Morning Sickness...more like ALL day sickness

Written By: Audrey Luck, Tree of Life's newest midwife

            Morning sickness is commonly known as nausea and/or vomiting in pregnancy. This is a normal and common occurrence in pregnancy.  It usually starts around 6 weeks of pregnancy, but it can begin as early as 4 weeks. It tends to get worse over the next month or so and disappears around 

12-14 weeks. 

           

            The exact cause of morning sickness is not known for sure. It is believed that rising hormones, Human Chorionic Gonadatropin (HCG), Progesterone, and Estrogen, are the primary suspect. They can increase a woman’s sense of smell and cause sensitive stomachs. For some pregnant women, the symptoms are worse in the morning and ease up over the course of the day, but they can strike at any time and last all day long. Because of this eating can be a challenge.

           

            The initial surge of morning sickness may be hormone induced but the lack of eating because of it perpetuates the condition. Nausea is also a common symptom of low glucose, sugar, in the body. Thus, you have the vicious morning sickness cycle that last ALL day.

           

            Here are some recommendations that you may find to be helpful in reducing your symptoms. First off, do NOT skip meals and snacks. Increasing or spreading out your food intake minimizes the highs and lows of sugar levels in turn minimizing nausea due to low blood sugar. Aim for eating 5-6 small meals/snacks daily (breakfast, snack, lunch, snack, dinner,...snack), but remember the caloric demand in pregnancy is 300 extra calories to you normal non-pregnant caloric demand.

           

            Secondly, make all snacks and meal include protein and complex carbohydrates (ie. whole grains, certain fruits, vegetables, and legumes). When you eat  complex carbohydrates, they get converted to glycogen and are used immediately for energy, providing a steady dose of blood sugar or they are stored in the muscles and liver for energy at a later time. Simple carbs, by contrast, cause a spike in blood sugar that quickly dissipates resulting in nausea. Regarding protein in pregnancy, women should eat 60 – 80 grams of protein. Protein are the building blocks for all muscle cells in the body.

           

            A few other helpful recommendations are: sucking on lemon candies, drinking ginger tea or eating ginger candy, snacking on dry foods like crackers, and trying to reduce stress. Believe it or not, stress has been discovered to play a component in nausea and vomiting in pregnancy.

           

            Morning sickness can be an annoyance at times but it is a reassuring sign of pregnancy. Just remember it does not last for ever. Discuss your morning sickness with your health care provider. If you hold more that 50% of your daily intake you may need medication.

The Truth about Transition

Written by: student midwife, Jaclyn G. Hauge

            Transition is a normal and predictable phase during labor.  It is the shift between the first and second stage of labor and an indication that you will soon be ready to introduce your baby to the world.  It’s during transition that I begin to fill with excitement and anticipation.  I know that birth is imminent and that the waiting, hard work and sensations of labor will soon be over for the woman.  It’s also a point in the birth process where I have to work my hardest.  So, why is this? How can one event illicit such opposing feelings? Frankly, it’s the physiology of birth.

            Labor and birth is a positive feedback mechanism initiated by our body.  Our bodies begin the process of labor and then continually intensify it in order to expel the fetus and return to its normal state.  Simply put, the body doesn’t stop working until the job is done.  Transition can be the greatest reminder of this.  Transition exaggerates labor, intensifies sensations, and is the overture to the grand finale of birth. 

            With the onset of early labor moms are excited, coping famously, talking, cleaning, laughing and joking.  They really don’t need a whole lot of focus, they just go on with their day, noticing a surge every 5-7 minutes.  A few hours later once active labor begins, the intensity of surges increases, moms start working a lot harder now.  They may stop during a surge, focus their breathing, and might ask for some help.  Birth partners can be very helpful during this time reminding moms to release tension, focus their breath, and massage their backs, hips or legs.  

            Somewhere around the 7-8 centimeter mark, transition begins.  At this point, the last bit of cervix is beginning to melt away, making room for the passage of the baby. Surges begin to increase in frequency, approximately every 2-3 minutes with 30-60 seconds in between.  Along with the frequency, the intensity also escalates.  Women begin to sound more “primal”, and operate on instinct. Moms move their bodies, they get up, they get down, move to the toilet, then to the bed, then maybe to the tub.  Needless to say women in transition are also very indecisive.  One minute they’re burning up, the next they’re shivering and calling out for a blanket.  Some women experience vomiting, others experience involuntary shaking of the limbs.  They may feel as though nothing helps, and the woman who liked guided meditation during active labor may not want talking at this time. 

