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Childbirth Trust and Accountability

Posted by Sarah Al Hajjar on July 3, 2016 at 3:35 PM Comments comments (41)

Childbirth Trust and Accountability


By Aisha Alhajjar, 2011


Recently I was required to read Born in the USA: How a Broken Maternity System Must Be Fixed by Marsden Wagner, M.D., M.S. Dr. Wagner is a medical doctor and an outspoken supporter of the midwifery model of maternity care. He also served as the director of Women’s and Children’s Health in the World Health Organization for fifteen years. He has personally studied, researched and witnessed both the medical model of maternity care that is most often applied in the USA (and Saudi Arabia) and the midwifery model of care. In his book he compares the difference between obstetrics and midwifery and makes a compelling argument in favor of midwifery care for low-risk women.

 

In my assignment I was also required to review a number of short articles about the United States’ ranking in terms of maternal and neonatal deaths (mothers and babies dying around the time of childbirth). What I learned about the way the medical model handles birth coupled with the poor outcomes as indicated by low rankings was alarming. I want to share with you my completed assignment, which was to write a personal reflection of what I read.

 

Please note before reading that I completely support the need for obstetric surgeons to care for women who encounter complications. However, I truly feel that the midwifery model is better equipped to care for the majority of low-risk women who chose natural birth. The system should always provide obstetric back up for women who may experience complications as well as fully manage the small percentage of high-risk maternity cases. There must be mutual respect, yet autonomous separation between midwifes and obstetricians and a referral from a midwife to a surgeon should be as professional and welcomed as that of a general practitioner to a surgeon.

 

As I read through the assigned articles taking notes, it struck me, “Whom do we trust for birth?” The answer is often times, “Obstetricians.” When we put our faith in humans we must then ask, “Where is the humanity and human accountability?”

 

In my opinion, misplaced trust is the biggest issue at hand. The theme over and over again displays women’s trust in their obstetrician’s management of birth more than Allah’s perfect design of their bodies for giving birth. Somewhere along the line of cultural evolution, women have been brainwashed into believing that the creation of the human female is flawed. The result is expectant mothers turning their bodies over to obstetricians, like cars to mechanics.

 

To make matters worse, obstetricians don’t trust in Allah’s perfect design of the female body. They put their trust in drugs and interventions instead. They work above the laws of nature and outside the evidence of science and impatiently override the divine plan for birth. The results, as shown in the assigned readings, are often times disastrous!

 

Ina May Gaskin’s Safe Motherhood Quilt gives us a real visualization of the number of women dying from pregnancy and childbirth related complications in the United States. [Looking at Arab News just this week you find an article, Hospital staff quizzed over deaths of women after giving birth, which supports my guess that Saudi’s experiences are probably similar.] The fact that we [the United States] spend more on maternity care than any other country, yet rank so low in terms of maternal death, is absolutely appalling. What’s worse is realizing that half of these deaths were preventable! I was totally unaware of the lack of regulation regarding reporting of such events, let alone the lack of investigation into them. I applaud Ina May for her creative vision to bring this virtually unseen epidemic into public view.

 

Even if the obstetric community succeeds at sweeping maternal and infant mortality under the rug, there are millions of women and babies who are suffering from various short and long term consequences of the unnecessary interventions that are forced upon them. The voices and stories of these families mostly go untold, as the women themselves are usually not aware of the iatrogenic [doctor caused] nature of their injuries. We are blinded by our trust in obstetrics and our lack of belief in our body’s ability to birth. This leaves women extremely vulnerable to human error.

 

As an American, I used to think that there was a level of accountability built into our government regulations, if not our cultural humanity. I had no idea of the “holier than thou” mentality that exists in the world of obstetrics. I would have never fathomed that protecting oneself from legal accountability for actions would come before patient needs and rights. I also had assumed that ACOG [American Congress of Gynecology, a powerful private body of obstetricians that most all American obstetricians belong to which makes recommendations to the U.S. government, courts, and practicing doctors regarding maternity practices] was a dependable source and had no clue that they are self-serving and put the defense of obstetricians ahead of best practices for women and babies. Reading Born in the USA was a real eye opener into the minds and workings of our obstetricians.

 

Until I began working with European couples in Saudi, I was unaware of midwifery models elsewhere. Based on my American, Saudi, and Egyptian experiences it appeared that the obstetric model reigned throughout the developed world. Wagner’s review of studies and midwifery examples was enlightening. I gleaned a better understanding about the differences and I realize there are better options to the obstetric model that I’ve come to know.

 

Considering that the majority of pregnancies and births are low risk, midwives really can fill the gap for millions of women worldwide. Educational and working costs are much lower in the midwifery model. Thus making the establishment of infrastructure a realistic task, if funds are appropriately reallocated away from expanding the current obstetric hierarchy.

 

What’s more, woman-to-woman care is inherently more compassionate and humane. Midwives are patiently confident in divine design and encourage mothers to trust their abilities to birth. They understand the importance of hormones in birth and work hard to encourage the natural flow while unobtrusively monitoring for signs of complication. Statistically speaking, planned birth with a midwife is at least as safe as hospital births for low-risk women.

 

Within the context of their work, midwives build intimate bonds with the women they serve. The relationship aspect of care ensures humanity and realistic expectations for outcomes and accountability becomes a byproduct of the union. Women are naturally empowered and take responsibility for care, as midwives spend a great deal of time educating the clients they serve.

 

As shown in the European countries where midwives serve the majority, care can be found in all neighborhoods. It should be a goal for the ethnicity of midwives to be as diverse as the areas in which they work. This goal alone will decrease racism and preferential treatment, as midwives would identify with the women they serve.

