Mittelschmerz

Why is it that everything in German sounds like you’re clearing your throat? Or is some dread disease? Or some weird sexual thing?

I was prompted to write this post because I experienced mittelschmerz today. It literally means “middle pain” and is the abdominal discomfort that many women get in the middle of their cycle and in the middle of their bodies (the abdomen). Although the exact reason (or reasons) is unknown, it has to do with ovulation — whether the egg actually breaking out of the ovary, or the follicles ripening, or something. This pain can last from a few minutes to many hours. Some women feel this pain on both sides of their abdomen, but I’ve only felt it on one side at a time — although there have been cycles when I’ve felt it on both sides, but it’s been at distinctly different times. (I joke that if I were to get pregnant that cycle, it would be twins, but I don’t know for sure that two eggs were released — it could have been follicular ripening on both sides, but only one egg matured.)

I would describe the pain as a dull, nagging ache. Today, it seemed to go on for a long time, so I finally took some calcium. (I’m a big fan of calcium for aches and pains — it’s my pain reliever of choice, especially for menstrual cramps.) Since mittelschmerz can come and go, I can’t say for sure that the calcium relieved the pain — it’s possible that it would have stopped at that time anyway. But within about 30 minutes of taking the calcium tablets, the pain was gone and hasn’t come back. Since I get mittelschmerz with great frequency, I’m going to try to remember to take calcium at the beginning of the pain next cycle, and see if it helps. However, maybe it’s just my body’s signal that it needs more calcium in general, and if I take calcium regularly, it will prevent the pain in the first place….

Wow, what a great birth history!

Check out this guest-post on my friend Nicole’s blog: “Quiet, Sweet, but Not Compliant.“

Round Ligament Pain

During pregnancy, many women experience a sharp pain or dull ache in the abdomen/pelvis area. This is frequently “round ligament pain,” caused when the ligaments that hold the uterus stretch to adjust for the growing baby. (There are other reasons, such as ectopic pregnancy, appendicitis,ruptured ovarian cyst, etc., so be sure to check any pain with your midwife or doctor if you’re unsure of the source.) I only ever got this pain on my right side, just above the pubic bone and about halfway between my belly button and my hip. My midwife shared with me this tip of getting rid of it — massage it, and lift your leg slightly (like on the rung of a chair; whichever leg is on the side of the pain) and lean forward. Worked every time.

HPV vaccine

Although this isn’t strictly birth-related, it is a woman’s issue, and I think it is an important one. Here is an article I just read which raised some serious concerns about Gardasil. One of my chief concerns about this or any vaccine is the length of immunity the shot gives. Gardasil’s estimated protection is for five years. But it’s being given to 12-year-old girls. And they aren’t required to test to see if this is cancer-causing, or if it has any bearing on future fertility. As someone who was exposed to DES in utero, that scares me. This vaccine is just so new, how can they know?

Birth of Multiples

Here is a great video montage of women who have given birth to twins or triplets vaginally. Nowadays, it is almost taken for granted that they’ll be surgically removed from the uterus. Thanks to Ruth for the link! And the pictures are of the proud, happy, and victorious mamas and their babies, not of the actual births, fwiw.

Authenticity

Often when watching a movie, I notice accents — especially movies that take place in my area. You’ve probably done the same thing, whether you’re from Boston, Chicago, Canada, England, or wherever. I’m from the South, so I can tell when people are faking their Southern accents. Unless you’re from the South, you probably think they’ve got pretty authentic accents. When I watch movies based in Boston, Chicago, or various parts of England, for the most part, I can’t tell whose accent is real and whose is fake. I know that different areas have different accents, even if all of Great Britain sounds the same to me, except for perhaps the cockney accent. When Sean Connery’s character in The Untouchables was supposed to have an Irish accent, I didn’t realize how poor it was, with his natural Scotch accent showing through — but Irish people certainly did.

What does this have to do with birth? Authenticity. Take a look at this blog, which tells the story of a woman whose care provider originally said he’d support her decisions about her birth, but also talked about the routine things he did to every woman. At first, she thought she’d be able to have birth the way she wanted, but finally realized that his routine would trump her wishes, so she switched care providers to a midwife, and had a home birth. You see, he pretended that he would do what she wanted; he pretended that he would abide by her wishes — just like Sean Connery pretended to have an Irish-American-Chicago accent in The Untouchables. But this doctor was faking. Some actors are better than others at acquiring accents — I think Minnie Driver is pretty dang good — I’ve seen her with a Boston accent in Good Will Hunting, with an American accent in Return to Me, and with some other accent (I forget which — it’s been too long since I’ve seen it) in Circle of Friends. And she’s not even American! Just the same, some doctors are better than others at acquiring the words and phrases that make you think they agree with you. But if you listen long enough — to doctors who are faking or to fake accents — you’ll hear something that makes you question the authenticity.

