domingo, 31 de mayo de 2009

Notes on Prematurity

Midwives have very little experience with preterm labor, not so much because we are supposed to refer it, but because it rarely happens with women in midwifery care. This has to do with 1 hour prenatals that focus on emotional support, nutritional advice and holistic care. So my first note regarding prematurity would be that every woman get a midwife. Even if she ends up with a medicalized birth and a baby in intensive care she would probably benefit on someone to guard the normal- go to her house every day and listen to her, hold her, help her figure out why her baby is feeling like she needs to get out of her mothers safe womb. A midwife can help be an advocate if they end up in a pre term birth, helping the woman keep up some sort of milk production, advocating for kangaroo care and skin to skin contact which have been proven to improve outcomes for premmies. And long term support as well. Moms often talk about how estranged they feel from their baby who spent her first few weeks in the Neonatal Intensive Care Unit with a team of experts and all of a sudden mom is home with this fragile stranger. Its hard!!!

Last year I heard a midwife who works with a group of women who have really high rates of premature birth. She talked a lot about the "toxic womb", a place so stressful and malnourished that babies have to leave them before their time. She talked about 2 important aspects- stress... what are we passing to our babies- what messages, what hormones, what thoughts.... what is the burden of continuing the pregnancy for another 2 months on the mother- exhaustion, financial drama, career stuff, on and on. Each woman needs to define deeply why it is best for her to have her child out sooner than what should be. These questions are hard and challenging, but when women identify their responsibility in that and talk to their baby and understand that finally baby in or out, those stressors are still there.

Then nutrition- its very hard to improve nutrition in adults and in women at the end of their pregnancy, however right now baby needs a lot of nourishment. Omegas, protein, liquid, etc... she must eat and eat and eat. But she needs to eat from the Earth. 

I just finished reading a book about nourishment and moms and babies (Laura Gutman, La Revolucion de las Madres, 2008). The thesis of the book is that nourishment is our relationship to being loved and giving love. The womb is the epitome of nourishment, 24 hours a day of food and love and warmth. Why would anyone want to leave that?? This author talked out premmies as starting their life immersed in high technology- their existence depending on that. She works with women to help them grasp that their bodies are sublime technology and irreplaceable. All the tubes in the world will never replace the placenta!

At Luna Maya when we have had moms in this position we recommend bed rest, nutrition and hydration and the midwives and family therapist visit her at home to clarify what is going on. Recently a woman in her 33rd week of pregnancy called to say she thought she was going into labor. I gave her Aconite (homeopathic) for her fear. Her issue was that during her pregnancy she had come to realize that her boyfriend not available to her and her pregnancy and she couldn’t count on him for fathering her child and supporting her. So she had decided to say goodbye to him.

We talked about the difference between expelling her man from her life and expelling her child from her womb. Everyone has their place in the family and that needs to be honored. Within 24 hours of intensive midwifery care and some support from the therapist she was a whole different woman with a quiet uterus. She finished the week thanking us for how safe and comfortable she feels with us. I finished the week thanking her for opening her heart so gently and taking such good care of herself and her baby.

There is a reason why we shouldn’t be born before 36 weeks and every mother facing a premature birth needs to connect deeply with that. The mother, more than her doctor or midwife needs to know that she will carry this baby to term and take her baby back to the family bed hours after birth where she belongs for delicious honey momma nourishment. And we, as those who hold moms need to provide mom with delicious honey momma nourishment. Moms who nourish their little ones need to be nourished by the rest of us. Prematurity is our responsibility.


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