Dr.Jayashree Jayakrishnan expert in Water Birth, Chennai

This is a tribute to the angel of my life dr. Jayashree I was introduced to her in the 20 th week of my gestation at my birthing centre , as a child birth instructor. Me & my husband would doze off and used to rush to her classes every Saturday. Realised in the first class that she is a world of knowledge, highly factious breaking all myths was her practises and tips . Loved the way she wanted partner to take notes and play the pivotal part while the woman be on leisure .The outcome of classes was wisdom along with physical preparation & fearless attitude for labor . Not just that Her every fact about post partum was so true . Finally came the D day , the activities on my labor started with exercises with my favourite ARR music with a special play list , relaxing on a gym ball to eating gobi manchurian and cheese balls. Soothing time in pool for the contractions with my favourite Aqua mist fragrance candles lit around the room , a nap for a while , photo sessions . Exercises over again followed by energy & motivation talks boosting my self confidence by doctor . My evening came , contractions became intense physical strength of mine put together with mental strength of my husband along with judiciousness of our great guide Dr. Jayashree I did it . Delivered an angel on 21 September (8.33 pm) after 39 hours of sac break . I was certainly dazed and left joyful tears . Natural ( normal ) birth after such a long course of labor is an amazing factor . All my happiness goes to one soul proprietor Dr. Jayashree Vinodha. We are grateful for her. She is just awesome !! Thank u doctor .

Husband delivering his baby in Water Birth in Chennai,Its a VBAC

Sinduja Nagarajan blessed with baby boy  @ 9.30 pm. Vaginal Birth after Cesarean VBAC in water, water birth with 30 minutes delayed cord clamping. Nagarajan had received the baby at the time of birth, we can say like this also he delivered his baby boy. He was in so much joy while he was receiving the baby. It's all his determination to give natural birth to sinduja.

Traveled from Erode to experience Natural/Water Birth in Chennai with HappyMom & Bloom Birthing Centre Team

Abinaya karthikeyan blessed with baby girl on 2 nd December ,water birth.
Abinaya came all the way from Erode to experience this birth
Another great team effort from Bloom Birthing Centre.

Let the baby to be intact with the cord in the picture.
Staff nurse ,myself and Dr.Misha Pepsi

After the birth of abinaya s baby we wanted to see whether its boy or a girl
I managed to see but not clear as baby was so comfortable in this position.
I assumed to be a boy
I started to say its a boy and everyone thought it to be a boy

After 45 minutes karthikeyan(abinaya husband) called me over phone and said its a baby girl.

I was like ahhhh
Oh I missed
No wonder this pic is so special for me

IUI,GDM does'nt have restricition towards WaterBirth in Chennai

Beautiful birth, it was the most satisfied birth for me

WaterBirth happened in Chennai

Congratulations on Vaishali Prakash for Waterbirth

Testimonial by Father Om Prakash
it was a scintillating experience to be in labour and watch the baby deliver.. BIG thanks to Jayasree ma'am for answering all questions no matter wat time it was and arriving spot on to assist Vaishali.. it is a wish come true, in all aspects 😊

Labor Support(Doula) for waterbirth in chennai

Met Vilasini in the  Happymom Antenatal around 34 weeks. It was a short time for both of us to know each other .After attending the birth choice session she preferred to have her husband with for the next session. So next session her husband came , vilasini was finding difficult to do exercise with GDM and less physical activity from the beginning of her pregnancy made it difficult for her to do exercises, but still she tried a lot. That weekend we had planned for Aquanatal session, Vilasini and her husband was little hesitant to come but they made it as reassured to them that they will luv the session. After the Aquanatal session their perspective towards birth choice changed, her husband was so confident to go waterbirth, I didn't promise them but told them we will decide during that time.

That day night vilasini called me saying of slight discomfort, around 2.00 am, her mom got panicked as no one is there to accompany them I told them to come to hospital.Around 3.00 am Ganapathy called me from Hosur, I assured him that things are fine no need to worry.
Around 8.00 am I reached hospital, I aasked her whether she wants to go to pool, than after 1 hour she was shifted to Birth pool.

She was intermittently on and off the pool, she was having food and water and tender coconut water in the pool itself , she was progressing slowly we ere taking time. Around 6.00 pm Gynaec came and did internal examination she 7 cm dilated and in -2 pelvic station.
She was shifted out of the pool and wanted to stay in the rest room for some time.She was comfortable in birthing while lying on the stomach , back labor. Everytime contractions comes she will lean forward, sac broke and saw grade 1 meconium stain, Foetal Heart rate been monitored consistently , baby was fine so we progressed,.

Around 8.00 pm she delivered baby girl , Meconium stain and cord around the neck. Baby was completely fine , than shifted her to the bed and breastfed in the labor bed itself.

