Posiciones para una lactancia exitosa

Otro video informativo desde la Isla del Encanto.

¿Deseas una lactancia exitosa? La clave está en el buen posicionamiento del/la bebé.

Pulsa sobre la imágen para ver el video:

 

~M

Desde Puerto Rico – Vídeo-cápsulas para preparación para el parto

La Monitriz María de Lourdes Pérez nos muestra el método de respiración completa para relajación durante el trabajo de parto:

Favor de pulsar sobre la imágen para ver el video.

~M

Postpartum Depression is also a male issue.

When we hear the term Postpartum Depression, we think about sad, exhausted, confused women overwhelmed by the hormonal rollercoaster that follows birth. However, this is a shared condition. A study conducted by scientists and behaviorists from the University of West Virginia sheds light on this topic. In fact, it states that between 10 and 25 percent of the men that were part of the study suffered postpartum depression. In May 2010, the Journal of the American Medical Association released one of the first comprehensive studies on this topic. Some of the most common causes for this type of depression in males seem to be: sleep deprivation, pressures from the prospect of having to assume new and more challenging responsibilities, and the expectation of supporting the new mother. In addition to that, we have the expectations of post-modern society in which it’s expected that the father will be engaged and involved in the process of gestation, birth, postpartum, and new born care. At the same time, the emotional stability of the mother is of great importance, as male postpartum depression is more common when the mother also suffers it.

Thus, we need to be mindful of each other. Being sensitive to the needs of the new father is as important as caring for the new mother and baby. And for those men out there that are still skeptical of this topic…Beware! Postpartum Depression is also a masculine issue. So much so, that there are now numerous online resources for the depressed daddy. Browse, peruse, read on…Get educated, Become empowered!

Online resources for male postpartum depression:

www.saddaddy.com

http://www.mmwi-stl.org/

http://www.postpartummen.com/



 

Click on the picture to read a related article on Newsweek.

La depresión posparto…cosa de hombres

Cuando escuchamos el término, depresión posparto, pensamos en madres llorosas, agotadas, confundidas y agobiadas por el sube y baja hormonal que sigue al alumbramiento. Sin embargo, este es un mal compartido. Un estudio realizado por científicos de la Universidad de West Virginia arroja luz sobre el tema. Incluso, señala que un promedio entre 10% y 25% de los hombres que formaron parte de dicho estudio sufrió depresión posparto.

Pulsar sobre la foto para ver el articulo completo sobre el estudio de la Universidad de West Virginia.

Las causas más comunes de este tipo de depresión en el hombre parecen ser: la pérdida del sueño, las presiones producidas por el prospecto de tener que asumir nuevas y más retantes responsabilidades y las expectativas de apoyo a la nueva madre. A todo eso deben añadirse las expectativas de una sociedad posmoderna en la cual se espera que el padre esté implicado en cada detalle del proceso de gestación, alumbramiento, puerperio y cuidado del infante; cosas que no se esperaban de  los hombres de antaño. Además de ello, la salud emocional de la nueva madre es de gran importancia en cuanto a este tema, ya que la depresión posparto del padre podría exacerbarse si la madre sufre de depresión posparto también.

Por tanto, hay que estar alertas. Tan necesario es estar sensibles a las necesidades de la nueva madre y del bebé, como del nuevo papá…y para los hombres que aun lo dudan, ¡cuidado! que la depre también les ataca a ustedes.

The Shame(s) of the nation…musings on maternal death rates in the U.S.

You might recognize the first part of my title. It’s borrowed from a phenomenal book written by long-time educator, writer and activist Jonathan Kozol.

In it, he blows the whistle on the abysmal state of education in cities throughout the U.S. It’s an issue that’s been prevalent for more than two decades. However, most of us look the other way because it doesn’t affect us.

 The same title could be used to describe the horror of maternal death rates in the U.S. in recent years. Today, in our country, more than two women will die of pregnancy-related causes. Will we look the other way as well? Does it not affect us?

Maternal mortality is a serious issue. More serious than we like to think. The ratio has doubled from “6.6 deaths per 100,000 births in 1987 to 13.3 deaths per 100,000 births in 2006”. Nonetheless, as extreme as those rates are, they could very well be much higher because there are no federal requirements to report these outcomes. Guidelines for reporting maternal deaths lie at the state and local levels.

