Rachel Nash Birth Story

Posted by on Sep 26, 2014 in Birth Stories, Blog Posts, Houston Midwife

The Home Birth of Archer Lux Guimbellot

March 11, 2014

From the moment I learned I was pregnant I knew I wanted a home birth. I hate hospitals and being around people when I’m not feeling well, so I couldn’t imagine trying to accomplish a natural birth in the presence of strangers and with the pressures of intervention.

As soon as we met with Nanci for our consultation we knew she was the one. Her experience, confidence and calm demeanor were the qualities I was looking for in a midwife. She was always quick to answer my first-time-mom questions and reassuring of my concerns.

My husband was well prepared to coach me and Nanci was excellent in supporting us both throughout the labor. Knowing I had two experienced professionals caring for my baby and me allowed me to be completely present and give birth with intention.

Houston Midwife Nanci StanleyLabor pains began around 7 am and by 4pm things were serious. Contractions got closer together and more intense. I got into the birthing pool and was really able to relax between contractions. I pushed a few times but did not feel comfortable enough to continue in the water. We moved into the bedroom where I laid on the bed and, hands behind my knees, I continued pushing. About 20 minutes later he crowned. Nanci took my hand and placed it on his head. It was a huge encouragement to feel that progress! Another few pushes and his head was out. Another push and his whole body shot right out! Josh and Nanci caught him and placed him on my chest. He was tiny and purple and mad. He was perfect. He weighed 7 pounds and 1 ounce, was 20.5 inches long. Josh cut the umbilical cord and we were a family.

I write this summary of my experience. No one’s story is the same. Some women have pleasant memories of giving birth. Some women do not. I am of the latter. For me, this was a traumatic experience. I had no complications, no real issues, but it was Houston Midwivesinexplicably difficult. It was painful. I’d read birth stories, natural birth books, watched home births…nothing could have prepared me for the intensity of the birth of my son. It is something I could not think on for some time after. It is also something I would never take back.

Thank you, Nanci, for helping us to introduce our sweet baby into the world. Our lives are forever changed.

-Rachel Nash

Houston Midwives

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Trying to Conceive after Age 35

Posted by on Sep 19, 2014 in Blog Posts, Houston Midwife

Trying to Conceive after Age 35

Many women today find themselves trying to conceive after the age of 35. This opportunity can be full of joys and riddled with new questions. Despite the challenges, many women in their thirties and forties successfully conceive.

What are some of the challenges when trying to conceiving after age 35?

The most common cause of age-related decline in fertility is less frequent ovulation. As women age, they begin to have occasional cycles where an egg is never released. Egg quality and quantity also declines in a woman’s 30s and 40s. Other reasons conceiving after 35 may be more difficult include:

  • Infection or surgery that caused scar tissue around the fallopian tubes or cervix
  • Endometriosis
  • Fibroids or uterine disorders
  • Decrease in cervical fluid
  • Chronic health problems such as high blood pressure or diabetes

Miscarriage is also more common in women over 35. This is often caused by increased incidence of chromosomal abnormalities. Women aged 35-45 have a 20-35% chance of miscarriage.

How can I increase my chances when trying to conceive after 35?

Trying to conceive after 35 may seem overwhelming, but there are many things you can do to make getting pregnant easier. Here are some things to remember:

  • Schedule a pre-conception appointment. You and your health care provider can review your medical history, current medications and overall lifestyle. This gives you the opportunity to address any concerns about trying to conceive after age 35.
  • Women over age 35 take longer to conceive. The average time it takes a couple over 35 to conceive is 1-2 years, so try to remain positive if you do not become pregnant immediately.
  • A woman who is physically, mentally and emotionally healthy is more likely to conceive. Alcohol, smoking and caffeine can negatively affect fertility. Being overweight or underweight can also affect fertility by interfering with hormone function.
  • Observing your fertility signs can tell you a lot about your body. Recording your basal body temperature and cervical fluid can help you pinpoint the best time to have intercourse while trying to conceive. These fertility signs can also reveal if you are ovulating regularly. Becoming familiar with your fertility will also help you discern between pending signs and symptoms of pregnancy.
  • Consider taking an at home fertility screening test.. There are over-the-counter tests that help screen for key elements either male or female fertility. This often gives couples a peace of mind as they move through the journey to conceive.
  • Visit your health care provider if you haven’t conceived after 6 months of purposeful intercourse. If you have not conceived after 6 months, contact your health care provider to discuss the possibility of fertility testing. You may decide to consult a fertility specialist at this time.  
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Preconception Health

