Last day of 2009

Wow — hard to believe it’s already here! At the risk of sounding terribly clichéd… where has the year gone?!?!?

There have been some big changes in obstetrics — that’s right — ACOG has changed its name from “American College of Obstetricians and Gynecologists” to “American Congress of Obstetricians and Gynecologists.” That is big news, because “college” refers to academics, or “A body of persons having a common purpose or shared duties”; whereas “congress,” of course, refers to sexual intercourse. No, seriously — that is one of the definitions of “congress”! — check the link. 🙂 [Ok, I admit it — I did read Dave Barry’s “2009 in Review” column recently, and that sounds like something he would say. He must be rubbing off on me. :-)] But I suppose they mean one of the other more common definitions, such as “A formal assembly of representatives, as of various nations, to discuss problems,” or “A single meeting, as of a political party or other group.” I don’t like the political overtones of the name “Congress,” and don’t really know why they changed their name — it seems that academics is more of a high ground than politics, so why shift focus from that?

In other ACOG news, they finally realized that women in labor do not suddenly lose all their competence when it comes to eating, drinking, and being able to vomit without inhaling, so they are now magnanimously allowing women in labor to consume “modest amounts” of clear beverages. In a condescending quote, Dr. Barth upholds the restrictions on eating solid food in labor (which includes fruit juices with pulp and soup), by saying, “As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common.” This is logical?? — “We’re restricting food because most women don’t want to eat anyway.” No – it’s circular reasoning (and also quite false). If women don’t want to eat in labor, then why have a formal restriction? Just don’t force-feed ’em! And if they do want to have something light, like soup, you ought to have a better reason than, “Trust me, dearie, you might end up throwing this up, so although you’re starving now, you’ll thank me later when you dry-heave bile and pure stomach acid instead of this yummy chicken soup!” Not all women want to eat during labor — I didn’t my first time, but did the second. I threw up the first time (and, gee, would you know it — I managed to keep from inhaling that vomit every single time, just like when I threw up with morning sickness, and just like I threw up as a child from a stomach bug — imagine that!) — threw up the entire large meal I had eaten just prior to labor starting, and then threw up the sips of apple juice the midwife urged me to take; but didn’t throw up the second labor nor have the slightest bit of nausea. Wow! Imagine that — maybe my body knew that it couldn’t handle labor and digesting Chinese food the first time; but likewise knew that I needed energy during my second (24-hour) labor, so I was hungry and thirsty like normal, ate whatever appealed to me, and didn’t throw up. Isn’t that just so weird?? [Not.]

In another statement on elective inductions, ACOG recommended that no elective inductions be done prior to 39 weeks, also saying, “A physician capable of performing a cesarean should be readily available any time induction is used…” Those of you who are around inductions (doulas, friends, L&D nurses)…

And once again, continuous electronic fetal monitoring for the low-risk mother/baby dyad is recommended against, since it doesn’t seem to help neonatal outcomes, nor lower the risk of stillbirth, nor lower the likelihood of cerebral palsy, but does raise the risk of C-sections. “The false-positive rate of EFM for predicting cerebral palsy is greater than 99%. This means that out of 1,000 fetuses with nonreassuring readings, only one or two will actually develop cerebral palsy. The guidelines state that women in labor who have high-risk conditions such as preeclampsia, type 1 diabetes, or suspected fetal growth restriction should be monitored continuously during labor.” However, women who are induced and/or given epidurals usually or always need continuous monitoring, in case their babies take a sudden turn for the worse, which is more common in drugged than natural births.

So much for ACOG changes — now for something that remained the same: demonizing CPMs and home births stayed at #2 on the ACOG Legislative Agenda. I guess a 99% share of the market isn’t good enough.

