Happy Cesarean Awareness Month

April is Cesarean Awareness Month!  I am here to talk about my experience today, and why cesarean awareness is such an important subject for women to get involved with, even if you have not had one!

When I was 22 I gave birth to my first child via an unnecessary cesarean because my my physician wanted to go home for the day.  I never knew how much that experience would impact my life not only as a woman, but as a mother, and my mothering skills. I look back often and know that had I taken the time to take a childbirth education class, it would have prevented that experience completely, and honestly I would have never stayed with the OB/GYN practice I was with at that time.

When I got pregnant with my second child, only 9 months postpartum from my first, I knew that it needed to be different and I set off to find a midwife for a VBAC.  After the experience and postpartum emotional toll my first surgical birth took on me, I knew it would be best for my family to not deal with the emotional and physical repercussions of a repeat cesarean.

My Birth Journeys from Danielle Elwood on Vimeo.

But after over 26 hours of a VBAC labor, doing everything right from staying in shape, exercising, preparing for birth, having a doula, and receiving regular Chiropractic care for the duration of my pregnancy, my second child was born via a medically necessary cesarean that saved not only his life, but my own.

It gave me a different perspective on being a birth activist, and cesarean awareness supporter. I went from angry, bitter, and sad insisting most of cesareans were unnecessary (which statistically most still are) to grateful for my experience the second time around knowing and giving me the understanding behind a medically necessary cesarean birth.  It still sucked big time, it was painful, my recovery was much worse than the first time around, and emotionally it was devastating because of the hard work and commitment I had to working towards a VBAC.

I am thankful for both of my experiences as it helps me to know I can help women on all sides of the cesarean spectrum because I have been there myself.

I hope everyone takes some time to get involved this April in some way!

A couple great events taking place this month :

ICAN will kick of Cesarean Awareness Month today with a Radio show about Cesarean Mothers Experiences

I Will also be on The Feminist Breeder’s radio show this coming Sunday Night at 10pm CST discussing the recent Cesarean Feelings Survey I worked on with the Healthy Baby Network.

The ICAN Blog will be having birth stories from Cesarean Mothers, and VBAC Mothers all month long, so take some time to check that out.

Birth Activist to Childbirth Educator

I never thought I would be so excited to work more and spend more time in the childbirth community!  When I met Robin the lovely founder of Birth Activist she became an instant mentor to me. Any help, advice, or encouragement I needed, she was right there.

When the choice came to looking into the various programs and pathways for becoming a childbirth educator I could not even imagine where to start. There were distance programs, workshops, shadowing programs, anything under the sun, and all seemed to be nearly out of my price range. I was leaning towards a distance training program when Robin suggested hosting a Passion For Birth workshop to become a Lamaze Trained Childbirth Educator and it dawned on me, there really aren’t too many Lamaze teachers in my area! Perfect!

I eagerly booked the Passion for Birth Workshop for July, and I encourage anyone that is interested in becoming a childbirth educator to do the same. I am excited that an online mentor and friend is traveling far out of her way to visit me in little ol’ Connecticut to teach my three day workshop.

I became more excited when people actually started signing up, and I brought my first two books of recommended reading yesterday.

I encourage anyone interested to check out Passion for Birth!
It makes it incredibly easy for you to become a childbirth educator as well as host your own training!

Danielle’s Woman’s History Month Picks

There are so many women who have shaped my life, views, and involvement in the childbirth community. Some are greatly famous that everyone knows, and some are amazing women in my personal life.
I thought I would share a few.

Karen Kilson & Danielle Elwood

Karen Kilson was a local birth doula, and Childbirth educator who really “got me started” after the birth of my oldest which was a c-section, I started an ICAN chapter and had no idea where to start, what to do, or how to really get involved in the local birth community and Karen swooped in to save the day. She knew so much, and was just a great resource for me. We became great friends over a short period of time, and our friendship expanded outside of the birth community, but into our family lives. She was my idol in the birth community, from being on of the pioneers of a hospital based doula program in our state, all of her certifications from DONA to CAPPA, and the library of more books than either of us could ever count. She was a devoted grandmother, not only to her own grand children, but to my children also, and she was just the brightest, and most amazing soul you could ever encounter.
She was the doula for my birth of my second child Benjamin, and unexpectedly passed a few short months after he was born.
Though I was never able to thank her, she knows as I still speak to her daily.

