Christine Sheets Birth Services

Birth and Post-Partum Doula, Birth Photographer, Childbirth Educator, Lactation Counselor

Remedies for Nausea

 

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April 2003, approximately 30 weeks pregnant


As a three-time survivor of Hyperemesis Gravidarum (HG), I have LOTS of suggestions to relieve the nausea and vomiting that is common during pregnancy!
 

DISCLAIMER

I am not a medical professional;  Nor do I play one on the internet!  The intention of this post is to provide information; not to diagnose, treat, cure or prevent any disease.  Information provided here is not intended to be a substitute for advice from your Care Provider or other health care professional, or any information contained on or in any product label or packaging. 

As a doula and childbirth educator, I encourage you to do your own research, ask questions of your Care Provider and make informed decisions.  Please consult with your health care professional before starting any supplementation program, before taking any medication, or if you suspect that you might have a health problem.
 
 

REMEDIES

This is NOT how a pregnant woman should normally eat.  But, at some point, it becomes more important to eat/drink anything that will stay down and quit trying to avoid the “bad” foods.

It’s quite normal for remedies to work for a time, and then become less effective.  Many women find that they need to rotate through a number of these measures throughout their pregnancy.  You have to continue to eat and drink. Even if it comes right back up.

  • Before you conceive, build up your omega oils by taking flax seed or fish oil.  These can be continued during your pregnancy.
  • Preggie pops, which are available through Amazon, at Target, Walgreen, Babies R Us, GNC, and Buy Buy Baby.
  • Ginger is very efficient against nausea and vomiting. Try ginger cookies, crystallized ginger, ginger ale, ginger tea, ginger candies or ginger in capsule form.
  • Good, old Coca-Cola.  It didn’t stay down any better, but I was tired of vomiting ginger ale.  This gave me some variety, helped boost my blood sugar and improved my hydration.
  • Potato chips and lemonade.  The combination of salt and sour seemed to really help!
  • Avoid warm places, as heat can increase the nausea.
  • Eat small, frequent snacks throughout the day, rather than attempting regular meals.
  • Drink small amounts of fluids regularly throughout the day to avoid dehydration.  Water with a little juice tends to stay down better than plain water.
  • Avoid strong odors such as perfumes, tobacco, certain foods, cooking smells.
  • Avoid dairy products and natural juices high in citric acid.
  • “Hot” cinnamon candy  — such as red hots, atomic fireballs, etc.
  • Peppermint can reduce intestinal gas and quell nausea.
  • Rest as much as you can.
  • Sea-Bands are wristbands that apply continuous pressure to an acupuncture point (the P6 or Nei-Kuan)  on each wrist using a plastic stud. Both must be worn, one on each wrist in the correct position to be effective. Even worn properly, they may not work for everyone, but are worth a try. (These helped me – especially when I needed to ride in the car!)
  • Meditation, hypnosis, meditation, guided imagery, prayer, focused breathing, positive visualization and relaxation can be helpful in coping with nausea.  But it’s very hard to do once the nausea has a hold of you. So start beforehand, and just try to stay relaxed as much as possible.
  • Relaxing music that you find soothing — whether classical, jazz or pop. In my experience, the most effective are special relaxation tapes.
  • Teas to be sipped hot: spearmint, peppermint, raspberry, chamomile, ginger.  It’s recommended to rotate teas since the mint teas contain a lot of tannic acid.
  • Chew food thoroughly.
  • Avoid large amounts of fluid with meals.  Drink 15 minutes beforehand for maximum absorption.
  • Avoid greasy, gassy or fatty foods.
  • Chewing gum/eating mints.
  • Moderate exercise improves GI tract function.
  • Papaya (fresh, dried, or enzyme tablets) may big help too.  But should NOT be used during the first trimester.
  • If you can’t keep down your prenatal vitamins, two Flintstone Complete Chewable vitamins contain almost the same nutrients and are easier to digest.
  • Marijuana has been proven to help relieve many forms of nausea. There are even doctors and midwives prescribing it for HG. [Before anyone pulls out their soapbox, let me clarify: When the pregnant woman has been losing weight for MONTHS, is being hospitalized due to dehydration and NOTHING else is working, anti-nausea drugs (like those given to chemo patients) may be advised. Some medical professionals recommend medical marijuana over these level-three drugs.]
  • Alternative therapies, such as:  hypnotherapy, homeopathy, acupuncture, etc.

