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The Birth Experience

1/21/2016

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The Birth Experience Every Birth is Different.  The Goal is the Same. 
What to Expect in Natural Births, C-Sections, VBACs and preventing Preterm births.
By Michelle Brown-Echerd, ND and provisional doula ICTC
Natural Births:
Natural birth is a process of delivering vaginally without any interventions.  This can occur in a variety of situations, including in hospitals, at homes or in birthing centers and unfortunately, but not the end of the world, sometimes occurs in cars, while people are on the way to the hospital or stuck in traffic.
There are various types of birth workers around the world including doctors (MD/ND), midwives, nurses, doulas, perinatologists, neonatologist, lactation consultants, massage therapists and other practitioners that have special training in birth related treatment including chiropractors, counselors and Reike practitioners.
  • Naturopathic (ND) midwives are naturopathic physicians who have an additional certificate and midwifery.  In the state of Oregon, a separate licensing exam is given and licensure is granted after all requirements are met; which includes attending at least 50 births of which, the student midwife needs to have medical hands on, at; at least 40 births.
  • ND midwives can deliver in homes and birthing centers in Oregon.
  • ND midwives are eligible to take the NARM exam in Washington state and become certified Licensed midwives (other rules for naturopaths vary by state/providence).
  • ND midwives can prescribe prescription medications, botanical medicine, homeopathics, suppositories and more.
  • ND midwives can administer IV medications; including for dehydration and for positive group B strep; in which antibiotics are given every 4 hours, while in the home or birth center.
  • ND midwives can use oxygen as needed for births.
  • ND midwives can use Pitocin only after the birth; to reduce bleeding.  Other medications can be used at home as well; as needed.
  • ND midwives are certified in Neonatal resuscitation and carry equipment to each birth
  • ND midwives do not have admitting or hospital privileges but in the event for a need to transport; will call ahead to hospitals to see if they have space or find out recommendations if the hospital is on divert.   NDs often call ND friendly physicians and midwives to discuss the transport plan.  NDs will call the hospital in advance to let them know that the patient is coming and what the situation is; the chart notes; including all lab testing results will be brought to the hospital as a valuable resource for hospital staff to review.  The ND and student will meet the family at the hospital and stay for the birth and often several hours immediate post-partum and will follow up with additional post-partum care after hospital stay.
  • Other practitioners can deliver in homes, birth centers and hospitals and the criteria and regulations vary state to state and country to country. 
C -sections:
  • Cesarean sections are performed in hospitals. 
  • Many are planned in advance for “high risk” births and women may be given this route as the “only” option.
  • Dr. Barfield, African American Medical doctor/neonatologist; of the CDC states that 2013 rates in the US 32.7% and in 2009 32.9%4
  • Women are choosing elective C-sections prior to 39 weeks gestation; some convenience knowing due dates and when to take maternity leave.
  • Risks include:
  • Preterm babies
  • Retained fetal lung fluid
  • Respiratory distress
  • C-sections can be a life saver in urgent situations and extenuating circumstances.
VBACS:
  • Vaginal birth after C-section
  • These can be done by midwives at home births.  Many hospitals will tell women who have C-Sections that they cannot ever have an out of hospital birth.
  • Uterine rupture is a risk after C-Section or transmyometrial surgery.1
  • Signs and symptoms include:
  • Abnormal heart rate tracing
  • Uterine tenderness
  • Vaginal bleeding
  • Shock
  • Peritoneal irritation
  • Fetal death
  • If you are a mother or supporting a mother who is having her first vaginal births, be informed on signs of labor and be prepared for how to cope with uterine contractions.
 