 So… since the feds don’t require reporting these deaths as they should be, private citizens, NGOs, and birth activists around the country have been forced to take it upon themselves to blow the whistle on this topic.

According to a recent report by ABC news, maternal death rates in the U.S. are the same as they were in the seventies. How can we regress instead of progress in terms of maternal health and care? At a time in which labor inductions, usage of epidural anesthesia, and surgical births are at an all-time high, so are maternal deaths in this country. There seems to be a correlation between the two.

 A recent report published by Amnesty International titled “Deadly Delivery”, states that “approximately half of the pregnancy-related deaths in the U.S. are preventable, the result of systemic failures, including barriers to accessing care; inadequate, neglectful or discriminatory care; and overuse of risky interventions like inducing labor and delivering via cesarean section”.

 The report clearly supports my statement in the paragraph above. It also calls us to question the validity of more interventionist approaches to prenatal care.

Internationally renowned midwife, writer, and birth activist Ina May Gaskin has been speaking on this issue for two decades now.  She spearheaded “The safe motherhood quilt project” in 1982. The project is a national initiative developed to bring awareness to maternal deaths in the U.S., an issue that is grossly underreported.

 So, if Gaskin has been blowing the whistle since 1982, why have federal authorities not taken purposeful actions to prevent, report, and address this issue?

Model, film director, and activist Christy Turlington Burns seeks some answers in her documentary “No Woman, No Cry”. She captures the stories of at-risk pregnant women in Tanzania, Bangladesh, Guatemala and the United States. According to her website, www.everymothercounts.org , the maternal mortality rate in the U.S. is 1 in 4,800. If these figures are not appalling enough to make us take a stand on the issue, I don’t know what will.

 Steps we can take to contribute to improvements in maternity care that will bring the maternal mortality rate down in our communities are the following:

• Tweet your senator and support the health reform to ensure all mothers have access to adequate prenatal care.
• Become a skilled birth attendant and support the women in your community. Research shows that having a midwife or doula attended birth decreases the need for an unnecessary cesarean section by 50%.
• Get involved in your local ICAN chapter.
• Ask questions, demand evidence-based information for every possible intervention.
• Choose your prenatal care provider wisely.

 Maternal mortality affects all of us. Don’t wait until you have to bury someone you know to take a stand against it. It is our moral responsibility to each other.

~MRM

And why did I think this was a good idea?

So I started this blog on the spring of 2010 because I am  passionate about maternal health issues. I also know there is a need for objective, evidence-based information out there for all mothers, but especially for Spanish-speaking and/or bilingual moms since we are at a higher risk of premature births, unnecessary interventions in pregnancy and birth…and maternal mortality as well.

However, as much as I LOVE words (I have a PhD in literature)… I am terrified about writing. Not academic writing,the kind of writing that you can hide behind… but creative writing…or personal writing for that matter. Yes, I have been able to write the occasional blog entry from a personal standpoint…but I have stayed away from doing so very often because I am afraid. I was afraid to share my musings in writing circles as a graduate student. I am afraid now.

Nonetheless… I have vowed to become more active in my community, and the online community. I feel called to serve and raise awareness. Thus, I will write. More. More often. Afraid or not. Until the fear goes away or the maternal death rates in this country go down. Whatever comes first. Hopefully the latter before the former.

So there it is. I’m on the path to reinvention, reconfiguration, recommitting myself to the things I hold true.

Read me if you want. Delete me if you must. Pass the word along.

My mantra is the same: Get educated, become empowered!

~MRM

And where is Dad in all of this?

Since my last blog entry in may many things have happened in my personal life. The most recent, shocking, traumatic, sad and confusing of them all has been the loss of my most recent pregnancy. It has been a loss like no other. Of all the personal projects and life goals I have set upon, this pregnancy, my third, has been the one that required most preparation, struggle and preparedness. After my second cesarean, an unnecessary surgery that opened the doors to birth activism, I entered fully into a process of healing, search, expansion, questioning and education, that in turn made way to personal empowerment to consider a third pregnancy. It was a deeply individual and personal process…and at the same time, one that was profoundly shared with my spouse.

