When a Pregnancy is not Viable

I think that this is a hard decision for any mother to make when she is told that her baby may not be viable.  I can see several ethical things here that would make a decision difficult to make.  First of all, there is the termination of the pregnancy recommended because the baby will not be viable at birth, and then there is the religious aspect.  These are both ethical situations that can be very difficult for parents when they have to make a decision.  Doctors make decisions based on the viability of a baby and feel that if the baby will not make it, the pregnancy should be terminated.  In a Christian hospital, for example, these conversations may not happen, because they do not do terminations of pregnancy, so that suggestion would not be made. However, at a non-Christian hospital, that type of discussion may happen there frequently.

Each hospital should have an ethics team to explain the choices to the mother so that a mother that does not believe in termination is aware that she does have the right to keep the baby until he passes.   Allowing the parents to use their own judgment in a case like this,  provides for better healing as they cope with the impending loss.  The termination of a pregnancy before its time is devastating to any parent. A parent’s religious beliefs in the Lord keep them holding on for a possible miracle and we should not interfere in their decision making.  If the miracle does not happen, those parents will find the way to grieve the loss but at least they were offered a choice and will not have to worry that the choice was not given to them and they will not have to live with the “what ifs.”  This would be their way of coping with the death of that child (Denisco & Barker, 2012).

References

Denisco, S. M., & Barker, A. M. (2012). 25. In Advanced practice nursing: Evolving rules for the transformation of the profession (2nd ed., pp. 547-567). Retrieved from https://campus.capella.edu/web/library/home

Rosie Moore, RN, DNP

Visit my Website to learn more www.rosiemoore27.com
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When You Love Unconditionally

Do you ever wonder why people help a total stranger?  Do you ask yourself why is it that some people have babies and some who want them cannot? It is sad when these circumstances of infertility happen and a couple feels that they do not have anywhere to turn.  Rosie Moore founder of The Gift of Life a nonprofit that supports premature babies and nurse consultant for Windermere Baby and Family knows all too well the struggles that parents who cannot conceive face.  Sometimes when the parents are able to conceive, the baby may be born prematurely or the baby is miscarried, these are the heart-wrenching stories that led Rosie to start helping intended parents find a surrogate to carry a baby for them. Miracles do indeed happen, all it takes is unconditional love.

A few weeks ago Becky Kammes, a doula in Wisconsin, shared her moving story about how she gave a couple the gift of a lifetime, the gift of birth!

Read Becky’s touching story as she shares her journey

“I have two children of my own and have been a gestational surrogate twice (working on a third journey currently). Surrogacy is my heart and soul, truly.  My intended parents( IP’s) resided on the West Coast and I live in  SW Wisconsin. My IPs were quite active during my prenatal appointments through FaceTime.  When I turned 20 weeks, they traveled to WI for my 20-week appointment and ultrasound.  When it was time for the baby to be delivered, they flew back for the glorious day, the birth of their baby.   We had a doula present at the birth to support all of us during the birth process. My IP’s were elated with the idea, so my Doula and Hubby were a sensational birth duo for both of my IPs and myself. The experience went so well, that I am currently working on a sibling journey with them. They have since become our extended family and that makes my heart soar!

This was their first baby and they entrusted me with the entire pregnancy and birth; they continuously told me that I was “the birth baby professional” and they wanted me to be most at ease and comfortable. I reminded them that although I had birthed three babies prior, one of which is a surrogate delivery, THIS moment was THEIRS. This special time was THEIRS. I’m just along for the ride! Everything we discussed, every idea mentioned every suggestion made, was crucial to the process because we all had to agree on it.  The five of us were a wonderful team! There was an insatiable cohesive bond that was built without really even trying-it was innate, as silly as that sounds.

Part of the doula’s job is to learn your client’s ‘love language’ as I call it and that was done, to a T! But also, our doula managed to learn my IPs love language in such a short amount of time and didn’t overstep any support boundary in the least bit. There was a strong, energetic bond and everyone, including our nurses and OB, respected that and we ALL conquered the birth as a rockstar unit!

I would love to one day Doula for a surrogate and her IPs. It’s such a profoundly intimate moment-in every aspect of the word and to offer my own experiences and insight to help a fellow surrogate and her family have an exceptional birth experience would be a CHERRY ON MY BIRTH SUNDAE!”

 

Thank you, Becky, for sharing such a special and personal experience with Windermere Baby and Family

Visit Windermere Baby and Family to learn more about becoming a surrogate and what it entails.  We can walk you through the entire process of being someone’s miracle.

