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Post of the week

Posted November 17th, 2014 in Birth Doula in Fresno, doula, fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma

You must be the change you wish to see in the world.

Mahatma Gandhi

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10 Rreason Not to Let a Bayb Cry-it-out

Posted February 26th, 2014 in Babies, Birth Doula, Birth Doula in Fresno, fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma

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Comments Off on A Baby’s View of Birth By Beth Kephart

A Baby’s View of Birth By Beth Kephart

Posted May 16th, 2013 in birth, Birth Doula in Fresno, fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma
A Baby’s View of Birth

By Beth Kephart

Her voice comes to him like a stream of music, particles of sound from a  world outside his own. He has awakened from a sleep and from a dream he  won’t remember, and feels swaddled by sound — not just the voice, which pleases him, but the decisive beating of his mother’s heart, the  grumble of her intestines, the murmur of her lungs as they balloon and  then deflate. The light is dim inside the womb. Blood gurgles as it  washes by. He feels the weight of his mother’s hand pressing in, toward  his knee, and he presses his knee out toward it, as if to say, Yes, I am here.

Thirty-eight weeks ago he was nothing but one cell. One cell that then divided into  the stuff of tissues, organs, bones, and hormones, each cell finding its place in the growing cluster by heeding the instructions inscribed in  its genes. Some cells sloughed off and others settled in for life —  folding and migrating until, for instance, a miniature tube became his  pumping, robust heart. Now, transparent nails cap the tips of his  fingers and his toes. Billions of neurons are bundled in his brain.  There are creases on the bottoms of his feet, and on the sides of his  head are the fleshy blooms of his ears.

Now that he has a mouth and hand, he sucks his thumb. He squints toward the placenta through the amniotic fluid in which he floats. Attached to the back wall of his mother’s uterus, the placenta utterly encircles him,  anchoring him in with the ropy umbilical cord. The placenta is the only  organ he’ll discard upon his birth. An ingenious collaboration, composed partly of his cells and partly of his mother’s, it has served him these last many months as lungs, liver, kidney, endocrine glands, commissary, and telephone. How has he been getting his oxygen and blood? Through  the placenta. Where has he been sending his waste? Back to the placenta. From where have his glucose, amino acids, water, fats, mineral ions,  and vitamins come? The placenta. By what means has he already initiated  the processes of his own birth? By sending a squirt of hormone to the  placenta, of course.

For indeed the time has come. There’s enough fat on his body now to help  him make the transition to what will be a far cooler, drier environment. Enough neural pathways have been established between his sense organs  and his brain. He has shed his lanugo (the fine hairs that have covered  his body for many weeks) as well as his vernix caseosa (the waxy white  coating that has protectively sheathed his skin during his long  incubation), and then swallowed both; they’ll ooze away from him after  birth, with his first bowel movement. His bloodstream has been fortified with his mother’s immunoglobin proteins. And he’s ingesting the salty,  growth factor-enriched amniotic fluid that he floats in — thereby  helping the maturation of his digestive system.

For weeks now, he has been practicing breathing — exercising the muscle  fibers of his diaphragm, strengthening the nerve connections between his respiratory center and his brain, ensuring that his lungs will have the stuff it takes to expand and ventilate when they finally meet air. And, just to ensure that all systems will indeed be go, he has lately given  himself over to the stuff of sleep, napping as much as 95 percent of the time. He’s been spending much of that naptime in rapid eye movement  (REM) sleep, which has increased his heart rate, fluttered his eyes,  quickened his pulse, sparked the release and receipt of electromagnetic  pulses. This has been integral to the development of his brain —  pushing the mass of bundled nerves, cells, and connections to sort  themselves out in time for life outside the womb.

Now the fetus hears a low-frequency sound — the voice of his father. Soon  thereafter, the voice of his mother wafts in. He feels his body swaying, and senses that his own oxygen level has started to decline, for his  mother is pacing again, exerting herself and, therefore, him. His body  responds as it always does at times like these — channeling the  oxygen-rich blood to his brain and other critical organs, protecting  them above all else.

