How to Prepare for a Home Birth in a Post Collapse Situation, by C.C., CPM

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This article isn’t designed to cover all aspects of childbirth, of course, but it is meant to reassure people who are unsure of their abilities to do prenatal care and their own or a neighbor’s birth, if the stuff hits the fan. I am a Certified Professional Midwife, and have assisted people in birth as a childbirth educator, doula, and now midwife since 1984. (My North American Registry of Midwives certification, however, is fairly recent, since I have concurrently raised three children alone, and earned a BS in Computer Information Systems.)

One of the first things to remember when the stuff hits the fan, is that most births, if not tinkered with, are straightforward.  Most women are quite capable of birthing at home just fine. I would recommend having several good books on hand, such as Spiritual Midwifery by Ina May Gaskin (the only midwife who has had a procedure named after her), Heart and Hands by Elizabeth Davis, and either Varney’s Midwifery, or Myles Midwifery. Varney’s is for the American audience, Myles is British, but easy to read and understand.  Laura Shanley’s Unassisted Childbirth, and Dr. Gregory White’s Emergency Childbirth are two others. There is also the book Where There Is No Doctor; it has a good section on childbirth, but doesn’t go into the details that one might need in a post-collapse situation.

I am not calling this article Emergency Childbirth for a reason, because most home births are not! They are normal physiological functions that only require good nutrition, watchfulness and cleanliness to have a good outcome. One should study, to know what normal is. If you have time before the birth (months, I hope), try to find your nearest CPM. They are trained in out-of-hospital birth, and are trained to know how to help the mom birth twins, breeches (a variation of normal) and Vaginal Birth after Cesarean Section (VBAC).  In a post collapse scenario, there won’t be access to the hospital for pregnant women in labor, as was discovered during Hurricane Katrina. (Laboring women were turned away from the hospitals, and either birthed alone, with family, or with the two CPMs that were available to help until more help arrived).

If there is no one that can assist you, then concentrate on the best nutrition you can do, specifically plenty of protein (50 mg daily, minimum) and green leafy veggies (at least 3 servings daily, but more is better). The protein helps maximize fetal development, and the green leafies provide B Complex, Iron and other necessary nutrients. Nutrition is covered more thoroughly in the books mentioned. Better nutrition means a healthier mom and baby, often an easier labor and breastfeeding and better ability to withstand blood loss. Avoiding caffeine, illegal drugs, pesticides, chemicals, and tobacco goes a long way to a healthy pregnancy.  Some people follow a vegan diet successfully, and as long as you get enough protein, it should be okay. In the first three months, the following herbs should be avoided (see Herbal for the Childbearing Year, by Susun S. Weed); Basil, Caraway Seeds, Celery Seed, Ginger(except in small doses for morning sickness and/or heartburn), fresh horseradish, Savory, Marjoram, Nutmeg, Rosemary, Saffron, Sage, Parsley, Taragon, Thyme, and Watercress, Aloe Vera, Angelica, barberry, Buchu, Buckthorn, Cascara Sagrada, Coffee, Comfrey, Ephedra, Goldenseal, Juniper, Lovage, Male Fern, Mistletoe, Mugwort, Wormwood, Pennyroayal, Rhubarb root, Rue, Shepherds purse, Tansy, Yarrow, Senna, and Mandrake. Seems like a long list, but most people won’t encounter these herbs.

Red Raspberry Leaf tea, however, is a great uterine strengthener and just tastes good! If you have access to prenatal vitamins, those should be taken as well. Folic acid is very important to help prevent neural tube defects and any vitamin regimen should have at least 4 mcg daily.

