Category Archives: Pregnancy & Birth

My thoughts, ideas, and commentary on various aspects of pregnancy and childbirth…

Eating After a Cesarean: How soon is too soon?

Plate of Food

When I was a new nurse working on the post partum floor in 1994 mothers who had c/sections were not given solid food for at least 2 days after their surgery. We advanced them from ice chips, to clear liquids, to soft diets, and to regular diet slowly over the course of a few meals and as their bowel sounds returned.   This practice was done theoretically to help prevent various digestive problems such as nausea and vomiting, severe abdominal distention or an ileus.  Bowel sounds returned to normal and women were able to advance their diets, have bowel movements and go home within a reasonable amount of time.  I don’t remember many mothers with severe abdominal distention from gas. I don’t remember severe gas pain  (though women definitely complained of gas pains).  I don’t remember large amounts of nausea and vomiting and I certainly don’t remember any patients needing NG tubes.  The biggest complaint we heard was “Is this it?! Is this all I’m getting? I’m HUNGRY!”

Now… its been a long time and so my memory may be a little shaky but there is one thing I am certain of…. These days women who have c/sections are given regular food sometimes within a few hours after delivery and I DEFINLTEY see many more problems, vomiting, pain, distention, constipation, need for NG tubes than I ever saw before. With that in mind, I was very surprised to read an article from Reuters Health that said: “Early oral intake after cesarean section speeds recovery of gastrointestinal function and does not increase the risk of ileus and other gastrointestinal complications, the authors of a new systematic review conclude.”  The study this article makes reference to was published in the May issue of The Journal of Obstetrics and Gynecology (The Green Journal)

The article goes on to say…  “On average, women in the early oral intake groups had return of bowel sounds 9.2 hours sooner than women in the delayed intake groups, while passage of flatus occurred 10 hours earlier and bowel evacuation occurred 14.6 hours earlier. Earlier intake was not associated with an increased risk of ileus symptoms, vomiting, nausea, abdominal distention, or diarrhea.

 ”A neurogenic nonadrenergic pathway of postoperative ileus is activated during abdominal surgery and until three hours after surgery,” Dr. Chang said. “To avoid stimulating this neurogenic pathway, oral intake between six to eight hours after cesarean delivery is suggested. Both liquid diet and solid diet can be served as an ideal initial intake after cesarean delivery.”

SERIOUSLY?? I’m shocked! You can read the entire article from Rueters HERE This is definitely something for me to ponder. What do you think of this? Did you have a c/section?  When did you eat foods after your surgery? Do you care for post-c/section mothers? What do you tell them about eating and drinking after delivery?

Are we Listening to Mothers?

Do you know about the “Listening to Mothers” reports?  They are a WONDERFUL resource for anyone who is working with or on behalf of childbearing women and families.  The first report was published as a project of Childbirth Connection in 2002.  That report was … “the first national U.S. survey of women’s childbearing experiences.  They survey explored women’s attitudes, feelings and knowledge about many aspects of their maternity experiences.“   A second report, Listening to Mothers II was released in 2006 and last week they released the newest report Listening to Mother’s III.

Unfortunately, I have not had the time to read through this third report but I am very excited about the report as well as all of the data analyses they have created.  I know this report will bring more valuable information to help support our work as mother friendly advocates.  If you haven’t heard of these report before… its time you get to know them.  LTM III Cover

In the email they sent announcing the release of the third and most recent report they say  “As with previous Listening to Mothers surveys, the latest data show that risky procedures are overused, many beneficial practices are underused, and all too often women lack the support and knowledge required to effectively navigate their maternity care.”  This is an unfortuante finding. In 10 years… the results haven’t changed. Be sure to get your hands on a copy of this full report.  The fight definitely continues

Have you read any of the Listening to Mothers Surveys? Have you seen/read the most recent one? What was your biggest take away or surprising finding.

Transvaginal Mesh Causes Harm to Women

I personally know a woman who is experiencing pelvic pain and problems as a result of transvaginal mesh.  With that in mind, when I was asked, I was happy to share the following article from DrugWatch.com so I could help spread the word about the dangers of this treatment for urinary incontinence.  From their website:  “Drugwatch is dedicated to informing you about dangerous prescription drugs and medical devices.” As always WE have to ask questions, get second opinions and be vigilent about learning what is best for ourselves.   Share this information with others… and Remember… A few kegels a day can keep incontinence away :-)

From DrugWatch.com…

“Transvaginal mesh is a surgical product used in procedures to restore the function of the pelvic floor and reverse symptoms of stress urinary incontinence (SUI) and pelvic organ prolapse (POP). However, up to 10 percent of women who undergo prolapse repairs using transvaginal mesh experience complications

Abdominal pain.

Pelvic Floor Disorders

The most common form of incontinence in women is SUI, which is the unintentional loss of urine prompted by activities that put pressure on the bladder like running, heavy lifting, coughing, laughing or sneezing. When transvaginal mesh surgery is performed, a small piece of mesh is implanted through the vagina to support the weakened bladder and urethra support tissues.

Not all women with prolapse experience symptoms, but those who do can feel pain or pressure in the abdomen and low back caused by displaced pelvic organs sagging against the vaginal wall. When the pelvic floor is no longer strong enough to support the pelvic organs, transvaginal mesh can be implanted, and used like a hammock to provide support and reduce pain.

Women should discuss all surgical options with their doctor before deciding which procedure is right for them. There are several surgical options that do not use transvaginal mesh.

Complications

One of the major problems with transvaginal mesh is that it is prone to erode through tissues. In fact, the sharp edges of the mesh can even perforate organs—causing a piercing, knife-like pain.

