"What is a rebozo" you ask? By definition, a rebozo is a simple piece of fabric. It originates from the Mexican culture. It varies in length and width depending on the use. In Mexico, these special cloths are used from birth, throughout life, and into death. The heritage of the rebozo is deep.
I attended a class this weekend to learn more about how to use the rebozo in pregnancy, labor, and birth. The one thing that stood out to me the most was how beautifully the rebozo incorporates the partner. So many times partners are afraid the doula will take their place, or are uncertain of what they can do to help the laboring woman. Never fear, the rebozo is here!
Prenatally the expecting woman and her partner can practice relaxation and comfort measures with the rebozo. "Under the tent" they will find intimacy and absence of distraction. They can discuss the day as the rebozo is used in "roving body relaxation" and massage. As the rebozo is used prenatally, it becomes associated with peace and relaxation so that it evokes those same feelings when used in labor.
In labor, the rebozo can be useful in techniques to relieve back pain (without causing the partner pain!). Again it can be used to block out distraction and bring the same relaxation practiced prenatally. This is a very concrete, hands on way for the partner to participate in labor. It is a way to bring the laboring couple close, both physically and emotionally.
Have you ever wondered, "Exactly HOW do I push, WHERE do I push?" We can use the rebozo during this part of the birth process to help focus pushing efforts and bring your baby down and out. The rebozo can support the laboring woman as she squats to birth. It can be used in bed, in the tub, sitting, standing, squatting.
The rebozo is a versatile tool that will become a beloved symbol of peace, strength, support, and intimacy throughout pregnancy and beyond. I am now offering an add-on rebozo package to my complete labor doula package. This will include an additional 2-3 hour prenatal visit where I will show you how to use the rebozo, a written guide of different positions and techniques, and a new rebozo for you to keep. Contact me today to learn more about this new offering.
Essential oils are a very popular natural medicine. Essential oils support the body as the body balances and heals itself. Essential oils do not carry as many contraindications or side effects as pharmaceuticals, making them a good choice during pregnancy and beyond. Be sure to discuss your use of essential oils with a trusted care provider as the information here shall not be considered medical advice.
1. Lavender - Lavender is often associated with calming and restfulness, but it also has many other uses. Try lavender when dealing with morning sickness, leg cramps, sore muscles, stretch marks, sore breasts, or water retention.
2. Peppermint - Not only is peppermint a great oil for alertness, but it is also a digestive soother. Peppermint might be helpful if you have morning sickness, constipation, or heartburn. Other applications for peppermint include sore muscles, hemorrhoids, and possibly encouraging a breech baby to turn.
3. Cypress - Cypress is a great oil for circulation. As such, it is great for leg cramps, varicose veins, hemorrhoids, and swelling.
4. Orange - That unmistakable smell when you peel an orange comes from the essential oil in the peel. Enjoy this uplifting aroma when you are fatigued or feeling blue. It might also soothe morning sickness and heartburn.
5. Lemon - Lemon is another oil that might be helpful when dealing with morning sickness. Also consider this oil for varicose veins, constipation, swelling, and fatigue.
Disclaimer – I am not a trained aromatherapist. I have studied essential oils as personal interest. Essential oils are very potent. The source of your oils is a big factor in safety. I have decided to use DoTerra for my family because of the in depth multi-stage testing to guarantee safety, potency, and purity. If you would like information on how to purchase and use DoTerra essential oils, please contact me.
Third Stage of Labor: Active vs. Physiological Management
The third stage of labor is considered the time between baby’s birth and placenta being expelled. Active management and physiological (also called expectant) management are the two approaches to this stage. What is the difference between these two approaches? What are the risks and benefits of each? What will be best for you? True informed consent means analyzing risks and benefits in the context of your medical history, and taking responsibility for that decision.
Active management of the third stage is a medically managed approach. Medication is given (ie – Pitocin) within one minute of birth. The umbilical cord is cut and cord traction (gently pulling on the cord) is applied to hasten the release of the placenta. After the placenta is expelled, the uterus is massaged. The American Congress of Obstetricians and Gynecologists considers active management of third stage to be the best practice standard of care.
There are risks to this approach. We know that 1/3 of a baby’s total blood volume is in the placenta at the time of birth. By immediately clamping and cutting the cord, baby is deprived of this blood. This means baby is starting life in a compromised state. Some medications used in this stage can cause nausea, vomiting, and high blood pressure. Be sure to ask your doctor what medication is being used and what the risks are of that particular medication. If medication is administered before the cord is cut, baby will be exposed. Another risk is that pulling on the cord increases the likelihood of partial detachment where some blood vessels are torn open but the placenta is still in the uterus so the uterus cannot clamp down to stop bleeding. Cord traction also contributes to placental fragmentation. It is also possible to completely detach the placenta prior to medication induced contractions which are needed to stop bleeding. Ironically, some of these risks lead to the very thing active management seeks to reduce – excessive blood loss.
Active management of labor aims to reduce total blood loss, length of third stage, and severe postpartum hemorrhage. Studies indicate these benefits more clearly in the hospital setting.
In a physiologically managed birth, the mother expels the placenta on her own. She waits for post-birth contractions and pushes gently. The umbilical cord is typically cut after it stops pulsing, which indicates that baby has received the full volume of blood.
The risk to this approach is increased chance of postpartum hemorrhage.
The benefits include full blood volume for baby, no risk of medication reaction, and no risk of manually separating the placenta.
It is important to note that if a physiological approach is taken and excessive bleeding does occur, there are measures that can be taken to reduce bleeding whether at home or in a hospital setting.
It is important to consider the place of birth when deciding which approach to take for third stage management. In a natural birth taking place in a home setting, natural oxytocin is plentiful. Dim lights, quiet and calm atmosphere, love and support all facilitate the release of natural oxytocin. The same natural oxytocin that causes contractions to birth the baby also causes contractions to release the placenta and stop bleeding. Natural hormone production is further stimulated thorough skin to skin contact between mother and baby, and nipple stimulation of baby suckling at the breast.
On the other hand, if labor was induced or augmented with synthetic oxytocin (ie – Pitocin) the production and release of natural hormones is altered. When used to induce or augment labor, Pitocin can overstimulate the uterus leaving it less effective at clamping down in the postpartum period (uterine atony). Saturating the oxytocin receptors with synthetic oxytocin can make the uterine response to natural oxytocin inadequate. Epidural anesthesia inhibits the natural production of oxytocin. These and other interventions in the natural birth process increase the risk of postpartum hemorrhage by disturbing the natural hormonal changes that take place in labor, birth, and the postpartum period. When natural oxytocin is inhibited, it might become necessary to use synthetic oxytocin to prevent hemorrhage.
Look at your own health history. What is your nutritional status? Ask your care provider about nutritional supplements (vitamins, minerals, herbs, etc) that might help reduce the risk of excessive bleeding in birth. Do you have a history of postpartum hemorrhage? Discuss this risk factor with your care provider.
There are risks and benefits to both active and physiological management of third stage. You must consider these risks and benefits, along with the context of this birth (interventions such as induction and augmentation, anesthesia, place of birth, etc) and your own health history when making a decision on the best approach for your birth.