True Birth

The occiput posterior position otherwise known as the OP position is important to familiarize yourself with because it is the most common fetal malposition in labor. It can be associated with assisted vaginal delivery (aka operative vaginal delivery) and even cesarean delivery.

In this episode, we review the OP position, why it should and should not happen and what can be done about it.

Reach out to us at www.truebirthpodcast.com

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Dr. Yaakov Abdlehak and Kristin Mallon, CNM discuss listener mail and change their thinking on hyperemesis gravidarum. You can now see the updated show notes for episode 6 about hyperemesis in pregnancy.

True Birth is all about raw honest truths when it comes to labor, delivery, pregnancy and the postpartum period helping women have better births and better birth experiences. The whole essence of this podcast is we are telling you the way pregnancy and birth really is. We are not sugar coating it and we are not just reading from the book. We are two practicers in the trenches on the labor floor everyday telling you the truth about birth. We are going to give you the truths as we see them that are not diluted or even mitigated by what the convention of today is. We are giving the truth as the way forward and the way to start thinking about birth. We'll share stories from the labor room from the professional's perspective. We provide an all-about pregnancy and birth through the eyes of Dr. Yaakov Abdelhak, a NYC metro area Perinatologist, Maternal Fetal Medicine Doctor and his trusty side kick Certified Nurse Midwife Kristin Mallon.

We would love to hear from you and you can reach out to us on our podcast page at truebirthpodcast.com

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We're back with the second part of this information and extremely important episode about perinatal loss. We want to remind everyone that while Pregnancy and Infant Loss Remembrance Day is October 15, any day is a good time to reach out and show support to your friends and family who have experienced this type of profound loss. Our perinatal loss support information can be found here

The March of Dimes is one of the most well-known and well-established organizations focusing on pregnancy health. March of Dimes has a lot of information on the causes and possible prevention of premature birth, a leading cause of infant death, and it is involved in numerous advocacy efforts to drive research into ways to prevent birth defects and infant death.

As a start, every woman who is pregnant should be aware of the risk factors for premature birth as well as the signs and symptoms of premature labor.

The International Stillbirth Alliance (ISA) is a coalition of stillbirth awareness groups and organizations that work to promote stillbirth research and awareness of stillbirth. The group offers support resources for parents as well as information about ongoing research into stillbirth. The Miscarriage Association is a UK-based support association that offers many resources to help families cope with miscarriage and to spread awareness of miscarriage. They use the general term miscarriage but include support for those who have had an ectopic pregnancy or molar pregnancy as well. The group has a network of support volunteers who can lend a listening ear

The miscarriage association also provides information to help people better understand everything from the tests done to look for a miscarriage, to information on "trying again" after your loss.

Sands stands for Stillbirth and Neonatal Death Support. This group is based in the UK, but Sands has chapters in countries around the world. The group offers support to all individuals affected by stillbirth or loss of a newborn infant, and its website includes information on local groups and advocacy opportunities.

Sands also recognizes the importance of bereavement care,2 which has, unfortunately, been addressed to a less degree than the symptoms and treatment of pregnancy loss.

The Compassionate Friends (TCF) is not exclusively focused on pregnancy loss but focuses on providing support for bereaved families who are grieving the death of a child. The group does offer information and support for pregnancy loss of any kind.

The MISS Foundation focuses on crisis support and other aid to families grieving the loss of a child. The group is not exclusively focused on pregnancy loss but is involved in a lot of activities related to miscarriage and stillbirth awareness, such as the MISSing Angels Bills that have been considered or passed in many U.S. states with the idea of granting parents the right to receive a state-issued certificate of stillbirth recognizing the loss of a baby to stillbirth.

The Center for Loss in Multiple Birth (CLIMB) offers support to parents who have lost babies in multiple pregnancies, including those who have lost all babies in the pregnancy as well as those who have lost one twin.

The site offers fact sheets aimed at dads, grandparents, siblings, and survivors as well as information about research into this type of pregnancy loss.

Helping After Neonatal Death (HAND) is a California support group for late pregnancy loss and neonatal loss. Its website features fact sheets and information about local groups in northern California. The group also offers two in-person support groups as well as phone support for grieving parents.

Even if you are not a California native, the HAND website provides support, including letters addressed to parents, friends , and family, and even health care professionals who are facing the grief which accompanies stillbirth and neonatal death.

