Wedding Analogy

I woke up the other morning thinking about an experience I had last summer.  I was following a mommy blogger who was preparing to have her first baby.  She was talking about her 36-37 week prenatal visit.  She was hoping that the baby would stay breech so that she could schedule a c-section and be done with it.  Her whole post mad me feel sad.

She had started blogging, as many women do, around her wedding.  She had countless posts with paragraph after paragraph about the intricate details of which flower for which bridal party member and why.  She talked for hours about the flavors of the cakes.  And let’s not forget the wedding dress – that needed the be exactly what she wanted.  It had to be perfect.

To be fair this mom was an event planner.  This was what she did for a living.  She took one day and turned it into something really special for her clients.  She said that a marriage should start out on a perfect note, that it set the stage for the marriage.

So when I heard her talking about how birth was only a day and that it didn’t really matter, I knew she was wrong.  And more than that, her own statements about marriage, when applied to her thoughts about birth were incongruent.  How could she say that how you gave birth didn’t matter?  That it didn’t deserve the same amount of planning that her wedding did.  All she wanted to do was to get it over with…

My heart broke for her.  She is certainly entitled to her opinion and I said nothing to her.  But what I wanted to say was that you could get an amazing sense of empowerment through birth.  That giving birth to your baby was every bit as important and empowering as stepping into the limelight in a beautiful dress as you walked down the aisle towards your husband-to-be. And please note, I’m not saying that you can only achieve this through one type of birth, because that’s not what I believe.

So, if in her world, a marriage that was not carefully planned could start your marriage out on the wrong foot – why couldn’t a birth that wasn’t prepared for also cause similar issues?

In the end her baby turned, much to her dismay.  She decided to “try” a vaginal birth via scheduled induction.  She had an early epidural and what sounds like (via Twitter) a violent instrumental delivery.  She had a really rough recovery and gave up breastfeeding early so that she could rest and heal.  She intends to breastfeed her next baby after her scheduled c-section with baby number two.  I can’t help but thinking if a bit of planning for her birth, like a childbirth class might have helped her a bit.  I think it would have helped her achieve her breastfeeding goals at the least. Her birth certainly impacted her beginning into parenting.

So what I had wanted to say to her before her baby was born, but never posted, was that just because you elope and don’t plan for your wedding, doesn’t mean that your marriage is doomed.  It means you missed out on a beautiful experience, the support, the thrill of planning and the joy of walking down the aisle…

In Control

When a pregnant woman shows up for her first prenatal appointment, the doctor presents her with a long list of tests that she will undergo in the coming months.  He might also give her information on what’s okay to do, eat and inhale during pregnancy… and if he doesn’t, she will surely know from the 9 different online pregnancy newsletters she signed up for as soon as she saw the two pink lines.  Everyone knows a pregnant woman shouldn’t drink alcohol or caffeine, shouldn’t smoke, shouldn’t eat sushi.  But she will soon discover that the list is much longer than she had thought: many types of herbal teas, unpasteurized cheeses, meat or eggs that are not thoroughly cooked, deli meat, hot dogs… and let’s not forget, you’re pregnant now, so you better start eating right.  It’s all whole-wheat and rabbit food from now on.

I have often seen this turn into hysteria.  It’s one thing to eat right and avoid foods that may be harmful.  We all should.  It’s another to fly into a panic over the rumor that eggplants can stimulate labor.

And then she goes in for her tests with her heart pounding every time.  She needs to know that everything will be okay with this baby.  She can’t wait to find out the sex so she can start planning the nursery and decide on a name.  Towards the end of her pregnancy her doctor will keep close tabs on the baby’s weight and position to make sure all will be smooth.

Let’s not even talk about what happens during the birth itself.

Control.  It’s all about control.  The modern pregnant woman is infused with this totally disproportionate sense of responsibility.  Because what if something does go wrong?  What if her baby is born with a defect that wasn’t detected by the multitude of ultrasounds and blood tests?  The first thing she does is blame herself.  This is my fault.  It was because I couldn’t resist and ate sushi at that wedding.  I knew I shouldn’t have.  And those old ladies there told me, they wagged their fingers and said it would be my fault and I laughed them off.  I will never forgive myself for this.

