(It was brought to my attention that I forgot the link to the news story ( Thanks Laura! ). That's what I get for trying to do a blog post while tired with a day-long headache. )
Click HERE for story on MSNBC
You'd think that babies being abducted from hi-tech hospitals with lo-jack type security bracelets, security checkpoints, and nurses everywhere isn't possible, right?
Wrong.
Just this past Friday, a baby was abducted from a hospital in Santa Barbara, just 5 hours after the baby boy was born.
Wait. Where the hell were the parents when this baby was 5 hours old? Was baby in the nursery alone? Why wasn't baby with mom, where he should have been? Why wasn't baby being held, nursed, loved?
By the time that they caught up with the abductor, she had gotten all the way to Santa Maria...roughly an hour and a half north of Santa Barbara. The baby, at just 5 hours old, was carried out of the hospital that is supposed to be a "safety net" for myriad things as far as labor, pregnancy, birth ( unless you know better, that is! LOL )...and yet, a baby was carried out of it.
This is why home birth keeps looking better and better. You don't get pressured into unnecessary intervention that will likely lead to a cesarean ( hell, how do you think we got to a 31+% cesarean rate, and that's only nationwide. Most hospitals have higher rates! ), or a baby in the NICU, or a mom who needs post delivery surgery. You aren't led to believe that you have to agree to the "mandatory" separation period of 1-4 hours so that the baby can be "monitored".
When a baby is born at home, there is no confusion over possibly mixed-up babies. There is no possibility of someone walking out with your baby, and you not knowing. There is NO separation. Babies should never be separated from mommy after birth. Unless there is a life-threatening condition, baby should never be separated. Baby should be not only *with* mom, but ON mom. Hearing her voice, her heart beat, her breathing rythm, and being warmed by her body and nourished by her breast.
And yet, people think that us home birthers are crazy. Ha! With the way that hospital births are going anymore, I'm more scared for the majority, than for us in the minority who choose to birth at home. We are at a dramatically lower risk of many of the things that go wrong in the hospital...the iatrogenic.
Saturday, February 28, 2009
Monday, February 23, 2009
When a Woman's Body Fails Her
Within the past month, I have heard more than a handful of stories where planned vaginal births ended up in "emergency" cesareans, and mom was given a diagnosis of either FTP or CPD. More horrifying, I keep hearing of *ELECTIVE* cesarean surgery, to avoid the pain or possible injury of a vaginal birth, because a woman is led to believe that a VBAC is just too risky, or because she "cannot" find a care provider to support her in one. I continue to be utterly baffled by the mentality in our society, surrounding cesarean sections, ie, major abdominal surgery. The risks are pasted all over the internet, warning women about choosing such a dangerous mode of delivery, and yet...we have the highest cesarean rate that we've ever had as a country. There's absolutely no excuse for a 31.1% ( and that was 2006, we don't know 2007's rates yet! ) cesarean rate. The WHO has recommended a national cesarean rate of NO MORE than 10-15%, which means that roughly 1/2-2/3 of *all* cesareans done are unnecessary!
I'll say it again. Roughly 1/2 - 2/3 of ALL cesareans done right now are unnecessary.
Does that not bother anyone? Ah, but I get the myriad stories of "My body wouldn't dilate", "My baby was too big", "My pelvis was too small", "I have already had a cesarean, and my OB ( SURGEON! ) wouldn't 'do' a VBAC".
I did a recent poll on a mommy-site, to see what reason women were given for their "emergency" c-section. 85% of them said that it was an induction ended in either FTP ( Failure to Progress ), or CPD ( CephaloPelvic Disproportion...pelvis too small, baby too big ). And they believed their diagnosis, because why would their doctor lie to them? They tried *everything*, and their baby just could not come out naturally.
Why is it that women are so ready to believe that their body failed them, rather than the SURGEON that they hired, screwed them over? Maybe not intentionally, no. I'm not saying that all Obstetricians are evil, and I'm also not saying that ONLY Obstetricians are the cause for unnecessary cesareans. Midwives can be just as bad, if not more damaging, IMO. But, let's face it. Women are hiring trained surgeons, but begging to avoid surgery. Why?
