I’ve been thinking about the passage of time as we slip into a new decade. I was a doula at my first birth in 1992; that baby recently turned 27. The same year I started teaching prenatal classes for what was then Harvard Community Health Plan; I taught families there for 25 years until they eliminated their Health Promotion department. In all this time, pregnancy, birth, babies, and breastfeeding have lost none of their magic. Watching couples transform into parents and discover new strengths in themselves and each other, while being humbled by the awesomeness of birth and parenting, as they learn to care for a tiny human, will never grow old. Every baby is a miracle.
We have family-centered cesareans now, with babies breastfeeding during the surgery, something I once couldn’t have imagined. Milk banks are back and some NICUs are now exclusively feeding human milk. Informal milk sharing isn’t new, but Facebook groups have made it possible in new ways. More people initiate breastfeeding. Geez I remember when there was only one size pump flange available.
But the cesarean rate has gone up over 60% since I started this work. Midwives who gave me my early training lamented that the hospital cesarean rate was 20%. How we wish it was that low now. The rate of inductions is higher than ever. I’ve watched us spend more and more money on perinatal care as our maternal and infant mortality rates climb.
I have watched many wonderful doulas and midwives suffer trauma from seeing how some hospital staff treat laboring people and newborns and burnout from long hours, unpredictable schedules, and inadequate financial compensation. I’ve laughed and cried with colleagues as we discuss how to make it better for one family at a time. Must we work like the child on the beach throwing one starfish at a time back into the ocean?
I’ve been a birth professional for almost 3 decades now. Over that entire time I have heard delayed cord clamping, delayed first bath, declining the eye erythromycin, the healing properties of human milk, the physiology of cosleeping, and the harmful effects of epidurals and pitocin discussed as new ideas. They say it takes an average of 17 years for research evidence to reach clinical practice, but at 27 years and counting, I can tell you it can be much longer than that.
To all the dedicated doulas, childbirth educators, lactation consultants, nurses, and midwives thank you for all that you do for families. Here’s to a happy new year and a decade of improvement for perinatal families.
Did you know that when your baby is born, 30% of his or her blood will still be in the placenta? Waiting to clamp and cut the cord will allow your baby to receive this vital blood. Babies who get delayed cord clamping, or as it is now being called, appropriately timed cord clamping, have higher iron levels even a year later. And they are less likely to lose significant weight in the first week of life, because they don’t have to burn calories trying to restore their proper blood volume. Waiting to clamp the cord can protect babies against unnecessary formula since early weight loss and low iron are common reasons pediatricians encourage supplementation.
At birth, a new baby transitions from fetus to newborn, and begins to breathe because of the change of temperature. So your baby can begin breathing with the cord intact. This is a gentler beginning, because he or she will still be receiving oxygen from you, via the cord. After breathing, the next newborn job is to begin regulating body temperature. The best place to do this is on your bare chest, and most cords are long enough that babies can comfortably rest there. This is the perfect place to transition; your baby wants to hear your heart beat, smell you, and gaze at your face. Ninety-six degree cord blood flowing in will also help to keep him or her warm. Some obstetricians are still citing a concern about allowing the baby to go skin to skin with the cord intact, but this concern has been debunked.
Sometimes parents worry that their babies will be taken away from them at birth. With the cord intact this is impossible. Many expectant parents have heard to wait until the cord has stopped pulsing. But handling the cord to see if it’s still pulsing will encourage it to stop pulsing. A hands-off approach will allow more of the baby’s own blood to flow into his or her body.
How long should you wait to clamp and cut the cord? Any wait has benefits. The early studies on delayed cord clamping looked at waiting thirty or sixty seconds. There’s a doctor doing a Ted Talk saying we’d save millions of health care dollars worldwide if we waited ninety seconds. But waiting two minutes benefits babies more. And five or ten minutes confers even more benefits. The studies started with the premise of immediate cord clamping, and looked at slight delays. But the biological norm is waiting much longer. If you wait, you’ll notice that the cord goes from thick and dark, to pale or white and stringy. The blood has gone into your baby at that point. There is no too late, the cord can be clamped and cut after you birth the placenta.
