Sunday, May 30, 2010

Going Past Your Due Date: Answers to Common Questions

The following is a brochure that I made for my doula course. If you would like copies to share, please let me know :)

Q. How is a due date determined?

A. The modern 40 week due date is based upon Naegele’s rule which assumes that all pregnancies last for about 280 days from the first day of the last menstrual period.

Q. Are due dates accurate?
A. Naegele’s rule assumes that all women have a 28 day cycle and ovulate on day 14, however, this is not true of all women. Some women have significantly shorter or longer cycles. One of the dangers of making this assumption for all women is that if a woman with a longer cycle were to have her baby forced out prematurely based on the LMP (last menstrual period) the baby could have long term consequences from the premature birth.

Q. What about due dates found by ultrasound?
A. When a woman’s LMP is unknown, ultrasounds are often used to find an EDD (estimated due date). Ultrasound scans taken early on in the pregnancy have an EDD accuracy of +/- 4-5 days at 12 weeks gestation, whereas, scans taken past 12 weeks only have an accuracy of +/- 7-10 days.

Q. Are most babies born on their due date?
A. If pregnancies are left to themselves, 50%-80% of them will continue past 40 weeks. Only 5% of babies are born on their due date with 10% arriving after 42 completed weeks.

Q. What are the risks of going past your due date?
A. The greatest concerns for pregnancies continuing past 40 weeks gestation are Postmature Syndrome and an increased risk of stillbirth. Postmature Syndrome is caused by the placenta failing to provide adequate nutrients for the growing baby. Symptoms of Postmature Syndrome range from minor ones such as longer fingernails and toenails to more severe symptoms such as impaired breathing or meconium aspiration. The risk of stillbirth has a slight increase as the pregnancy continues past 40 weeks with a .12% at 40 weeks and .2% at 42 weeks. However, most studies show that up to 25% of these stillbirths are directly related to genetic abnormalities and not to being postdate.

Q. What tests are offered after you pass your due date?
A. Routine tests that are offered by active management caregivers include a Nonstress Test (NST), Amniotic Fluid Index (AFI), and Biophysical Profile (BPP). A Nonstress Test can show if a baby is responding well to stimulus by an increase in the baby’s heart rate during 20 minute intervals. An Amniotic Fluid Index gives a rough estimate of the amount of amniotic fluid. A Biophysical Profile includes both of these tests. Because there are so many variables to their reliability and the fact than none of these tests can predict events such as cord prolapse or placental abruption, there is no data to show that using these types of monitoring improves pregnancy outcomes.

Q. When should you consider induction?
A. When your caregiver will recommend induction will most likely depend on whether or not you have chosen an active or expectant management caregiver. While most active management caregivers routinely induce at 41 weeks, the American College of Obstetricians and Gynecologists do not recommend routine induction in low-risk pregnancies until 42 weeks. Because inductions themselves carry a whole host of risks, most expectant management caregivers, specifically those who follow the Midwives Model of Care, will take a more wait-and-see approach and will avoid induction unless they believe it is indicated. Having a comfortable relationship with your caregiver where you make the decisions, your concerns are addressed, and your questions are answered is the surest way that you can avoid an unnecessary induction.

Friday, May 7, 2010

10 Things I Hate About Me

My friend, Nina, inspired me to be more authentic. So, here goes...

1. I have apeirophobia (an abnormal fear of infinity). I am a Christian and I have peace about where I'm going when I die, but the thought of being anywhere forever makes me panic.

2. I hate it when I lose my temper with my children. Most of the time I am a very laid-back person, so I can't stand that other side of me. I want to be that mother who is sweet and loving with her children 100% of the time.

3. Since I was a teenager, I've struggled with depression and self-injury. God is good and He gives me victory over these things, but I wish it wasn't a struggle.

4. I hate that I'm not naturally thin and althetic. I know that it's my own fault that I'm not in good shape (I hate exercise!) but it makes me jealous when I see people out running and it's obvious they enjoy it.

5. I wish that I enjoyed planning meals and cooking them. At the end of the day, it's so hard for me to motivate myself to go into the kitchen and make magic happen.

6. I wish that I craved the things that are good for me and disliked the bad things.

7. Sometimes I resent the fact that Nathan gets to go to work every day to do a job he loves where he gets to use his brain. So much of being a stay at home mom is emotional and that's hard for my academic side.

8. Angel's birth, or what I more accurately refer to as his "extraction", left me an angry, traumatized, fragile mess. By the grace of God, I'm healing, but it's a slow process.

9. I have issues trusting people. I'm always afraid that they'll hurt me in some way.

10. I wish that I had a "crafty" side. Some women can sew, knit, look at a pile of scraps and egg crates and see possibilities. Yeah, I'm not one of those women...

25 Random Things About Me

1. I love Jesus. He is my everything. Without Him, I am nothing. I believe that with all my heart.

2. I am a birth junkie! I love watching beautiful birth videos and reading birth stories. They make me cry (in a good way). I am close to becoming certified as a birth doula and I am going to pursue midwifery. I know in my heart that is what I'm called to do.

3. I love my husband with all my heart but I hate using the term "married". I don't believe that signing a piece of paper shows that a couple is in a covenant for life.

4. I love horses, especially my sweet Mustang, Mr Manners. I love everything about horses. Training them is so fulfilling. I love riding English, especially hunter/jumper and I want to eventually compete in three day eventing.

