Birth Your Way!

Four Reason Why Moving in Labor is Best!

2012-01-03T22:47:00.000-08:00

I want to start off by saying that I think most women who are allowed to find their own rhythm in birth will do just that! They will find a rhythm and ritual that works best for them as long as they have freedom of movement, are educated and informed of the birth process and well supported. Having said all that, I believe that one of the best things for a women to do in active and sometimes even in late labor is MOVE! Freedom of movement in labor is essential to the process and here are four reasons why:

1. IT MAKES YOU AN ACTIVE PARTICIPANT IN LABOR AND BIRTH: Labor and birth are active processes. Your baby and your body is working together to achieve birth. Waiting around for contractions can diminish your mental resolve. Many of my clients report feeling better when they have something to doing in birth. In the late stages of labor, it's the pushing that gives them something to do. In active labor it's movement. By walking, rocking, "dancing", swaying, or other physical activities, you are working with your body to achieve the goal of birth. It can help to distract you in late phases of early labor and in active labor, while also having great physical benefits.

2. IT HELPS MOVE YOUR BABY INTO MORE OPTIMAL BIRTHING POSITIONS: While I've come to believe that most positions your baby is in during labor are variations of normal, there are more optimal positions for labor and birth. Most will agree that one of the more optimal positions is LOA (Left Occicput Anterior). There are many things you can do to encourage your baby to rotate into that position and lying down on your back is not one of them. Movement, in particular, pelvic tilts, rocking in the hands and knees positions, squats, and lunges are helpful.

3. IT CAN HELP SPEED UP LABOR: The process of labor and birth is greatly benefited by walking and the use of gravity. Gravity can help move the baby down in the birth canal, thus allowing the baby to press down the cervix more as it descends. This in turn helps to dilate the cervix with the pressure from the fetal head that also promotes more oxytocin to be released. Oxytocin is the hormone produced in the female body that causes contractions. The more efficient the contractions a woman has are, the better there are at effectively dilating the cervix. This is how labor can be sped up by walking, standing, and squatting! All movements that utilize the help of gravity!

4. MOVEMENT CAN BE A COMFORT MEASURE FOR BIRTH: Movement, such as walking, rocking, swaying, bouncing on birthing ball, and squatting can all help to decrease the perception of pain, thus making it a comfort measure and labor coping technique. As a woman labors, any tension both during a contraction and after, increases her pain perception level. Effective relaxation techniques help greatly, but so does the use of movement. Through movement, a woman is effectively managing her pain, thus decreasing her stress and tension levels naturally and in turn her pain perception is lessened.

In the end, the goal of birth is always a healthy baby and healthy mom! The journey of birth should be distinct to every woman's ideals and birth vision. Your Journey belongs to you and your baby! Freedom of movement is one way to help you reach your optimal goal of a healthy baby and mom, while also giving you many options to use on that journey. Happy Birthing to all!

Maternal positions and mobility during first stage labour. Cochrane database of systematic reviews (Online) (2) PMID: 19370591

Simkin, P., & Ancheta, R. (2005). The labor progress handbook (2nd ed.). Malden, MA: Blackwell Science.

Simkin, P., Whalley, J., & Keppler, A. (2001) Pregnancy, Childbirth and the Newborn (Expanded & Updated Edition). New York, NY: Simon & Schuster.

Three Postpartum Things No One Tells You While You're Pregnant!

2011-07-22T07:45:00.000-07:00

Pregnant women always seem to bring out the inner expert in people. Everyone from your mother-in-law to the grocery store clerk has advice to give or a story to tell about pregnancy, childbirth, and beyond. However, rarely do we hear about certain things postpartum that could be useful to us if we had advice about it or even a heads up. I'd like to take some time to go over the top three things that occur postpartum I hear from clients, see on parenting/pregnancy boards, and have personal experience with, yet seemingly pregnant women rarely know anything about. I hope this list helps some of you ladies out there navigate through your first weeks postpartum with more knowledge and confidence that what you going through is normal and common.

#1 - HAIR LOSS

You read that right. Lots of women experience hair loss postpartum. It can be very daunting watching clumps of your once luxurious pregnancy-induced Pantene locks falling out suddenly, but fear not! It's perfectly normal and probably not premature female balding! Telogen Effluvium is the excessive shedding of hair that can occur anywhere from 1-6 months postpartum and you can blame those pesky hormones for it! Normally, about 90% of your hair is an active state and 10% is dormant. During pregnancy, the increase in hormone levels can keep your hair from entering the dormant phase, so hair you would shed normally stays put. When pregnancy ends and hormone levels return to normal, your hair that ceased to shed during pregnancy, then begins to fall out postpartum. It seems like you are losing more than normal, but in fact are losing hair you essentially should have lost before.

Here are few things you can do to help during this time:

*Eat a diet high in fruits and vegetables, which contain flavonoids and antioxidants.

*Avoid hair styles that place stress on your hair such as ponytails, braids, and weaves.

*Use shampoos and conditioners containing biotin and silica

If for some reason you still feel your hair loss is exceptionally excessive, consult with your physician.

#2 - NIGHT SWEATS

I know some of you pregnant women out there are probably thinking big deal! I sweat already. To that I would say, not like this. Postpartum night sweats are a completely different beast. I've had clients who reported waking up with sheets soaked so bad they felt they'd been doused with a bucket of water. Although it may seem like a very strange post-pregnancy symptom, it's actually quite understandable considering all the extra fluid retention a pregnant woman takes on. After birth your hormones (yes, hormones again) adjust and signal to the body that it’s time to eliminate the extra fluid. Like many postpartum symptoms, this too shall pass. Usually in about 2-4 weeks. In the meantime, here are a few things you can do to make yourself more comfortable:

*Drink plenty of fluids. It may seem counter-intuitive, but drinking extra fluids will keep you hydrated (all that sweating can dehydrate you afterall) and help your body reestablish a normal water balance more quickly.

*Put a soft towel or a pad over your pillow and under your sheets to absorb some of the moisture.

*Wear loose, lightweight clothing and sleepwear made of cotton, or even sleep in the nude.

As always, if you have other accompanying symptoms with the night sweats such as fever or dizziness consultant with a physician.

#3 - DISCOMFORT AND UNCERTAINTY WITH BREASTFEEDING

Many pregnant women read up on the benefits of breastfeeding, hear about the magical bonding of mother and child, and may even witness a mother, sitting on a park bench, breastfeeding her baby with ease and grace. A real pro. Then you birth your wonderful baby, settle in to breastfeed the little angel and realize not only do you not know what the heck you are doing, but it hurts as well. Yes, it's a perfectly natural thing, breastfeeding, but it doesn't come without it's challenges, i.e., pain and discomfort. Especially those first few days postpartum. Now I completely understand words like pain and discomfort are subjective. One woman's mild discomfort is another woman's severe pain. Keep in mind though, that my point here isn't about those cases of bleeding cracked nipples, mastitis or severe engorgement, but the run-of-the mill discomfort caused by a hungry baby vigorously sucking (and at times tugging and pulling) on your virgin nipples.