Parents sometimes ask me about delayed cord clamping and cord blood banking. It is possible to wait a moment or two prior to clamping, and still have enough cord blood to bank. However, when most or all of the baby’s blood is allowed to enter his or her body at birth, there isn’t enough left to save. Some delay is even possible with a cesarean birth.
In my childbirth classes, I encourage students to ask that the cord not be cut until they request it. Birth is the first transition, and cutting the cord is the next one. They do not need to be done one on top of the other. Immediately after birth parents are usually processing what has happened, smelling their baby, checking the gender, counting fingers and toes. There is no rush, the cord can be cut after they have had a chance to meet their little one. Interested? Read more.
Join us on Sunday September 17 for a day of learning, networking, and fun in Westford, MA. We will be talking about business and marketing, chiropractic care for better pregnancy, birth, and breastfeeding outcomes, natural hospital birth, and preventing burnout with self-care. 6.5 CAPPA CEUS available for those who attend all sessions.
9-10:15 Chiropractic Care for Better Pregnancy, Birth, and Breastfeeding Outcomes with Dr. Linda Slak, DC In this workshop we will focus on the physical stressors present during pregnancy, and relate them to possible effects placed on the developing fetus and newborn. Participants will learn how chiropractic care can help decrease these stressors, make pregnancy more comfortable, and assist with optimal fetal positioning. We will review the Webster Technique, a specific chiropractic analysis and adjustment that reduces interference to the nervous system and facilitates bio-mechanical balance in pelvic structures, muscles, and ligaments, which has been shown to reduce the effects of intrauterine constraint, allowing the baby to get into the best possible position for birth. We will also cover an overview of common challenges facing infants and natural solutions.
10:15-10:30 morning break
10:30- 12:00 Supporting Natural Childbirth in the Hospital Setting with Julie Brill, CCCE, CLD, IBCLC Why do some women choose to labor naturally and what does the term natural childbirth even mean? How are the motherbaby labor hormones changed by interventions, and what are the implications for their well-being during labor, birth, and postpartum? How can we promote natural childbirth? This session will include hands on techniques.
12:00-12:15 introductions and networking
12:15-12:45 lunch break, a fridge and microwave are available for your use
12:45-345 Business & Marketing for Birth Professionals with Jen Middlemiss Are you interested in taking your birth business to the next level? Ready to start working with clients, but aren’t sure how to reach the people who need you the most? We will discuss finding your ideal clients, creating your vision and a matching marketing message and brand, and understanding website basics, the importance of social media , and SEO (Search Engine Optimization). Jen is excited to share what she’s learned works with business and marketing, and help you connect with the women and families that need your support. She believes that each woman, family and doula are unique, so the more we can work together to create thriving practices, the more women and families we can serve.
3:45-4:00 afternoon break
400-5:00 Your Long-Term Career as a Mother-Baby Professional: Preventing Burnout and the Practice of Self-Care with Julie Brill, CCCE, CLD, IBCLC Often we come to this work because we want to serve families, and we throw ourselves into it body, mind, and soul. But what happens to our health, our relationships, our sense of well-being? Join us as we discuss how to do this work sustainably. Learn techniques for turning off work stress, being in the moment, and self-care. We nurture others; let’s focus now on nurturing ourselves.
Registration: Early Bird rate of $85 when paid by August 17. Regular registration fee is $100. 6.5 CAPPA CEUS available. Payment may be made with PayPal to Julie@WellPregnancy.com or mailed to Julie Brill, 5 Warren Ave., Bedford, MA 01730 Please include your name, email, and cell phone with registration. No refunds can be issued, unless the event is canceled due to events beyond our control. If you can’t attend you may send a substitute or your payment can be transferred to another WellPregnancy event.
