mamablogess's blog

The Chemistry of Breastmilk

Fri, 21 Nov 2008 12:56:51 -0500

When my husband, a Chemical Analyst, brought home an issue of Chemical and Engineering News with an article entitled "Unraveling Breastmilk" I was a bit skeptical. There was a photo of a breastfeeding infant on the cover, which addmittidly was quite impressive. However, the objective of unraveling the chemical components of breastmilk seemed to be to create a superior formula, and I wondered how a superior formula would help with encouraging women to breastfeed, which has far greater benefits than the nutrition and antibodies alone.

I read the article with a critical eye, but I found it to be both respectful of the amazing substance that is breastmilk, and extremely fascinating. To see just how complex breastmilk is on a scientific level, and how hard it is for them to replicate this amazing substance was really very interesting.

The article can be found here: Unraveling Breast Milk: Analytical scrutiny reveals how complex fluid nourishes infants and protects them from disease

I have to warn you that the article is written for chemists, so it is not the easiest thing to read. Even though I didn't understand the entire thing, reading about the chemistry of breastmilk really gave me a new understanding and appreciation for the substance. I think the last sentence of the article sums it up nicely; "It is a remarkable fluid," German emphasizes. "It's extremely embarrassing how little we still know about it."

Study Shows That Pregnant Woman Do Not Lose Cognitive Ability

Sat, 08 Nov 2008 11:34:58 -0500

Here is the link to an article entitled "Pregnancy does not cloud the brain, says Australian study". Many people, including pregnant women themselves, feel that pregnancy clouds their judgment. Perhaps this study will put that myth to rest.

Some notable quotes from the article:

A study by the Australian National University's centre for mental health research found that there is no evidence to suggest that impending motherhood affects a woman's cognitive ability.

"It really leaves the question open as to why (pregnant) women think they have poor memories when the best evidence we have is that they don't.

The professor said research on rodents had found that mother rats had an improved capacity to do more than one task, navigated mazes more efficiently and suffered less anxiety and fear.

"There's enormous changes in the rat brain during pregnancy so you might actually expect that women perform better during pregnancy than when they're not pregnant," Christensen said.

The Effects of Birth Trauma on Breastfeeding

Fri, 07 Nov 2008 16:42:02 -0500

Here is a recent article on new research from Cheryl Beck on the effects of birth trauma and breastfeeding. The article is entitled "Study shows birth trauma can impact new mothers' ability to breastfeed".

Highlights from the article include:

For some, the trauma propels them into persevering in breastfeeding to prove their “success” as a mother and perhaps to make up to their infant for the difficult birth.

Yet for others, birth trauma sets in motion a chain of events – intrusive flashbacks, detachment from their child, and physical pain – that can curtail their attempts to breastfeed.

Beck concludes that intensive one-on-one support for traumatized mothers may be necessary to help them establish breastfeeding. Sensitivity and awareness by medical professionals of the traumatized mother’s needs may also be helpful.

During the postpartum period, it is suggested that healthcare providers be attentive to the symptoms that may indicate a new mother is traumatized, such as being withdrawn, having a dazed look, or suffering temporary amnesia.

See the linked article above for more information.

Birth Vernacular

Thu, 16 Oct 2008 01:40:29 -0400

The language we use gives an impression of our knowledge on a given subject. Certain subcultures often use words that have special meaning only to them. The best example is local dialects. Here in Minnesota, we call soda, "pop". We say things like "uffdah" and "ish", which I am told most of the country is not privy to the meanings of. It is like this amongst the natural childbirth community as well. We are a subculture, and we use words amongst ourselves that have meaning only to us, or that mean something different to us then they do to others.

When this happens within subcultures, one can forget that the majority of people don't use those words, or don't use them in the same way. In extreme cases, it can even be difficult to communicate with people outside of your subculture about your subculture. A good example of this would be trying to explain the Star Trek universe to a non-Trekkie. Whether you are a Trekkie or not, I think you'll know what I mean. Birth advocates must be mindful of this when representing their stand to the mainstream culture.

Certain words originate in a subculture and make their way into the mainstream culture, usually because there is no other term for it otherwise. A word that originates this way (among other ways) is called a "neologism". If a word or phrase is going to originate from the natural birth community, ideally it should be clear and obvious and should not have any other meanings attached to it.

