What is Group Bata Strep (GBS)

All women in the US are offered GBS testing at 36 weeks. The following information may be useful in making informed decisions regarding your Group B Beta Strep (GBS) Screening and Treatment option.



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Your Body…Your Baby.

Education is key.

What is Group B Beta Strep (GBS)?

GBS is a normal bacteria that can be present in the digestive tract of 15-30% of healthy adults.  People who carry the bacteria generally do so temporarily.  If GBS is present in the lower intestines during labor and birth, it may migrate to the vagina and a small percentage of newborns may What pick up the bacteria from the vagina during their birth and can become ill.  GBS infection is a very serious newborn condition, with a mortality rate of 5-20%.  Babies who develop a GBS infection and survive may have long-term neurological problems, such as hearing loss, vision loss or learning disabilities.  



Rates of newborns with GBS infection

In the general population (both positive and negative mothers)   .2-.3 in 100

In mothers who test positive of GBS    .5-1 in 100


Risk factors for infection

It is not clearly understood why some babies become sick from GBS exposure while others are unaffected, however the following factors are known to increase the likelihood of infection:

Babies born before 37 weeks gestation

Prior pregnancy with a baby infected by GBS

Bladder infection caused by GBS at anytime in current pregnancy

Rupture of membranes greater than 18 hours before delivery

Sign of infection in mother during labor (i.e. fever)


Testing and treatment options

Because GBS colonization can come and go in a persons system often, it is recommended that women be tested for GBS every pregnancy between 35-37 weeks (estimated to miss only 3% of women who will be positive during labor).  

The test consists of a culture swab of the vagina and rectum. 

If the culture is positive 

The Center for Disease Control (CDC) recommends antibiotic treatment intravenously (IV) in labor with penicillin (or an alternative antibiotic if you have an allergy) to prevent GBS infection in the newborn (by approximately 86%).  

You also have the option of antibiotic treatment only in the presence of one of the previously stated risk factors (50-68% of newborn infections prevented). 

In mothers who have one dose of antibiotics in labor for treatment  of a positive GBS culture, approximately  1 in 4,000 babies may acquire GBS infection.

In mothers who have 2 or more doses of antibiotics in labor that number is reduced 1 in 20,000.

Risk of antibiotic Treatment:

~  Risks of treatment include allergic or anaphylactic response to antibiotics.  

~  Approximately 1 in 10 will have a minor reaction such as a skin rash to antibiotics.

~  Approximately 1 in 10,000 will have an anaphylactic response, which could include increased irritability, difficulty breathing and/or convulsion.  

~   Approximately 1 in 100,000 will have a response so severe it results in  7death.

~ Risk of discomfort and/or bruising at IV site.

~Treatment of mothers for GBS during labor may mask other infections in newborns, making appropriate diagnosis more difficult.

~Increased risk of thrush in the newborn.

~Increased risk of other bacterial infections after the IV antibiotic treatment .


Our next Blog Post will dive into some alternative treatments and preventative options for positive GBS in labor!


Vitamin K for Newborns

There are so many decisions to be made for your newborn baby…….and it’s important to start researching and educating your self before your birth! What ever you decide should be listed in your birth plan.

The medical model of care is for every newborn baby to have a Vitamin K injection within 24 hours after birth to prevent Vitamin K deficiency bleeding (VKDB).

The following information is intended to help educate and inform you of your choices.


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What is VKDB?

Vitamin K Deficiency Bleeding is a non-inherited disorder that can occur in babies during the first 6 months of life. There are three different types of VKDB.

  • Early onset VKDB present with bruising or spontaneous bleeding within the first 24 hours of life.

  • Classic onset VKDB is the most commonly seen and occurs within the first week of life.

  • Late onset VKDB typically present by 6 weeks of life, but can occur in babies up to 6 months old. 

When bleeding occurs early on it may resolve on its own or may be treatable with vitamin K supplementation. Classic onset VKDB usually responds well to treatment. Late onset VKDB is the most severe and damaging type of bleeding. It is typically caused by liver disease or absorption problems. This is seen primarily in exclusively breast-fed babies.

VKDB can have devastating effects on a baby. Intracranial bleeding can occur very rapidly and can result in long term brain damage or death. Depending on the severity in which the hemorrhage occurs will effect how severely the baby is affected. 

Frequency of VKDB:

VKDB is a life threatening disease, yet is considered rare. The incidence of bleeding is between 3: 2,000 and 1:10,000 babies. Of the babies affected by VKDB 1 out of 5 will die. 

