Participants: Patti Barnes, Don Mackintosh
Series Code: HFAL
Program Code: HFAL000058
|
00:46 Hello and welcome to "Health for a Lifetime"
00:48 I'm your host Don Macintosh, 00:49 and today I'm delighted to be talking with Patti Barnes 00:52 Welcome Patti! Thank you Don 00:54 Now you are a certified professional midwife, 00:58 is that right? Correct 00:59 And how long have you been doing that? About 15 years 01:03 15 years... So you've seen a few babies born! 01:06 How many about? About over 750 now. 01:11 And do you have children of your own? 01:12 I have 2 children. And how old are they? 01:14 Genesis is 24, and Jason, he's 18. 01:22 All right, well great! 01:24 So you have a wealth of experience as a mother, 01:26 and as a midwife, and with the time as well. 01:29 You work with a team, I understand, 01:31 you have some physicians and people that 01:32 work with you as well where you are practicing. 01:35 Today we're going to be talking about postpartum care. 01:39 What does that big word mean? 01:41 Postpartum care is right after the birth thru 6 weeks, 01:46 and we do postpartum care on the mother right after delivery. 01:52 We go back the 3rd day to check her and the baby again. 01:56 Then we see her in 2 weeks, 01:57 and then we would like to see her again at 6 weeks. 02:02 So right afterwards, then 2 weeks... 02:04 3 days, 2 weeks and then 6 weeks... Okay, got it! 02:09 You know, one thing before we get into that, 02:11 you and I were talking and maybe we can just 02:15 discuss this a little bit. 02:17 What if someone has had several pregnancies, 02:19 and maybe the last one or maybe their first one, 02:22 or whatever it was, was a cesarean section or a C-section, 02:25 and they want to have a vaginal delivery or a regular birth, 02:30 can that ever happen? 02:32 Yes, they are actually encouraging VBACs. 02:37 They call it "vaginal birth after cesareans. " 02:52 This was proven in a Flamm Study, 1994. 02:56 Okay, so it is possible then to have it again. 03:07 Okay, so does it mean you just 03:09 naturally have to have another one? Right 03:20 So, if your physician is a younger OB-GYN 03:25 they're going to be more open to that. 03:27 Have you ever, as a midwife, delivered someone 03:30 that was a cesarean before? 03:32 Yes, but we encourage the VBACs to be delivered in the hospital 03:39 Just in case there is a rupture. Yes 03:41 And like we said, it's very rare, 03:43 but I know they are estimating about $200,000 03:50 could be saved a year by giving them a trial of labor, vaginally 03:55 $200,000 across the nation... okay 03:59 Let's go back to postpartum care... 04:02 You know, we talked about when it is, 04:04 3 days, 2 weeks, and then 6 weeks again, right? 04:08 Immediately after the birth too. Um hm 04:09 But what do you do then? 04:10 What do you do immediately after the birth, 04:12 and walk us through that; what does it entail? 04:15 Okay, well immediately after the birth, 04:17 we check the uterus to make sure that it's firm, 04:21 and the baby will be nursing right after the birth 04:24 to contract the uterus. 04:26 The uterus releases oxytocin, it's a natural oxytocin 04:31 to cause the uterus to contract... 04:35 So that's a hormone or something? 04:36 Yes, and it causes the uterus to go back to size 04:39 called uterine involution, back to its pre-pregnant state. 04:45 So we check the uterus to make sure it's firm, 04:49 and check for bleeding; make sure that 04:52 there is very minimal bleeding... 04:54 And we make sure that the mother is breastfeeding, 04:58 the baby has latched-on and they're bonding. 05:01 Let's go back to that... checking the... 05:03 what did you call it, the fundus... 05:05 The top of the uterus is the fundus. 05:08 And that's the top of the uterus, 05:10 and how do you make sure it's firm? 05:11 You just feel the top of the uterus to make sure 05:14 that it's firm... 05:16 So, like if I had a uterus, which I don't, 05:19 which I'm fairly certain, I'd be touching it 05:21 right up here above my belly button? 05:23 Well after the baby is born, it's usually about 05:25 2 fingers below the umbilicus. 05:27 Okay, so my belly button... 05:29 and I just take 2 fingers and below that 05:31 there should be what there? 