There are also words that have been shunned by certain subcultures, and replacements have been invented. In the natural birth community we could site "yoni" as an example of this phenomenon. These words are used as advocacy tools themselves. "Yoni" is used in place of "vagina" because that word's origin was deemed unacceptable by some. Using these words with the general public usually wont have the intended effect. They can make the speaker seem uneducated or folksy. The audience usually will not understand the intended lesson meant for them.

Am I saying that we should abandoned our vernacular? No, not at all. It brings people together as a community when they share a language, or a dialect. We can use these terms amongst ourselves all we want. We do need to be careful, though, when we are facing the mainstream culture and taking our message of birth advocacy to them. We don't want any confusion. We want to be clear about what we mean and what we say and how we say it.

With that in mind, lets examine some of the words or phrases that are used within the natural birth community. Some of these words or phrases are used in the mainstream culture as well, but the natural birth community uses them differently.

Let's start at the beginning:

Birth

Birth is straightforward enough, right? You would think, however, we use this word differently then the mainstream culture, and notably incorrect. We say "my birth" or "your birth" as in "my birth was fast" or "its your birth". We have to remember that mainstream culture doesn't often talk this way. Also, it is incorrect english. In the examples above, what you are really referring to is when you yourself were born, not when you gave birth. The mainstream culture would say, "my labor was fast" or "when I gave birth, it went really fast". This is a distinct difference and one that can cause some confusion if we forget who we are talking to.

Natural Childbirth

This was a term that was created in retrospect, which is called a retronym. Examples of retronyms are "acoustic guitar", "snail mail", or "cloth diaper". After analgesics started to be used in most childbirths in this country, the term "natural childbirth" was coined to refer to drug-free births. Sadly, after using this term exclusively to mean "drug-free childbirth" for decades, the natural childbirth community seems to be loosing their descriptive term. The mainstream culture now terms any non-cesarean birth as a "natural birth". Apparently, they can't get the words "vaginal birth" out of their mouths or typed across their computer screens, so they had to steal a term that already had a well established meaning in both the natural childbirth community and in mainstream culture. As a birth advocate, if you use the term "natural childbirth" now, you run the risk of not being clear enough. The term "drug-free" may start to replace it as time goes on. If so, the good thing about this change is that women who had interventions will not feel the implication that their births were "unnatural".

Birth Trauma

Within the natural childbirth community, "birth trauma" often refers to the emotional trauma that some women may suffer after a challenging birth. The hard part about using "birth trauma" to describe emotional suffering from childbirth, is that the term was already quite common in mainstream culture to describe a physically traumatic childbirth that results in injury, usually to the baby. For example, chiropractors often use the term "birth trauma" when talking about babies that need chiropractic adjustments after a difficult birth. The term "birth trauma" alone can therefore be confusing to anyone who has not heard it applied to the emotional trauma after a difficult birth. I often wish this term could be clarified by tacking on the word "emotional" to the front of it, because I don't think it is specific enough to be understood by all.

Birth rape

Birth rape is a term that has been embraced by an even smaller sector of the natural childbirth community. Some women who have experienced birth trauma, of the emotional sort, have elected to refer to their experience as a "birth rape". A birth rape is a very specific type of birth trauma. This word falls into the category of a word used as an advocacy tool itself. Whether the word has the intended effect is debatable, but it does describe something that no other word does. It describes being mistreated or abused while giving birth, whereas "birth trauma" can also happen from a painful birth, a physically difficult birth, or a birth that triggers a past trauma. I personally wish there was a gentler term that had the same meaning, as this can be a bit abrasive to the mainstream culture who has never heard it before, yet "birth trauma" does not feel specific enough when one was abused while giving birth.

Childbirth Education

This term is straight forward enough, and carries meaning in the mainstream culture as well as the natural childbirth community. However, the natural childbirth community uses nuances of the word "education" to mean different things. In other words, there is education and there is "education". I see the term as having three meanings. Mainstream culture would likely tell you that childbirth education is hospital-sponsored childbirth classes that teach women and their partners about what to expect during labor and birth and during their stay in the hospital. Then there are natural birth advocates who will tell you that "educating" yourself means learning about childbirth from multiple sources; mainly books, videos, and private (non-hospital based) childbirth classes. This type of education is really referring to "preparedness" which includes preparing physically, mentally, and emotionally for labor and birth. Then there is the last type of "education" and that refers to learning about the selected provider, hospital or birth center, and medical interventions and procedures. This would include learning the ins and outs of the hospital system and how to navigate it, learning the intervention rates for a given provider or facility, and making choices of what you personally want based on the things you have learned, and then in turn teach your support team how to advocate for your choices. All three of these types are often referred to by the natural childbirth community as "education", but the first type is all the mainstream culture registers when the term "education" is used. I wish we had three different commonly used terms for the things I mentioned above, such as "childbirth education", "childbirth preparation" and, hmm that last one is hard..."maternity care preparation"? "Maternity care education"?