Think about your own accent, and how you can tell when somebody is just affecting your accent, but isn’t really real. What gave it away? Often you can’t really tell — something small — a vowel that wasn’t said quite the same, or a consonant was too clipped, or not clipped enough. But once you find that first thing that makes you question the accent, you find more and more and more things that make you realize that the accent was fake all along. This is important to do with doctors. While there are some doctors who are truly low-intervention, many doctors just fake it. Some doctors don’t even do that (like Kevin Costner not even affecting a British accent in Robin Hood), and I find them to be preferable to those who pretend to be what they’re not — you may not like what you get in the end, but at least they’re not liars. Just listen to your doctor, and if you listen long enough (as long as you are well-grounded in your own “accent”), you’ll either know that they truly are what they say they are, or else you’ll pick up on something that just doesn’t quite ring true.

Cool video

A woman who submitted to a C-section for her second child because she was told he was too big to fit through her pelvis gave birth to her (larger) third child at home. Any guesses as to the baby’s weight? You’ll have to watch the video!

Can I refuse…?

People often have a question about what they can refuse, when it comes to pregnancy. I’m not really sure why they even question it, except perhaps just because they’re so used to doing what they’re told to do without questioning anything. This post is inspired by a question somebody put into a search engine and came across my blog. The short answer is, yes, you can refuse anything you want! This is still a free country, right? Until you become a ward of the state, or are given a court order for something, you can refuse any medical procedure. Whether it would be wise, beneficial, or risky to do so is another question entirely.

In thinking on this question, I remembered a column a woman wrote about her experience when placed on bed-rest during pregnancy. Much of the column was about how mind-numbingly boring it was, and how difficult it was to lie in bed day after day, week after week. She did some research and found that bed-rest has been prescribed for generations for all types of pregnancy ailments, but very little research has actually been done on whether or not it is even beneficial. Apparently, her doctor told her that there was no guarantee bed-rest would help, but he recommended it anyway. She could have refused. Why didn’t she? Because a person in a white coat suggested it. She says that she was “placed on bed-rest,” even though the doctor could say he merely suggested it. It’s true he didn’t enforce it, but that is what happens when the medical professionals are given that amount of authority in our own minds — a suggestion becomes a command.

Henci Goer wrote in The Thinking Woman’s Guide to a Better Birth, in a discussion on why VBAC hasn’t become routine (p. 163),

Reluctant doctors like to believe that hey haven’t much influence over their patients, but that is clearly not the case. Several studies have found that when doctors genuinely encouraged women to have VBACs , most of them did, and when they said nothing or acted neutral, most women didn’t. Finally, when obstetricians discouraged VBAC in women who wanted to try it, none of them did.

So, can you refuse things? Yes. Anything short of a court order. This goes for vaginal exams, ultrasounds, electronic fetal monitoring, IVs, hep-locks, enemas, restrictions on food and water, restrictions from moving, etc. Hospitals have policies set in place partially by their insurance companies to protect them from malpractice claims. You may have to fight, and it may not be pretty, but you as a patient have rights. You may not like to deal with the hospital staff who disagree with your choices — I’ve heard some down-right nasty comments from offended and rude nurses. But it’s your call. Technically, anyway.

The True Cost of a Cesarean

….may never be known.

There are so many different factors — some financial, some health-related, some emotional. While not everyone agrees with this, many studies show a higher death rate for both mothers and babies with a C-section. Some C-sections are done for failed inductions; and the inductions failed because the babies weren’t ready, and many times have to spend extra time in the NICU. Many mothers are left with sadness regarding their surgeries and feel as if their bodies let them down. But here are some real stories I am acquainted with, that each show that in some ways, the C-section isn’t the end — its effects may continue to be felt for years.

1. A life-long friend had a C-section a year ago when her baby was transverse and her water broke. It was an uncomplicated C-section, and she didn’t even stay in the hospital a full 48 hours. Her bill was $25,000. This greatly surprised me because I assumed that an uncomplicated C-section would be more in the $15,000 range. While her insurance covered 80%, their portion was still $5,000. Ouch! Even worse, her recovery was so bad (couldn’t get out of bed or a chair by herself for 3 weeks), that she told me that she wouldn’t have any more children if she knew she’d have to have another C-section.

2. Someone whose blog I keep up with is currently having secondary infertility, probably due to her C-section a few years ago. In addition to the emotional toll of having multiple miscarriages, there is the added burden of going through tests (some of them expensive, some not covered by insurance), to try to find the cause of her inability to carry another child to term.