 

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Battle of the Bellies with my Dad (In early labor and heading to the hospital, still 15lbs UNDER by pre-pregnancy weight.)

MY EXPERIENCES

My first bout of HG was the worst.  At first, I didn’t know there was a diagnosis beyond “morning sickness.”  Friends and family members didn’t understand or believe the severity of my illness.  But I was EXTREMELY fortunate to have a care provider who recognized and acknowledged my condition and offered real treatment options.

Many women report that their providers dismiss their illness as hysterics or an exaggeration.  NO woman should be treated in such a manner — especially when she is so very ill!

During my first pregnancy, I lost over 30 pounds.  Eventually (through a combination of medication, weekly IV infusions, increased protein and modified bed rest), I was able to stop losing weight and even managed re-gain a small amount.

For my subsequent pregnancies, I knew what to expect.  I was better informed.  And I was still breastfeeding a toddler.  Many HG survivors report that lactating while pregnant reduces their symptoms and this was definitely true for me.

The most common recommendations are to eat carbs, but for some women (myself included), these increase vomiting.  The main thing your body and baby need is protein. For me, the easiest high-protein things to eat (and vomit) were eggs, bone broth and soft cheeses. (Make sure everything is pasteurized!) 
 
For a time, I survived exclusively on Ensure nutritional drinks. To improve the taste, I would dilute with an equal part milk and add Hershey’s chocolate syrup.  Today, I would recommend the High Protein version.

I was on Zofran (ondansetron) for a bit, but one of the most common side effects is constipation.  Mine was so painful and severe, that I couldn’t continue with this medication.

Finally, what turned the course for me was starting a nightly course of Unisom sleep aid (doxylamine succinate) and vitamin B6 (pyridoxine hydrochloride).  I REALLY resisted this treatment because of my fear of taking drugs while pregnant. But when your only other course is a hospital stay….

The Unison/B6 didn’t completely take away the HG, but I was actually able to go entire days without vomiting. Since my own pregnancies, doxylamine succinate and prridoxine hydrocholride has been approved by the FDA for use by pregnant women in order to relieve nausea and vomiting.  This medication is known by the brand name Diclegis and is available by prescription from your physician or midwife.
 
 
Now I ask you, my readers:  What remedies have been successful for you?  Please leave your response in the comments.
 
 
Also, please feel free to contact me if you’d like more information or support.  Best wishes for a happy and healthy pregnancy! 
 
 
 
 
 

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Working to Improve Birth

This article was originally posted on the Fierce Mamas blog in April 2010 — years before I decided to become a birth worker.  Five years later, the U.S. maternal mortality rate continues to rise.

 

DSC_0271-2In January 2010, the Joint Commission issued an alert1 to U.S. hospitals which stated, “trends and evidence suggest that maternal mortality rates may be increasing in the U.S.”  The national rate is currently three to five times GREATER than that of European countries.2

Unbelievably, a woman giving birth in the U.S. today has a greater risk of dying than a woman birthing in 40 other countries.2

The Commission (which is the leading health care accreditation and standards group in the United States) went on to state that between 28-50% of maternal deaths were PREVENTABLE.  In fact, half of the most common errors were related to post-operative care following caesarean sections.1

Recent reports also show that, in the U.S.,3 rates of both labor induction and c-section are TWICE the World Health Organization’s recommendations.2  As we are seeing, these medical interventions (while common) are not without risk.

