Birth Doula Support
re: Maternal Anxiety as a Risk Factor for Preterm Birth
Did you know Pregnancy-specific anxiety (PSA) is a risk factor for preterm birth (PTB)? Mamas with anxiety during the prenatal period, specifically concerns such as fear regarding the pregnancy, delivery, and health of the child, have a higher risk of delivering their baby before 37 weeks gestational age.
Just like how births are all different, research studies also have their own differences. Different processes and different outcomes. The study my research team worked on was a Systematic Review and Meta Analysis on studies that looked at anxiety in the prenatal period and the outcome of preterm birth (PTB).
We took these studies and their results and not only compared them but also combined them to determine if the relationship between PSA and PTB remained statistically significant, and it did.
While working on this research project and during the process of writing the manuscript to be published in a scientific journal, I was not aware of the work of Doulas. My research does not look at Doulas and their work impacting PSA, however, with my knowledge and experience since that time I can see that Doulas really matter!
The prenatal visits, continuous support, the ability to provide information to the client, and suggestions for prenatal classes and a Birth Doulas knowledge of childbirth gives pregnant Mamas the confidence they require to care for themselves and their babies during the prenatal period.
There are many risk factors that can cause preterm birth (PTB), but in helping alleviate pregnancy-specific anxiety (PSA) we may have a hand in decreasing their risk for PTB, and in turn preventing health issues that plague babies born too early.
Gianella Pana is a Birth Doula serving Chestermere, Calgary and Airdrie families. To read her published research paper <<click here>>
It is CRAZY! We completely agree with you.
Shopping for essential baby gear can be completely overwhelming and one of the most challenging things about the third trimester. Not only do baby products and styles vary, the brand choices and colours are infinite too!
As parents-to-be we imagine you want to get this right. First of all, please don't worry. We are here to make this an enjoyable time for you.
For a stress free experience download a copy of our Baby Essentials Shopping List.
Is it safe?
We all know that exercise improves muscle tone, strength and endurance, but is it safe during pregnancy?
Both the Society of Obstetricians and Gynaecologists of Canada and the American College of Obstetricians and Gynecologists (ACOG) recommend that pregnant women include exercise in their healthy lifestyle, as long as they have no medical or obstetrical complications. ACOG suggests a total of 30 minutes or more of moderate exercise every day, or on most days, throughout pregnancy.
Exercise in pregnancy can ease or eliminate aches and pains, leg cramps and circulatory challenges; strengthen pelvic floor muscles; and aid in the prevention of insomnia and pregnancy blues. In addition, exercise provides us with a better self-image, prepares our bodies for the physical journey of labour and birth, helps us retain our pre-pregnancy fitness levels and makes returning to our pre-pregnancy shape achievable.
Although many sources compare natural childbirth (involving no pain medications or interventions) to running a marathon, I don’t suggest you start there. Choose your activity by taking into account your fitness level, as well as common sense safety precautions. Brisk walks, stair climbing, swimming and downloadable prenatal workouts are fantastic low-impact and low- or no-cost options. If you can afford to invest a little and you feel social, a group class like water aerobics, prenatal yoga or prenatal dance might be the perfect fit. Classes also allow you to meet other moms-to-be.
Now that you’re excited to get moving, don’t forget to prepare yourself well. Avoid overheating by wearing breathable, layered clothing; drink generous amounts of water before, during and after exercise to stay hydrated; wear comfortable running shoes with proper support for your ligaments and tendons; and, most importantly, know your limits but have fun!
Editor's Note: This piece was originally written for Guided Synergy Magazine in 2014.
We met in her first trimester and her words still echo in my head...
"My doctor is recommending a C-section if baby doesn't turn by my next visit?
I am considering asking about delivering breech. What do you know about breech birth?"
Well that's a great question. Here's the gist of what I know:
3-4% of babies are in a breech position at term.
There are 3 types of breech presentations:
Frank Breech - the most common type
Meaning: the baby's bottom faces the cervix and his legs are straight up, with feet near his/her head.
Footling/Incomplete Breech - the second most common type of breech
Meaning: one or both baby's feet are directly above the mother's cervix.
Complete Breech - the least likely breech position
Meaning: the baby is bottom first with his/her knees bent and one or both feet near his bottom.
Recognizing approximately 13,500+ Canadian babies present breech annually perhaps the following options could help turn some babies - there's no harm in trying...
Best at: 32+ weeks gestation
The Tilt - an inversion technique
The Webster Technique - a chiropractic adjustment
Best at: 37+ weeks gestation
Moxibustion - using heat to stimulate an acupuncture point
External cephalic version (ECV) - external rotation of the baby by an obstetrician
*consultation with your health care provider should be sought prior to the above*
Women should be offered a breech vaginal delivery, rather than a cesarean birth, according to the clinical practice guidelines set by the Society of Obstetricians and Gynaecologists of Canada (SOGC), No. 226, June 2009.
The basic labour selection criteria for Vaginal Delivery of Breech Presentation Guidelines states:
-an ultra sound showing the baby and position are optimal
-mother has no contraindications for successful vaginal birth
-baby's weight is estimated between is 2500 - 4000 grams (more on ultrasound estimates later!)
Knowing this, why do many women still report their physicians suggesting cesarean birth as the optimal choice for a breech baby?
Is their hospital not open to breech vaginal deliveries? Is planning a c-section better for the healthcare provider's schedule? Or is it the serious shortage of physicians willing to facilitate breech birth because their skill set is incomplete?
Regardless of the reason this is disheartening!
Autonomy and women-centered care demand that competent physicians emerge from university programs with the confidence and know-how to support breech vaginal birth. If this isn't possible, senior physicians should be mentoring the new doctors so they can develop the skills needed to support these women while birthing.
Furthermore, don't all doctors have an ethical responsibility to decrease our alarmingly high cesarean birth rate? Perhaps, supporting breech vaginal birth would be a beautiful place to begin...
Our society has robbed us all! The saddest part, it's been replaced with fear.
Fear of pain in childbirth.
So how do we get our power, peace and confidence back?
Honestly, it's simple. Get educated!
The best place to begin is reading Healthy Birth Practice #2, walk, move around and change positions, from Lamaze.
An alternative is to watch this short video.
Here is an acronym to help put things into perspective.
P - purposeful (helps move baby down and out)
A - anticipated (contractions get longer, stronger and closer together as labour progresses)
I - intermittent (our body gives us a break, in healthy birth contractions are not continuous)
N - normal (nothing is wrong, discomfort can be a healthy response to labour and birth)
Healthy mothers-to-be need reassurance that their body is designed to give birth.
It's imperative to understand pain does not always mean suffering.
If you require additional information please do not hesitate to connect.
Are we really a generation full of broken women? With a cesarean birth rate of 1 in 3 (Alberta) one might think so!
As an educator and advocate of safe, natural, and healthy birth my simple answer is "NO".
The true challenge exists because birthing women, and their families, are often uneducated.
I've been in private practice supporting pregnancy, birth, breastfeeding and early parenthood since 2006. Although technology abounds women still rely heavily on the opinions and personal experience of others rather than evidence.
In the birth world deciphering between opinions, myths and facts is always easier said than done. I encourage you to do your own research and choose what YOUR best birth looks like.
To simplify things I have listed a few reputable sites for you to explore:
6 Healthy Birth Practices - Lamaze
Evidence Based Birth
Now that you've clicked on the links (or even if you haven't) you likely have new questions. My best advice to you - invest your time and money into independent childbirth education. Doing so will guarantee your questions are answered with evidence and all of your birth options presented in an unbiased manner,
Learn more about our classes here.
You and your baby are worth it!