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birthpanama

~ Pregnancy & Birth in Panama

birthpanama

Category Archives: WATERBIRTH

Misty

09 Thursday May 2013

Posted by partonaturalpanama in HOME BIRTHING, IMAGES, NATURAL BIRTHING, WATERBIRTH

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Barbara Harper

The first look

The first look

All together

All together

In a beautiful house from the reverted area on Panama City we lived un unforgettable experience.

It’s the house of Misty and Matt. They are a very special couple. They perform a generous and extraordinary effort in Panama, protecting abandoned children.

Misty was awaiting the arrival of her first baby. She is simple, intelligent and infinitely motherly.

Matt is joyful, secure and immensely tender. They both prepared cautiously for the arrival of their son.

We arrived at Clayton at night. Misty was already in the transition stage, meaning an advanced dilation. In this stage the energetic cost of the mother is huge and comes with the sensation of “I can’t” or “I’m not going to make it”.

Graciela prepared the pool quickly and a few minutes later Misty was in it and was relaxing.

Parting from here everything changed. Graciela and I went to another room to rest and read. Matt stayed beside Misty without moving from her side, giving her all the possible love of this world and watchful of everything.

After 2 hours we got close to Misty and little time was missing. She had reached the complete dilation and it started to appear the common sounds of her body of an imminent birth.

Isaac was born! Beautiful! Strong! Healthy!

We step aside a little and did nothing else but watch this infinite enchanted moment of reunion between both mother and baby.

We can’t say much more but: Thank you Misty and Matt for letting us feel the warmth and love of your home and the marvelous arrival of Isaac.

A few days later we visited Misty and her family in the company of Barbara Harper and Elizabeth Noble.

We couldn’t keep from sharing with our lustrous visitors this unique and wonderful experience.

An unforgetable day

An unforgettable day

Barbara Harper, Misty, Matt, Graciela and the King!

Barbara Harper, Misty, Matt, Graciela and the King!

Dra. Graciela A. de Aybar
Dr. Rodrigo Aybar

The umbilical cord: Part II

11 Thursday Apr 2013

Posted by partonaturalpanama in HOME BIRTHING, NATURAL BIRTHING, WATERBIRTH

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The Umbilical Cord II

What happens when we have a birth with the umbilical cord around the baby’s neck? How does the baby manage to get free from this challenge without any harm?

Let’s remember that between 30-40% of the births are produced with some kind of compression of the cord forming a circle or a loop around the neck. It could be a circle or one loop, as it can be two or three loops. It can be loose or tighten. Those of us who accompany the mother during labor can see the loop in the moment of child birth or in the moment the head of the baby girl or baby boy appears. We can easily tell how many are there? and if they are tighten or not.

Normally if it’s only one loop and it’s not tight the birth of the shoulders will continue and the cord will slip slowly around the body as a “bandoleer”. If it’s more than one loop or only one loop is tight, we ask the mother to breathe with her mouth opened, to gasp so that she can give us time to cut the cord, unwind it and then let the shoulders and the rest of the body out. With a couple of simple instructions the mother can easily understand what she has to do and they always do it very well!!

At the moment of showing his head for the first time if the child comes in contact with the air around, he immediately starts with his first breathings. They aren’t deep because the thorax is still in the birth canal but it’s immediate as a reflex answer. If the loop of the cord is tight we have an extra difficulty. Frequently he turns a little pale and loses some body tone. The opportune maneuvers of drying that we perform and in occasions providing some oxygen throughout a mask, helps the baby overcome the difficulty quickly.

When the birth is performed in the water the situation is different. If it’s more than one loop of the cord around the neck we cut it and take the baby out of the water so that we can dry him up and help him. If it’s only one loop then we slide the cord through his body. When the body is completely out, we observe the newborn under water without putting him yet in direct contact with the air. This way we can avoid for a few seconds that he makes this effort and also give time for the cord, that is no longer compressed and its loosen to allow the baby to receive all the oxygen the mother is sending him through it.

Let’s remember that immediately after the compression of the cord when it ends a compensatory tachycardia is produced allowing the girl or boy to restore the oxygen he or she needs by increasing its cardiac frequency. We see how they brighten up underneath the water and recover their body tone their color and movements. Then we take them out of the water and give them to their mother.

The cord remains intact until slowly its pulsations start decreasing and are almost imperceptible mean while the breathing of the baby replaces completely its function and then and only then we cut it. This process generally lasts a few minutes.

Usually during the controls the mother has during her pregnancy we talk to the future mother about this and other situations that are normal in any birth. We analyze every aspect in detail and that makes it easy to solve any surprise that any childbirth has.