After the arrival of my second princess, my husband was positive that there would be no more children. No more pregnancies or emotional tornadoes to deal with, no more having to deal the unknown, no more traumatic births. However, upon six months of having had my second daughter it became very clear to me. The trauma and pain of having been stripped of my right to birth my child could not be the last word on my travel journal of my journey through motherhood. I felt my arms empty, and the conviction that there was a soul out there in the universe that belonged to me…and would come to me in time.

However, this process was not only mine. Yes, it’s true that I had been the one who had held my princesses inside me for nine months, and I was the one they were taken from me when I went into the operating room. But I did not go in there alone. My daughters were not the product of an immaculate conception of sorts. They were the product of a great love story, a common life project between my husband and I. We had planned, desired, imagined, longed for and received them…together.

It took us months, two years concretely, to come together in agreement, and process the traumas and insecurities that came as a result of two traumatic births (for both of us), before deciding to try to conceive our third baby. Mom had been protagonist, but Dad had lived, with equal intensity, and in silence, his own experience.

Hopeful, optimistic and with all the excitement in the world, we received the news that we were expecting. Loudly and proudly I announced to my father-in-law (in front of the whole family) that the reason he thought I looked so ravishing that day was because I was pregnant with his fourth grandchild. Sadly, in fast-forward motion, the laughs turned into worry. Upon the sixth week of gestation ultrasounds and blood exams took the place of  debates to decide whether we should find out the sex of this baby or wait until the moment of birth.

Then came a loss, a surgery, and the end of a dream.

Mom… well, she found support, compassion, and love in her female friends, in her birth activist comrades, in the monthly ICAN meetings, in support groups online, in the parents that came to care for her from far away.

Dad… has yet to receive emails offering consoling remarks, his friends have showered him with messages of a speedy recovery for the wife. But I ask myself… And where is Dad in all of this? Where can he go find a group of committed postmodern fathers that open their hearts and minds to share the pain of a loss like this, the impotence of having to witness the pain of the wife and having to mitigate the confusion of the princesses? Is it only the mother who experiments the shock and trauma of having lost a pregnancy?

Here’s a trailer of a film that explores the experience of birth from the vantage point of a father:

On the other hand, Michel Odent, French obstetrician, expert and advocate of natural birth, establishes that the presence of the father during birth in our times “Is a doctrine of sorts that needs to be reconsidered. To have fathers there observing id the main reason for long and difficult labors. I know of many cases in which the birth is extremely slow until the man leaves for some reason, like for example, to get mineral water. And as soon as he leaves, the woman screams, contracts, and the baby is born. In the perinatal period priority must be given to non-verbal language. Women say they could not imagine birth without the company of their spouse. But with their body they say the opposite: that they birth more easily when they are alone.”(http://www.doulalluisa.cat/entrevista_michel_odent.htm)

So, I ask myself… Where is Dad in all of this?

Should he be present at birth? We could have probably spared him the trauma (in our case).

He surely suffers the loss as much as the mother does. So, where do we send him to get support to process it?

For now, we are both chugging along and trying to move forward. Each of us is processing our loss and mustering the courage to try again. For now, send Dad a message and next time you see him ask how he’s doing…how HE is recovering from the experience, it’ll mean a lot to us.

¿Dónde queda Papá en todo esto?

Desde la última entrada en esta bitácora en mayo pasado, han pasado muchas cosas en mi vida diaria. La más reciente, más chocante, traumática, triste y confusa de todas ha sido la pérdida de mi más reciente embarazo. Ha sido una pérdida como ninguna otra. De todos los proyectos de vida que me he propuesto, este embarazo, el tercero, ha sido el que más preparación, lucha y preparación me había tomado.  Después de mi segunda cesárea, una cirugía cabalmente innecesaria que me abrió las puertas al activismo, entré de lleno en un proceso de sanación, búsqueda, expansión, cuestionamiento y educación, que dió paso al empoderamiento personal para plantearme un tercer embarazo. Fue un proceso muy mío… y a la vez, muy compartido con mi pareja.

Luego de la llegada de mi segunda princesa, mi esposo estaba segurísimo de que no habrían más hijos. No más embarazos, no más torbellinos emocionales, no más temerle a lo desconocido, no más alumbramientos traumáticos.  Sin embargo yo, a los seis meses de haber nacido mi segunda hija, lo tenía muy claro. El trauma, el dolor de haber sido despojada de mi derecho a parir no podían ser la última palabra escrita en mi diario de viaje en la jornada a convertirme en madre. Sentía los brazos vacíos y la convicción de que había un alma en el universo que me pertenecía a mí… y llegaría a mí en algún momento.