The Ectopic Pregnancy Trust is a group sponsored by London's King College Hospital. The website has information on the causes and treatment of ectopic pregnancy, as well as support forums. The group supports research into early diagnosis of ectopic pregnancy and means of prevention.

The website (of course, easily accessible to those outside the UK) has abundant resources with information on a number of topics surrounding ectopic pregnancy. It even has information for dad's and ectopic pregnancy, recognizing the difficulties faced by those who are "so close but yet so far."

Tommy's functions as something of a UK-based March of Dimes equivalent. The group has information on how to have a healthy pregnancy and prevent any preventable stillbirths or preterm births. The group also supports research on miscarriage prevention and causes

Western New York Perinatal Loss Center https://wnypbn.org

In order to get on our email subscription list and never miss a book update, sign up at www.truebirthpodcast.com

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Perinatal loss is a profound experience for women and her family. Examples of perinatal loss include miscarriage, ectopic pregnancy, stillbirth, neonatal death, and other losses. In this episode. Dr. Abdelhak specifically examines unexplained loss which most often will happen in the second trimester at 13 weeks to 28 weeks, but in rare occasions this type of loss will happen in the third trimester as well. We tread lightly. We share our same true-birth-ism that are part of each episode and we honor and support those in our families and communities who have experiences such sorrow. These truths are keeping the conversation going, sharing new information as we think differently about this heartbreaking experience. We hope to this knowledge can bring a sliver of peace to a mourning family. Our perinatal loss support information can be found here

The March of Dimes is one of the most well-known and well-established organizations focusing on pregnancy health. March of Dimes has a lot of information on the causes and possible prevention of premature birth, a leading cause of infant death, and it is involved in numerous advocacy efforts to drive research into ways to prevent birth defects and infant death.

As a start, every woman who is pregnant should be aware of the risk factors for premature birth as well as the signs and symptoms of premature labor.

The International Stillbirth Alliance (ISA) is a coalition of stillbirth awareness groups and organizations that work to promote stillbirth research and awareness of stillbirth. The group offers support resources for parents as well as information about ongoing research into stillbirth. The Miscarriage Association is a UK-based support association that offers many resources to help families cope with miscarriage and to spread awareness of miscarriage. They use the general term miscarriage but include support for those who have had an ectopic pregnancy or molar pregnancy as well. The group has a network of support volunteers who can lend a listening ear

The miscarriage association also provides information to help people better understand everything from the tests done to look for a miscarriage, to information on "trying again" after your loss.

Sands stands for Stillbirth and Neonatal Death Support. This group is based in the UK, but Sands has chapters in countries around the world. The group offers support to all individuals affected by stillbirth or loss of a newborn infant, and its website includes information on local groups and advocacy opportunities.

Sands also recognizes the importance of bereavement care,2 which has, unfortunately, been addressed to a less degree than the symptoms and treatment of pregnancy loss.

The Compassionate Friends (TCF) is not exclusively focused on pregnancy loss but focuses on providing support for bereaved families who are grieving the death of a child. The group does offer information and support for pregnancy loss of any kind.

The MISS Foundation focuses on crisis support and other aid to families grieving the loss of a child. The group is not exclusively focused on pregnancy loss but is involved in a lot of activities related to miscarriage and stillbirth awareness, such as the MISSing Angels Bills that have been considered or passed in many U.S. states with the idea of granting parents the right to receive a state-issued certificate of stillbirth recognizing the loss of a baby to stillbirth.

The Center for Loss in Multiple Birth (CLIMB) offers support to parents who have lost babies in multiple pregnancies, including those who have lost all babies in the pregnancy as well as those who have lost one twin.

The site offers fact sheets aimed at dads, grandparents, siblings, and survivors as well as information about research into this type of pregnancy loss.

Helping After Neonatal Death (HAND) is a California support group for late pregnancy loss and neonatal loss. Its website features fact sheets and information about local groups in northern California. The group also offers two in-person support groups as well as phone support for grieving parents.

Even if you are not a California native, the HAND website provides support, including letters addressed to parents, friends , and family, and even health care professionals who are facing the grief which accompanies stillbirth and neonatal death.

The Ectopic Pregnancy Trust is a group sponsored by London's King College Hospital. The website has information on the causes and treatment of ectopic pregnancy, as well as support forums. The group supports research into early diagnosis of ectopic pregnancy and means of prevention.

