Blog Archives - THE MOM DOC

4/26/2023 1 Comment

what does it mean to be induced during labour?

if if your labour is not progressing as fast as your provider thinks it should be (And this can be subjective), they may induce labor using pitocin.

pitocin is a synthetic (man made) form of the hormone oxytocin. it is given through an iv.
chemically, pitocin and oxytocin are identical. however, how they actually perform in the body differs.

pitocin is given to induce labour, to increase the strength of contractions, and to treat symptoms of post partum hemorrhage.

high levels of pitocin during labor can cause de-sensitivity of the receptors, which may cause irregular and non productive contractions. This is less likely to happen in a spontaneous labor (meaning you haven't been chemically induced and you’re not given Pitocin). In spontaneous labour, natural oxytocin is released in pulses and then rapidly broken down by an enzyme so that there’s very little oxytocin left in between each pulse.

some people claim that higher dose pitocin reduces your likelihood of needing a c section, and this is not true. there is no evidence for this. high dose pitocin has no effect on c-section rates, and has many side effects such as hyperstimulation of the uterus and abnormal fetal heart rate.

There is no clear consensus in the medical community about when labor should be augmented with Pitocin, what dosing to use, or the timing of the dose increases. some studies actually show no medical rationale for using pitocin. rather, it seems to play a more important part in efficiency of hospital rooms.

though it probably doesn't need to be used as often as it is, pitocin can play a beneficial role when used appropriately. pitocin can help cause stronger contractions when needed, which can be beneficial in stalled labour or if you had an epidural that caused contractions to reduce in strength.

the 4 big risks of pitocin:
1. Uterine tachysystole
having more than five contractions in 10 minutes averaged over 30 minutes. This is an abnormal contraction pattern that can lead to fetal distress.

2.increased risk of uterine rupture if you’ve had a prior cesarean

3.IV line and continuous fetal monitoring needed (often internal monitoring), which has it's own risks.

4. Pitocin is considered a “high alert drug.”
if a mistake is made or a drug error, this could lead to a bad outcome.

alternatives to high dose pitocin augmentation
1. use a birth ball to address fetal position by opening the hips and pelvis to help baby come down.

2.walking or standing in an upright position to help baby come down.

3.stay hydrated. aim for 125mL per hour, and be mindful if you are vomiting you need to replace those fluids lost, too.

4.maintain your energy through food. your uterus cannot contract if it has no energy. having complex carbohydrates throughout labour can give you the energy you need to keep going. high sugar packaged snacks can cause issues for babys blood sugar, so try to focus on whole foods that include protein (apples with peanut butter, protein balls, fruit and nuts), other light meals.

**if your provider suggests you should not eat or drink during labour in case of an emergency c section, please know this is not evidence based and there is no literature to support this*

5. nipple stimulation or cuddling your partner can boost natural oxytocin, which can help promote uterine contractions.

6.if you have exhausted all of these options, an epidural can give you the relief in order to rest or sleep before you're ready to continue with labour.

7. ask your provider to start with low dose pitocin instead of high dose, as it has fewer side effects.

remember that birth is a natural process, and you know your body best, momma.
USING PITOCIN FOR INDUCTION IS NEITHER GOOD NOR BAD, BUT IT'S IMPORTANT TO KNOW YOUR OPTIONS, AND KNOW THE RISKS VS BENEFITS. IF YOUR DOCTOR/MIDWIFE SAYS THERE IS IMMINENT RISK TO YOU OR BABY IF YOU DON'T USE PITOCIN, IT MIGHT BE TIME TO UTILIZE IT AS AN INTERVENTION. IF IT SEEMS LIKE IT'S SIMPLY TO SPEED UP LABOUR FOR THEIR BENEFIT, AND YOU'RE FEELING OKAY, THEN MAKE SURE YOU OR YOUR BIRTH PARTNER IS ABLE TO ADVOCATE FOR WHAT YOU NEED AND WANT. THERE IS NO JUDGEMENT IN THE INTERVENTIONS YOU USE TO BIRTH YOUR BABY.

Not intended to be used as medical advice. this is for informational purposes only

1 Comment

4/7/2023 0 Comments

gestational diabetes

WHAT IS IT?
IT IS A TYPE OF DIABETES THAT OCCURS IN PREGNANCY. IT USUALLY OCCURS DURING THE 2ND AND 3RD TRIMESTER. BETWEEN 3 AND 20% OF PEOPLE IN CANADA WILL DEVELOP IT DURING PREGNANCY. THE BAD NEWS, IT DOES NEED TO BE TREATED. THE GOOD NEWS, IT USUALLY GOES AWAY AFTER BIRTH!

HOW DOES IT HAPPEN?
IT IS SIMPLY DUE TO BABY GROWING, MORE HORMONES AND OTHER FACTORS ARE BEING UTILIZED BY BABY, AND YOUR BODY ISN’T ABLE TO PRODUCE ENOUGH INSULIN TO KEEP BLOOD SUGAR UNDER CONTROL. SOMETIMES, GD HAPPENS BECAUSE YOU HAD ISSUES WITH YOUR GLUCOSE BEFORE PREGNANCY, BUT JUST DIDN'T KNOW IT! OTHER TIMES, IT HAPPENS SIMPLY BECAUSE BABY HAS A LOT OF NEEDS AND YOUR BODY IS JUST DOING THE BEST IT CAN TO ACCOMMODATE!

