Virginia Apgar: An Advocate for Newborn Health

Virginia Apgar

The APGAR test, a standard newborn test developed in 1953 by Virginia Apgar, assesses an infant’s health immediately after birth. At 1 and 5 minutes post birth, the infant is examined and given a score based on the following criteria: heart rate, respiration, color, muscle tone, and reflex irritability. The term APGAR score is a mnemonic learning aid based on its inventor’s last name which stands for Appearance, Pulse, Grimace, Activity and Respiration. By the 1960’s, because of its readability and effectiveness, this score was used widely across the United States. Now, it is globally used and adopted by most doctors and midwives.

This pioneering anesthesiologist worked effortlessly throughout her career to save countless newborns. Born in New Jersey in 1909, she became passionate about medicine in High School. She completed an undergraduate degree at Mount Holyoke College in zoology with minors in physiology and chemistry. She also played on multiple sports teams, reported for the college newspaper, acted in local plays, and played violin in the orchestra. Her teachers were astounded at her capacity to succeed.

She went on to attend Columbia University College of Physicians and Surgeons (CUCPS) as one of nine women in a class of ninety. She received her medical degree in 1933 and began a surgical residency. The chairman of surgery at CUCPS highly encouraged Apgar to switch to anesthesiology. Anesthesiology, at the time, was given by nurses but surgeries became more and more complicated. This procedure then became a doctor’s specialty. Because the field was relatively new and unresearched, Apgar had the enthusiasm and grit to take it and run with it. And that is just what she did. In 1937, she received her anesthesiologist’s certificate and returned to CUCPS to become the director of the newly formed division of anesthesia and, in 1949, she became the first female full professor in CUCPS’ history.

This high position allowed her to research and study more in depth at Sloane Hospital for Women with laboring and new mothers. She soon realized that there was no developed way and standardized measure to asses the overall health of newborn babies. Mortality for children under a year old in the U.S. had been going down in this time, however, the rate of mortality for newborns remained the same. This was mostly due to the fact that doctors weren’t identifying the babies that were born at risk. Hence no necessary interventions could be put into play. This prompted the brilliant Virginia Apgar to develop the APGAR score in the 1950’s.

She went on, in 1959, to pursue a Masters of Public Health degree at Johns Hopkins University and soon after took a position at the March of Dimes Foundation directing its research into the prevention and treatment of birth defects. She was one of the first people to focus on the effects that premature birth has on an infant’s overall health. Today, the March of Dimes still works to prevent premature birth and is one of their top priorities because of the legacy Apgar left them with. Apgar published over 60 papers and continued to tirelessly work and research until her death in 1974.

David Rose wrote, on the 100th anniversary of her birth in 2009, “Virginia Apgar was an irrepressible and charismatic champion for babies whose wit and lively personality captivated everyone she encountered in her constant quest for improvements to maternal and infant health… it has been said that every baby is first seen through the eyes of Virginia Apgar.”

 

Source: www.amightygirl.com

Baltimore Clinical Herbalist Specializes in Women’s Health

Baltimore clinical herbalist

Today on the blog, we have an interview with Melanie St. Ours, an author and Baltimore clinical herbalist who specializes in women’s health and mental health.

How did your clinical herbalist passion ignite?

Even though I’d had a lifelong interest in natural healing, I didn’t have the courage to turn to herbs until I ran head-first into the limitations of our current healthcare system. It was 2008, and by day I was working as a massage therapist at a busy physical therapy clinic in downtown DC where I was the go-to person for clients with chronic illnesses, trauma histories, and other complex cases. Even with weekly treatments, I could see that they needed more options and that pharmaceuticals often didn’t work for their needs. Meanwhile, I was getting sicker and sicker with Ulcerative Colitis — and was shut out of the system because my “pre-existing condition” made it possible for health insurance companies to deny me access to a policy in those days before The Affordable Car Act had passed.