Posted by on Sep 19, 2014 in Blog Posts, Houston Midwife

Preconception Health for Women

Pregnancy should not be considered only a 9 month journey but as a year  long journey. Knowing that the first few weeks of pregnancy are the most vital to the development of the baby, a mother should be healthy and avoid any harmful activities and substances near the time of conception. Some habits are harder to break, and some health issues take longer to address. Preconception health for women will be beneficial to you and your baby. Following these simple guidelines can help you prepare for pregnancy.

Before you become pregnant you want to make sure that you cut out any habits that are harmful for your baby. These habits include:

Smoking – Smoking during pregnancy is estimated to account for 20 to 30 percent of low-birth weight babies, up to 14 percent of preterm deliveries, and about 10 percent of all infant deaths according to the American Lung Association.

Drinking Alcohol – There is no safe amount of alcohol to consume while you are pregnant.

Recreational drug use – For example, smoking marijuana during pregnancy can increase the chance of miscarriage, low birth-weight, premature births, developmental delays, and behavioral and learning problems.

Prescription drugs – There are many prescription drugs that are teratogenic (cause birth defects). Talk with your healthcare provider about any and all prescription drugs you are taking.

Hazardous chemicals – There are some chemicals that can also be teratogenic. For example, most studies show that the greatest risk of exposure to pesticides is during the first three to eight weeks of the first trimester when the neural tube development is occurring. This is often before a woman knows she is pregnant.

Stress – Stress has been linked to delayed or missed periods which can cause difficulty tracking ovulation and getting pregnant. Limit your amount of stress as much as possible. You may find it helpful to employ relaxation techniques or yoga to help calm things down.

Herbs – Most herbs and herbal remedies are not mandated by the FDA, and therefore, there is little to no research on the effect they have on pregnancy. Discuss any herbs with your healthcare provider.

Caffeine – Some studies have shown a link between high levels of caffeine consumption and delayed conception. A few studies have shown that there may be an increase in miscarriages among women who consume more than 200 mg (one 12oz cup of coffee) a day versus those who do not consume any caffeine.

You should replace these old habits with new healthy habits. These healthy habits include:

  • Exercise – Start exercising now. Set goals for what you want to achieve. Ask yourself if you want to lose weight, gain weight, build muscle, or improve lung capacity. Some good exercise options include walking, swimming, bicycling, and aerobics. Yoga is an excellent choice for exercise because it incorporates posture, breathing, and concentration which will be beneficial for you during labor. Talk with your healthcare provider about what is best for you.
  • Read – Read books on pregnancy and child birth. It is important that you are educated and prepared.
  • Track your menstrual cycle – This is very important. Your doctor will ask you about your menstrual cycle, so you need to be prepared. Keeping track of your cycle will also help you track your ovulation and increase your chance of pregnancy.
  • Practice relaxation techniques – Relaxation can help minimize stress, and as you have already read, stress is not a woman’s best friend. Try Yoga or listening to soft relaxing music in a warm bath.
  • Get lots of sleep – If you are not receiving 8 hours of sleep a night, you should start. Adequate amounts of sleep can also help relieve stress and tension.
  • Eat healthy – Nutrition is vital to your health. The healthier you are the easier the pregnancy will be for you. You might start on some supplements to make sure you are getting all the nutrients you need. Just make sure to tell your health care provider about any supplements you are taking.

Nutrition

You are what you eat, and so is your baby. Make sure that you are getting lots of vitamins in your diet, and start taking folic acid now. Studies have shown that folic acid (300-400mcg a day) can help reduce the risk of neural tube defects when taken before conception.

