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Prenatal Nutrition Facts

Nutrient and energy requirements differ during pregnancy from woman to woman.

PRENATAL NUTRITION FAQS:

• Approximately 20-30% of women are deficient in a vitamin during pregnancy.
• Vitamins and minerals, including B vitamins, magnesium and zinc, are involved in the metabolism of carbohydrates, fats and proteins, and their deficiencies are associated with impaired fetal growth and development. 
• Vegetarian diets often provide insufficient levels of vitamin B12, which may result in impaired red blood cell formation. 
• Maternal iron levels affect iron stores in the developing fetus, and are necessary for the production of hemoglobin;  Prenatal vitamns help to prevent iron deficiency anemia.
• Calcium demands also increase during pregnancy, leading to enhanced calcium absorption from the intestine and mobilization from bones.
• Vitamin D helps absorb and use calcium and phosphorus for normal bone mineralization.  Deficiency of vitamin D during pregnancy may lead to impaired fetal bone development or osteomalacia, although 600 IU of vitamin D daily helps maximize bone health in pregnant adults.
• Daily supplementation with 800 mcg of folic acid in the first trimester may help reduce the risk of neural tube defects by nearly 70%.

Vera's New Bag - Consolidating Your Equipment

Please note: this is our second entry on bag reviews. You can see the first one here. 

The following bag is also included with more photos (with less stuff for clearer picture taking) in the above link.

Vera is a friend and local midwife. Having been to a planned home birth with her as a doula, I have seen first hand how she would practically move in with all her gear. She felt it was time to re-consolidate her home birth equipment into one bag that was very functional and easy to manage in all home birth circumstances. Here is how she did it:

First off, she started carrying less stuff (good first step). Before, she was carrying multiple sets of disposable supplies with her to each birth. Now, she has a home-birth box that clients can pick up at 38 weeks and keep at home for the "big day". Here is what it contains (all supplied by Midwifery Supplies Canada, by the way):

Labour Supplies 

20 non-sterile gloves

5 pairs of sterile gloves

5 packets of lubricant21+

1 In/out catheter

1 amniohook

2 amnisticks

10 blue pads

10 alcohol swabs

1 10ml vial of sterile water

1 1cc syringe/needle

 Delivery Supplies 

1 Cord Clamp

1 RH Blood Tube

6 sterile gauze

2 3cc syringes with needle

2 alcohol swabs

 Suturing Supplies  

1 lap sponge pack (contains 5 sponges)

1 sterile underpad

3 sutures (2-0, 3-0, 4-0 vicryl on a small needle)

1 10cc Syringe

1 18Gx 1.5” needle

Newborn Supplies 

1 1cc Syringe and needle

1 alcohol swab

1 packet of sterile gauze (2 per pack)

2 Neatnick heel lancets

1 bandaid

1 cord clamp cutter

 PP Hemorrhage Supplies  

1 Foley Urinary Catheter

1 Urinary Drainage Bag

3 1000ml NaCl

1 IV Kit (see website)

1 Wire hanger

 Lactation Supplies

1 Foley Cup Feeder

1 10cc Syringe

1 5fr feeding tube

 Personal Supplies and Container 

10 blue underpads

1 peri bottle

1 60ml bottle of peroxide

12 hospital maxi pads

2 mesh panties

1 waterproof sheet for the bed

Before, Vera was carrying multiple sets of this stuff with her all the time. Now she carries one set of labour and emergency supplies for quick, unplanned home births, and all planned home births have the supplies there already. The box gets inspected and re-stocked before going out to a new mom, so nothing is expired (have you checked your expiration dates recently)?

Here is the new bag Vera chose to carry her equipment: the Ferno Airway Management/Oxygen Bag

She wanted wheels for her bag, so she went out to the local suitcase store and purchased a set of wheels and bungie cord for $30 (she feels she could use one more bungie cord). 

She also wanted a back-pack for those times when dragging wheels up the front stairs wasn't practical (and potentially harmful to the equipment inside). This bag is also a well-designed backpack. 

The straps can also be put away for ease of transport when you don't want to use it as a backpack or want to use it as a shoulder or carry bag (they do tuck away completely, but Vera wanted them to be reasonably accessible in a pinch):

Here is how she fits everything (other than her spare O2 tank) into a single bag:

That bag of disposable supplies is pulling out from a zippered compartment that is hard to illustrate in these pictures (excuse my crude iphone photography!). This is one of the side compartments of the bag.

 further deconstruction of the same compartment reveals all the stuff that fit into that pocket.