Preventing preterm labor and births:
  • Premature is “Born or manifest before full development has been achieved” 5
  • < 37 weeks gestation
  • Normal is 40 weeks; not exact date known
  • </= 2500 g or 5.5 lb.
  • Crown heel </= 47 cm (crown rump </= 32 cm) diameter occipital femoral </= 11.5 cm
  • Head ratio thorax < 93%
  • Preemies in US
  • 7.1% white live born
  • 13.4% non-white live born </+ 2500 g
  • Socioeconomic status educated 16+ years of school vs. </= 9 years5
  • Prematurity a leading cause of death for neonates (<2500 g 17 x higher mortality rate)
  • Immediate Risks:5
  • Abnormal pulmonary ventilation (can be given steroids)
  • Infection
  • Intracranial hemorrhage
  • Abnormal blood conditions
  • Congenital anomalies
  • Physiologic and anatomic limitations:
  • Weak suckling/swallowing reflex
  • Small stomach
  • Renal function impairment
  • Incomplete lung capillary development
  • Immature alveoli of lungs
  • Weak cough and gag reflexes
  • Weakness of the thoracic cage muscles and other respiratory muscles
  • Inadequate regulation of the body temperature
  • See your healthcare provider regularly during pregnancy
  • If there are any concerns; do not hesitate to contact your provider, you will not be bothering them.  It is okay to get support from your doula.  The doula can give you information and encourage you to contact your provider with confidence in listening to your instincts.
  • In some “high-risk” situations; delivering pre-term may be “lifesaving” –i.e. pre-eclampsia, eclampsia, twins/multiples, infection, insufficient placenta, large for gestational age, Marfans, connective tissue disorders, severe trauma and more.
  • Intra-amniotic infection is common after premature rupture of fetal membranes. 
  • Signs and symptoms:
  • Abdominal pain
  • Maternal and fetal tachycardia
  • Uterine contractions
  • Uterine tenderness
  • fever
  • Differential diagnosis- includes acute cholecystitis which would often present with pain in the RUQ region instead of the uterine area and the membranes would likely still be intact.1
  • In hospitals, options include cervical cerclage if the cervix ripens (shortens and dilating prematurely); in which stitches are used to close the cervix.3
  • Work with a well-educated health care provider on options for VBACs, risks and prevention of uterine rupture or other complications.
 
Sources:
  1. UpToDate:  Gallstones in pregnancy.  David C Brooks, MD
  2.  Personal knowledge, Michelle Brown-Echerd, ND; from education and experience.
  3. www.mayoclinic.org/tests-procedures/cervical-cerclage/basics/definition
  4. Medscape –Reducing the C-Section Rate Aug 24, 2014.  Wanda D Barfield, MD MPH
  5. Tabors Medical
This blog post is for entertainment and educational purposes only.  It is not intended to take the place of medical care and is not intended to diagnose, treat, cure any disease or condition.  See your healthcare provider for health related issues. 

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Winter is coming!

11/28/2015

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Welcome to the holiday season.  What does this mean to you? Does the hype of the holiday cause you stress?  There can be so many pressures during the holidays, leading to winters in the northern hemisphere, shorter days, cooler weather and expectations.
The winter months are also associated with cold and flu season.   In our society, it is not always possible to stay home during the duration of an illness.  Also, there are times when contagious illnesses are more contagious prior to knowing one is ill.
Keeping up with regular activity and extra holiday obligations may lead to stress, reduced sleep and less desirable food choices.  These may make one more susceptible to becoming sick.  We are all exposed to microbes at school, work, public places and from friends and family.
Good hygiene and frequent hand washing may help reduce exposure to germs and microbes.  Staying away from sick people would be ideal.  Find out work or school policies on sick leave prior to becoming sick to help reduce the stress of decision making in times of illness.  Talking to health practitioners prior to becoming ill can help to be educated on how to make urgent or acute appointments, treatment or prevention options and information on the process of obtaining sick leave letters.
Setting boundaries can help to reduce stress during the holidays.  Using a technique that works for you can become an invaluable tool to help get through the season.  Starting with a simple piece of paper and pen can get the ball rolling quickly.  The following list can get you started on setting up boundaries that work for you, your family and your budget:
•    Finances & budget; needs vs. wants
•    Food choices and staying hydrated
•    Holiday activities
•    Holiday gifts and cards
•    Entertainment
•    Vacation time
•    Family time
•    Children’s activities
•    Self-care
•    Respite
•    Friends and fellowship time
•    Setting boundaries with family; knowing when to draw the line and set limits
•    Simple decorating ideas
•    Immune support techniques
•    R and R; rest and relaxation
•    Pet care
•    Home and yard care
•    Work and home parties
•    Heating and indoor air quality
•    Weight management
•    Physical activity
•    Charity
This blog post is for entertainment purposes only.  This is not meant to diagnose, treat, prevent or cure any ailment. For medical advice talk to your primary care practitioner.