Seeing the ways that the system can fail people — both those with access and those without — made me passionate about becoming an herbalist so that I could teach people how to care for themselves with the medicines the Earth herself provides. I think of herbal medicine as a powerful complement to the medical system. The combination of both approaches is incredibly powerful, and we all deserve access to the best of both worlds.

How has this professional journey helped you in pregnancy?

More than anything, my herbal knowledge allowed me to enter into pregnancy in great health. I’m convinced that being well-nourished and well-supported was a big part of what made it possible for me to conceive right away at age 35 and to have a pregnancy that’s been pretty comfortable and uneventful. I’m at 34 weeks today and still feeling good!

What has been the most helpful natural remedies for you while facing typical pregnancy ailments? Inflammation? Constipation? Decreased energy levels? Leg cramping? (Feel free to add any others)

It was a shock when I started experiencing constipation since I’m a vegan and am fantastically regular outside of pregnancy, but my favorite flax seed stool softener has been a huge help! (And I plan to drink this during labor and early postpartum to help make that first BM after birth as easy as possible.) If you want to try it, here’s the recipe:

Flaxseed Stool Softener
(from The Simple Guide to Natural Health by Melanie St. Ours)

Ingredients:

1 heaping TBSP whole flax seeds
8oz room temperature (or cold) water

Directions:

1. Combine flax seeds and water in a cup or jar. Stir until all of the seeds are wet.

2. Let the cup or jar sit undisturbed at room temperature or in the fridge for 6-12 hours.

3. After steeping it complete, strain the seeds from the water. (You’ll notice that the flax water is thickened and gel-like, especially toward the bottom of the glass/jar. This is what you want!) Drink the water/gel. You can use the soaked flax seeds in a smoothie or on food, or simply discard/compost them.

4. To prevent constipation, drink 1 serving per day. To reverse constipation, drink at least 2 servings per day — one in the morning and one in the evening. You can increase to up to 4 doses per day if needed, and/or use this remedy in combination with Magnesium to enhance results.

I hope this will help you get some relief in the near future! If you try it for 2-3 days and don’t notice much change, I’d add some liquid Magnesium (or Natural Calm dissolved in water) to the equation until you’re feeling better.

I understand you have written a book that compiles your professional journey as a clinical herbalist. What inspired you to write the book? What is your hope for the book after publishing?

Well, the book isn’t really about my journey as much as it’s a guide to help others who are starting out on their own. 🙂 It’s called The Simple Guide to Natural Health and is designed to make it easy for beginners to get the most out of all kinds of natural remedies including essential oils, natural body care recipes, healing foods (these are some of my favorite recipes in the whole book!), and homemade herbal tea blends, tinctures, and treats. We’ve already sold over 10,000 copies and I’ve spotted the book “in the wild” at Whole Foods, so really my biggest hope at this point is just that it reaches people and helps them to start experiencing how amazing herbs are in their own lives. This medicine really does belong to all of us, and I hope that my work somehow makes it a little bit easier for people to get started.

 

Acupuncture and Moxibustion: A Dynamic Duo

moxibustion acupuncture

What is Moxibustion?
Moxibustion is a form of heat therapy in which dried plant materials called “moxa” are burned on or very near the surface of the skin. The intention is to warm and invigorate the flow of Qi in the body and dispel certain pathogenic influences.

Moxa is usually made from the dried leafy material of Chinese mugwort, but it can be made of other substances as well to achieve the same goal.

What is Acupuncture?
Acupuncture is the method of treatment based on influencing the body by inserting needles in the specific points of human body, called acupoints. The name originates from Latin and literally means “inserting needles” – Latin “acus” – needle and„ “punctura” – to needle/to stick needles.

Why are these two therapies often used as a pair?
Practitioners often pair the two therapies because it is believed that the two of these together can be more effective when the diagnosis allows for it, such as a breech presentation of baby.

 

How can this double therapy be helpful in pregnancy?
This powerful pair is often used in relation to breech baby presentation which typically appears around 20+ weeks of pregnancy. This happens in about 4% of all pregnancies. Many times, baby turns on his/her own and no further treatment is needed. However, when approaching the end of pregnancy with a breech baby, these two ancient Chinese therapies could find themselves extremely useful! A study in 2009 showed that these two methods were, in fact, effective in changing the presentation of the baby.

