ML Interest Tag: bladder

Answering the 5 Most Common Questions about C-Sections

By Dr. Alan Lindemann

In the United States, approximately one-third of all babies are delivered by cesarean section. Many pregnant women have questions about C-section safety and frequency and wonder if they will need to undergo the procedure themselves. Here are some of the most common questions and concerns expectant mothers have about C-sections.

1. What is the rate of C-section births in the United States?
The Centers for Disease Control and Prevention report that more than 31% of U.S. deliveries were by C-section in 2018. Alabama, Louisiana, and Florida have the highest C-section rates, while Idaho, Utah, and Nevada have the lowest. C-sections are the most common surgery in the United States.

Few people are aware of this—and many of these C-sections are unnecessary. In fact, the number can be safely reduced to less than 15%, and for those women with low-risk pregnancies, reduced to 11%. When I joined my first practice after residency, the C-section rate in that group was 15%, which I regarded as too high. My C-section rate in my residency had been 10.9%. Working with the clinic staff, we safely reduced the C-section rate to 10% by offering women vaginal birth after cesarean section (VBAC), delivering breech babies vaginally, and using appropriate labor management treatment for dysfunctional labor and fetal distress.

2. Why is the C-section rate so high in the United States?
The rate is high for many reasons, a number of them unfortunate. For example, the use of fetal monitoring during labor and delivery has increased the C-section rate. The intent of the monitoring is to increase the baby’s Apgar score during labor and delivery, but it doesn’t. It just increases the C-section rate. A baby’s heart rate may decelerate after a contraction, and this is considered a sign of distress. This triggers the notion that a C-section is needed because the baby is in distress. The problem is that there is no way to know why the baby is in distress, and hence whether the baby needs to be delivered immediately. Fetal scalp blood samples can be taken, but this delays the C-section if needed.

There is no doubt some C-sections are done to save time. If you know what you’re doing, C-sections take 20-to-30 minutes. Inductions can take hours, as can natural labor. Add to that the fact that insurance companies pay about twice as much for a C-section as for an induced or natural delivery, and it’s easy to see why the procedure is so popular.

3. What are the risks involved with having a C-section?
With a C-section, the two highest risks are infection of the tube that connects the kidney to the bladder, and hemorrhage. Infection occurs in 6 – 11% of C-sections. Bladder or ureter injury is also a high risk with this procedure. These injuries can often be repaired by the surgeon doing the C-section, but the long-term effects of failure to recognize this condition are bothersome.

4. What questions should I ask the obstetrician or surgeon doing my C-section?
The time to ask questions is before the need to have a C-section, during a prenatal visit. Your physician should be able to tell you their C-section rate as well as whether or not they have performed any C-hysterectomies. It’s also important to ask what the hospital’s C-section rate is. Hospitals vary widely in the number of C-sections performed. If you really want to avoid the chance of a C-section for “failure to progress,” choose a physician who regularly delivers babies vaginally, choose to avoid inductions, and check your hospital’s C-section rate.

5. If I’ve had a C-section for a previous birth, will I still be able to have a vaginal birth with a later pregnancy?
In most cases, you may have a vaginal birth after C-section (VBAC) as long as your C-section incision is left to right rather than up and down. When I joined my first practice after residency, I began doing VBACs after one previous C-section. I then offered VBACs after two C-sections, even three C-sections. A nurse practitioner came to see me with four previous C-sections. She knew and understood her options, and wanted to try a VBAC. Her labor and delivery went fine. She delivered her fifth child vaginally with no problems. The patients simply need to be monitored carefully. Checking for uterine rupture is to be expected. In all the VBACs I have done, including with women who’d had multiple C-sections, I have never had a uterine rupture.

Be sure to take these questions and any others you may have to your own obstetric care provider before giving birth with them. It’s important to ensure that you and your doctor are aligned on your goals and wishes for delivery, and it is very wise to advocate for yourself and your baby before delivery.

Dr. Alan Lindemann
Tinybeans Voices Contributor

An obstetrician and maternal mortality expert, “Rural Doc” Alan Lindemann, M.D. teaches women and families how to create the outcomes they want for their own health and pregnancy. In nearly 40 years of practice, he has delivered around 6,000 babies and achieved a maternal mortality rate of zero! Visit LindemannMD.com

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The Bare Necessities of Potty Training during Quarantine

By Karlee Vincent

Last month, my younger daughter tried to start a nudist colony inside our four-bedroom, two-bath home. It wasn’t a cult. She’s two. We were potty training. As soon as I had her ditch her diapers, she refused to wear clothing. Her older sister also began streaking through the house. But that wasn’t all. 