One thing I told them I was ready to be their doula is just because of her husband who was so confident.She kissed me in the labor bed saying tons of thanks.
It was so emotional for me

vedic birth in WaterBirth with 2 hrs delayed cord clamping in Bloom Birthing Centre chennai

Its is a mom of 6 year old boy who had a Instrumental delivery in their previous pregnancy was highly disappointed with the delivery system that for their second pregnancy they were in search for a perfect place were they could experience Natural Birth.
She was already in her 37 weeks when in first met her in Happymom Pregnancy clsses. I was late that day to the claases I could see everyone waiting in the hall , among them was arti, she was bright when I saw her first time.
That day I gave an insight on Birth Options and ways to choose, she was so much into it and started to ask questions based on her previous birth experience. When she was receiving which is favourable to her she got to be excited.
As that day was too hectic for me I was not able to talk to her privately on birth options and it almost crossed lunch time and I was in a hurry to go the next hospital . I promised her that I will her for sure in my next visit, during that she asked I am interested in waterbirth, I was not in a position to reply as I don't know much about her , told her that we can take a call in the next session and I left.
Next session , I was speaking to them on their physical exercises and how far they are prepared for waterbirth and their knowledge on it. They were far above to my thoughts on their knowledge which gave me confident on them. They were also desperate on delayed cord clamping which I promise it will happen depends on the circumstance at the time of labor say for example if there is excessive bleeding,passed meconium cord around the neck means I can't promise for 2 hour wait to cut the cord. They do agreed to everything I told them.
They were pre planned about their labor process, No edema, they preferred to go natural edema,no pelvic examinations only if it is atmost necessary, no IV infusions and inductions and want to the hospital as delayed as possible.I was so happy to see a couple who has been well planned on their Birth.

she was on her due date I was worried and I called to know if there is any sign , she was relaxed and no worries mam I am completely fine. I told her to visit the hospital to check on Foetal Heart rate and have a word with her gynaec. So she went the next day, I was been informed from the gynaec that she didn't allow to do pelvic examination and after explaining the requirement she agreed.
She was almost 3 cm dilated and she was informed to go home and come next week until and otherwise if there is a requirement to come no need to come.

Anyway I informed the hospital to keep the birth pool ready as she may go anytime by nexy day. Next day morning around 4.00 am I received call from arti saying contractions every 5 - 10 minutes once. Informed them to wait for sometime and leave to hospital.
From the hospital I received call informing they have reached , I was there by 6.30 am.She was quiet relaxed and then I told her to get into the pool if she wants to.
she got into the pool after sometime , she started to do acupressure stimulation to trigger labor progress and was taking homeopathic medicine kal phosporicum to trigger childbirth. I was supportive to her options. 1 hour later she started to say its time now I am going to give birth.
I informed the gynaec Dr.kavitha to come till than instrusting her not to push but let you give way for the baby to descend so breathe slowly she was just following the instruction.
By the time gynaec she was completely crowning and around 8.20 am she delivered beautiful baby girl with no tear and meconium stain.

Baby was with her and her husband , we all were silently waiting for the placenta to expel till than baby was intact with the cord. After 30 minutes without any syntocin injection placenta came out, we kept the placenta in the bowl with the cord intact for 2 hours. Her husband was literally holding the bowl for 2 hrs to drain blood from cord to baby . Till than baby was not been taken away for suctioning or wiping and no Vitamin K injection as the couple had chosen to avoid vaccinations completely, we respected their choice.With Placenta intact we breastfed the child and arti was also having idly as she was in hunger she had her breakfast on labor bed.

Around 10.20 we clamped the cord and I said thank you for letting me to be a part of this birth. As this is dream birth for me. I was so happy that day and in the hospital all the staffs was so surprised to see the confidence what the mother had.



around

How are the couples been prepared for delayed cord clamping

In Happy Mom Pregnancy/childbirth classes been prepared for delayed cord clamping.
But not everyone were able to establish delayed cord clamping.
Delayed cord clamping is at least 2-3 minutes delay in clamping.
Unfortunately there are many reasons , listed some to my experience
Due to delivery process like
Cord around the neck: baby been rushed to the Neonatal Intensive Care Unit
Baby passed Stools/ Meconium
Forceps/Vaccum Delivery
Delay in baby cry
Fundal pressure / pressure given over the mother stomach to expel the baby
Episiotomy; mother would be bleeding no time to wait

Than how can to have Delayed Cord clamping to happen
If there is a Natural birth/water birth is happening , delayed cord clamping is more possible
Like no fundal pressure, no episiotomy, no rush to deliver the baby ie no push push while delivering its a natural expulsive reflex were it will happens on its own.

Medical emergencies like meconium stain,baby didn't cry than delayed cord clamping is delayed.

All this requires prior preparation for the couples to decide according to the circumstances. 

Lotus Birth, Placenta intact with cord after delivery

A new trend in natural birthing methods strives to ease a baby's transition into the world by not detaching the cord and placenta immediately following birth. Unsurprisingly, reactions are mixed.
There is a new trend in the world of natural birthing methods. Some mothers are opting for “lotus births,” where the umbilical cord is not cut immediately after birth. Instead, the baby remains attached until the placenta and cord dry up and fall off on their own, usually after 3 to 10 days. The cord detaches at the navel on its own.
The placenta is stored in a cloth bag, often placed on a pillow for easier transportation, and the cord is wrapped in silk ribbon. Apparently the placenta is odorless for the first day and then has a “slightly musky smell” in the following days (unless you seal it up in an airtight container, in which case it smells bad).

What are the benefits of a lotus birth?