Let's go over a VERY common scenario:
First time mom, hires an OB because that's "just what's done". Plans a hospital birth. Really wants a natural birth, or as natural as she can "handle". Excitedly prints up her birth plan, that includes "No cesarean unless absolutely necessary", and has her doctor sign it, who is happy to do so, and says to patient "I ONLY do cesareans when necessary!". Patient gets to her due date. Doctor begins to check her cervix, that is yet "not doing anything". Cervix is high, thick, and closed. Doctor begins planting seeds about induction being necessary if patient is still pregnant by 41 weeks, because her body may need a jump start. And, baby might be a bit bigger since the baby has not dropped.
Mom may not necessarily want to be induced, but trusts that her doctor knows more about childbirth than she does, because she's never given birth before, and he's seen thousands of deliveries.
Does this sound familiar yet?
Patient gets to 41 weeks, cervix is still high, thick, and closed. Baby has not dropped. Doctor fails to inform patient of her Bishop's Score ( chart that can predict the likely success of an induction ), and says to head over to the hospital for an induction the next morning. Doctor also fails to tell patient that the labor hormones are more potent at night ( which is why women usually begin laboring at night ), because it's more convenient to schedule an induction during business hours.
Patient is excited, and nervous, and doesn't do any research, because she believes that she will go in, have baby, and leave hospital happy. She arrives at the hospital between 6 and 7 am, signs paperwork, is monitored, blood drawn, and cervadil is usually administered. For doctors who don't care about the risk of DEATH, cytotec might be administered instead. Patient must lie in bed for roughly an hour, and then is *allowed* to walk the halls if she wishes. But, needs to sport her IV pole and sexy hospital gown as well. Patient is checked a few hours later, and the cervadil has softened the cervix a bit, but hasn't done much dilation wise, so she is informed that the Pitocin is being ordered, and will be started shortly. With the pitocin comes constant monitoring, because of the risk of overstimulation to the uterus, though she isn't told this risk.
Sometimes, the doctor will also suggest breaking the bag of waters, to get things moving more. Patient is not told the risk of causing, or cementing, a malposition along with this procedure, nor of the risk of distress to baby by causing head to hit pelvis unnaturally. ( Meaning before it would have broken on its own ) So now, patient is in bed ( or in a chair if she's *allowed* to be out of bed ), dealing with the unnatural contractions that pitocin brings, and will shortly ask for the epidural that she didn't really want to resort to, just a few weeks ago.
She is given her epidural, and left to lie/sit in bed, while not being able to feel much from the hips down. She is likely not told of the risks ( both short and long term ) of the epidural anesthesia, to both her and baby. However, she signs a blanket consent form, without reading, and happily gets a very long needle inserted into her dural space. She is checked a few more times, and is told that she is making progress, but slowly. So, the doctor is ordering that the unit of pitocin is turned up a bit. Sometimes they will then insert an internal monitor for both contractions, and for the baby's heartrate. The one for baby is a monitor that *screws into the baby's scalp*. Patient is not told of the risk of infection to baby in doing so.
When she is checked again and found at the same dilation as the last two checks, the Obstetrician comes in and talks to her about CephaloPelvic Disproportion, or CPD. He explains to her that her pelvis is not large enough to allow the baby to drop, nevermind be born through it. He tells her how good of a job she has done in labor, and that she gave it her absolute best. He explains that if they continue, there is a risk of injury to the baby, since her pelvis is too small to allow him/her to pass through. He tells the patient and her partner, that he can do a cesarean section, and they can see their baby within 30 minutes. He has a team waiting in the OR.
Or, alternate outcome....patient is finally found to be 10cm, preparations for the birth begin. The bed is broken down, the stirrups are pulled out, and the doctor dons the facemask, surgical gown, gloves, and turns on a very bright light. Mom is told when to push, where and how to push, and for how long. The baby's descent is seen, but baby continues to go back up after mom pushes. After a few of these, the doctor explains that he is going to help mom out, by using a set of forceps, or a vacuum extractor. The "aid" is placed, and doctor pulls on baby, to try and assist in the delivery. After a few tries, the doctor tells the patient that her pelvis is not large enough to allow the baby to pass, and that is why the baby never descended, and that is why the baby was not able to be born, despite the aid of forceps or vacuum. Patient is rushed off to an "emergency" cesarean.