And maybe once she works past that totally false guilt, she’ll turn her anger against the ultrasounds that “should have seen this”.  They should have told me.  How dare they not have told me.

You are not in control. And the medical establishment is even less so.

Yes.  It’s important to take the necessary precautions and try to keep yourself and your baby from harm.  But even if you do everything right, eat all the right things, get all the right exercise and make all the right choices–it doesn’t mean that nothing bad is going to happen.  And on the flip side, if you slip up or shrug off “the rules” once or twice, that doesn’t automatically mean that something is going to be wrong with your baby.  And it also doesn’t mean that if something does, it was your fault.

This attitude carries over into childbirth in such a profound way.  How many C-sections have been performed for the sake of control?  “To be on the safe side”?  How many women have chosen induction at their convenience so they could know exactly when the birth would be and plan accordingly?  How many women walk into the hospital announcing that they want an epidural NOW because they are deathly afraid of facing the excruciating pain everyone has told them awaits?

And don’t think that natural birthers or homebirthers escape it.  How many of us have pounded our chests over not getting enough exercise, over giving in to that ice cream craving, over not drinking red raspberry tea in time?  “Now my birth will be ruined.”  No it won’t.  It’s not in your control.  Not everyone who drinks red raspberry has a five-hour labor.  Not everyone who eats ice cream has gestational diabetes.  Not everyone who misses a yoga practice is going to demand an epidural.

And then these surges of immense power and energy take over your body.  Your uterus is doing this all on its own.  You are not in control now.  And the more you step out of the way and let your body do its work, the better it will do.  When I was very young I asked my mother what giving birth was like, and she told me it was kind of like lying on a raft in a very fast river.  “If you can just lie there and let yourself be carried by the flow, you will be fine.  The more you try to fight it and control what is happening, the more everything will spin out of your control.”

If you have spent your entire pregnancy obsessively setting up everything to be perfect, it’s going to be very hard to let go at these moments.

So start letting go a little now.  Breathe.  Smile.  You’re doing great.  Everything is going to be fine, as long as you have faith in yourself to face whatever comes your way.

A Weighty Issue

Americans have been warned for years about the perils of being overweight or obese.  Indeed the risks for a host of complications increase steadily as the pounds pile on.  For many people, the risks can be temporarily ignored; after all, it takes years to develop heart disease or Type II diabetes.  But for one segment of the population, the risks are immediate and grave: Pregnant women.

For obese women expecting a child, the nine months of gestation bring with them potentially life-threatening complications (to mother and child).  Chief among the issues related to obesity in pregnancy are pre-eclampsia, gestational diabetes, and cesarean section.  The New York Times published an article the other day outlining the risks and providing the real-life example of one woman and her ordeal with a 29 week preemie.

So what are we to do?  Weight is such a sensitive issue for so many women, even those without excess pounds.  Doctors are often hesitant to bring up the subject of a patient’s weight during an office visit, for fear of offending the patient or “pointing out the obvious.”  And the short time allotted for an office visit, for general practitioners as well as OB-GYNs, means that little time is able to be devoted to counseling in nutrition, exercise, and weight loss or maintenance.  Traditionally, midwifery care focuses more on nutrition and holistic pregnancy care, but midwife care is not available to all women, nor is it the end-all, be-all solution.

We need greater outreach to obese women of childbearing age, both before and during their pregnancies.  In fact, we may need to start sooner than that.  According to the CDC, almost 1/3 of American teenagers are overweight or obese.  Outreach needs to start as early as middle school, and continue throughout high school.  We also need community resources to reach across all income strata, in the form of outpatient clinics/support groups as well as education for Medicaid and WIC recipients.  We need to work to take away the shame and stigma of weight issues, while still providing empowerment for all people to take charge of their weight, and ultimately, their overall health.

We need more people thinking about solutions beyond “wider, sturdier” examining tables (as the NY Times article mentions).  What are your ideas and experiences?