Ina May Gaskin is another, now there isn’t much that can be said about her that has not already been said once, or a dozen times, but between the Farm and her publications women all over the world have greatly benefited from her education and experience. She has truly shaped the face of modern midwifery in The United States.

The Women of ICAN : For me, after I had my first child via unnecessary cesarean I felt like I would never find anyone that felt the same way as me until a friend introduced me to the birth group. Through the healing of my first birth, to the ending of my VBAC attempt turning into a CBAC, I feel like these women are the most heart felt amazing women who are just such a great support system.

Who are your woman idols?

CDC Releases Home Birth Data

Today the Center for Disease Control and Prevention released some much anticipated data regarding home birth from 1990 to 2006.

Inside the released data, it showed an increasing trend in out of hospital births.  Home births rose about 5% from 1990 to 2005 and were steady in 2006.  About two thirds of these births were at homes and about another third were in birth centers. Which I believe has come from more education on the safety of home birth, as well as the increased interest in women who do not wish to be put through the hospital birthing system, or are looking to VBAC in an area with no hospitals currently permitting the hot button procedure.

What this study also showed was an increase in Midwife attended home birth, showing that women are planning these births and not just accidentally birthing at home, or not making it to the hospital in time. The number of midwife attended home births increased from 43% in 1990 to 61%.

What Robin pointed out on Pregnancy.about.com is that people will try and blame or say these trends are due to the popularity of the film The Business of Being Born, or the Big Push for Midwives campaign but these were unavailable during this time. The Business of Being Born was not released until 2007.

I find these statistics encouraging because women are becoming more educated on their options, and truly are being informed consumers.

_{MacDorman M, Menacker F, Declercq E. Trends and characteristics of home and other out-of-hospital births in the United States, 1990-2006. National vital statistics reports; vol 58 no 11. Hyattsville, MD: National Center for Health Statistics. 2010.}

But Why is VBAC so Important?

I am sure that I am not the only person to ask myself this with the announcement of the National Institute of Health VBAC Conference announcement.  But unlike most, I know more than my fair share about VBAC after having a cesarean with my first child it became more than a healthy obsession to me. But sadly the more I learned, the more sad I became about the access to VBAC nationally.

In a 2009 survey from The International Cesarean Awareness Network, it was found that nearly 50% of all hospitals in The United States has some sort of a VBAC Ban in place. Whether it be a formal policy written by hospital administrators, or a de facto ban, meaning there simply are no providers who will take on a patient who wishes to have a Vaginal Birth after Cesarean.

But what does this mean for women nationally? For the women who have had cesarean sections, whether medically necessary, or unnecessary?  It means that once they have experienced once cesarean birth, they have no choices regarding future pregnancies or deliveries. Essentially leaving them with no real informed consent.  To me, as a huge activist, that is not only a violation of a patients rights, but it is a major human rights and bodily anatomy violation.

Right now, 90% of women who have had one cesarean section will go on to deliver all of their children through multiple major abdominal surgeries, the next more risky than the last. When the safe and relatively low risk  option of a VBAC is not available.  But lets look at the numbers regarding the risks of VBAC as opposed to repeat cesarean sections.
The major risk associated with a Vaginal Birth after a Cesarean section is something most near the most not knowing the risk is so low. Uterine Rupture.  Not something we should discount or not worry about, but when we look at the statistics, the average healthy woman who has had one previous cesarean section has a 0.6% chance of experiencing a uterine rupture.

When I went through the process of filling out and signing my VBAC consent form for my second pregnancy, there was paragraph after paragraph panting VBAC in a scary pictre, then a small paragraph with the minor risks of a repeat cesarean, almost like the practice of Obstetricians backing my midwives wanted me to change my mind and run in fear.
This form was not informed consent by any means, it was skewed, biased, and provided misinformation, but sadly this is what we are seeing Nationwide today.