The main compartment of the bag. The top stuff is in the lid. The blue-rimmed clear plastic compartments come with the bag, and velcro out. If she needs the supplies in that top left section there, she can just rip it off the bag and take it where she needs to.

After removing the electric heating pad from on top, we reveal layer two of the main compartment stuff. The blue pads are useful for birth, but also offer some extra padding for her Laerdal compact suction below, as she opted not to use the carry case. Pictured on the right is her manual resuscitator. Next to that are some more of those blue-rimmed clear-topped removable segments that come with the bag.

 As you can see, these removable compartments are great for things like dopplers, IV supplies, medications, etc.

Here we see her suction unit (bright yellow), and her oxygen tank, which is buckled in. It's hard to see, but there is a padded black divider in the middle of the bag, so the suction and the oxygen tank are not knocking up against each other. This divider is velcroed in and removable if you just want one large compartment. Vera also has all the tubing, etc for the suction in this compartment.

This oxygen carry bag comes included with the bag. It has a drawstring at the top, and a sturdy handle. Pictured here is a D-tank. Vera has since purchased a c-tank so she can have even more room in her bag, and has a D-tank as her spare that she keeps in the car. (This picture was upright in my photo program!)

So there you have it - a one bag system that can be worn on your back, over your shoulder, or put on wheels. It's versatile, functional, and compartmentalized for easy access. 

Singing the Praises of Accel Wipes

People ask me all the time what I carry in my doula bag. I usually list off the typical stuff - massage oil, rebozo, LED tealights, etc. However, one of my favourite and most-used items is my Accel TB wipes (I always carry a little pouch of 10). Here's why:

- It's accelerated hydrogen peroxide, so it's great at removing blood stains. Just wipe the carpet or couch, and voila! (individual results may vary, but I have had incredible success). 

- I can wipe down my TENS machine, reflexology ball, or anything else that might have bodily fluids (including sweat) on it. I can quickly make sure everything is clean BEFORE it goes into my doula bag, and then I know it's ready to go for the next birth. 

- It's gentle enough to wipe down a birth pool without corroding the material. In fact, it's so gentle that the MSDS sheet states it doesn't even require gloves to be worn. It's incredibly convenient and quick to disinfect the birth pool. After I drain the pool and take off the liner I wipe the pool down, I let it sit for 20 min or so, and then pack it up so it's ready to go for next time. No need to re-inflate it at home in between births!

- It doesn't have a noxious fume to it, so you can use it right there at the birth place without it bothering anyone (including yourself). 

- Because it's medical grade, I can use it to wipe the faces of my baby dolls before an infant CPR class. This is especially wonderful when I am teaching more than one class in a day, and therefore can't go home and bleach everything.

- The little 10 pack is no larger than a packet of facial tissue, so I don't have to make much room for it in a full bag.

So there you have it - a doula and midwife bag essential!

Bag Reviews

This past Wednesday I had three newly graduated midwives come over and give their opinion on some of my new Ferno bags. It was so helpful to me to see the bags filled, and get some professional input!

Bag #1 - Green Rucksack

Here is the bag filled with Amy's equipment (everything except her oxygen).

The entire inside of both sides of the rucksack is velcro, and it comes with a bunch of colour-coded clear mini bags that can be arranged any way you want with the velcro. It's great for compartmentalizing all the gear. For example, you have all your meds in one bag, all your IV stuff in one bag, all your intubation equipment in another, etc. Because they're colour coded, in an emergency you can yell to someone "get the red one!". Amy thought the colour coding was a great feature. While it did not have room for an oxygen tank, it did have room for everything else, with quite a bit of space to spare. You can see that her doppler, suction unit, resuscitator, and everything else are highly visible and fit with ease.

This picture shows the front pocket on the rucksack. It's quite ample. Here it contains an IV kit and an intubation kit that are both packed full. 

Here's Amy wearing the rucksack (though we didn't really make an effort to fit it to her properly). She found the weight to be very manageable. The straps on this one are not as comfortable as a couple of the other backpack models we tested. It would be great for just taking it from the car to the house. It would not be comfortable to trek with. Amy appreciated the versatility of this bag, however a midwife would also require a second bag with her oxygen equipment if this was her bag of choice.

Bag #2 - Ferno Airway Management/Oxygen Bag

This was Amy and Rachel's pick!

Here is the bag opened to the main compartment. This bag came with 3 different sized see-through bags that were detachable with velcro for compartmentalizing equipment. Amy also liked that she could fit her oxygen in here. This bag came with a blue fabric casing for an oxygen tank, and it also had a durable handle on it. You can't see Amy's tank because it is a C- tank and it's fully enveloped in the blue fabric. A D-tank would stick out a bit (the bag is designed for a D or jumbo D, so a C fits really easily). Amy was able to fit all of her equipment in here, so a second bag would not be necessary. It's also well padded, making oxygen transport safer.