This is just a sampling of some of the words that I thought of that would make good examples. I am sure there are many more. Whatever words we use, we want to avoid confusion and clarify our meaning when needed. It is good to always keep in mind that the mainstream culture doesn't always understand the natural childbirth community's lingo. In some cases, certain words may sound shocking, silly, or unclear to them. If we receive this type of reception to the words we use, it will get us nowhere. We want our words to have meaning, carry our message, and be understood and well received. Thinking before we speak and choosing our words carefully is always good practice in any case. Remembering that we are not always speaking to people within our subculture may help us to become more effective birth advocates.

Northwestern Women's Law Center Writes Article About Birthing Women's Legal Rights

Thu, 04 Sep 2008 11:53:08 -0400

Sarah L. Ainsworth is senior legal and legislative counsel at Northwest Women's Law Center. She is the author of a recent article in a Washington paper. The article is entitled "High rate of C-section births is health concern for women".

Some notable quotes from the article:

Both the law and respect for women's humanity require that every pregnant woman be fully informed of the risks of all forms of labor and delivery in a language she can understand; that she be supported in her decisions about how to bring her children into the world, whether it be in a hospital, a birthing center or at home; and that she not be penalized for those decisions either medically or legally.

A pregnant woman must either submit to a subsequent C-section, whether she thinks it is a wise medical decision or not, or deliver her baby outside the hospital. For those women who do not want a home birth, or who cannot have one because of lack of health insurance coverage or lack of available midwives within a safe distance of home, this is coercion, not consent.

Policies and practices that force pregnant women to submit to unnecessary surgery cannot be justified. We would never countenance that practice for any other patient. Pointing to potential risk to the baby does not justify ignoring the mother's decisions about her medical care.

Such reasoning inappropriately views a pregnant woman's decision about her and her baby's needs as suspect, and it ignores her legal rights as a patient. All pregnant women, whether they view birth as a natural event only rarely needing medical intervention, or whether they willingly accept medical assistance with the birth process, have the legal right to informed consent and to direct the experience of bringing their children into the world.

Cesarean's are just one of many procedures that many birthing women are not allowed to give informed consent to. This is the first article or statement I have ever seen by someone in the legal field that says that this is legally wrong to do to women. I personally have contacted several lawyers and not one would talk to me, or allow me to pay them for an hour of their time while I presented my case to them. I am thrilled to see some acknowledgment by a legal organization that ignoring a pregnant woman's rights is illegal and cannot be justified.

Women Willing To Accept "Natural Birth Risk"

Fri, 29 Aug 2008 01:29:50 -0400

A study done in the UK shows that women are more likely to accept risks to have a "natural birth" (I think 'natural' means 'vaginal' in this case, not 'drug free') than their care providers are. When women are given the power to make an informed choice about their births, they are willing to take risks to avoid a cesarean section.

To be fair, this wasn't a very broad study. However, the majority of the women chose to take the risks and go for the "natural" birth. With attitudes like that, it is hard to imagine why the cesarean rates are so high. I feel it must have something to do with the care provider's influence or sway over the woman while she is in labor.

Click here to read the article.

The Birth Survey: The Talk of The Blogosphere

Sun, 24 Aug 2008 01:54:00 -0400

If you search Google --> Blogs, and type in "The Birth Survey", the first seven pages are filled with blog entries about The Birth Survey. After reading many of these entries, it seems that most women are very pleased with the survey. A few have commented on how detailed and extensive the questions were. Many express excitement at having a resource that will help them and others to find providers or facilities that will match up with their own desires. All of these bloggers are encouraging their readers to take the survey. I'm very happy to see that the blogosphere has embraced The Birth Survey. Many are showing a lot of enthusiasm for the project and I think they will help to make it a success!