It is wonderful to confirm every day how the mother does everything so naturally and efficiently.

Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar

The umbilical cord: Part I

10 Wednesday Apr 2013

Posted by partonaturalpanama in HOME BIRTHING, NATURAL BIRTHING, WATERBIRTH

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The Umbilical Cord I

A frequent question of the woman during her pregnancy is: Can my baby get tangle up with the umbilical cord? What happens if it gets tangled around my baby’s neck? How can I know if during labor it isn’t going to tighten even more and suffocate my baby?

The umbilical cord is a fundamental structure of mammals. It is through it that the fetus is going to receive all the nutrients in the form of the glucose molecule, the air that the mother breaths in the form of the oxygen molecule and an innumerous of indispensable components for its intrauterine life. Throughout the umbilical cord, it passes from the fetus to the mother all of the fundamental waste products from the respiration and the fetal metabolism.

The cord varies in length and in diameter sometimes being very long or very short, thick or very thin. It’s elastic and very resistant. The baby’s play around during their intrauterine life with the umbilical cord and I even dare to say that it is the baby’s first toy! This is well seen in the ultrasounds when we see them tighten it and loosen it frequently.

When the cord tightens or compresses the fetus receives less blood. Immediately he feels a sensation of suffocation because it’s receiving a lot less oxygen. It’s like if someone covers the mouth and the nose of a child all the sudden. What does the fetus do then? He releases immediately so that he can get out of the urgency and receive again the air that the mother is sending, which is the oxygen that goes throughout the umbilical cord.

Sometimes the fetus tightens the cord with an extremity or with their own body. What do they do then? They move and change position. It is frequent that the future mother tells us about “abrupt movements” of his daughter or son that sometimes wakes her up during the night. It is more of the same: the baby waking up the mother so that she changes position and he can get out of the hurry.

Said in other words, the compression of the umbilical cord during the fetal life it’s a magnificent respiratory exercise that trains the future infant to deal with critical situations when a lack of air exists. This ability accompanies the human being during its lifetime. These intrauterine compressions occur as many times as the occasions when the fetus sucks on his thumb. It occurs frequently and during the whole pregnancy.

How can we know if during labor there is a dangerous compression of the cord?
Actually it isn’t difficult or complicated. It’s listening and auscultating the fetus heart frequently during the labor.

When the cord compresses is makes a drop of the Fetal Cardiac Frequency. Meaning that if the heart of the fetus was beating for example at 130-140 beats per minute it produces a descent or a drop in the Fetal Cardiac Frequency of 70-80 beats per minute. This drop is sudden and brief and it goes away quickly.

What happens after the drop or descent of the FCF?
Immediately after the compression of the cord meaning after the drop of the FCF, a compensatory tachycardia occurs. To make it even clearer during the minutes after the drop, the fetus heart accelerates leading the hearts frequency to 170-180 beats per minute. Then it goes back to its usual rate of 130-140 beats per minute. This way the fetus receives the oxygen that he stopped receiving during the compression. It’s what a child does for example, after holding its breath when he submerges in a pool. When he gets out, he takes a deep breath several times.

We can listen to the cardiac frequency in several ways:
Putting an ear on the mother’s abdomen, auscultating with the stethoscope or a Pinard horn or with a Doppler or a Fetal Monitor.

The auscultation mustn’t be continuous or permanent. It is very uncomfortable for the mother and it doesn’t have any advantage. The auscultation or monitoring of the Fetal Cardiac Frequency it’s intermittent. It’s performed frequently during the labor job in brief periods trying to make the mother the least uncomfortable.

Next time we will make an explanation in relation to the enormous benefits that the water birth has when an umbilical cord compression happens in the moment of childbirth.

To conclude I must add that the odds of the umbilical cord around the neck can be present in 30-40% of all childbirths around the world, so it is an usual and normal event during any birth. The real accident of the cord, meaning a real tighten nod of the cord or a real and mortal compression of the cord, it is produced in a rate of 1 to 40.000 childbirths!! In other words it is extremely rare. In Panama there are born 50.000 infants per year which means that the real cord accident happens once a year.

Dr. Rodrigo Aybar
Dra. Graciela A. devAybar

Image

Barbara Harper visit us !

02 Tuesday Apr 2013

Dear mothers, dear fathers, dear babies!

As a result of a huge effort, patience and almost a three years work in which you have been the main protagonists we can see the “fruits”.

Each day, more and more mothers live the delivery experience in a soft and free way.

It has been more than seventy women who had a childbirth at home and in a pool. Half of them, Panamanians.