The conclusion of the study is as follows: Acupuncture plus moxibustion is more effective than observation in revolving fetuses in breech presentation. Such a method appears to be a valid option for women willing to experience a natural birth.

Using Elderberry to Boost Your Child’s Immunity

Having sick kids is nothing we look forward to come winter time. Snotty noses, unstoppable coughing, and grumpy attitudes. Not to mention the worrying a mama goes through about the illness. It’s truly a lose-lose situation. And then if mama gets sick, then the whole ship sinks.

This winter, I wanted to try to give my family the tools we needed to avoid those cold induced ear infections and the terrible flu virus that often plagues our communities. Because for me, staying quarantined the entire winter is not an option. We have to get out and moving, in public places even, where those big, bad, ugly germs are lurking.

The most potent tool in my arsenal right now is my Homemade Elderberry Syrup. I priced some already made syrups online and thought they were outrageously priced for such a small bottle. So, after reading the amazing benefits online, I knew I had to make it myself and cut back on some of the cost. Also, it makes you feel like a total mom boss when you can boil down berries and yield a substance to boosts your child’s immunity.

The first step is finding a quality, dried, organic elderberry online to use as your base of the syrup. The same rings true for honey. You will need a good local honey that contains the area’s pollen and seasonal allergens. This will also aid in cough suppression.
Organic Elderberry
Raw, Local Honey

Then you will boil a third of a cup of dried elderberries with three cups of water. Add a few shakes of cinnamon and clove and a tablespoon or so of fresh ginger and boil until the liquid decreases by half and looks more like a syrup. Wait for it to cool and then use a fine sieve to strain in a jar. Cool completely and add a cup of honey. TADA! You did it. Your very own elderberry to build that immunity in the whole family.

According to Dr. Google, the recommended dosage is a teaspoon for children and a tablespoon for adults daily during the week. Take the weekend off.
**Remember a child under 12 months of age should not consume honey.**

15 Facts about the Foreskin and Circumcision

Circumcision

Circumcision, the surgical removal of the foreskin from the penis, is most commonly performed on newborns.  With a global circumcision rate of approximately 30%, the United States in the only country in the world that circumcises infant for non-religious reasons.