05:32 The top of the uterus. What does it feel like? 05:35 It will feel just like a hard... 05:38 I want to say grapefruit or something. 05:41 Okay, and if it's not there, what do I do? 05:43 If it's real loose and boggy, it will feel loose, 05:49 but you probably have a bleed. 05:51 A pretty good bleed. Okay, what do you do? 05:53 Well, what we would do is what they call... 05:57 "bimanual compression" where you clamp it yourself, 06:00 and you hold it until it gets firm. 06:02 You can give... if you use herbs to control bleeding. 06:09 And of course, in the hospital, they'll give Pitocin 06:13 or a drug to clamp the uterus. 06:15 So that's like the oxytocin but it's a medication. 06:19 So you check and make sure and if it's NOT, 06:22 then you probably have a bleed or something... 06:24 and you have to be careful about that. 06:27 Anything else then? Any education or 06:29 different things that you tell moms afterwards... 06:31 Well, we make sure that they are well-educated, 06:33 what to look for; if they have fever, pain, excess bleeding. 06:38 Check the baby; make sure that the baby is nursing well... 06:45 How do you know if a baby is nursing well? 06:46 Well, we wouldn't leave until the baby has latched-on, 06:51 and nursing well, and we want to make sure that the 06:56 mother who had the baby can get up and void, have a shower, 07:01 and everything works normal before we leave. 07:04 We wouldn't leave her until everything is fine, she's fed. 07:08 Okay, back to that breastfeeding thing... 07:10 How do you know that it has attached well or whatever? 07:12 Latched-on... the baby is latched-on. 07:14 I pretty much can figure that out, 07:16 but what do you mean exactly? 07:17 How do you know if it has latched-on well? 07:19 The baby will be nursing... 07:23 Okay, and no air or different things in there. 07:26 Yes, you would know because it wouldn't be crying. 07:30 It would be nursing. 07:32 Plus, let me just say this... 07:35 It wouldn't hurt... when the baby is nursing right, 07:39 it wouldn't hurt her. 07:41 Oh, it doesn't hurt the mother. Yeah 07:43 Because if it doesn't have a good latch on, 07:46 then she could say, "Well, this just doesn't feel right. " 07:50 So, what should the mother then be watching for, 07:56 I mean, you're there right after the delivery... 07:58 Do you do the Apgar score then right after? 08:00 Is that part of postpartum care? Yes 08:02 What are they checking on an Apgar score? 08:04 Okay, we check at 1 minute, and then at 5 again. 08:07 And what are you checking? 08:08 We check the baby's color. 08:10 We make sure that the baby is breathing well. 08:12 The heart rate is 120 or above, 08:18 and the normal rate is anywhere from 120-160... 08:22 And we also make sure the respiration is good. 08:26 The baby should be well-flexed and not limp... 08:30 And of course, we make sure the baby is warm. 08:32 We put a warm towel on the baby and cap on its head. 08:37 So babies can get cold pretty easily; 08:39 it's very important to do all that. 08:40 Yes, it's hard to hold their heat in for the first 24 hours, 08:43 and that's why we encourage the baby to be extra warm. 08:46 What about when a baby gets yellow? Jaundiced? 08:49 Or jaundiced, whatever you call that. 08:52 Jaundice is fairly normal in newborn babies. 08:56 And why is that? What's going on? 08:57 Because we have an elevated Bilirubin, 09:00 the excess Bilirubin and the weakened or the immature 09:05 liver of the baby is having trouble... Can't handle it... 09:10 And around 3 days, the third day is the peak; 09:12 in 8-10 days then it should be fine. 09:17 But usually the jaundice isn't a problem. 09:22 I know in the hospital when I was in nurses' training, 09:26 they put me in this little nursery thing, 09:27 and there were like 30 babies in there, and they had a 09:29 bunch of them under these little lamps or different things. 09:31 Do you do that at home? 09:33 We use sunlight. 09:35 Sunlight... put them by the window? 09:36 Yes, and nursing is a benefit. 09:40 It helps flush excess Bilirubin, 09:43 and also activated charcoal. 09:47 What about circumcisions? 