We received a wonderful news: Barbara Harper an American , nurse, midwife, educator , author will visit us and will make a workshop to families, nurses, physicians… During the activity some of our marvelous mothers will tell their experience .

We would like to invite you to be present during the activity. The workshop is without cost, with a coffee brake and are invited all of you with your children . The idea is to motivate other future mothers in the way to a gentle, free and natural delivery.

After the workshop we will be in Chiriqui and will give support to the nurse students of the Gnäbe Bougle Comarca who are receiving a training in indigenous way in pregnancy and delivery care , with respect to their wise traditions .

We attach to you the activity poster and are very grateful for your attendance to the activity. You can confirm your participation in :
aybar_anhel@ yahoo.com.ar

Kind regards,

Dra. Graciela A. de Aybar
Dr. Rodrigo Aybar

Panama, April 2013

WaterBirth english

Posted by partonaturalpanama | Filed under HOME BIRTHING, IMAGES, NATURAL BIRTHING, NEWS, WATERBIRTH

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Benefits of Waterbirth

05 Tuesday Mar 2013

Posted by partonaturalpanama in HOME BIRTHING, NATURAL BIRTHING, WATERBIRTH

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Kathy

Kathy

Water seems to relax the body muscles and the relaxation reduces the pain.

Birth positions:

The water helps the future mother to be in a pressing position for longer time than she could normally endure.

A gentle start for the child:

To be born in water is a gentle start for the child who is given a little more time before it will start breathing. Waterbabies cry less after birth.

Stay and birth in water:

Many pregnant women choose to stay in water during the birth because it feels good. The warm water seems relaxing and pain relieving and it also provides more freedom of movement. Often labours tend to be shorter and the contractions become more efficient. Also it can influence whether the woman has less tearings.

The water helps to a better birthing positions:

The water in the pools helps the woman to find more ergonomically correct birthing position, and at the same time the warm water is powerfully relaxing the muscles and thus pain relieving. This relaxation and pain relief often result in a shorter and easier labour.

Dra. Graciela A. de Aybar

Dr. Rodrigo Aybar

Verónica

Verónica

Technology and Natural Childbirth

03 Sunday Mar 2013

Posted by partonaturalpanama in HOME BIRTHING, HOSPITAL BIRTHING, NATURAL BIRTHING, WATERBIRTH

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Technology and Natural Childbirth

Delyleth

The delivery process is a biological event, common in all the mammals. It has not direct relationship with the neo cortex activity in human being. This process is regulated by more ancients structures in our Central Nervous System, in the evolutive’s point of view.

The beginning of the delivery process, is a result of a very complicated biological events in which play a roll both: the mother and her child. The more significant moment is the huge augment of the Oxytocin hormone in mother’s body, the so called love’s hormone .

During the childbirth process, the mother needs to avoid external connections with her neo cortical structures to let the low cortical structures work without interference and in harmony . The labor does not depends of mother’s volition .

The mother in labor needs silence. She needs a bit of light. She needs to eat and ingest liquids in low and frequents quantities. She needs a nearly and warmly presence of the persons that will be near her during all the delivery process, only in case she requires some support and help. She needs a deep respect of her intimacy .

During the seventies it was being a technological boom. Appeared sonograms , foetal monitors, intravenous infusions pumps, Epidural Anesthesia , digital beds, blood’s pressure monitors, transports incubators, new medicaments …

It had being added a lot of new professionals in the delivery room:

Neonatologists, Perinatal Gynecologists , Anesthesiologists. Each of these specialists need some nurse and technicians support in the room.

So suddenly the reality inside the delivery room,changed completely for the mother and her child. Around her 4-6-8 more people !!!

Each of these persons are there to make something . In other words,after the moment the future mother arrives to the Obstetrical Unity in any Hospital, the nurse puts her an intravenous needle and some minutes later begin a cascade of aggressive medical interventions.

For example :

If the team put a fetal monitor fastened in mother’s body, she cannot walk.
If an epidural analgesic intervention is planned, the future mother cannot eat or drink nothing… And so consecutively …

I can not loss the opportunity to comment, that all of these in-necessaries interventions mean a huge money cost for the mother and her family, for the State and for all the society.

All of these medical equipment are useful only in case we really need them. This is very rare in the total quantity of deliveries around the world. The low risk pregnancy represents the 85-90% of all the pregnancies.

Our task consists precisely to avoid it use , giving the mother and her child the space and necessary peace for the development of an harmonious , physiological and peaceful event,in relationship with the unique features of each delivery process.

This is our challenge . This is our goal. To it we give all our wisdom and love.

Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar

Irene

Irene

Images

18 Monday Feb 2013

Posted by partonaturalpanama in IMAGES, WATERBIRTH

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Lucia

Lucia

Leah

Leah

Lucia

Lucia

Kathaleen

Kathaleen

Kathaleen

Kathaleen

Sandra

Sandra

Sandra

Sandra

Image

Sandra

15 Friday Feb 2013

Tags

home birth in Panama, natural birth, Pregnancy in Panama, Umbilical cord and natural birth, water birth in Panama

Sandra arrived from New York city. She came with her husband John and her children.She arrived to Panama in her 39th week pregnancy. She wanted to have a panamenian son or daughter and still more: to have a home and water birth. And it was so. The day she was in her 42th week was born her beautiful daughter, Azela.

A few times in our life we were present in such a beautiful birth. Character and Sandra´s personality are really unique. All was smile and joy. All was naturalness and a deep connection and communication with her body and her daughter. She came in to the birth pool and in some minutes she even had a break and relaxed sleeping in the pool. Niki, Graciela, John and me were unable to avoid our emotion and gladness in these unforgettable moments.

We only say: Thank you…. Sandra !!!!

Dr. Rodrigo Aybar

Sandra

Sandra

Together

Together

Posted by partonaturalpanama | Filed under HOME BIRTHING, NATURAL BIRTHING, WATERBIRTH

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Uninterrupted Mother-Baby Tie

13 Wednesday Feb 2013

Posted by partonaturalpanama in HOME BIRTHING, HOSPITAL BIRTHING, NATURAL BIRTHING, WATERBIRTH

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Uninterrupted Mother-Son Tie Part I

One of the most important missions during a natural delivery consists in to make sure the close contact between the mother and her newborn.

Just immediately after the birth, even before the moment when we cut the umbilical cord, begins their mutual relationship which will be decisive to them during all the life.

Is absolutely necessary to create the conditions and give peace to the mother. The silence is crucial, not much light and to provide the initial contact.

The baby is placed softly just he birth, still humid on the naked mother´s belly. Immediately begins their visual and physical contact between them.
Both, believe me, talk! The newborn babbles and converses with her mother.

They touch and caress each other. We invite the mother and her couple to dry the baby, maintaining him or her always in direct contact with her belly, skin to skin. This contact assures the transfer by irradiation of the high mother´s temperature to the baby, saving him stress and energy so important for his initial adaptation.

After a couple of minutes, when the umbilical cord stops their beats, we proceed to cut it. This procedure is absolutely imperceptible to both of them: the baby and her mother.

Once we cut the umbilical cord is easier to the mother to approach the baby and place him (her) on her chest, which in women is endowed with a very high temperature and the newborn can easily hear the mother´s heart beats, which will bring him security and peace for all his life.

Mother´s heart beats strong and quickly due to her recently ended big effort.
We encourage the mother to speak with her baby, to dry him and to approach him to her breasts.

The newborn do not need to suck up yet. He sucks a bit and enjoys. He feels her mother´s odor which is for him so familiar, as well as he (she) listen her mother´s and father´s voice so well-known to him (her).

All these events should happen in silence. We should keep the deepest respect to them in these so decisive minutes.

While all these moments are happening, we make a courteous and watchful look, observing the baby´s adaptation process to the extra uterine life. We are located in some distance of them.

With these quiet moments, some minutes later arrive the moment of the placental birthing. The placenta appears softly.
We show the placenta always to the parents. This act give her the possibility to better understand and to visualize the internal ambient in which was her baby before the birth.

We ask her some minutes and make carefully and meticulous baby´s examination.

This procedure do make the Pediatrician or we, maintaining always the newborn in skin to skin contact with her belly. We take advantage of this moment to clean, to cut and fix the clamp of the remainder umbilical cord. After a few days the clamp and the remainder cord will fall.

We ask the mother her permission to weigh the baby, taking care of her continuous glance to him.

We make a carefully placental inspection being sure of her complete integrity as well as the well uterine retraction.

Occasionally we must  suture some lacerations and normally we make it with local anesthesia in some minutes with the baby preferably in mother´s hands.
Al these events normally take some 20-30 minutes.

After we clean the mother gently we propose her to rest in this intimate ambient, preferably with mild light in her room together with her child. During these first two hours we must be sure about the suitable womb retraction and the beginning of the breast feeding.

This can be the appropriate moment in which the rest of the family congratulate the mother and meet the child.

This is the real task we think about in each birth. We can say that always results marvelous!

Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar

Johana, Emerson y Aldair

Johana, Emerson y Aldair

First contact

First contact

 

Uninterrupted  Mother-Son tie.  Part II

In the first section of this narration, we commented about the crucial importance, for the mother and her child, of the uninterrupted link between them during the first hours after the child´s birth.