Presenters:
Julie Brill, CCCE, CLD, IBCLC has worked with thousands of families as a 
childbirth educator and doula over the last twenty-five years. Since 2003, she has mentored hundreds of childbirth educators and doulas for CAPPA. She is a Certified Holistic Lactation Consultant and an IBCLC in private practice offering in home breastfeeding consultations. She is the mother of two young adult daughters and a La Leche League Leader. Julie runs WellPregnancy based in Bedford, MA and is the author of the anthology Round the Circle: Doulas Share Their Experiences. Julie loves working with birthing families and specializes in natural and VBAC childbirth classes. She strives to provide accurate information and tools so each birthing woman can choose the birth options that are best for her. Julie believes passionately birth can be extremely empowering for women, positive birth experiences set the stage for many other positive life experiences, babies benefit immeasurably from having the best beginning, and we all have the right to make informed choices about our health care.
Dr. Linda Slak, DC is a 1984 graduate of Life Chiropractic College. She earned 
her Bachelors of Science in Community and Family Services from the University of Delaware and certified in Pediatrics through the International Chiropractic Pediatric Association (C.A.C.C.P) and in Child Developmental Disorders (C.A.B.C.D.D.) through the Academy of Functional Neurology. Dr. Linda maintains an active family-based practice with her husband, Jean-Marc in Burlington, MA. Her practice emphasis is with children under five with neuro-developmental disorders.
Dr. Linda serves on the post-graduate faculty of Life University. She teaches and lectures to professional audiences nationally. Locally, she serves on the board of Partners in Perinatal Health and on the board of the MACP as treasurer. She is a published author in the Journal of Pediatric, Maternal and Family Health. In addition, she is the co-founder of the Slak Institute. As life is always about creating balance, Dr. Linda values spending time with family and relieving stress by competing on the tennis court.
Jen Middlemiss is a senior midwifery student at the Midwifery College of Utah, prenatal yoga teacher, doula, 
childbirth educator, business & life coach, and mother of five. Through her unique prenatal yoga classes, natural birth education, and support before, during and after birth, she has been able to help hundreds of families have inspired births. She is the founder of the NH Mama & Baby Expo, a bi-annual event that connects families to products, services, and education that promote healthy pregnancy, birth and parenting. Jen has worked with the midwives at The Birth Cottage of Milford and assisted a homebirth midwife in northern New Hampshire for three years. These experiences have shown her the true beauty of undisturbed birth. She is passionate about supporting other birth workers to connect with their intuition, clarify their vision, and create sustainable businesses!
Anesthesia was first used for birth in 1847, 170 years, or roughly seven generations
ago. In response to this, Grantly Dick Read coined the term natural childbirth in the 1940’s. Before that it was just called birth, like organic food was just called food before Lord Northbourne coined the term organic around the same time. Natural birth, normal birth, physiological birth, Michel Odent’s term undisturbed birth, are all essentially words for the same thing. Some use the term un-medicated birth, but I believe that defining something by what it is not inadvertently reinforces the other. Sometimes I ask my natural childbirth students what they think natural birth means and the answers range from no medications or interventions, to an epidural-free birth that may include analgesia or nitrous oxide, to any birth that is vaginal.
In the course of human history, seven generations is a short time. Even if each generation of grandmothers in your family chose anesthesia, you come from an unbroken line before that of women who gave birth naturally. If you can, go up your family tree as far as you can, and see how the women in each generation birthed. Natural birth isn’t unusual or complicated, like folk dance it is something that all the folk can do. But since the majority of people in the United States give birth with epidurals, normal birth is not the norm here.