Upside down and snug in his mother’s womb, the fetus is aware that his  mother’s abdomen is tightening around him. Small, painless contractions  that are a mere precursor of what’s soon to come. “The baby comes when  the baby’s ready” may be folk wisdom, but it is also a fact, and this  fetus — fully developed, with no more space to stretch and grow — is  definitely ready for life outside.

Life On the Outside

A few days ago, his brain’s hypothalamus sent a message to his pituitary  gland. His pituitary, in turn, sent a signal (a small dose of the  chemical adrenocorticotropin, or ACTH) to his adrenal glands, which  subsequently played their part by releasing a stress hormone, called  cortisol, through the umbilical cord to the placenta. There, it has  begun to promote the production of estrogen, suppressing the manufacture of progesterone and, at the same time, releasing enzymes that are  capable of converting progesterone into estrogen. Thus, without raising  the suspicions of his mother, the fetus — as seemingly helpless as he  is — has triggered the processes of his birth.

All throughout her pregnancy, his mother’s abdominal muscles have been held in stasis by the predominance of progesterone over estrogen. Enough  progesterone has kept her body from rejecting the foreign object of her  fetus; the right amount of estrogen, on the other hand, has made mild  contractions possible, keeping the abdominal muscle toned.

Now that contractions are required to bring the pregnancy to a close, the  hormonal ratio must begin to shift in favor of estrogen. The softening  and dilation of the cervix is reliant on estrogen, as is the production  of proteins that encourage contractions. The ability of the mother’s  blood to coagulate during the birthing process depends on estrogen; so  does the production of prostaglandin and oxytocin receptors. Without  these, vaginal childbirth would be impossible, for it’s only after  estrogen makes the mother’s uterus more suspectible to oxytocin — and  oxytocin and prostaglandin then stimulate the contractions of smooth  muscles in the uterine wall — that the whole choreography of labor can  genuinely begin.

To get the contractions moving at some meaningful tempo, what’s needed is a dose of oxytocin, whose production is a collaborative effort: it’s  released by the pituitary glands of both the mother and the fetus. The  release of the oxytocin promotes further hormonal releases from the  adrenal and pituitary glands of the fetus. Mother and child have  officially entered the first stage of labor.

Contractions will start coming every 15 to 20 minutes or so now, each lasting 30 to  60 seconds. For the mother, there’s pressure and pain. For the fetus,  there’s the sensation of being squeezed. He hears voices outside  himself, feels the rock and walk of his mother’s pelvis. As labor  progresses and the cervix starts dilating, contractions come more  forcefully, more quickly, bring more pain to the mother. With his own  head, the fetus helps the process along — stretching his mother’s  cervix until it initiates a new cascade of nerve impulses that travel up the mother’s spine to her pituitary gland, which answers with the  release of more oxytocin. This further stimulates the contractions.  Inside, the fetus feels the squeeze and release of the muscular chamber  that’s housed him these many months.

With every contraction, the uterus shortens and closes, inching the fetus  farther down. With every contraction, the cervix widens. If things  seemed tight before, they’re nothing short of crowded now. The  contractions are coming far more often, and the fetus is dimly aware of  an array of new sounds outside the womb. He hears the groan of his  mother, the soothing voice of his father. Now he is squeezed tightly;  it’s not pain he feels, but pressure. The uterine muscles clamp down on  his head with such persuasion that he begins to release the thyroid  hormones and adrenaline that his body instinctively knows it will need  to adjust to the cooler temperatures in the outside world.