Who accompany the mothers and their children should be very carefully and respectfully in such relationship that begins between them immediately after the birth, trying to do nothing to interfere or interrupt this tie so crucial for both of them.

We only support with a thoughtful and alert look, from some distance and through it we can easily identify any change or deviation of the natural or normal process, such that merit some minimal correction.

The arrive of the rest of the family to congratulate the mother and know the child should be gradual, short, joyful, trying to not distract them from such so important link between the mother and her child.

In home deliveries the task for us is easy: The mother and her newborn are in their home! For both we repeat: Is their home, their ambient. For both is familiar.

All flows easily. Both will be this day and the next days in the parent´s bedroom. There and very near will be the bassinet. It will be near them their bathroom.

The newborn will have his clothes. The mother will can dress his child with the clothes such she, with love and patience, selected for this moment. The bassinet will have surely an embroidery blanket for one of the grandmothers!

All this and much more, give us the possibility to obtain an intimate ambient, so essential for them and for their mutual understanding.

The human being is a mammal. For the mammals the direct contact with the baby´s body, skin to skin, is indispensable and determinant for their development. It would be babies with different character and personality:  Some of them would like to be virtually all day “pasted” to the mother, others not so. The most important is to adapt to their needs.

The first breast feedings days are not easy. They require patience and calm and the most important a lot of intimacy between the mother and her baby.

Another very different reality occurs when the birthing it produced in a Panamanian Hospital:  State or Private Hospital!

For us Obstetricians and Pediatricians the task is much more complicated. We must say: almost titanic!

Why?

1-    Some minutes after the birth the newborn is detached from her mother and transferred in a transportable incubator! in another floor of the building. The nurses promise the mother “to carry” the baby to her room that is located in other floor three, four hours later!

2-    When they give the baby to the mother, the hospital personal  “allow” the mother be with her baby maximal  two-three hours with the idea to carry the newborn once again to the Rooming In , “to watch over” him until the next turn!

3-    During all this time a lot of members of the hospital´s team, like nurses, assistants come in to the mother´s room frequently, during the days of her permanence in the hospital, during the day and at night, measuring her body temperature, pulse, etc.

In the Rooming In, they assure the mother that the baby don´t receive any artificial milk. They explain that occasional they give them some “serum” (water with sugar). The result is absolutely discouraging: The baby arrives to the mother´s room asleep, without hunger. She try to breast feed him and nothing: “he do not want”, “he do not like my milk”. I “ do  not produce milk”: These are the unanimous mother´s protests!

The baby became nervous, because she is stressfully.

4-    When at the end of their permanence in the hospital and they return to their home, the hospital give away them some artificial tins milk if the baby need because the mother milk production is not enough!

In our country there are only three States Hospital with the UNICEF´s designation: “Children Friends Hospital”. That means: In these hospitals is prohibited the use of feeding bottle for infants and exclusively breast feeding.

Only to give one example: In Sweden, one of the best healthcare lands of the world, all the Maternity Care Hospitals have the United Nations recognition through the UNICEF of “Children Friends Hospitals”.

We believe and are anyway confident that in our country the things are changing. The woman and their families are asking for.

Although still timidly, in some Hospitals of Panama City there are some changes and they are discussing how to make them.

In our mother´s honor and their children invite them to continue in this direction!

Dr. Rodrigo Aybar
Dra. Graciela A. de Aybar

Mariah

Mariah

Marijke

13 Wednesday Feb 2013

Posted by partonaturalpanama in HOME BIRTHING, WATERBIRTH

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Marijke wrote Us:

Dear Rodrigo & Graciela,

I’m sitting on my bed feeding Janne. Her name is Janne, I believe we forgot to tell you at the night she was born. And I’m so grateful that our beautiful girl is healthy and happy. You must know that I’m even so grateful to you. What a beautiful day it was, as soon as Graciela walked through our door my first contractions diminished and got a rhythm, both Janne and I knew that now everything was going to be just fine. I was alert during the whole birthing process, knowing each second from start to finish, so different than from Jiske’s birth. But again a very quiet, peaceful experience. Thank you for making this possible! Thank you for being here in Panama, for your warmth, your guts, expertise and common sense and just being you.

I will keep on spreading the word of your good work here, where I can I would love to help you gain more and more recognition of your practices. And when we ever leave Panama, I will never forget you! I want you to know how grateful I am to you both!

I wish you a beautiful Christmas and so many more beautiful births.

Lots of love

Marijke, Joris, Jiske and Janne!

 

Marijke la foto(25)

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