This picture shows how there is a flap on the front of the bag that opens up so that you can access the oxygen without taking it out of the bag. You had to dig a bit with the C tank, but with a D tank the regulator would be right at the top there for easy access. There is also a little pouch on the inside of the flap for airways or oxygen masks.

Here Amy shows the backpack straps. This backpack has well-built, padded straps, as well as a sternum strap. You could actually trek with this on! 

Bag #3- Ferno Trauma/Airway Management Bag II

The perk about this bag was the flip top that allowed for very quick and easy access to the O2 without taking it out of the bag.

The bag also had lots of little compartments that you could change around with velcro, and was also a well designed backpack.

(As you can see, at this point my 2 year old came home from the park, so that was the end of our morning bag testing session with Amy).

Bag #4 - Ferno Saver Duffel O2 Kit

This bag was quite long and skinny. I was well padded, and had a buckle for safe oxygen transport.

Here you see the long, versatile pockets.

On one end there is an ample end pocket. On the other side there is a wide elastic strap.

Bag #5 - Ferno Saver ALS Bag

This coupled with an oxygen carry bag was Jasmine's pick. Between the two bags it contained all of her equipment, including a De Vilbiss suction (the larger one).

This bag was not as compartmentalized as some of the more expensive Ferno bags, and it does not convert into a backpack. It also is a bit smaller in size. However, Jasmine found it to be a perfect match for the amount of equipment she carried. 

Our Economical Classics - 

The benefit of the high end Ferno bags is that they are made with top quality material and have lifetime warranties. Their Saver liner is also good quality, but doesn't carry the same warranty. Also, unlike the top-quality bags, you can't unzip the padding for proper cleaning.

But what if you're not looking to spend $100-$300 on a bag? We have some other great options for you as well!

These bags can be purchased separately or as a set. They all come in red and blue, however, not all bags are always in stock in both colours.

Our prenatal bag is affordable and versatile. The inside dividers can be removed or rearranged with velcro, and more items can be zippered into the inner lid.

The "Midwife" duffel bag is a run-of-the-mill duffel bag with extra inner pockets in the front for organizing little things, as shown. It's well constructed, and has ample end pockets.

Our entire new registrant kit fits into the duffel bag and the oxygen carry bag. This includes a De Vilbiss suction, but it can be a bit tight. With a Laerdal suction there would be plenty of space.

Mini Bags-

Ferno IV Bag

This handy little organizer is great for storing your IV supplies.

This kit contains an entire antibiotics IV kit (except the 1000mL fluid), as well as some extra butterfly needles and a saline lock.

I also used the Ferno Intubation Bag for the same purpose, shown below:

Perineal Healing Tips

I don't know about you, but I needed a few stitches when my daughter was born (she decided to shoot out like Superwoman with one fist charging our straight in front of her head). Perineal healing herbs were an invaluable asset to have handy. When you're sore like that, you want to have some arrows in your quiver.

Here are some ideas for using our Perineal Healing Herbs:

NOTE: These herbs are not to be taken internally - It is for topical use only.
 

Brew a tea (for a sitz bath, not to drink!)
Begin by making a strong infusion of your herbs:
Bring two cups of water to a boil then remove from heat. Pour the water over two heaping
teaspoons of herbs and cover. A wide mouth jar or teapot is useful. Allow the mixture to
steep for at least half an hour (overnight is best) then strain well. Keep any unused mixture
in the refrigerator for up to three days.

Sitz Bath 

A sitz bath is a basin that fits over a toilet, allowing you to soak your perineal area without
having to take a full bath each time.
Fill your sitz bath with two cups of your brewed herbal tea and 6 to 10 cups of warm water. You
may use cold water if there is inflammation or swelling. Sit and soak for 10-20 minutes, 1-3
times daily (can alternate between a sitz bath and a bath). You may also add in 1/4-1/3 cup
Epsom Salts.

Regular Bath
Add the full two cups of Perineal wash tea to your bath water, or try our Perineal Wash
Bath Bags, which you can simply toss in your bath and steep. You may choose to add 1
cup of Epsom Salts.

Peri-Bottle
A favorite! Peri Bottles are plastic squirt bottles that allow you to squirt water out as you go
to the bathroom or for cleaning (instead of wiping -especially if you are still feeling sore or
sensitive) when you are finished. It can greatly reduce stinging during urination. The tea
may be used undiluted or add some hot water to make it warm. It is handy to have a bottle
ready in your bathroom at all times. The bottle is also useful for people with hemorrhoids
and during menstruation - just add water or other useful herbs for the different situations.