But I can hope with the NIH VBAC conference we can start to see a change in the way that VBAC is handled nationally.
Women have the right to real informed consent, and give birth vaginally if that is what they choose for their own birth.

For more information on Cesarean Awareness, and Advocacy, check out The International Cesarean Awareness Network.

Congenital Heart Defect Awareness Week

Starting on February 7th, and going through till February 14th, we will be celebrating Congenital Heart Defect Awareness week. I was first touched by this subject on Twitter when I met a mother who had lost her daughter, Cora, to an undetected congenital heart defect shortly after she was born. Since that time, Kristine Brite, the mother of baby Cora has become an internet advocacy all star making strides to help others know about the issue and prevent other mothers from going through what she had to endure.

According to Congenitalheartdefectfact.com an estimated 10,830 babies are born a day, and 411 of them are born with a congenital heart defect, making it the most common birth defect according to the March of Dimes.

“In the US alone, over 25,000 babies are born each year with a congenital heart defect. That translates to 1 out of every 115 to 150 births. (To put those numbers into perspective, only 1 in every 800 to 1,000 babies is born with Downs Syndrome.)”

Knowing this information, and learning about Cora’s Story has made me realize that in the United States this is an issue we need to work on tackling, and work on testing, and mandatory pulse oximetry testing in newborns, which Kristine Brite is currently working towards, even only two short months after the loss of her baby girl.

On Sunday February 7th, 2010, at 3:00pm EST, to help kick off Congenital Heart Defect Awareness Week, Kristine Brite will be joining myself for the Momotics Radio show to help kick off CHD awareness week with Cora’s Story.

Please join us and help spread the word on Cora’s Story.

Distortion of Natural Birth

I was so happy to follow up on Ashley’s Midwife Vs. Medwife post because I really feel as though this will be a little piggy back on the subject. Last night I tuned into ABC’s hit series Private Practice, and during the episode I seriously started to wonder why I continue to watch the show that makes my blood boil.

But what really ate at me was they way they portrayed a mother who was working towards a natural birth. Which made me think about the way that the public views the natural birth community, as well as women who simply want a natural birth for themselves.

They treated this woman in the episode like the butt of all the jokes in the episode until the emotionally charged climax of her birth viewed by perfect strangers that would have been a major HIPAA Violation.  The episode shows this woman with a multi-page birth plan, grinding on the door frame of the birth suite trying to squat to help her labor, joking about how she had been in labor for 3+ days, all of which as a mother who has labored naturally, I found offensive.  The character was essentially the comedy of the episode.

It made me think about the perception the American public is going to get from this message, as well as their views on women who do choose to give birth naturally. Do they think we are all just a bunch of hippies that bite on sticks until we drop a baby out in the middle of a meadow while singing show tunes?  Come on!

The problem is shows like this.
The problem is the myths about who has natural births.
The problem is typical stereotypes.

Where do we start?
How do we start to re-educate and properly educate the public so they don’t think all moms who want to have a natural birth aren’t ding bats like this character was?

I really hope that shows like this, and Grey’s Anatomy, and other medical drama’s take the time to fix the American stereotype of birthing naturally. Women from all walks of life do it!

Just on a side note, the character who was attending this woman’s birth “Dell” a “student midwife” came off as a Student OB/GYN if anything. He had no type of midwife qualities in him what so ever and I think that is another huge slap to the natural birth community. He at best was a “medwife” if that!

Healthy Eating During Your Pregnancy

I can certainly say, when I got pregnant with my oldest, I thought pregnancy was a free ticket to pig out and live on junk food, but I quickly learned through my reading, that is not the case at all!! Another misconception of pregnancy nutrition is that Mom should be eating for two, nope! Not at all. But one of the most swept under the rug, neglected, and black listed parts of pregnancy is nutrition.

We do not see Obstetric models of care including nutrition counciling, or really taking the time to say skip on this, or add that. You get a sheet of things not to eat and most are sent on their way. Which is one of the reasons I am intrigued to write about this.