HOW WILL I KNOW IF I HAVE IT?
TYPICALLY, YOU WILL BE SCREENED FOR GD AT 24-28 WEEKS. FIRST, YOU WILL UNDERGO THE GLUCOSE CHALLENGE SCREENING (GCS). THIS IS A BLOOD TEST. YOU WILL BE ASKED TO DRINK GLUCOSE (A VERY SUGARY DRINK), AND THEN HAVE YOUR BLOOD DRAWN 1 HOUR LATER. IF THE RESULTS FOR THIS TEST ARE POSITIVE, YOU WILL BE SENT FOR A SECOND TEST: THE GLUCOSE TOLERANCE TEST (GTT). THE IMPORTANT THING TO REMEMBER HERE, IS THAT JUST BECAUSE YOU SCREEN POSITIVE ON THE GCS, DOES NOT MEAN YOU HAVE GESTATIONAL DIABETES! IT JUST MEANS WE NEED TO DO A BETTER TEST (THE GTT) TO IDENTIFY IT.

CAN IT BE PREVENTED?
ES! SOMETIMES GESTATIONAL DIABETES JUST HAPPENS AND WE DON’T ALWAYS KNOW WHY. HOWEVER, YOU CAN DRASTICALLY REDUCE YOUR RISK OF GESTATIONAL DIABETES BY MANAGING YOUR WEIGHT, EATING A HEALTHY DIET, AND BEING ACTIVE BEFORE AND DURING PREGNANCY.

HOW DO I TREAT IT?
THE GOOD NEWS IS THAT TREATMENT CAN BE DONE USING NATURAL INTERVENTIONS! THIS INCLUDES EATING A HEALTHY DIET BY INCORPORATING ENOUGH PROTEIN, FRUITS AND VEGETABLES, AS WELL AS PAIRING FOODS TOGETHER THAT REDUCE GLUCOSE SPIKES. IT ALSO INCLUDES BEING ACTIVE, DOING CARDIOVASCULAR ACTIVITY AS WELL AS INCREASING MUSCLE MASS THROUGH STRENGTH TRAINING (YES, BODY WEIGHT ACTIVITIES COUNT, TOO!). SOME PEOPLE MAY NEED DIABETIC MEDICATION OR INSULIN INJECTIONS IF BLOOD SUGAR SPIKES BECOME TOO HARD TO CONTROL.

WHAT IF I DON’T TREAT IT?
NOT TREATING GESTATIONAL DIABETES CAN LEAD TO PREECLAMPSIA, ISSUES STEMMING FROM HIGH BLOOD SUGAR IN BABY, INCREASED SIZE OF BABY (WHICH INCREASES THE RISK OF NEEDING A C SECTION), AND OTHER ISSUES WHEN IT COMES TIME FOR DELIVERY OF BABY. LEAVING GESTATIONAL DIABETES UNTREATED DURING PREGNANCY LEADS TO AN INCREASED RISK OF HEART DISEASE AND DIABETES FOR BOTH YOU AND BABY LATER IN LIFE.

HOW DO I EAT IF I HAVE GD OR WANT TO PREVENT GD?
AIM TO EAT A VEGETABLE AT EVERY MEAL OR SNACK (AIM FOR AT LEAST 5 SERVINGS A DAY). THIS CAN INCLUDE RAW AND/OR COOKED VEGGIES. PAIR YOUR FRUITS AND VEGETABLES WITH A HEALTHY FAT AND/OR PROTEIN. FOR EXAMPLE, APPLES WITH NUTS AND SEEDS OR NUT/SEED BUTTER. VEGGIES WITH HUMMUS. CHICKEN WITH ROASTED BROCCOLI. FRUIT SMOOTHIE WITH PROTEIN POWDER. TRY TO LIMIT SWEETS! IF YOU HAVE REALLY STRONG CRAVINGS FOR JUNK FOOD, AIM TO HAVE IT IMMEDIATELY FOLLOWING A LARGE HEALTHY MEAL. FOR EXAMPLE, IF YOU NEED TO HAVE ICE CREAM OR CAKE OR COOKIES, TRY TO HAVE IT IMMEDIATELY FOLLOWING DINNER AS THIS CAN HELP REDUCE THE GLUCOSE SPIKE!

THIS FEELS TOO OVERWHELMING…IF YOU’RE LOOKING FOR SUPPORT PREPARING FOR PREGNANCY, INCLUDING PREVENTING GD OR MANAGING GD, YOU CAN BOOK AN APPOINTMENT WITH OUR NATUROPATHIC GRADUATE AND DOULA, ADRIENNE! SHE CAN HELP YOU UNDERSTAND YOUR OPTIONS AND EMPOWER YOU TO MAKE DECISIONS THAT ARE BEST FOR YOU WHEN IT COMES TO PREVENTING AND MANAGING GD.

0 Comments