 

In my case, residing and working to bring midwifery to Saudi Arabia, I face many of the same challenges as described in these readings. Unfortunately, Saudi has copied the American obstetric model. When comparing the two countries maternity care I have always felt that the informed consent laws in the States afforded some sort of safety net. It wasn’t until I read Wagner’s behind the scenes account of American obstetrics that I realized that it’s nothing short of smoke and mirrors. I now feel it’s even more dangerous in America, where we have the illusion of informed consent and women are left ill prepared to advocate for themselves during the most vulnerable time of their lives.

 

My goal is to work with proactive members of Saudi government and society to establish community midwifery where women birth within their own neighborhoods and homes. Learning of the mistakes of the American system gives me an overview of the magnitude of such transformation. Infrastructure framework must be developed and resources dedicated for training midwives, educating the public, integrating obstetric back up, and collecting data to measure key indicators and maintain accountability. Fortunately, as a country founded on religious principles, trust in Allah’s design of our bodies and birth seems a natural concept.

 

Reference:

 

Amnesty International. (2010) Deadly Delivery

 

Gaskin, I. Safe Motherhood Quilt

 

Midwives College of Utah. (2011) Introduction to Midwifery Syllabus Article

 

Wagner, M. (2006) Born in the Usa: How a Broken Maternity System Must Be Fixed. University of California Press: Berkley, CA.

Dr. Marsden: Defender of Natural Childbirth

 

Women’s Health USA 2010

 

World Health Organization: Maternal mortality ratio

 



During Pregnancy Protein is Key

Posted by Sarah Al Hajjar on June 25, 2016 at 8:30 PM Comments comments (2)
During Pregnancy Protein is Key
By: Umm Layth

When pregnant, it doesn’t take long to realize that our world no longer revolves around us. It’s the tiny being inside of us who calls the shots now, especially in terms of our nutrition.


Foods we used to have passion for become abhorred while those we never even thought of eating become regular cravings. On top of it all, our doctors, friends, and family are presenting us with whole lists of ingredients we can’t even go near, for the health of our baby of course.


And while going through this experience may be unsettling at times we should really be grateful. After all, many women in the world aren’t able to conceive. Yet Allah, in His infinite wisdom, has chosen pregnancy for us, whether it’s our first child or our 15th.


In the Qur’an we’re told, “To Allah belongs the kingdom of the heavens and the earth. He creates what He wills. He bestows female offspring upon whom He wills and bestows male offspring upon whom He wills. Or he bestows both males and females and He renders barren whosoever He wills. Verily He is the All-Knower and is able to do all things, (Ash-Shoora: 49-50).”


But with this great blessing comes the great responsibility of doing everything we can to properly nourish our bodies to help support the growth and development of our unborn children. Out of those most essential nutrients to consume during pregnancy, protein is by far the most important.


Protein is the main ingredient for growing healthy cells and manufacturing hormones that help regulate life. During pregnancy our body’s need for protein increases dramatically to meet the demands of our growing baby so it’s recommended to consume 80-100 grams each day.


Not having enough protein can result in maternal fatigue and moodiness, as well as low fetal birth weight, slowed fetal brain development, and other pregnancy complications such as preeclampsia and toxemia.


“But won’t increasing my protein make me gain more weight?”


Protein is a caloric nutrient, meaning it does have the potential to add pounds to your body. But remember that we’re talking about pregnancy here, a time when moms are supposed to gain weight to keep themselves and their budding babes healthy.


The current weight gain recommendation for a healthy single pregnancy is 25-35 pounds (11.5-16 kilos), most of that being gained during the second and third trimesters when your baby is growing the fastest.


Also, consuming more protein doesn’t mean you have to consume more fat (although fat isn’t necessarily a bad thing during pregnancy either). There are plenty of high protein, low fat foods you can choose from such as beans, legumes, nuts, fish, dairy, egg whites, and poultry.


Eating these foods regularly will also boost your body’s health and your baby’s growth with important vitamins and minerals like Calcium, Vitamin D, Phosphorus, Vitamin E, Thiamin, Niacin, and Iron.


Try a few of the following ideas to add a punch of protein to your diet without padding your hips.


1. Use low-fat milk to make your cereal or oatmeal in the morning. You can even use it to make a glass of hot chocolate for a tasty evening treat.


2. Sprinkle a handful of nuts on top of your salad and take a couple of handfuls with you to work to snack on when your energy gets low.


3. Poultry with the skin on has 50-60 percent fat. To cut this down, remove all the skin and fatty parts of the meat before cooking and serving it. This will reduce the fat content to just 8-15 percent without compromising the protein.


4. Top raw fruit or veggies with a yummy nut butter like almond or peanut butter. This works just as well with apples as it does celery.


5. Skip the meat and have a seafood night! Enjoy fresh tuna or other low-fat fish. You can grill it, bake it, roast it, or bbq it, and much, much more! What’s best is that not only will you get loads of protein; you’ll also get a good dose of Omega-3 Fatty acids like DHA which are vital for your baby’s brain development.

 


Should We Rearrange the Pain?

Posted by Sarah Al Hajjar on June 11, 2016 at 8:05 AM Comments comments (3)

Shoud We Rearrange the Pain?

By Aisha Al Hajjar

Ask any woman who has bore a child about her experience with labor and birth and two things will most likely hold true:

 

1. She will be able to tell you every little detail, even decades later.

2. She will not be able to tell the birth story without mentioning the PAIN!

 

These things will remain consistent, regardless of whether or not she opted for pain medication for her delivery. Of course, depending on the type of pain medication administered, she may or may not remember everything, but what she does remember will surely include pain.

 

There are basically three types of anesthesia given for childbirth pain “relief”: local, regional, and general.

 

“Local” refers to the numbing medication given at the “local’ site of the pain. For birth it is administered by a needle injected into the genital area during the pushing stage of labor. Its purpose is to numb that area so that the mother does not feel the baby passing out of her body, or to numb her for the surgical cut (given far too routinely) that widens the opening and makes it easier for the baby to pass. This anesthesia does not prevent her from feeling the pain of the contractions nor does it prevent her from effectively pushing to assist her body with the delivery.

