Link Round-up

Ok, for lack of spare time, in conjunction with internet connection issues [long story, but my husband’s LAN port shorted out or something so we can’t both be on the computer at the same time], I have a whole bunch of interesting posts I’d like to share, and no time to discuss them. But I’m not going to be getting any more time in the future — I’m pretty sure we’re stuck at 24 hours per day for a while, anyway! — so, I’m just going to post the links with a little commentary, so I can clear out both my mental space and my computer browser.

Mom has a successful birth after eighteen miscarriages.

Ms Baker had high levels of a subtype of white blood cell, known as Natural Killer (NK) cells.The cells would normally protect the body against foreign viruses, but in Ms Baker’s case they mistook the foetus for a foreign body and attacked it.

Dr Shehata’s treatment is pioneering because it starts before conception and uses higher than normal doses of steroids.

Natural vs. artificial oxytocin [Pitocin, Syntocinon] in birth.

Oxytocin administered as an i.v. bolus of 10 IU induces chest pain, transient profound tachycardia, hypotension, and concomitant signs of myocardial ischaemia according to marked ECG and STC-VM changes. The effects are related to oxytocin administration and not to pregnancy, surgical procedure, delivery, or sympathetic block from spinal anaesthesia.

Think your doctor knows about breastfeeding because s/he graduated from med school? Think again!

One of the speakers, ABM member Dr. Nancy Wight, spoke on breastfeeding. Almost every word was news to me. Medical school, residency, chief residency and part of a neonatology fellowship and I did not know about any of the content she was presenting. One of the other speakers lectured on lice- that I knew something about. But breastfeeding? Nope. How did Dr. Wight know this stuff when I didn’t? Who taught her yet set me loose on an unsuspecting patient population armed only with my personal 7-week breastfeeding experience? [….]

You really need to read the whole article — I want to cut and paste the whole thing because every part of it is worth reading. But that would be plagiarism, so just go read it.

While on the subject of breastfeeding, a nurse writes about a conversation she overheard between a breastfeeding mother and a mother planning on formula-feeding, occurring a few hours after birth. Very good article!

And “The Language of Breastfeeding” — highlighting the importance of noting that breastfeeding is not “superior” but is “normal,” while formula feeding is “inferior.”

When we (and the artificial milk manufacturers) say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy–and thus safety and adequacy–of artificial feeding. The truth is, breastfeeding is nothing more than normal. Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.

I may at some point write a whole post on guilt and breastfeeding, but this isn’t it. However, formula is inferior to breastmilk, and everyone should know it. A recent study showed that over 900 babies’ lives could be saved every year here in the United States, not just in some third-world country with nasty water, if 90% of women breastfed. So, yeah, I think if you could have breastfed and chose not to, you ought to feel guilty about it, just as you should feel guilty for blowing smoke into your baby’s face or getting drunk while pregnant or having an elective induction at 35 weeks gestation just because you’re tired of being pregnant. HOWEVER, many mothers who end up using formula are not choosing to use it, they’re making an “un-choice.” Their choice would be to breastfeed, but because of one or another of the “Booby Traps” (TM), end up not being able to. My intent is not to make these mothers feel bad. There are many women who would love to breastfeed, but must work in order to feed, clothe, and house themselves and their babies. Formula is inferior to breastmilk, but starving your baby all day doesn’t work either! And there are many, many more women who wanted to breastfeed or tried to breastfeed, but for one reason or another — perhaps bad advice or hearing too many horror stories — ended up falling back on formula. I know at least two different women — both stay-at-home moms — whose mom or dad died when their baby was young, and the stress of the situation caused their already-shaky milk supply to dry up completely. It wasn’t their fault that their parents died; and such a situation is certainly stressful, either due to a sudden death or due to a lingering hospital stay. They did not choose to stop breastfeeding — that was just life circumstances forcing them into an “un-choice.” In these instances, formula was necessary, and though inferior to breastmilk, was superior to starvation. But this article is about changing one aspect of the culture to truly promote and enhance breastfeeding, by slightly changing the wording to give breastfeeding more force and highlighting not just the superior nature of breastmilk but the inferior nature of formula.