Exercise is very important, for both physical and mental health. Just getting outside and walking in the yard if weather is inclement is a great stress reducer and helps blood flow to the baby. Yoga, tai chi, and other relaxing stretching types of exercise can help the mom’s body adjust to the changes that are occurring over the course of the pregnancy, and prepare for the birth. Massage is a wonderful relaxing tool and can be used during the birth as well. Learning simple massage, and reflex points can help tremendously during birth. Whatever it takes to get mom loose, can help. Talking to the baby in utero helps the baby learn your voice (Dad’s too!) and helps establish a bond that will make breastfeeding easier. Reading good books, thinking good thoughts (I bet that won’t be easy during post collapse, but it can be done), prayer, meditation, visualizing an easy birth, saying birth affirmations,  and examining your birth beliefs (overcoming negative ones) is calming to the spirit. You have to come to a place within yourself where you recognize that birth is normal, and your body can do this, that it was designed for this. Mind has a lot to do with how easy or difficult a birth may be. Not everything, but negative emotions and unspoken fears can inhibit labor pretty significantly. Mothers who learn to draw on their inner strengths can often know when a situation during labor needs correcting. They learn to get in “touch with the baby”, so to speak.

Rest each day if possible, especially in the last trimester. The baby is getting bigger and it takes more energy just to keep up with daily demands of the family. Napping helps recharge mom’s batteries. If that isn’t possible, getting off your feet for 15 minutes twice a day, can both give some rest, and help avoid varicose veins. Especially with a multiple gestation, getting your feet elevated helps blood circulation to the babies.

You can do your own prenatal care, writing down your blood pressure, taking temperature and pulse, and your weight. You or whoever is helping you might be able to learn to feel baby’s position in the uterus (palpation), to better prepare for labor. A baby that is posterior (his spine is laying near mom’s spine, feet kicking outwards) can often be turned around before labor, avoiding much backache and a long labor. Spending 15 minutes twice a day on hands and knees can frequently turn a baby anterior (spine facing out, away from mom). There are other tricks for turning a posterior baby on SpinningBabies.com.  Optimal Fetal Positioning by Jean Sutton  and Pauline Scott is an excellent resource for this. Paying close attention to nutrition in the earlier parts of pregnancy can pay off by helping avoid Metabolic Toxemia of Late Pregnancy, otherwise known as preeclampsia, and noting weight gain in the last trimester, along with any swelling (edema) of the hands, face, or legs (some in the legs/feet is normal especially during the summer months, but should not maintain a depression if pressed with a finger (pitting edema). Facial swelling is not normal, and may indicate a need for medical help.  This is one of the reasons  blood pressure is checked so often. Dr. Tom Brewer developed a nutritional system for nearly eliminating preeclampsia in a low-income population in Denver Colorado. (see www.blueribbonbaby.org)

List of items to have on hand for the birth:
Scissors,
Cotton shoe lace (preferably unused, or you could make a “friendship bracelet” out of embroidery floss) (both can be placed in a pan of water during labor, boiled for 20 min, then heat turned off and covered until after the birth)
Bulb syringe,
Chux underpads or black and white newspapers(they can be rolled up to make a bowl of sorts),
4 receiving blankets warmed on a heating pad or near a wood stove (not on it! Or you can heat some water, fill 2 or three mason jars with hot water, put on lids and rings and wrap the blankets around them)
Maxi pads, or cloth menstrual pads
Bath towels, at least 6 if planning a water birth
2 Shower curtains or plastic drop cloths (to protect the mattress and/or floor)
Sheets that are clean, for after the birth, and a set of older sheets for labor/birth that you don’t mind if they get stained.

Herbs: Shepherd’s purse, Ladies Mantle, or Motherwort tinctures or commercial ones like HemHalt or Wombstringe (in case of bleeding),
Superglue (for vaginal tears(small ones, less than an inch long-although those very small ones will heal just fine by themselves as long as the moms stay in bed for the first few days and keep legs together! No tailor sitting or climbing stairs)). For longer tears, you might have to know someone who knows how to suture. Most home births occur without any tears at all, since mom is more relaxed, and water births help too!(we’ve seen 12 lb  babies born with no tear to mom at all) If no suturing available, have mom keep legs together, only moving to get up to potty for the first few days. Nori seaweed is also used as a binding agent on mom’s bottom to help hold a tear together until it heals.
Large bowl or pan (or newspaper bowl) for placenta
Pen and paper to write times or notes on labor/birth
Baby diapers and clothes
Stethoscope, if possible
Tape measure and hanging fish scale(for newborn)
Sling for weighing baby(or you could use a receiving blanket. Just remember to weigh the cloth and subtract that to get the weight of baby.
St. Johnswort tea or capsules (for after pains)

To make the bed for birth, put a plastic shower curtain or drop cloth on mattress, place the clean, “after the birth” sheets on bed, then put plastic drop cloth or shower curtain over them, then the birth sheets. After the mom is cleaned up, all you have to do is take the dirty sheets and first plastic off and voila! Fresh bedding.