The pressure from the contractions, as well as the rising concentration of  prostaglandins, also protect him from a serious danger: the temptation  to breathe. Breathing before his head is completely free of the birth  canal would mean taking in fluids and risking pneumonia, so the fetus  obeys the blueprint in his genomes that instruct him to wait until the  world can hear him cry. It might sound easy, but his oxygen supply is  getting thin. His umbilical cord, with its many vessels supplying  oxygen-rich blood, is stretching. His mother’s blood vessels are  squeezed. The placenta is starting to tear away from the anchor of her  uterus. But he mustn’t yet breathe.

All of a sudden something breaks. he feels the amniotic fluid trickle, then rush past him. Just below his head, the cervix is at last fully  dilated. He feels his head push through a narrow channel, caught in the  vice of a contraction. With the cervix fully dilated, he can now push  through the birth canal, but it’s not a journey even this world-ready  fetus could make were it not for his own soft skull, which deforms in  the narrow passage. Still, no pain for the fetus. Just pressure.

It seems to go on for an eternity. The umbilical cord is stretched thin.  There’s hardly any oxygen in his blood. The amniotic fluid is being  squeezed from his lungs. His body fights fatigue.

Suddenly, there it is: A cold, bright, shouting light — dry air! Sound turned up to a whole new level. Slippery hands upon his head. A clamp on his  umbilical cord. He wails. Instinctively, he turns 90 degrees in the  birth canal, and trusts the hands in this new world to pull his naked  body free.

The fetus’ holler is that very first breath he’s practiced for. His lungs  draw in the air and its air sacs open. The oxygen relaxes the walls of  his lungs’ blood vessels, causing them to dilate. Whereas in the womb  the fetus’ blood bypassed his own lungs and was shunted off to be  oxygenated by his mother’s, now the shunts close forever, and his blood  begins to find its way into his lungs. There, it is oxygenated, and  rushed into his arteries via his heart.

The world the baby has entered is strange and new. There’s five times more  oxygen available now than there was ever before, and the rush of its  life-giving molecules stimulates his nerve cells. He still has a lot to  master, for his umbilical cord has been cut and his placenta —  surrogate lung, kidney, protectorate — is no longer a part of his life. Now his nutrients must come from milk. Now his kidneys must take charge of balancing his bodily fluids. But before he’s given much of a chance  to grasp the skills he’ll need, he’s given (and isn’t this just like  real life?) an exam — an Apgar test — which assesses his heart rate,  respiratory effort, color, muscle tone, and reflexes. Then he’s carried  beneath the harsh lights, through the dry air, toward a new destination.

A sweet voice he recognizes speaks to him, and a second voice whispers in his ear — his father. Who knows what the proud, encouraging sound  waves mean, but they play like music to his ears. He nuzzles close in  his mother’s arms.

Beth Kephart’s A Slant of Sun: One Child’s Courage was a 1998 National Book Award finalist.

Comments Off on Merry Christmas!

Merry Christmas!

Posted December 14th, 2012 in Birth Doula in Fresno, doula, fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma

Comments Off on After the Birth, What A Family Needs

After the Birth, What A Family Needs

Posted December 14th, 2012 in doula, fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma

Such a great article by Gloria Lemay. Please read and consider this!

After the Birth, what a family needs

 Posted on October 28, 2008 by gloria lemay

“Let me know if I can help you in any way when the baby is born.” … “Just let me know if you need a hand.” … “Anything I can do, just give me a call.”

Most pregnant women get these statements from friends and family but shy away from making requests when they are up to their ears in dirty laundry, unmade beds, dust bunnies and countertops crowded with dirty dishes. The myth of “I’m fine, I’m doing great, new motherhood is wonderful, I can cope and my husband is the Rock of Gibraltar” is pervasive in postpartum land. If you’re too shy to ask for help and make straight requests of people, I suggest sending the following list out to your friends and family. These are the things I have found to be missing in every house with a new baby. It’s actually easy and fun for outsiders to remedy these problems for the new parents but there seems to be a lot of confusion about what’s wanted and needed…

1. Buy us toilet paper, milk and beautiful whole grain bread.

2. Buy us a new garbage can with a swing top lid and 6 pairs of black cotton underpants (women’s size____).

3. Make us a big supper salad with feta cheese, black Kalamata olives, toasted almonds, organic green crispy things and a nice homemade dressing on the side. Drop it off and leave right away. Or, buy us frozen lasagna, garlic bread, a bag of salad, a big jug of juice, and maybe some cookies to have for dessert. Drop it off and leave right away.