For more information on the suggested amount of vitamins to consume during pregnancy (which is the same for preconception) look at our chart on Essential Nutrients & Vitamins.

Maintain an ideal weight

Your weight can play a significant role during conception and pregnancy. When planning to conceive you want to avoid being over or under weight.

Underweight (10% below normal range)

  • Exercise to build muscle
  • Increase energy intake
  • Eat at least three meals a day
  • Eat more food at each meal
  • Eat more snacks
  • Drink juices and milk

Overweight (20% above normal range)

  • Choose a realistic eating plan
  • Make sure your eating plan includes nutritional adequacy
  • Drink adequate amounts of water
  • Combine your eating plan with exercise

Discuss any plans for weight loss or gain with your healthcare provider.

Make an appointment with your Midwife or Doctor

It is important that you see your healthcare provider before you become pregnant. There are medical conditions that you may not be aware of that can affect your pregnancy. Some of the most common conditions include:

  • Diabetes – If you are diabetic you should get your diabetes under control. Pregnancy increases the chances of diabetes, and it can make it hard for a mother who is already suffering from diabetes.
  • High blood pressure – If you have high blood pressure before pregnancy, you must closely monitor your blood pressure during pregnancy.
  • Anemia – A complete blood count (CBC) can measure your hemoglobin, red & white blood cell count, and the appearance of your platelets. Anemia can cause weakness and fatigue during pregnancy.
  • Thyroid problems – The test to check for thryoid issues consists of a blood test which measures your thyroid-stimulating hormone (TSH). Hyperthyroidism (overactive) can lead to premature birth and low birth weight if left untreated. Hypothyroidism (underactive) can lead to infertility or miscarriage when left untreated.
  • STDs – It is best to know if you have an STD before getting pregnant, since some STD’s can cause pregnancy compliations. For example, ectopic pregnancy is a risk for a woman who has chlamydia. If chlamydia is left untreated, it can also lead to Pelvic Inflammatory Disease (PID) which can cause infertility.

Other testing and screening that is common during a preconception health check up are:

  • Pap Smear – A pap smear can check for cervical dysplasia.
  • Breast exam – If over the age of 35, you may receive a mammogram.
  • Blood type – If you are RH negative you will have to be desensitized prior to labor.
  • Immunity to Rubella (measles) – The March of Dimes recommends that all women be tested for immunity to rubella before they become pregnant and that they consider being vaccinated at that time if they are not immune. The Centers for Disease Control and Prevention (CDC) recommends that a woman wait at least 4 weeks after receiving the vaccination before trying to conceive.
  • Immunity to Varicella (chicken pox) – As with rubella it is recommended that all women be tested for immunity to varicella before they become pregnant and that they consider being vaccinated at that time if they are not immune. The CDC recommends that a woman wait at least 4 weeks before trying to conceive after receiving the vaccination.

At your appointment you will also be asked for your medical and family history.

Medical history may include:

  • Medications you take
  • Past pregnancies
  • Diet
  • Exercise
  • Medical conditions

Family history may include:

  • Diabetes
  • High blood pressure
  • Seizure disorders
  • Mental retardation
  • Twins

Some couples may also need to seek Genetic Counseling. For the majority of couples, genetic counseling is not necessary .

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Early Pregnancy Symptoms

Posted by on Sep 19, 2014 in Blog Posts, Houston Midwife

Early Pregnancy Symptoms

Pregnancy symptoms differ from woman to woman and pregnancy to pregnancy; however, one of the most significant pregnancy symptoms is a delayed or missed period.

Understanding the signs and symptoms of pregnancy is important because each symptom may be related to something other than pregnancy. You may experience signs or symptoms of pregnancy within a week of conception. However, it is possible you may not experience any symptoms for a few weeks.

What are Early Pregnancy Symptoms to Watch For?

Symptoms to watch for early on include a missed period, headaches, tender breasts, nausea and lower backaches. If you have been sexually active and are experiencing any of these symptoms, it is important to take a pregnancy test.  Are you experiencing morning sickness- are you pregnant or experiencing something else?

