Wednesday, February 19, 2014

Preventing Maternal Exhaustion and Dehydration: for Moms and Birthworkers


Preventing, Detecting and Treating Maternal Exhaustion and Dehydration

Exhaustion occurs as the body’s ability to meet the stress diminishes and finally gives out.  A major cause of clinical exhaustion is the loss of potassium ions.  As cells lose potassium, their functioning is increasingly impaired until they finally start for to die.  Unless this process is rapidly reversed, vital organs will stop functioning.  Another component of exhaustion involves the depletion of adrenal glucocorticoids which is the result of a sudden fall in blood glucose and a lack of nourishment for the cells.  It is of vital importance to conserve the laboring mothers energy and taking necessary steps to keep her well nourished on physical and psychological levels.   Encourage the mother to eat, drink, and rest when possible throughout labor.    Your alertness for possible signs of exhaustion and dehydration should be heightened as labor lasts longer and longer.
Signs of impending exhaustion: 
·         Ketonuria of +2 or more may be the first sign of impending clinical exhaustion and dehydration
·         High specific gravity values is an early sign of dehydration
·         Dry mucous membranes
·         Rising pulse above 100 (note normal range)
·         A rising temperature of above 101F (which may result in fetal tachycardia)
Checking for dehydration:
The tilt test is one way of determining the degree of dehydration.     Measure the pulse and blood pressure with the woman lying flat on her back.  Then have her it sit upright for one minute with her legs dangling off the edge of the bed and reassess her vitals.  Her vitals should remain approximately the same for each reading.   You can try a third time if necessary.  If the person is dehydrated, exertion from arising results in temporary vasoconstriction which raises the pulse rate.
Moderate dehydration is a 10 bpm increase in pulse. 
Severe dehydration if the pulse rises as much as 30bmp.
When exhaustion and dehydration are present, you must act quickly to turn it around.  
·         Astragalus is a Chinese herb that relieves exhaustion
·         Homeopathic Arnica is good for any kind of exhaustion related to exertion
·         Drinking electrolyte-balancing fluid – coconut water        Nutriive enema
·         IV
Coconut water is the liquid endosperm inside young coconuts.   Endosperm is the tissue produced in the seeds of most flowering plants around the time of fertilization. It surrounds the embryo and provides nutrition in the form of starch, though it can also contain oils and protein. This makes endosperm an important source of nutrition in human diet. For example, wheat endosperm is ground into flour for bread, while barley endosperm is the main source for beer production. Other examples for edible endosperm are coconut "meat", popcorn and banana.
Coconut water is a natural isotonic beverage which has the same electrolytic balance as our blood.  It is identical to human blood plasma which makes it a universal donor.  Plasma makes up 55% of our human blood therefore by drinking it we get an instant blood transfusion.   Coconut water is also a blood purifier.
Anne Frye’s electrolyte balancing recipe


1 tsp miso
1tsp lemon juice
1 tsp salt
1 tsp honey
1 tsp calcium (liquid or powdered)
2 cups water - warm to dilute ingredients.   Have her sips slowly but surely!


Salt/Sodium  has the most “grounding” descending activity of any substance used as food.  In the Ayurvedic  tradition, the active quality of salt was emphasized as markedly strengthening one’s energy.  It can be used to a person “down to earth”.

Potassium is a mineral that naturally balances the metabolic action of sodium.  When there is deficient potassium relative to sodium, neuromuscular function decreases – the body becomes weak, and reflexes become poor.   High concentrations of potassium are found in every vegetable, all types of potatoes (with skins), soy products, millet and other grains, and legumes; also in bananas and most other fruits.  In terms of labor, it is unlikely that you will be able to get her to eat much.  There food are important throughout pregnancy for prevention.    If there is need you could make banana/soymilk smoothy, add some honey.

Honey contains minerals and enzymes and has a harmonizing affect on the body.

Water water water before, during and after.  

The mother should be taking in a minimum of 4oz of fluid every hour.

Bibliography

Frye, Anne.  Holistic Midwifery.   Portland, Oregon: Labrys Press, 2004

Pitchford, Paul.  Healing with Whole Foods.   Berkeley, California: North Atlantic Books, 2002

Pummer, S.  Influence of coconut water on hemostasis.  The American Journal of Emergency Medicine, Volume 19, Issue 4, Pages 287-289.

 

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