You may have heard or even read before that old saying If you are doing it right it shouldn't hurt. Let me interject my first (and only) swear word in this post by saying that is utter bullshit. Well meaning women say this without realizing how condescending and hurtful those nine words can be. It's also wrong. Breast-feeding is a learned skill, and you'll need time, along with practice, and patience to make it a comfortable, successful experience. While many issues that come about during breastfeeding can be attributed to malpositioning of the baby and a poor latch, there is still that initial discomfort you can feel without experiencing those aforementioned issues. You may also feel unsure you baby is getting enough milk that exacerbates you concerns. These feelings are all within the range of normal and there are measures you can take to help you along with breastfeeding:

*Nurse on demand. During the first 12-24 hours after your milk comes in, by letting the baby nurse almost continuously, you may be able to avoid the initial engorgement (and accompanying pain) that normally occurs when the milk comes in.

*Even though fear of pain and discomfort may make you shy away from it; always begin feeding the baby on the sorest breast or the one that seems to be the fullest.

*Expose your nipples to air whenever possible to help toughen them up and to prevent continuous contact with moisture, which can cause nipple irritation, soreness, and damage.

*Lastly, you want to make sure you latch is correct. If you need further help you can contact breastfeeding consultants at Le Leche League International . Also consult a physician if you have severe bleeding cracked nipples and/or fever accompanying swollen painful breast.

As a passionate advocate of breastfeeding I urge any mothers going through this to allow for yourself and your baby the time patience to hang in there if you experience this rough patch! There are many reasons that make it worth it and a few weeks postpartum you'll mostly like be that mother looking that old breastfeeding pro in the park.

What does Choice mean to you? An open thread.

2011-07-05T12:33:00.000-07:00

I am truly curious about women who advocate for choices but have no problem removing the ones from women that they don't agree with. This post comes about after many conversations I've had and read regarding an article that reported one hospital banning elective cesarean sections and inductions.

Now to be fair, there is part of me that wants to give in and celebrate this a victory for natural birth advocates, for women, for babies, but then there is another part that first and foremost terrified of the word ban and choice being in the same sentence when it comes to how women birth their babies. So before I get up on my high horse and tell you all why, I want to hear from you. I am hoping to learn something and have meaningful dialogue, not discredit anyone's point of view or argue. So let's try not do that in the comments, passionate as you all may be! Let's open it up to all choices in childbirth, not just this one. Do you feel there are other things that should be banned? If so, why, and again, why do you think it's not a dangerous thing to do, banning any choice in childbirth. So it's open to you ladies (and gentlemen if you are out there).

Woman! You ain' t nothing special!

2011-06-28T16:18:00.000-07:00

Birth is nothing special. Any mammal can do it. Just because you got knocked up doesn't make you a goddess and it certainly doesn't matter that you were crazy enough to have the kid without medication.

That quote speaks volumes to me. It's not exactly verbatim, meaning I actually left out the more offensive stuff (if you can believe that), but that's the gist of it. It's an attitude that I keep running into and the really disturbing part is that like the quote above, a lot of it is coming from women. Aside from the fact that some woman would have the audacity to tell me (or any other woman), that my birth experiences are nothing special, I find it tremendously sad that she would feel that way about her own.

It seems to me that this push to devalue birth has reached a fever pitch and is part of a greater problem. There are misogynistic undertones to almost every debate made against natural birth, even when the debater is female. There is a scene in Business of Being Born where one of the doctors interviewed equated natural birth to "feminist machoism" (whatever the hell that means)and that he "frankly, didn't see the need for it". I can not tell how incredibly offended I was by that statement, not to mention shocked that it's not referenced more in the more "feminist" circles as the exact reason many men have NO BUSINESS in the realm of birth. But of course I shouldn't be shocked because like I said, many women feel the same way he does.

Where does these attitudes come from? Is the disregard for the process and act of birth a direct correlation to the disregard of women in this culture? When we are told our choices in birth don't matter and our accomplishments in birth aren't special, the underlying message is, we as women don't matter and we are not special. When you think back on the way obstetrics was practiced long ago and even now it's quite hard not to see a correlation. Misogyny, gender inequality, sexism are deeply ingrained in our culture, and so how can it not take root in one of the most powerful thing that sets us apart from men?

It saddens me to see these attitudes in women. It reminds me how effectively we've been pitted against each other. We are constantly seeking to invalidate each others choices, especially when it comes to birth. Whether it be vaginal or surgical. Pain-med free or epidural. VBAC or Repeat Cesarean. Each time we argue and belittle these choices, we forget the very meaning of choice and we devalue our sisters as a whole. Nothing, however, is worst than telling a woman that birth in and of itself is not special. Though it's been liken to any other physiological function (like shitting - an analogy I've really come to detested), it's not. It's by far one of the most complex and still in many ways mysterious physiological functions. We should all marvel at the fact that any conception is made and once made "sticks". The odds are usually against us. Then when it comes time to birth our babies, an even bigger miracle happens. We still do not know everything about why labor is started, but we do know that mother and child work together to achieve the goal of birth. When left alone and barring complications, it's a very harmonious dance between mother and child. It matters, how a woman is treated during this time. It matters how the child (both unborn and born) is treated.

Think about this: Without birth, our species can not survive. How we view birth is very telling about how we view life itself. Do you feel each life is special? If you are pro-life, then birth and how it unfolds should be special to you. If you are pro-choice, then choices in birth should be important to you. If you are against the death penalty because you value life, then how it's treated in the beginning should be of value and special. If you are a feminist, choice is one of the most holiest of words. How can you devalue another woman's? Birth is a very powerful thing and that makes it special. Women are the only one's capable of birthing a human child and so that is one of the many things makes us special. However, even if you choose not to birth or can not birth a child, birth is still special too you, because you were once born. If you've adopted, that child was once born. Let's stop denying our power as women and the importance birth. How our species thrives and survives depends on it.

The Birth Story of Simone! My wonderful home birth!

2011-06-26T17:45:00.000-07:00

On January 18th of this year, just after midnight I started feeling my first rushes. Initially, I didn't think much of them. Even though I was "overdue" I really thought I feel a few rushes, go to sleep and wake up the next day still pregnant, ready to go about my day. Part of that was true.

After about 35 minutes I started to feel like something was happening. I wanted to get really excited, but I also wanted to rest too. It's a strange feeling, being up that late with those surge of emotions running through you. It's a surreal feeling. After an hour I decided that I would tell my boyfriend and mother (she was in town, waiting on the baby to arrive) that I may actually be going into labor soon. The birthing tub was in my 2½yr old's room and I needed that placed in the front room, as well as few other arrangements. Once those things were done, I told myself I would tell the midwives what was up, let them know I might be calling them back and then catch some shut eye!

Three hours later my rushes were still coming, but not progressing and I finally began to feel sleepy again. By 4:30am I started to drift off to sleep, being awaken every 20minutes by rushes. By 6am, after six hours, they'd stopped altogether. That morning I made some breakfast, saw my 5yr old off to school, watched television with my mother and felt a mix of emotions. I was slightly disappointed that I wasn't in labor yet, but still amazingly calm and patient. For the last part of my pregnancy I was blessed with a calm knowing that things will unfold as they were meant too. My baby would come when it was time and the fact that I wasn't in labor yet just meant it wasn't time. I wasn't going to rush anything!