According to a website called Lotus Birth: A Natural Birthing Practice, keeping the umbilical cord intact allows for a greater transfer of iron- and oxygen-rich blood to the newborn baby:

“The infant obtains 40 to 60 mL of ‘extra blood’ from the placenta if the cord is not tied until pulsations cease. Common practice of immediate cutting of the cord before pulsations cease deprives the newborn of a possible 60 mL of blood, the equivalent to a 1200 mL hemorrhage in an adult. This is a likely explanation of the strange phenomenon of weight loss that most newborns seem to endure. The new organism is put immediately under undue stress to reproduce the blood it was denied.”

The Royal College of Obstetricians and Gynaecologists objects to the practice, citing increased risk of infection in the blood-saturated placenta, which could spread to the baby. Lotus birth supporters counter this by saying that risk of infection is actually reduced because there is no wound at the navel.
Hilda Hutcherson, a professor of obstetrics and gynecology at Columbia University, said there is no scientific evidence that waiting days for the cord to detach has any benefits, but that delaying clamping the cord may help:

“There has been research in the past few years which found that when doctors delay clamping the cord for three minutes, the baby receives higher levels of iron which prevents anemia, but beyond that time frame, leaving the cord attached to the baby serves no purpose because it no longer feeds nutrients to the baby.”

I love the idea of easing a baby’s transition into the world and, as a home birth veteran, I understand the appeal of making the birthing process as calm and stress-free as possible. The lotus birth model encourages new mothers to stay home, relax, and heal quietly in the days following delivery, because it’s inconvenient both to entertain guests and leave the house with a newborn and placenta-bag in tow.
I do find it difficult, however, to imagine handling a placenta-bag on top of all the other hassles of newborn life, from incessant diaper changes to breastfeeding agony, as well as managing older siblings. There comes a point when what’s easiest for the mother becomes best for the baby because those first few post-partum days are extremely challenging. A lotus birth is not something I’ll be doing when my baby arrives in April, but that doesn’t mean it wouldn’t work well for someone else.

First time in Chennai Delayed Cord Clamping , leaving placenta intact with the cord for 2 hours in Bloom

Delayed Cord clamping is something which is not been practiced actively in day to day births which are been seen. Leaving even for 2 minutes shows to have large benefits to baby.
For the first time in Chennai Bloom Natural Birthing Centre and HappyMom Pregnancy to Motherhood are working together to bring this awareness.
We in HappyMom pregnancy classes reinforce the importance of delayed cord clamping make sure leave the cord intact for atleast for 2 minutes.

Delaying Cord Clamping May Offer Years Of Benefits, Study Finds

By Sam McCulloch in Birth. Last updated on August 1, 2015

After a baby is born, it’s common practice to immediately clamp and cut the umbilical cord, before passing the baby to her mother.
After all, the placenta and umbilical cord are unnecessary once the baby has arrived, right?
Due to a plethora of studies telling us that waiting before clamping the cord does offer benefits to newborns (after 10 years of lobbying, the UK are finally set to make delayed clamping to be standard practice), some of us have started to open our minds to the possibility of leaving the cord alone after the birth.
It seems that we’ve been thinking incorrectly in the past.
New research just out suggests that waiting before cutting the cord has more far-reaching benefits than we realised, with impacts well past infancy.
Researchers suggest that waiting at least three minutes before cutting the umbilical cord after the birth may help to improve children’s fine motor and social skills at four years of age. This is in addition to the huge benefits already discovered.
Globally, clamping and cutting the umbilical cord immediately after birth is standard practice. In 2011, researchers demonstrated that leaving the cord intact for at least three minutes decreases the risk of iron deficiency in babies for up to 4-6 months after birth. Now we are learning that delayed clamping provides long-term benefits too. Delaying clamping of the umbilical cord allows the volume of blood from the placenta and cord to transfer to the baby. This increases the baby’s blood volume by up to a third, providing valuable red blood cells and boosting iron stores. It also contains precious stem cells that belong to your baby. Why cut off this valuable source of goodness? What The Researchers Found In their investigation, the researchers followed up on babies from their earlier study. The children were now four years of age. Of the original 600 infants, 263 children took part in the study. Of these children, 141 had cord clamping delayed by three or more minutes after birth. The other 122 had cord clamping within 10 seconds of birth. The researchers completed developmental assessments, including IQ and cognitive tests. Parents completed a questionnaire regarding social and personal care skills. The results of the tests and questionnaires showed there was no difference in IQ or development between the children who had immediate cord cutting and those whose cords were left intact for three minutes after birth. - See more at: http://www.bellybelly.com.au/birth/delaying-cord-clamping-years-of-benefits-study/

But what the test results did show is that the boys who had delayed cord clamping (DCC) had better fine motor skills, such as gripping a pen, and more pro-social behaviour, compared to those boys who had immediate cord clamping after birth. Girls generally have better iron stores from birth, and are better protected against iron deficiency. Why Does Iron Matter? Iron deficiency has long been associated with poor behavioral, motor and intellectual development in children. The World Health Organisation (WHO) recommends leaving the cord intact for one minute as a general practice, with a target of at least three minutes if possible. Other peak groups as the UK National Institute for Health and Care Excellence (NICE) also recommend delayed or deferred cord clamping for at least one minute. The practice is not widespread, but is growing as the evidence showing the clear benefits grows. Doctors vary in their understanding of the current evidence showing that delayed cord clamping is beneficial to babies for the first 6 months following birth. This new research has long term implications for how maternity care providers proceed with the management of the third stage of birth. Iron deficiency in toddlers has become prevalent in developed countries. Statistics showing countries such as Australia, the US and UK have an average 10% of children aged between 1-3 with iron deficiency. During early infancy, the brain is rapidly growing and developing and iron is essential to that process. Limiting the amount of iron that is available to a baby during this time of rapid brain growth clearly impacts future brain development. While iron supplements are an option, natural sources of iron are more gentle to tummies (much less likely to cause constipation) and are more readily absorbed. - See more at: http://www.bellybelly.com.au/birth/delaying-cord-clamping-years-of-benefits-study/