FACTS ABOUT CIRCUMCISION

  1. Originally, the goal of circumcision was to desensitize the penis to curb masturbation. Dr. Kellogg, inventor of the corn flakes, was a major promoter of the procedure.
  2. The foreskin, containing 20,000 nerve endings as opposed to the 8,000 in a clitoris, is a highly sensitive, functioning part of the male anatomy.  It’s purpose is to protect the glans, or the head of the penis from abrasions and to keep dirt and bacteria from the urinary tract.
  3.  The average adult foreskin consists of 1½ inches of outer skin, 1½ inches of inner mucosal lining – totaling a length of 3 inches – and is 5 inches in circumference when erect. This amounts to a surface area of 15 square inches, or a surface area equivalent to that of a 3″ by 5″ inch index card.
  4. Circumcision is not routinely practiced in most countries.  In fact, The United States is the ONLY country where circumcision is done routinely for non-religious reasons. Aside from being a Muslim and Jewish cultural practice, it is a very American practice.
  5. After reviewing 40 years of research, it has been determined by the American Academy of Pediatrics that routine infant circumcision cannot be recommended.  In fact, no professional medical association in the world recommends routine infant circumcision, nor do they state it is medically necessary.
  6. When the foreskin is removed, the head of the penis can develop a thick layer of skin to protect it, making it much less sensitive.  As a result, circumcised men are 3 times more likely to have issues with erectile dysfunction.
  7. Circumcision can reduce a baby’s risk of getting an urinary tract infection (UTI) by 1%.  In other words, in order to prevent 1 UTI, 100 circumcisions would need to be performed.
  8. It has been claimed that circumcision can reduce one’s risk of contracting HIV/AIDS. The United States has one of the highest incidence of HIV/AIDS, yet we are the only country that routinely circumcises male babies.
  9. A foreskin doesn’t separate from the head of the penis until adolescence, sometime between 3 and 15 years of age.  Until this separation occurs, you only need to clean the outside of the penis.  You clean it just as you would any other part of your body.  In fact, a newly circumcised penis, which has an open wound, may be more difficult to clean and care for during diapering.
  10. 117 babies die each year as a result of circumcision complications. The foreskin and penis is a highly vascularized area that contains a significant amount of blood flow. A newborn only has a total of  11.5 ounces of blood.  That’s just shy of a cup-and-a-half.  A newborn only needs to lose 1 ounce to hemorrhage, and 2.3 ounces, which is a the amount in a shot glass, to bleed to death.  You can read more about it here from DrMomma.org.
  11. According to the CDC, circumcision rates have fallen to 55.4% in the United States.
  12. A Mohel, a person specially trained  in circumcision techniques, can perform the circumcision, even on non-Jews.  It has been argued the Mohels perform the procedure more quickly and gently than in clinical settings.
  13. Cortisol levels, a stress hormone, are 3-4 times higher during circumcision than prior to the procedure, which can contribute to post-op breastfeeding challenges.  It is also thought that the pain and trauma from undergoing circumcision may impact the child’s response to pain or stress throughout their life.  Canadian investigators report that during vaccinations at age 4-6 months, circumcised boys had an increased behavioral pain response and cried for significantly longer periods than did intact boys. For more information about this click here.
  14. Foreskins are harvested to make high-end face creams and are often used for cosmetic testing to determine a product’s safety.
  15. Anti-circumcision activists are referred to as intactivists.
If you’re in Maryland and researching topics related to pregnancy, birth, and newborn care, please visit our class descriptions page. We’d be honored to help you prepare for an amazing birth and entry into parenthood.

Yoga Poses for the Pregnant Mother

yoga poses for the pregnant mother

Written by: Stephanie Misanik

Yoga is one of my FAVORITE things to talk about with expecting mommas.  Whether you are an experienced yogi or brand new to the mat, prenatal yoga can be a fantastic tool to help ease moodiness, shortness of breath and swollen ankles often experienced during pregnancy.  It provides you with a sacred space to really bond and connect with your baby AND helps prepare your body for the upcoming mystery of labor.  In addition, hitting your mat in a room full of other expecting mommas really creates an energy that I have never experienced anywhere else.  There is something super powerful about expecting mothers coming together and taking time to connect with themselves, their babies and other moms.  If you are feeling all alone in your pregnancy, like nobody gets it…get to a prenatal yoga class!  It’s a safe space to share your experience (the good, the bad and the ugly) with other moms who really truly understand what it is you’re going through.  It’s a fantastic way to create community and feel supported during this beautiful time of life.

If the thought of doing any physical exercise whatsoever seems incredibly overwhelming to you, think of it like this.  Labor is one of the most physically and emotionally intense experiences you will ever endure in this lifetime.  You wouldn’t run a marathon without some physical preparation, and labor is no different.  The asanas (physical poses) of yoga help you to build your strength and stamina while improving circulation.  The meditation during savasana can help you relax and bring your awareness within.  The pranayama (breathing exercises) will be an indispensable tool that you can use to breathe through your contractions when the big day comes.

Safety is key when it comes to exploring the world of prenatal yoga.  If you have never practiced yoga before, it’s important that you only practice prenatal yoga when pregnant.  Now is not the time to check out hot yoga for the first time.  If you already had a strong yoga practice before pregnancy, you may be able to continue that practice (with modifications) during your pregnancy.  Whether you are experienced or brand new, I recommend sticking to a gentle non-heated flow during your first trimester as the fetus is still implanting and the risk of miscarriage is highest.

As you hit your mat, keep in mind that when pregnant, your body produces a bunch of the hormone relaxin, which softens the connective tissue.  This is super important because it allows the joints in your pelvis to become more flexible as your uterus expands, making room for your growing baby.  Unfortunately, it also can lead to instability in the sacroiliac (SI) joints and can cause lower back pain, so be careful not to overstretch during your practice.