By 11:30am I started feeling some twinges. Nothing big, just what I like to call a hint of labor. I had things to do so I decided if labor was coming, it would make itself known soon enough. I went on with my to-do list. By 1 pm my rushes got my attention. I called my midwife again and let her know what I was feeling. No big deal, just letting you know, yada, yada, yada. She told me to keep updating her and enjoy my day. My son got out of school at 3:35pm and by the time it was getting close to get him, my rushes were getting stronger and closer together. It felt, quite frankly, wonderful! I was excited and filled with adrenalin. My mother was with me. My boyfriend had been getting things ready. I was at home and we didn't know what sex our baby was. It was like Christmas. Everyone who was anyone was hoping for a girl, just because I already had 3 boys and so was I. Either way, I was having my beautiful baby...be it a Miles Christopher or Simone Renee!

I called my midwife and said I think maybe you should come over. She was already on her way to another birth and told me I had great timing considering where she was on the road! So she arranged for the other head midwife and student midwife to be at that birth and she would bring the other student midwife to mine. I decided to really test my labor by going to pick up my son. I thought with all the walking, if my rushes still felt strong, I would know for sure if this was it. Needless to say, it was :-). I called my doula and told her to come over and a dear friend who would update a cheering squad online as well.

By the time I got back home my rushes were strong and steady, maybe about 6-7minutes apart. I didn't bother with timing them too much after a while. I got out the birthing ball, stripped down to a tank top and underwear and rotated from straddling the ball to kneeling with chest across the ball. Both positions felt wonderful. My mother spent most of this time siting close by and we chatted. I can not classify what I was feeling as pain, just intense feelings in my abdomen. My boys played in the room together and from time to time got loud enough to where my mom would go in a remind them that I was working to get the baby out. They were fine though. They weren't a distraction at all. I thrive on the normalcy of it all. Chatting with my mom, Rick (my boyfriend) working on his computer in the office, poking his head in from time to time, the kids playing in the room, fussing, laughing, being silly. It all felt so right, so perfect. And me, straddling the birthing ball or kneeling, feeling these wonderful sensations! It made me feel so powerful and so alive. I kept thinking about how my mother once birthed me, and I birthed the two little boys playing in the other room and life goes on. It's surreal and humbling and wonderful.

Around 5:00pm or so, I started feeling pressure in my bottom with the rushes. I started to get a warm sensation as well and for a minute or two thought this might be an unassisted birth if my midwives didn't show up soon. However, at just a little after 5:30pm there was a knock at the door and it was them. They weren't even completely inside yet before I had another rush came and pressure, then pop! My water broke. I heard myself saying: My water just broke! And then they were quickly there, helping me get something under me to save my carpet and getting my underwear off. Good thing I had them on, because very little fluid got on my carpet :-).

After that, I sat rocking on the ball as they filled up my tub and we all chatted. The rushes were stronger, but still not painful. I briefly considered being checked (up until now I'd not been, not during my prenatals or anything), but realized that was remnants of the medical procedures creeping in my mind. There was really no need and I certainly didn't want to ever be put in the supine position. As soon as that tub was filled I got in and didn't get out again until after the baby was born.

The water felt so calming. It was where I belonged. Shortly after getting in my doula arrived and from that point I felt completely taken care of. I felt like the birthing part was my job and the job of everyone else was making sure I didn't want for anything during the birth. My mother made sure the boys didn't get too loud. My doula got me whatever I needed, my midwives were really just there. They rubbed my back a few times, listened in on the baby a few times, but mostly we all chatted when I wanted to chat and everyone was extremely quiet when they sensed I needed it and they had great senses. As it got darker, candles were light to keep the lighting dim and my rushes got stronger and closer together still, but again, I can never say it was painful. I did feel like my whole body was electrified. My senses were heightened. Everything felt hyper-real!

As my rushes got stronger, so did my focus. I let my body float in the water at times, other times getting into the hands and knees positions. Again, both positions felt right and I loved having the freedom of movement to decide which was most comfortable and efficient at the time!

With each rush I would let the tension go, again using water, but also allowing my mind and heart to embrace what I perceive as the true nature of the sensations. I was opening up, letting go, and allowing my body to do what it needed to do. In one very crystallized moment I realized that if I stay out of my bodies way, opening up my heart and mind to the process, it would be okay. I did just that and each time I let go, the sensations became at times almost pleasurable. Intense, always, but I never felt the need cry out in pain. I oohed, I aahed, at one point I even cooed and the sensations of that vocalization coupled with my rushes further electrified my body.

I could feel pressure building in me and eventually I knew the time to push was coming soon. This in between moment was to me the most unpleasant part of my birth only because I began to get nauseous. As soon as that passed and my doula got me something to drink and gum to chew, I felt fine again. Then the strong undeniable urge to push came. I didn't fight the urge at all, but instead relaxed my bottom to give into it. In my mind, I told myself I would lie back, let my body take over and gently allow my baby to be born. My body had other ideas. A strong wave came over me, all but forcing me to grunt and go primal, I think I called out it was time to push, and with that I quickly got back to the hands/knees positions.

I grunted loudly and it felt divine. It was fast and furious, but I had time to hear in the distance my 2½year son slightly freaking out and saying, "tell mom to stop making that noise". Even in the middle of that, hearing that grown-up tone in his voice made me crack up on the inside. I know I cracked a smile, but it didn't last long as the baby quickly crowned, then out popped the head. I didn't feel that burning sensation, but I did feel the stretching. She was completely out shortly there after and Rick was handing her to me, under water, through my legs.

The initial feeling of relief took over me, and then almost immediately I felt like I was drugged. I felt so high. The world melted away and it was only me and Simone. Oxytocin is a wonderful and powerful thing! It felt like forever before I got out of the tub. I just held my little girl, thinking of how maybe one day I will be able to share in her moment of birth like this. It made my heart swell up. Thoughts of her and her three brothers ran through my head as well. I could not have imagined a more perfect birth. It was 8:03pm.

My boys came in to meet their sister at that time, but this part is a blur because like I said, the world had melted away. Afterwards, Simone and I hung out on the couch, waiting for her cord to stop pulsating and the placenta to be born. I breastfed her for the first time and felt even higher. I love breastfeeding and had been secretly missing it as my 2yr old self weaned very shortly after his 2nd birthday! My mother and midwife surprised me with cake, fruit, and cheese. A wonderful after birth snack and I ate while Simone breastfed and we chatted a bit. No one touched my baby but me for what seemed like hours and hours, but in reality was probably 40-45minutes. I'm not sure. I just know it was shortly after the placenta was born.

We marveled at her true knot in the cord, took pictures, her weight, 8lbs 5oz, and the midwives gave her a thorough, yet quick evaluation and then she was back in my arms. I don't even think my mother held her for hours and hours after her birth. It was perfection, even the postpartum.

After the midwives left and the boys were put to bed, I spent time just staring at my baby. I hung out with her, just two of us. Eventually mom came in and hung out with us too and for the first time I felt a strong female connection to my mother I'd not experienced before, not even with the birth of my sons. It was three generations of women laying in my bed and I'd just birthed one of them. It was a very powerful and defining moment for me. I felt overwhelmed and calmed by that moment at the same time. I was so incredibly happy to be sharing it in my own home, surrounded by the people I love. Sleeping in my bed that night was a cherry on the top of a wonderful cake!

Here is a link to all the wonderful pictures my doula took at the birth!

Why I've been afraid to share my home birth.