The morning it started, I removed my younger daughter’s diaper and told her we were out of them. At first, she was excited and that gave me hope. I didn’t know that meant she had a plan. My husband is an essential worker and I work from home. In the middle of wrangling statistics for a PowerPoint presentation, I heard my daughter call: “Mama, I’m done!” I hurried down the hallway to the bathroom where she stood proudly in front of the wall she had painted with poop. At least it was hers, and not the dog’s. 

It’s possible that all of this gives me a certain edge of expertise I can now offer to other parents who decide to potty train during quarantine.

1. Toddlers in potty training will shred your precious supply of toilet paper—or toss entire rolls in the toilet, fish the roll out, and leave it sopping on the counter. Try locking away spares somewhere.

2. If you have a pet, you will soon realize the location of their poop is more predictable.

3. When your eldest daughter yells, “Something stinks!” Put your laptop aside and lock your eyes to your feet, watching where you step at all times.

4. Clean up pee stain might be on your top action item for the day.

5. Your child may fall forward while wiping themselves during your most important meeting of the day. 

6. You cannot control your child’s bladder during your conference calls. Pee will come.

7. Hover over the mute button. A naked two-year-old might run into your home office yelling, “Where is my underwears?” 

8. You may walk outside and discover your 5-year-old teaching her two-year-old sister how to pee like the family dog. 

9. Listen for the distant splash of water after your child uses the toilet. They may be doing tricep dips into their pee water.

If you’re stuck trying to potty train your little ones during quarantine, don’t give in to a diaper or the nudist’s colony. Capture your kid’s poopy antics. You’ll laugh about it later. I promise.

 

Karlee Vincent is the mother of two beautiful, spirited little ladies and the wife of one awesome Canadian. During her journey back into the workforce, Karlee has had to traverse the international frontier while nursing, pumping and generally just trying to figure out what it means to be a parent. 

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At What Age Can I Potty Train My Child?

By Andrea Olson

New parents in the world are constantly wondering: When can I begin potty training? (Some don’t even realize that, with the right information, they can even begin potty training their baby).

Believe it or not, there are options for the first year of life (yes! you heard me right!), as well as the 11-18 month range, and 18 months and beyond.

So which potty training age is truly most beneficial to your child’s health?

There is a lot of crap out there on the internet about potty training, pun absolutely intended. It can boggle the mind. And there are a lot of marketing-fueled lies circulating (with the primary aim of selling more diapers). So. Because the current society is so convinced of certain mistruths, we need to push those aside right now. Before we dive into which potty training method works best for each age range (super-detailed info below), let’s first get something crystal- clear: Early potty training will NOT damage your child in any way.

There is no scientific study that actually proves that early potty training will harm your child (contrary to Dr. Hodges’ marketing influence, which is based on a study that doesn’t say early potty training will damage them, but that incomplete emptying of the bladder will).

And late potty training (starting at 2 years old and up) CAN potentially damage your child, in many ways. (This article compares and cites all the science that proves this, inarguably.)

The point:

• If your child is already over 18 months old, get educated and begin potty training this week.

• If your child is less than 18 months old, it can only benefit your child to begin today, in some way, big or small.

The science supports it. Again, I will break the ages down further, below, so keep on reading. And the most healthy time to begin? Early, early, early. As early as birth. (As early as wherever YOU are when you read this post.)

Establishing healthy potty use and attitudes from an early age is beneficial to your child, on so many levels. Parents: You get to choose, from birth, whether to train your baby into using the diaper as a full-time toilet, or using the toilet as a full-time toilet.

Full permission granted to choose what works for you (and a little bit of research might be necessary so you can feel confident executing this decision!).

Okay, now that this myth is completely disproven, we can confidently move in to answer the question: “At what age can I potty train my child?”

The top method for starting potty training at 0-12 months

The method you would use for starting potty learning with babies 0-12 months is called “elimination communication.” It is a way of tending to your child’s natural instincts for cleanliness by learning and responding to the signals, rhythms, and preferences of your baby.

It is not hard to do, and you can do it part-time! And the earlier you start, the sooner you integrate this into your life and it becomes your “normal”…no potty training usually necessary. Learn more about elimination communication (EC) on my EC 101 page here.

The best method for starting potty training at 11-16 months

To start potty training with 11-16 month (likely walking) babies, which is actually considered by Montessori school of thought to be the “sensitive period” (the best time!) to begin toilet learning, you would use either pure EC or a hybrid of EC/potty training.

This is a time period where you can both begin and wrap up toilet learning all within one developmental stage! Learn more about why starting at 12-18 months is great with this post and video here.