Optimal timing of cord clamping for the prevention of iron deficiency anaemia in infants

Full set of recommendations*

WHO recommendations (1)

In summary:
Delayed umbilical cord clamping (not earlier than 1 min after birth) is recommended for improved maternal and infant health and nutrition outcomes.

From 2012 WHO guidelines on basic newborn resuscitation (2):

In newly born term or preterm babies who do not require positive-pressure ventilation, the cord should not be clamped earlier than 1 min after birth.
When newly born term or preterm babies require positive-pressure ventilation, the cord should be clamped and cut to allow effective ventilation to be performed.
Newly born babies who do not breathe spontaneously after thorough drying should be stimulated by rubbing the back 2–3 times before clamping the cord and initiating positive-pressure ventilation.

From 2012 WHO recommendations for the prevention and treatment of postpartum haemorrhage (3):

Late cord clamping (performed approximately 1–3 min after birth) is recommended for all births, while initiating simultaneous essential neonatal care.
Early umbilical cord clamping (less than 1 min after birth) is not recommended unless the neonate is asphyxiated and needs to be moved immediately for resuscitation.

Remarks

• The evidence base for recommendations on the optimal timing of umbilical cord clamping for the prevention of postpartum haemorrhage includes both vaginal and caesarean births. The WHO guideline development group considered this recommendation to be equally important for caesarean sections.
• Delayed umbilical cord clamping should be performed during the provision of essential neonatal care.
• Recommendations for the optimal timing of umbilical cord clamping apply equally to preterm and term births. The guideline development group considered the benefits of delayed cord clamping for preterm infants to be particularly important.
• Some health professionals providing care for an HIV positive pregnant woman and/or working in high HIV prevalent settings have expressed concern regarding delayed cord clamping as part of the management of the third stage of labour. These professionals are concerned that, during placental separation, a partially detached placenta could be exposed to maternal blood and this could lead to a micro-transfusion of maternal blood to the baby. The evidence shows that the benefits of delaying cord clamping for 1-3 minute outweighs the risks of transmission of HIV. HIV testing should be offered intrapartum, if not already done. WHO recommends that all HIV positive pregnant and breastfeeding women and their infants should receive appropriate antiretroviral (ARV) drugs to prevent mother to child transmission of HIV. Thus, the proven benefits of at least a 1–3 minute delay in clamping the cord outweigh the theoretical, and unproven, harms. Delayed cord clamping is recommended even among women living with HIV or women with unknown HIV status. HIV status should be ascertained at birth, if not already known, and HIV positive women and infants should receive the appropriate ARV drugs.
• Delayed umbilical cord clamping should not be confused with milking of the cord. The terms are not necessarily synonymous (milking refers to physically expressing blood from the umbilical cord). There are various recent studies assessing the effect of cord milking, practised at different times after birth, with a variety of “milking” times, associated with early or delayed cord clamping. These studies need further analysis, as cord milking has been proposed as an alternative to delayed cord clamping, especially for preterm infants.
• The WHO guideline development group considered that the package of active management of the third stage of labour includes a primary intervention: the use of a uterotonic drug. In the context of oxytocin use, controlled cord traction may add a small benefit, while uterine massage may add no benefit for the prevention of postpartum haemorrhage. Early cord clamping is generally contraindicated.
• Clamping “not earlier than one minute” should be understood as the lower limit period supported by published evidence. WHO recommends that the umbilical cord should not be clamped earlier than is necessary for applying cord traction to reduce post-partum haemorrhage and speed expulsion of the placenta (3), which the guideline development group clarified would normally take around 3 min.
• For basic newborn resuscitation, if there is experience in providing effective positive-pressure ventilation without cutting the umbilical cord, ventilation can be initiated before cutting the cord (2).

* This is an extract from the relevant guidelines (1-3). Additional guidance information can be found in these documents.

---

References

1. WHO. Guideline: Delayed umbilical cord clamping for improved maternal and infant health and nutrition outcomes. Geneva, World Health Organization; 2014 (http://www.who.int/nutrition/publications/guidelines/cord_clamping/en/).
2. WHO. Guidelines on basic newborn resuscitation. Geneva, World Health Organization; 2012 (http://www.who.int/maternal_child_adolescent/documents/basic_newborn_resuscitation/en/).
3. WHO. WHO recommendations for the prevention and treatment of postpartum haemorrhage; 2012 (http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241548502/en/).