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You might be a birth junkie if…

With a tip of the hat to Jeff Foxworthy of “You Might Be a Redneck…” fame, I thought of a series of things that may be tip-offs that you just might be a birth junkie (in no particular order). (By my definition, which is, I suppose, an infatuation bordering on addiction [if not actually there] for birth and all things related to it.) Without further ado…

You might be a Birth Junkie…

  1. if you blog about birth (more than just your own birth for historical purposes) or if your birth story is at least two pages long
  2. if you failed math, but can quickly convert grams to pounds and ounces (approximately)
  3. if you can say “vagina” in a sentence without blushing
  4. if you can correctly use “os” in a sentence
  5. if you can’t remember who won any gold medals for the US in the last Olympics, but you know US statistics for maternal and infant mortality, and the national C-section rate (bonus points if you know your local hospital(s) epidural, induction, and C-section rates) — if you’re not from the US, insert your own country
  6. if you can list the mother-friendly and baby-friendly guidelines from memory, and know which hospital in your area (if any) fulfills those goals
  7. if you can recite the midwifery model of care
  8. if when you’re discussing something related to birth, you receive those polite but puzzled looks… right before your conversation partner moves away
  9. if you see a circle about 4″ big, and you think “that’s fully dilated”
  10. if you have birth-related artwork somewhere in your house (includes placenta pictures and belly casts, etc.)
  11. if you currently have or ever did have a placenta in your freezer
  12. if you have ever consumed placenta
  13. if you have a model of a pelvis, uterus, or some other female organ
  14. if you always keep honey sticks on hand
  15. if you’ve ever gone to the bookstore and hidden “What to Expect When You’re Expecting” (or some other similar non birth-junkie book) and replaced it with some pro natural-birth book
  16. if other women get tired of telling you their birth stories before you get tired of hearing them
  17. if you have a library (or would love to acquire one) of birth-related books and videos
  18. if you have 10 or more birth-related videos saved to your account on YouTube
  19. if you appear on any YouTube (any internet) video talking about birth, in labor, or giving birth (picture montages count)
  20. if at least half of the blogs you regularly read are birth-related
  21. if someone tells you she “had to have” a particular intervention and you can come up with several alternatives that were never mentioned to her (bonus points if she doesn’t get mad or defensive)
  22. if you refuse to play the “my birth was worse than your birth” game
  23. if you feel like you know your fellow online birth junkies (even though you’ve never actually met them) better than you know some of your flesh-and-blood friends
  24. if ten or more of your Facebook friends (or other equivalent) are people you’ve never actually met but know them through birth-related functions (blogs, email lists, etc.)
  25. if you’ve ever gone to a birth conference
  26. if you’ve ever emailed, mailed or called your state or national representatives about a birth-related matter
  27. if someone tells you her baby is breech and you give her names (bonus points if you know phone numbers) of chiropractors skilled in the Webster technique or people who can perform moxibustion
  28. if you know what counterpressure is and how to apply it (bonus points if you’ve done it)
  29. if you know what a rebozo is (bonus points if you’ve used one)
  30. if you encourage your children, especially young children, to watch birth videos
  31. if you can get hoarse from watching TV birth shows (like A Baby Story), because you’re yelling through the screen at the woman or her care providers
  32. if you hear “prom” and don’t think about dancing, but think “preterm/premature rupture of the membranes” [thanks to Desirre for that one!]
  33. if you carry a “due date calculator” in your purse [again, thanks to Desirre!]
  34. if you get paid to catch babies all day, and you come home and talk about it all night with your husband who just nods his head and say “uh huh”. [Reality Rounds in the comments]
  35. if a majority of your internet bookmarks are contained under the heading “birth” [Cuddlebaby in the comments]
  36. if you sit as far away from others at the restaurant after a birth so you can discuss the birth without offending anyone. [Sally Stevens in the comments]
  37. if the ‘user ID’ that you most frequently use has something about birth in it. [Knitted in the Womb, in the comments]
  38. if you see someone else’s poop and you are happy! [this and the next two from Brenda, in the comments]
  39. if you can wake, dress and leave your house in less than 20 minutes with enough supplies to last you until you come home – with no idea how long that may actually be.
  40. if you can be next to a woman groaning, howling and sweating and know that it’s a good sign.
  41. if you have 10 or more birth related apps on your iPhone [Juliet in the comments]
  42. if you see someone spell epitome “epitomy” and you do a double-take as your mind registers “episiotomy” [added June 20, 2010]
  43. if you see “perennial” and your mind registers “perineal” [added Aug. 10, 2010]
  44. if you’re searching your email for “Frank” and you have more birth-related emails (“frank breech”) than you have from your friend or family member named Frank [added Sep. 1, 2010]
  45. this whole blog post written by my friend Diana — funnily accurate! [added Sep. 4, 2010]