4. Come over about 2 in the afternoon, hold the baby while I have a hot shower, put me to bed with the baby and then fold all the piles of laundry that have been dumped on the couch, beds or in the room corners. If there’s no laundry to fold yet, do some.

5. Come over at l0 a.m., make me eggs, toast and a 1/2 grapefruit. Clean my fridge and throw out everything you are in doubt about. Don’t ask me about anything; just use your best judgment.

6. Put a sign on my door saying “Dear Friends and Family, Mom and baby need extra rest right now. Please come back in 7 days but phone first. All donations of casserole dinners would be most welcome. Thank you for caring about this family.”

7. Come over in your work clothes and vacuum and dust my house and then leave quietly. It’s tiring for me to chat and have tea with visitors but it will renew my soul to get some rest knowing I will wake up to clean, organized space.

8. Take my older kids for a really fun-filled afternoon to a park, zoo or Science World and feed them healthy food.

9. Come over and give my husband a two hour break so he can go to a coffee shop, pub, hockey rink or some other r & r that will delight him. Fold more laundry.

10. Make me a giant pot of vegetable soup and clean the kitchen completely afterwards. Take a big garbage bag and empty every trash basket in the house and reline with fresh bags.

These are the kindnesses that new families remember and appreciate forever. It’s easy to spend money on gifts but the things that really make a difference are the services for the body and soul described above. Most of your friends and family members don’t know what they can do that won’t be an intrusion. They also can’t devote 40 hours to supporting you but they would be thrilled to devote 4 hours. If you let 10 people help you out for 4 hours, you will have the 40 hours of rested, adult support you really need with a newborn in the house. There’s magic in the little prayer “I need help.”

 

Comments Off on The Birth of Abigail Jean…

The Birth of Abigail Jean…

Posted December 4th, 2012 in Birth Doula, doula, fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma

The following birth story was written by one of my clients.  I have been granted permission to put it on my blog to share with you.

The Birth of Abigail Jean

by Sara Dearden on Thursday, November 1, 2012 at 10:38am ·

This is Abby’s birth story except told through the eyes of my Husband, Scott. About an hour or 2 after she was born he decided to write it all down because we were afraid that we would forget something later on.

“Labor began at 7 am with strong, low contractions and Sara’s bag of water leaking. She got a shower, ate breakfast, and had contractions until around 8am. We started timing them and they were 8 minutes apart and lasting 45seconds to 1 min 15sec. Sara knew “this was it.” At close to 9am I (Scott) finished packing the car. We call our Doctors office, Doula and Doula-in-training to let them all know that we were headed to the hospital. Sara contractions were now 5 minutes apart.

We left for Central Valley Hospital around 9:15ish and arrived around 9:40 am. On the way, Sara’s contractions got down to 2-3mins apart. With no space in the parking lot, we had to drive around the corner to turn around and park on the street. With ever stronger contractions, Sara said, “I don’t think I can do this anymore.” What I heard was ” I AM IN TRANSITION!!!” From the car to the hospital door Sara had four more contractions. On the last one, on the sidewalk in front of hospital, she said “I feel like I have to push.” I encouraged her not to push, but instead to grunt through it and to wait until we were checked in.