Risk Factors of VKDB include, but are not limited to : 

Prematurity

Jaundice

Maternal use of anti-coagulant, anti-convulsant or anti-tubercular drugs

Traumatic birth

Vacuum or forceps delivery 

Inadequate nursing in the first days of life


What is Vitamin K? 

Vitamin K is an essential factor in the production of several substances needed for blood clotting. It is a fat soluble vitamin that occurs naturally in the body, and is absorbed in the gut. Normal intestinal bacteria play an important role in the production of vitamin k. Newborn babies are born with out this bacteria and are unable to start the production of vitamin k the first few weeks of life. 

There are many natural sources of vitamin k including alfalfa, olive oil, liver, cows milk and dark leafy green vegetables. No matter how rich in Vitamin K a mothers diet is , almost all babies are still born with very low levels at birth.


How is Vitamin k given?

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Vitamin K can be given as a single injection into the muscle at the top of the baby’s leg.

The injectable Vitamin K is shown to be the most effective prevention against late onset bleeding.

Side Effects of Vitamin K injection:

Pain and redness at the injection site

Rash

Mild bruising 

Local infection

Jaundice- as the liver is working harder to process a foreign substance

All medications carry the risk of a allergic reaction, anaphylactic shock and death

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Vitamin K can also be given in a liquid form that is given orally. The baby must receive a 2g dose ( 4 drops) of Bio-K-Mulsion after birth, followed by a 1 gram dose ( 2 drops) every week for 12 weeks. 

International studies have shown the oral supplement to be very effective, but it must be given carefully to insure that the whole dose is swallowed by the baby, and that follow up dose are given on time. Failure to do so may put your baby at risk of VKBD.

**Bio-K-Mulsion is a high quality vitamin supplement that is used regularly in the midwifery community but it has not been approved by the FDA for use in newborns. 


The most important aspect in making the decision about vitamin K supplementation is understanding all of the information before the baby is born. This is the time to spend researching and educating your self. This is one of the first decisions you will make as new parents and it will reinforce what responsibilities are placed on you in this roll.

All parents, and especially those who chose to make the informed choice to decline vitamin K therapy, should learn and know the early signs of VKDB. This is essential in obtaining early treatment to reduce the severity if bleeding should occur. 

-Spontaneous bruising

-Bleeding from the eyes, ears, nose, mouth, umbilicus or digestive tract 

-Prolonged jaundice

-Pale stools or dark urine 


**Because the majority of babies have received Vitamin K therapy at birth, most pediatricians tend to assume that all babies have been treated. It is essential that you tell you pediatrician or any provider that is treating your baby that your child has not received vitamin K, especially if you are concerned about any of the above warning signs. 

Please talk with your Midwife or Doctor if you have any questions. Feel free to reach out to Napa Valley Midwives as well, we’re happy to answer any questions for you.

Easing Morning Sickness

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I have a dear friend and Midwife who is 8 weeks pregnant right now. We check in every couple of days and the first thing we talk about is this constant state of nausea that so many pregnant women are dealing with. Until you have felt this queasy, hungry, not-hungry state of rocking sea sickness that really never leaves you…. at least not for the first 15 weeks or so, you just don’t understand! It can be hard to conquer even the simplest tasks. But, hang in there mama! All of these feelings are good signs of a healthy pregnancy. Try a few of these tips below.

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Morning sickness ( but don’t be fooled….this is an all day - all night sensation) , nausea, or vomiting can be caused by one or many of the following factors:
 Hunger, low blood sugar, strong smells, hormonal surges and imbalances, pregnancy related changes in digestion, & vitamin deficiencies. 
There are MANY remedies for this common early pregnancy discomfort. You may only need to try one or you may need to try them all. If at any point, you are unable to hold down any fluids or foods for a full day call your midwife or doctor to be evaluated for dehydration. 
Diet- Try eating many small meals and snacks frequently throughout the day and keep crackers by bedside to eat before rising in the mornings to maintain blood sugar and reduce stomach acid.
 Make sure your protein intake is adequate. A high protein and complex carbohydrate diet helps stabilize blood sugar longer then simple carbohydrates alone. 
Dehydration can aggravate nausea, even when the thought of drinking sounds horrible. Take small sips and add a little honey or lemon to your water to help get it down.
 Supplement support- 20-40 mg of B-complex 2x daily
. Herbal Remedies- Ginger tea with honey is proven to help relive nausea. Steep 1 tea. of ginger root in one cup boiling water. You can also take ginger capsules, 2 caps every few hours. Not to exceed 10 caps or two cups of tea. (Ginger should not be used if there is a history of miscarriage)
 Dandelion Root supports the liver in filtering all the extra hormones of pregnancy. 
Chamomile tea relaxes the stomach, reduces acid in the stomach, supports the liver and improves the appetite. It also relieves anxiety and tension.
 Herbs in the mint family relive digestive upset: peppermint, spearmint, catnip, and lemon balm.
 Wild Yam reduces vomiting and nausea by relieving spasms in the stomach. 30 drops of tincture 4 to 6 x daily .
Homeopathic Remedies- Ipecac 30x or Nux vomica 6x
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Fresh air, sunshine and short walks outside can also ease queasiness and sooth the soul. Be sweet and patient with yourself. You are doing such big work right now!