Labor induction typically involves the use of synthetic oxytocin.  This artificial substitute interferes with a woman’s own oxytocin receptors and can lead to postpartum hemorrhaging, delayed or inhibited bonding with her newborn and difficulty establishing breastfeeding.A medically induced labor also significantly increases a woman’s chances of having an unplanned c-section.5

The risk of a mother’s death after a c-section is more than three times greater than a mother who gave birth vaginally.Over a 10 year period, California had a 50% increase in c-sections AND a 50% increase in maternal mortality.7

 

A Climate of Coercion

The current mainstream birth culture in the U.S. is simply appalling.  Pregnancy and birth are treated as a disease and acute trauma-waiting-to-happen.  Many women are not given complete information about the birth process.  More and more cases are being reported of maternity patients being coerced into submission; their basic human rights are ignored or even revoked through the courts.

Serious medical interventions are presented as a matter of course and focus exclusively on the expected benefits.  Risks and adverse effects are usually not even acknowledged!  The provider states whatever he or she believes will result in the mother’s compliance with the provider’s desired course of action.8

According to “Evidence-Based Maternity Care” (Sakala and Corry), a truly informed choice “requires access to a range of options, good understanding of best evidence about benefits and harms of offered care and of alternatives and solid support for the choices women make.”  This rarely occurs among U.S. maternity patients.4

In a 2009 interview, Dr. Debra Bingham, Executive Director for the California Maternal Quality Care Collaborative and a member of a Maternal Mortality Review Committee, told Amnesty International that the process of gaining an obstetric patient’s consent is highly variable and can depend on who provides information, what information is shared, and how that information is presented to a pregnant woman. “For example, someone who will benefit financially from the woman’s decision may provide information differently than someone who is not financially affected by her decision. Currently, there is limited documentation on what information is shared, how and by whom.”9

Astonishingly, this behavior is not limited to maternal care providers for disadvantaged, low-income or uneducated women.  Time and time again, I’ve seen high-powered, confident, educated women become completely submissive.  They forgo asking questions and just trust their doctors to make decisions for them, and then accept whatever course of treatment may result.

 

The Alternative Birth Movement (or What’s “Normal” for the Rest of the World)

83% of women in the U.S. have low-risk pregnancies.10  In most countries, these low-risk women would receive their maternal care from midwives or family practice physicians and often give birth at home.  Outside of the U.S., the goal is to minimize risks and maximize good outcomes for mothers and babies, rather than maximize income for a provider and facility.  So most obstetricians limit their practice to treating women with high-risk pregnancies and those who develop unexpected complications.11  Ironically, many OBs in the U.S. no longer have the aptitude or knowledge possessed by their predecessors for such  uncommon procedures as:  external version to manually turn a baby, vaginal breech birth or vaginal birth of twins.4

It’s interesting to note that groups of maternal care providers identify their roles very differently.  OBs feel it is their responsibility to actively manage childbirth.  Midwives and other physicians perceive their function to be facilitators in the birthing process.12  This fundamental distinction is evidenced in the care and treatment of their patients: 4  Midwives possess more hands-on skills and are better able to support a woman in labor and assist her during birth than OBs;  midwives use medical intervention more judiciously than OBs;  and midwives understand that a woman’s individual mind-set, desires and personal history play an important part in her birth, while OBs deny these influences. 12

In low risk situations, intervention can, in fact, actually impede the birthing process and create those life or death situations that doctors claim to be trying to avoid.  Despite their lengthy and expensive educations, far too many U.S. care providers have little or NO experience in observing a normal, natural birth.  Therefore, they have no idea what a normal birth looks like, much less what a woman in that situation may need.

Not surprisingly, across the nation, low-risk women and their babies have better outcomes when attended by a midwife, rather than an OB.4, 8

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Loss of Faith, Rise of Fear

In contrast to the rest of the world, almost all pregnant women in the U.S. choose to receive their care from an OB and give birth in a hospital.  When it’s truly needed, medical intervention can, of course, mean the difference between life and death.

But women’s bodies are designed to give birth — without any interference!  It’s only been in the past 100 years13, that birth was appropriated from women and transformed into a paternalistic, medical, mechanized event.14  As such, women lost the knowledge that comes from witnessing and assisting their mothers and sisters give birth.  And women lost faith in their bodies’ innate abilities.