Women choose natural birth for many reasons. They want to experience the birth process, the physical sensations, and the accompanying hormones. They want to avoid the other interventions that often accompany pain meds. And they don’t want to expose their babies or themselves to the effects of the narcotics in epidurals and analgesia. Ani DiFranco said, “I believe the act of giving birth to be the single most miraculous thing a human being can do and it is surely the moment when a lot of women finally understand the depth of their power. You think it can’t possibly be done, you think you can’t possibly take the pain, and then you do – and afterward you look at yourself… in a whole new way. If you can do that, you can do anything.” We carry our birth experiences, good or bad, with us through the rest of our lives.
Hospital natural childbirth is possible, but there are more challenges then you would find at home. We protect our babies during labor by keeping them inside when we feel unsafe. This means little or no dilation when adrenalin levels are high, and it is a functional response to fear. (The process is different during pushing when increased adrenalin helps the baby come more quickly; at this point we are committed and the best strategy is to birth the baby, then get up and run.) Fear is what keeps us alive, and what enabled all of your ancestors to live long enough to reproduce. But for us to open to the process of birth we need oxytocin levels to soar, an impossibility when adrenalin levels are high. So natural childbirth in the hospital depends on feeling safe.
Obstacles in the hospital include being asked to rate your pain (a practice ACOG now discourages), staff including anesthesiologists asking if you want an epidural (many parents ask in there in birth plans that this not happen), monitors and IVs which inhibit movement, thereby increasing pain and slowing down labor, and restricting oral intake (a practice not supported by evidence). One study found that even the presence of a hospital bed in the center of the room increased the risk of pain medication. Additionally, in many hospitals, women are not able to access tubs in labor, although we know that being in water decreases pain in labor. Another issue is the overuse of cervical exams, which can be encouraging or discouraging, and often interrupt how a laboring woman is coping and result in her being in bed, a difficult place to labor.
More monitoring in labor doesn’t improve outcome, but it increases the risk of interventions including pain medication for the increased pain caused by not moving, and Pitocin to speed up the labor slowed by lack of movement. Oxytocin driven contractions, the kind we make ourselves, come in a package with endorphins, which help us with pain. Pitocin driven contractions, by contrast, do not come with endorphins, so we make them in response to experiencing the contractions, a more painful process. Thus we see increased use of epidurals with Pitocin. If a mom must be monitored, she may still be able to labor near the bed instead of in it, or get a telemetry monitor which allows her to move within and outside her labor room. If continual monitoring is being done out of concern over a baby’s flat heartbeat, cold and sweet foods will often wake the baby up and create a more reassuring heartbeat.
If you are planning to give birth without pain meds in the hospital, ask yourself how you generally cope with stress. Do you like to exercise after a hard day? Do you prefer a warm bath? A massage? Meditation? Listening to music? Develop a plan for how to use your coping skills in labor both at home and in the hospital. Bring along things that will help you relax: music, aromatherapy, snacks, etc. Choose a practice with a lower epidural rate and labor tubs if you can. Consider hiring a doula; doulas lower the rate of interventions, in part by helping to keep adrenalin levels low. Take a quality, independent natural childbirth class to learn tools for labor and labor support, and practice those techniques.
Natural childbirth is worthwhile. As Polly Perez said, “When a woman births without drugs…she learns that she is strong and powerful…She learns to trust herself, even in the face of powerful authority figures. Once she realizes her own strength and power, she will have a different attitude for the rest of her life, about pain, illness, disease, fatigue, and difficult situations.” At the end of a physiological labor, you and your baby will have endorphin levels higher than if you’d just run a marathon. That is the feeling of bliss that we remember, that make us want to have another baby. Natural childbirth allows you to see what your body is capable of. Joyce Maynard said, “Before I had children I always wondered whether their births would be, for me, like the ultimate in gym class failures. And I discovered instead . . . that I’d finally found my sport.”
Julie Brill, CCCE, CLD has taught childbirth education to thousands of families over the last twenty-five years and has mentored hundreds of doulas and childbirth educators since 2003. She is the mother of two daughters, a La Leche League Leader, and the author of the doula anthology Round the Circle: Doulas Share Their Experiences.