 

“Regional” refers to the medication given by injection into much deeper tissues or cavities to numb a much larger “region” of the body. The widely used epidural is a “regional.” It is administered by inserting a needle into the spinal cavity. It prevents the woman from feeling any sensations from her waist down and she becomes immobile from the time it is administered until it has worn off. It’s important to note that it also relaxes the uterine muscles and hinders her ability to push effectively.

 

“General” refers to the medication given that renders the patient completely unconscious so that medical procedures can be performed while she sleeps. It is commonly administered as a gas via a breathing mask, or intravenously through an IV. With this type of anesthetic, there is no way the woman can work with her body to push the baby out.

 

In the article Drugs, Myths and Birthing printed in The Bradley Method® [of Natural Childbirth] Student Workbook, Jay Hathaway, Executive Director of the American Academy of Husband-Coached Childbirth® raises some interesting points about the “myths” surrounding birthing and the use of pain medications. Some quotes from the article include:

 

• “Birth is not without pain. Birth is never without risk.”

 

• “Pain can be minimized, rearranged, changed or postponed…but I doubt it is ever truly gone.”

 

• “…in labor women make noise, and he [referring to an obstetrician] was trained to make them quiet by giving them drugs to ‘shut them up.’”

 

• “Has silence been mistaken for pain relief?”

 

• “…mothers [who plan ahead of time to take pain medication] did not learn any of the many natural, effective techniques for handling pain in labor because they expected the drugs to ‘work’ and assumed they would feel no pain. By the time they realized the drugs were not going to render their labors painless, they were helpless to do anything else.”

 

• “All drugs used in childbirth are dangerous…they [can] have serious effects…[or even] disastrous effects on the baby and the mother…”

 

• “…[there is very little] difference between cocaine and the drugs used for epidurals...all of them…[are] caines just like cocaine. All these drugs belong to the same chemical family.”

 

• “How can street ‘caines’ be bad but, medically administered ‘caines’ be harmless? The chemical effects of the drugs are the same, regardless of the source or the intentions of their administrators.”

 

• “All obstetrical pain killing drugs have been proven to reach the unborn baby, including epidurals. (Anesthesiology 29:951)…epidurals and even so-called locals ‘may result in significant neonatal drug exposure.’ (Am. J. Obstet. Gyne-Col. 149:403)”

 

• “…no drug…has ever been proven safe for the unborn baby.”

 

• “All childbirth pain medications…do reach the unborn baby, usually within one minute.”

 

• “An epidural…may relieve the pain before birth but it can leave the mother paralyzed and in pain for hours after the birth, and sometimes…can last for days or longer.”

 

• “The majority of anesthetics are administered into very sensitive areas of the body with very long needles…’pain-relief’ can actually be quite painful [to administer].”

 

• “A lot of things in life are painful, and yet, nobody uses anesthetics for them. Ever watch a baseball player crash into the…wall to catch a dumb little ball and save the game?...[He doesn’t] ask for drugs…”

 

• “Drugs decrease performance. What have you ever done that could be more important then giving birth? Drugs mess-it-up.”

I can tell you from my personal experience of giving birth naturally eight times, (without any pain medications or medical “intervention”;) that the pain of birth is over the minute the baby is born. Sure, I feel pain up until that point, but it’s nothing I couldn’t handle by applying the natural techniques I had learned about coping with pain in labor and by working with my body.

 

I can also tell you that I’ve seen many mothers coming out of the delivery room after a medicated, so-called “painless” birth. Those are the mothers that are moaning and groaning, groggy and sick. They are miserable at the moment when they should be overjoyed and eager to care for their newborn baby.

 

My experience, and that of other natural (non-medicated) mothers I’ve seen, is that we feel great when it matters most, when our baby is placed in our arms for the first time. We typically are up and walking immediately following the birth. Most of us “natural moms” are ready to go home from the hospital with just a couple hours of restful bonding time in the recovery room.

 

“Natural moms” also have far less interventions; interventions which cause bruising and injury to our bodies and require a great deal of healing after the birth. It is far less joyful to care for and bond with your new baby when his/her birth is the source of the misery and pain a mother must deal with afterwards. Most “natural moms” feel great and have nothing to “recover” from.

 

Sure, we can delay or rearrange the pain with drugs. But do we really want to? Do we want to move the pain from a few hours before the birth to a few days or weeks after? Think about it…how you choose to deal with the pain of your labor and birth will not eliminate it, but will seriously affect the outcome and how well you feel during those precious early days with your new baby. Allah (SWT) prepared the perfect plan for our labors, maybe we shouldn’t interfere!

 


Ten Interesting Facts About Newborns

Posted by Sarah Al Hajjar on June 3, 2016 at 6:45 AM Comments comments (1)

Ten Interesting Facts About Newborns


Photo Courtesy of Precious Little One http://preciouslittleone.com

By: Aisha Alhajjar


I remember people telling me, “Enjoy the newborn period; it passes so quickly.” With our babies changing so rapidly, we often forget or miss these little-known facts of infancy:

 

1. There is a “soft spot” in their skull that does not become solid until around two years of age. This allows their head to mold when passing through the birth canal, thus allowing them to be born.

2. They are able to hear in the womb and they can recognize their parent’s voices at birth.

3. The average length of the umbilical cord is about 50 cm. This is just long enough to nurse, even before the cord is cut.

4. When their cheek is brushed, they turn towards the touch, open their mouths, and try to latch on and suck.

5. Babies first few bowel movements are a sticky, tar-like substance called meconium. If they are exclusively nursed, it changes to a thin consistency and is yellowish in color after a few days.

6. Newborn babies can see; however, they may not track or follow an object for a few months.

7. Their vision is limited to 20-30 cm. Just far enough to see mother’s face while nursing in her arms.

8. Newborn babies don’t have tears. Sure they cry, but they emit no visible tears from their eyes until they are several months old.