The website (of course, easily accessible to those outside the UK) has abundant resources with information on a number of topics surrounding ectopic pregnancy. It even has information for dad's and ectopic pregnancy, recognizing the difficulties faced by those who are "so close but yet so far."

Tommy's functions as something of a UK-based March of Dimes equivalent. The group has information on how to have a healthy pregnancy and prevent any preventable stillbirths or preterm births. The group also supports research on miscarriage prevention and causes

Western New York Perinatal Loss Center https://wnypbn.org

In order to get on our email subscription list and never miss a book update, sign up at www.truebirthpodcast.com

Integrative OBSTETRICS SocialFacebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources SocialFacebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

Subscribe to the podcast on Apple Podcasts, Spotify, Google Podcasts, & Stitcher and leave a review!

NatureBACK is a philosophical approach to pregnancy as well as a tool that optimizes a woman's chance of having a vaginal delivery. It represents the cumulative knowledge of Dr. Abdelhak's career in obstetrics that has spanned several decades. A career dedicated to providing women guidance to their desired birth outcome.

NatureBACK stresses that the process that leads to natural birth needs to start early in the pregnancy. It incorporates the important criteria for selecting the right OB/GYN or midwife provider. It's a return-to-nature approach in regards to diet and activity. NatureBACK guides you to the 'Mother Nature Train' so that you optimize your chance of avoiding a C-section.

The analogy of getting on a train. It would be silly to go to Penn station jump on a random train and then start planning where you want to go. Yet that is what many do when approaching vaginal birth. They research and plan for their delivery in the third trimester. Many have no idea they have been on the cesarean section train for months with little chance of reversing course.

There's a tendency to believe, actually more than believe, to have faith in Mother Nature. To be balanced, women have been birthing vaginally for millennia and we have no reason to suspect a parturient would grow a baby that cannot physiologically pass through her birth canal. It's more than common sense, It's history. All mammals birth as humans do. There is practically no cesarean section in the animal kingdom nor was there in human history shy 100 years ago. Historically pregnancy was always associated with morbidity and occasional maternal. Historically 1-3% of women would not survive labor. A high er percent of babies would sustain permanent birth trauma. Yet, there is absolutely no historical indication that 30% of mothers and or babies would have perished or sustained long term morbidity before the advent of c-sections. Further, we do not see this in the animal kingdom. Both domesticated and wild animals birth unassisted and it is rare for mother to die in childbirth. So in light of these obvious facts, why has nature let us down? How could this time-tested, proven, physiological, fine-tuned process be blamed for contributing to today's cesarean sections epidemic?

There has been a C-section epidemic in the last 50 years. Today, cesarean sections represent over 30% of all deliveries. This is a dramatic increase from the mere 5% of babies delivered via C-section in 1970. The explanations for the multiple fold increase in cesarean delivery are familiar. Fingers often point at the bias of over-worked obstetricians, the increase of counterproductive medical interventions such as induction of labor, and the widespread use of the external fetal monitor contributing further to the anxiety of litigious weary obstetricians. Some of these usual suspects have earned their nefarious reputation while others are surprisingly completely innocent of said charge. Most surprising is the culprit, possibly making the largest contribution to the explosion in cesarean births, has managed to sleuth under the radar and is rarely, if at all, recognized. This monster in the shadows is.... babies are way too big! So large they often don't fit through their mother's pelvices.

Research confirms this explosion in baby size. Today the median size of a baby is 1 lb 5 oz larger than it was in 1920. The number of babies that are classified as extremely large (over nine pounds) has increased even more dramatically. It is possibly 10 times as prevalent as it was in 1920. True, mothers are taller and healthier than ever before and can birth larger babies than their great-grandmothers. However this sorely falls short to allow the birthed to accommodate the spectacular increase in today's birth weights. We have deviated from nature and mightily so. Our diets, our lifestyle, and our expectations have all evolved or possibly devolved. For most of us, modern society represents a sedentary lifestyle. It is synonymous with processed food and we are consuming carbohydrate consumption on a scale never seen before. Babies are bigger than ever and growing them is turning out to be much easier than delivering them. The irony is the deviation from nature should have been obvious to us yet was masked by cesarean sections. Imagine the same modern society we have today without the option of C-section delivery. The maternal and fetal mortality rate would increase so dramatically that there would be an immediate recognition of the problem. Women would be much more careful about getting exercise and eating correctly. If there was no such invention as the modern Cesarean section we would have recognized this phenomenon long ago. NatureBACK is the expression of this philosophy. A goal oriented pregnancy method that can mitigate or possibly eliminate this seed of cesarean sections. It incorporates recognizing the factors that lead to cesarean section are initiated and are progressing from the beginning of pregnancy. NatureBack advocates for carbohydrate restriction, regular exercise and the criteria for selecting the right provider. When a woman goes into labor her risk of cesarean section is set long before any medical intervention.