2011-06-26T13:29:00.000-07:00

Before I write this post I want to make you all aware that I may ramble a bit. This is more reflection than anything, but I feel compelled to share it. If, and I am sure it does, it fails to follow the usually blog writing rules, so be it.

When I birthed my baby this past January I thought I'd be dying to write about the birth and share it with everyone I knew, but it's been five months and I've yet to really share it with anyone. Yes, I've given a few details here and there to a few choice people, but something has been holding me back from really putting the experience out there. I've been telling myself, it's being busy with my work, research, four kids but the truth is it's been fear. I've been fearful of sharing it for two reasons: I've been worried what affect my birth story might have on others and I've been concerned about negative feedback.

If you know me, those fears probably sound crazy to you. I am after all the woman very fond of using the quote: "Opinions are like assholes; every one has one and they are usually full of shit". Yet here I am, fearful of sharing my story. The really crazy thing is I am beyond proud of my birth. I am extremely happy with it, as it was the best birth I've had and I think that is the big problem. For you see, I am not afraid of scaring other women with a horror story of a birth, but instead somehow shaming them or worse, giving them false hope with a story of what was in my mind a perfect birth. I know, I know it's ridiculous. First off, nothing I can say or do regarding my birth experience can cause shame in anyone. If there is shame, it's already there, it comes from within. I strongly believe in this, but somehow that notion still had a hold of my heart. The idea that something other than good, positive feelings could come from sharing my birth just held me back.

So we come to the false hope part. When I stepped out of the fake illumination of denial and really allowed myself to address why I hadn't shared my story, the idea that I felt this way horrified me on many levels. If I really thought that sharing my wonderful story would be perceived as giving some women false hope, what did that mean? Could it be that deep down I didn't believe in home birth (or natural birth) as much as I thought? No, that wasn't it. It's a different issue. I believe that somewhere deep inside, I was worried that sharing my birth was wrong because I might be hurting the feelings of women who can not do what I did. Then I also wrestled with the idea that somehow I may even be bragging.

I've seen this fear when other women share their stories. It manifests in the "if's", "and" and "butts". How many times have you read a wonderfully inspiring story, but at the same time see it qualified by the author with the "I know not every woman can", or "natural birth isn't for everyone". Worst still is the comments that often follow the story of those women who want to defend their births that are different than the one they read about: "But if I'd birthed at home my baby would have died", "I had to have a c-section, epidural, pitocin, because...".

So where did these feelings come from? Is it a need to sugarcoat things? Be political correct? Or is it bigger. Is it a part of the fear indoctrination culturally ingrained that surrounds birth. Is there a part of me that feels lucky that I birthed my baby at home and everything was okay? I really feel deep inside that isn't case, but I can't deny that I've felt afraid to share. Maybe I am just being a control freak by wanting everyone to feel inspired by reading my story. I can live with that explanation. It's very silly of me, but what the hell, nobody is perfect. Whatever the case, I threw the shackles on myself, and so I can remove them. I am proud of my home birth. I will not qualify any of it with any kind of warning or disclosure. I will share it because I was inspired by others stories and I want to do the same. I will share it because I want to make my mark in the world of home birth advocacy. I will share it because I am proud. I will share in hopes that other ladies will also share their experiences as well. Good or bad. It's how we learn. It's how we grow!

My birth story can be viewed here.

The Standard of Care Conundrum

2010-12-07T22:21:00.000-08:00

When you think of the Standard of care in obstetrics, what comes to mind? Obviously your views on pregnancy and birth will dictate what you think the standards of care in obstetrics should be. However if you were to look up what the standard of care means in obstetrics, you'd get wide variety of definitions. Most commonly there are two schools of thought. The first is the Legal definition. This applies to the various standards of practice that should be done in order to maintain a good legal standing. For example, continuous fetal monitoring is considered a good way to indicate to a court of law (if you are doctor who finds him/or herself on defense there) that you gave proper standard of care to a mother whose baby ended up stillborn. The other school of thought is defining the term as the means of care that would be rendered by the majority of well-trained individuals. The latter is a little more tricky because it begs the question; which well-trained individuals are we talking about? Furthermore, with this definition, who sets the standards? Certainly many would say ACOG, but we must remember there are guidelines ACOG encourages that even members of their own group refuse to practice. It's also worth noting that not all practitioners, namely skilled and trained midwives, agree with some if not most of the practice guidelines set forth by ACOG.

The most compelling of the two main definitions is the implications for promoting the practice of defensive medicine. For those who are not familiar with the term, defensive medicine is basically medical practices designed or applied to avert the future possibility of malpractice suits. Let's take for instance the example I gave before of continuous fetal monitoring. Research and evidence shows that this practice is not only often times applied unnecessarily for every woman in labor, but in fact can cause more harm than good. Continuous fetal monitoring is connected with increased risk of false alarms, unnecessary interventions, increased need for pain medication, and even an increased risk of cesarean section. Yet with all the research that shows that intermittent monitoring with a doppler is just as effective and safe, doctors still apply continuous fetal monitoring with an EFM to many if not every woman, largely due to the fact that it protects them in case of a law suit.

One can now ask how policies such as continuous fetal monitoring be considered the Standard of Care if they can cause so many complications? Furthermore, how can true standards be set if there is not clear cut understanding of who has the authority to set them, or if they aren't guided by the best evidence? These questions expose what I like to call the Standard of Care Conundrum. It's the inherent flaw of our maternal health care system. Sure on the surface they all seem like gold standards, that is until you asked the dreaded three letter question: Why? Why exactly does a woman with a normal pregnancy have to be strapped to a bed throughout her labor? Why is it standard and widely accepted that a mother have a non-medically indicated induction at 39 weeks? Why is the cord clamped immediately after birth? Why, why, why? If any of the answers to these questions come from a place of legal protection to the physician this should be unacceptable! If any of the answers are skirted, ignored, or meet with an explanation from the stone ages of birth practices this should be unacceptable. Furthermore, if your questions breed contempt or agitation from your physician, not only should this be unacceptable, but you should run for yours and the life of unborn child!

Now we come to what the answer to all of this is? While many would say home birth is the answer, I strongly disagree with this. Home birth is the answer for some (I am having one this winter myself) and it's an option certainly every woman should be able to explore, but it's not the answer for all. Nor should it be. We have a system adopted long ago that was always broken. As much effort that is applied in making home birth a viable option for all women who can choose it, should be put into repairing that broken system. We need to fix it so that it becomes a viable option for women who want it, and an acceptable alternative for those who must choose it due to complication with their pregnancy. In short, as consumers we need to see to it that better standards are set and applied. These standards should not only put the safety of mother and baby first, but honor the mother's desire to birth in a way that she chooses. It's important for us not shy away from the fact that if we truly want better standards we are going to have to demand them. Change only going comes from the voices of dissent!

References:
- American Academy of Family Physicians, May 1, 1999
http://www.ncbi.nlm.nih.gov/pubmed/14501630
http://www.suite101.com/content/reason-for-cesarean-rate-increase-a7407

My choices are better than yours!