9. A baby typically is born with dark or gray eyes. It’s not until a few months after birth that their true eye color can be determined (about the time their tears come in).

10. At first, babies cannot automatically coordinate breathing through their mouths. If their nose is plugged, they must cry in order to take in air.

Subhan’Allah, Allah (SWT), in his infinite wisdom created all mankind in stages. It is amazing to gaze into the eyes of a newborn and know that he was created from nothing but drops of fluid. Even before the child was born, his provision was promised his and his fixed time in this world was set.

 

On the authority of Abdullah bin Masud, who said: the messenger of Allah, and he is the truthful, the believed narrated to us:

"Verily the creation of each one of you is brought together in his mother's belly for forty days in the form of seed, then he is a clot of blood for a like period, then a morsel of flesh for a like period, then there is sent to him the angel who blows the breath of life into him and who is commanded about four matters: to write down his means of livelihood, his life span, his actions, and whether happy or unhappy. By Allah, other than Whom there is no god, verily one of you behaves like the people of Paradise until there is but an arm's length between him and it, and that which has been written over takes him and so he behaves like the people of Hell-fire and thus he enters it; and one of you behaves like the people of Hell-fire until there is but an arm's length between him and it, and that which has been written over takes him and so he behaves like the people of Paradise and thus he enters it." (related by Sahih Bukhari and Muslim)

 

It is a great blessing and responsibility to watch and guard our babies as they grow and pass through the many stages of this life. The creation and growth of our child is one of the many miracles from Allah (SWT). What an honor it is to be witnesses of this miracle from the start, alhamdulilah.

 

What is a Doula

Posted by Mohammed Haider Al-Hajjar محمد الحجار on December 22, 2015 at 1:02 PM Comments comments (6)

من هي الدولا



ترجمة مقال كتبته : عائشة الحجار

اصبحت خدمات الدولا في فترة المخاض والولادة والنفاس معروفة ويزداد الطلب عليها يوما بعد يوم في مختلف انحاء العالم. بل انها اصبحت خدمة مطلوبة في الدول المتقدمة كبريطانيا وامريكا وكندا وسويسرا واستراليا وامثالها. وحنى في السعودية والامارات وقطر وعمان والبحرين والاردن مصر وماليزيا واندونيسيا ازداد اعداد الدولا المتوفرة فيها ماشاءالله

وبالرغم من ذلك فان مفهوم الدولا لايزال جديدا نسبيا في العالم الاسلامي

الكثير من منسوبات اماني للولادة الطبيعية معتمدات كدولا بالاضافة الى اعتمادهن كمدرسات للولادة الطبيعية

ولكن ما هي الدولا ومن يحتاج لها؟ الدولا هي المرأة التي تقدم دعم غير طبي خلال الحمل والولادة وفي مرحلة النقاهة بعدها. وتتلقى عادة تدريبات وتكون لها خبرة في الولادة الا انها تدريبات غير طبية. وهي تجري عدة لقاءات مع الحامل لمساعدتها وتعريفها بالخيارات المتاحة لها وما تتوقعه عند الولادة. كما تمضي الدولا وقتا للتعرف على رغبات الحامل عند الولادة وتشجعها على اعداد خطة الولادة ثم تقدم توضيحات تساعد على شرح هذه الرغبات بفاعلية للطاقم الطبي

كذلك تعرض بعض الدولات تدريبات دورية او غير منتظمة للاعداد للولادة. ومن المعتاد ان تظل الدولا مع الام لبعض الوقت بعد الولادة لمساعدتها في بدء تغذية والعناية بالمولود الجديد بالشكل المطلوب، وفي نفس الوقت تقديم الاهتمام الكافي بالام. كثير من الدولات تزور المنزل في مرحلة النفاس كما قد تقدم خدمة شاملة للنفساء تتضمن البقاء في المنزل للعناية بالمولود الجديد والوالدة الجديدة والمساهمة بدور في مهام الام العادية كالاشراف على النظافة والطبخ وغسيل الملابس والعناية ببقية الاولاد وما الى ذلك

يختلف دور الدولا من حالة الى اخرى. فتحدبد ما المطلوب منها والطريقة التي تقدم بها الدولا هذا العمل هو احد المواضيع التي يتفق عليها في الزيارات التي تتم في مرحلة الحمل. ان الاهتمام الشخصي والعناية المخصصة للدولا نادرا ما يمكن تقديمها من أي اخصائي الولادة الاخرين

في المستشفى يكون لدى الاطباء والممرضات والقابلات الكثير من الواجبات والعديد من المريضات. حتى الطبيب عند الولادة قد لا يكون نفسه الذي تابع حالة الحامل. وبغض النظر ان كان هو او غيره فانه عادة لا يتواجد الا عندما تكون المرأة في مرحلة الوضع، وعند هذا الوقت عادة تكون المراة في المستشفى قد انتهت من الاوقات الصعبة والطويلة من مرحلة المخاض. من المتوقع في هذا الفترة ان تتم بعض الفحوص وان تجرى بعض الكشوفات من وقت لاخر ولكن في الغالب ان المراة لن تجد احدا من الكادر الطبي باقيا الى جانبها طوال هذه الفترة - الا اذا كان هناك تعقيدات جديرة بان تكون تحت الملاحظة المستمرة. ان احد المزايا المهمة لوجود الدولا هو ان المراة في مرحلة المخاض - وعائلتها كذلك - على ثقة بانها لن تترك بمفردها. وهذا مفيد ايضا للطاقم الطبي حيث تكون المراة وعائلتها في العادة اقل اعتمادا عليهم او حاجة لهم في التفاصيل الصغيرة في مرحلة المخاض