09:49 Well, if they want to have circumcisions, 09:53 we always recommend the 8th day, 09:56 like the Bible says, because the vitamin K factor 09:59 is the highest in the baby. 10:00 And they do that in the hospital? 10:03 No, they have their own pediatrician if they 10:05 choose to have circumcision, they would go to. 10:07 Many times new moms like to call the doctor 10:10 and check things out or maybe they call you very often. 10:13 When should they call their pediatrician? 10:15 Okay, well they should call their pediatrician when 10:20 they don't see stools or urination in 24-48 hours. 10:24 That's constipation then? 10:25 They could be bound up, that's why? 10:27 Well after delivery, we just want to make sure 10:32 everything works. 10:35 It might be but it might not be. 10:36 It might be that something is not developed properly. 10:40 Difficult breathing. Baby's color is blue. 10:45 Jaundice with lethargy... 10:47 Remember we talked about jaundice as... 10:48 Yellowing skin and all that. 10:50 But is fairly normal, but if you have jaundice 10:53 with lethargy and failure to nurse, then there's a problem. 10:57 So lethargy - that means just like what? 11:01 Just being out-of-it? Yes 11:03 It just lays around and you have to wake 11:06 ...sleepy baby, doesn't want to nurse. 11:08 Vomiting; fever over 99.6 under the arm, 11:13 or umbilical cord red or swollen with odor. 11:17 Okay, so there might be an infection. 11:18 Might be an infection. 11:20 Okay, so these are the reasons that you need to call 11:23 the doctor then right away. Yes 11:25 And, we show them how to watch for signs, 11:29 and how to take care of the umbilical cord; 11:33 make sure that it stays... Well how do they do that? 11:35 Well, we make sure it stays above their diaper. 11:39 Every time they change a diaper, 11:40 clean it real well with alcohol. 11:42 So none of the fecal material gets on it 11:44 causing an infection from that. 11:45 Keep it above their diaper so they don't urinate on it. 11:48 Look for any pus or any swelling, 11:52 or red irritation or odor. 11:55 So as long as you keep it clean... 11:57 it usually falls off about the 10th day. 12:00 So these stools that the baby has right off the bat, 12:03 they could be a little bit 12:05 something to deal with, can't they? Yes 12:10 So what advice do you give to them so they don't develop 12:13 a rash or different things... Or if they do what 12:15 I've seen some pretty bad cases of diaper rash. 12:17 Well, just to check them and to make sure that they 12:21 change their diaper often and not leave 12:23 the urination or the messy stools on their bottom. 12:26 But if they develop a diaper rash, 12:34 they could use... there are some natural remedies 12:36 like blended-up oatmeal... 12:39 Blended up oatmeal... Um hm 12:40 Just like into powder and that's real soothing 12:43 and healing for the diaper rash. 12:46 Open to air? Yes, that's fine. 12:48 What would you say, cloth diapers better than regular ones 12:53 Yes, 100% cotton. 12:54 100% cotton... So wash those diapers! 12:57 That's better than the other. 12:58 Yes, supposed to be less irritating, 13:00 but I know the others would be more convenient. 13:03 They are very convenient. 13:04 Well, I know you've written a new book called... 13:08 "The Ministry of Midwifery" 13:10 Is that right? Yes 13:11 And it says it's a manual here as well. 13:13 Does it cover the things we've been talking about today? Yes 13:17 So you could have a reference for that. 13:19 We've been talking to Patti Barnes 13:21 She is a certified professional midwife. 13:23 And when we come back, we're going to be talking about 13:26 other issues that you face with a newborn; 13:28 breastfeeding, all these different types of things. 13:31 So we hope that you join us. 13:35 Have you found yourself wishing that you could shed a few pounds 13:38 Have you been on a diet for most of your life, 13:41 but not found anything that will really keep the weight off? 13:44 If you've answered "yes" to any of these questions, 13:46 then we have a solution for you that works. 13:49 Dr. Hans Diehl and Dr. Aileen Ludington 13:52 have written a marvelous booklet called... 13:54 "Reversing Obesity Naturally" 13:57 and we'd like to send it to you FREE of charge. 