Wednesday, 30 October 2013

Types of Birth Control Available in Korea

Updated 21 September 2016

There really are a lot of birth control options available here in Korea. If you're looking to breastfeed, you have to be careful about estrogen that is in some birth control pills. The mini pill isn't available here, but there are pills with low amounts of estrogen. Most lactation consultants advise waiting at least 8 weeks after giving birth (though 12 weeks is ideal) to start taking birth control pills with estrogen. The reason for this is that it can affect your milk supply.

If you are trying to breastfeed remember that there is a lot of English speaking help available out there here in Korea. Here's a list of birthing professionals in Korea who can help you.

Birth Control Options Available in Korea
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Here are what people use as birth control (preventing getting pregnant and/or terminating an early pregnancy) methods here in Korea. TCOYF by Toni Weschler (Taking Charge of Your Fertility) is an amazing book with information on how to get pregnant and how to avoid getting pregnant. It's the leading book on fertility and women's reproductive health. Whether you think these options are right or wrong is up to you, I'm just letting you know what options are out there.

Some of these methods are more effective than others, so please do your research accordingly! Perfect-use failure rate is very different than typical-use failure rate. Some are permanent, others are not. Some need to be done daily, others months, others yearly. Some will require a visit to a doctor or pharmacy, others can be done on your own. Here are some hospitals and clinics in Korea.

Medical and Barrier Methods
  • Abortion
  • Cervical caps
  • Condoms, male
  • Diaphragms
  • Implants (such as Implanon or Jadelle)
  • Injections (such as Depro)
  • IUD, Cooper 
  • IUD, Hormonal (such as Mirena or Skylar)
  • NuvaRing
  • Patch
  • Pill, birth control (피임약) Here's a list of what's available in Korea. You can buy birth control in bulk so many women just stock up here. In addition to the ones listed on the link you can now also find Alesse (에이리스), Meliane (멜리안), Minivlar (미니버러), and Qlaira. Birth control pills are usually 6,000-10,000 won and many are available over-the-counter. Yaz and Yasmin (yes, they are different) are not available over the counter and require a prescription. They cost about 30,000.
  • Pill, morning after 
  • Tubal ligation
  • Vasectomy

Natural Family Planning Methods 
You should also read, TCOYF by Toni Weschler (Taking Charge of Your Fertility) since many of these options are discussed in the book. 
Sources: Mothering and Wikipedia.

Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.

Thursday, 24 October 2013

Changing Hospitals/Clinics Late in Your Pregnancy

Many women get attached to their caregivers in the sense that they don't want anyone else delivering their baby. Some have even gone as far as submitting to a C-section because their doctor was going out of town and they'd rather have their doctor perform a C-section than give birth vaginally with another doctor.

I believe these three tips can help women get the birth they want.
1. Choose their caregiver wisely and find someone who agrees with them.
2. Get a doula. They're worth their weight in gold.
3. Labor at home as long as possible. The clock is your worst enemy.

Here in Korea, and even back home, doctors are superstar doctors! That means that while you're in labor (average time is 18 hours for first time moms) you're probably not going to see your doctor at all: most of the time you'll have nurses attending you. When the main event comes, ie, when you birth your baby, the doctor will come in, deliver the baby, check to make sure everything's all right, and leave. That's it. A couple minutes, maybe a half hour, and then the doctor leaves. You'll spend most of your time with the nurses.

Some women aren't 100% happy with their caregivers but would rather stick with them than change. It's up to you, but you should trust your gut. I read Mama Cairo's blog and found three reasons to switch doctors.

Reason 1: Your doctor brushes you off and doesn't answer their questions. This can be a cultural thing. Doctors in Korea are seen as all-knowing and shouldn't be questioned. As a foreigner, ask away!

Reason 2: You leave the hospital/clinic in tears. Your doctor should not be making you cry.

Reason 3: They flat out refuse to give you want you want even though there's evidence to back up your claims, ex. skin-to-skin, breastfeeding, episiotomies, shaving, enemas, no pitocin, eating and drinking while in labor, laboring in water, not being strapped to the bed to labor on your back, not being able to opt out of an IV, etc.

I will have to saw that you might want to do a little give and take here. While ideally it would be fantastic that you could get everything you want, it doesn't happen to everyone. Pick your battles. If you don't want an episiotomy or an IV, but your doctor wants you to have both, pick the one that you feel more strongly about. For example, you could agree to an IV if the doctor agrees not to give you an episiotomy (just be careful, they're fast!).

