Tag Archives: Doulas

That’s me on the radio…

Adriana Lozada

Adriana Lozada

I just had the pleasure of discussing the advantages of delayed cord clamping with the wonderful Adriana Lozada over at birthful.com.

Here’s the link:

http://www.birthful.com/podcastdcc/.

Check out the rest of birthful.com, too–it’s a great resource–and read Adriana’s fascinating personal history. (Great photo here of Adriana with her 10-year old “mini-me,” Anika.) Adriana has a growing list of podcasts, including interviews with such well-known figures in the childbirth world as Gene Declercq, Rebecca Dekker and Sarah Buckley. I’m honored to be in their podcast presence. Thanks, Adriana!

Advertisements

Leave a comment

Filed under Cord clamping, Doulas, Iron deficiency, public appearances

Epidurals: Do they prevent postpartum depression?

Leonardo da Vinci

Leonardo da Vinci

Do epidurals prevent postpartum depression? That’s the intriguing conclusion some people are drawing from a study published in this month’s issue of Anesthesia and Analgesia. But is that conclusion correct?

In a study of 214 women at Peking First University Hospital in Beijing, researchers found that 14% of women who received epidural analgesia during labor reported symptoms of postpartum depression (PPD) six weeks later, compared with 34.6% of women who refused epidurals. The authors point out that their findings don’t necessarily prove that epidurals can prevent PPD, but the language in the discussion sure sounds like that’s what they believe.

But…the premise of this study is flawed from the start, because the investigators compared epidural analgesia to, well, nothing:

“Each parturient made a decision by herself to have epidural labor analgesia or no pain relief at all. Other forms of analgesia are not available at our hospital.”

What does “no pain relief at all” mean at Peking First University Hospital?  Were spouses/doulas/other support people allowed in the room? Did the mothers labor alone? Does “no pain relief at all” mean no freedom to move about, no bath/massage/music/visualization exercises/birth balls, none of the myriad other comfort measures that can reduce pain during labor? It obviously means no nitrous oxide, and I presume no tylenol or ibuprofen, either. In this particular hospital it seems, the choice is pretty stark: you get an epidural or you tough it out.

Which means we’re left with a study of unaddressed labor pain and postpartum depression, not the benefits of epidurals.

Karl Gauss, inventor of Twilight Sleep

Not exactly “new news”: Dr. Karl Gauss, inventor of Twilight Sleep

It’s hardly news that uncontrolled pain can lead to postpartum depression. One of the main drivers in the “painless childbirth” movement of the mid-19th century and the development of Twilight Sleep in the early 20th century was the prevention of neurasthenia—a debilitating combination of anxiety and depression that haunted many postpartum women.* 

This study would be more compelling if the authors had compared epidurals with other pain relief modalities in the setting of a well-supported labor. Otherwise we’re left with the conclusion that uncontrolled labor pain can make women miserable, and medically obliterated pain makes them less so. 

I can’t think of any other form of human pain that would be studied in such an all-or-none way.

* * *

* Department of Shameless Self-Promotion: You can read more about the history of painless childbirth, as well as what a lousy labor coach I was, in my book, Birth Day: A Pediatrician Explores the Science, the History, and the Wonders of Childbirth.  

Leave a comment

Filed under Birth Day, Labor pain, Maternal-child health, Natural childbirth

Shout-out #1: Enlightened Mama in the Twin Cities

Such a place!

Such a place!

I’ve given a couple of talks in the Midwest this month, and I want to give a shout-out to two very worthy organizations: Enlightened Mama in St. Paul, Minnesota (this post) and Southwest Tech in Fennimore, Wisconsin (coming soon).

I first met Liz Abbene, Enlightened Mama’s founder and “Alpha Mama,” a couple of years ago when I was speaking at the 2012 REACHE conference in Seattle. As we chatted about the conference I was impressed by Liz’s ability to carry on a coherent conversation while buried in children (she has four beautiful kids). Anyone who could keep that many balls in the air at one time, I figured, must run a pretty interesting business.

When the conference wound down, Liz extended me an invitation to speak at Enlightened Mama if I was ever in the Twin Cities. Sure, I said, figuring what are the chances of that ever happening? I’d never been to the Twin Cities and didn’t really have any plans to travel there.

Liz Abbene

Liz Abbene

Ah, but life has a way of changing one’s plans. Last year I enrolled in the University of Minnesota’s Masters in Public Health program, which requires online students to spend a couple of weeks on campus during the year. So I came to the Twin Cities for UMN’s Public Health Institute in early June and, as Liz had willed back in Seattle, I wound up at Enlightened Mama talking on the wonders of the newborn microbiome.

Space does not allow me to describe all that Liz does at Enlightened Mama. Suffice it to say that along with doula services she and her staff and partners provide lactation support and breastfeeding classes; massage, acupuncture and chiropractic care; family therapy and career counseling; and a number of other classes and services that promote wellness before, during, and after childbirth. Alas, there is no brewpub or nail salon at Enlightened Mama, but for all I know these are in the works.

Enlightened Mama is a great resource for families in the Minneapolis-St.Paul area. So if you live there and you’re pregnant, give Liz a call!

P.S: When I asked one St. Paul mother how her town differed from Minneapolis, she told me this:

“People from Minneapolis love to tell you how cool it is to live there. People from St. Paul already know we live in a cool town. No need to brag about it.”

I remain neutral in the matter…

Leave a comment

Filed under Breastfeeding, Doulas, Maternal-child health, Natural childbirth