ان وجود الدولا يساهم في تخفيف الضغوط بشكل كبير. وهدا الامر مهم جدا خصوصا لوالد الطفل الذي قد يكون الشخص الوحيد الذي يسمح له بالبقاء في مرحلة الوضع. في معظم الحالات يكون الوالد - وربما الوالدة ايضا - غير معتاد على خطوات الوضع او الاجراءت الطبية وربما على غير علم بما الذي يمكن ان يقدمه في هذه الفترة. بالطبع انا انصح كلا الوالدين على حضور دروس الاستعداد للولادة التي تساعد في مواجهة الامور في مثل هذه الحالات

اضافة لذلك وباعتبار ان الدولا ليست من موظفي المستشفى فان الاهل يثقون في انها ستقدم مشورة غير متحيزة. ولكن يجب على الوالدين ادراك انه بالرغم من قدرة الدولا على شرح بعض المفردات الطبية المعقدة الا انها لن تتخذ أي قرار او تقدم مشورة طبية محددة عن الوضع الصحي . انها مصدر جيد للمعلومات المعتمدة على خبرتها ولكنها تظل على الحياد عند اشراكها في الامور الطبية وتذكر الام بانها هي المسئولة عن اتخاذ القرارات وان الدولا ستعمل مع الفريق الطبي لتنفيذ قرارات الام

من مهمات الدولا مساعدة الام وكذك افراد الاسرة الذين قد يتواجدون عند الولادة. ودورها هو المساهمة في حصول الام على وضع امن ومرضي وحسب الشكل الخاص الذي تريده كل امراة لنفسها. وهذا يعتبر مهما خصوصا للامهات اللاتي ييقع سكنهن بعيد عن افراد العائلة او اللاتي يلدن في بيئة وهن مغتربات عن منازلهن. هؤلاء الامهات لن يكون لديهن الدعم المتوقع من امهاتهن او قريباتهن الاكثر خبرة لارشادهن خلال الولادة. وهنا تسد الدولا هذه الفجوة بتقديم الدعم والمساعدة الهامة خلال مرحلة الحمل والمخاض والنفاس

وحتى في الاوقات التي يتواجد فيها الاب - او اي قريبة اخرى - عتد الودلاة فان الدولا يمكن ان تقدم مساعدة للعائلة باكملها. فهي تشجع الزوج وتقترح الاشياء التي يمكن ان يقوم بها لمساعدة زوجته خلال المخاض. انها تدعم دوره وان لم تحل محل مشاركته في عملية الولادة. ان غاية ما تسعى اليه هو ان تكون الولادة تجربة جيدة ورابط عائلي ايجابي لكل افراد الاسرة من خلال التجربة المبدعة لعملية الولادة

في الزمن الذي تحولت فيه الولادة الى مجرد عمل روتيني بادارة طبية، تستطيع الدولا ان تساعد العائلة في ادراك الاجراء الطبيعي وتساهم في زيادة ثقتهم فيه. وبالرغم من ان الدولا تدعم اختيار الام في استخدام التدخل الطبي - او عدمه - سواء اكان من الادوية المخدرة او مسرعات الطلق او عمليات التوسعة او القيصرية وما الى ذلك من التدخلات الطبية فانها تظل تفضل الاتجاهات الطبيعية للولادة وهي مؤهلة بكفاءة لمساعدة الام خلال الانتقالات العاطفية بدون استخدام هذه المداخلات

اننا نشعر ان كل أم تستحق العون والمساعدة التي تقدمها الدولا عند الولادة. يمكن زيارة صفحة ابحثي عن مدرسة او دولا في منطقتك للاطلاع على قائمة منسوبات اماني المعتمدات لمعرفة ما اذا كنا نستطيع خدمتك في المنطقة التي تبحثين عن الخدمة فيها

Natural Birth Increases Breastfeeding Success

Posted by Aisha Al Hajjar, MSM BSM LM CPM AMANI on December 18, 2015 at 7:10 PM Comments comments (2)


Natural Birth Increases Breastfeeding Success


 

ALLAH designed the female body perfectly to carry, birth, and feed babies. This miracle has been a trusted fact since the creation of humankind. It wasn’t until the last century that there were other options besides natural, non-medicated birth followed by breastfeeding.

 

With these new options women have begun to doubt their bodies and the natural process. The introduction of medical interventions in labor and birth have produced side effects that take an irreversible toll on woman and babies. Following closely behind has come bottle feeding and man-made infant formulas.

 

Women have always known that with childbirth comes pain. But when we look at the modern culture of birth we find a society of women who fear the unknown pain of labor so much that they seek medical help to avoid it. There are a precious few who still trust the perfect design of their body and choose a completely natural, non-medicated birth. These “natural moms” are also most likely to choose the natural method of breastfeeding their baby as opposed to bottle feeding.

 

Fortunately, childbirth education is beginning to become available around the world, albeit sparse in Muslim communities. Women who take AMANI Birth classes learn about the physiology of their bodies and the process of pregnancy, labor, birth, and lactation (and how to best prepare for it) find that they are capable of birthing their babies without pain medications and medical interventions and subsequently of feeding their babies without bottles or formula.

 

Unfortunately, the majority are still in the dark, blinded by the false hope for something better than nature. What they fail to realize is that the medical interventions and pain medications used for labor and birth only offer to rearrange or change the pain of childbirth, not to eliminate it. What’s worse is that these modern interventions and drugs come with a myriad of unnecessary risks for both the mother and baby. Many also fail to realize the importance of breastfeeding their newborn baby, mistakenly believing that formula is just as good as breast milk, or maybe even thinking formula is somehow "better" than the breast.

 

Below are some of the things women should consider when making choices about their labors and births.

 

Birth is an athletic event which takes training and preparation. “Birthing a baby is equivalent to swimming a mile [1.6 km],” according to Obstetrician, Dr. Robert A. Bradley, in the video “Bradley on Birthing.” I seriously doubt any woman could survive the swim without months of training first.

Neither a medical nor a natural birth are painless. It’s best to learn to cope with it.