Also, remember that you'll need evidence to back up your request. As foreigners there's a lot we can get away with, but if you want to do something that's totally out in left field, such as have your pet dog there while you give birth, don't expect your doctor to allow you to do this.

Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.

Monday, 14 October 2013

How to Turn a Breech Baby or Forward Facing Baby

Updated 15 November 2016

As you get further on into your pregnancy, the majority of babies turn meaning that they're head down. About 3-4% of babies are breech at term (which is 37-39 weeks depending on what doctor you talk to). Ideally they should also be facing your spine since their faces are squishy. If they're facing forward this can cause back pain and back labor. Even if your baby is facing forward there's still a chance that the baby can turn while you are in labor. Here are some things that you can do to help your baby turn.

Things that help babies get in the right position 
  • Both
  • Breech
  • Forward facing 
Some techniques, such as pelvis rocking, myofascial release, and acupressure are traditionally used for breech babies, but can also be used for forward facing babies. Talk to your caregiver or seek out an alternative medicine specialists to see what's right for you.
  • Abdominal stroking: for forward facing babies, get all on fours and have your partner stroke from one side of your belly to the other; only stroke in one direction!
  • Acupuncture: traditional oriental medicine that is said to cure a lot of things.
  • Acupressure: similar to acupuncture, but no needles! Bladder 67, located at the outside of the pinkie toe. Use with caution. Seek a licensed acupressurist.
  • Aromatherapy: may help you relax and the baby turn. 
  • Bagnell Technique: similar to Webster but also takes the cervical vertabrae into account.
  • Belly dancing: can loosen muscles and help baby turn.
  • Belly lifts: simply lift your belly up. This can give your baby space to move. 
  • Bowen technique: gently uses the thumbs and fingers over muscles, tendons, fascia, and nerves. Frequent pauses are used in this technique.
  • Breech tilt: lie on your back so your hips are higher than your heart. You can also use an ironing board. Find out more in the Spinning babies parent class and Daily Essentials
  • Chiropractors: some chiropractors can help adjust your pelvis and spine to help the baby turn. Make sure your chiropractor has experience doing this. 
  • Circuit: 3 simple exercises that you can do at home. 
  • Cold at the top of your belly: this encourages breech babies to move away from the coldness. 
  • Craniosacral therapy: addresses the body as a whole and believes fixing minor misalignment can have huge benefits. 
  • Diet: eat more yang foods (fish, poultry, eggs, red meat, dairy, and miso). Decrease yin foods and products (fruit, ice cream, oil, coffee, sweets, drugs, chemicals, cigarettes, and stress). 
  • Doulas: some doulas can help you use the techniques mentioned here. For example, Kate Beslame who is a doula and midwife has helped mothers turn their babies with moxa, Bowen technique, and hypnosis.
  • Elephant walking: walk on hands and feet.  
  • Emotional Freedom Technique (EFT): based on the connection between mind and body.
  • External Cephalic Version (ECV): your doctor or midwife will manually try to turn your baby from the outside. It has about a 50-60% success rate but babies can flip back into a breech position. Using acoustic stimulation before an ECV is performed has been shown to dramatically increase the success rate. YouTube has some videos that show how it work. Some places will use medicine to relax your uterus and/or only do it up until 36 weeks, so be sure to ask around. Some hospitals and birthing centers in Seoul such as Cheil Hospital, Jungan Hospital, Medi Flower, Rosa, Soonchunhyun, and Yeon and Nature will do them. Here's the contact information for these places.
  • Forward leaning inversion: find out more in the Spinning babies parent class and Daily Essentials
  • Forward sitting: don't lean back while sitting. 
  • Homeopathy: they often prescribe pulsatilla, ignatia amara, or natrum muriaticum.
  • Hypnosis: mind over matter. Here's a sample script.
  • Inverted shoulder stand: hold your waist so your feet are up in the air. Do twice a day for 5 minutes. 
  • Light: towards the base of the belly can help breech babies turn
  • Lunges: helps loosen muscles.
  • Mayan massage: can help with alignment.
  • Meditation: some believe that a mother's fears can inhibit a baby to turn. Releasing these fears can help the baby get in the correct position.
  • Moxibustion 무연 미니 뜸: this herb is said to help turn babies between 34-36 weeks. You can buy it over the counter at Korean pharmacies.
  • Music near the bottom of your belly: breech babies move towards the music.
  • Myofascial release: they help release muscular shortness and tightness. 
  • Pelvic rocking: Both birthing balls and peanut balls are great for this.
  • Photos: get photos of babies in the optimal position and place them at work and at home so you see them all the time.
  • Polar bear position (knee-chest; modified handstand): for breech babies, get on all fours, bend your elbows to the ground and stick your butt up in the air for 30-45 minutes.
  • Rebozo sifting: helps loosen muscles and tension. 
  • Relaxation: these techniques can help your baby turn
  • Spinning babies: you'll learn how to what position your baby is in and how to get your baby into an ideal birthing position. Find out more in the Spinning babies parent class and Daily Essentials.
  • Side-lying: helps babies turn.
  • Side lying release: find out more in the Spinning babies parent class and Daily Essentials.
  • Slow dancing: helps loosen muscles so a forward facing baby can turn.
  • Squatting: helps a forward facing baby turn. 
  • Standing sacral release: find out more in the Spinning babies parent class and Daily Essentials.
  • Swimming: somersaults may help the baby turn. 
  • Talking to the baby: telling the baby that you want it to turn.
  • Visualisation: mind over matter, see your baby turning.  
  • Water: you might be dehydrated and the baby doesn't have enough amniotic fluid to turn.
  • Warmth near the bottom of your belly: breech babies move towards the warmth
  • Webster Technique: is a chiropractic method. Here's how it works and the history behind it