When it comes to knowing which poses are safe and which should be avoided, there are some general guidelines, but mostly I suggest listening to your body.  If something feels good, keep doing it…and if something feels bad, stop.  Here are some helpful guidelines to get you started:

Safe Poses:

Standing poses such as Utthita Trikonasana (Triangle), Utthita Parsvakonasana (Extended Side Angle) and Virabhadrasana 1-3 (Warrior 1-3) are safe and a great way to ground you to the earth and build strength throughout your pregnancy.

Balancing poses such as Vrkasana (Tree) and Garudasana (Eagle) are okay too.  I recommend doing them near a wall or chair if you are feeling unstable.

Hip openers such as Baddha Konasana (Bound Angle Pose), Upavistha Konasana (Wide-Angle Seated Forward Bend), Agnistambhasana (Ankle-to-Knee Pose), Eka Pada Kapotasana (1/2 Pigeon Pose), Balasana (Wide-Knee Child’s Pose) and Malasana (Deep Squat) are great because of the focus on flexibility that will be needed later on for delivery, just don’t overdo it because the hormone relaxin is softening all the joints and they are easily dislocated with excessive stretching.  These hip openers are especially helpful in the third trimester because they relieve lower back pain and create space around the pelvis.  They are great poses to use during labor as well to release the lumber spine and open the hip joints.

Stretches on the back such as Supta Baddha Konasana (Recline Bound Angle Pose) and Supta Padagusthasana (Reclining Big Toe Pose – with a strap) are great during the first trimester.  After 20 weeks, I suggest placing a blanket or bolster under your upper back to elevate your upper body past 20 degrees

Poses to Avoid:

Avoid intense abdominal work like Paripurna Navasana (Boat Pose) because the uterus is super delicate right now.  As you progress in your pregnancy, doing super intense abdominal work runs the risk of tearing and separating your abdominal muslces.

Avoid deep twists like Parivrtta Trikonasana (Revolved Triangle), Parivrtta Parsvakonasana (Revolved Side Angle) as they tend to exert too much pressure on the abdominal cavity.

Avoid inversions except Adho Mukha Svanasana (Downward-Facing Dog) for short amounts of time.

Safe Backbends During Pregnancy:

I am often asked if backbends are okay during pregnancy, and my answer is YES, with modifications.  It is super important to listen to your body, so if your body is telling you that something doesn’t feel good listen to it!  Here are some safe backbends to take during pregnancy, if it feels good to you:

Supported Matsyasana (Supported Fish Pose)

Sphinx Pose on two blocks and a bolster underneath your thighs.  During pregnancy, the femurs shift forward in the hip sockets.  Placing a bolster underneath your thighs helps to lift the femurs toward the hamstrings, centering the thighbone in the hip socket.  The blocks give extra height to create space for you baby bump.

Urdhva Mukha Svanasana (Upward-Facing Dog) with a bolster under your thighs

Purvottanasana (Upward Plank)

Ustrasana (Camel Pose) with blocks on the outside of your legs

In addition to the asanas, breath work is a fantastic yogic tool to calm the mind and prepare you for the big day.  The two most beneficial kinds of pranayama (breathing exercises) during pregnancy are Ujjayi (long, strong deep breaths in and out, through your nose with a slight constriction in the back of your throat) and Nadi Shodhana (alternate nostril breathing).  It’s important to stick to these two and avoid any kind of breath retention or hyperventilation because it could limit the baby’s oxygen supply.

In the end, remember that you are a powerful woman.  Trust your intuition.  If something doesn’t feel good, don’t ignore that feeling.  Listen to your body, do what makes you feel good.  Prenatal yoga is a great opportunity to bond with your baby, to meet other moms and to prepare your body for the birthing process.  I hope to see you in class!

Plants for Life,

Stephanie Misanik, INHC, RYT-200

Pin It on Pinterest