Dr. Abdelhak is working on a book which elaborates on all the aspects of each part of pregnancy and delivery from the NatureBACK perspective. In order to get on our email subscription list and never miss a book update, sign up at www.truebirthpodcast.com

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Dr. Abdelhak bust up some of the conventions that have been around for decades and dispels myths about what is safe and what isn't in pregnancy when it comes to food and why. This mini-episode is full of true birth-isms.

Reach out to us at www.truebirthpodcast.com

Integrative OBSTETRICS SocialFacebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources SocialFacebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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Episiotomy, which literally means surgical cutting "tomy" and epis "pubic region" is a practice that largely fell out of favor after this 2005 JAMA study. Even though this practice was railed against for years by midwives and several concerned OB/GYNs it took a while for the research to catch up with the truth that a natural tear is better than a surgical cut when childbirth is concerned. This is a perfect example of how often the research lags behind truths in medicine and the importance of the opinions of experts who are at the bedside everyday. Especially in childbirth.

With all this great knowledge about why this surgical opening to enhance the birth outlet and facilitate or expedite delivery of the fetus is inferior to a natural tear, why is it still utilized in the labor and delivery room? In this delightful episode Dr. Abdelahk will answer this questions and more like:

Why is a natural tear better than an episiotomy for birth? Why is episiotomy still performed today in labor? What type of episiotomy is best? What can a pregnant woman do to educate herself about how to avoid an episiotomy or reduce her chance of having an unnecessary episiotomy in her own birth?

We also have a great Youtube Video about this very topic. Don't miss this! We linked the video here. Dr. Abdelhak sits down and explains all about episiotomy and birth. Its a must see for any woman about to have a baby or anyone who cares for her.

We would love to hear from you and you can reach out to us on our podcast page at truebirthpodcast.com

We are putting together a follow-up episode to this one about tips and tricks to minimize tearing and we would love to hear from you, doulas, labor coaches, OB/GYNs, women, midwives and nurses about what you have seen work. We are compiling everything that works and dispelling what doesn't. We will of course divulge our own secrets and truths about what works to minimize tearing in childbirth.

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Can a woman sleep on her back in pregnancy? Is the left side really best? All of these questions answered in this mini-sode of True Birth Podcast.

Sleeping on your back is a common and perfectly safe sleeping position for most people, despite some internet myths that suggest otherwise. Let's debunk these myths and discuss why sleeping on your back can be a healthy choice for many individuals.

Benefits of Sleeping on Your Back:

1. Spinal Alignment: Sleeping on your back allows your spine to maintain a neutral alignment. This can help reduce the risk of developing back and neck pain over time.

2. Minimizes Facial Wrinkles: Sleeping on your back can minimize the formation of sleep lines and wrinkles on your face, as your skin isn't pressed against a pillow.

3. Reduced Acid Reflux: Back sleeping can help prevent acid reflux symptoms, as gravity keeps stomach acid from flowing back into the esophagus.

4. Healthy Breathing: For some individuals, back sleeping can promote better airflow, reducing the risk of breathing difficulties during sleep.

5. Reduced Pressure Points: This position evenly distributes your body weight, reducing the likelihood of pressure sores or discomfort.

However, it's essential to note that not everyone will find sleeping on their back comfortable, and individual preferences vary. Some people may naturally prefer other sleeping positions, such as side or fetal position. The key is to find a position that allows you to get restorative sleep without causing discomfort or exacerbating any underlying health conditions.

Find some true-birth-isms in this quick episode all about sleeping on your back in pregnancy.

Find us on our website at www.truebirthpodcast.com

Please connect with us, as we'd love to hear from you. Please comment on a topic you would like us to cover related to pregnancy, childbirth, fertility or the postpartum period.

We also have a YouTube Channel. Linked here Integrative OBSTETRICS SocialFacebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources SocialFacebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

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What are the best tips and strategies for preventing and treating nausea and vomiting in pregnancy?