So, if you haven't taken The Birth Survey yet, what are you waiting for? If you have taken it, then do as many others are and help spread the word!

Post Traumatic Stress Disorder After Childbirth

Wed, 13 Aug 2008 02:59:38 -0400

There has been a great deal of awareness about Postpartum Depression in recent years, but not so with Post Traumatic Stress Disorder after childbirth. The reason for this is likely that people believed this to be a very rare disorder. Only three years ago, after my son was born and I began to experience symptoms of this disorder, there was barely any information available about it online or elsewhere. The rate of occurrence was reported to be between 1.5 and 5.9%. There were only two websites at that time that focused on this issue, both of which were from other countries.

There is a new survey out that suggests that PTSD after childbirth occurs quite a bit more frequently then previously thought. The survey is called New Mothers Speak Out and was a follow up survey to the Childbirth Collective's Listening To Mothers II survey. The survey found that 9% of the 900 women screened met all of the diagnostic criteria for PTSD, and 18% showed some signs of it.

This new data indicates that many more women are suffering from PTSD, or symptoms of trauma after childbirth then previously thought. It is not clear why there is a discrepancy in figures, if it is because the women are not seeking treatment, or they are being misdiagnosed. Either way, it is very good that this issue is being brought to people's attention.

One of the main risk factors for PTSD is having negative interactions with care providers and staff during your birth experience, and feeling not in control of your labor or birth. When women, birth care providers, and staff are aware of these risk factors, adjustments can be made that may help prevent PTSD or symptoms of trauma from occurring. Women may decide to choose providers or birth settings where they feel they will have more control over their experience and will be respected. Care providers and staff should be aware of how their treatment affects women and strive to allow her to be in control of her own experience and to respect her wishes and individuality. It is also shown that a large amount of medical interventions can be a big risk factor for experiencing PTSD after childbirth. Both women and care providers should be aware of this and try not to use interventions that are not necessary. Another risk factor is previous trauma, which can be screened for before a woman gives birth. If previous trauma is an issue it may be helpful for the care provider and the woman to strategize on how to work with this issue during labor and birth. Debriefing shortly after a birth that was perceived as traumatic by the mother can also be very helpful for some women and this should be an option for women who find themselves experiencing symptoms of trauma.

The Wall Street Journal just ran an article about this issue entitled Birth Trauma: Stress Disorder Afflicts Moms. There is a very interesting accompanying podcast found here.

Today, there are more resources available for PTSD after childbirth then there was three years ago when I was searching for information. There is a growing awareness of the issue and this will hopefully help to prevent it from occurring in the majority of cases. In the cases where there are true emergency situations, an awareness and the subsequent adjustments in treatment of the mother and her baby can hopefully help to minimize the trauma that the woman might experience.

"Doula" in Entertainment Weekly!

Sun, 10 Aug 2008 14:15:53 -0400

In the August 8th, 2008 issue of Entertainment Weekly, a weekly entertainment magazine that talks about popular books, TV shows, and movies, doulas are mentioned. There is a small piece each week called "The Shaw Report" that is written by Jessica Shaw. It is a chart with three columns across and three rows down. The things that are listed fit into categories called "In", "Five Minutes Ago", and "Out". The row that mentions doulas says that "Massage School" is "Out", "Yoga Seminars" are "Five Minutes Ago", and "Doula Training" is "In".

I thought this was rather significant as there is no supplementary text, no explanation of the word "doula". It just puts it out there as if we all know what it is. This is not a parenting magazine either, this is a popular entertainment magazine. "The Shaw Report" generally refers to things rich people or celebrities are into, and out of. I'm thrilled that the word "doula" no longer has to be followed up with a definition or explanation, and even more thrilled that "Doula Training" is "IN"!

Birth Track, a New Way to Monitor Labor

Mon, 21 Jul 2008 15:56:43 -0400

I recently was directed to this new device marketed for women in labor called Birth Track. It is mentioned in Jennifer Block’s book “Pushed: The Painful Truth About Childbirth and Modern Maternity Care. It is a device that tracks the position of the baby via sensors placed on the abdomen, the baby’s heart rate via an internal fetal monitor that is screwed to the infant's scalp, and cervical dilation via electrodes that are clipped to the cervix.

I read over the website but was left with several questions. At first glance, I thought this machine was a bad idea, however, the promise of no vaginal exams was intriguing and prompted further investigation. Though everything I read about the device in the natural birth community was very critical, there was something in the back of my mind that wondered if for some women this machine might be a useful tool.