By the time pain medication is administered the woman has already spent a considerable amount of time laboring (which she probably didn’t prepare for).

Pain medications may not take away all the pain or may not work at all!

The administration of the drug usually involves needles in sensitive areas of the body and is a cause of pain in itself.

There are additional medical interventions that come from not being able to move or feel or push effectively (due to pain medication) which cause greater injury to the body and will be felt after the birth (and often times hurt worse than the birth itself).

Natural birth mothers, who prepare their bodies for birth, learn to work with their labor, and employ simple techniques for minimizing pain, usually feel great after birth.

Medicated mothers often feel nauseous, sick, and have a great deal of pain from medical interventions and feel miserable after birth.

A mother who feels great is more capable of caring for her baby and thus more likely to breastfeed her baby right away.

The fact that “natural mothers” usually feel great after the birth, while medicated mothers do not, is of extreme significance. Do we really want to move the pain from a few hours BEFORE birth to a few hours/days/weeks AFTER birth? Think about that for a moment. You are not going to eliminate pain, but simply move it around. Wouldn’t you rather feel great when it counts? When you have your newborn baby in your arms?

 

Mothers should also know that all medications that are used during the labor and birth of her baby do reach the baby within an estimated sixty seconds of administration. She should also know that NO medication, not even the medications used during childbirth, have been proven safe for the unborn child.

 

Additionally, she should realize that these medications affect her and the baby in ways that outlast the birth. Even a medicated mother who has full intention of breastfeeding may find it extremely difficult to get started due to some of the short-term effects of these medications:

 

 

  • Interferes with Mother and Baby’s Alertness
  • Effects Mother’s Ability to Care for Baby
  • Causes Nausea and Other Discomforts
  • Requires Prolonged Recovery Time for Mother and Baby
  • Mother and Baby’s Bonding Time May be Compromised or Delayed 
  • Interferes with Baby’s Sucking Reflex Making Nursing Difficult
  • Interferes with Mother’s Milk Supply

 

There are also a myriad of medical risks associated with using these medications. Rather than making a list I’d like to ask expectant mothers, “Can you be absolutely positive that you or your baby won’t have an adverse reaction to the man-made drug you are considering for your short-term comfort? Would you put your baby in harms way for a couple hours of pain relief for yourself? If you can learn how to minimize the pain and birth completely naturally, would you try?” Simply put, “Why risk it?”

 

Sadly, many expectant mothers around the world don’t have the opportunity to take classes. Subsequently, they don’t know what to do to prepare for their upcoming labor and birth. They are unaware of the physiology of pregnancy and birth and they are unclear about proper diet, simple exercises to prepare their body for the event, or natural techniques for coping with the pain.

 

These women often find themselves in a panic and unable to bear the discomforts and pains of birthing their baby naturally. They unknowingly fight their labor and make the pain worse! These women often times come into the hospital in a panic and searching for medicinal relief. In the end they feel they have “suffered through” the event and are often too sick and in pain to be able to care for themselves, let alone cuddle and nurse their new baby. The hospital staff is then left to take over and keep the baby in the nursery, feeding them with bottles of formula.

 

In today’s medically managed birth culture it is rare for medical professionals to witness a completely natural birth. The panicked patients who seek rescue from their birth have become the norm and the calm joyous natural birth of our great-grandmothers has become abnormal.

 

It is a sad state of affairs when abnormality becomes normality and normality seems impossible. But it doesn’t have to be this way! There is hope. As more and more women find their way to quality childbirth education there will be more and more doctors witnessing the benefits of a calm, confident, non-medicated woman, an empowered woman who confidently labors in peace.

 

As these women leave the delivery room touting the joys of a truly natural birth, others will listen. They will not tell of births without pain, but they have understood the process, had techniques to cope, and worked effectively with their bodies. They were in control of minimizing their pain and were able to trust the natural plan for their bodies.

 

They will tell of their pain being over the moment their babies were born. They will tell how they insisted on birthing completely naturally, without intravenous drips, without pain medication, even without episiotomy.

 

They will have advocated for their baby and insisted that the doctor delay clamping their babies’ umbilical cords and that they be allowed their right to nurse their babies on the delivery table, before the placenta is even expelled. They will have acted in confidence, knowing that immediate breastfeeding is not only possible, but beneficial to both the mother and her baby.

 

These women knew that they were not in need of synthetic hormones to expel the placenta and prevent maternal hemorrhage. They learned that breastfeeding their babies produces the same hormones, naturally, that these synthetic injections provide. They knew that their breast milk is full of important antibodies that their babies need to have the healthiest start in life. They were keenly aware of the importance of bonding and nursing in the first moments of life.

 

What sets these “natural moms” apart is that they take the time to get educated and prepare for their births. They are determined to have the healthiest, most natural, joyous births possible. They are dedicated to their babies and insist on bringing them into the world undrugged, alert, healthy, and ready to breastfeed. They are confident in themselves and understand that early breastfeeding is the best assurance to successful breastfeeding.

 

They are the women who will set the trend for a change in our birthing culture that will bring us back to what’s worked, naturally, for thousands of years. As more women become aware of the benefits of totally natural childbirth, they will become a driving force that will create a demand for quality childbirth education. Change is on the horizon and a new era of naturally born, exclusively-breastfed babies is dawning.


©2010 AMANI Inc., All Rights Reserved. All writings are the original work of Aisha Al Hajjar and are based on her personal research, experiences, and opinions.

Interesting Facts About Newborns

Posted by Aisha Al Hajjar, MSM BSM LM CPM AMANI on December 18, 2015 at 6:57 PM Comments comments (3)


Interesting Facts About Newborns 




SUBHAN ALLAH, Allah (SWT), in his infinite wisdom created all mankind in stages. It is amazing to gaze into the eyes of a newborn and know that he was created from mere drops of fluid. Even more amazing is before the child was born, his provision was promised and his fixed time in this world was set.