And finally

  • if you regularly read this blog, you know you’re a birth junkie!

What others can/would you add to the list? 🙂

Update: Welcome SOBers!

I just saw that Dr. Amy, now calling herself the Skeptical OB has linked to this post. Denigrating it and me of course — wouldn’t expect anything else from good ol’ Amy Tuteur!

To those of you who are not familiar with my blog, look around yourself and see if you agree with the SOB’s opinion of me and my blog. Do your own research — don’t just believe everything the good doctor says, because she loves to twist what I and other like-minded people say.]

Alternative Reality

Continuing the series of blog posts on Dr. Rixa Freeze‘s doctoral dissertation on unassisted childbirth…

On page 167 of the pdf (p. 153 of the document), she notes that with the advent of the internet, it has become easy — or even possible — for people in otherwise isolated locations to come together around a common purpose. In this case, the cause or practice of unassisted birth; but it could be anything — birth-related or not — it could be “people with pink poodles” or afficionados of Pride and Prejudice, or a specific food, musician, artist, etc., as far as that goes:

With unassisted birth, there is a paradoxical withdrawal from conventional social interactions that surround pregnancy and birth and an immersion in alternative virtual communities in which unassisted birth is seen as a normal, reasonable choice. Women often withhold their birth plans from family and friends, fearing disapproval and negativity. Some also worry about governmental interference because of their alternative choices, so they too choose not to reveal their plans. In order to make up for the social isolation that UC often brings, they selectively enter into intentional communities that support unassisted birth.

I recently expressed this same type of feeling on one of my email lists. Out of hospital births, intentional or not, make up about 1% or so of all births in the nation. Intentional home births are even less. We who support the idea of home birth are a small group — obviously! But it doesn’t feel that way when I’m online and reading and writing to the women who are on these lists who share my opinion and thoughts on the matter.

There is a story I heard of years ago, of a preacher back in the olden days who had a member of his church who had stopped coming to church. The preacher stopped by to see the man one cold winter day, and sat by the fire to warm himself. The man braced himself for a lecture, and was getting ready with all the excuses he could think of; but the preacher didn’t say anything. He merely took one of the coals out of the fire and set it apart from all of the other coals. Of course, within a short period of time, the coal died out. The preacher picked up that piece of coal and put it back in the fire, where it instantly caught fire again and burned brightly. Then he got up and left. The man was back in church the next Sunday, having caught the message of the silent lecture: when you are isolated from the group, you can only burn so long before you burn out and get cold; but by going back to the group, you rejuvenate yourself and help others to stay warm, as well.

That’s the same kind of thing that happens with online communities, for good or bad, regardless of the subject matter. It happens just as much on pro-C-section groups getting the women to all conform to the group norm and willingly choose a C-section, as it does on UC groups who promote giving birth unassisted.

If I had only my “in real life” friends, I’d probably burn out on birth pretty quickly, because most of them don’t really care too much about it, are certainly not as passionate about it as I am, and some of them think I’m a little weird for having home births instead of having epidurals, etc. Some people support home birth as a choice — have even given birth at home themselves — but it’s not their “thing” — their “thing” is… fill in the blank — home schooling, quilting, literature, economizing, music, art, etc. Birth is a side issue for them, just like art is a side issue for me. Sure, I like to look at pretty pictures, but I’m not enthralled by it the way some people are. I am, however, enthralled by birth. Fellow “birth junkies” get that; other people don’t — although they may be equally “into” some other issue or cause that I’d become bored with after a day. Diff’rent strokes for diff’rent folks.