I emailed the company with an entire page of questions asking about the product. A representative of the company emailed me back and asked to have a phone conversation about it, which we did this morning. I learned quite a bit about the product. I also saw first hand the medical communities vast ignorance and prejudice about natural childbirth.

It is important to note that this machine is only being marketed in Europe, and is not currently being marketed to the United States. In fact there are no plans to market it in the United States anytime in the future. The reason given for this is that the US is much more conservative, they have a much higher rate of cesareans, and the representative told me this was due to the financial gain that cesareans provide to them. A machine that may reduce the rates of cesareans and provide a printout of legal evidence that a labor was progressing and the baby was fine, is not something doctors in the US are very excited about. Europe is actually looking to avoid cesareans and therefore they welcome tools that allow them to do so. The US is not interested in a tool that would help them avoid cesareans.

I of course was very skeptical that this machine would help physicians avoid cesareans. However, it was pointed out to me that digital exams are inaccurate and don’t measure the nuances of dilation. This machine measures tiny nuances of dilation that a digital exam will not be able to decipher, and it also measures the babies head moving down. At any given time during labor, if the baby’s head is moving down, or if there is an increase in dilation, then labor is progressing no matter how slow. Most cesareans are due to failure to progress, and if a machine shows some progression, any progression, then a cesarean is not warranted.

I asked how the electrodes attached to the cervix. He explained that they hook and clip onto the cervix. I asked if this was painful, and he told me that there are no nerve endings on the cervix and that these clips, once in place, are not painful at all. I asked if there were reports of pain in the studies that were done, and he assured me there was no pain whatsoever in both the epidural group and the drug free group. He said that patients reported being extremely pleased with the machine and didn’t report any pain. He explained that a vaginal exam is painful because there are nerve endings on the vaginal wall, and therefore attaching the device may be uncomfortable, but once it is attached there should be no pain. I still have a hard time believing that and would have to see a lot more data on the studies they did, how many women were in the drug free group, and exactly what they said about their comfort in wearing this device.

I next inquired about the ability to move around. He explained that there are two phases of labor, the latent phase and the active phase, and that during the latent phase is when the doctor wants the woman to walk the hallways and move around, but once she is dilated to 3 – 4 centimeters she is going to be in a lot of pain and will want to stay in bed. He told me that contractions will be so bad at this point that women wont be able to stand up through them. I informed him that the majority of women are able to stand through contractions and that it actually decreases the pain if they are able to remain mobile. He then said that the latent phase can take a great deal of time, but that the active phase must go quickly or there can be damage to the mother and baby, and he then explained in detail the many ways a baby could die if the active phase isn’t moving along. I inquired as to how quickly the active phase must be before damage to the baby ensues, and he admitted that this was highly debatable.

We then discussed the epidural and how it causes cesareans. He said that his machine would help in this way, because as long as there is any dilation or movement of the baby down the birth canal, then it is okay, there wont be any damage to the baby. They just don’t want to see a baby’s movement or the cervix stop progressing during the active phase of labor. He told me that the epidural causes cesareans because, since there is no pain, then oxytocin is not released, which stops progression of labor. I pointed out that another issue with an epidural is that the woman is laying on her back in bed, and not moving around to facilitate the baby being able to move through the pelvis, and her pelvis can’t move to allow for the baby to come through it. He then finally saw what I was getting at and assured me that women could move with the device on. He said they could roll in bed, squat by the bed, or use other positions, by the bed. They can not walk around unless they disconnect the machine, which he indicated would be no problem at all and that women can do this easily to use the bathroom.

He admitted that this device was not going to be for every labor. He suggested that it would mainly be for that first time mother who was planning to use an epidural. He told me that most women are required to be on a fetal monitor during the active phase and that you can’t move around while you are on a monitor anyway. I told him that I was on a fetal monitor for my sons birth, but it was not routine, it was indicated. He then asked if I was a nurse. I said no. He said, “well then how do you know what is routine and what is not at the hospital?” I was a bit shocked, but collected my thoughts enough to say, “because, when I was planning the birth I checked into the hospital to see what their routine procedures were. It was important to me to be able to move around.”