It can wait for tomorrow…

I had one of those days where I had a list of things to do while out on the town, had my 10 month old in tote, and because of forces out of my control, got none of them done. I planned my outing to go something like this: get the oil changed in my car, go to the bank, and pick up dog food. NONE of this happened. I was waiting around way too long at the oil change shop when they said I was next in line (they lied). During this time the baby got cranky and by the time we were out there (without the oil change), it was nap-time so we did not proceed to the bank or the dog food store. What a HUGE waste of my day. When I got home I was really worked up and frustrated and then yelled at my husband who unfortunately works from a home office and is available to yell at whenever the mood strikes me, poor guy. On top of this, the baby would not go down for her nap when we got home so she was still cranky. Great.

When daddy stopped work for the day and was able to lend a hand in childcare, I was able to breathe and reflect a bit. My anger subsided and this feeling of  ”it’s okay, it can wait for tomorrow” took over me.

This got me thinking about all those mommas that are being persuaded into labor induction and this made me sad. In my first pregnancy my OB asked me if I’d like to schedule a cesarean when I was about 17 weeks along. There was no medical reason for this, it was for convenience! This is when a light bulb went off for me and I got the momma sixth sense that something was very, very wrong here. I immediately proceeded to change providers and practically ran to a natural birthing center where ended up having a non-complicated, peaceful, water birth.

What about the mommas who do not know that there are birthing choices? Do women think that it is normal to schedule a date to induce labor? To schedule cesareans?

It seems that many young, healthy women that I’ve had conversations with recently do not believe it is possible to have a natural birth. They were told for one reason or another that they aren’t “allowed” to. That they “have to” schedule inductions to not pose any “risk” to the labor process. These women pack their bags, do their hair and makeup before they leave for their scheduled date at the hospital, get induced and often receive an epidural when they get there, and with one or two pushes the baby is out.

Is this what birth has become? Do we have our babies like we shop online? For convenience? If there is no MAJOR medical reason why you need to have your labor induced, please stop to to think of the risk you are really putting your baby in by inducing.

Why would labor be induced?

There are several possible reasons. Those nearer the top of this list are cases where the benefits may outweigh the risks. Those nearer the bottom of this list,  the risks are more likely to outweigh the benefits.

1. If the baby or mother has a SEVERE health condition which makes it riskier to continue the pregnancy than to induce;  severe pre-eclampsia, diabetes with complications (it is estimated that this rationale for induction only applies to 3% of pregnancies)
2. Water breaking. If mom is more than 35 weeks pregnant, and it’s been more than 24-48 hours since membranes ruptured, most caregivers recommend induction to reduce risk of infection.
3. A baby that’s “overdue” – pregnancy lasting over 42 weeks.
4. If baby or mother has a MILDER health condition.
5. A pregnancy lasting over 41 weeks.
6. The baby is “too large.” (Although this is a common reason for physicians to recommend induction, research seems to indicate that there are not significant benefits to inducing labor)
7. Convenience or preference. Of the mother, or the caregiver. The risks outweigh the benefits.

Summary of induction risks.

All of the forms of induction can lead to stronger, more painful, and more frequent contractions, which may lead the mother to use pain medications she might otherwise not require. These powerful contractions may also limit oxygen supply to the baby, so increase the risk of fetal distress. Also, due to the uncertainty of due dates, and the variation in the amount of time any given baby requires to reach maturity, early induction carries a risk of causing premature birth. There is a significant increase in the chance of cesarean.

Questions to ask your provider if induction is recommended:

1. Why? What are the reasons why it would be better to deliver the baby sooner?

2.  How? Could we start with one of the non-medical options and see if that works?

2.  When? Is this something that needs to happen today? What would happen if we waited a few more days? Another week? Is it possible that it can wait for tomorrow….

Think about it, challenge providers, do your research. Only you know what’s best for yourself and your baby. 

Much love,

Amy

VBAC from a Care Provider’s Perspective

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What is it really like to be a hospital care provider attending VBACs? Janelle from Birth Sense describes it in this post submitted to the ICAN VBAC Blog Carnival.