 

On the authority of Abdullah bin Masud, who said: the messenger of Allah, and he is the truthful, the believed, narrated to us :

 

"Verily the creation of each one of you is brought together in his mother's belly for forty days in the form of seed, then he is a clot of blood for a like period, then a morsel of flesh for a like period, then there is sent to him the angel who blows the breath of life into him and who is commanded about four matters: to write down his means of livelihood, his life span, his actions, and whether happy or unhappy. By Allah, other than Whom there is no god, verily one of you behaves like the people of Paradise until there is but an arm's length between him and it, and that which has been written over takes him and so he behaves like the people of Hell-fire and thus he enters it; and one of you behaves like the people of Hell-fire until there is but an arm's length between him and it, and that which has been written over takes him and so he behaves like the people of Paradise and thus he enters it." (related by Bukhari and Muslim)

 

I remember people telling me, “Enjoy the newborn period; it passes so quickly.” With our babies changing so rapidly, we often forget or miss these little-known facts of infancy:

 

1. There is a “soft spot” in their skull that does not become solid until around two years of age. This allows their head to mold when passing through the birth canal, thus allowing them to be born.

 

2. They are able to hear in the womb and they can recognize their parent’s voices at birth. This is a good reminder to recite Qur’an for our babies in the womb as well.

 

3. The average length of the umbilical cord is about 50 cm. This is just long enough to nurse, even before the cord is cut. Delayed cord clamping and immediate nursing ensures early bonding and has health benefits for mother and baby.

 

4. When a newborn’s cheek is brushed, they turn towards the touch, open their mouths, and try to latch on and suck.

 

5. Babies first few bowel movements are a sticky, tar-like substance called meconium. If they are exclusively nursed, it changes to a thin consistency and is yellowish in color after a few days.

 

6. Newborn babies can see, however they may not track or follow an object for a few months.

 

7. Their vision is limited to 20-30 cm. Just far enough to see mother’s face while nursing in her arms. I love this as it is such a sign of the importance of nursing and Allah’s perfect plan.

 

8. Newborn babies don’t have tears. Sure they cry, but they emit no visible tears from their eyes until they are several months old.

 

9. A baby typically is born with dark or gray eyes. It’s not until a few months after birth that their true eye color can be determined (about the time their tears come in).

 

10. At first, babies cannot automatically coordinate breathing through their mouths. If their nose is plugged they must cry in order to take in air.

 

It is a great blessing and responsibility to watch and guard our babies as they grow and pass through the many stages of this life. The creation and growth of our child is one of the many miracles from Allah (SWT). What an honor it is to be witnesses of this miracle from the start, alhamdulillah.


©2010 AMANI Inc., All Rights Reserved. All writings are the original work of Aisha Al Hajjar and are based on her personal research, experiences, and opinions.

Video About Staying Active in Labor

Posted by Sakina Ahmad Salawati on December 18, 2015 at 4:17 PM Comments comments (1)


Video About Staying Active in Labor

 



ENJOY this nice video about staying active during labor to make the process faster and easier!  

Thanks to Sakina Ahmad Salawati, AMANI Birth Teacher in Jeddah, Saudi Arabia for sharing.

Appreciate the Last Days

Posted by Aisha Al Hajjar, MSM BSM LM CPM AMANI on December 11, 2015 at 8:25 AM Comments comments (1)

Appreciate the Last Days

Photo Credit: Naja Helal

THERE are many transitions in life. Some happen subtly and leave us wondering, “Where did the time go?” The month of Ramadan is a prime example.

 

I find myself looking at the calendar in amazement when there are just a few days left. I question, “Did I do enough during the blessed month? Did I work my hardest? Will I live to see the blessings and opportunities of the next Ramadan? Have I truly earned Allah’s mercy or have I carelessly let the month slip by virtually unnoticed?”

 

But some transitions are far from subtle. Birth and death are two such grand events. In the context of birth, the evolution from pregnant woman to mother happens in a dramatic event that can’t go unnoticed.

 

In fact, birth is such a life-altering event that I can notice some similarities with Judgment Day. Below are just some of the ways I can see a comparison:


  • We are aware of the coming of both days.
  • It benefits us to prepare for birth and Judgment.
  • Each is a transition that brings dramatic changes.
  • These changes are lasting and cannot be undone.
  • Both are inevitable events divinely scheduled in our future.
  • The date of birth is as unknown as the hour of Judgment.


End-of-Term Weariness


It’s understandable that many women feel tired of pregnancy as their term comes due. In fact, some women rush to finish the process by scheduling medical intervention just to get it over with. 


Personally, I feel in doing so they are cheating themselves and their babies of the important last days of pregnancy as well as the benefits of the completely natural birth experience, Allahualim.  Not to mention that the due date is the middle of a four week window, not an absolute expiration or eviction date.  It's important that we allow our baby to complete his/her growth in the womb and wait for baby's readiness to spark the start of labor naturally.


In my opinion, the emotional weariness that can come before birth is a blessing from Allah. I see this as a natural psychological preparation for letting go of pregnancy and welcoming motherhood, subhan’Allah. 


Allah Guides


I, for one, love being pregnant (hence the eight children), alhamdulelah. Honestly, I like being pregnant more than not. For me, if it weren’t for the exhaustion of the last few days, I’d probably never be emotionally ready to move on from my pregnancy.


But Allah has a way of preparing us, subhan’Allah. In my case, I truly feel that the fatigue of the final days, coupled with the discomforts of labor, are the guidance I need to transition into mothering my new baby, alhamdulelah.


Take Advantage of the Last Days


I find it helpful to remember that these last days truly are the last you’ll live in the life you know. This is especially true for first-time mothers. It’s easy to see that once you birth your baby, life surely will never be the same again.