At this point in the conversation I was beginning to see his point of view; that most women get epidurals, and most women do not move about in the active phase of labor, and that most women are not going to be bothered in the least by a device that may limit mobility. He pointed out to me that doctors in the US may digitally check for dilation and find no progress, and tell a woman “I don’t think your progressing, we’re going to have to take the baby out.” He told me this is simply guess work, and that this device would take away the guess work. With this machine, instead of guessing, they would know, and they could make a decision based on knowledge and not an educated hunch. He reminded me that this device can measure what the contractions are doing on the inside by measuring the cervix dilation and the movement of the baby. Any progression will take away the justification for a physician to perform a cesarean, which is likely why many US physicians would not want this product available.

I asked what would happen if the baby was born before the cervical clips could be removed. He told me they would simply move aside and out of the way. They wont tear or damage the cervix, or harm the baby. This did happen in a few of the births in the studies and the clips functioned properly and did no damage. He said it only takes a second to take the clips off. I asked if they recommended breaking the water early in order to hook up the machine, as the internal fetal monitor part of the machine would need to be inserted into the baby’s scalp after the water was broken. He told me no, that they do not advocate breaking the water simply to attach the monitor. He told me that the machine will still measure the baby’s position and cervical dilation, and the monitor is only to be used if the baby is being monitored anyway. He told me that the machine is not intended to monitor a distressed baby, it is intended to track progression. The internal heart rate monitor is optional.

I asked what the studies that were done on the machine showed. Did they show that the machine worked, or that the machine caused better outcomes for mothers and babies? He assured me that there were several types of studies done and that they showed both. The machine functions properly, and there were better outcomes for mothers and babies, and parents were extremely satisfied with the use of the machine. He said that they were surprised to find that the rate of cesareans decreased with the use of the machine. They didn’t think the machine would change behavior, and performing cesareans is more of a behavior, but they did indeed decrease the rates of cesareans. He reasserted that this is why the machines are doing so well in Europe, because they want to decrease the rate of cesareans. He also said that the machine increased the speed of labors. I inquired as to how, and he told me that if the labor is not making any progress, drugs to speed it up are given quicker which results in faster overall labors. I also wondered if part of the reason is that women are not being given exams throughout their entire labors, not even that one to see if it is okay to push. I would have to see the actual studies, but I think this would be a logical presumption. We know that the less we tamper with women, the faster they labor. Perhaps a fortunate side affect of the machine is that women are left alone far more often then they normally would be.

We discussed the parent’s satisfaction with the machine. He said that mothers and fathers both were thrilled to be able to watch the machine track the baby’s progress. He said there is even a picture generated based on the data the machine collects that shows the station of the baby’s head as it moves down the birth canal. Though I have reservations about parents watching a screen instead of actively participating in the birth process, I asked if he thought that this gave parents a greater confidence in the process and empowered them to deny a cesarean when they could see for themselves that things were progressing. He said that he can’t speak to what parents thought in that regard, but that parents reported having a greater appreciation for what was going on when they had the visual information in front of them. Though this is not the way I would choose to empower women, perhaps in our technological culture, this is what it is going to take?

When asked if he thought that this machine had a place in natural birth (which we defined as non-epidural birth for the sake of the discussion) he began spewing off statistics to me, that 40 – 50% of labors are non-progressive and that when labor happened in the home many more infants and mothers died. I reminded him that there were several factors for that, and also that deaths increased when births moved into the hospital. He did not believe me and I told him I would email him information to back this up. I told him that the deaths increased due to poor hygiene and infections this caused. He said that if you have a homebirth with a midwife, and she has to check you every few hours, that can introduce bacteria and cause infections, so using the machine would be safer. I said, true, but homebirth midwives don’t tend to give women very many vaginal exams. He was very confused by this and acted as if he didn’t even understand how this would be possible. I explained that they look for other signs that labor is progressing, you know, they look at the woman herself. I cleared up misconceptions he had about midwives not using any technology, even to check heart tones. He continued to rant against homebirth, and I reminded him that this machine can only be used in a hospital and so homebirth was irrelevant to our discussion.