Sin embargo, este proceso no era sólo mío. Si bien era cierto que era yo quien había acunado a mis muñecas por nueve meses en el vientre, y a mí es a quien me me las desgarraron de las entrañas en el quirófano, no había entrado sola allí. Las chicas no habían resultado de una inmaculada concepción: eran producto de un gran amor, de un proyecto de vida en común entre mi pareja y yo. Las habíamos planeado, deseado, imaginado, encargado, acunado y recibido…los dos.

Nos tomó meses…dos años en concreto el ponernos de acuerdo, el procesar los traumas, los temores, las inseguridades vividas a raiz de dos partos traumáticos para ambos, antes de decidir ir por nuestro tercer retoño. Si bien Mamá era protagonista en todo esto, Papá había vivido, con la misma intensidad y en silencio además, su propia experiencia.

Esperanzados, ilusionados y con toda la emoción del mundo, recibimos la noticia del embarazo. En plena cena familiar y a boca de jarro le anuncié a mi suegro (frente a todos) que la razón porque le parecía tan guapa y radiante era porque estaba esperando su cuarto nieto. Tristemente, como en cámara rápida, las risas se tornaron en preocupación. A partir de la sexta semana de gestación las ecografías y los exámenes de sangre tomaron el lugar de los debates por determinar si debíamos enterarnos del sexo del bebé en la semana 21 o si debíamos esperar hasta el nacimiento.

Una pérdida, un legrado y con ellos la conclusión de una ilusión.

Mamá…pues encontró apoyo, compasión, cariño en las amigas, en las compañeras de lucha en las reuniones mensuales de ICAN, en los grupos de apoyo cibernéticos, en los padres que vinieron a socorrerla y a acunarla como cuando era niña, a darle ánimos y consolarle desde tierras lejanas.

Papá…aún no ha recibido correos electrónicos ofreciendo consuelo, los amigos se han volcado a preguntarle por la esposa y le mandan los mejores deseos de recuperación. Pero, pregunto yo ¿Dónde queda Papá en todo esto? ¿Adónde se va en busca de un grupo de padrazos posmodernos que abran sus corazones para compartir el dolor de la pérdida de un embarazo, la impotencia de tener que atestiguar/mitigar el dolor de la madre y las princesas? ¿Es que sólo la madre experimenta el choque y el tráuma de la pérdida?

He aquí un trailer de un film que explora la experiencia del padre en el parto:

Por otro lado, el Obstetra francés, Michel Odent, a quien se le atribuye la vuelta aun parto humanizado establece que la presencia del padre en el parto en nuestros tiempos “Es una especie de doctrina moderna que habría que reconsiderar. Que los padres estén ahí observando es la principal razón de que haya partos largos y difíciles. Conozco infinidad de casos donde el parto es extremadamente lento hasta que el hombre se va por alguna razón, por ejemplo, comprar un agua mineral. Y tan pronto él se aleja, la mujer grita, se contrae y nace el bebé. En el período perinatal, hay que darle prioridad al lenguaje no verbal. Las mujeres dicen que no podrían imaginarse el parto sin la compañía de su esposo. Pero con su cuerpo dicen lo contrario: que dan a luz más fácil cuando están solas.” (http://www.doulalluisa.cat/entrevista_michel_odent.htm)

Entonces… ¿Dónde queda Papá?

¿Debería estar presente en el parto? Probablemente le hubiésemos ahorrado el trauma…al menos en nuestro caso.

Seguramente sufre la pérdida tanto como la madre. Entonces, ¿Adónde lo mandamos a buscar apoyo para procesarlo?

Por lo pronto, nosotros vamos tirando hacia adelante. Cada quien procesando su pérdida y armándose de valor para volver a intentarlo. De paso, mándenle un mensajillo a Papá y la próxima vez que hablen con él pregúntenle cómo anda… cómo se va recuperando, valdrá la pena hacerlo.