            As exciting as this time is for me, women have difficulty seeing the finish line in the distance.  They might feel like they’ve done all the work they can do.  They may begin to doubt themselves.  Usually once a mom says “I can’t do this”, most of the work is done and it’s almost time to push.  It’s hard to convince a woman that what she’s experiencing is all normal.  This may be her first baby, and she’s never felt this way before. It may be her third and she remembers the sensations all too well.  Women may try to back away from transition, they may be scared of what’s to come.

Luckily, transition doesn’t last forever.  On average transition occurs in about 40 minutes.  The most important thing to remember is that the feelings, emotions, and sensations of transition are normal and they are positive. Transition is working with you, it’s helping you to welcome your baby.  So, don’t fear it, embrace it and take solace in your midwives when they say “you’re doing great, this is normal, you’re almost done.”

Breastfeeding Mom and Midwife by Rebecca Luckey

Most of you all know I’m a midwife, well I’m also a nursing mother of a one year old.  Being an on-call practitioner with a nursing infant is not the easiest of things, especially when your kid doesn’t like pacifiers or to self soothe to sleep.  This past year of nursing and pumping while away has been quite an adventure.  Getting a call in the middle of the night or not being home for days is the norm.  I have had to have students make milk runs to daddy for me since we had no other way for him to pick up milk or   to bring baby to me, only having enough “stashed” away for about 24 hours.

As I write this article, I have Nora nursing in my lap, a foot in my chin and little fingers pinching at my arm.  I am a seasoned mother of now four children.  I write this out of a practical need, not a late breaking new article with an English major midwife behind it.  I’m just a working mom with a different schedule than most. 

It takes commitment from not only the mother but daddy too.  My husband would keep track of how much was in the freezer and let me know when I needed to “bump up” my production to ensure the baby will have what she needs.  I will tell you once solids came in to the mix at six months I felt a little reprieve from feeling like a cow, but still without fail I manned the pumps every 3-4 hours.  Finding the right pump makes the difference.  I use a Hygia double pump and it’s so much better than my Medela.  I find I actually can express more per feed with the Hygia and have less clogged ducts when away from my nursling.  You have to find what works for your body.  Not to say Medela is at all a bad pump, it’s very highly recommended across the board, but I found another brand that fit my body and my baby.

Finding the time to pump, that is a dilemma at times.  When in the office I can sneak away for a few minutes and lock myself in a room, but while at a home birth or driving half way across state doing home visits I have to pump and drive.  I single pump with a hands free bra and have cool packs with me to store the milk….sometimes I have to stop in convenient stores for cups of ice along the way.  Oh and believe me you do cry over spilled milk.  Seeing even an ounce of liquid gold go bad or leak out of a bag is so frustrating.  I have had to work hard for every ounce. Even if I go four or five hours and feel engorged I only get 3-4 ounces between the two sides.  But that’s all my daughter needs.  She still only takes 2-3 ounce feeds at one year of age.  For these women that can express eight or more ounces at a time I applaud you.  If you’ve seen my daughter, she is quite the chunk and seems to be doing just fine on my 20-24 ounces per day.

Ways that I increase my supply: eating steel cut oats, having a dark beer here and there, increasing my water intake and calories as well putting baby to the breast the second I am home.  Even if I just pumped on the way home, I put her on the breast.  I don’t pump when I’m home, only to the breast with baby and I try to take her with me as much as possible. 

I want other moms to know that if I can make it work so can you.  I look back on my other childrens’ nursing experiences and see all of my mistakes…I made a vow not to make them this time.  Breastfeeding is so important that first year...and I finally did it! 

Welcome Abraham James 9lb1oz born at home while siblings patiently waited. Mommy was 42weeks and baby #4 was very different from previous births.....she trusted her body and stayed in the moment and the beautiful baby boy finally entered earthside! Each birth can be so different which is why being out of the hospital allows the space to trust and be present so much easier. The distraction of new faces, hospital equipment, and procedures can really distract and even paralyze the birth process which is why pitocin is so often needed. Remember, we can always transfer into the hospital if we need intervention. We can't leave the hospital and go home once everything is going exactly as it should!