HypnoBirth in Chennai

Subashini and Sudarshan are such a bubbly couple in my Antenatal Classes. They tend to be so active in all me activities I do in the pregnancy classes.They had choosen for HypnoBirth option of Birth. They are so much involved in it , I could readily see them getting into self hypnotize stage so easily.
This had helped them in large at the time of labor.
A series of practice for 2 months made them completely prepared for the birth they have wished for .
They been blessed with Baby girl on April.

Family Support for Birth Pool and WaterBirth Deliveries

I had been mentioning in all my previous labor support stories about Birth Pool and WaterBirth deliveries.Does all labor been decided only by the couples. Actually its NO.

Family plays a vital role in their decision making process. Couples who are coming for my pregnancy classes or childbirth classes comes alone. They are not accompanied by family members mostly thinking ancestors will not favour to their thoughts.

I usually reinforce on having atleast on family member in my Pregnancy Classes.
I could see vast difference in the couples who choose to bring and who choose not to bring at the time of labor. Family members play a crucial part during Labor in our community mainly in South Indians.So there expectations and anxieties towards labor is far more different than current generation .

If they been educated on the outcomes and advantages towards the birth, they do readily agree for sure. But either way if not informed of they come to see the scenario happening in the labor room which is not up to their expectation means they get to a panicky mood of what will happen to baby, baby may drown or  may be something life threatening to either mother or baby. Which will directly influence the couples decision making process and the whole idea of birth changes.As I always says to all my couples in the antenatal class is
'you are a vulnerable person  at the time of labor so decision making will be difficult but your knowledge will not allow you to become a victim"

So I respect every ones view on labor it differs from person to person but not the same for anyone. 

First Vaginal Birth after Cesarean in Water (WaterBirth in Chennai) April 4 2016

Valarmathi and her husband entered the auditorium with their 6 year old daughter in between my sessions not what this place is about.Once I saw them I could figure out they are for their second pregnancy and I thought they should have come to learn general exercises for back and leg pain alone.
As most expected moms who come for the second pregnancy wants to learn exercises alone not much of labor plans.But Valarmathi made my assumption to be wrong.
She is a normal Housewife been so committed to family and Kid.Once I started to talk to her she made all my ideas about her to be wrong. She had a planned caesarean in her First pregnancy as she doesn't know much about labor she just got in to C-Section. Now for her second Pregnancy she was so determined that she wants to experience Natural Labor. I was initially not sure on how far she will be to her decision but I was moulding her in my sessions.
In my Birth Choices session one of the favourite session for most of my couples Valarmathi started to learn about Birth Options.She was so Thrilled and immediately she said I want to go for WaterBirth.I usually don't take decision fast so I told lets see how it goes.
Every session she use to reinforce me on WaterBirth , I myself also give her a word on it. I could than feel that she can go for it by seeing her determination and motivation. She use to tell me after 34 weeks of pregnancy half of her day will go by doing all the activities I have taught her to do. So regular in her schedules.
Everything was going fine with her, I thought that I should introduce her to water before directly going to waterbirth so I told her to attend one aquanatal session. She was so amazed with the comfort what she got with water and got still more assured to her decision of WaterBirth.

From her 38 weeks i use to talk to regularly to know how she is feeling. from one week before her due date she started to say of false contraction which she tend to say as i feel like pushing. I will be on toes than and i will send her to hospital for examination she will be normal than she will be back home.Next time when she told me like this around 10.00 pm i told her to eat and go to bed. I slept off suddenly i got up 1.00 am to know what happened to valarmathi , her husband picked up the call and said that she is sleeping peacefully. Like this it went for 10 days everytime she sleeps she will become normal.

April 3rd like wise it happened but very minimal contractions . They reached hospital in the evening i than went by 11.00 pm she started to say its get severe so i shifted her to the labor were we had BirthPool.

Once getting in to the pool she started to feel better. The whole night her husband was supporting her. Around 3.30 am i told her to come of the pool to change water , after she got outside she was not able to bear contractions she started to say do something i am not able to take the pain , i could her as a first time mom. Ofcourse she is for me like that as she is experiencing natural birth for the first time.
It took 45 minutes to change water than i shifted her to water she started to feel better.

Around 5.00 pm onwards she started to say i feel like passing stools. Her Aminiotic sac didn't break till than , the nurse next to me always wants to do pelvic examination  which i mostly don't allow , just by checking heartrate of the baby position of the baby will be known. So i told her to hold. Around 6.00 pm she started to say i feel like pushing than i could see gush of fluid in water will bleeding so i informed the Gynaec Dr.Kavitha Gautham.

Around 6.20 am i could see the baby crowning, i was about to wear the glove Dr.Kavitha Gautham came. Now we are in positions, her husband in the pool sitting behind her to support her a duty doctor to support her arms i am in front of her talking to her.She was doing it really well but it happened for us to say push when she did that there was a slight perineal tear and baby was out than. 2.8 kg Baby boy.

Gave baby to valarmathi and then clamping of the cord done than she was shifted to be dto stitches for the perineal tear and i made her to breastfeed the baby immediately on the labor bed.
Valarmathi was so happy that she had achieved what she dreamed for.

It was the first VBAC in water . We were so happy in it.

Everything was so happy but it was a learning lesson for me.
I shouldn't have told her to push it has to be a gentle breath and no need to support her in water she knows how to balance herself in water.
So now i was preparing myself for the next birth to give the best with whatever lesson i have learned.