And if you think that this is causing unnecessary guilt because “everybody knows” that breastmilk is superior… you’re missing the point of the whole “mental shift” in breastfeeding language that this article is talking about, and you need to read the “overheard conversation” in the link above, in which the mother who had decided to feed her baby formula had been told that formula was “just as good” as breastmilk.

Nowhere is the comfortable illusion of bottlefed normalcy more carefully preserved than in discussions of cognitive development. When I ask groups of health professionals if they are familiar with the study on parental smoking and IQ (1), someone always tells me that the children of smoking mothers had “lower IQs.” When I ask about the study of premature infants fed either human milk or artificial milk (2), someone always knows that the breastmilk-fed babies were “smarter.” I have never seen either study presented any other way by the media–or even by the authors themselves. Even health professionals are shocked when I rephrase the results using breastfeeding as the norm: the artificially-fed children, like children of smokers, had lower IQs.

Inverting reality becomes even more misleading when we use percentages, because the numbers change depending on what we choose as our standard. If B is 3/4 of A, then A is 4/3 of B. Choose A as the standard, and B is 25% less. Choose B as the standard, and A is 33 1/3% more. Thus, if an item costing 100 units is put on sale for “25% less,”the price becomes 75. When the sale is over, and the item is marked back up, it must be marked up 33 1/3% to get the price up to 100. Those same figures appear in a recent study (3), which found a “25% decrease” in breast cancer rates among women who were breastfed as infants. Restated using breastfed health as the norm, there was a 33-1/3% increase in breast cancer rates among women who were artificially fed. Imagine the different impact those two statements would have on the public.

Yes, imagine the paradigm shift that would occur if people — particularly mothers — were told that infants fed formula had lower IQs and higher rates of breast cancer as women. I think there would be a stronger push from mothers to promote breastfeeding, if the conversation proceeded along those lines — making breastfed babies the standard against which formula-fed babies were measured, rather than the other way ’round.

What is said, vs. what is heard” — if you’ve ever been in one of “those conversations” when you react not only to what someone has actually said but what you thing s/he meant, you’ll enjoy this. Here’s a taste:

She said, “Are all those kids yours?”

I heard, “Is that impossibly large number of children yours? Have you ever heard of birth control?”

I said, “Yes. They are all mine.”

She heard, “They are all mine. I am a saint.”

Whose responsibility is it? — when a woman ends up with an unnecessary intervention during birth, is it her responsibility or is it the doctor’s? This says a lot of what I’ve said before and/or wanted to say on the topic, although I don’t necessarily agree with 100% of it. In short, there is a balance between women’s responsibility in choosing the right care-giver and between the doctor’s responsibility in not intervening unnecessarily. If a woman knowingly chooses a doctor who has a high C-section rate, she shouldn’t be too surprised if she ends up “needing” a C-section too; on the other hand, if the woman believes the doctor (or hospital) to have a low rate of unnecessary interventions and then ends up with an unnecessary episiotomy or C-section, then she should rightfully be upset if she finds out that she was lied to or misled. Women should be conscientious consumers of health care, and not just blindly follow their doctors; but doctors should be conscientious providers of health care, and should be able to be blindly followed. They both have responsibilities; but I would put the emphasis more heavily on the side of doctors, because they have an implicit office of trust, in that they are “the medical professionals who have gone through years and years of study of medicine,” so often their opinion has more weight (and rightly so) than the average person. Since they speak with more authority, they have the greater responsibility not to abuse that authority. And doctors who have a 70% C-section rate for low-risk moms would have a hard time convincing me that even most of them were the responsibility of the mother.