According to The March of Dimes, women should be including the following into their diet on a daily basis :

• 6 Ounces of Grains Per Day
  • Slice of wheat bread
  • Wheat Tortilla (6 inches)
  • 1/2 cup of cooked rice or pasta
  • 1 cup of cereal
  • 1 large pancake (about 4 1/2 inches)
• 1 1/2 to 2 cups of fruits per day
  • 1/2 cup of 100% fruit juice (be careful of the amount of sugar in fruit juices)
  • 16 Grapes
  • 1/4 cup of dried fruit
  • 1/2 of fresh, canned or frozen fruit (My best pick would be fresh fruit since you often do not know what canned products are being preserved with)
• 2 1/2 Cups of Vegetables per day
  • 1 Cup raw or cooked veggies
  • 1 Baked Potato (skip or go light on the butter, sour cream, or bacon)
  • 2 Cups of raw leafy greens
  • 1 Cup veggie juice
• 400 Micrograms of Folic Acid
  • Most likely found in your pre natal vitamin
• 5-5 1/2 ounces of Protein per day
  • 1 Tablespoon of peanut butter
  • 1 ounce of lean meat
  • 1 egg
  • 1/2 cup of nuts
  • 1/4 cup of cooked dried beans
• 3 cups of Milk products per day
  • 1 Cup Milk
  • 2 ounces of processed cheese
  • 1 Cup yogurt
  • 1 1/2 ounces natural cheese

It really doesn’t sound like a lot of work does it?

We know the typical things to avoid… soda, sugar, caffeine, raw fish, unpasteurized foods, and make sure to keep your water intake up. This was a big one for me in both of my pregnancies. 6 to 8 glasses of water a day!  That is what I hated most of all and often got dehydrated. Which is something you want to avoid!

Remember, everything you eat, so is your baby!
You want to give your baby the best start at life, so just be picky and careful for your pregnancy.
It will pay off in the end!

Cesarean Recovery

With the number of cesarean sections increasing in our country annually, many women do not really understand or know that recovering from a cesarean section is much different from a vaginal delivery. After my first cesarean section I learned this the hard way and wish I had a couple tips on making recovery more bearable.  But we often forget that the recovery after a cesarean birth is not just physical, but it is also emotional for a large portion of cesarean section mothers.

The different types of healing to be considered are in the hospital, long term, when you return home with your new baby, and also things you should be aware of such as when to call your health care provider post cesarean. (I also want to thank ICAN and their Recovering from a Cesarean White Paper in aiding to my post today)

While in the hospital :

• Get as much help as you can from family members, your partner, nurses, and other hospital staff. That is what they are there for and during the hours, and days immediately after your surgery, you will need it even if you do not want it.
• Stay hydrated and eat. You may not want to eat, but working on eating a well balanced and healthy diet, as well as staying hydrated (stay away from sugary drinks such as fruit juice and soda) will help to make you start to feel semi human again.
• If private rooms are available opt for one so someone (family member or friend) can stay with you to help you during this time.
• Use a pillow between your legs, and/or on your side to help sleep to be more comfortable. In the days, and even weeks following your cesarean it will not be easy to get comfortable. This is completely normal.  It took me almost a full 2 months to even get comfortable in my own bed at home after my second c-section.
• Take pain medication that is being offered if you are in pain. With my first child, I was breastfeeding and was overly concerned about any of the medications being transfused though my milk so I opted for over the counter pain medication such as motrin instead. But it certainly made my recovery longer, and made taking care of my son harder. (As ICAN recommends, ask your provider about a stool softener, as narcotic pain medication can cause constipation.)
• Get up and walk around.  It may hurt like hell, but it will help to get you back on your feet sooner rather than later. The longer you wait, the more painful it will get up, and the harder it will be.
• The use of a pillow to protect your stomach while coughing, standing up, nursing or moving around in bed is a smart idea.
• Do not hesitate to ask for a lactation consultant in the hospital. Breastfeeding after a cesarean section is more difficult not just for mom because of her incision, but also for baby. Check out the ICAN white paper on Breastfeeding After a Cesarean.

The first couple days in the hospital may feel like you are dying, I know because I have been there, but in most cases, you will only get better. When you get home, there are some more great tips for healing, although your housework may suffer for the first couple weeks, I am sure no one will mind too much.