The whole post provides a very rational, no nonsense description of the actual problems that care providers face without an emotional “WE’RE ALL GOING TO BE SUED AND EVERYONE IS GOING TO DIE AND YOU JUST DON’T UNDERSTAND RISK!” She calls upon providers of modern obstetrics to “speak up on behalf of women who want VBAC and insist that realistic, evidence-based guidelines are instituted.”

Furthermore, Janelle points out something that would probably shock the public about hospitals. The “special” mandate that an OB remain in the hospital during the entire VBAC labor with an operating team standing by is hypocritical. If hospitals are so serious about having a team ready to handle VBAC-related emergencies, why would they not want to have the same safety net available to deal with comparable emergency scenarios in “low-risk” women? When I gave birth in a hospital for the first time, I mistakenly assumed that there was an OB and an operating team on hand for those rare emergencies. Why else would I have been in a hospital?

What is most perplexing to me is the mandate that the provider remain in the hospital during a VBAC labor “just in case”, yet other serious causes of perinatal morbidity and mortality are not considered adequate reason to have a surgeon and operating team standing by.  Some examples are:

1. Cord prolapse, with an incidence of 0.14-0.62 percent.  This can cause permanent fetal injury or death.¹
2. Placental abruption, with an incidence of 0.6 percent.  Again, this complication of labor can cause permanent fetal injury or death, as well as potentially life-threatening blood loss for the mother.²
3. Placenta accreta, and its variations (placenta increta and placenta percreta).  With a reported incidence of as many as 1 in 533 births, this is a serious maternal complication which can cause death.³

If we are serious about being able to take immediate action in the event of uterine rupture (approximately 0.5% incidence in low-risk labors VBAC labors), we should be equally serious about being prepared to immediately manage other perinatal emergencies.   The truth is, VBAC is not much riskier than a normal first birth, provided a few criteria are met:

• One low transverse uterine scar
• Normal onset of labor, no cervical ripening or induction
• No use of pitocin augmentation during labor
• Prior vaginal delivery increases chances of successful VBAC
• At least 18 months since cesarean birth

The risk associated with VBAC that concerns hospitals, insurance companies and care providers isn’t just the potential risk to women and babies. They are naturally concerned about the risk to their financial bottom line associated with a potentially predictable obstetric emergency.

The next time you hear anyone try to tell you that patients or laypeople just don’t understand risk, the question should be “The risk to whom?” I would argue that, given accurate information and percentages, most patients understand risk just fine. When you read between the lines, it’s clear that patients are expected to believe that the risk that lies behind scare tactics and lies about necessity of many cesareans and inductions is based on a certain risk to them or their baby. Unfortunately, it often has little or nothing to do with risk to the patient and everything risk to the care provider or institution.

And that’s the risk that most patients do not understand about how decisions are made about their bodies until it’s too late.

Restriction of Food and Drink in Labor from a Medical Anthropologist’s Perspective

The recent Cochrane review, Restricting oral fluid and food intake during labour, analyzed five studies and concluded that women should be free to eat and drink in labor at will.

Since the evidence shows no benefits or harms, there is no justification for the restriction of fluids and food in labour for women at low risk of complications. No studies looked specifically at women at increased risk of complications, hence there is no evidence to support restrictions in this group of women.

The rationale behind denying laboring women food is that the danger of aspiration and the potentially lethal complication known as Mendelsohn’s syndrome while under general anesthesia is greatly reduced.

Medical anthropologist Robbie Davis-Floyd wrote extensively about the cultural myths about non per os and childbirth in the 1992 book, Birth as an American Rite of Passage. Mendelsohn’s original 1946 article reported several cases of aspiration and subsequent pneumonia, but no deaths. Davis-Floyd cites Baggish’s 1974 study which showed that at most 2 percent of maternal deaths were caused by aspiration under general anesthesia and Scott’s 1978 work that placed the risk of death at 1 in 200,000 women.