Michelle Brown-Echerd, ND
Naturopathic Physician
Owner of Tower of Health, LLC
Phone: 971.407.3684
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Happy Independence Day AKA 4th of July 

7/4/2015

 
Greetings from Oregon USA.
It is a day to celebrate and relax; if possible.  There are so many people on social media posting pictures of themselves with family and friends doing activities such as camping, boating, river floating, going to concerts, parades, BBQs, participating in running events and just hanging out with others and enjoying each other's company. 

 You have woken up this morning with a beating heart and breathing lungs.  Allow your mess to become someone else's message and grow in this time for the better.



Services OFFERED:

7/4/2015

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Primary care medicine
Women's health
Men's health
Infants
Pediatrics

Geriatrics
Acute care; colds/viruses, injuries, skin issues/rash, stitches and more
Chronic conditions
Medications:  herbs, supplements, homeopathic, prescriptions & medical devices.
Hydrotherapy
Diet & food plans
Meal planning including vegan, vegetarian & raw foods
Home visits
Mobile medicine
House calls Portland Metro area - ask for details
Lab work
Food allergies & intolerances



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Detox

7/3/2015

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What does it mean to detox?
I have a lot of experience with removing toxins from the body via herbs, juicing, saunas, exercise, with charcoal and other modalities; including massage.

One strategy in helping overall health is removing toxic people from you and your family's life.  This is one area in which I could use help.  Do you ever feel obligated to continue to listen to abusive talk and put downs because someone is your neighbor or your relative?  What if you are a busy person, with home and business and there are a couple of people who contact you frequently, but they only want to use you for information or other things, but ignore you whenever you call or contact them?

Thoughts are a powerful thing and thoughts lead to speaking.  Thoughts and speech lead to action and we would like to have healthy thoughts, speech and actions in order to maintain the integrity of a healthy lifestyle. 

Three tips for removing toxic people from your life; that I am experimenting on myself:
1)  Take a break from these people; give yourself a timeline and journal about your thoughts and growth during this time.  Do you have a lonely neighbor you feel sorry for?  Do you feel obligated to hang out with that person even if he/she is abusive?  Do you feel guilt, say knowing a holiday is coming up and you know that neighbor will be alone?  Keep your promise of taking a break from that neighbor for a time; if you cannot stand to think of the neighbor alone, send or drop off, with being seen, a gift and card to let him or her know that you are thinking about them and that you have been working on some things that are taking up time in this period of life.  You may feel growth and be able to forgive and release some of the toxic words that were said by this person and realize that your self-confidence and self-esteem have risen and you are becoming a better person in society because of this avoidance.

2)  Do you have a friend who uses you?  Have you sensed the red flags and continued to fall for the same tricks over and over?  Have you continued to tell yourself; what goes around comes around, I'll help this person and one day she will help me.  Then the day comes and goes (multiple times) that every time you ask for a small favor she avoids you like the plague.  However when she wants something, she will blow up your phone 24/7 until you give her what you want.  Set up boundaries, write out the pros and cons of this relationship.  Are you feeling drained around this person?  Do they stop calling at midnight when you tell them not to?  Do what you need to do: block them from your phone, social media and don't feel obligated to bend over backwards for this person.  They are good at getting what they want and will probably be fine.  If you feel you can, let this person know how you feel.  If you have brought this up before and there has been no change, it may be time to call it quits or at least take a break from this person.