One Little Bite at a Time

One Little Bite at a Time



Meet Kristina Parks!

Hello Napa families! My name is Kristina Parks LM, CPM and I am here to introduce myself as the newest member of the Napa Valley Midwives’ team. It feels very special to be back here in Napa providing midwifery and doula care to families. I grew up in Napa and just recently moved back after living in Portland, Oregon for almost 5 years.

My path to midwifery has been full of twists and turns, yet an undeniable call has lived in my heart through the whole journey. My upbringing had its challenges, which quickly informed me of my passion in connection, healing, and compassion. As a child of addicts, I assumed a caretaker role in my family which easily became second nature for me. Aside from that, looking back I now know that even as a child my connection with babies, pregnancy, and plants was apparent in who I am in my essence.

My ongoing list of “what I want to be when I grow up” included: teacher, nurse, doctor, race car driver, and artist. Funny enough, being a midwife includes bits and pieces of those ideas combined into one! I attended New Technology High School in Napa which is a small school providing a “project-based learning” style. As part of the curriculum, I was required to complete a 50 hour internship my senior year of high school. After talking with the counselor about options, she offered to place me with an OB/GYN (Dr. John Kirk) at Queen of the Valley Hospital in a shadow position. My first day I arrived, the nurse told me, “oh, he just stepped into a c-section… let’s get you into scrubs!”. At 17 years old I was privileged to attend countless prenatal visits, vaginal births, cesarean sections, hysterectomies, and even a pelvic floor repair operation. The very first vaginal birth I attended was one I will never forget. The (soon to-be) grandmother grabbed on to me, crying, “I know I don’t know you, but, oh my god! That’s my grandbaby being born!”. My eyes filled with tears too… from that moment on, I was hooked on birth.

Following my internship, I decided to attend Humboldt State University with a major in Pre-Med. After a very challenging year, I decided to come home, feeling unsure of whether to continue pursuing becoming an OB/GYN. After a couple of years at the Napa Valley College, I finally landed in a Women’s History course. Midway through the term, our teacher presented a section on Midwifery and showed us the documentary, “The Business of Being Born”. I. Was. SHOCKED. How had I never heard of a midwife until the age of 20? I knew while watching that documentary that it was the path for me. I began to explore all of the different paths to midwifery and found myself inspired by the educational offering at Birthingway College of Midwifery in Portland, Oregon to become a Certified Professional Midwife. I began to prepare my application and manifesting my acceptance into this incredible program.

During that time period, I was also taking classes at Intuitive Way in Clairvoyant Training. Through my year taking classes there, I honed my skills at running energy, clearing space, giving healings, and providing aura, chakra, and past-life readings. I realized that as a sensitive empath in the world, I could use a myriad of tools to conserve my energy in addition to providing information and healing for others. I often silently use these tools while I attend births to clear the space, ground the room, and send a blessing to each family I serve.

I got accepted to Birthingway College in Portland, Oregon and began attending classes there in April 2014. The program provided me a very thorough education including training in plant medicine, non-violent communication, allowing me practice hands-on skills on my peers, and a 2.5 year internship. I completed most of my internship with Angela Truby CPM, LDM at Glow Midwifery, being thoroughly trained in what it takes to run a midwifery practice, attending home births, and attending all visits for clients. I also completed part of my internship at Canyon Medical Center, a birth center outside of Portland where I got to practice under several naturopathic midwives. These aspects of my training helped me come away from my education as a well-trained midwife, eager to provide care to families throughout my career!