Join us on Saturday April 22 for a day of learning, networking, and fun in Westford, MA. We will be talking about business and marketing, prenatal depression, natural hospital birth, and preventing burnout with self-care. 6.5 CAPPA CEUS available for those who attend all sessions.
9-10:00 Prenatal Mental Health: What All Perinatal Professionals Need to Know with Dr. Lauren Brown Prenatal psychopathology is arguably less known than its cousin: postpartum depression. Overlooking the pregnancy period however can be harmful for mom, baby, and the entire family. This discussion will identify the hallmarks of antenatal mood disorders, OCD, PTSD, substance use and psychosis, while providing participants with an understanding of best practices when working with this vulnerable population. The use of holistic treatment alternatives will also be discussed.
10:00-10:15 morning break
10:15- 11:45 Supporting Natural Childbirth in the Hospital Setting with Julie Brill, CCCE, CLD Why do some women choose to labor naturally and what does the term natural childbirth even mean? How are the motherbaby labor hormones changed by interventions, and what are the implications for their well-being during labor, birth, and postpartum? How can we promote natural childbirth? This session will include hands on techniques.
11:45-12:00 introductions and networking
12:00-12:30 lunch break, a fridge and microwave are available for your use
12:30-3:30 Business & Marketing for Birth Professionals with Jen Middlemiss Are you interested in taking your birth business to the next level? Ready to start working with clients, but aren’t sure how to reach the people who need you the most? We will discuss finding your ideal clients, creating your vision and a matching marketing message and brand, and understanding website basics, the importance of social media , and SEO (Search Engine Optimization). Jen is excited to share what she’s learned works with business and marketing, and help you connect with the women and families that need your support. She believes that each woman, family and doula are unique, so the more we can work together to create thriving practices, the more women and families we can serve.
3:30-3:45 afternoon break
3:45-4:45 Your Long-Term Career as a Mother-Baby Professional: Preventing Burnout and the Practice of Self-Care with Julie Brill, CCCE, CLD Often we come to this work because we want to serve families, and we throw ourselves into it body, mind, and soul. But what happens to our health, our relationships, our sense of well-being? Join us as we discuss how to do this work sustainably. Learn techniques for turning off work stress, being in the moment, and self-care. We nurture others; let’s focus now on nurturing ourselves.
Registration: Early Bird rate of $85 when paid by March 22. Regular registration fee is $100. 6.5 CAPPA CEUS available. Payment may be made with PayPal to Julie@WellPregnancy.com or mailed to Julie Brill, 5 Warren Ave., Bedford, MA 01730 Please include your name, email, and cell phone with registration. No refunds can be issued, unless the event is canceled due to events beyond our control. If you can’t attend you may send a substitute or your payment can be transferred to another WellPregnancy event.
Presenters:
Julie Brill, CCCE, CLD has worked with thousands of families as a childbirth educator and doula over the last twenty-five years. Since 2003, she has m
entored hundreds of childbirth educators and doulas for CAPPA. She is the mother of two daughters and a La Leche League Leader. Julie runs WellPregnancy based in Bedford, MA and is the author of the anthology Round the Circle: Doulas Share Their Experiences. Julie loves working with birthing families and specializes in natural and VBAC childbirth classes. She strives to provide accurate information and tools so each birthing woman can choose the birth options that are best for her. Julie believes passionately birth can be extremely empowering for women, positive birth experiences set the stage for many other positive life experiences, babies benefit immeasurably from having the best beginning, and we all have the right to make informed choices about our health care.