What about naturally birthing women in a hospital? He then reiterated that this machine was not for all women, and that they do not advocate it’s use in every single birth, though he stopped short at admitting that it was not a good idea for a naturally birthing woman. He told me that he had met with hospital midwives who were at first opposed to the machine, but then realized there would be use for it in their practice. This makes perfect sense to me though, since not every woman in a hospital midwife program is going to go drug free. He finally stated that if they are going to do vaginal exams (and he just could not wrap his mind around how they could get away without doing them) that the machine would be a good option for any woman, whether she had an epidural or was laboring naturally. I couldn’t disagree with him on this, as I pictured my own birth experience sans vaginal exams and I knew it would have been a much better experience. I had machines connected to me anyway, so that would not even have mattered. However, if a woman wants to have a natural birth, she rarely plans on being given an excessive amount of vaginal exams or in being hooked up to a monitor. He said, “if you want a natural birth, then don’t use it”. He said that some women don’t even want to be hooked up to a heart monitor and that if they want to take a risk like that then that is their choice. He told me how his two children were born with the cord around the neck and a lot of babies are, and that you can miss something like that if you are not monitored. I explained that 25% of babies had the cord around their necks and it was rarely a problem, and he explained that when the doctor saw the cords around the necks and yanked his children out with forceps, he believes it was because there was a problem. I understand how he could think this, and our discussion had gotten off topic. I got the information I wanted and so we ended our conversation.

He was a very friendly man and answered all of my questions to the best of his ability. I enjoyed talking to him. He was knowledgeable about his product and about what influence it has in the birth room. He was even more knowledgeable about the state of maternity care in the United States than I thought he would be. The only thing he was not knowledgeable about was natural childbirth, but in his line of work, I would imagine that topic rarely comes up unless it is in a negative way.

Before I contacted him I was intrigued by the machine, but I honestly thought it was likely a bad idea. Now I am not so sure. I do think it is a bad idea for a woman planning a natural birth, unless they would prefer to have one vaginal exam to attach the machine instead of two or more, and they would like to monitor their baby’s progress. I wonder though if it might be a good idea for women who plan to labor with epidurals. Once the machine is attached during active labor, there is the potential that the woman would be left alone to labor. Perhaps if there is some progress shown on the machine, any progress, it would make a cesarean legally difficult to justify. Women would then not be pressured to progress or threatened with a cesarean if they don’t. They would not be subjected to a multitude of vaginal exams when their labor slows, as long as it keeps moving along, everything is fine. If a woman used this machine, she could potentially avoid a cesarean simply by having legally documented proof that her labor was progressing. Also, by being left alone more frequently, she is more apt to labor quicker, which is what the hospital wants. Most of all it has the potential to reassure parents that everything is fine and normal, and that the woman’s body is doing what it is supposed to do in order to have a baby. I wonder if this could reinstall our cultures faith in a woman’s body to birth? This could also potentially empower the parents to advocate against an unwanted cesarean, since they are seeing with their own eyes that they are making progress. If each woman had the option of this machine if they choose an epidural, I can see how that would have the potential to help women avoid cesareans. Throwing a doula into that mix would increase her odds even more.

On the other hand though, we don’t know how this machine would be used by US physicians. Would they simply redefine “failure to progress” to reflect what the machine shows on average? Perhaps if there is often a lull in labor of an hour or two, that will be justification for a cesarean then? Perhaps they would ignore the advice of the manufacturer and simply break the woman’s water immediately. This could potentially increase the rate of cesareans and infections as well as other complications. They may even make this machine, along with it’s internal fetal heart monitor, mandatory for all women in active labor in order to reduce the amount of personnel on staff. Using a fetal monitor in normal labors when they are not indicated has been shown to have little benefit and only increase the rates of cesareans.

Now that I’ve looked into it further, I am not sure what I think about this device and how it may help or harm woman in the birth room. I think I need to see more information. It would be nice to have access to the actual studies, and of course independent studies would need to be done as well. I tend to think there may be something to the claim that it would help decrease cesareans as they are not even able to market it to the US. I also wonder though if there is some other reason that the US is rejecting the device. The bottom line is, I will have to reserve judgments about the Birth Track until I have more information.

Jennifer Block's Article in the Los Angeles Times

Fri, 11 Jul 2008 10:50:04 -0400

Jennifer Block wrote this article, Big Medicine's blowback on home births for The Los Angeles Times. The article is about the AMA's recent statement on homebirth, and why this is not in women's best interest.