Compress
Soak a washcloth in the cooled mixture and apply to the sore area. You may soak a
maternity pad and wear it for continuous healing. Many women find great relief when the
soaked pads have been cooled in the refrigerator. You may wear an additional dry pad or
folded blue underpad inside disposable mesh panties to keep your seats dry.

When Faith and Science Mingle and Conceive

[Creighton Model is a method of charting a woman’s fertility and helping her to understand the natural processes of her own body. NaPro technology is a medical regimen that treats a whole host of gynecological issues without obstructing or suppressing any reproductive functions.]

Despite what I often see portrayed in the media around me, I firmly believe that faith and science are not mortal enemies. In fact, there are times when religious doctrine necessitates innovation, and amazing discoveries are made as a result.

The Creighton Model fertility care system and NaPro are two such examples.

In the Catholic Church, as well as many other world religions, the use of any artificial birth control or purposeful fertility obstruction is expressly forbidden. So what is a pious Catholic woman to do if she suffers from raging hormonal imbalances, severe endometriosis, out of control PMS, or reoccurring ovarian cysts? What if her health or socioeconomic situation dictate that she should not conceive a child at this time, but she still desires a sexual relationship with her husband? The rest of the world solved these problems with hormonal birth control. Out of this dilemma, a pious Catholic doctor responded, and Creighton Model was born.

While this system was created by a Catholic to meet the needs of Catholic women and families, the knowledge learned can help a whole generation of women regardless of religion, creed, or point of view.

Creighton Model is more than keeping a chart. It is a way for women to learn to trust their bodies, understand their reproductive cycles, and receive natural, hormone balancing treatment for any abnormalities that occur.

We live in a society that loves to solve every problem with a pill. The problem with this is that pills usually treat only the symptoms of a problem, and don’t get to the root of it. If a woman suffers from heavy periods, severe cramping, irregular cycles, excessive body hair, or other hormonally driven problems, the most common solution offered by doctors is a birth control pill. While on the pill, women typically have regular 28 day cycles, bleed less during menstruation, and often any external issues also lessen or disappear. However, they have not been cured, and if they choose to go off the pill, these problems often simply return. So these women are left with two choices: stay on the pill, or suffer.

But what if a woman wants to conceive? Obviously she would need to stop taking her birth control. What if the problems return? What if her hormones return to their imbalanced state and conception is unlikely or impossible? This is where pharmacology alone fails us.

When a woman charts her fertility through Creighton Model, and regularly reviews her chart with her practitioner, many problems can either be caught early, or treated quickly and simply. I have personal experience with this.

I had no idea that there was anything abnormal about my cycles other than their length. They were incredibly variable. Sometimes they were 30 days long. Sometimes they were 70 days long. It had always been that way since I began menstruating, so I never thought twice about it. When I began charting with Creighton, my practitioner quickly saw that I had abnormal spotting, prolonged bleeds, as well as other abnormalities in my cycles. My husband and I were not trying to conceive at the time, so I had really not considered any issues with future fertility. My practitioner referred me to a Creighton trained physician in my area, and through blood tests and ultrasounds, I was diagnosed with PCOS (polycystic ovarian syndrome). I had no outward physical symptoms of it, but my cycle showed it clearly. If I had been on birth control, I would never have known.

This diagnosis can be devastating for a family trying to conceive. Many women with PCOS struggle for long periods of time, and often go through many different therapies to try and ensure ovulation, conception, and retention of a pregnancy. This is where NaPro came in. NaPro protocols simply work to balance the hormones to bring back (or create for the first time) normal reproductive function. While I can never know definitively, I have a feeling that our ease in conceiving our daughter is due to this therapy regimen.

However, the greatest benefit that I have taken from fertility awareness is the power and knowledge I have acquired about my own body. I don’t have to rely on a regular 28 day cycle to know when I will menstruate or when I am optimally fertile. I can listen to and work with my own body to plan my family and be responsible for my own reproductive health. It puts the power back into my hands, and out of the pockets of drug manufacturers and doctors. It costs me nothing per month, and there are no negative side effects or drug interactions. It will last me my entire reproductive life. When I choose to become pregnant again, I will be able to know my due date without the help of an ultrasound, regardless of the length of my cycles.

So, when it comes to reproductive science: religion does not necessitate ignorance, and knowledge is power. Let’s give that power back to women.

For more info:

http://www.creightonmodel.com
http://www.naprotechnology.com