The top method for starting potty training at 15-20 months

To start toilet training a 15-20 month toddler, you’ve already mostly passed the EC window (although you can give it a whirl if you’ve got a super laid-back, not-yet-walking baby!)…and you’re now sitting at what’s called early start potty training. But, don’t you dare feel bad! You will now spend less time potty training/doing EC and more time teaching the final pieces of independence. Like ripping off a Band-aid, potty training at 18-24 months is a much more rapid process than EC (and it should be! Toddlers crave mastery at this stage, and being lax or hands-off about toilet training at any toddler age is a disservice to your wonderful toddler!!). Learn about early potty training on my Potty Training 101 page here.

The best method for starting potty training at 20 months and up

For this, you’d also do the same as the previous age range, but it’s not going to be called early potty training…just your regular ole run-of-the-mill potty training (but pls don’t use a boot camp or gradual plan!). Again, do not feel badly! The earlier you begin, the sooner you’ll be done, and you do not have to wait for readiness signs or fear that you’ll harm your child by doing the training too early. That is all BS funded by the diaper companies.

Some quick reassuring facts (for those of you who are skimming)

Which is the best time to potty train your child? Whatever age your child currently is. That is the best time to start the learning…now!

What is the current average age of potty training completion in the US? 36-38 months average.

What is the current age of toileting independence in the rest of the world? 12 months average.

What was the toilet training age in 1957 in the US? 92% of children were toilet trained by 18 months of age.

What would happen if we reduced the toilet training age by 1 year (from 3 to 2 years old)? The diaper companies would lose approximately $8 billion/year in revenues.

Remember: You can begin potty training at any age, starting as early as birth. It just looks a little different at each stage. And, no shame mama/daddy! You are where you are right now, given what you’ve learned so far. Now you know some more stuff about what age is best to begin potty training, get started today. We’re rooting for you!

 

Andrea Olson is an author and expert in potty training by Elimination Communication (EC). She's worked with thousands of parents worldwide to make the practice of pottying their babies efficient and enjoyable! She holds a Masters Degree in Psychology and lives in Asheville with her husband and 5 children (all EC'd from birth).

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A Preschooler’s Guide to Managing Your Personal Assistant

By Shannon Curtin

My day begins as usual: I am awoken by compliments and gentle caresses from my parental authority, Mom, or as her ilk is called in my community, my personal assistant. She informs me of the weather report and presents me with a curated outfit perfect for the day’s events, my personal taste, and the aforementioned weather. Unfortunately, she has selected the blue shirt and today I’ve decided blue doesn’t match my aura this morning so I insist upon the yellow. She fetches the yellow shirt and sighs, “Whatever, just get dressed.”

I contemplate her sass whilst picking out my socks, slowly and deliberately. She’s not the perkiest assistant, but I’ve had her for almost five years now and I’ve grown accustomed to her presence. She returns a few times to remind me of our schedule, muttering something about “being late again” and “on notice at work.” Sock selection is an important process and it takes however long it takes; I wish she would remember this.

Half an hour later, my assistant chauffeurs me to my destination whilst huffing something that sounds like “ducking finally” under her breath. In order to lighten her mood, I pepper her with philosophical questions like “What does ‘tomorrow’ mean?” and “What does a five and a three make?” Most PA’s find this exercise enjoyable, just be sure to never accept “I don’t know” for an answer. It’s important to keep challenging their brains.

We arrive at our destination and I spend the next 9 hours listening to briefings about letters and numbers and navigating office politics. My coworkers and I have a working lunch. There are carrots on the menu today and we discuss at length what superpower they provide. Kyle says they make you see underwater. Jaden says they make you see at night. I like Kyle’s idea better; I’ll share that with my assistant later. She always laughs when I tell her about our progress at work. I don’t completely understand her sense of humor, but I’m glad she enjoys the fruits of our labor.

My assistant comes to drive me home just as I’ve started working with the Magna-Tiles. I wait all day for my turn on this equipment and now she’s rushing me to leave. I cross my arms and glare at her, but decide not to share the reason for my sour mood. I take slow, tiny steps to the car in protest. She questions me about my motives, but I stay strong and silent in the face of her exasperation. She knows what she did. She needs to learn. It’s important for PA’s to figure things out for themselves. She makes an empty threat about “losing screen time.” She’s bluffing. I hold strong. She threatens again. I meet her gaze, steely-eyed. She leans down to me and hisses something about no screen time for the rest of the week. I notice a few of my colleagues exiting the building. I’ve got to get control of my assistant before her outburst ruins my reputation, so I make a quick decision to run to the car. She can’t embarrass me if she can’t catch me.

Clearly shaken, she secures me into my seat, rambling about safety and parking lots. She is tiresome when she is panicky. Remember: regularly increasing your PA’s heart rate keeps them healthy. We start our trip home in silence and then she asks me about my workday. I can’t remember anything. As if you had a clearance high enough to know what I do all day, wee lamb. I do tell her about the carrot incident, though, and she laughs like I expected. Such an uncomplicated creature.