2010-11-11T23:54:00.000-08:00

A short while ago I was reading an article about the safety of home birth. The article was well written, concise, and to the point about how home birth can be a viable option to many women in the United States, however what really struck me was the overall theme of the comments section. Over and over I read comments that stated something that amounted to this: It's more important to birth your baby in a hospital where it is safe, than to have some spiritual, or hippie like experience. This sentiment is echoed by doctors and women alike. Even ACOG stated that "Choosing to deliver a baby at home, however, is to place the process of giving birth over the goal of having a healthy baby"

I find this line of thinking somewhat hypocritical and here is why: Many times the same women who make comments like the ones above, are the same that can be heard saying she wanted to enjoy the birth of her child and not be in pain. How many times have we heard of the nurse trying to convince a woman she isn't a martyr and that there are no rewards for women who endure the pain? Doctors are always selling the experience of easier, pain-free birth through epidural. Yet epidural does not come without risks, some of them very serious. By the previous rationale, aren't the women who choose epidural putting the experience of having a pain-free birth experience over the goal of having a healthy baby as well?

Now before anyone gets all riled up, I want it to be known, I believe epidurals have their place, but so does natural birth. It does come down to personal choice. So why as a whole, does our society value one personal choice over another? Some out there in pro-medication land may be quick to site that home birth holds more risk than a medicated birth and let me be the first to go on record and say you don't know what you are talking about. Yep, I said it and what's worst, I am NOT going to cite any references to back that statement up. I am not playing the statistics game today. I am blogging from a different place. Matter of fact it can be quite liberating stating my opinion as fact! Now I know why so many do it, but I digress. More or less risk is really irrelevant. The risks are there regardless and most times the risk of epidural is completely downplayed.

I've been pondering this double standard for sometime and while I can speculate on many different reasons one thing that comes to mind is ignorance. This is going back to my previous statement about people not knowing what they are talking about. The bottom line, people are ignorant. They are ignorant about home birth. They are ignorant about the real risks of interventions. They are ignorant about the driving force of hospital policies and procedures. They are ignorant about midwives. They are ignorant about the reasons so many women truly choose home birth. They are ignorant about the kinds of women who choose home birth. They are ignorant about their rights. They are ignorant about their choices. Wow, that's a buttload of ignorance. Now, I'm well aware these aren't the only reasons this double standard exist. There is the Hospital, Insurance, Doctor factor. We all know that song and dance, so let's get back to the ignorance.

See, the underlying problem that keeps coming up in these article's comments section and in conversations I have with people, not only in person, but all over the internet is that this ignorance often morphs into something I like to call willful ignorance. You try to share statistics, research papers, medical articles, journal entries, books, and just plain common sense with people and it falls on deaf ears. They say the information is tainted, bias, unreliable, or the completely ignore the evidence and harp on one regurgitated statistic of their own. Yeah I am looking at you she-who-shall-not be named! This is why I am writing this totally opinionated blog post. I'll write another one chalked full of evidence later, but for now I just want to get this off my chest.

So what is the solution? How can we allow for value to be placed on both choices. I think first we have to teach everyone, women, men, doctors, nurses, insurance companies, hospitals, to value choice . Because let's face it, many do not. The system isn't set up for valuing choices or informed consent and decision making and that crap way of thinking just spreads in our society like a disease. We devalue the choices women make that do not mirror our own, and what's worst, we devalue our own right to have choices and this couldn't be more evident than in the birth practices. So I guess once again, my opinion is that everything begins with choice. Owning them, having them, respecting others, and understand what they are.

Naysayers, hijackers, and Angry B*tches...OH MY!

2010-09-29T18:34:00.000-07:00

Warning - Strongly worded rant, read at your own risk!!

I've had the privilege of being in some pretty heated, balls out, inspiring, eye-opening discussions over the course of just three short days. Some of these took place in person others over the internet. Indulge me for a few while I talk about the debates of the latter.

If you haven't already seen the post Racism and Low Birth Weight 101, by The Unnecesarean, it might be hard to completely get where I am coming from, but then again I think my point is kinda basic: When it comes to racial injustices, you don't have to fucking buy it, because it aint up for sale!

In regards to some of the many comments about the aforementioned post on The Unnecesarean, let me be the first to say, I understand healthy skepticism. I understand exploring other causes of infant mortality in blacks. I understand just having a different point of view. What I don't understand is this incessant need to divert the discussion from what the post is originally about, without really opening yourself up to any real discussion. Examples of the diversion/hijacking:

*Not all white people are racists (I don't remember the studies drawing that conclusion but whatever)

*I don't even know any racist people where I live (my personal favorite because, what the fuck does that mean?)

*What about Native Americans or Hispanics? Why is just about African Americans?

I'd like to address that last one. Here is the answer: Quite simply, because it is ONE study about African American rates of Infant mortality and any possible links to systematic racism. What the hell is wrong with that? It could as easily been a study about the Native American Community or another minority, and still be worth our attention and important enough for us to have an open mind with meaningful dialogue about it. I would find any study about any culture and their infant mortality rate compelling and worth my interest. We could, of course, debate the merits of how that study came to be, but doesn't that in and of itself require an open mind, a level of respect and understanding. Would there be as much resistance if we were talking about a culture of women in some foreign land or would we all be shaking our heads and fists in disgust and anger, outraged at the mistreatment of these other women? Of course, I can't say for sure, but I'm curious.

Lastly, the thing that really grinds my gears (this is a rant remember) is the sentiment I've seen these few days about how linking racism in this way is not scientific. The underlying feelings and some outright comments have been that you can't prove racism because it's how a person feels, namely the victim of it. Therefore, it has no real place in the debates about birth and especially birth outcomes. It's so utterly amazing that some of the same people I've seen make this argument about racism, champion a woman's right to use the term "Birth Rape", citing how you can't deny what the woman felt as she was victimized and her right to categorize what happened to her in birth this way. I know there is a huge difference between racism and that of rape (of any kind), but why does a woman's feelings in this aspect deserve our attention and respect, but the other does not. Why is the outcomes of trauma in birth and say the link to postpartum depression, or even negative outcomes on the mental well-being of infants, more plausible and worth more time and attention, than that of any links to negative outcomes of birth in African American women who suffer systematic racism? Further more, how did that post fail to link racism and it's outcomes on birth in a scientific or at the very least plausible way?

Battles of The Birth

2010-04-10T23:09:00.000-07:00

I woke up on the morning of September 28, 1996 feeling as I had for the last several weeks, like I'd be pregnant forever and starving. Whenever I look back on that day a surreal and eerie feeling comes over me, knowing how oblivious I was to the events that were about to unfold. Not only was I going into labor that day, but I was going into a battle that had bittersweet consequences. A battle that I lost, but set me up to fight a war I intend on winning.

It all started because of my feet. I spent the later part of the morning and early afternoon at my mother in-law's house, taking walks and standing around talking and having fun. After one of her sons noticed how badly swollen my feet were, I was convinced to go have it check out, "just in case". My instincts told me it was no big deal, but I sold out my instincts to her experience (she was the mother of four after all) and felt insecure due to lack of my own.

At the hospital I saw a doctor who check my blood pressure, my urine, my swelling, and my weight, then deemed it, drum roll please, edema! After looking in my chart he ask would I like to have this baby today. I thought he was humoring me so I said that would be great! He said something like, "Let's check your progress" and so now I was laying flat on my back naked from the waist down because of swollen feet. I was 4cm (as I had been for a few weeks), 50% effaced, -2 station. I can't really tell you why I remember all of that, but I do. He asked if I wanted to be induced and because I'd just read in my trusty "What to Expect When Your Expecting" book that induction entailed drugs, I said no thanks. Then things got weird. For the first time in all my vaginal exams I felt pain. It wasn't super intense, just painful compared to all other vaginal exams and by far more uncomfortable. So just like that, my membranes were stripped. No informed consent, no permission to do so, he didn't even tell me what he'd done. I had to find that out later. Also, for the record, I wasn't "due" until October 5th.