So what purpose would denying food and drink to all laboring women serve more than six decades after Mendelsohn’s work and with the great improvements made to regional anesthesia? Davis-Floyd wrote:

According to Feeley-Harnik, “persons undergoing rites of passage are usually prohibited from eating those highly valued foods that would identify them as full members of society” (1981:4). In rites of pregnancy and birth across cultures, food tabus serve the purpose of marking and intensifying the liminal status of the pregnant woman. The pseudo-foods (ice chips and lollipops have no nutritional value) allowed in the hospital are often fed to the laboring woman by her partner as if she herself were the baby, a symbolic process that can heighten her own sense of weakness and dependence.

In a recent article in Birth, Broach and Newton (1988) address the question of why laboring women are still prohibited from eating and drinking in labor in spite of mounting evidence that such prohibitions are medically contraindicated. Pointing out that this custom started in the 1940’s when general anesthesia was widely used for childbirth and the danger from aspiration was therefore higher, they posit that its continuance is the result of “culture lag”—that is, of “culturally patterned behavior that continues to be practiced long after the reasons for doing so have disappeared” (1988:84).

Davis-Floyd views denying food in labor as indicative of the confirmation of a woman’s initiate status as a dependent of the institution.

On the contrary, I would suggest that this custom forms an integral part of the technocratic tapestry of birth in the United States, continuing as routine procedure not because of culture lag but because it serves so well to legitimate and further necessitate the technocratic interventions we investigate here as transformative rituals. To deny a laboring woman access to her own choice of food and drink in the hospital is to confirm her initiatory status and consequent loss of autonomy, to increase the chances that she will require interventions, and to tell her that only the institution can provide the nourishment she needs—a message that is most forcefully conveyed through the “IV.”

Restriction of food and liquids in labor was the subject of many discussions last year following the American Congress of Obstetricians and Gynecologists’ press release that women should be allowed “modest amounts” of water and clear liquids in labor, with physicians defending IV use and telling women to calm down their rhetoric and fight for things that matter.

Loyally Devoted to Doctor

I recently read the book The Highly Sensitive Person by Elaine N Aron, Ph.D. In the chapter called Medics, Medication, and Highly Sensitive People, the author states:

“Keep in mind, too, that it is common to feel an attachment to anyone you have been with during an arousing experience, especially if it was a truly painful or emotionally significant ordeal. In the medical realm you hear these sorts of extra feelings when people describe their surgeon or women talk about the person who delivered their child, which is perfectly normal. The solution is simply to know why it happens and compensate for it appropriately.”

In the chapter about relationships, she talks about studies that were done that showed people are far more likely to fall in love under stressful circumstances. She applied this phenomenon to attachment in all relationships, not just romantic relationships. Later when I read the above statement in the medical chapter, so many things started to make sense to me.

Why do women love their maternity care provider, even when they may have done unnecessary procedures on them and not allowed them to make their own choices? Why do many providers use scare tactics? Why do women hold so adamantly to the belief that their provider “saved their life” or “saved their baby” or “was a great doctor” or “really took good care of me”, even when evidence to the contrary is right in front of them? Why do they fail to make important connections, such as that their c-section may have been one of the many unnecessary ones, or that there may not have been a true evidence based need for their induction? Why is childbirth treated like a major emergency with so much fear and anxiety around it? Why aren’t all women who give birth in this system severely traumatized from it, and instead defend and adore their doctors? The answer is simple: the culture of fear that surrounds childbirth actually endears women to their doctors. It cements the relationship between women, their doctors, and the hospitals their doctors practice at. It ensures that the women will keep coming back, and will recommend their providers to all their friends as they speak about them in glowing heroic terms. It is quite brilliant really, providers and hospitals have found the key to running a very successful business, and it has nothing to do with allowing women to make their own choices. They simply have to give the illusion prenatally that the woman can make her own choices for her birth, and then make sure that the actual experience of birth is one filled with fear, anxiety, and of course a healthy baby, and then the narcissistic provider will come out looking like roses to the woman who must endure the “horrors of childbirth”.

Of course, I am not really giving the doctors the benefit of the doubt here. They likely don’t know on a conscious level what they are really doing. They have been trained to act this way, by people who were also trained to act this way, and it is reinforced for them every time a woman profusely thanks her doctor for a job well done, and every time a woman tells her birth horror story where the good doctor makes an appearance as the hero who delivers her baby to her despite all the dangers that presented at the last minute. Both the woman and the doctor seem ignorant of the psychological effects that framing every average birth as a medical emergency creates.