13:59 Here's a medically sound approach successfully used 14:02 by thousands who are able to eat more, 14:05 and lose weight permanently without feeling guilty or hungry 14:08 through lifestyle medicine. 14:10 Dr. Diehl and Dr. Ludington have been featured on 3ABN 14:14 and in this booklet, they present a sensible approach 14:16 to eating, nutrition and lifestyle changes 14:19 that can help you prevent heart disease, diabetes, 14:21 and EVEN cancer. 14:23 Call or write today for your free copy of... 14:25 "Reversing Obesity Naturally" 14:27 and you could be on your way to a healthier, happier YOU! 14:30 It's ABSOLUTELY free of charge, so call or write today. 14:36 Welcome back, we've been talking with Patti Barnes 14:39 She is a certified professional midwife, 14:42 and we're talking now about what the mother has to face 14:45 after the baby is born; so-called "postpartum care" 14:49 Is that what we call it? 14:52 Does the mother need any help? Yes, she does. 14:55 We always recommend that hopefully the father can 14:59 stay home and help her, or she can have her mother 15:03 come to help her for at least 2 weeks. 15:06 Also, I find that a lot of church members 15:09 will bring in meals for the next 2 weeks postpartum. 15:12 So the biggest thing is to bring in activities 15:14 that they normally would have to do on their own; 15:16 cooking meals and different things, 15:18 take care of those things for them. Yes 15:21 And, you know, I want to just point out that you 15:25 asked me to ask that question, right? 15:28 Someone might be watching and say, 15:29 "Boy, that's a pretty insensitive comment by that 15:32 man, to say - do they need any help" 15:34 But you did ask me to ask that question, didn't you? Yes 15:37 Because you promised to take 15:38 off work when your wife has a baby. All right 15:42 When can she return to a normal lifestyle... 15:44 And again, this is something 15:45 we talked about we needed to talk about. 15:47 Usually after the 6-week period, 15:51 because 6-weeks postpartum is actually when 15:56 the placental site is healed over... 16:00 Because when the placenta comes out, 16:02 after the placenta detaches, 16:05 there is a space where the placenta was 16:12 and the bleeding takes place. 16:15 So there's the potential for bleeding and different things 16:17 if you get too vigorous and exercise and different things 16:20 How soon can you start exercising afterwards? 16:23 Right after the 6-week period. 16:24 Right after the 6-week period, but up until that point 16:27 you kind of take it easy. 16:28 Can you walk? Oh yes, you can walk. 16:30 Your uterus starts returning to normal around the 10th day. 16:38 10 days to 2 weeks 16:40 What about taking the baby out; taking the baby to church, 16:44 to the store or to different places - when can they do that? 16:47 Well, when they feel like getting up and around, 16:51 usually after the 3rd or 4th day. 16:53 The 3rd or 4th day... 16:56 Um hm, they are up moving around slowly. 16:57 So, the first week maybe afterwards, 16:58 they can go back to church or different things? 17:00 Well, I recommend taking it easy for a couple of weeks, 17:04 and just not overdoing it. 17:06 And as far as exposing the baby to the public, 17:08 you just want to make sure that the baby is not exposed 17:12 to a lot of sickness or whatever. 17:14 Don't have all the people in your church or whatever club 17:17 you go to hold the baby? 17:19 Just say, "Hey, leave the baby alone for a while" 17:22 Well, you just don't want to overexpose the baby. 17:26 Okay, so then 6 weeks that that placental site is healed. 17:32 I guess another big thing that maybe a change especially 17:35 for new moms but others is probably breastfeeding. 17:38 Is it something that's a must, 17:40 or is it something you can do without? 17:43 Well I, of course, encourage breastfeeding. 17:45 We see a lot of benefits toward breastfeeding. 18:07 Now, colostrum is the first milk that comes in. 18:11 And how long does that last? 18:12 About 2 or 3 days first, and then the rich milk comes in, 18:18 but it contains the antibodies to protect from germs. 18:23 Of course it's more convenient than bottles, breastfeeding... 