3)  Is there someone in your life that ignores you for the most part but when you decide to hang out with them, they become overwhelmingly clingy?  For instance, at a time you actually have a break and you've spent time with your own family, you decide it would be fun to hang out with this person and go to a movie.  Then every day they want you to go to a movie and they call you and text you when you are work and get mad after texting 12 times and getting no reply --because you are actually working-- they blow up and tell you how rude you are.  Have you set boundaries with this person and told them that your availability is scarce and you have a job and family to take care of; yet they still feel offended.  Do they keep quiet when you keep to yourself but when you hang out they contact you day and night and feel you have to be joined at the hip.  Don't allow yourself to fall into this person's trap.  If you have fun with this person then become overwhelmed and smothered, it may be time to move on if this person doesn't respect your boundaries.  Take a break.  Find a group of people to go on an adventure with, join a book club, volunteer at a local non-profit, sign up for online dating and meet some new people.  Let yourself know that everyone does not behave the way this friend does and that it can be draining and affect your health.

Now that you have started thinking about some ways to protect yourself from toxic people realize that you may start by taking a break from these people and even blocking them from phones or social media.  If you do this discretely and decide to go back to being friends with these people it is okay.  Give yourself time to heal and set up boundaries; if they cannot adhere to the boundaries make a decision of what to do, and realize that the way certain people affect your mind will lead you to treating others away that is not your style.

This blog is not meant to diagnose, treat or cure any ailment.  Please seek the care of your health practitioner and/or mental health provider for any advice or care related to your health and wellbeing. 
This blog is meant as an educational and entertaining subject; relating to health and wellbeing.

Please leave your comments below! 

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May 2015

5/12/2015

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Hello Portland, Oregon, USA and the whole wide world AKA Earth...and those of you floating around in outer space!

4/16/2015

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Today is a new day!  I am a licensed naturopathic physician and I am looking for you.  I sacrificed in order to complete my medical school education as well as the educational goals prior to medical school.  I really attended classes and did not just have my classmates sign me in.  I read my notes over and over and still do, my books, my study guides and I continue to learn new things every day, not just wait until required CEUs are taken.  I have done hundreds of extra hours of observation with doctors and I am still shadowing a naturopathic midwife while completing my requirements for naturopathic midwifery.  I have embraced healing and have transformed my own life over the past 15-20 years and have bumped up my methods of healing after being involved in an automobile accident in October of 2014, which occurred on the highway and the vehicle I was in was totaled.  


I am raising 2 children by myself and do not receive child support, food stamps and feel blessed to have the things we have.  I am working a part-time lab job in order to pay my ever rising rent and to buy food for my family including my son's companion animal, Shiro, the dwarf rabbit.


How can naturopathic medicine help you? Health, spirituality, recovery,  food intolerance, raw foods, juicing, physical medicine, homeopathy, botanical medicine, lab testing, GI kits, hormones, healing power of nature, exercise, fitness, trans health and much, much more.  Call me on my cell 503-464-6911 for a free 15 minute consult.  
To make an appointment to see me in Oregon call 503-464-6911.  10 AM - 6 PM PST


Sincerely,
Michelle Brown-Echerd, ND AKA Dr. Mia
Owner of Tower of Health, LLC
*Transmitting Health to the Community*
Owner of Trinket Health and Home, LLC
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Welcome the New Year, 2015!

1/3/2015

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End of the year transition...

12/23/2014

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This is the end of 2014, which marks the beginning of a new career.  I recently, completed the fingerprint portion of my state naturopathic board licensing application.  
I have completed a doula training course and will be working as a provisional doula; free of charge for the time being, until I complete the certificate requirements of 5 births.  Contact me at [email protected] for more information.  I will be servicing the Portland, Oregon metro area and some surrounding neighborhoods.

It is Christmas time and a time to reflect on the year which has been overwhelming in some ways and miraculous in others.
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