In the statement above, the author states: “it is common to feel an attachment to anyone you have been with during an arousing experience, especially if it was a truly painful or emotionally significant ordeal.” This describes childbirth perfectly. The word “arousing” here is referring to sensory levels. That can mean physically, emotionally, sexually, or any other assault to the senses, good or bad, that can be had. We know childbirth can be described as “arousing” in many ways. It is also inherently “painful” and “emotionally significant”. Even when women use drugs, there is still some level of pain before she took them, and depending on what type of drugs she took, she may still experience pain while she is taking them. So really, all births fit this criteria. Births in a hospital, or at home, or in a birth center all have these same basic elements. It seems women are wired to form an attachment to the people who were with her and helped her through the event. This could be her partner, her doula, her midwife, her doctor, her nurse, or her friend or relative. I think this type of attachment likely had an evolutionary purpose at one time. It would be ideal to attach to an older, wiser woman who assisted with the delivery of babies who would have been there to care for the mom postpartum, and to slowly help her to bond and form an attachment to the baby. This wise woman would then help the mother learn to breastfeed and care for her new infant, while slowly pulling back her own attentions from the situation. This is what we have in homebirth midwives today. How would our ancestors have fared if a man had shown up in the tribe to deliver a baby, and then disappeared immediately afterward? The woman would be left adoring him, yet not having help from him to form an attachment to her infant. Never learning how to breastfeed or other infant care skills. What would have become of humanity? What is becoming of humanity?

Midwives and doulas seem to understand this phenomenon. Doulas usually visit a woman once or twice postpartum and are available if she needs to talk or has questions about the baby, breastfeeding, or the birth. Midwives start seeing a woman more and more as the birth approaches, and then once the baby is born, they start to taper off again, seeing her less and less until she is no longer needed at all. This is a much more natural and appropriate response to caring for a woman during such a pivotal transition in her life. What happens when women see doctors or CNM’s in hospitals though? They are likely seeing a practice, not a specific provider. They will likely not give birth with the same doctor or CNM they saw prenatally. They may never see the same doctor or CNM again after they give birth, or perhaps just once at the six week checkup. How does this affect women emotionally, or in her relationship with her baby, when instead of having a slow winding away from her provider, there is just an abrupt ending to the relationship? Does this interfere with breastfeeding, or affect feelings of trauma related to the birth, or feelings of depression related to her new role as mother? It is ingrained in our psyche to attach to these people who help us through such a major event in our life. How will the people we choose handle this responsibility? Are we choosing someone who will corrupt our experience and force an unnatural attachment to them by creating more anxiety around the experience? Are we choosing someone who will be there for us days, weeks, and months later to answer our questions about the baby or to offer us emotional support? Will the person we choose even be available for the birth, and will we ever see them again afterward?

Now I realize why other women feel the way they do about their provider. I did not attach to my provider, I was instead extremely traumatized by her actions. I still wonder why some women are traumatized, and others fall in love with their providers, given the same set of circumstances. I wonder if it is actually more natural, and thus common, to attach to a provider even when (or perhaps especially when) that provider creates an atmosphere of fear. It makes sense then why so few of us are speaking up about the system and the way women are treated. It makes sense that women are extremely loyal to their providers, even when many aspects of their births were disappointing or upsetting to them. It makes sense that many women are reluctant to accept that there is anything wrong with maternity care. It makes sense why the maternity care system is so hard to change and is met with so much resistance from every side.

What can birth activists do to help women form healthy attachments during this transitional time in her life? It may be tempting to try to convince all women to have a homebirth with a midwife since we know that they are probably the best option for healthy attachments and a healthy weaning away as well, however, if a woman has already formed a strong attachment to a certain provider, it may be more realistic to recommend having a doula. A doula will be there prenatally, for the birth, and postpartum, and therefore can provide much of the physical and emotional support that new moms need and deserve. Some moms may hire a doula, yet keep her same provider that she has formed an attachment to, and others may find that a doula is a stepping stone to having a homebirth the next time. One day I hope that maternity care shifts to being centered around the mother again, and not around the provider and his schedule or routine.