Is it normal to feel nausea all day in the first trimester? The answer is a resounding Yes! Is there anything that can be done? That answer is also a resounding Yes! What about the second trimester? Or the third?

Nausea and vomiting are so common during pregnancy, that up to 80 percent of pregnant women reporting nausea and up to 50 percent of women in pregnancy report vomiting.

The term "morning sickness" is often wrongly ascribed to nausea and vomiting of pregnancy as women will find that it comes and goes and does not have any particular credence to the time of day. Women are nauseous in the evening and nauseas in the morning. There is often no distinction.

Nausea and vomiting may be mild, moderate or severe, but is usually separate from the disease hyperemesis gravidarum as this term is reserved for the most severe type of nausea and vomiting and typically involves a metabolic disturbance and significant weight loss (usually an excess of 5 percent of a woman's pre-pregnancy body weight)

Hyperemesis is often so severe; it almost always interferes with activities of daily living and can lead to depression and anxiety. Most woman can barely keep up with their own care, they cannot care for others and have difficulty with work performance. Before modern medicine, hyperemesis was so severe it could even lead to death in the worst cases.

What causes nausea and vomiting of pregnancy is unknown and most likely the result of multiple different factors including hormone changes, changes in the gastrointestinal tract, genetic factors, and nutritional deficiencies.

While there are several factors that cause it individually and the exact cause may be unknown, hyperemesis is usually an accumulation of more than one type of trigger. Nevertheless, even though the exact cause is hard to pin down, there are several remedies that work well. This podcast outlines a myriad of treatment tactics for nausea and vomiting and hyperemesis gravidarum.

How is hyperemesis gravidarum different from the standard nausea and vomiting a woman typically feels? What can be done? What modern treatments are available to women?

These questions and more are answered in our latest episode.

Update: June 2021. We have an update to include from a listener.

In April, Dr. Fejzo gave a seminar on HG to over 5000 mfms from 169 countries translated in 4 languages https://fetalmedicine.org/courses-n-congress/fmf-webinars/webinar-videos. The quick seminar is just 15 quick minutes followed by a discussion and a great way to get up-to-date on HG.

Further, the HER Foundation www.hyperemesis.org can help with education and support and HER and UCLA co-developed a free iphone app to help with HG management https://www.hyperemesis.org/tools/hg-care-app/

Find us on our website at www.truebirthpodcast.com

Please connect with us, as we'd love to hear from you. Please comment on a topic you would like us to cover related to pregnancy, childbirth, fertility or the postpartum period.

We also have a YouTube Channel. Linked here Integrative OBSTETRICS SocialFacebook https://www.facebook.com/IntegrativeOB Instagram @integrativeobgyn

Maternal Resources SocialFacebook: https://www.facebook.com/maternalresourceshackensack |nstagram: @maternalresources

Subscribe to the podcast on Apple Podcasts, Spotify, Google Podcasts, & Stitcher and leave a review!

True Birth is all about raw honest truths when it comes to labor, delivery, pregnancy and the postpartum period.

This episode covers what the listener can expect to get out of this informative pregnancy podcast.

The whole essence of this podcast is we are telling you the way pregnancy and birth really is. We are not sugar coating it and we are not just reading from the book. We are two practicers in the trenches on the labor floor everyday telling you the truth about birth.

Dr. Abdelhak reveals two historical figures he has found inspirational when it relates to truth.

Truth is not fungible or related to what society is doing at the time. We have certain beliefs about obstetrics that are just truths and we are sharing them with you.

We are going to give you the truths as we see them that are not diluted or even mitigated by what the convention of today is. We are giving the truth as the way forward and the way to start thinking about birth.

On major tenet ob

Our goal is to share the truth with the listener and to tell what we are thinking. We explain what we are thinking. We not trying to think for you make decision for anyone, rather we give the facts. We want you make the decisions about birth. If there is a problem surrounding pregnancy of birth, we present it, we give the options. but we are not deciding for the audience. We leave it up to them. We are here to be as straightforward and transparent as possible.

We serve the truth straight up in common English. We are not using large medical jargon. Our goal is to make medicine, obstetrics, and the information here as easily digestible as possible for the listener to enjoy, share and learn.

We would love to hear from you! Find us on our websites at www.truebirthpodcast.com We also have a YouTube Channel. Linked here

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Instagram @integrativeobgyn

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