5. I really like pizza. I could live on pizza. When there's nothing planned for dinner and my hubby suggests ordering pizza, I'm like "YES! Made my day!"

6. I hate meat in any and all form, but especially fish, or any seafood like crab, lobster, shrimp, and shellfish, etc. I HATE the smell, despise it like the plague! Blech...

7. I have a very wide range of music and TV that I like and my hubby (smart man) lets me have control of the remote and the radio. On his days off, I'll search out my favorite music videos online and make him dance along!

8. I am completely and passionately against routine circumcision, spanking, and vaccinations. I will argue against all three until the cows come home. Then, when the cows are in the barn, fed and watered, I'll argue some more! :)

9. I am an animal lover and I believe that God wants us to treat animals with respect. I have no respect for anyone who intentionally causes unnecessary harm to an animal.

10. I am a mother to seven amazing children. Three are with their Father in Heaven and four are with me here on earth. I love them all.

11. I love being pregnant and giving birth. Babies are God's sweetest creation. Motherhood is the most challenging thing I've ever been called to, but it's helping me to appreciate God's grace and love even more.

12. I am an avid gum chewer. I chew a couple (sometimes more) pieces a day. This is probably not a good thing since I have issues with jaw pain but, in the words of Jack Twist, "I wish I knew how to quit you..."

13. Shoes and lingerie are my favorite articles of clothing and I have quite a collection of both.

14. I've always enjoyed writing and have attempted to write a few books but the perfectionist in me has a hard time seeing them through to completion.

15. I really enjoy shopping. In our family, I am the "spender" and my hubby is the "saver". Together, we have a good balance.

16. I would rather watch a good TV show than a movie or read a good book instead of either. Movies bother me because it's hard to build a relationship with the characters and the plots develop too fast.

17. I enjoy being out in nature but I don't like camping. I've been there, done that for nine weeks straight. I'm so over camping!

18. I traveled all over Europe as a teenager and I want to do it again with my family someday.

19. I hate having my bare feet on the carpet. I think it's disgusting. I wear socks, slippers or flip flops all year round. When I build my dream home, there will not be a stitch of carpet in sight!

20. I detest bees, wasps, hornets, etc. If they are around, I will most likely run away screaming. I don't care if they sense fear, when they are present, my common sense goes out the window.

21. I really dislike chocolate. I have never understood how people can bite into a mushy, bitter chocolate bar. Yuck!

22. I try to live a very "earth conscious" life. I think, as a Christian, I'm supposed to be a good steward of this beautiful planet so I try to reduce, reuse, recycle as much as I can.

23. Eating healthy is important to me. I buy organic as much as I can and I avoid fast food. Ever since I watched Food, Inc. the thought of a Big Mac makes me ill...

24. I love learning how to play instruments. My next goal is to learn to play the cello. I've been searching for a used one at a good price, if you know of any, let me know!

25. I cannot stand getting up in the morning. If I'm up in time to see the sun rise, it makes me depressed cause it means I should be sleeping. Sometimes I'll stay up really late because going to bed means I have to get up in the morning (weird logic, I know)

Saturday, May 1, 2010

Positive Parenting

Recently, Nathan and I took an afternoon to sit down and discuss our parenting goals and strategies. It was very good for us to solidify what is acceptable and what is not and how we plan to deal with various situations that will arise. It was a much needed conversation and I'm grateful that we had an opportunity to come to an agreement on parenting matters.
Our goals are to raise healthy, happy children who love Jesus. We want them to have a beautiful childhood and, most importantly, never doubt that they are loved. The fact that we want them to know, without a doubt, that they are loved is so essential to us as parents because, after all, this is what Jesus does for us.
Since we are attachment parents, spanking is not an option for us at all. While I respect the decisions of other parents who seek the best for their own children, spanking goes against everything that we believe as Christians as well as attachment parents. Because we refuse to use this form of discipline (or rather punishment) for our kids, we've had to become more creative and involved with finding other methods.
One thing that we have been working on is how we communicate with our children. We make a point to speak to them at their eye level in ways they can understand. We also want them to repeat back anything that we ask them to do so that we are sure that they heard us and understand what is requested of them. Talking to them in a polite, respectful way is important if they are to feel truly loved.
We also use natural consequences for their negative actions instead of vague punishment. For example, if Angel has been warned not to throw his monster trucks and continues to do so, a natural consequence is to have the monster trucks go away. This teaches him that no one will play with you if you're mean to them. Another example would be if Jazmyn has been told not to run out to the street and she does anyway, she will lose the privilege of playing outside. Natural consequences are consequences that are directly related to the negative action and they make sense. Telling a child not to hit their sibling and then smacking them if they do so would not be a natural consequence and would not make sense.
Something that's been working beautifully with our preschooler, Angel, is his reward board and his tickets. He earns stars on his board when we're home or tickets when we're out for doing what he's asked and behaving himself during the day. When they add up, he gets rewarded for his good behavior. Since we implemented the reward board, we've seen an improvement in his attitude and behavior. One of the reasons why I think it works so well for him is because it gives him a tangible way for him to see that good behavior has good results. Another reason why it's effective is because it focuses on the positive. I don't think parents realize how many "Atta boy's" it takes to make up for just one negative reaction.
We try to make a point to focus on what our kids are doing right instead of waiting for them to mess up and punish them. We want our kids to know that they are loved and accepted even if they make wrong choices. Their wrong choices are never encouraged and they are never ignored but the focus is on them making healthy, positive choices.
Here are some articles and resources that helped us and we totally recommend them!