Why Our Women are Afraid of Birth

Deliver Me

It is Tuesday, at 10pm while I settle in after getting my little ones to bed. I flip through the channels and settle on discovery healthy which is a personal favorite of mine, but it really has only recently become a favorite because of shows like I didn’t know I was pregnant. It fascinates me that women could make it though a full term pregnancy and not know they were pregnant, but that is just me, and the experiences that I had with my children is what makes me wonder how the heck women could not know they were pregnant.  But that is completely besides my point today.
So as I watch this show, I am noticing a trend. High risk, high risk, high risk, previous cesarean section, scheduled cesarean section, high risk, healthy first time mother, scheduled cesarean, high risk. Well I mean, that is how it is in Los Angeles right?  You would think so!  But apparently because only these crazy, scary, uncommon births make something called ratings, that is all they are going to feature on TV. Because in reality, no one wants to watch a natural birth or a home birth because no one is running around with a scalpel screaming about the emergency that childbirth is. Nor is the mother screaming for her epidural because she just cant deal with the pain of the 3 hours of labor so far.
But what we should be thinking about most importantly is the message this is sending. What is this teaching first time mothers or even young women that may not be planning on having children soon but will some day?  It is teaching them how scary, dangerous, and medical birth is supposed to be. But is that really how birth is? Of course not. Anyone who has taken the time to read the studies, and just not follow what mainstream society thinks is the right way to handle pregnancy will know that birth is not scary or dangerous or a huge emergency. While it can be in some cases, in most cases it can and will be beautiful when just left alone.

When a woman becomes pregnant today, if they do not already have an Obstetrician they have been seeing for well women care since 16, or whatever age their parent decided it was the right them for them, what is the first thing that they do? They ask around their circle of female friends for the best Doctor out there because isn’t that what we all want? We want the one who is the BMW of pre natal care. Little do women know that they are really going to end up with the 1990 Dodge Dynasty when they take this route because hands off is better.
But because our society has told us this is the way things should be, they run off like lemmings right off the cliff of medical interventions landing in the valley of cesarean sections.

Maybe if the television channels like Discovery health followed a dozen home births or even aired The Business of Being Born they could get a popular, and controversial other side to what they are constantly airing. Maybe it will boost their ratings even more, maybe not?  But what it will do is give the other side of the whole issue. Let’s get Marsden Wagner to do a half hour special on Birth in The United States and see how many women run off to the midwives.  Instead they air these disgustingly inaccurate “Freebirthing” shows. They find the one idiot who is going to make women who choose unassisted birth look like a bunch of uneducated yokels.  Which is exactly what they did with their special on Unassisted birth.

I guess in the end, like anything else the television airs, it is biased and we shouldn’t expect much different.

Quote of the Day: Make Yourself Look Important and Busy

“A doctor must do something. He cannot remain a spectator merely, where there are many witnesses, and where interest in what is going on is too deep to allow of his inaction.”

Walter Channing, 1848
Harvard Medical School professor of obstetrics

Read more about Channing’s career and what the Harvard Medical School’s alumni blog calls the Channings “legacy of compassion” and “commitment to social justice.”

The Infamous Cascade Chart

As someone strongly involved in the birth community, this is probably one of my favorite pictures floating around the internet that I run across every once and a while.? One day when I find out the person who actually put these thoughts and cascade of interventions into a physical chart to view, I am going to kiss them!