18:26 You don't have to get up in the middle of the night 18:27 and sterilize, you know. 18:29 How often are you feeding the baby? 18:31 Oh, around every 2-3 hours. 18:33 And, helps protect against allergies. 18:38 Again, helps uterine involution, so you go back to 18:41 your pre-pregnant weight sooner. 18:43 If you're breastfeeding. Yes 18:45 And messy diapers are not as unpleasant, in other words... 18:52 Breastfed babies maybe wouldn't have an unpleasant... 18:57 A foul odor because that's their mother's milk 19:01 not some foreign thing that 19:02 they're trying to deal with. Correct 19:04 Okay, so every 2 hours... I mean... 19:09 Maybe you remember breast feeding 19:11 your children different things... 19:12 Did you find that a great burden, 19:13 or did you just ENJOY getting up every 2 hours? 19:15 Well, this is just after the baby is first born... 19:21 Of course you need to nurse 19:23 it often to establish your milk supply... 19:25 And then after it's well-established, 19:29 you can help maintain a schedule, maybe every 3-4 hours. 19:35 Okay, so wait-a-minute, how long does it take to 19:37 establish that it's well supplied, like you were saying. 19:41 Well, when you first have the baby, 19:43 we encourage nursing often to bring the milk in... 19:49 And like I said, it's usually around the third day 19:52 that the milk comes in; 19:53 they're just getting colostrum at first. 19:55 And then once the milk comes in 19:58 they'll have, what they call, engorgement, 20:01 which is like - oh my, to have SO MUCH milk! 20:04 But, we encourage them to just keep nursing through, 20:08 and you can help with engorgement maybe by 20:11 doing hot and cold compresses. 20:16 Some people say WARM heat feels better, 20:18 and some people say ICE feels better. 20:20 So they just experiment which one would feel better to them. 20:26 And just with nursing, they can get through that, 20:30 and usually after the first week or two. 20:33 What about breast pumps? 20:35 Breast pumps, some people use if, let's say, they have 20:41 mastitis which is a breast infection, 20:44 and they get high fever or chills, 20:48 just like they have the flu, they feel awful... 20:51 And it's usually from breast infection, 20:54 and a weakened immune system. 20:56 We would encourage them to nurse often on that side, 20:59 and if they are having a problem keeping the baby awake 21:05 to nurse as much as it needs to, then we would have them use 21:08 the breast pump to empty that breast. 21:11 So they empty it so that the 21:13 what is it - the solution to pollution is dilution, 21:17 or whatever... you just move things through there. Yes 21:22 And that milk is okay for the baby? 21:24 Yes, it is fine. 21:26 And we also, I find what helps for mastitis is 21:31 doing charcoal compresses. 21:35 Charcoal compresses... so you just would take some 21:38 charcoal and what would you do, is this in your book too? 21:41 Yes I believe it is. 21:44 And then how do you do that? 21:45 You just make a paste, put it in a cloth and just do a poultice. 21:50 Do a poultice, and you leave it on for how long? 21:52 About 30 minutes. 21:54 30 minutes at a time. Yes 21:56 And then how many treatments would you do? 21:57 Just probably 2 or 3 a day. 22:00 And that draws all the infection out or works on that. 22:05 Any common problems people have with breast feeding 22:08 besides mastitis? 22:11 Well just, for the first-time mom, it might be 22:15 a little bit rough getting started just because 22:17 it's new to her and we just encourage her to 22:23 stick with it even though it might feel a little bit 22:28 painful at first, the pain goes away. 22:31 Also, we have some mothers that may complain of 22:35 cracked or sore nipples, even bleeding... 22:41 And what we recommend is, again, maybe doing some heat, 22:46 and take a vitamin E capsule and pop it over, 22:51 put some oil on the nipple area, the vitamin E, 22:56 right before the baby nurses, 22:58 and it's soothing and healing also. 23:02 Now, if a mother doesn't breast feed, 23:06 how long does it take for her to quit producing milk? 23:11 You know, like for instance... 