Happy Birthday, Seth!

Last year on this date, I published Seth’s birth story; now, here are the pictures that were taken right after he was born. Just a very slight recap of the birth story — because I had called the midwife when I had false labor and had her come too soon (from about 90 minutes away), I decided to wait to make sure it really was really for sure really labor before calling her again. So, I called her when my water broke… and Seth was born about an hour later. You do the math. 🙂 Plus, she had to arrange child care, so she got there about an hour after he was born.

Seth's First Picture (I'm talking to my husband, who missed everything!) :-(

Seth's First Picture (I'm talking to my husband, who missed everything!) 😦

Keith meets his little brother for the first time

Keith meets his little brother for the first time

03

I remember thinking that the baby was so small — probably about the same size as Keith was when he was born, which was 7 lb., 5 oz. Wrong!

The midwife looks over the baby

The midwife looks over the baby

Weighing my "itty bitty" -- nine pounds!

Weighing my "itty bitty" -- nine pounds!

The student midwife performs the neonatal assessment

The student midwife performs the neonatal assessment

Let your voice be heard

There is a birth video being made which will feature all different women, and you are invited to be one of those women, by submitting a short audio or video clip about homebirth — why you chose it, your experience, or how it affected your family. You can also submit a written account. Click here for more information.

Thanks to Citizens for Midwifery for the link!

“Birth Matters Virginia” Video Contest

Previously, I had blogged about the video contest sponsored by Birth Matters Virginia. Now that the deadline for new entries has passed, there are 44 videos in the running. In order to be considered for the contest, entries had to have a YouTube tag of “BirthMattersVirginia,” so it’s easy to find them. Here is the link to all the videos with that tag. I haven’t had a chance to watch them yet, but it promises to be good. Remember to vote for your favorite(s)!

Here is a video that was included in the facebook group’s links, but is not actually entered in the contest (perhaps because Dr. Buckley is one of the judges, and also appears in the video?). Enjoy “We Can Be Much Kinder,” a video about delayed cord clamping:

Same team!… Same team?

A few weeks ago, on someone’s blog, I read a comment which said something along the lines of all women who support home birth need to band together, rather than break up into somewhat antagonistic groups over things like unassisted birth; this commenter said we need to remember that we are all on the “same team.”

I’ve thought about that comment a lot since I read it, and while I agree with it in some ways, I disagree with it in others, and think it doesn’t go far enough in still other ways.

On one hand, I infer (perhaps wrongly) that a lot of people set up some goal or outcome as the paragon everyone should aim at, and those who aim at it and get it are the highest, those who aim and miss are next, and those who don’t even aim are lowest. This isn’t just in birth — you see it in everything, from people who get on the exercising bandwagon to those who go on certain diets, etc. But I get the sense from the UC people I’m exposed to that unassisted childbirth is considered the paragon of birth. This doesn’t mean that UCers look down on women who do not choose UC, necessarily (although I have heard disparaging comments made towards any midwife who does not wholeheartedly support UC as an abstract or who does not support women who wanted to have a UC; and somewhat casual denigration of women who choose hospital birth because they don’t “trust birth” enough, or whatever). Rather, what I remember most strongly is women who have acted apologetic because they just didn’t feel quite comfortable with UC — for whatever reason. Perhaps I was reading into it more than was meant.

But it goes both ways. There are more than enough ways for everyone to look down in some way on everyone else. And it’s destructive. So as far as that goes, we should realize that we are on the “same team.” But it might be impossible to be on the “same team” with some people, because of some basic philosophical differences, or perhaps even antagonistic behavior between some of the sub-groups of people within certain groups. But I think we should try.

And here’s how I think it doesn’t go far enough: the original analogy was that all home-birth people were on the “same team.” This implies that those who do not support or have home births are on a “different team,” and that we struggle against each other. In some ways, we do — specifically when home-birth or CPM advocates have to fight tooth and nail against the intrenched medical establishment for legislation that legalizes CPM-attended home birth. But can we not find some common ground, even in this area?

Here’s the “same team” idea I have — everyone who wants mothers and babies safe are on the same team. We may differ in what “safe” looks like, but we can all at least agree that whatever “safe” is, we want.

Among the blogs I read are those written by L&D nurses, CNMs, CPMs, doulas, childbirth educators, and other “birth junkies”. Some of the hospital-based nurses support home birth, while others think it is unsafe. We can all learn from each other. For my part, I get so into my “healthy, low-risk profile” women that I can easily forget that a lot of women are not healthy and low-risk, and bad stuff can and does happen, and home birth can be dangerous for some mothers and babies. Reading blogs written by nurses who see the not low-risk births is eye-opening for me. Contrariwise, a lot of L&D nurses can get their perspective about birth changed by a “refresher course” in normal low-risk births by reading about out-of-hospital births. Those who cannot understand why women would “take the risk” of having an out-of-hospital birth or a UC can read what these women have to say about the reason behind their choices, and then learn. Same goes for home-birthing women who don’t understand why women would choose to go into the hospital when they don’t have to.