My first contraction came very soon after that, in the parking lot actually. I remember dismissing it as a stronger Braxton Hicks, and pressed on in my quest to get my fifth meal of the day. It was about 6pm. As the early evening progressed, my contractions got stronger and closer, but I kept waiting for them to be unbearable. My naive mind kept telling me I have want to cry or scream before it's time to go to the hospital. Sadly, it wasn't until I actually got to the hospital that I felt that way, and not because of any physical pain.

I arrived at the hospital shortly after 11pm and was greeted by a nurse who I felt clearly did not like her job or women. She moved without a purpose, practically cleaning her nails while talking to me. Everything she said was either dripping with sarcasm, disdain, or both and I swear she was popping gum. After I checked in, got the gown on in the bathroom, she insisted the first thing I do before going to my labor room was pee in a cup. I actually took the cup in the bathroom and tried a few times but I simply had no pee. When I told her this she stared at me blankly and replied: "We can't really do anything until we check your urine". I looked her squarely in the eyes, grit my teeth through the contraction and asked her: "What the hell does that mean?" Her reply: "Ma'am, we need your urine." My contraction was stronger and longer than ever before so I closed my eyes and rode it out. When it was over, I didn't open my eyes right away. In my minds eye, I glimpsed what this must have looked like. Me standing in the bathroom, door half opened, in a stupid Kaiser hospital gown. Her standing arms folded with that indignant look in her eyes. It irritated me. I opened my eyes and said: "I have no pee, I peed earlier use that." Then I pushed my way passed her. Round one over.

I have to admit that short exchange between me and the nurse took a lot out of me. I was feeling anxious and intimidated that I pissed off one of the people who would be "delivering" my baby. I felt like I'd made an enemy. It wasn't until I got into the bed, and had my first cervical check that I felt some relief. I was 8cm dilated. Awesome news! Then the doctor told me he was breaking my water. I remember looking over at my ex-husband who quite frankly looked like a lost tourist in all of this, and asked the doctor if we had too. He looked at me with extreme annoyance and said: "Either I break your water or your going home". My jaw literally dropped and the harshness of his tone brought tears to my eyes. I looked at my ex-husband again for help and before I could reply he did it. He stuck that hook into my vagina, rather roughly I might add, and broke my water. Coming from a woman who grew up with domestic abuse in my family (my dad beating my mother), both parents on drugs, and surviving sexual abuse myself, I can safely say it was the single most humliating and terrifying thing I'd felt since my childhood. He didn't just break my water, he broke my spirit that day as well. Round two over.

Everything after that was blurry. I remember vomiting. I remember not wanting my ex-husband more than a foot, if that, away from me. I remember being asked if I wanted something for the pain, but I don't remember what I said. I know I didn't receive pain medication, but I just can't remember what I said. Then I remember being told it was time to push. I didn't believe them, because I'd read that women felt the urge to push when it was time. I had absolutely no urge to push, but I didn't want to argue. God knows what they would have done if I argued. An image of foreceps delivery came to mind. It scared the hell out of me. However, when the nurse said to push during the contraction, I got a bit of my spirit back. Surely she was joking, I thought. She wants me to push when it hurts the most. I stalled. One contraction went by, then another, and another. Still no urge to push. In all honesty I had no urge to birth anymore. I wanted to crawl into my own bed, pull the covers over my head and cry. I didn't do that though. I held my breath, chin to chest and pushed. Just like they told me to.

As I was pushing, I heard the doctor (A totally new doctor by the way. Somewhere during my haze I guess they must have changed shifts or some such thing!) say something about tearing. I don't know exactly what she said, but I blurted out: "I don't want to be cut". Very shortly after that, my friend who was present for the birth, said: "Do you know she is cutting you". I didn't know. All I knew is my bottom was on fire and I felt like not pushing but people were yelling at me to push. All my focus was on that. I heard what my friend said, and I wanted to scream, but I didn't. I pushed. Then at 2:14am, my baby was born. Less than four hours had passed but it felt like a lifetime. Round three over.

Josiah, my son, was loud and strong from the beginning, but at the time I didn't care. I had very little interest in him. I just wanted to go to sleep. I can remembered feeling exposed as she stitched me up. The tugging and pulling I felt as she did it made me sick to my stomach. I remember feeling like nothing but a piece of meat. When she was finished, I mumbled something like everyone has seem him, you can go home now. I am not even sure anyone heard me, but after that everything was a blur. I don't remember what my ex-husband said or when he left. Or his mother, who was there, or my friend. I don't remember transferring rooms. I don't remember how. I just remember being in the bed and having my my uterus pushed on and my pad checked. It hurt like hell and was again humiliating having someone pulling at your underwear to check your pad. I asked if I could do it, and the nurse said something like I heard you were trouble. I shut up and let her do it. She was so smug and her touch was rough. I felt scared and alone and wished they allowed husbands to stay overnight. Round four over.

I remember not wanting to nurse Josiah anymore like I'd planned too. I know that I loved him, but I just didn't have anything to give just right then. I laid there, with him beside me in that glass crib that they put babies in and at that moment I needed him near me. I picked him up and as stared at him. I didn't really know what to think, except that he looked like his father to me. The thought made me smile. The smile warmed my heart and then I cried. I didn't really know why I was crying. Was I happy or was I sad?

Later that evening, I made the mistake of allowing him to be circumcised. He wouldn't nurse after that. I thought, he knew I didn't want him earlier when I refused to nurse him and now I let them hurt him, so he no longer wants me. I cried again, but this time I knew why I was crying. After an hour of sheer heartbreak, I tried nursing him again, and after he got on with a very painful latch, I decided I wasn't going to be sad, because I didn't want people thinking I was weak and looking for pity. There are women in the world being beat by their husbands, raped, and I am not going to let myself be selfish enough to wallow in any grief over what happened to me.

Then, just like that, I had a hard time remembering what happened to me. Out loud I pondered: "What did happen?" I remember, deep inside, being afraid to ask why did it happen. That was the scary question. I buried it, let it go. Didn't think about it again. As time went on and I learned about other women and their birth trauma I vaguely remembered being unhappy with my birth. I thought, Boy was I being a brat. Women have had worst birth trauma's, unnecessary c-sections, terrible iatrogenic injuries and even death. I felt guilty for ever thinking I had a bad experience and so I buried it further. Not until sometime in September of 2004, about 5 hours after finding out I was pregnant again would I recall to memory what happened in the early morning of September 29th as if it was yesterday. It was as clear to me then, as it is to me now. I cried and cried alone in my bed and silently I vowed never again.

The Wonderful Benefits of Delayed Cord Clamping

2010-03-29T09:37:00.000-07:00

We Can Be Much Kinder - Free videos are just a click away

Want to have a healthy and safe birth? Try the 6 Healthy Birth Practices.