If it was just me and no internet… I can’t even imagine it! In some ways, it might be better, because not having an online community (this blog, other blogs I read, my email lists) would force me to move beyond my comfort zone in my real community and reach out and find some connections somewhere. But if I couldn’t, I’d probably burn out. That’s one thing that conventions do, I’m sure — bring together far-flung Trekkies (or birth junkies, or whatever other die-hard fans you can think of) into one big fire, and stoke the individual coals into a huge flame — far bigger than the sum of the individual parts could be.

I’ll admit it: sometimes I get so immersed in my pro-natural or pro-home-birth online culture, that when I step out into the real world and have discussions about birth, I’m taken aback by some of the things I hear. These things are, almost certainly, the norm — or at least are valid choices by most people’s thinking; but they seem weird to me: “you’re choosing a C-section when the doctor is willing to attend a VBAC??”; “you’re getting induced for no medical reason?”; “you’ve already planned on having an epidural, and you’re not even pregnant yet?” — that sort of thing. But in my little corner of the ‘net, these things are weird. And I think they ought to be! I like living in my alternative reality, and have no plans to change that any time soon.

Still wondering what to get for Christmas?

If you’re like me, you may have to buy yourself your own Christmas presents. If you’re like most women, even if you don’t have to buy your own presents, you’ll have to buy Christmas presents for everybody else in your life (and your husband’s life) too. “What to get for Christmas” — either for yourself or others in your life — is always a difficult question to answer. Laura Keegan has made it easier. I know I just blogged about her book Breastfeeding with Comfort and Joy, but I want to do it again, because I didn’t realize when I wrote my earlier post that there were excerpts from the book available on her website — just click on the picture of the front cover to view 9 pages from the book.

This book is self-published, and is available only from her website. Since she has to do all of the promoting and distributing herself (not having a big publishing house to undertake the marketing), even if you cannot purchase a copy of the book right now, she would sincerely appreciate any help you can give in “spreading the word”, by telling people about her website (The Breastfeeding Book.com), on your blog, or any birth, baby, or “natural living” or “alternative” email lists or groups you’re a member of, or even the old-fashioned way of talking one-on-one.

Some of the people I thought of who would be interested in the book include the following:

  • midwives
  • doulas
  • childbirth instructors
  • obstetricians
  • La Leche League groups or leaders
  • breastfeeding consultants
  • lactation specialists
  • WIC offices (since they serve low-income mothers and babies, who are at higher risk of many negative occurrences, these women and children can especially profit from the benefits of breastfeeding)
  • pediatricians
  • L&D nurses
  • nurses or other workers in hospitals or doctors’ offices
  • family physicians
  • any “birth junkie”
  • pregnant women
  • new moms (and this is not limited to first-time mothers — I just recently found out that one of the people on an email list I’m on has for the first time managed to successfully breastfeed her child beyond 2-3 weeks… and this is baby #5! Nursing was excruciating for her with all of the babies, and she always gave up; finally she decided to stick with it, even through the intense pain, for at least 6 weeks. Getting past the three-week mark finally made breastfeeding not (as) painful for her, and she can actually see herself continuing to nurse her baby.)

If you want to give a meaningful gift to any of the above people in your life — whether for Christmas, a baby shower, a “thank you” gift, a birthday present, Mother’s Day, or “just because” — this will be truly appreciated. Even if you can’t get this book in time to present it at Christmas, you can order the book, and give a beautiful card telling the recipient that the present will be arriving very soon. Also, when you get those, um, less-than-wonderful gifts on Thursday, and you’re tempted to exchange it at the store — why not get a refund, and then buy yourself what you really want? And why get just one book? — order several, so that you’ll always have something to give when those gift-giving occasions sneak up on you or slip your mind.

I can’t wait to get mine!