You can search for a pregnancy center for free testing by using the search tool on the right sidebar. Questions about paternity can be made at 1-800-798-0580. Other numbers and helpful steps can be found at the bottom of the page.

First Sign of Pregnancy: Spotting

Implantation bleeding can be one of the earliest pregnancy symptoms. About 6-12 days after conception, the embryo implants itself into the uterine wall. Some women will experience spotting as well as some cramping. Some women do not even notice this so don’t worry if you are trying to get pregnant and don’t see it – you could still be pregnant.

Other Explanations: Actual menstruation, altered menstruation, changes in birth control pill, infection, or abrasion from intercourse.

First Sign of Pregnancy: Delay/Difference in Menstruation:

A delayed or missed period is the most common pregnancy symptom leading a woman to test for pregnancy. When you become pregnant, your next period should be missed. However, some women can bleed while they are pregnant, but typically this bleeding will be shorter or lighter than a normal period.

Other Explanations: Excessive weight gain/loss, fatigue, hormonal problems, tension, stress, ceasing to take the birth control pill, illness or breastfeeding.

Swollen/Tender Breasts:

Swollen or tender breasts is a pregnancy symptom which may begin as early as 1-2 weeks after conception. Women may notice changes in their breasts; they may be tender to the touch, sore, or swollen.

Other Explanations: Hormonal imbalance, birth control pills, impending menstruation (PMS) can also cause your breasts to be swollen or tender.

Fatigue/Tiredness:

Feeling fatigued or more tired is a pregnancy symptom which can also start as early as the first week after conception.

Other Explanations: Stress, exhaustion, depression, common cold or flu, or other illnesses can also leave you feeling tired or fatigued.

Nausea/Morning Sickness:

This well known pregnancy symptom will often show up between 2-8 weeks after conception. Some women are fortunate to not deal with morning sickness at all, while others will feel nauseous throughout most of their pregnancy.  If you are experiencing morning sickness at all, take a look at our articles on morning sickness to learn how to manage it better.

Other Explanations: Food poisoning, stress, change in hormonal birth control method or other stomach disorders can also cause you to feel queasy.

Backaches:

Lower backaches may be a symptom that occurs early in pregnancy; however, it is common to experience a dull backache throughout pregnancy.

Other Explanations: Impending menstruation, stress, other back problems, and physical or mental strains.

Headaches:

The sudden rise of hormones in your body can cause you to have headaches early in pregnancy.

Other Explanations: Dehydration, caffeine withdrawal, impending menstruation, eye strain, or other ailments can be the source of frequent or chronic headaches.

Frequent Urination:

Around 6-8 weeks after conception, you may find yourself making a few extra trips to the bathroom.

Other Explanations: Urinary tract infection, diabetes, increasing liquid intake, or taking excessive diuretics.

Darkening of Areolas:

If you are pregnant, the skin around your nipples may get darker.

Other Explanations: Hormonal imbalance unrelated to pregnancy or may be a leftover effect from a previous pregnancy.

Food Cravings or Food Aversions:

While you may not have a strong desire to eat pickles and ice cream, many women will feel cravings for certain foods when they are pregnant. This can last throughout your entire pregnancy. Some women develop adversions to certain types of food early in pregnancy and this too can last for the next 9 months.

Other Explanations: Poor diet, lack of a certain nutrient, stress, depression, illness or impending menstruation.

Your Next Steps:

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Understanding Pregnancy Tests

Posted by on Sep 19, 2014 in Blog Posts, Houston Midwife

Understanding Pregnancy Tests

There are two types of pregnancy tests; one uses a urine sample, the other a sample of blood. Both tests detect the presence of a hormone called human chorionic gonadotropin (hCG). This hormone is produced by the placenta shortly after the embryo attaches to the uterine lining and builds up rapidly in your body in the first few days of pregnancy. It is this rapid shift in hormones that triggers most of your pregnancy symptoms.