If the mesh perforates the vaginal wall, sexual intercourse can be extremely painful, or even impossible. In addition, women may experience an unpleasant vaginal odor, fecal or urinary incontinence, and frequent infections.

Women experiencing these debilitating side effects may need revision surgery to remove the mesh. These revision surgeries are not always successful since the body’s tissue grows into the mesh, and some women require multiple procedures.

These painful and costly procedures are part of the reason why so many women who suffered the adverse effects of transvaginal mesh are taking legal action.

Legal Action

Thousands of lawsuits have been filed against mesh manufacturers by women who have experienced complications from transvaginal mesh. They seek compensationto cover lost wages, emotional damage and medical bills, as well as punitive damages.

Alternatives

The Food and Drug Administration warns women and medical professionals about the risks associated with transvaginal mesh and the high number of complications reported. The FDA states that procedures that do not use transvaginal mesh can be just as effective in treating pelvic floor disorders.

Dr Talking w. Older woman

Women who are considering corrective surgery may wish to discuss surgical alternatives to transvaginal mesh with their doctor.”

Linda Grayling writes about dangerous drugs and defective medical devices for Drugwatch.com

A Mother’s Right to Parent Her Children

“SisterSong Women of Color Reproductive Justice Collective amplifies and strengthens the collective voices of Indigenous women and women of color to ensure reproductive justice through securing human rights.”

Sister Song will be holding an online event THIS Wednesday, May 22nd at 1pm-3pm ET.  They will discuss the story of Sheryl, a mother fighting for her parental rights. Connect with them on Facebook, and their website, for details and to receive the link for the livestream. They will “amplify the story of Sheryl, a mother whose three children were taken from her fifteen months ago, who now faces what she believes is discrimination as she battles for her parental rights. [They] will address the intersectionality of the Reproductive Justice and Human Rights frameworks to help clarify the elements impacting this powerful and compelling story of a mother who loves and misses her children. [They] will explore the environmental and health factors on the development of our children’s bodies, the historically racialized and class-based inequalities present in social systems and decision-making that criminalizes and disregards the individual, and the accountability practices necessary to prevent these cases” 

They will also Tweet Chat #amothersright from 1pm-3pm ET to answer questions and stay connected during the symposium – Join them… Twitter: @SisterSong_WOC

Mark your calendars!

 

HELP Improve Birth for Women

Help me start a Community Doula Network in Louisiana!

Below are the words from my personal fundraising campaign through Indiegogo. I am VERY Commited to making this happen and I pray that you will be so moved to endorse this project and share it with others.

The campaign launched last week.  We are on our way and have already rasied over $300 and I look foward to reaching our fundraising goal.  You can help by donating through Indiegogo directly or by sending a donations via paypal to Nicole at sistamidwife dot com.  You can also help by sharing and recommending our campaign to others. THANK YOU for your support. Continue reading to learn more about the program I am starting.

If we can inspire women to fight for better birth experiences, they will become inspired to fight for better communities. Doulas inspire that fight. We need more doulas in New Orleans and we need more doulas throughout the state of Louisiana.

The perinatal outcomes in Louisiana are deplorable. We have the highest c/s rate, we have the second highest maternal mortality rate and the third highest infant mortality rate in the country. Research shows that the availability of community doulas can improve birth outcomes. Women who use doulas report feeling more knowledgeable, they have fewer c/sections, they breast feed more often and for longer periods of time; they report increased satisfaction with their birth experiences and less post partum depression. That being said, IMO, all women should have an equal opportunity to hire a doula. Unfortunately all women don’t. In many places across the country, Louisiana included, women can’t find or can’t afford to hire a doula.

When I moved home to New Orleans in 2010, I knew I wanted to work to make birth better in my city. I was not exactly sure what role I would play, but I knew I needed to do something. As the Louisiana State Rep for ICTC, I have been reminded that there is a LOT of work to be done all over my state. I have received multiple calls from many women who are starting or want to start their birth work journey. Earlier this year, it came to me…. “I need to create a community doula program/network.” Once I made the decision women literally began to show up; women who genuinely want this information; women who are; ready to work.

We need YOU!

This June, Sista Midwife Productions will hold the first of many doula trainings in Louisiana.  Our goal is to train at least 30 women over the course of three training dates before the end of this year. Specifically, we will be looking to train women from various parts of the state who are committed to becoming a part of a community doula network. This community doula network will provide community outreach and education, free neighborhood-based pregnancy celebration events, free doula services, and ongoing education and support for the doulas within the network.

Our initial goal is to raise enough funds to give each doula student a scholarship, to purchase necessary training supplies, and to support our early community outreach efforts. Any funds raised above this initial goal will go toward providing free and discounted doula services and to hosting our monthly neighborhood pregnancy celebrations.

We already have women from across the state interested in participating in this training, and are committed to working as a part of a community doula network. While deposits have been made, many have limited income and are struggling to pay the full registration. I don’t want to deny them the opportunity to do the work they are called to do because of finances. The donations you make will help make sure that doesn’t happen. Please donate today!!! http://igg.me/at/CommunityDoulas4Louisiana/x/3224090

Unable to give personally?? Spread the Word!!!

I understand. I have been there. You may really want to help but you are unable to send your donation today. No problem. Please help us by spreading the word about this Indiegogo campaign. There may be people in your network who know doulas, who are doulas, who have used a doula… people who understand the value of community doulas who may be able to make a contribution.

Remember… Improving birth outcomes is a collective effort. Each positive change for a mother in LA is a change for mothers everywhere. Thank you for your support!! Together we can help women everywhere Birth Something Beautiful