We arrive home and my assistant turns on the television for me. (Bluff called.) However, she does not start the show from the beginning. This is unacceptable. I have been slaving away all day and I just want a few thirty-minute blocks of talking monster trucks and do-gooding dogs to relax into my evening. Is that too much to ask? I follow my assistant around the house continually alerting her to this injustice as she attempts to do a plethora of tasks that are obviously less important (her bladder does not need to be emptied as frequently as she insists, I am certain). Finally, between prepping a dinner that I’ve just decided I will no longer eat and emptying a dishwasher that she hasn’t noticed didn’t actually run, she pulls up Netflix and allows me to choose a show. During my tenure at this establishment, I’ve found success is all about persistence.

I can tell my assistant is losing her resolve. Instead of eating the dinner I raved about when she served it last week, I request various “healthy” snacks, one after another. “Healthy” is a buzzword for assistants and they tend to use it loosely. I will eat ¾ of an apple cut in wedges, half a block of cheddar cheese cut into squares, one piece of triangular peanut butter toast, ten half-moon grapes, and two pieces of deli ham rolled into cylinders. It is important to keep your assistant guessing the appropriate shapes. Never accept poorly cut toast, know your worth.

It also behooves you to keep a keen eye on your assistant’s emotional state. I notice my assistant has refilled her chardonnay twice during “dinner,” which is my cue to sit quietly and see how many extra episodes of Peppa Pig I can sneak past her before she looks up from her phone. I succeed in scoring one episode. Not my best work, but we can’t always hit it out of the park.

Assistants are forever preoccupied with our sleep. They talk about it incessantly. They attempt to tie our behaviors to our level of exhaustion, falsely thinking they can control our every action if they can only crack the code on our personalized, perfectly fine-tuned amount of sleep. It is our job to keep this code a secret. It is our one true power. Resist, at least until a new sibling is born, or until you turn six. Six years is the average length of time it takes for an assistant to be completely broken in. Stay strong.

After a rather rushed bath and singular measly story, my assistant tucks me into bed. Here is where I will shine. I get out of bed three times: once because Kyle mentioned the word “zombies” today and that’s scary; once because the door isn’t shut all the way (I could shut it myself, but that is beneath me); and once because I remembered the zombies again. It is a grand performance. I cry real tears. My assistant doesn’t growl at me through gritted teeth until the third instance and I’ve managed to extend the day by half an hour. I hear my assistant head to her room with a heavy sigh. After her door is shut, I sneak out of bed and play with legos for two more hours.

I will be impossible to deal with tomorrow.

It was a successful day indeed.

This post originally appeared on McSweeny’s.

Shannon J. Curtin is the author of two collections of poetry and her work has been featured in a variety of literary magazines. She holds an MBA, competitive shooting records, and her liquor. She would probably like you. You can find her at ablogofherown.wordpress.com.

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Why Is Pregnant Shay Mitchell Wearing Diapers?

by Erica Loop

Earlier in the summer, actress Shay Mitchell revealed her baby joy. In a wild Power Rangers-packed video, Mitchell and boyfriend Matte Babel told the world they’re having a girl! Now Mitchell is telling the world something else—that she wears diapers.

We’ve all been there. The growing baby in your belly presses on your bladder all day and night. That means you need to pee 24-7. When Mitchell couldn’t take the near-constant stream of bathroom breaks, she got creative.

The mama-to-be ditched her normal undergarments, swapping them for adult diapers. In a YouTube vide, she shared her diaper secret with her friends, saying, “So you want to see something?” That’s when the actress showed off her “full-on diaper.”

Mitchell explained her choice, saying, “Okay, because it gets so annoying having to go to the bathroom all the time.” She added, “You know, I’m having to pee way too much. It’s just like, I’m over it.”

—Erica Loop

Featured photo: Shay Mitchell via YouTube

 

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Hilarious Parenting Tweets of the Week

by Red Tricycle

From the soccer carpool to the never-ending assortment of mismatched socks, sometimes there are days when you’ve only got a few seconds (or 140 characters) to get in a good giggle. Well, sit back and get ready to scroll because we’ve scoured the Twitterverse for moms and dads that rap about the highs and lows of parenting, and the results are hilarious.

1. Ugh, the worst.

2. Win!

3. LOL, Nice try.

4. Does this ever happen to you?

5. Ugh.

6. Ha! True for you?

7. Siblings.

8. Yep. BRB.

https://twitter.com/MommaUnfiltered/status/750335571646615552

9. Ha! Got ’em.

10. NO!

Do you have any #funnyparenting moments to share with the Red Tricycle Community? Tell us in the comments below! 

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