23:13 You know what I'm saying, you understand the question. Yes 23:16 Okay, I'm not real sure how long it takes for it to dry up, 23:20 people vary, but you can do things, I guess naturally 23:28 to help, like they say cabbage leaf will help dry up milk. 23:34 So you wear that kind of like a poultice on that area. Yes 23:39 Anything that you can take to increase milk production? 23:44 Yes, you could take a combination of herbs 23:49 to help increase the milk supply. 23:51 Equal parts of dill seed and anise seed and fennel seed. 23:59 Do you have that written down in your book as well? 24:02 Yes, I believe I do. 24:03 Those can be some real helpful things. 24:06 Well what role, if any, does the husband play in all this? 24:11 Of course he plays a BIG role. 24:13 We encourage him to just be a part of this pregnancy 24:18 in every way - to help encourage the wife in labor/delivery. 24:25 He will be there, and massaging, comfort measures, an active part 24:34 And also postpartum, encouraging her, 24:35 and helping her with changing the diapers, 24:40 and bathing the baby. 24:44 Of course, she's going to need help with house cleaning 24:46 and feeding... And all those different things. 24:50 Let's go back to breast feeding just for a minute... 24:53 How often do you switch breasts 24:56 or how much on one side or the other? 24:58 Usually they nurse about 15-20 minutes on each side. 25:03 Okay, so the baby will feed for 15-20 minutes, 25:06 and then you will switch the other side. Right 25:08 And what about water? 25:10 Does the baby need water or 25:11 anything else to drink besides milk? 25:13 Well if they are breast feeding, mother's milk has 25:18 all the water the baby needs in breast milk, 25:22 so there's really no need to give the baby water. 25:24 Okay, so they have what they need. Yes 25:27 And, how long do you usually tell moms that they 25:32 can safely breast feed? A year? 6 months? 25:37 Is that a matter of preference? 25:39 Yes, it's usually a matter of preference... 25:41 how long they feel comfortable breast feeding, 25:44 or when they feel that the baby 25:47 needs something other than breast milk. 25:51 I'm sure you get many, many calls for deliveries, 25:55 and different things, but do you get a lot of calls 25:57 after you have ministered in this way in homes? 26:00 Yes, we get a lot of calls even after delivery, 26:05 well-after their postpartum period just to keep in touch, 26:11 and to ask questions, just concerns 26:15 of other members in their families. 26:18 Have you ever led anyone to the 26:20 Lord as a result of your ministry 26:22 working as a Christian midwife? 26:25 Yes, I'm thankful that the Lord 26:28 has a big part in this ministry. 26:30 We pray with all our clients, 26:32 and we encourage them in the Lord... 26:35 And we have had good success with Bible studies, 26:41 and just openness. 26:44 Now does your husband... I notice you said the word "we" 26:47 ...does you husband and then 26:48 your daughter's name is Genesis, I think, 26:50 and then your son's name is Jason, 26:52 do they see this as much their ministry as you do? 26:55 Yes, I couldn't do this without their encouragement 26:59 because they play an active role, 27:03 and every time the phone rings in the middle of the night, 27:06 and just encouraging me to 27:10 do seminars... and being away from home so much. 27:16 Yes, your son is kind of your right-hand-man... Yes, he is. 27:19 He brings those things and I know that your daughter, 27:21 as well, speaking with her just really sees this as a part of 27:25 her ministry as well. 27:27 Well thank you so much for coming and sharing with us. 27:30 We've been talking to Patty Barnes 27:32 She is a certified midwife. 27:35 She has had over 750 deliveries. 27:37 She has a delightful new book called... 27:39 "The Ministry of Midwifery" 27:40 a manual that goes through many things that we covered 27:43 that take us through the pre-birth process 27:46 all the way through delivery, then postpartum care, 27:49 all these different aspects. 27:51 It's a REAL blessing. 27:52 We hope that what you have learned has been helpful, 27:54 and we hope that as a result of today's program, 27:58 you'll have life and have life abundant! |
Revised 2014-12-17