Sara was very concerned with timing contractions. She would apologize every time she forgot to hack the stopwatch when another one started. When we got to labor and delivery the nurse took our info and asked us to wait while they got us checked in. Sara felt like she couldn’t sit down without pushing, and had several contractions leaning against me. She felt like she had to pee and maybe that would take some of the pressure off, so I asked where the bathroom was that she could use. They took her to the room where they bathe and evaluate newborns after birth and let her use the bathroom in there. I followed her in to be supportive and to my surprise another one was just starting. Sara threw the plastic pee cup that she had be given and she held herself above the toilet with her hands and screamed that she needed to push and really started screaming. The nurses came in quickly. One threw a towel on the floor and the other looked between Sara’s legs and yelled, “The Baby’s crowning!!!” We got her off the toilet and the nurses wanted her to lay down but I(and she) wanted to squat. We came to a compromise of sitting with me behind her. Sara was screaming like a banshee (in my ear of course, and the tile-covered bathroom did not help muffle the sound at all!!!) but the midwife on duty told her to stop screaming and focus that energy into pushing (Sara would later tell me that, that was the best piece of advice that anyone gave her). As Sara leaned back into me with chin on chest and four good pushes, Abigail was born.

As Sara picked up and held a screaming Abby for the first time, the nurses clamped and cut the cord, took her to the warming table, and helped Sara onto the bed that had been rolled into the room. Abby measured in a 7lbs 8oz and 20inches long. She scored perfect on the apgar test. Sara was almost given pitocin to help deliver the placenta, but I covered where they were about to inject her and stated “No Meds,” and the nurse thanked me. The nurses never had the chance or time to look at the birth-plan and I found the one that I was going to hand them crumpled and a little blood splattered in the corner of the bathroom. Sara only had a small tear that needed two stitches. Abby was born at 10am 10/12/12. Forty mins later we were in a room on the Maternity ward.”

Abby’s birth was a huge surprise. If you would have told me that labor was only going to 3 hours and I would have my baby in the bathroom before the Doctor could make it I would have laughed:) But when my Doctor did make it in to see us he said that we made history that day because NO ONE had ever delivered in that bathroom or that quickly in that hospital. I also have a better understanding of why so many of my friends prefer a Midwife to a Doctor. It was nice to have someone who was supportive of everyone needs throughout this experience. If there is a next baby I think we may look into that option a little more closely:) But Ms. Abigail has been a blessing and joy to are little family and I can’t wait to see what God has planned for my little whirlwind as she grows-up.

Comments Off on A child is born…

A child is born…

Posted November 14th, 2012 in fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma

The moment a child is born, the mother is also born.  She never existed before.  The woman existed, but the mother, never.  The mother is something that is absolutely new!    Quote from Osho, a spiritual leader and Indian Mystic

Comments Off on Babies!

Babies!

Posted November 4th, 2012 in Babies, doula, fresno, Fresno birth, Fresno Birth Doula by Kathryn DiPalma

I LOVE getting pictures of ‘my’ babies!

Elliana Rene: 2 months!

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The Golden Hour by Bob Sears

Posted September 20th, 2012 in Babies, doula, fresno, Fresno birth, Fresno Birth Doula, Newborns by Kathryn DiPalma

by Dr. Bob Sears

The Golden Hour: Getting the Best Start with Your Newborn

When that tiny baby is placed into your arms, he or she is the ultimate reward for your nine months of careful preparation. You may not know that what you and others around you do in that very first hour of your baby’s life can have a significant—even lifelong—impact on the bond you have with your baby. This article shows you how to best prepare for that golden hour, how to maximize the bonding experience, how to defer hospital procedures that may interfere with bonding during that first hour and how to communicate those needs to your medical caregivers.

To read the entire article by Bob Sears, please go to:  http://choicesinchildbirth.org/choices/postpartum/golden_hour

Comments Off on Getting Organized!

Getting Organized!

Posted August 20th, 2012 in Birth Doula, doula, fresno, Fresno birth, Fresno Birth Doula, Fresno Birthdays, Fresno VBAC, labor by Kathryn DiPalma

This weekend I spend a lot of time organizing all of my DVD’s.

  Several of them were loose and needing to be put in cases and labeled.  Now they are ready to be checked out!