Dr. Lauren Brown is a licensed clinical psychologist and the owner of Concord Therapy in Concord, MA. She counsels women and their partners on fertility and 
family planning, pregnancy, childbirth, postpartum health, and work-life balance. She helps individuals recover and sustain a healthy sense of self and well being after the major life changes of child loss, child bearing and child rearing. Dr. Brown has broad expertise in women’s issues of all kinds, with specialized training in crisis, grief, and trauma support. She has presented at National conferences and to general audiences speaking on the topics of perinatal mental health, gender identity, countertransference, and suicide prevention. Dr. Brown uses an integrative approach to treatment, drawing on clients’ needs and personal preferences. Her style is warm, authentic, and nonjudgmental, focusing on one’s inherent strength and wisdom in guiding their healing journey.
Jen Middlemiss is a senior midwifery student at the Midwifery College of Utah, prenatal yoga teacher, doula, childbirth educator, business & life coach, and mother of five. Through her unique prenatal yoga classes, natural birth education, and support before, during and after birth, she has been able to help hundreds of families have inspired births. She is the founder of the NH Mama & Baby Expo, a bi-annual event that connects families to products, services, and education that promote healthy pregnancy, birth and parenting. Jen has worked with the midwives at The Birth Cottage of Milford and assisted a homebirth midwife in northern New Hampshire for three years. These experiences have shown her the true beauty of undisturbed birth. She is passionate about supporting other birth workers to connect with their intuition, clarify their vision, and create sustainable businesses!
An increasing number of hospitals in the United States have begun offering nitrous oxide to women in labor since the FDA approved new equipment for use in labor in 2011. In the Boston area where I am, Brigham and Women’s Hospital started offering it nearly two years ago, and then other hospitals, including South Shore, Emerson, Wentworth-Douglas, Exeter, St. Joseph, and Newton Wellesley, scrambled to offer it as well. Among other things, a hospital is a business competing with neighboring hospitals for customers. If they get you to come there to birth, you could become a lifelong customer. You’ll know when nitrous comes to a hospital near you because your local paper will feature an article about it, prompted by a hospital press release, in which smiling women hold their babies and rave about how much they enjoyed using it in labor.
Doulas and childbirth educators who are seeking answers to their clients and students questions, are looking for information on Facebook. The attitude towards nitrous is overwhelmingly positive in the discussions I’ve seen. Most seem to be comparing it favorably to epidurals. But if we don’t ask the right questions, we won’t get the right answers. If we ask does nitrous oxide cause epidural fever, a drop in blood pressure, or the need for urinary catheterization, and then go away satisfied because the answers to the questions are no, we have failed the families who depend on us for information and support. It is impossible for them to make informed decisions in the absence of information. In this pro-nitrous piece, Judith Rook sums it up when she says, “The major benefits (of nitrous) are mainly lack of disadvantages associated with relying on epidurals, opioids and nonpharmacologic methods to relieve and help women cope with pain during labor.”
Women and their birth partners need a toolkit filled with contraction rituals and support techniques as they prepare for labor. If we describe these skills by labeling them as what they are not, as Judith does above (they are not pharmacologic) we are revealing our bias. Just as if we say un-circumcised we show that we our starting point is the circumcised penis, or if we say out of hospital births, we are showing that we see hospital birth as the norm. It is important to remember that when we look at these issues globally or historically we see that hospital birth, circumcision, and pain meds in labor are in fact not the norm. The healthiest birth for mother and baby is usually the one in which no medications are used. This is made more achievable when birthing women educate themselves prenatally about techniques for labor, and surround themselves with supporters who know and trust normal birth, and are skilled in labor support techniques. It is easier when women are eating and drinking in labor, can move to follow their bodies’ cues, have the option of laboring in water, are not continuously monitored, etc.
It’s not a perfect analogy, but please bear with me. Your teenager is invited to a party where you know there will be drinking. You discuss the risks of drinking with him or her. Then your kid discovers there’s an alternative to drinking at this party, some kids will be smoking cigarettes instead! So you compare drinking with smoking. The risk of alcohol poisoning is zero when smoking cigarettes! Smoking cigarettes does not increase the risk of being sexually assaulted! Driving after smoking cigarettes is not illegal! Would you therefore conclude that your child should start smoking? If we don’t ask the right questions, we will not get the right answers.