Today’s mother-to-be has probably heard more birth-related horror stories than she can count.  From the time she was a young girl, she may have heard her mother, her aunts, and even her friends discuss childbirth as a painful, frightening injury.  Unfortunately, these misconceptions are perpetuated and reinforced through popular culture of television and movies.  In reality, a normal birth wouldn’t bring in big ratings or box-office dollars.

 

Follow the Money

The U.S. spends more on health care than any other country.15  And more money is spent on maternal health than ANY other form of hospital care.8  Unfortunately, the majority of OB policies, routine procedures and official recommendations are woefully out of date in regards to evidence-based care.4

Outside of the U.S., hospitals typically have a variety of low-tech equipment to aid a woman giving birth – tubs, birthing balls, robes, birthing stools, squatting bars, etc.  Any of these can help make birth safer and more comfortable.  Unfortunately, very few U.S. hospitals can offer anything besides pharmaceuticals.  For the hospital administrator, a birth free of medical interventions is a lost billing opportunity.11

The vast majority of births do NOT require any intervention; but 50-80% of births in U.S. hospitals have AT LEAST one.  In reality, any one of these procedures is truly medically necessary in fewer than 20% of all births.8  Ergo between 30-60% of women giving birth in U.S. hospitals are having unnecessary medical procedures performed upon them!  But, necessary or not, all of these medical procedures and interventions allow physicians to maximize their billing opportunities.11

In some parts of the country, it’s extremely difficult to find a provider willing to intervene ONLY when truly medically necessary — especially if the woman has had a previous c-section.  Fewer and fewer facilities are willing to accept VBAC (Vaginal Birth After Cesarean) patients.

After years of increased c-sections, most hospitals have reconfigured their maternity units to accommodate more surgical deliveries: more services scheduled during weekday hours, and more postpartum beds – needed for the longer stays required after c-sections.  These changes required costly capital investments.  Now administrators need to see a return on those investments.  So it’s not surprising that hospital policies reflect the facility’s increased dependence on the revenue generated by c-sections.  After all, a c-section brings in TWICE the revenue of a vaginal birth.4  A surgical birth is also easier on the doctor.  It takes less time and is much more predictable than a normal labor and delivery.

For years, the medical establishment has been working to limit birthing options. They’ve fought against birthing centers, homebirth, midwives, even against their own accountability.

Many believe that they’re more interested in protecting their revenues than improving outcomes for our mothers and babies.11

Rather than abolishing choices, vilifying alternatives and criminalizing their competition, I’d prefer to see them working for other, more worthy goals – such as educating their patients, encouraging normal/natural births and working with facilities to update protocols to reflect evidence-based medicine, all of which will ultimately reduce maternal mortality.

Until then, it’s up to us to change the birth culture!

 

Improve Your Own Chances of Survival

If you are pregnant or planning to become pregnant:

  • Examine your pre-conceived ideas on birth.  How were these formed?  From stories of women of previous generations?  From fictional or sensationalized movies and tv shows?  YouTube is awash with amazing, joyous videos of women experiencing normal, natural births.  Use these to visualize the kind of birth YOU want.
  • Take responsibility for your own education on birth!  While pregnant, you have months to prepare and can seek out accurate, complete information.  Labor is a time of extreme, internal focus.  It would be difficult to absorb and comprehend a significant amount of new information.  So preparation is key, in case you need to make decisions quickly.  Research common interventions such as:  ultrasounds, fetal monitoring, induction of labor, epidurals, extractions and c-sections.  Learn the risks and what factors determine when each may truly become necessary.  Insist that your provider obtain informed consent for each procedure.
  • Read books on natural birthing options.  Consider alternatives to the standard OB-attended hospital birth.  Choosing a high-tech OB at a high-tech hospital doesn’t guarantee you a safe birth.  But it WILL increase your risk for high-tech interventions which may or may not be medically necessary.16  Certified Nurse Midwives (CNMs) are licensed in all 50 states and can attend births in hospitals, birth centers or even your home.  Don’t be afraid to make an unusual choice when it comes to what’s best for you and your baby!
  • Don’t choose your provider or facility simply based on location or insurance coverage.  Seek out like-minded mothers and local doulas and get their recommendations.
  • Schedule a consultation with potential providers before committing to one.  Get their rates of various interventions – fetal monitoring, inductions, episiotomies, forceps  delivery, vacuum extraction and c-sections.  Ask how much freedom you’ll have during labor – particularly on movement, eating/drinking and positioning for birth.  Are there limitations on who is allowed to attend your birth?  If they’re anything less than forthcoming with these answers, find another provider.  Tour the facility.  Ask questions there as well, specifically regarding their procedures for newborn care, policies on  rooming-in and breastfeeding support.
  • Listen to your instincts.  More women are educating themselves and seeking providers based on their shared philosophies of birth.  Unfortunately, medical professionals can also offer the all too familiar “bait-and-switch.”  The provider will agree with everything the mother-to-be wants for her birth throughout her pregnancy, but has NO intention of letting the birth happen on those terms.  Shockingly, some will even go out of their way to make SURE it doesn’t, regardless of what’s in the best interest of the mother and her baby.  So if you have any reservations about your provider or facility, especially if you feel they are patronizing you, don’t be afraid to make a change – no matter how far along you are.
  • Surround yourself with others who have had intervention-free births.  Listen to their stories.   Ignore those who tell you that you won’t be able to handle it.
  • Take a childbirth class, preferably one OUTSIDE of a hospital setting.  (Too often, classes hosted by the hospital are more about “How to Be a Good Patient.”)  Bradley and Hypnobirthing are excellent choices.
  • Choose your labor support team wisely.  While your partner, family members and friends may want to be present at the birth, consider hiring a doula.  She can provide physical and emotional support throughout your pregnancy, birth and post-partum period.  She is knowledgeable about the process of birth, familiar with area providers and facilities and can facilitate communication with staff to help you make informed decisions.  A woman in labor is vulnerable – both physically and emotionally.  A doula can help protect your space and your choices.

 

Empower yourself to have the birth YOU desire!  Birth is a business.  As more mothers demand normal, natural births, providers and facilities will be forced to adapt to attract consumers.  Reducing unnecessary interventions will lead to healthier mothers and babies!

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REFERENCES

1 The Joint Commission, Sentinel Event Alert, Issue 44 from January 26, 2010, “Preventing Maternal Death”; available at http://www.jointcommission.org/sentinel_event_alert_issue_44_preventing_maternal_death/

2 WHO, UNICEF and Wellstart International, “Baby-friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care”, 2009; available at http://apps.who.int/iris/bitstream/10665/43593/1/9789241594967_eng.pdf

3 J. A. Martin et al, Centers for Disease Control, Births: “Final Data for 2006”;  National Vital Statistics Reports, Volume 57, Number 7, from January 7, 2009; available at http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf

4 C. Sakala and M. P. Corry, “Evidence-Based Maternity Care: What It Is and What It Can Achieve,” Childbirth Connection and the Reforming States Group, 2008, pages 37, 47, 62-67; available at http://www.childbirthconnection.org/pdfs/evidence-based-maternity-care.pdf

5 K. E. Kaufman, “Elective Induction: An Analysis of Economic and Health Consequences”; available at http://www.ncbi.nlm.nih.gov/pubmed/12388964

6 C. Deneux-Tharaux et al, “Postpartum Maternal Mortality and Cesarean Delivery”, Obstetrics & Gynecology, Volume 108, Number 3, Part 1, September 2006; available at http://www.invs.sante.fr/publications/2006/mortalite_maternelle/annexe_6_3_qualite.pdf and

Villar et al, “Maternal and Neonatal Individual Risks and Benefits Associated with Caesarean Delivery: Multicentre Prospective Study”, BMJ, 2007; 335; 1025; page 5; available at http://www.bmj.com/cgi/reprint/335/7628/1025?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Caesarean+delivery+rates&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT

7 California Maternal Quality Care Collaborative; available at www.cmqcc.org/maternal_mortality

8 R.M. Andrews, “The National Hospital Bill: The Most Expensive Conditions by Payer, 2006”, Healthcare Cost and Utilization Project, Statistical Brief 59, 2008, page 7;  available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb59.pdf

9 Amnesty International Publications, “Deadly Delivery: The Maternal Health Care Crisis in the USA”, 2010, page 1 and 79, available at http://www.amnestyusa.org/dignity/pdf/DeadlyDelivery.pdf

10 National Center for Health Statistics.  2006.  2003 Natality Data Set. SETS 2.0, Rev. 805.  Vital and Health Statistics.  CD-ROM Series 21, Number 17, May.