2010-03-18T15:01:00.000-07:00

INTRODUCTION

1. LET LABOR BEGIN ON IT'S OWN

2. WALK, MOVE, AND CHANGE POSITIONS

3. HAVE CONTINUOUS SUPPORT

4. AVOID UNNECESSARY INTERVENTIONS

5. GET UPRIGHT AND FOLLOW URGES TO PUSH

6. KEEP YOUR BABY WITH YOU

Increase Womens Access to VBAC! Petition

2010-03-12T16:51:00.000-08:00

Increase Womens Access to VBAC! Petition

I've signed this petition and urge all of you to do the same!

Informed Consent - The Myths Vs. Reality

2010-03-04T08:47:00.000-08:00

When discussing maternity health care practices there is one phrase that will inevitably be mentioned and that is informed consent. The belief is that women should have informed consent before any procedure, intervention, or alternative action is taken by the provider before, during, or after labor and birth. This supposedly ensures that she is given the optimal chance at being involved in making choices regarding her health care, but does it really?

The Surgery Encyclopedia defines informed consent as: a legal document in all 50 states. It is an agreement for a proposed medical treatment or non-treatment, or for a proposed (emphasis mines) invasive procedure. It requires physicians to disclose the benefits, risks, and alternatives to the proposed treatment, non-treatment, or procedure. It is the method by which fully informed, rational persons may be involved in choices about their health care.

Let's examine the language and implications of that definition. On paper and at first glace, informed consent seems like the gold standard in allowing for participatory practice in maternity health care, but upon closer examination there are some limitations. Because informed consent begins with the caregiver proposing a certain course of action, it suggest that the caregiver has already decided that action is best. Yes, the practitioner may disclose information on not taking that particular action, or other alternatives, but is this enough to be considered participatory care? Let's look at an example of how informed consent may be given:

A first time mother arrives at the hospital, membranes still intact, having regular contractions at about 6-7minutes apart. She has already labored at home for more than 8 hours. During her cervical check, it is discovered that she is only about 3cm dilated. Her contractions are manageable to her, but she can't help but express disappointment that she isn't further along. She doesn't have a written birth plan, but wants to labor without pitocin or other forms of drug augmentation because of fear of what it might do to her labor. After an hour of laboring in bed on monitors, her labor begins to slow. Her contractions are spacing and getting weaker in strength. Although her baby is fine, and she is doing well, her doctor suggests (trying to honor her wishes to avoid pitocin) that her membranes are artificially ruptured. He goes on to tell her that because they rupture her membranes, they may have to monitor the baby more closely as labor is better tolerated by baby with membranes intact, and that there is a slight risk of infection and fever if she labors too long with her membranes ruptured. He tells her the benefit is that it may put her in a better labor pattern and make the contractions longer, closer together, and generally more efficient. He also tells her that her that she could wait a few hours and see what happens considering the baby is looking good, but that in his experience, once a labor stalls, it usually requires some action to get labor going again. He reminds her that, although he knows she doesn't want pitocin, it is still a viable option that usually yields the fastest results. After hearing all of this, the mother decides to have her water broken, and in 7 more hours goes on to delivery her baby vaginally. She did, however, require an epidural (which she was also trying to avoid), not only because of the intensity of the contractions after her water was broken, but because she wasn't allowed to labor outside of the bed. The lack of freedom of movement increased her perception of pain.

In that scenario many would argue that she was given informed consent and in the truest definition of the word, she was. The doctor proposed a course of action, told her the risks and benefits of that action and also discussed the option of not taking that action. He also presented another option (although the patient was already aware of the option and had already declined it) However, when we consider that scenario closely, it's then we can see the true limitations of informed consent. Did the doctor prescribe that particular course of action without bias? Since that action was the only alternative mentioned besides one the patient clearly did not want, I would be inclined to believe no, he did not. The bigger question is why weren't more alternative augmentations discussed? There are a host of different options that could have been presented but were not.

Having said all that, it has been clear to me for a long time that we need more than informed consent to really be participants in our maternity care. We need informed choices. As I learned from both my Doula studies and experiences, the act of informed choice is a process. It suggests that a dialogue is opened between the practitioner and patient. The communication is such that in certain situations the patient may face, multiple options are presented to the patient, with risks and benefits of each, in addition to the option (if possible) of doing nothing. The patient can then carefully weigh the pros and cons of all viable options, without pressure or bias from the practitioner, and then can give her informed consent. Informed choice invites the patient to truly become a participant in her care, and should always be the first step before obtaining informed consent. In this scenario the caregiver has engaged the patient and in doing so builds a positive atmosphere in the birthing room. No longer is the caregiver inviting the patient to "sign off" on a procedure or course of action the he deems necessary, but is "engaging in a dialogue to help the client take responsibility for her own choices."

In closing this post, I want to add that it is important for expectant mothers to know that there can be situations that are true emergencies. In these situations it goes without saying that discussions will have to be limited, if there is time for any at all. This is another reason why informed choices are so valuable, because the act of discussing choices and options should happen not just during labor, but throughout pregnancy at prenatal visits. The open dialogue and subsequent trust the practitioner fosters as result is invaluable in those instants of true emergencies. Not only does the doctor get to understand his patients wishes more deeply, but the patient in turn is able to trust the doctors expertise and opinions if an emergency should arise.

If you are happy with your choices, why does mine bother you so much?

2010-02-15T08:29:00.000-08:00

I'm not usually one to go on a rant. Not that people who rant are doing this, but when I do I always feel like I am jumping to conclusions. Perhaps I over analyze things for fear of making assumptions. Having said that, I feel a rant brewing. I believe it's been cooking up from weeks of reading articles and then foolishly going through the dreaded comments section. Seriously, if you for some reason want to change positive energy to negative energy, read the comments section of any controversial story and that outta do trick!

My rant is about peoples choices. Yes, I write about choice a lot, because I, like the great Morpheus of the Matrix, believe everything begins with choice. Let's examine the word for a minute. Choice in it's most stripped down form, implies ownership, yet I don't think people always own their choices. They may think they do, but their actions, emotions, and words say otherwise. I believe when people don't own, or take responsibility for their choices, it's usually because they are not happy with them. When you are happy with your choices, you don't feel the need to defend them or explain them. Or my favorite, get defensive and hostile when a person makes a choice opposite yours.

Example #1. I chose a natural birth. I blog about my experience and my satisfaction with my choices. You, having chose a medicated birth, read my blog and immediately become defensive. You launch into explaining why you had the birth you did. You also accuse me of trying to make people who don't birth "naturally" feel bad.

So, not only are you seemingly unhappy with your choices, you are also not owning your feelings, by blaming me for how you feel about your choices.

Example #2. A story is written about the high induction rate, and how many of the inductions done are not medically indicated. The article talks about the risks of inductions, one being the cascade of interventions that can sometimes lead to unnecessary cesarean sections. Again a woman who chose an induction reads the article and feels attacked. She explains her baby was suspected to be too big at 39 weeks. She needed an induction. Later as the induction failed she found out her baby was in danger and she needed an emergency c-section (that took 2 hours to happen from the moment the doctor say c-section time, to the moment she was on the table). The baby is delivered and low and behold her baby was 8lbs and she is only 5'4! She is pissed that anyone would assume her induction and subsequent cesarean was unnecessary!