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Home Birth vs. Birth Center

Pinky RN is looking for home-birthers to answer questions about home birth vs. birth center births:

Would folks who want a homebirth because of the restrictive nature of the hospital, come to a freestanding birth center? Is there a demand for Birth Centers? Especially a Birth center across the street from the hospital that has a large staff and 24 hour Ob and anesthesia folks so they can handle anything you throw at them. And a Nicu would be good too. I was thinking, if we did start up a birth center across the street from the hospital I worked at, would it be used? If we build it, will they come?

So for any home birth folks out there, could you please leave me a comment on your thoughts. What would you need in a birth center to make it attractive to birth at?

Go to her blog and give her your opinion!

You Have a Choice

Click here to go see the video, a short documentary. The thing that I remember most is the nurse at the beginning, talking about the standard assembly-line procedures they do when a woman in labor comes to the hospital. So mechanical; so rote.

Considering a VBAC

I like what NavelGazing Midwife has to say about the process of considering whether to have a vaginal birth after a previous cesarean, or whether to choose a c-section for a subsequent birth. She says in part,

I encourage you to start a list, even from the very beginning of research. A column for Risk of CBAC and then another for Benefit of CBAC. Then do the same for VBAC. As you learn, put your thoughts into those columns. I promise, as you read more and hear about more, your risks and benefits might flip flop several times. But, having the columns allows you to keep a somewhat logical head about the impending decision.

Then from VBACfacts, a post titled,

An OB you like or who makes you comfortable isn’t enough

It includes a letter from a woman who just had a repeat Cesarean after wanting a VBAC. She begins,

It is with great reluctance that I submit payment to you for services rendered.

I hired you for an intervention free VBAC.  Instead I had EVERY intervention I told you I did not want.  Under your care, I failed in the most basic way a woman can fail – I failed to birth my children.   You ignored each and every point on my birth plan.  I cannot help but wonder if you even read it, or if you ever had any intention of following it.

Birth wars

This post is a must-read for everyone. I won’t comment on it, so as not to detract from it, nor to take any extra time — except to say, it’s from Australia, so aside from a few things that pertain strictly to that country, it could be written about America. Just go read it. Here’s a teaser:

YOU’RE in the dentist’s chair with a painful tooth, feeling fragile.

“That tooth has to come out,” says the dentist.

“I’ll give you an anaesthetic and extract it.”

You’re surprised – you had hoped the tooth would be all right – but you nod and say something like “Ungh-hnghm” through a mouthful of cotton wool and dentist fingers. After all, he’s the expert.

The dentist turns to prepare the needle, when a dental technician leans over and whispers in your ear: “You know you don’t have to do what he says.

“He doesn’t know what he’s talking about. What about root canal? Or homoeopathic remedies? And anyway, you don’t need an anaesthetic.

“There’s a dentist next door who does acupuncture and hypnosis for pain relief. It’s much safer. Oh, and did you know fluoride is toxic?”

The dentist snaps at her to stop: “Ignore her – she’s pushing her own agenda.”

Tense, stressed and utterly confused, you lie back, open your mouth and look up at two medicos glaring at one another.

Who is in charge here? What’s the real truth? And why didn’t anyone tell you there was some sort of power struggle going on?

Of course, this doesn’t happen in dental surgeries. Open hostility between clinicians would be madness, serving only to baffle patients and undermine the whole purpose of creating healthy smiles.

But this is exactly what happens in maternity care, every day, in birth centres, hospitals and homes. Hostility, suspicion, mistrust, abuse and vitriol abound in relationships between obstetricians and midwives, clinicians, academics and activists.

h/t to Sidney Midwife for the link

Reducing Infant Mortality

Unfortunately, I can’t embed the video in WordPress, so you’ll just have to click here to watch this free 15-minute video on reducing infant mortality. The thing that struck me the most was the woman with the “MD, JD” after her name that taught at UCLA, saying something about there being the midwifery model of care and the medical model of care — that women need to know that there are two models, and then saying, “But why are there two models? We should see which one works better, and then move toward that one.” Yes, indeed.

Obviously, some women will actually need the medical safety net, but why does midwifery care often get the short shrift?