I have always loved how it starts with induction, because lets face it, so many women today are starting their labors with some kind of artificial labor stimulant. Whether it be pitocin, or the oh so dangerous cytotec. I can personally say I have been the victim of the cascade myself with my first child. Had I seen this before my pregnancy with him, I would have never opted for the induction. Many do not realize that induction in many cases will fail, almost half of the time according to the most recent figures, and when I quote that, I am quoting Robbie Davis Floyd in a 2008 interview, I believe it was in Pregnant in America but my birth/pregnancy movies and interviews all start to blur together when you watch so many of them. These babies are not ready to be born in many cases, especially when we are seeing these inductions before the “due date” or the 40 week gestation mark. Although we know that “due dates” aren’t much to put stock into, many women and providers use them as some type of eviction date, which history has shown to be a pretty bad idea. No one is going to be pregnant forever and many women left alone will go into labor on their own. Now granted, there are cases that induction is medically necessary and for these special cases, I am completely thankful. Without induction these women would be subjected to cesarean sections instead of labor inductions which could in turn be even more hard on their body, and experience over all.
What we do not understand with the induction of labor is, we are creating unnaturally strong contractions in attempt to simulate something similar to natural labor. As someone who has experienced pitocin labor, and natural labor, I would take a million natural contractions over being on the receiving end of pitocin again. The comparison in my opinion is not even in the same ball park. Another issue with these contractions as most know, is the fact that they are more likely to cause fetal distress on the baby because they are not natural contractions or what normal contractions are supposed to be. So in turn we are putting our children under unnecessary stress. Especially if they are not ready to come and join us in “our world” yet. Again something I learned with my first.
Then we have the provider who comes in and looks at the fetal heart monitoring and says, “Oh No! Your baby is in danger!!” So off to the operating room we go for an “emergency” cesarean which in reality was caused by the pitocin to begin with. You would think by this point there would be a bit of common sense in the Obstetric community to say, ya know, I think we are causing these actions instead of blaming the increasing cesarean rate on “patient choice cesareans” which only make up 3% at most of the incredibly high cesarean rate in our country.

But a cesarean is only one path that this induction cascade can lead to. There are still women out there that will have a vaginal delivery when subjected to a labor induction, but in turn these women have greater risks for other procedures including episiotomies which have all in all been proven to really have little to no benefit to women in the long run. While episiotomy rates are starting to decrease, they are still over used in many communities. For example, here in my state of Connecticut, some hospitals have an over 25% episiotomy rate, when science tells us there really shouldn’t be over 10%. Trying to obtain these numbers are like pulling teeth too FYI!

We also have vaccum extraction. I had never really discussed this or spoken with someone who experienced this until I met my Chiropractor in the summer of 2008. He was discussing with me why Chiropractic care in infants is important, and then he described his own daughters birth, they had applied the vaccum to the top of her head, and while “assisting” her out, they pulled so hard the vaccum literally flew right off of her head. My Chiropractor described it so vividly… “I thought her HEAD popped RIGHT OFF! I was horrified to even look!”? My heart broke for him because no parent should have to go through that kind of fright during the birth of their child!

These all often lead to epidurals, which especially if you are going to have a cesarean section, you will either have this or a spinal block. All types of anesthesia that will have a direct impact on the baby. Although I have experienced women told there will be no effects on their baby at all.
I am sure most know about the “breast crawl” and I can say after watching a baby who’s mother did have an epidural, as opposed to a mom who had a natural birth, there is no comparing the instincts of the baby. While I had epidurals with both of my children, I didn’t have the opportunity to breastfeed then until they were a little over an hour old. My first was almost 2 hours. For more information on epidural effects on babies, click this link!

The last thing I want to touch on is the separation of mother and baby after a cesarean section which is very common. It is pretty uncommon for an newborn to be allowed to stay in the OR with mom, although it does happen sometimes. I can really related to the lack of bonding, breastfeeding problems, and reduced bonding because of this because I deeply experienced this with the births of both of my children. While I bonded, it was not that “instant motherly love” I am sure most feel. It hurts me to this day to know that my bonding was an almost learned bonding because I knew as a mother it was something I needed to do in order to protect my babies.? While most women who have had cesarean sections are not quick to admit this, I think by discussing this and acknowledging that this is a true problem it will only help to improve it for others in the long run. I also noticed that mothers who do experience this may be ashamed or fearful to admit this because it make portray them in a less than perfect light, or maybe others may look down on them because of this, but they should not be ashamed. It happens and there is nothing we can do about it but help other women to not go through what we did!

Be empowered by your birth, no matter how you birth!
If it is a bad experience, help to educate others so they do not go through what you did, so they can avoid the pain or heartache you have dealt with!