 

 

 

 

Case Study on Continuous Support During Birth

Most recently I was contacted by a mother to be who was interested in having a doula at her birth.  She was very excited to have a natural childbirth because she had heard about horror stories when women went into labor and their doctor rushed them through the delivery.  Much to her disatisfaction, she was told that she could not have a doula and her family in the room at the time of delivery, she had to make a choice because the doctor did not want that many people watching.  I let her know that the choice was ultimately hers as we are not friends or family but we are part of the medical team helping the moms to be through labor and delivery.  She decided that she would go with her family in the room and hope for the best.

Delivery day came and she was very excited to give birth, what she did not anticipate was being in labor for almost 2 days with a failure to progress.  She received her epidural the minute that she arrived there and she thought surely she would deliver within a few short hours.  Well, she notes that was not the case after she failed to progress.  The Epidural slowed the labor down and because she was bed bound, she was not able to put all the labor tips into action to help herself along.  She ended up with a C-section for failure to progress.  The good part is that both mom and baby are doing great, the sad part as she put it was that she was never given an opportunity to try to birth her baby naturally before she was offered an epidural the minute she walked in the door.

The benefits of having a doula documented by the 2017 Cochrane Review indicated that having continuous support for women during childbirth, showed positive outcomes when a doula was part of the birth team.  When a doula is present, it decreases the chances of having pain medications, c sections, and it helps the mother have a positive birth experience that she will remember for life.

Here is the study that was done by the Cochrane Review https://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth

  • Review: 26 studies on the effectiveness of continuous support during labor, which can include doula assistance. The studies included more than 15,000 women from a variety of backgrounds and circumstances.
  • Results: “Continuous support during labor may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labor, and decreased cesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score, and negative feelings about childbirth experiences. We found no evidence of harms of continuous labor support.”
  • Quick birth terminology lesson: “Analgesia” refers to pain medication and “Apgar score” is how babies’ health is assessed at birth and shortly afterward — the higher the score, the better.The researchers also looked to see if the type of support made a difference. They wanted to know—does it matter who birthing persons choose for continuous support? Does it matter if they choose a midwife, doula, or partner for continuous support? The researchers were able to look at this question for six outcomes: use of any pain medication, use of Pitocin during labor, spontaneous vaginal birth, Cesarean, admission to special care nursery after birth, and negative birth experiences.For two of these outcomes (designated with asterisks*), the best results occurred when a birthing person had continuous labor support from a doula– someone who was NOT a staff member at the hospital and who was NOT part of their social network. The researchers found that overall, people who have continuous support during childbirth experience a:
    • 25% decrease in the risk of Cesarean; the largest effect was seen with a doula (39% decrease)*
    • 8% increase in the likelihood of a spontaneous vaginal birth; the largest effect was seen with a doula (15% increase)*
    • 10% decrease in the use of any medications for pain relief; the type of person providing continuous support did not make a difference
    • Shorter labors by 41 minutes on average; there is no data on if the type of person providing continuous support makes a difference
    • 38% decrease in the baby’s risk of a low five minute Apgar score; there is no data on if the type of person providing continuous support makes a difference
    • 31% decrease in the risk of being dissatisfied with the birth experience; mothers’ risk of being dissatisfied with the birth experience was reduced with continuous support provided by a doula or someone in their social network (family or friend), but not hospital staff

    The rate of special care nursery admissions was no different between people who received continuous support and those who received usual care. The rate of Pitocin was also no different but there was a trend towards more Pitocin with continuous support from hospital staff and less Pitocin with continuous support from a doula.

If you have questions about your birthing plan, contact us for a complimentary 20 minute call to discuss your concerns 407-760-1662 or email us at info@windermerebabyandfamily.com

The Benefits of Hiring A Doula

Doulas provide emotional, physical, and educational support to expectant mothers during the labor process and postpartum.  The doula is professionally trained in childbirth with the purpose of helping women have safe, memorable experiences and empowering a birth the way the mother desires. The doula services begin typically a few months before the birth in order to establish a relationship with the expectant mother.  Having the relationship early allows the doula to answer any questions that the mother and father have prior to delivery, ease any anxiety, and assist in developing a birth plan. During labor, the doula will provide the mother with comfort measures, position changes, breathing techniques, and partner involvement in the birthing process.  A doula leads to a better birth outcome and helps to reduce complications for both mother and baby.    Doulas use touch and massage as a means to decrease stress and anxiety during labor.  They use the sound of their voice to have the mother focus during the difficult stages of labor allowing this moment to engage the birth partner on the focal point.

After the delivery, the doula will help the mother start the breastfeeding process and to enjoy “the golden hour” of bonding.
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