3. Another person whose blog I keep up with is currently in the midst of a (hopefully) 12-week hospital stay. She has placenta previa, which can happen even in an unscarred uterus, but is more likely to happen if you’ve had a C-section before. She was put on hospital bed-rest after having a few episodes of slight vaginal bleeding. She’s hoping to get to 36 weeks, at which point they’ll take the baby by C-section. But it’s possible that she may dilate too much before then, and they’ll have to take the baby prematurely. Now, I don’t know what the cost of her hospital stay is, but for 84 days of hospital care, and the frequent (sometimes constant) monitoring that she is undergoing cannot be cheap. Then there is the emotional toll of being in the hospital, away from her husband and daughter, and worrying or at least wondering about the health of her baby, and hoping that she’ll be able to remain pregnant long enough that he won’t have to stay extra time in the NICU.

When C-sections save lives, that’s one thing. But there is a current article promoting Cesareans on demand. It just makes no sense to me, but maybe it does to some people. Then there are all the C-sections that are made necessary because of “the cascade of interventions” that so frequently happens in a hospital setting.

In light of the long-term downsides of a C-section, just make sure the cost of a C-section is worth what you’re going to have to pay.

Should men attend the birth of their baby?

There was this article that has recently been printed in which Dr. Michel Odent, world-famous obstetrician, says that he has long thought that men hinder the birth process. One of my fellow independent childbirth members emailed him directly, and he said that the article was not written by him, but by a journalist after a telephone interview, and that he has never said that men “should not be at the birth of their child.” Still, it opens up an avenue of thinking and questioning for me.

First, my personal experience — I was glad that my husband was there with me when our first child was born, but he didn’t really help that much; the midwife and doula were much better at the whole “labor thing” (which stands to reason, since it is their job and calling, and what they do all the time, while it was the first time for my husband). It is one of my biggest regrets that my husband missed the birth of our second child, being out of town and unable to make it back in time.

When I’ve posed this question or made a statement along this line in my birth-related email groups, there have generally been two types of response: 1) women who gush about their husbands and say that they couldn’t have done it without them; and 2) women who have the same thoughts as me — that men are not really that beneficial at a birth.

There are some men who should not be at a birth. I’ve recently read a blog post in which a woman said that although she felt like she was handling labor fine, her husband talked her into getting a C-section because he couldn’t stand seeing her in pain. (I guess that a C-section recovery isn’t painful?) One of my brothers-in-law watched TV the whole time my sister was in labor, and was glad when she got an epidural so he wouldn’t have to listen to her vocalize during contractions. I’m not saying that these types of men are hopeless causes, but that if they’re not willing to be supportive of their wives during labor, then why should they be there at all?

Back in the 50s, it was taken for granted that the father’s “place” in labor was pacing in the waiting room. Then came the “natural childbirth” revolution of the 70s and the pendulum quickly swung to where it was taken for granted that the father’s place in labor was to be right by the mother’s side as a labor coach. I will posit that neither of these extremes is totally accurate or healthy. Most men fall somewhere in the middle.

Some men may start out having to be coerced to attend the birth of their baby, and then be ecstatic when they are there to witness the birth. Other men may not even entertain a thought of not being there, but be disturbed by what actually happens at birth. (There may be sexual side effects either from seeing the birth itself, or having so many strangers touch his wife’s genitals, etc. It may be disturbing to many men to see their wives in pain yet be unable to stop it — they may even feel guilty for getting them pregnant in the first place. Some birth attendants may be rude or unfeeling, and leave the man feeling like he should have done something, but didn’t know what.)

While having your husband at the birth may be the best thing to happen, it would be extremely beneficial to have certain things ironed out beforehand, to make sure you’re both on the same page. Men are different from women. I think it’s an extremely important fact that for all of recorded history, up until fairly recently, childbirth was “women’s business,” and the usual order of things in almost every society in the world was to have other women attending the laboring mother. Sometimes the father of the baby was there, but this is the exception to the rule. Don’t expect a man to act like a woman. Hire a doula or a midwife if you want the unique benefits that a woman offers. Men can be wonderful — may even be surprising!

Case in point — a friend of mine realized that her husband would not be the kind of man to support her in labor as she felt like she needed to be supported. On one of the long drives back from a childbirth class, she had the painful discussion with him, and basically let him off the hook, and mentally lowered her standards of what she expected from him. In labor he was “P-E-R-F-E-C-T” she said — he read her cues, did what she wanted without asking, etc. Perhaps it was that he was able to relax, and feel like he wasn’t being held to an impossibly high standard. Perhaps he just wanted to prove her wrong.

Childbirth is an amazing, life-changing time — for both mother and father. While I think it is unfair to bar all men from attending the births of their children, I think it equally unfair to mandate all men to attend the births of their children. Think about it. Ask him what he wants. Ask yourself what you want. Have the difficult discussion with him if necessary. Hire a doula as a labor support — both for you and for him — having a knowledgeable and well-trained person to “fall back on” or suggest helpful things can ease the pressure. And be realistic about your husband’s personality. Don’t try to force your husband to become a perfect female labor companion. Men are different from women. Enjoy that! And be realistic.

For another perspective, click here.