Rather than just disparagingly saying, “I don’t know why they’d do that,” we can atually sit down and find out why and then we will know — and as the saying goes, “knowledge is power.” For instance, take an L&D nurse that can’t figure out why a woman would choose to give birth at home. She can read the stories of women who felt like they were abused (physically, emotionally, mentally) or coerced into unwanted and unnecessary interventions by those who were supposed to be caring for them in the hospital. And then she can learn from that more of the perspective a laboring woman has — of her care givers, her hospital, and herself — and the nurse can work on making her hospital unlike what these other women experienced. If she reads that a woman blames her PPD on her C-section which she believes was unnecessary, she can double her efforts to make sure 1) that the women she cares for do not have unnecessary C-sections or other interventions; and 2) that women fully understand what is happening to them and their babies, and why it is necessary. Because a lot of the thrust behind the home-birth movement is simply anti-doctor and anti-hospital — and this is because a lot of women believe themselves to have been taken advantage of by doctors or hospitals. A lot of the thrust is simply pro-natural, “back to the earth” philosophy, but there is a definite percentage of women who choose home births simply because of how they were treated during a previous labor or birth. The whole “god complex” of some doctors, and the inflexibility of hospital protocols (especially those not rooted in any sort of science or evidence-based medicine) contributes a lot to the home-birth movement. And people who refuse to listen to what home-birthers are saying, simply because they are home-birthers, do themselves a disservice. Also, if you believe home birth to be dangerous (or at least, that hospital birth is safer), then dismissing out-of-hand what home-birth advocates have to say, ignoring the experience of thousands of women who were traumatized by their hospital births, and trying to legislate home birth out of existence, is actually serving to increase the number and rate of women who will choose an out-of-hospital birth. And some of these women will be truly high-risk and will truly be putting themselves or their babies at risk by having a home birth with or without a midwife. Let this sink in — they are willing to take the risks of birthing without medical assistance, than to take the risks of birthing within a hospital — so what does that say about birth in a hospital? If you want these women to give birth in a hospital because it is safer for them or their babies, then change the system to accommodate them. By forcing them to adjust to the hospital, you are keeping them out.

So, let’s get on the same team and be on the same team as much as possible, shall we? Here is an analogy that comes to mind. In this country, we have several branches of military, and sometimes they fight and squabble amongst themselves (jockeying for position, prestige, money — whatever), and they even have football games or other sports matches in which they directly oppose each other. But when an outside enemy comes along, all differences disappear because they all understand that they are truly on the same team. In a similar way, we have several branches of people involved in birth, and sometimes we oppose each other on certain issues; but let’s always remember that we do have one common goal, and that is that we protect mothers and babies from unnecessary harm. We can learn from each other, and support each other in the common goal — even if we don’t always get along in other matters.

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It Just Doesn’t Get Any Better Than This

The other day, my husband and I got an ice cream cone from Baskin Robbins. I can’t remember the last time I’ve been there. I ordered a scoop of praline pecan in a waffle cone, and he ordered a scoop of pistachio in a plain cone. As we were each savoring our cones, almost at the same time, we both said something to the effect of, “It just doesn’t get any better than this.” We sampled the other’s, and we both thought the other’s was good… but we still liked the ones we each ordered better.

I think about how that some people — for whatever reason (perhaps insecurity?) — just can’t let people have their own likes and dislikes. Maybe they do for simple things like ice cream (although I’ve known some people who would nearly berate a person for liking or disliking certain things), but they can’t for other things. We’re not talking about differences in morality — just differences in personality and preference. And birth.

Click here for a fascinating post and ensuing comments along these lines of personal preferences about UC, home birth, and hospital birth.

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Intuition

In a previous post, I started talking about intuition in childbirth, particularly in unassisted birth, inspired by Dr. Rixa Freeze’s doctoral dissertation. Continuing on that topic, I want to delve a little more deeply into it. I just can’t stop thinking about it, so I’ll backtrack in the paper.

First a little personal background — I first got pregnant in 2004, and became interested in pregnancy and birth then. That’s the way I am — when faced with a new situation, I try to learn as much as possible about it, and become as familiar as I can, so that when I go through the situation, it feels most comfortable to me. (Unfortunately, my husband is about the opposite, which means we drive each other nuts — like when we’re both playing a computer game, he prefers to just jump in and figure it out as he goes along, while I prefer to read the manual and the user guide and go through all the tutorials before I even start. When I ask him before I begin playing how something works or what to expect, he says, “Oh, just start playing — you’ll figure it out!” And I just can’t do that. It frustrates and annoys me!) So, I read and studied extensively while pregnant. Afterwards, I went into hyperdrive, going deeper and further into natural birth — not just drug-free births in hospitals, but pro-midwife, pro-CPM, pro-homebirth, and pro-unassisted birth.

When I read this section on intuition in Rixa’s paper, I was extremely glad to read her say that it seemed to her that the UC forums she read, moved away from learning medical and clinical knowledge as preparation methods for UC to relying solely on intuition as not only the best but the only way of preparing for a UC. Not having studied UC like she has, and only having limited exposure to it, I have noticed recent things on emails promoting just intuition, and even some people at times saying that women should not read negative things or stories about emergencies or bad outcomes (UC or otherwise), because then they’ll set themselves up for fulfilling those same things in their birth. It seemed that at first when I was introduced to UC that there was a lot more talk about complications and how to deal with them — sharing knowledge and real “what if” scenarios. I’m glad to know that what I picked up on was actually true.