In that scenario, one might argue that the women really didn't have a choice, because she was not given true informed consent and while I can agree with that, I don't agree that she sees it that way. She is angry that her decision to have an induction is questioned, and so again I have to wonder how secure she is in her decision. Perhaps maybe she feels she didn't have all the facts. Perhaps she secretly wonders how necessary her cesarean section was, but if she allows herself to question the events, she questions her judgment and role in the events that took place. That is an admittedly hard thing to do.

There are other examples I could give, but I'll stop with those two. The bottom line is that when a person is happy and secure in the choices they've made, another person words or actions can not make them feel otherwise. If you've felt defensive, angry, or guilty about choices you've made, you have to explore why, instead of blaming others. Own your feelings and take ownership of your choices.

Food For Thought on the Vaccine/Autism Links

2010-02-13T19:57:00.000-08:00

Watch CBS News Videos Online

Are we advocating for Choices or The Choices we would make?

2010-01-10T09:39:00.000-08:00

You are sitting at your favorite in-door play area with your little one, talking to another mother who frequents the spot. She just had a baby and you are super excited to hear about the birth. She begins to tell you that at her 38 week check-up her OB said the baby was measuring big (oh boy, here we go), and so an induction was scheduled. Of course she remarks on how the doctor said it was safe and she was full term, so she agreed. By this time you've kept that smile on your face, but are feeling you could easily continue this story for her. She goes on.

At 6am (why are those things scheduled so damn early in the morning), she arrives at the hospital, does the paperwork, changes into the gown, blood work, yada, yada, yada the doctor comes in at 9am. Wait, why did she have to come in a 6am? Oh well, you keep nodding. The doctor decides because she a multip (she tells you admitting she didn't know what the hell a multip meant, but didn't ask either) and already dilated to 2cm that he would break the water and start a low dose pitocin drip. You nod at her, but your heart drops inside.

So she talks about how as soon as that pitocin was put in she is deep pain. She kept wanting to get up, but the nurse kept telling her no. She says the nurse said the best thing to do was to get the epidural, but she would have to wait until she was 4-5cm. Of course, she thought that was pure torture, but she made it. She got the epidural and everything was copasetic. She tells you how she was playing cards with her husband, chatting on the phone, and it was hard to believe she was actually in labor, because with her first baby, she didn't get the epidural until she was 8cm. Wait, why did she get the epidural at 8cm? Never mind that's a whole different story.

So, by now it's 7pm and she has been stuck at 7cm. You nod, ready for what you've known was coming. Yes, you guessed it. Decels! The doctor tells her that he will give it one more hour. Wow, a whole hour really? And by now your friend is getting really scared. She says she didn't know what to do, but understood that the doctor knew what he talking about and decided to try and relax and pray.

So the prayers worked because in an hour, she became fully dilated. You perk up again, happy to hear that she wasn't sectioned! But wait, baby is hasn't moved down the birth canal. Oh, yeah, she's been laying her back this whole time. So after 2+ hours of pushing it's c-section time because after all, that is a big baby in there.

So you ask. How big was she? When the mother tells you 7lbs 8oz you force a smile and say she is so precious, because, what else can you say?

So you ask your friend how she feels and she says good. She is just happy the baby is healthy, and nothing bad went wrong. She completely understands that those things happen, and that's why she chose to birth in the hospital with a doctor in the first place.

When you re-tell her story to your group of natural birthing advocates, the first thing you say is, How do I tell her that her c-section was unnecessary? And therein lies the conundrum. You don't, because quite frankly, did she ask you? Telling her that is tantamount to telling her that her choices were wrong. She doesn't feel that way and it certainly isn't anyone's place to try and convince her otherwise.

Almost everyday I read something like this from one of my colleagues and associates and I am frustrated on two levels. I am frustrated for the women who got put through a system that doesn't always have the best of interest of her or her child in mind; and I am also frustrated by the advocates that seem to forget that it's not about changing a person's mind. It's about educating women, giving them all the facts so that they can make the best choice for them and on a bigger level it's about bringing change to that system.

I would ask myself if I were the woman listening to the mother's birth story; Did I offer up information, advice, resources to this woman while she was pregnant? Did I talk to her then and really listen to her? If you did, in the end, that's all you can do. It's her choice. If a woman makes a choice to be induced, knowing the dangers of induction, it's still her choice. Just as it the woman who chooses not to be induced, or to have a home birth or an unassisted birth. Are we really advocating for choices, or just the choices we would make?

Cesarean Scar Care in the Post-Partum Period: Hosted By ICAN

2010-01-01T19:44:00.000-08:00

ICAN (International Cesarean Awareness Network) is hosting a Webinar at the end of this month designed for new moms and healthcare professionals alike who are looking to understand and implement some real-world techniques to get relief from pain, itching, burning, and tingling. It is also to learn how to restore the abdominal muscles and posture so that you feel like yourself again.

If you are a woman who is going to have a c-section or had one in the past, you can benefit greatly from this webinar. Please click the link here http://ican-online.org/webinars/cesarean-scar-care for more information.

Just be happy you got a healthy baby!

2009-12-28T15:31:00.000-08:00

Often times when a mother feels cheated, hurt, disappointed, angry, or dare I say traumatized by her birthing experienced, her feelings are countered with the argument that she should just be happy she got a healthy baby. After all, that is the only thing that matters right? Sometimes her feelings are dismissed, ignored, or worse, met with resentment and hostility. She should count herself lucky and stop complaining. It never ceases to amaze me how cold, contemptuous, and lacking in compassion some people can be. They feel it's their duty to point out that she got a healthy baby as if she is somehow ignorant or ungrateful of that fact. They make a woman feel that by expressing any of the feelings and emotions listed above, she is not being a good mother, and quite frankly should just get over it.

I would like to take a little time to look at this situation from a different angle. I am quite fond of using analogies and thought of one I believe will help us garner a better understanding of why statements such as the ones above are wrong!

A woman has been planning her wedding for nine months with the help a Wedding planner she hired. The Wedding Planner was in charge of a great many details, two of which were very important to the bride: Acting as liaison between the bride and venue staff, and procuring a capable,professional, wedding photographer. On the day of her wedding, a great many things did not go as planned. The bride was prepared for unforeseen things to go wrong, like an unruly flower girl or bad weather, but not the negligence of the person she hired and entrusted with management of her special day. The Wedding Planner had failed to iron out all the details of the ceremony and reception start time with the venue and therefore, the wedding before the brides overlapped. Her guests were forced to stand around and wait 30 minutes before the start of the ceremony. The Wedding planner hired a very incompetent photographer in an effort to cut costs and so all of the services the bride wanted were not offered. Very few pictures were taken, and the photographer took very few candid shots as the bride requested, because he was more comfortable with posed shots. The communication between the florist and the wedding planner was minimal, as the planner, overbooked that month with other brides, had very little time for meetings. As a result, the decor was not as the bride wanted.

As the bride took stock of her wedding, looking at her poorly produced wedding photos and all recounting all the poor management, she grew angry and disappointed. The vision of how her wedding would be was destroyed and not because of some uncontrollable set of circumstances, but because of what her planner did or did not do. She complained to her bridesmaids, her friends, and family, who agreed that all of this could have been avoided had she hired a better, more competent wedding planner. Of course she had the right to complain, after all the planning and hard work, the person she paid to help her, ruined it. They joined her in her anger and offered their support and a listening ear. Not once did one person say to her; Get over it and just be happy you got a husband.