I graduated Birthingway College May 2018, and passed NARM in June 2018. I then moved back to California July 2018 and began working with the Napa Valley Midwives in the Fall of 2018. Aside from being a full-time midwife, you can find me writing poems on my typewriter, taking film photos,, traveling to magical lands, creating ritual, giving a past-life reading, or talking to plants! I feel very excited to be a part of this team and hope to bring connection, healing, and compassion to all of the families I serve. I look forward to meeting you!

The Wisdom of Water Birth

When a laboring woman steps into the birth tub the atmosphere changes, voices quiet and the softness of her body is noticeable.

Midwives have known for decades that warm water is one of the most powerful tools we have in reducing pain and tension in child birth. And yet, in the medical model of care, we are still seeing fear and resistance to letting women soak their bodies in water during labor and birth.

Recently, I was in Indonesia meeting with an Obstetrician and his group of students at a local hospital. We were discussing the differences between maternity care in the U.S. verses Indonesia. He asked, somewhat startled, “You don’t do water birth do you?” I replied, “Of course, more than half of the births I attend are water births.” His jaw dropped a little and he said, “You let babies eat their mom’s poop!” The table erupted in laughter. It was funny, but it also reflected that the medical world is still in the dark about the safety and benefits of hydrotherapy in birth.

The majority of hospitals in California will allow a laboring Mama to get in the shower for short periods between of time while being connected to a hospital bed for electronic fetal monitoring. Rarely are you able to be in active labor in the shower, and if you are blessed to find a hospital that offers a birthing tub, it is unlikely that you will be allowed to birth in it.

Midwives are skillfully trained in the art of monitoring fetal heart tones in any position, in any room. We use water proof hand held dopplers which allows us to keep a close eye (or ear) on your baby while you are in the tub.

There are many myths revolving around the risks of water birth. The primary myth is that the baby will take a breath underwater and aspirate fluid into the lungs. Rather, a healthy baby that has been thriving during labor and born into the water will be perfectly safe and will not inhale water due to the design of their throat. The larynx has 5 times more taste buds then the tongue does, which allows it to interpret solutions as they hit the back of the throat. As the solution passes the larynx the taste buds will signal the glottis to automatically close, while at the same time swallowing anything in the mouth. This automatic response is called the Dive Reflex. All healthy active babies have one. Indeed, it is believed that infants are born with this reflex so that they can easily breastfeed and not inhale milk.

Midwives have known about the wisdom of water for a long time. By facilitating mobility and reducing stress related hormones, while at the same time increasing endorphins (which neutralize pain and encourage a trance like state during labor), midwives have have seen and experienced the following benefits of water birth:

•  Enables the mother to assume any position which is comfortable for labor and birth
•  Speeds up labor
•  Reduces blood pressure
•  Gives mother more control of body
•  Provides significant pain relief
•  Promotes relaxation
•  Conserves her energy
•  Reduces the need for drugs
•  Gives mother a private and protected space
• Causes the perineum to become more elastic and relaxed, reducing the incidence and severity of tearing and the need for an episiotomy and stitches
•  Reduces cesarean section rates and transports to the hospital for pain management
•  Encourages an easier birth for mother and a gentler welcome for baby

It is a common belief that because babies have been happily floating in warm water for the last 40 weeks or so that birthing a baby into the water ensures a smooth and gentle transition into life with gravity. These babies are less likely to be stressed by a harsh environment. They are more likely to be born into their Mama’s hands, quietly, gently, and peacefully.

Of course, there are situations that are not ideal for a water birth. Each mama and each baby are different and require individualized care to create a birth plan for you.

For more information about water birth or the benefits of laboring in water, contact Napa Valley Midwives. We are more then happy to discuss your birthing options!
Love, Bee Lauher, LM, CPM

Back Together Again

Napa Valley Midwives is so excited to welcome Bee Lauher Lm.Cpm back to California! After a three year adventure of globe trotting and baby catching with her husband and 2 daughters, Bee is back and ready to bring her international sprit and wisdom to our local Napa Valley Midwives families. Check back soon to hear more of Bee's birthing adventures and gems from indigenous labor and birthing women worldwide! 

Back together again

Napa Valley Midwives is so excited to welcome Bee Lauher Lm.Cpm back to California! After a three year adventure of globe trotting and baby catching with her husband and 2 daughters, Bee is back and ready to bring her international sprit and wisdom to our local Napa Valley Midwives families. Check back soon to hear more of Bee's birthing adventures and gems from indigenous labor and birthing women worldwide!