For the actual labor and birth, just let mom do what she wants to do. Most women will walk some, rest, dance or sway, eat, sleep, shower, etc, till the contractions become so close together and long (usually 1-2 minutes apart and long) that she cannot move much during them. She will probably vocalize, oohing, singing, or making noise, which is perfectly fine and normal (women are not beached whales, and should not be silenced!) As Ina May says, “an open mouth makes an open bottom”. At some point, the mom will start pushing, and she can reach down and catch her own baby. She can bring the baby to her breast and baby can start nursing right away. Nursing will help the uterus contract, and help the placenta separate more easily. There is no need to cut the cord at this time. One third of the baby’s blood volume is present in the placenta and cord, and it should be allowed to enter the baby (although the term “polycythemia” is used, to my knowledge it hasn’t caused any problems to the baby. He absorbs the extra blood, the unneeded cells break down and they are excreted).

If there is a tight cord around the neck, there is a technique called “somersaulting the baby out”, whereby the attendant holds the baby’s head near mom’s thigh and allows the body to be born over the cord. Unwrap the cord, and baby gets the rest of his blood supply. (I have seen wraps 4 times done this way). Baby should be moving, if not, you can rub baby gently on the back, or flick the bottoms of his feet, and mom can talk to him. He is still getting oxygen from the cord, and it will assist transition to breathing well. If it’s a Water birth, the baby is brought up out of the water right away, and placed on mom’s chest, with a warm towel placed over both mom and baby. The baby usually starts breathing and looking around, connecting faces with the voices he’s heard for the past 9 months. After this point (usually within an hour, but a little longer might still be okay), the placenta separates, there is a small gush of blood from mom’s vagina and she feels a need to push. Once the placenta is birthed, make sure the uterus remains firm(it’s about the size of a grapefruit and easy to feel) and mom breastfeeds baby, if not done earlier. Even if she isn’t planning on nursing baby, (but in a post-collapse, it may be the only source of pure nutrition for baby) breastfeeding helps shrink the uterus to pre-pregnancy levels (over the next few days) helps mom lose any extra weight gained, and minimizes bleeding. The cord can be cut, if desired, when it is limp and white. That shows the baby no longer needs it. Some people don’t cut it, just leave it wrapped in a diaper and carry it around with the baby for a few days until it dries naturally and falls off  (Lotus birth), but unless herbs are used on the placenta, it has a tendency to get a little stinky.

Mom should get up and see if she can urinate (this helps uterus clamp down) and if she wants a shower, someone should be there to help her. In the meantime the bed can be changed of its dirty linen and fresh put down, with plastic underneath. Someone should get mom something to eat and drink, high in protein, and some sugar(mom has done a tremendous amount of work!)  and let her rest and recuperate. Keeping an eye on mom for bleeding (blood pressure checks, color of her face, firmness of uterus) should be ongoing for the next few days.  She and baby should be kept together, to establish bonding and nursing. Wearing the baby in a sling, Mei Tei, or other wrap, helps the baby stay warm, regulate his heartbeat and respirations and establish other rhythms. Within 24 hours, he will probably have his first bowel movement (meconium) and will have peed. Milk will probably come in around the 2nd-to-4th day postpartum. Until then, the breasts produce colostrum, which helps clean out baby’s gut, add good flora to baby, and is anti-bacterial.

I hope this wasn’t too long, but birth is an amazing function, that is awe-inspiring to participate in. It can be a little scary sometimes, too, but the more you know, like any preparedness subject, the better you can be to deal with the unexpected.

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This page contains a single entry by Jim Rawles published on March 20, 2013 9:01 PM.

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