This bothers me — the trend away from some sort of practical knowledge about birth to “oh, just listen to your intuition and everything will be fine.”

I’ve read numerous stories where just this thing happened — mothers who were planning a UC and then changed their minds because of something in their minds they just couldn’t let go of, and it was a good thing because either they or their babies needed help and/or medical attention during labor or after birth; other mothers who were planning a hospital or midwife-attended home birth and changed to a UC, and were glad they did because they had a successful and even glorious birth which would have become a medical problem had they done it differently; one woman who had a placenta previa (didn’t know it until labor) and began bleeding during labor, and got a tremendous urge to push, as if her body just screamed it at her, and she pushed the placenta and baby out in one huge long push, and the baby was perfectly fine (because of the speed of the birth — no time for the oxygen to be cut off); mothers whose babies had meconium and they automatically “suctioned” it out by the mom putting her mouth on the baby’s mouth and sucking it that way; etc.

Intuition can be very powerful, and I don’t discount it; but I don’t want to promote that as the best, and certainly not the only thing that should be considered. For every story of “intuition” telling them that something was going to happen, someone could probably dredge up 10 or 100 or 1000 stories of intuition failing to warn them of advance circumstances. If intuition were so good, then no one would ever die accidentally — there would be no skiing accidents, no falls from roofs, no car wrecks — because “intuition” should warn you of these things. If it were perfect. For me, intuition is one of those things where you should “err on the side of caution” — that is, if intuition is telling you that something bad is going to happen, you’d better freakin’ listen to it! On the other hand, if your intuition is “silent” while there are obvious or clinical signs of something bad about to happen, forget “intuition” and listen to the signs!

I’ve read sometime in the past a discussion about intuition — including why it seems that females are much more intuitive than males — and this article basically said that “intuition” is the brain picking up on subtle signals that the conscious mind does not fully recognize, but the subconscious mind does. And this is why “female intuition” is so much more common than “male intuition” (is that even a term?) — because women’s brains are wired differently, we have a lot more social skills, we’re more talkative and more communicative, and the two sides of our brains share a lot more communication than men’s brains do (it’s no joke that “men have a one-track mind” while women can mentally multitask) — so we women pick up on these subtle “something’s wrong” signals more than men do. But it’s not perfect.

And sometimes, even when you intuitively know something is going to happen, it doesn’t mean you can prevent that thing from happening, just because you knew it ahead of time. One woman I know had a strong feeling throughout her entire pregnancy that something was wrong with the baby; and sure enough, about a week after he was born, he was diagnosed with a fatal heart condition. Her prenatal intuition was correct, but her baby still died — not because of listening or not listening to intuition, but just because the particular defect was not curable, even by the excellent heart doctors at Le Bonheur, one of the best children’s hospitals in the South, and possibly in the nation.

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Define “Safe”

In chapter 5 of Dr. Rixa‘s Born Free dissertation, she discusses risk and safety in birth.

How do you define “safe”?

Is “safe” defined solely as a birth in which both mother and baby survive? In that case, birth is universally defined as safe, since most mothers and babies survive birth even in Sierra Leone, which has the highest maternal and infant mortality in the world. And even among the unassisted births that most obstetricians and even many midwives warn against are safe.

Is safety defined as only births that happen in a high-tech hospital with the high-risk obstetrician in the room and the neonatal doctor just down the hall?

Rixa goes even further — does the woman feel safe?

I daresay that in many births, the mothers do not feel safe — they feel on edge, fearful that something will go wrong because all the technology is in use which must mean that all the technology is necessary to keep them and their babies safe. Some women choose unnecessary C-sections because they do not feel safe in attempting a vaginal birth — afraid that either they or their babies will be damaged or killed. Or maybe their doctors have told them that they must have this intervention or that intervention, so they think that either they or their babies are or will be at risk if they decline. They may be physically safe — that is, these women may not be in danger of their lives or a serious injury, but do they feel safe?

A lot of women do feel safest and best in the hospital, so for them, a home birth would make them feel unsafe (regardless of how safe it actually is or would be). But I remember a doula on an email list I’m on saying several months ago that she couldn’t remember the last hospital birth she’d attended in which the staff (nurses and doctor) were relaxed during labor. Instead, she said that the labors were always very tense, as if the nurses and doctor were on edge, just waiting for something to go wrong, and only seeming surprised when it didn’t.

If “safe” is defined as only those births that take place within the hospital, then any birth outside those parameters that ultimately ends in the safe birth of the child and without serious maternal injury or death is viewed as “lucky.” Hospital-birth advocates may even try to say that every safe out-of-hospital birth is anomalous, or an exception — or even if it is admitted that they are the rule and not the exception, it will still be intoned that such births are risky.

But it depends on how you define “safe.” And until everyone involved in birth can agree on a definition of “safety in birth,” there will never be agreement on which births are safe and which are risky.