Rising Maternal Mortality in the U.S. : A call to action

The L.A. Times has just released a disturbing article that blows the whistle on the rising rates of maternal morbidity in this country.  According to the article ” Though the U.S. spends more per birth than any other nation, maternal mortality is higher here than in 40 other industrialized countries, including Croatia, Hungary and Macedonia, and is double that of Canada and much of Western Europe.”  It is grossly ironic that today it is safer to birth your child in countries that are deemed as much less developed that the U.S. In fact, it is much more than ironic. This issue has raised major concerns from human rights organizations such as Amnesty International. After all, maternal health and the rights of childbearing women IS a human rights issue!

 Why are more North American women dying during childbirth and/or of birth complications? Are we broken? Is the system broken?

For so long we have been taught to trust our medical professionals blindly that we have lost the power of discernment. Many of us go into operating rooms unnecessarily, and more times than not, misinformed in regards to the complexity of surgical deliveries, their risks and consequences. In 1997 1 out 5 babies were born via surgical birth in the U.S. , today the rate has increased astronomically to 1 out of 3 births. Although the old adage of  “Once a cesarean, always a cesarean” is outdated and plain out false, the trend continues to be to advice in favor of a repeat cesarean rather than a trial of labor in completely healthy and capable women. Mothers across the country face hospitals with VBAC bans, unsupportive doctors due to fear of liability, and other frivolous reasons such as scheduled inductions or cesareans due to family concerns (such as special dates, vacations or pressures to go back to work) in lieu of support and patience when it comes to birthing their children.

The results are worrisome, no, they are alarming. With such rates of maternal morbidity what is a mother to do as she prepares for what should be one of the milestones of her life?

• Avoid induction at all costs = According to this article “When labor is induced a week or so before the due date, the uterus may not be ready, leading to prolonged labor. After delivery, the exhausted muscle may not contract properly to stop bleeding.” The March of Dimes (click on hyperlink to read document)has also published a useful article on this issue. Read on.

 

• Carefully choose your hospital. Research the nurse/patient ratio for labor & delivery. =  According to Nan Strauss ” , a senior researcher at Amnesty International and a coauthor of the organization’s March report on maternal deaths” […]”What we heard over and over is that facilities are underfunded in a lot of areas and providers are stretched thin”.

 

• Know your Medical History = Make sure you understand and throroughly discuss with your care provider your medical history and/or any risks for congenital diseases or family history that would put you at risk during childbirth.

 

• Be careful about the usage of  Electronic Fetal Monitoring = Request intermittent fetal monitoring, for fetal hearttones to be checked via doppler or go the traditional way. Studies have shown that EFM often has skewed readings and are a contributing factor to unnecesary cesareans. Click here to see a recent article published by the ACOG refining guidelines for EFM.

 

• Research, Ask Questions, Demand Evidence-Based Answers = Women have been socialized to trust, listen and obey. Speak up! You are your best advocate. You have a right to know in order to make informed decisions. Click here for a list of ten essential questions to ask your care provider.

 

• Get a Doula!= Your OB is there to care for the safe delivery of your baby. He/she will most likely not be there to nurture and hold you while you are experiencing labor.  Doulas are trained birth assistants/coaches. They are there to mother you, to support you and your partner during childbirth. They will remember everything you may forget from your childbirth preparation classes. Moreso, research indicates that hiring a certified Doula decreases the possibility of an unnecessary cesarean section by 50%! Click here for a great article on why fathers should demand a Doula at childbirth.

 

• Finally: Don’t get scared. Get mad. Get moving!

Turn your anger into a driving force to demand better Maternal Health services in your community. Here is a short list of national organizations currently working towards better Maternal Health. Click on the name of the organization to access a hyperlink to their page:

1. International Cesarean Awareness Network
2. Coalition for Improving Maternity Services
3. Amnesty International

Get Educated, Become Empowered!

-M

Lista de Cotejo Sobre los Riesgos de Una Cesarea

Excelente recurso desarrollado por la Dra. Ana Parrilla (Puerto Rico) y publicado en la pagina de internet de La Fundación Puertorriqueña para la Protección  de la Maternidad y la Niñez.

Una madre educada vale por dos.

Madre: Educate para que te Empoderes! Usa este listado para prepararte para el parto junto con tu proveedor de cuidado prenatal.

Pulsa aqui para ver el documento.

 

-M