Now is a time for first do no harm, critical thinking, and the precautionary principle. Remember the precautionary principle? It’s the idea that new drugs, food additives, cleaning chemicals, fire retardants on children’s sleepwear, baby powder, plastics in baby bottles, etc., should be treated as guilty (unsafe) until proven innocent (safe). This idea is echoed in the “First do no harm” oath that doctors take. When I’ve raised the precautionary principle in Facebook discussions about nitrous, my concerns are dismissed because they’ve been using it for generations in Europe. Nitrous is the gas and air you see moms inhaling in 1950s London on the tv show Call the Midwife. Does that prove that it’s safe?
One of the known risks of nitrous oxide is that it depletes the body of vitamin B12. Hospital policy will usually say that its use is contraindicated in mothers with low B12. However, health care providers are not routinely testing B12 levels of pregnant women, nor are labor and delivery nurses required to ask if women know if they have low levels of B12. I talked with a women who gave birth to a baby in Europe. Afterwards, she suffered from depression and her baby was failure to thrive. When she weaned her baby to formula, he improved. Eventually her low B12 levels were discovered and she was able to be treated and feel better. She had nitrous in her labor, but had never connected the dots. What if instead of asking does nitrous cause epidural fever, we ask does it increase the risk of postpartum depression or failure to thrive in breastfed babies? Have you read Kelly Brogan’s new book, A Mind of Your Own? She describes a case of severe depression that was cured by remedying the B12 deficiency.
Who is at risk for low B12? Vegetarians and vegans without proper supplementation are, and that is widely known. Stress depletes B vitamins. So does impaired digestion, so anyone with leaky gut, a history of antibiotic, antacid or NSAID use, Chrohn’s disease, diabetes, pernicious anemia, gastric bypass surgery, a diet high in GMOs, or a thyroid disorder is at risk. It also includes anyone with impaired methylation. About 40% of the population has one or more mutations of their MTHFR gene, a gene involved with methylation, which may put them at increased risk for low B12. When my childbirth students ask about nitrous, I ask them what their vitamin B levels are and if they have a MTHFR mutation. I am usually met with a quizzical expression. Most providers are not explaining this in prenatal appointments.
I would suggest that many, perhaps most, pregnant women in the United States have at least one of the risk factors above. We know that pregnancy is a risk factor for thyroid disorders and stress. I see some of my pregnant childbirth students taking Tums like candy and eating packaged foods out of the vending machine. And 30% of them will test positive for beta strep and receive iv antibiotics in labor. That is because in the United States doctors take a universal approach, and recommend antibiotics for all women who are GBS. In the United Kingdom, doctors take a risk-based approach, and recommend antibiotics for GBS women only when they have specific risk factors such as premature labor, a fever, prolonged rupture of membranes, a previous baby with GBS, or GBS in their urine. So while women in the UK have been using nitrous for generations, they don’t use antibiotics in labor as often, which would be an additional risk factor. Additionally, there are no GMO crops grown in the UK. While GMO food is imported, British women are likely eating less GMOs than American women. Most British women not drinking fluoridated water, while most American women are. Are there other differences as well that would also help them to have higher B12 levels going into their labors, and a greater ability to restore proper levels after nitrous use?
If you want to learn more about the effects of nitrous on the 40% of the population with MTHFR mutations, check out this study. Please note that for ethical and legal reasons, pregnant women were specifically excluded. It’s not considered ethical to enroll them in a study on the effects of nitrous, but it is legal to encourage them to use it in labor. Dr. Ben Lynch, an expert on MTHFR, considers all women who are pregnant or breastfeeding to be at risk for B12 deficiency, even when they have no other risk factors. Read his informative article about nitrous.