Nithyakala karthick march 29 2016

Nithyakala Karthick were been so regular to all the childbirth sessions.
From the beginning they are so excited about the birth options and choices.
Well prepared and planned couple.
Nithyakala been for Aquanatal sessions also.She always had some amount of difficulty in performing some exercises but she reported to be very comfortable in water.As she was in short in statue many assumed her to be having C-section and by her 36 weeks she been reported to have above average weight baby so they been  doubtful but very confident at the same time.

They booked me for labor support and birth pool also.
Nithyakala always waited for her day to come.
March 28th morning they called me informing about intermittent pains , told them to wait and see.
Than by 2.00 pm - 3.00 pm they went to hospital .
After examining mom was 1 finger tight baby in -3 station and 40-50% effaced.
She was so relaxed,been interacting with her through phone.
Night around 8.30 - 9.00 pm reached hospital.
Both of them quiet relaxed and having lots of fun.

By 10.00 pm we started to do some exercises, she started to report of low back pain from the beginning suspected her to occiput posterior.
slowly her intensity of the pain is getting higher and higher.
By 11.30 pm shifted her to labor room.
By 12.30 am she got to the Birth pool.She was finding very comfortable in the pool.
Myself and her husband was splashing water for every contraction were she was able to tolerate better.
As time went by she started to say its getting unbearable but her progression remained the same.

By 3.00 am -4.00 am made her to come out of the pool to change water in the pool and also to do some exercises.
By 4.30 am her sac broke.

she was back to the pool.By 5.00 -6.00 am everyone in the labor room started to drowse off and almost sleepy.
By 7.00 am I told her husband to go home and refresh and come.
Nithyakala was so calm I thought she was sleeping when I asked her she actively respond that she is in high level of contractions . and she preferred the room to be calm and quiet.
If someone whispers also she was not comfortable so made the room very calm.

By 10.00 am she started to say that she is getting the urge to push.
She preferred to deliver in water her husband preferred to be in land.
So by 10.45 am I shifted her to bed .
By 11.15 she was in the full squat position and delivered 3.6 kg baby boy without episiotomy.
It was a big thing for us to deliver a 3.6 kg baby without episiotomy.

I was so satisfied with her birth process.
couples were at the height of happiness as for her height and weight of the baby she felt this to be the greatest achievement 

Ishwarya ,natural birth without episiotomy

Ishwarya been long time wanting to join the session
But somehow it was getting delayed every time
Atlast she joind in her 2nd trimester
First session she came alone expecting some exercises and some general advices
After the session she understood that the session is not for her but for her husband

Following Sessions they came as a couple
Each week they would expect a lot from the session on what they are going to do today
They feel bad if they miss out ant session

As the days come closer initially they said they want to go for waterbirth
than later they want to go with normal birth process
It was all confusion as they came out with so much options
I gave them time to decide

They been to gynaec consultation where the doctor said baby has descended down to -2 station
Doctor called me and said should we wait or do induction
requested her to wait
she s so warm to agree to the request

That night ishwarya's husband called me and asked for labor support which they need to book
I was not sure as I was already booked for another labor
I told if I am free surely I will come and they booked birth pool also
It was already 3 days went but no signs of pain
The couples were so anxious as they were waiting for each day

On Feb 11 2016 night 10.30 pm I had a call , ishwarya husband siva informing me that she s getting contraction from evenng 6.30 pm
I told them to wait and call me when the contractions get effective
I had a call around 2.00 am informing that there is effective contractions and going to go to hospital
I said I will be there by 4.00 am
I have to cook food and arrange things for my 3 year old son and arrange for the baby sitter and started
On the way I had a call from the gynaec saying she is fully dilated but sac intact
requested her not to rupture(break) the sac
reached hospital, she was in active labor getting contactions every 2 minutes once

Birth pool was dilated but she was not in a state to use birth pool
she is in the labor bed
I took her to the rest room and made her to relax with warm water
within half an hour her sac broke and she started to say that she is getting the urge to push
I waited till I see the crowning of babyhead than I shift her to labor

the moment she is on to the bed she started to push
the gynaec is about to take scissors to do episiotomy
second push she delivered baby boy 3.2 kg at 5.15 am on Feb 12

there was a perineal tear
Gynaec need to do the stitches

it was a memorable one for the whole family
For me I could have avoided the tear
If the mother haven't pushed

labor position counts a lot in perineal tear
If the mother been allowed to labor to the position she wishes means we could have avoided even that tear

Dr.Jayashree Jayakrishnan in Sun Tv

priya feb 7 2016

Priya and her Husband came to the childbirth class in an idea to learn some exercises and go home
But after the first session they got an idea what the sessions are all about.
I do remember sending priya back home to practice exercises better and the most important thing is her husband use to show me the exercises .
Very supporting partner.

After a series of session there mind set towards labor changed.
They use to tell me that there friends were telling that these sessions are just waste of money and time as it doesn't make a difference at the time of labor.
I do agree to what they said but if the partner been educated to take decisions on labor makes a lot more difference you see in labor.
That's what happened in Priya's birth.

They booked me for the labor support in a month advance .
I have been verbally giving them the motivation about birth.