New Discussion Board for Healing Birth Trauma

Fri, 23 May 2008 13:32:31 -0400

I have been working with some women (Jenne Alderks, and another which prefers to remain anonymous) to create a discussion board for healing birth trauma. We joined together with Sharon Storton of Solace, who was thrilled to host the discussion board on her website. Here is the announcement about it. Feel free to pass it on to women who have experienced birth trauma;

This message is to announce a new online discussion board called Solace For Mothers, An Online Community For Healing Birth Trauma. It is for women who have experienced trauma around the process of giving birth. For these women, giving birth has left them feeling deeply disappointed, traumatized, or even violated. We want these women to know that they are not alone, that birth trauma is very real, and that other women have had similar experiences and feelings. We have created an online community as a place for women to begin or continue their healing journey.

In the online community, there are different categories and forums, and the topics covered are issues that often come up for women dealing with birth trauma. It is our hope that women can virtually support each other on their healing journeys in this online community, and perhaps eventually connect with each other in the real world if they choose.

There is an introduction page here; http://www.solaceformothers.org/forum.html, and from this page you can register for the discussion board. Due to the very personal nature of this subject, we have made an effort to keep this community private, and women must register before being able to enter or view posts. If you do not fall into the category of a woman suffering from birth trauma, or if you would like to see a preview of the community before joining, you may visit this link to do so; http://www.solaceformothers.org/preview.html. This link is not the actual community and you will not be able to view members' posts from there, it will simply give you an overview of the topics covered.

We are sending this message out via email and posting it to online communities and to lists in order to reach these women. Please send this message to anyone who you feel may benefit from it.

Sincerely,

Jenne Alderks and Jennifer Zimmerman, creators and moderators of the discussion board

Supported by Sharon Storton and the Solace For Mothers team

Cuddling Cuts Preemie Pain

Thu, 24 Apr 2008 20:56:21 -0400

I found this article on WebMD today;

Cuddling Cuts Preemie Pain
Kangaroo Mother Care Helps Very Preterm Infants Get Over Pain Faster

Some quotes from the article;

"It works in premature infants of 32 to 36 weeks' gestation, according to an earlier study by Celeste Johnston, DEd, RN, and colleagues at McGill University School of Nursing. But can it work in babies born as early as 28 weeks' gestation? The answer is a qualified yes, Johnston and colleagues now find."

"Kangaroo mother care was invented in 1978 by Colombian pediatrician Edgar Rey. Faced with a shortage of incubators, Rey found that mothers could use their own bodies to warm premature infants. Years of study show the technique to be at least as safe and effective as incubators, and it lessens mothers' anxiety while promoting mother/infant bonding and breastfeeding."

"The technique calls for the tiny child to be held upright between the mothers' breasts and covered with a blanket. Because the child must be held upright against warm skin 24 hours a day, mothers can share kangaroo care with fathers and others."

"More importantly, the very preterm babies recovered from the painful heelstick about a minute faster when held kangaroo-style than when left in the incubator. That's a sign the babies' bodies are beginning to self-regulate, a process known as homeostasis."

"'Mothers should be offered kangaroo mother care as neonatal intensive-care unit policy, not only to be close to their infant, but also to provide comfort,' they add."

If kangaroo care, or skin to skin contact, helps reduce preemie pain, wouldn't it help reduce the pain or discomfort of full term infants as well? If it "lessens mothers' anxiety while promoting mother/infant bonding and breastfeeding", wouldn't the same benefits be seen with full term infants? If kangaroo care becomes "neonatal intensive-care policy", why shouldn't it also become the policy in the regular labor and delivery unit?

C-Section First Time Moms 12% Less Likely to Have More Kids

Sun, 06 Apr 2008 11:14:38 -0400

New York Times Article: C-Section Moms Less Likely to Have More Kids.

Hmm, now I wonder why that would be?

Birth Rape

Mon, 31 Mar 2008 16:16:13 -0400

I just read this article the other day; More Than a Traumatic Birth. After reading the article and the comments, it is apparent how controversial the term "Birth Rape" is. The term isn't just controversial, but the idea of a birth that a person would classify as a rape, seems to be something that is very jarring to most.

I personally had a birth that fits into the category of "birth rape", however, I generally don't use the term, as it causes uncomfortable silence and ends conversations that I want to have. It is difficult though, not having an understandable term for what happened. Describing the birth as "traumatic" paints pictures of a birth that went physically wrong which required major interventions, which is not exactly what happened in my case. The actions of the hospital staff and midwife were the major source of emotional trauma for me.

How do you feel about the term "birth rape"?