Thursday, October 8, 2009

Lightbulbs


I just had a major lightbulb go on above my noggin over at Unnecesarean. The topic was postdates, and the conversation turned to induction. One commenter wondered about her own induction-turned-cesarean, and a midwife going by Birthkeeper replied:
As a Midwife, I would say that yes, your cesarean likely could have been avoided just from what you told me. When an induction occurs when a baby and body aren't ready, the body does just what it's supposed to do: it protects the baby. It's not a malfunction of your body, but rather functions rather beautifully in what it's supposed to do. Unfortunately, in the hospital, that means a cesarean for failure to progress. :( But had your body and baby been allowed to work in its own timing, it's very unlikely that you would have had a cesarean at all. I'm so sorry that you were led down that path.
The bolded part about blew my mind. WOW. I never thought of it that way before, but I think this is an amazing truth; in a way (a sad way, but still) a failed induction - in most cases - is actually an affirmation of the wisdom of the mother's body, devoted to its prime directive: protecting the baby. What a revelation! Brilliant . . . and a bit heartbreaking to think of how often it is unnecessarily violated.

I've had a few other lightbulb moments recently, including quite a few from my postpartum doula training this past weekend, of course.

One might seem completely obvious to you, and this is one of those situations where you kind of understand something, but it doesn't really click with you until something illuminates it. I definitely know the basics of breastfeeding, and even understand some unusual complications, due to my own experience. So I know, of course, that the main source of nipple pain when breastfeeding is a poor, shallow latch. And I know that a proper latch means taking in much of the areola, not just the nipple. I've even heard hard and soft palate mentioned in discussion of this before. But it wasn't until we watched the short film "Follow Me Mum" that I visualized exactly how this functions! Latched on to it, if you will.

The above isn't from the film, but it shows the physiology pretty well. Feel inside the roof of your own mouth, and notice where the palate changes from hard to soft. Now take a look at the top image: In the film, they distinguished between the hard and soft palate, and it was crystal clear to me how, if the nipple extends far enough back, it will be compressed against the SOFT palate and will be comfortable. If it doesn't, as shown by the example below with a tongue tie (though other factors, like positioning, can cause this to happen too), the nipple instead is going to be compressed against the HARD palate instead. Ouch!

If this is patently obvious to you already, then more power to you, but I really have a deepened understanding now. I grok this in fullness.

Another revelation from the workshop, that was more of a "DUDE, how cool is that?" moment: Babies spend about 50% of their sleep cycle in REM sleep. Did you know that babies, unlike adult sleep cycles, enter REM sleep first? Maybe you did. I remember reading that as well. Cool enough.

But did you also know that a breastfeeding, cosleeping mom's sleeping pattern actually adjusts to her baby? Even though she is an adult, she, too, will enter REM sleep first, and will follow the baby's cycles, and is thus more easily rousable when baby stirs to nurse. "Physical closeness causes a mother and baby to share sleep cycles. A baby usually wakes during light sleep and the mother is then likely to be in light sleep as well. She can settle the baby without her sleep cycles being seriously disturbed. Awakening from deep sleep is what leads to exhaustion." How freaking amazing is that? (All the cosleeping info on that whole page is very worth reading, by the way.)The more I learn about breastfeeding, the more I understand how intricate and miraculous the relationship between mother and baby is; the "breastfeeding dyad".

Finally, one other lightbulb from an ICAN webinar I attended the week prior to our training weekend. Insert another disclaimer about how this might already be obvious, old news to you. The topic of induction came up (bringing us full circle to the beginning of this post). Toms of great info is being shared, particularly about the various ways that early induction works against the mother's body - there have been a plethora of posts about this lately, like the aforementioned Unnecesarean one on postdates, as well as the recent multitude of riches included in the blog carnival from Science and Sensibility on letting labor begin on its own - so I won't even get into it here (definitely check the carnival out, though).

Where was I? Oh yeah, the webinar. We were talking about induction, and that led to the overdiagnosis of cephalopelvic disproportion. A childbirth educator and doula remarked that before reaching term, the relaxin released by mom's body throughout the course of the pregnancy, designed to allow the ligaments to stretch and therefore open the pelvis, may not have had enough of a chance to complete its job. AHA! We know that the Big Baby card is often a load of hooey anyway, for a number of reasons spelled out here, but here's yet ANOTHER reason. (Side note: relaxin also helps to soften the cervix by breaking down collagen.)

So there's a sampling of recent a-ha's, not to go all Oprah on you. Whether you learned a new tidbit or two, or whether you got to go "Pfff, she didn't get that already? What a rube," I hope you enjoyed.

3 comments:

  1. Wonderful post!!! Thank you! I love the co-sleeping information! And I too had a failed induction that resulted in a c-section at 40 weeks 4 days. I now know it could have been prevented and am a doula myself to help inform other women of these birth truths!

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  2. i stumbled on this because I was google imaging for a 'cartoon lightbulb' but I am sooo glad to have come to your site. I love the term "Unnecesarean." LOL. (After 4 natural, drug free births, I would never induce, ever.) What an encouragement! I breastfed and coslept with each of my four kids (one at a time!) but i never knew either point about the soft palette or the cosleeping REM cycles. so nice. thank you.

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  3. Welcome Amy! I'm glad you stumbled here too.

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