About 2.00 am Priya Husband called me and that she is in contractions.
I told them to wait and see the contraction frequency  and start to hospital.
Around 4.00 am I had a call that the aminiotic sac broke and they are starting to Hospital.

once reached hospital the duty Doctor has checked and said she is 2-3cm dilated and getting contractions 3 minutes once.
I reached hospital I made her to eat breakfast than shifted her to labor room.
Priya had booked for birth pool.
So pool was made ready once she entered the pool she got herself immersed in the pool.
initially she was asking for lukewarm water but after sometime she started to ask nice warm water.
She was so quiet and relaxed in water.

Around 12.00 pm she started to say I feel like passing stools.
They had choosen to deliver in land.
so she was shifted to bed .
Priya was completely exhausted.
She is not able to stand or sit in land.
she was so comfortable in water.

Around 1.00 pm she got the urge to push.
She was been trying to do for 20 minutes.
We could see the baby head crowning.
As she was exhausted and week she was not able to handle it.

So Gyneac said that baby is in Crowning position for a long time so I don't want to wait still more.
An Nurse gave a fundal pressure on her stomach and baby was delivered.
while delivering baby had passed fresh meconium(stools)
May be because of Fundal pressure because till than baby was fine.

It was a beautiful Baby Girl.
Priya and her relatives were in a surprise that she delivered vaginally without epidural and induction.

All credits to her husband.

What I learned from this labor is
If a women lower limbs are not strong means going for birth naturally is difficult.
 

Avitha Feb 3rd 2016

Avitha, changed name for identification reason
Avitha is a motivated mom from the day I met her.
I met her when she was in her 28-29 weeks.

She was so much into natural birth options that she use to motivate me to do more for birth.
When we started with Hypnobirth sessions she was so surprised that these are happening in Chennai.
she was under a impression that antenatal class will be only about some exercises and breathing, so she didn't even bring her husband with her.
But when she entered to my session the first thing what I asked was hwere is your partner, she was surprised. Than after that session she was so excited , every session she use to read articles regarding episiotomy, labor position , induction process and discuss in detail.

I was surprised to see her, being in IUI conception, conceived after 4 years, she was so bold n her thoughts . Which was very rare for me to see.

She had pre booked me for labor support and discussed with her Gynaec .
She use to discuss about her birth plans to her Gynaec and they were artially fine with it.
Around her 37 weeks/38 weeks she informed me saying that the AFI is 10 and from the hospital been informed that if it still gets low in her next she will be taken to C-section.
She stated on the researches saying only if it is less than 7 c section is required otherwise not required . Obviously AFI will come as days go by as baby is growing.
So she was bold enough to wait.
On her next visit the AFI came down to 9. Her Gynaec had informed her to come within three days for induction. She was so sure on not to have induction.
So there was a kind of conflict of interest between patient and doctor.
Doctor was worried whether the AFI may get lower than this which would be risky.
Patient thoughts where like AFI minimum level has to be 7, so why should I get myself induced.
so on the same day internal examination was done and stripping was done which was not informed to the mom . when later this was said she was upset with it as she preferred to go naturally.

She left home on the same day around 1.00 pm -2.00 pm she called me and said I am getting contractions 5-4 minutes once and to she said it has progressed fast so she decided to reach hospital.
she wanted me in her birth time so she was like no madam you take time and come near to birth. My worries were if she is not progressing she may be induced so I reached hospital by 7.00 pm.
she was shifted to labor room by 8.00 pm during that time she was 4-5 cm dilated and 60% effaced.
It was informed to start syntocin in half an hour time.
But we were working on exercises and ball to progress in labor so syntocin was postponed.
By 9.30 pm she was 7-8 cm dilated and she was starting to feel like passing stools.
It was informed to start syntocin.It was started but she not getting the vein so it took another half an hour.
syntocin was hardly given only for 10 minutes. when the Gynaec examined her by 10.30 she was 7-8 cm. This time I asked the Gynaec to let the mother off the bed to do some exercise for faster progression. There was a change in the Gynaec thoughts which I sensed , she said yes to us. We were so happy , immediately she started to do exercises, and she was fully dilated and she delivered beautiful baby girl around 12.30 am. No epidural,no fundal pressure,no syntocin.

It was so exciting for everyone,Avitha was so happy as her dream came true.
Till than the gynaec was waiting she didn't even had her dinner that night.
Thanks to her....

I could see the Gynaec pressure when the fluid is low and as a special conception,
They want both mom and baby to be safe.
But if the couples are very confident in the thoughts and decisions surely the Gynaecs also will show there support.

 

Informed Decision making

January 2016 last week I had a couple who came for my sessions.
They were able to make up for only two sessions as they were working.
Very anxious couple, there expectation was normal delivery with no new concepts or new ideas .
want it fast and safe.
they had a family history of intra uterine deaths so they were quiet suspicious with everything
By January end they called and said they wend to check up it was informed that the mother had -3 pelvic station and they been informed about the induction of labor.
Explained them about IOL than they discussed with the gynaec and went home .
They were insisting on me to take labor support for them, which I was not sure as I have another labor support which I had promised.
They been so worried that they are not getting strong contractions and the husband who had a situation in a family which had happened earlier gave lot of pressure
so went to hospital to check foetal heart rate, everything was normal
they went back the next night they got admitted wanting to go for IOL within 3 hours her labor was strong,as the mother not able to take it up contractions they opted for epidural.
in a short span she delivered vaginally.

than they informed me about the birth
husband was upset with the epidural option
he thought because of the sessions only my wife came to know about epidural orelse this could be avoided.