With that in mind, try to take advantage of your last days of pregnancy. Focus on the aspects of your life that will most be affected by the new addition. Considering the amount of attention the newborn will need, I feel the following are important:


  • Private time with your husband
  • Special time for older children (especially the youngest who will lose his status).
  • Attention to your personal needs.
  • Completing any projects you’ve started.
  • Stock up on groceries.
  • Letter writing to welcome the unborn child (for reading at a mature age).


A New Norm


Change is inevitable and it’s a well-known truth that the only thing constant in life is change. Even though life will never be the same again, you will settle into a new life with your baby. Your family will adjust and a new norm will be found, bidnillah.


Just as it’s difficult to imagine what life will be like with a baby while you’re expecting, it’s equally as difficult to remember what it was like before the arrival, once he or she is here, masha’Allah.


Treasure the Time 


Transitioning from pregnancy to motherhood and watching our children grow is a bold reminder of the ultimate passing of dunya.  Just as the blessed month of Ramadan always draws to an end in due time, so does pregnancy.  We should always bear in mind that we never know if this will be our last chance to balance our account. May Allah accept our deeds, bless our efforts, and have mercy on us all.

©2010 AMANI Inc., All Rights Reserved.  All writings are the original work of Aisha Al Hajjar and are based on her personal research, experiences, and opinions.

What is a Doula?

Posted by Aisha Al Hajjar, MSM BSM LM CPM AMANI on December 4, 2015 at 11:37 AM Comments comments (2)


What is a Doula?




DOULA services for labor/birth and the postpartum period are becoming more and more popular and well known worldwide. In fact they are becoming common-place in many developed nations such as the UK, USA, Canada, Switzerland, Australia, etc. Even in the UAE, Saudi Arabia, Qatar, Oman, Bahrain, Jordan, Indonesia, Malaysia, and Egypt there are growing numbers of doulas available, masha’Allah.

 

However, the concept seems to be fairly new amongst the Muslim populations.  

Many of the AMANI affiliates certify as doulas, as well as childbirth educators. 

 

So what is a doula and who needs one?

 

A doula is a woman who provides non-medical support during pregnancy, labor, birth, and the postpartum period (recovery time after birth). They usually have training and experience in childbirth, although they are not medically trained. Typically they will meet with the pregnant woman several times to help inform her of her choices and what to expect in birth. The doula will take the time to know her client’s desires for her birth and will encourage her to write a birth plan and provide tips for effectively communicating her wishes to her medical birth team.

 

Some doulas also offer some form of formal or informal childbirth preparation training as well. It is also common for the doula to stay with the mother for a short time after delivery to ensure a good start with feeding and caring for her new baby, as well as provide assistance in the mother’s care. Many doulas will make house visits during the postpartum period or may even provide comprehensive postpartum services which would include staying at the woman’s residence to help to care for the newborn, new mother, and pick up the slack in the household chores (cooking, cleaning, laundry, caring for elder children, etc.).

 

The duties and roles of the doula vary from case to case. What is wanted and needed by the woman and how the doula can fill these needs, is one of the many things they will decide upon during the pregnancy visits. This individualized attention and care can rarely be offered by any other childbirth professional.

 

In the hospital setting, the nurses, midwives, and doctors are busy attending to many patients and other duties. The doctor may not even be the same doctor she has had visits with during her pregnancy. Regardless, he or she often times does not come until it is time for the actual delivery of the baby. By this time the woman has usually spent a significant amount of time at the hospital in labor. The laboring woman can expect occasional checks during her labor, but most likely will not have someone from the hospital staff at her side the whole time (unless there are serious complications and she is being closely monitored). One major benefit of having a doula is that the laboring woman (and her family) can be assured they will not be left to labor alone. This is also a benefit to the medical staff as the patient and family are usually less needy or dependent on them for every small detail of the labor.

 

Having a doula can also provide a great relief of stress. This is especially true for the father, who may be the only other support person to attend the labor. In many cases the father (and mother for that matter) is unfamiliar with the birth process, medical protocols, and is simply at a loss as to what he can do to help. (Of course I recommend all parents take childbirth preparation classes which help to alleviate this situation.)

 

Additionally, since the doula is not usually an employee of the hospital, parents often trust the doula to provide unbiased information. Parents should be informed, however, that although the doula may be able to explain complicated medical terminology, she should not make decisions nor give specific advice about medical matters. She is a good source of information based on her experience, but she remains neutral in her involvement of medical matters and reminds the mother that it is her responsibility to make all decisions and to work with the medical team in doing so.

 

It is the doula’s role to support the woman as well as other family members who may be participating in the birth. It is her goal to help the woman have a safe and satisfying birth experience based on what each individual woman desires. This can be especially important to women who are residing away from extended family or who are foreigners in the country of the birth. These women typically will not have the traditional support of other, experienced mothers from their own family (mother, sister, aunt, etc.) to guide them through. The doula fills this gap by providing an important support throughout the pregnancy, birth, and postpartum time.

 

Even if the husband (or other relative) will attend the birth, a doula can provide support to the entire family. She encourages the husband and suggests things that he can do to help his laboring wife. She supports his role and does not replace his participation at the birth. Her ultimate goal is a good birth experience and positive family bonding of all members of the family through the miraculous experience of birth.

 

In an era where birth has become a process of medical management, a doula can assist the family in understanding the natural process and help them to have confidence in it.

 

Although the doula supports the woman’s choices regarding the use (or not) of medical interventions (pain relief, drugs to speed labor, episiotomy, cesarean, etc.), she usually favors natural approaches to birth and is well equipped to assist the mother through the emotional journey without the use of these interventions.

 

We feel that every woman deserves the support and assistance of a doula at her birth. Visit the Find Teachers/Doulas page for a list of AMANI certified affiliates to see if we can provide support in your area.


©2010 AMANI Inc., All Rights Reserved. All writings are the original work of Aisha Al Hajjar and are based on her personal research, experiences, and opinions.


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