Urine Tests:

Urine tests can be performed in two different ways and these can be performed at home or in a clinic. One way involves collecting your urine in a cup and dipping a stick into the urine, or putting urine into a special container with an eyedropper. Another option involves placing a stick into your urine stream and catching your urine in midstream.

Tests vary in how long you have to wait to get a result. You will be looking for a change in color, a line, or a symbol (like a plus or minus). The newer digital pregnancy test offered by Clearblue Easy makes reading your results simple: the window will either show the words “not pregnant” or “pregnant”. You can also get recommended midstream urine tests online:

All tests come with instructions, and it is important that you follow these instructions to get an accurate reading.

When can I take a urine test?

Most doctors recommend that you wait until the first day of your missed period before taking a urine pregnancy test. This is usually about two weeks after conception. However, some tests are more sensitive than others and can be taken earlier.

How accurate are urine tests?

Urine tests or home pregnancy tests are around 97% accurate when done correctly.

Home pregnancy tests are great to use because they can be done at home, they are usually low in cost (anywhere from $7.99 to $19.99), private, they give a fast result, and are easy to use. However, if done incorrectly or taken too early, the result can be inaccurate.

If you get a negative result and still have symptoms of pregnancy (missed period, nausea, breast tenderness and fatigue), wait a week and take another test or contact your doctor so you can have a blood test done.

Blood Tests:

There are two types of blood tests. A quantitative blood test measures the exact amount of hCG in the blood, and a qualitative hCG blood test gives a simple yes or no answer to whether you are pregnant or not.

Advantages of having a blood test done:

  • Can detect a pregnancy earlier than a urine test at about 7-12 days from possible conception ( but if a negative result is received, a test should be repeated if a period is missed.)
  • Can measure the concentration of hCG hormone in your blood (this is useful information for your healthcare provider in tracking certain problems in pregnancy)

Disadvantages to having a blood test done:

  • More expensive than a urine test (price depends on cost of doctor’s visit and lab fees)
  • Takes longer to get result
  • Must be done in a doctor’s office

Frequently Asked Questions About Pregnancy Tests:

If I get a positive result on a home pregnancy test, does that mean I am pregnant?

A positive result from a home pregnancy test shows the presence of the hormone hCG in your system. When an egg is implanted in a woman’s uterine lining, hCG hormones begin to develop and multiply. This is a sign that you have become pregnant.

If I get a negative result on a home pregnancy test, does that mean I am not pregnant?

A negative result can mean that you are not pregnant, you took the test too early, or you took the test wrong. Pregnancy tests vary in their sensitivity (how soon they can detect the hormone hCG), and you may not have given your body enough time to produce enough hCG hormones that will show up on the test. Also, if you let a test sit for too long (after the instructions on the box tell you), the test is invalid. It is best to follow the instructions and wait until you have missed a period before taking the test. Most pregnancy tests come with two in a box, and it is a good idea to take both.

When is the earliest that I can take a home pregnancy test?

It is recommended that you wait until you have missed a period to take a home test. A missed period is often one of the first signs of pregnancy. If you cannot wait that long to find out and you know the day you may have conceived, then the earliest you can take a test would be 14 days from possible conception.

What if I take a couple of home pregnancy tests and get different answers?

If you have received different answers on multiple pregnancy tests, it is recommended that you get a blood test done to get an accurate answer.  Feel free to contact Houston Midwife Nanci Stanley for more information on understanding pregnancy testing.

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Male Infertility

Posted by on Sep 19, 2014 in Blog Posts, Houston Midwife

Male Infertility

Infertility affects approximately one out of every six couples. An infertility diagnosis is given to a couple who are unable to conceive over the course of one year. When the problem lies with the male partner it is referred to as male infertility. Male infertility factors contribute to approximately 50% of all infertility cases, and male infertility alone accounts for approximately one-third of all infertility cases.

What causes male infertility?

Male infertility usually occurs because of sperm that are abnormal, because of inadequate numbers of sperm, or problems with ejaculation.