When you get home :

• Focus on yourself, and your baby. You just had major surgery and your baby needs you.
• Have your partner help/do the household chores. Laundry, dishes, cooking, or anything else that needs to be done. Don’t worry, you can put off the dusting, cleaning the bathroom, mopping, and all the big chores for a couple weeks, your house won’t be mad at you!
• Do not lift anything that is heavier than your baby for at least 4-6 weeks. Those infant carriers/carseats are tempting to pick up, especially when going to an appointment for you or your baby, but stay away from it. You do not want to hurt yourself, or have an extended recovery.
• Ask others for help. If you have older children it may be helpful for your partner to take some time off from work, or have an available family member come over to help you. During the first weeks after my second cesarean section my toddler not only got the flu, but I was the only person he wanted making it difficult on me because I could not pick him up.
• Take it slow!  Get back into your normal household routine over a long period of time. You do not want to over do it because you will certainly pay for it later on.
• Have access to baby stuff such as diapers, bottles, burp cloths, wipes, or whatever you and your baby need for a couple hours in several places around the house. If your bed is the only place you are comfortable, make sure you can set yourself up to be able to hang out with baby, change diapers, and everything else you need right there.
• Co-Sleep!  Room in with your baby, so when it comes time for midnight feedings, you do not need to get up or go far to take care of your little one.
• If you have school age children, have others help to prepare their lunches, lay out clothes for the next day and anything else that needs to be done. To spend quality time, sit on the couch, or someplace comfortable and assist them with their home work, or read a book. Find ways to spend time other than anything that may put a physical strain on you.
• Considering hiring a post partum doula. They can really be heaven sent in a post cesarean situation!
• Don’t push yourself. If you want to take a shower and get dressed for the day, make that your only goal for the day.
• Pajamas are your best friend. They are comfortable, and help to remind others you are still recovering from major surgery.
• Remember how important it is to continue to remain well hydrated, and eating healthy.

Many do not think of the long term or emotional recovery of a cesarean section. I personally did not even encounter the emotional recovery until my cesarean baby was 3 months old. Be gentle on yourself, you aren’t the first to go through this, but many people around you may treat your feelings like nothing because cesarean sections have become so common. I can’t tell you how the phrase “a healthy baby is all that matters” feels to me still today.  Do not let others discount your feelings on your experience.

For your long term recovery…

• Contact your local ICAN (International Cesarean Awareness Network) chapter. These are women who have been there, and done that and know how you feel and what you are going through. They are an excellent support system internationally and are such a huge blessing for many mothers. I know they were to me!
• Write out a birth story, express your feelings on paper, or on a blog, get it out. Keeping your feelings inside may be harder in the long run.
• Keep your baby as close to you as possible for as long as you can.

If you experience any of the following symtoms or problems, you should contact your care provider immediately.

• Any type of bleeding from your incision.
• Leaking, redness, or any type of fluids coming from your incision.
• If your pain does not decrease over time.
• Symptoms of post partum depression such as anxiety, fear, problems sleeping, depression, or anything else you may equate with something more than just the baby blues.
• Cramping or pain in your arms or legs that will not go away.
• Continuous headaches, migraines, or backaches.

Over all, be gentle on yourself.
You just went through major surgery!

The Duggar Family

I would like to extend my well wishes and thoughts to the Duggar Family though this difficult period of their lives after welcoming their 19th baby, Josie Brooklyn Duggar yesterday, December 11th 2009 via emergency cesarean section for Pre-E after a hospital stay due to gallstones. Baby Josie was born at 25 weeks gestation at 1 pound 6 ounces.

Over the past 24 hours I have seen some of this most disgusting comments via the internet on news articles, and just message boards. Whether Michelle was on her 3rd or 30th child, Pre-E can happen to anyone at any age and during any pregnancy. This family may live differently than the vast majority of Americans, but seriously, if you want to say something negative, say it when mother and baby are far out of the woods, not when a micro preemie is fighting to live.

Some people never cease to amaze me.

Michelle has been such an amazing asset to the VBAC community in having 12 VBAC’s herself.
I can only hope in future years she will continue to work with and praise ICAN like she has in the past.