11 S. Goodman, “Piercing the Veil: The Marginalization of Midwives in the United States”, Social Science & Medicine, 65, 2007, pp. 610–21; available at http://collegeofmidwives.org/wordpress/wp-content/uploads/2011/09/e-1-Marginalizing_NurseMfry_May07.pdf

12 B Reime et al, “Do Maternity Care Provider Groups Have Different Attitudes Towards Birth?”; BJOG: An International Journal of Obstetrics & Gynaecology, Volume 111, Issue 12, Pages 1388-1393; available at http://www3.interscience.wiley.com/cgi bin/fulltext/118813477/HTMLSTART

13 Y. Lapp Cryns,  “Homebirth:  As Safe as Birth Gets” The Compleat Mother Magazine 1995; available at http://www.compleatmother.com/homebirth/hb_safety.htm

14 J.J. Mathews and K. Zadak, “The Alternative Birth Movement in the United States: History and Current Status”, Women Health, 1991, Volume 17, Number 1, Page 39; available at http://www.ncbi.nlm.nih.gov/pubmed/2048321

15 Organisation for Economic Co-operation and Development, OECD Health Data 2009– Frequently Requested Data; available at http://www.oecd.org/health/oecdhealthdata2009comparinghealthstatisticsacrossoecdcountries.htm

16 M. Wagner, “Technology in Birth: First Do No Harm”, Midwifery Today, 2000; available at http://www.midwiferytoday.com/articles/technologyinbirth.asp

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A Wonderful Birth

I was a brand new doula when I first heard Naoli Vinaver Lopez’s words.  A wonderful birth.

Lopez quote

What makes a birth wonderful?  “Healthy mom and healthy baby” is the catch phrase casually tossed around many L&D rooms.  Yes, this should always be the most important goal.  (Do we really even need to say that?!)  But it certainly shouldn’t be the only concern.

As Midwife Shelly Girard states, “Perinatal psychologists have researched the long-term effects of the birth process on women and their families and conclude that giving birth is a momentous event which can impact all involved psychologically and spiritually for an entire lifetime.”

With such long-reaching consequences, I truly believe it is the right of every woman, child and family to have a wonderful birth experience.

“Wonderful” is a very individual concept.  Every person has their own idea of what a wonderful birth looks like.  From a surgical birth with general anesthesia, to an unassisted birth in the great outdoors, and everything in between.  Each birthing woman will have her own idea of “a wonderful birth.”  As will her partner.

As a childbirth educator, I help families discover their options and learn tools to help them prepare for and achieve their intended goals.

As a doula, I provide support for their choices, mental reassurance, emotional encouragement and physical comfort measures.

And as a birth photographer, I try to capture the love, anticipation, effort and exhilaration of everyone involved.

But what happens when plans go awry?  Just like life, birth is unpredictable.  Complications can develop slowly over weeks of pregnancy.  Or labor can shift dramatically within moments.  All the preparation and practice can’t guarantee a predictable result.  Nor can any provider or doula.

But while it may not be the birth anyone envisioned, it can still be a wonderful birth.

Research tells us that more importantly than the circumstances of the birth [method of delivery, level of interventions, use of pharmaceutical drugs or not] is how the mother perceives her treatment and care:

Was she treated with compassion and respect?

Where her plans and requests given due consideration?

Where her emotions validated?

Where the complications and interventions explained fully?

Barring an emergency situation, was she given time to process the change in plans and accept her new circumstances?

In addition to “healthy mom and healthy baby,” THESE are the goals medical care providers and birth workers should be striving to meet.  Because everyone deserves a wonderful birth.

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