Sperm can be considered abnormal for two possible reasons: unusually short life span of the sperm and/or low mobility. Sperm abnormalities may be caused by one or more of the following:

  • Inflammation of the testicles
  • Swollen veins in the scrotum
  • Abnormally developed testicles

Reasons for a low sperm count or lack of sperm include one or more of the following:

  • A pre-existing genetic condition
  • Use of alcohol, tobacco or other drugs
  • Severe mumps infection after puberty
  • Hernia repairs
  • Hormone disorder
  • Exposure to poisonous chemicals
  • Exposure to radiation
  • Blockage caused from a previous infection
  • Wearing restrictive or tight underwear
  • Injury to the groin area

Male infertility can also occur when there are problems with ejaculation. Ejaculation problems may include any of the following:

  • Premature ejaculation
  • Retrograde ejaculation, which occurs when the semen is forced back into the bladder
  • Erection dysfunctions
  • Complications from radiation therapy or surgery

Other causes of male infertility can include:

  • History of STD’s
  • Urinary tract infections
  • Use of certain types of medications

How is male infertility diagnosed?

Potential male infertility will be assessed as part of a thorough physical examination. The examination will include a medical history regarding potential contributing factors.

Your healthcare provider may use one or more of the following tests to assess fertility:

  • Semen analysis to determine the number and quality of sperm
  • Blood test to check for infections or hormone problems. Hormone levels are just as important in male fertility as they are in female fertility
  • Making a culture of fluid from the penis to check for infections
  • Physical examination of the penis, scrotum and prostate

Semen analysis is the most important part of male fertility testing.Some men find it more comfortable to do semen analysis testing in the privacy of their own homes. In-home testing kits are available.

What are they looking for in the testing?

When semen analysis is done, your health care provider will be looking for some specific markers to access fertility.

  • Total amount or volume of semen–2 milliliters is considered normal. A lower amount may indicate an issue with the seminal vesicles,blocked ducts or a prostate gland issue.
  • Sperm count- 20 million to 300 million per milliliter is considered in the normal range for sperm counts. Below 10 million is considered “poor.”
  • Morphology–the size and shape of the sperm affect the sperms ability to reach and fertilize an egg. 30% is considered a good amount of sperm that are shaped “normal.” And “strict” testing shows an even lower percentage as normal.
  • Motility–movement and number of active cells. Movement is rated from 0-4, with score over 3 considered good. The amount of active cells is rated in percentages from 1-100%, with 50% considered the minimum.

How is male infertility treated?

Male infertility is most often treated by conventional methods that include one or more of the following:

  • Taking medications to help increase sperm production
  • Taking antibiotics to heal an infection
  • Taking hormones to improve hormone imbalance
  • Avoiding taking long hot showers, using hot tubs or saunas
  • Wearing looser underwear such as boxer shorts versus jockey shorts

Sperm production may also improve by taking clinically proven supplements. Anything that increases the number of healthy sperm increases the chances of conception. Many health food stores and vitamin shops offer male fertility supplements.

Artificial insemination is an option if the man’s sperm count is low. In this procedure, sperm is collected through multiple ejaculations. They are then manually placed in the female’s uterus or fallopian tubes.

In vitro fertilization is another option that can be used to overcome male infertility factors. In this procedure, the sperm and egg are fertilized in a laboratory after which the fertilized egg is placed in the female’s uterus.

If tests show that there is no sperm production or that other related problems are present, donor sperm can be used to help facilitate conception. In this procedure, donor sperm are obtained from a sperm bank and placed inside the female’s uterus or fallopian tubes through artificial insemination.

Can male infertility be prevented?

There is usually nothing that can be done to prevent male infertility caused by genetic problems or illness. However, there are actions that men can take to decrease the possibility of infertility. These include:

  • Avoiding sexually transmitted diseases
  • Avoiding illicit drugs
  • Avoiding radiation when possible
  • Avoiding exposure to toxic substances
  • Avoiding heavy or frequent use of alcohol
  • Observing good personal hygiene and health practices
  • Avoiding long, hot baths, hot tubs or saunas
  • Wearing loose-fitting underwear

Contact Nanci Stanley for more information on male infertility.

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