I use to be very clear in my sessions.
I am an information source final decision in couples hands to the decisions they make
But they are aware of what they are doing.

HONEY Jan 10th 2016

Honeytha , I have misspelled her name
This couple is a young normal couple who doesn't know anything about the labor or birth. As its a first pregnancy they are quiet excited with each things they see and hear about labor.
when they been to my childbirth classes , I could see the joy and innocence.
From the time they started my sessions to the last session there was a big transformation I saw in them.
This transformation made them to choose natural birth with labor support.
Both mom and dad are well prepared , they had discussed there birth plan with Gynaec who sweetly agreed to their thoughts.
Honey was quiet excited as days are coming closer thinking whether she will get her contrations are coming closer.
this is the most usual thing I see in the present generation moms, anxiousness worried whether they will get contractions or not.
Explained them about the 41 weeks of pregnancy we can wait when all parameters are normal.

Jan 10th early morning I had a call around 4.00 am, honey informing me about mild contractions.
Informed her to take rest .
By 7.00 am they called me back saying that they are going to start to the hospital as they don't have a vehicle in the later period they want to come early.
They went to the labor room , accessed the foetal heart rate than she was shifted to the room.
I reached hospital by 10.00 am. Honey was quiet relaxed not much of contractions .
It was 25% effaced and 1-2 cm dilation.
I made her to be active for some time with intermittent fluids.
As time went by her contractions got stronger she wanted to lie down and sleep.
By 2.00 pm her contractions ws getting stronger like 3 minutes once and her sac broke.
Honey was so relaxed myself and her partner was not sure whether she went to hypnosis or what.
Her partner was amazing,he was just murmuring words to make her alert at the same relaxing her with the hypno scripts.
By 6.00 pm the gynaec came and said she is 6-7 cm dilated we can shift her to labor room. she saw grade 1 meconium stain which was not clear.
once been shifted to labor room honey husband informed me honey 4 episodes of breathlessness in stressful situations. I was not been aware of it, this was not discussed with me.
As syntocin was started my worries whether she will land up in the breathlessness situation because she didn't utter any word completely ,closed eyes breathing slowly.
so decided to take epidual.
after epidural when the syntocin was started baby's foetal heart rate went down, so it was stopped immediately.
heart rate became normal within 15 minutes she got the urge to push.
by 20 minutes she delivered a beautiful baby girl.

gynaec was so happy with the progress, from that time she started to send her patients to my childbirth sessions.

one thing I learned was I complete history of the mother is important , not only the pregnancy period prior pregnancy also.
honey issues of breathlessness is not in her case history also
good her partner discussed that during labor.

they are now so confident in handling baby
and breastfeeding is going beautifully without any issues

god bless

My lovely shyamala

It was 31st December 1.00 am I had a call which I missed than I made a call back , shyamala informed me that her water broke and there was a gush of water flowed.I told her to go to hospital to make sure there is no meconium stain(baby stools).
Its already 2.00 am I didn't receive any call from her I was so worried so I called the hospital. they have reached hospital and examination is going on.
At 2.30 am I call manick ,shymalas husband. He said doctor is doing the examination.
So I called the doctor to make sure everything is right for her.
it was told to me that she is 1cm loose and -1 station and grade 1 meconium stain.
ok I told manick I will be there in 30 minutes.
I reached hospital at 3.00 pm.

shyamala was so relaxed as there s no much contractions she was relaxed.
I asked her whether she wants to take a sleep ut she was so excited about the day for what she was waiting for.
so I made the couple to have some private time than we started to do some readings and some exercises intermittently we were checking her foetal heart rate to make sure things are right.
At 6.00 pm again a vaginal examination happened she was 75% effaced and now in -3 station.
Shyamala was happy and slowly she started with hip pain and low back pain with her breathing she was able to control very well.
at 8.00 am we had our breakfast and had a nap till 10.00 am
the obs came and said the same the progression and baby is in occiput posterior and she has given us time till 1.00pm if she is not progressing we need to start inducing labor.
we started to work with breathing and relaxation techniques.
By 12.30 pm shyamala felt like pushing stools
when we examined baby was showing signs of crowning.
shyamala was so calm
no one could belive that she was in active laboe she was so calm and was having water intermittently t keep herself hydrated.

Baby was crowning at each contraction at 1.20 pm shyamala delivered a baby boy without epidural and induction
she was so excited and her husband who wanted delayed cord clamping which also happened
thanx to the gyanec who listed patiently.

it was a beautiful new year gift for me
felt the whole year will so gifting as this day

hope to c u all in some more birth stories

Doula services in Chennai

Dear All
Been in the maternity service from 2008.
I had been to various sectors like pre natal exercise specialist,childbirth educator,post natal exercise specialist,lactation consultant,HypnoBirth Practitioner,doula and now in midwifery practice.
I was in search for an answer to all the problems in the delivery process and now I am able to get it one by one and I am now I seems to be confident in handling so.

In this blog I want to share about all my natural birth services I am being through.
I felt that sharing will make the world better.

From this year 2016
you can see all my birth stories,doula services and its activities

luv
Jai