As a childbirth educator and doula I see a large part of my job to be providing my families with accurate information so they can do their job, make informed decisions. Without information, informed decisions are impossible. Studies on the use of nitrous on laboring women may be years away. But t is vital that we educate ourselves about what is currently known about nitrous as it becomes increasing available to the women we serve. And in the absence of adequate information, let’s start with the precautionary principle.
Julie Brill, CCCE, CLD has taught childbirth education to thousands of families over the last twenty-four years and has mentored hundreds of doulas and childbirth educators since 2003. She is the mother of two teenage girls, a La Leche League Leader, and the author of the doula anthology Round the Circle: Doulas Share Their Experiences.
Your newborn’s wants and needs are the same. Later she 
may want a smart phone or a pony, and you’ll have to decide if that’s reasonable, but for now, if you can figure out what she wants you always get to give it to her.
Your baby’s behavior will make more sense if you think about what his life was like during pregnancy. For example, he was never alone for a moment. Many new parents are surprised that their babies will be happy in their arms, but begin to cry the moment they are put down, even when they are sleeping. Being alone is new for your little baby, and it will take some getting used. Hold him as much as possible to show him the world is a safe place, and before you know it he will be crawling away from you, walking away from you, running away from you, biking away from you, and eventually driving away from you. Enjoy the time when he’s little and wants to snuggle.
Baby wearing is a great way to be able to meet your baby’s needs for being held, while keeping your own hands free. It is an ancient way of baby care that is universal among traditional people. Babies that are worn frequently cry less, and so are able to put more of their energy into growth. Babies should always be worn facing towards the adult, not out. Some popular tools to wear your baby include the NuRoo, the Ergo, and the Mobi.
When a newborn is held or worn, his heart rate and breathing will synchronize with the adult he is with, and you may notice his breathing is more regular. Holding your baby skin to skin (he can be in a diaper) is a great place for him to acclimate to life as a newborn. When your baby is skin to skin, it’s easier for her to regulate her body temperature, a job she didn’t have to do as a fetus. If the room feels cool, you can put a blanket over both of you.
In utero life wasn’t silent; your baby could hear your heart beat constantly, as well as your digestive sounds, the swishing of the placenta, and sounds in the room. That’s why babies show a preference for familiar voices once they’re born; they’ve been in their listening and learning for months. Moms have noticed that if they play the same music while relaxing in the bath or during a massage during pregnancy, that playing that music for their newborns will calm them. That’s because during pregnancy mom and baby constantly converse hormonally. Therefore when you relax so does your baby, and he will learn to associate feeling calm with the music he feels at that time. Learn more about how you communicate with your baby prenatally in The Attachment Pregnancy.
While most parents know that crying is most commonly caused by hunger, I have heard many say that their crying baby isn’t hungry because they “just fed her.” However, just fed to a newborn and to a parent are often very different. Because your baby was fed constantly from the placenta down the cord, she doesn’t experience hunger until after birth. It’s a new sensation and she doesn’t like it. Because her stomach is so small, she can’t take in much at a time, so frequent feeds are key. It is normal for babies to need to feed ten to twelve times, or more a day. Keep her with you and feed her at the first signs of hunger (making sucking motions, rooting (turning her head), wiggling, touching her face with her hands). It will be less frustrating for both of you if you can feed him before he gets to the crying stage.
Have you heard that the days are long, but the years are short? The early days of parenting are intense, but you will soon be nostalgic for the tiny baby your child once was. Rest when you can, take pictures, and try to notice the details of this short but important time in her development.
Julie Brill, CCCE, CLD has been working with families in the childbearing year as a doula and childbirth educator since 1992. She is the homeschooling mother of two teenage girls, a La Leche League Leader, and a Certified Breastfeeding Specialist. She trains childbirth educators and labor doulas at New England CAPPA-approved workshops and teaches childbirth classes in the Boston area. She is the author of the doula anthology Round the Circle: Doulas Share Their Experiences.
Contact WellPregnancy
Julie Brill, CCCE, CLD, IBCLC
Julie (at) WellPregnancy.com