Breech Babies and C-sections
Many doctors do not like to deliver breech babies vaginally and will schedule a C-section. When a baby is at full-term, their head and butt are about the same circumference. If you want to deliver vaginally, ask your doctor if they have experience delivering breech babies and are comfortable doing so or change hospitals. Some hospitals and birthing centers in Seoul such as Cheil Hospital, Jungan Hospital, Medi Flower, Rosa, Soonchunhyun, and Yeon and Nature will do them. Here's the contact information for these places.

If you are willing to have a C-section, ask your doctor if you can labor on your own first due to the hormones that your body produces. You can achieve this by going into labor naturally or being induced (pitocin is commonly used). There are many benefits for both you and your baby if you go into labor. It helps your baby get a higher Apgar score, breath better, and transition to life outside the womb more easily. It will help you bond easier to your baby, help create a transition from being pregnant to being a mom, and help your milk production.

Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.

Thursday, 3 October 2013

Questions to Ask When You Interview a Doula

Updated 29 February 2016

There are a lot of birth doulas here in Korea now. Meeting with a couple doulas first and deciding which one you (and your partner) feel most comfortable with is best than just hiring them first doula you come across. Many doulas draw up contracts, which help both parties out. Here are some questions that you might want to ask. Gentle Birth Balance  and The Doula Book also have some very thought provoking questions to ask a birth doula.

  • Where did you get your training? Are you certified?
  • How long have you been a doula for?
  • How many births have you attended?
  • Have you attending a birth at my hospital? with my doctor? midwife?
  • Could you tell me about some of the births you attended?
  • Do you have children? Did you have a doula for your birth(s)?
  • What's your view on childbirth?
  • Have you attended a C-section birth? Home birth? Water birth? (Pick what's applicable)

  • Why did you become a doula?
  • How would you describe your style?
  • How do you support labouring moms?
  • Are there any books or websites that you'd recommend? 
  • How do you involve the birth partner?
  • How do you feel about pain medication? What other comfort techniques could I use?

The Fine Print
  • Do you have a contract we can sign?
  • What does your fee cover? What's your refund policy?
  • How many births do you schedule a month?
  • Is there a time limit for the birth?
  • Who's your back-up doula? Can I meet them ahead of time?
  • How do I get in touch with you? When should I get in touch with you?
  • Will you travel?
  • How many pre-natal visits do you do? For how long?
  • How can you help my partner during my birth?
  • Can you help me write a birth plan?
  • What happens if you don't make it to the birth because it was a fast labor?
After the Birth
  • How long do you stay after the birth?
  • Do you come check-up on us after giving birth? How many times and for how long?
  • Can you help with breastfeeding? 

Tender Embrace Birthing offers childbirth, breastfeeding, and newborn care classes and support.

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