDs reviewed in this issue''s column address the following topics: natural, safe, and healthy birth practices; doula care; breastfeeding; empowering women to make healthy lifestyle choices during pregnancy; encouraging mothers to bond with their babies before birth; and fathers'' and partners'' supportive role during labor and birth.     

Elizabeth Belle’s Birth Story

In this article, Jessica and Samuel Boro share the story of the birth of their daughter, Elizabeth Belle. With the physical and emotional support of her husband and her doula, this mother was able to cope with a long labor and have the natural birth she wanted. Her husband describes how important the doula was for him.     

Non-organic failure to thrive: Decision for and videotaped evaluations

Infants hospitalized for non-organic failure to thrive in the first six months of life are in a life-threatening situation and are already at risk for poor bonding with mother. In light of this, the meaning and use of foster care and how this separation affects the developing mother-child relationship are the issues addressed through examination of 16 cases in which 8 of the infants were placed in foster care and 8 discharged home after the failure to thrive hospitalization. This paper examines (1) maternal histories of pregnancy, labor and delivery and the neonatal status of placed and non-placed infants; (2) the developmental and weight status of placed children; (3) the nature of the decision criteria for after-hospital care; and (4) the mother-infant relationship at initial intake in terms of mother's report of events and observations of feeding and play interactions during a videotaped assessment process. The study found that the interactions between mother and infant in those situations which required foster care were clearly more dysfunctional when compared to those in which the baby was discharged home to mother. Babies in the two groups were comparable in weight status at the time of hospitalization although babies in foster placement had slightly lower scores on the Bayley Scales. Maternal histories of pregnancy, labor, and delivery were similar for the two groups as were the birth and neonatal histories of the infants.     

Dayton William Dix's Birth Story

In this birth story, a young mother relates her experience of moving beyond fear of labor and birth and developing confidence in her ability to give birth without an epidural. Knowledge and support, including the support of a doula, during the last months of pregnancy helped this mother change her plans for the labor and birth. This story highlights the importance of continuous emotional and physical support and how knowledge and confidence set the stage for a satisfying, safe, and healthy birth.     

The Birth of Joseph Gabriel

In this column, a mother shares the story of the birth of her first child. With confidence in the process of birth and in her ability to give birth, and with the support, confidence, and encouragement of her mother and sisters, Anne manages to cope with strong contractions through a busy day. Finally, her husband realizes how fast labor is progressing. Baby Joseph was born less than 2 hours after arrival at the hospital.     

Welcoming nora: a family event

In this column, Allison and Paul Walsh share the story of the birth of Nora, their third baby and their second child to be born at home. Allison and Paul share their individual memories of labor and birth. But their story is only part of the story of Nora's birth. Nora's birth was a family event, with Allison and Paul's other children very much part of the experience. Jane and Gavin share their own memories of their baby sister's birth.     

Breastfeeding problems following anesthetic administration

Research literature supports the notion that maternal comfort should be considered a priority and that mothers should receive adequate information regarding any drug prior to receiving that drug. Some studies indicate that difficulties with breastfeeding may be related to the amount of the anesthetic or analgesic that is administered to the mother. Thus, it seems wise to administer the lowest possible dose to the mother in order to minimize the amount of drug (or metabolite) exposure to the nursing infant. Infant exposure can be further reduced if breastfeeding is avoided during the times when the mother receives high doses of anesthetics and analgesics. However, because relatively small amounts of the drug are excreted into the breast milk, some mothers may opt to continue nursing after weighing the benefits of breastfeeding against the potential risk to the infant. Others may choose to "pump and dump" breast milk while they receive anesthetic or analgesic agents. Any concerns in this regard should be discussed with the anesthesia provider, preferably prior to labor or to any surgeries while breastfeeding.     

The most amazing 24 hours

In this column, a mother shares the story of her son's birth with her prenatal yoga instructor. The mother was able to work with her labor, was well supported by her husband and doula, and negotiated successfully with the hospital staff to have a safe, healthy birth. She describes how difficult labor is and the ways in which comfort and support strategies help women manage contractions.     

Step 5: has clearly defined policies, procedures for collaboration, consultation, links to community resources: the coalition for improving maternity services:

Step 5 of the Ten Steps of Mother-Friendly Care ensures that the hospital, birth center, or home birth service has clearly defined policies and procedures for collaborating and consulting with other maternity services and for linking the mother and baby to appropriate community services during both the prenatal and the postpartum periods. The rationales and evidence in support of this step are presented.     

Research Summaries for Normal Birth

In this column, the authors summarize four research studies relevant to normal birth. Topics of the studies summarized include the harms of screening for macrosomia late in pregnancy, the risk factors for and impact of postpartum pain in childbearing women, the effects of a breastfeeding approach called “biological nurturing” on reflexive behavior in newborns, and the effects of prenatal yoga on labor and birth outcomes.     

Research summaries for normal birth

In this column, the author summarizes four research studies that contribute to the body of literature on the benefits and physiology of normal childbirth. The topics of the studies include the effect of digital rotation of the baby in occipito-posterior position on position at birth and birth outcomes; temperature disturbances during skin-to-skin contact among babies exposed to epidural analgesia and exogenous oxytocin during labor; the prevalence of and motivations for "maternal request" cesarean surgery; and the benefits of delayed clamping of the umbilical cord after birth.     

Role models for pregnancy, birth, and breastfeeding

In this column, the editor of The Journal of Perinatal Education discusses how the media provide role models-good and bad-for pregnancy, birth, and breastfeeding. There is a critical need for more positive role models that promote natural, safe, and healthy pregnancy and birth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote natural, safe, and healthy birth.     

New Resources for Childbirth Educators and Parents

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and for expectant and new parents. The topics of DVDs and books reviewed here include fatherhood, labor-support techniques, optimal labor positions, infant massage, breastfeeding, healthy nutrition during the childbearing year, understanding a newborn''s cues, personal viewpoints on cesarean birth, and postpartum massage.