Your own Midwife

Honestly, I’m not really sure hot to approach this topic.. The question is do you really need us? And if so, what for exactly? We all feel that we need someone there, a second set of eyes and hands, someone to tell you that you’re doing great when you’re doing great, to help you set aside the worries when you’ve read too many “What to Expect When You’re– OMG I NEED TO CALL TO CALL THE DOCTOR” crap comes up, you also need/want a midwife/doula/doc there so that if, in the unlikely situation, you do need help they know what to do. In the rest of the cases I think that most women, if not all, could midwife themselves if shown how and if they wanted to.

Here’s my story. When I was pregnant with my first child I realized that hospitals scare the b-jesus out of me and I would rather sit in tub full of boiling water than birth a child in one of those places (I have a mild case of white coat phobia, I think). So what did I do? I got a list of doulas and midwives and called every single one of them to do an interview + got myself the most “respectful” OB word of mouth could give me. I had a home birth with a midwife, doula, spiritual healer, friend, and, of corse, my husband all there. My OB was lovely, and I mean that in the most sarcastic way possible, I got pressured, pushed, and oh, he compared my body to a car that you have to take to mechanic to know what’s is wrong with it. I’m pig headed and usually stick my ground in a passive aggressive sort of way. My husband, on the other hand, has the mouth that on occasion says the things I’m quietly steaming over. When my OB compared my body to a car my wonderful husband looked him right in the face and said “But she’s lived in her body for 24 years and you’ve only met her!” Que imaginary happy dance going on in my head.

Anyway, case in point, no matter how long you’ve lived in your body, what better time to get to know it than NOW. When I gave birth to Milo I had a crew of wonderful people around me, I knew as much as I could gather about birth but mostly I put my body and my baby in other people’s hands and that was fine. First births are a little of “what the hell am I getting into?” so it’s a little different second time around. When I got pregnant with Ananda my midwife was busy with her own daughter who lives on the mainland. She could do some checks but would not be there around my due date. I felt empowered after my first birth and did’t think I would need the whole army. This time, after much thought and discussion my midwife convinced my husband and I to do labor “unassisted”. “Unassisted” in my case does not mean alone in the woods with wolves howling. My midwife got my husband and I prepared, gave us the tools we needed, and offered up a girl she had just begun training to be there. This was the experience that I needed, this was the experience that my daughter was calling for.

As my midwife prepared us all for my birth I learned not only what to watch for but also how to check my own dilation and effacement. It is pretty easy to feel the position of your cervix. If it’s high it usually means that you are ether pregnant or getting ready to ovulate but if you swat you can usually reach something that feels a little like a thumb nub. If you feel an opening you’re about one centimeter dilated. The thinner the lining the more effaced you are, the wider the opening the more dilated. Pretty simple actually. When I wanted to check on my progress through labor I didn’t wait until I was between contractions, notify someone, get into an odd position, and then have them check. I simply checked my own dilation in whatever position was best for me. The woman who was still learning wanted to feel as well for her own training. This really made it hit home how uncomfortable it actually is to depend on someone else to assess yourself. Usually by the time I was in the right place for someone else to check me I had another contraction coming on. In addition, simply having my hands down there helped me feel Ananda’s head crowning. I actually took the warm rags out of our helpers hand and put them on my own perineum and it felt about a million times better.

I am not some crazy warrior woman, I am not Ms. Get Down to Business and Do Everything Just So. I just know, that who is better at saying what is happening in MY body than ME? For me, doing things myself helped me feel powerful and fulfilled in my labor. I am not the best communicator when I am in pain, who is? But being able to assess the situation and read my own body was taking possession of myself in a way that was great!

In my current pregnancy my midwife asked me “How would you like to midwife your own prenatals?” Huh? What? I can? How cool is it to take charge of your own pregnancy and know what is going on whenever you want to. It’s great! I had my first prenatal the other week and we sat around discussing the subtitles of my urine. It’s really very simple and can be read just to tell you “I need to drink more water, or eat less sugar.” I lie down feeling my pubic bone and the top of my baby’s head, and then I fill out all the paper work for myself seeing first hand what it all looks like. I don’t remember my doctor ever inviting me to look at my own paper work much less fill it out myself! It’s nice to be treated like the expert in my own body, just being taught how to read it a little better. We’ve all been living in our bodies for how long. Don’t you think it’s time that someone treated you like you know a thing or two about it?

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?

More Healthcare is Not Better Healthcare – well, duh…

I had to snicker when I saw the headlines that proclaimed that more healthcare was not better healthcare. I mean seriously, birth has been proving that time and time again. ?The more medicalized we’ve made birth the higher the cesarean rate has risen, and the higher the infections, NICU admissions, breathing problems in babies, etc. have risen. ?The more we induce labor, particularly before babies are really ready, the more we see a rise in NICU admissions, cesarean section rates rise, etc. ?Do you see the circle we are going in? ?We’re like a silly puppy dog chasing our own tails. ?

I’d like to suggest that we all just back away from the prenatal care. ?Prenatal care that means invasive tests and inductions of labor when not medically indicated, that is… ?Let’s use the interventions that we have as we really need them – sporadically. ?Just because a new fancy procedure is really cool and works really well to help sick mothers and babies, doesn’t mean it’s good for all mothers and babies.