I'm sure anyone reading this has heard a story ( or several! ) that runs along these exact lines. Is it that there are now so MANY women who cannot deliver their own baby, or have screwed up bodies that fail them in the one thing that they were LITERALLY designed for? Or is it that Doctors and Midwives are failing women in not informing them of the risks of the things that they walk into willingly, and equally, the fault of the women for not doing research for the most important thing they will ever do?
It makes me so incredibly sad, and so incredibly angry that women would rather believe that their body is broken, rather than understand that they weren't given a fair shot, and that their choices ( in care provider, place of birth, interventions ) failed them instead. I will agree though that it is MUCH harder to take responsibility. I didn't want to believe that I could have avoided my cesarean, or that I could have avoided my son being in the NICU. That was one of the hardest things that I have ever done. To realize that my choices led to what happened to my body and my son, was heartbreaking.
I don't wish heartbreak on every woman out there who had an obviously unnecessary cesarean, but I do wish that women would become educated. I would rather heartbreak, than elective repeat cesareans. I would rather heartbreak than the belief that a woman's body just didn't work for them, and failed them in becoming a mother.
So above, what went wrong, and why?
* First time moms with a low Bishop Score, is up to 80% more likely to have a cesarean section due to the body not being ready for birth.
* Pitocin is known for causing distress in a baby, as it causes unnaturally strong contractions. If a baby wasn't ready to be born to begin with, the baby was not ready for *any* labor, nevermind unnaturally strong labor.
* Artificially Rupture Of Membranes ( AROM ) is known to sometimes cause a malposition in baby ( if baby is not low in pelvis ), or cement a bad position such as posterior, asynclitic, transverse. It can also cause distress, as the baby's head could have gone from outside the pelvis, to rammed *onto* the pelvis, with no cushion.
* Drugs or Epidural anesthesia are known for slowing or stalling labor progression. The medication also passes through the placenta, and into the baby's blood stream. This can lead to breathing depression, lethargy, problems nursing, and lower apgar scores in baby. Epidural anesthesia can also lead to a spike or drop in blood pressure for mom, fever ( which will be treated as possible infection ), headache ( that can last for weeks ), infection at the injection site ( that can lead to Staph ), nerve damage to the back, and in extreme cases...paralysis.
Epidurals also inhibit the pushing phase. Not only is mom unable to get up into varying positions to facilitate a larger pelvic opening ( lithotomy position causes the pelvis to be up to 20% smaller than in other positions for birth ), has a high risk of instrumental delivery, and perineal injury. Controversially, epidurals increase the risk for cesarean delivery because of these factors. When a woman has an epidural, she cannot efficiently feel when/where/how to push. She loses the ability to push effectively, therefore leading to the risk of higher rates of instrumental delivery.
* Vacuum delivery comes with a list of its own risks to baby. The most common is a hematoma, or a pocket of blood underneath fibrous covering of the skull bone. This can result in a "lump" the size of the vacuum cap. Also common are "superficial" markings to the scalp, or splits in the skin. Less commonly, these can be open to infection. Less common risks include neonatal jaundice, intracranial hemorrhage, and retinal hemorrhage.
But the most damaging risks, in my opinion, are the risks that come with a woman believing that she did everything she could, and that her body just didn't work right. Women anymore have so little belief in their body's ability, and don't look at the risks that come with each of the interventions that are allowed into a normal labor.
My desperate goal is to get women to make more careful choices in care provider, place of birth ( What is your doctor's cesarean rate? What is the hospital's cesarean rate? What is your doctor's track record with NATURAL - not just vaginal - births? What is your doctor's instrumental delivery rate? What's your doctor's episiotomy rate? ) Women need to make truly INFORMED decisions. Not just take the word of their care provider ( whether this be OB, Hospital Midwife, Birth Center Midwife, Home Birth Midwife ), friends, family members, and online pregnancy sites. Women need to understand the possible consequences of their decisions.
So many women believe that inductions are harmless, and therefore don't research the MANY possible risks. Many women believe that epidurals are harmless, and therefore don't research. Many women sign up for repeat cesarean sections, believing that it's safer than a VBAC ( Vaginal Birth After Cesarean ), without actually doing the research.
Women, we're smarter than this. And yet, we allow our instincts to be overridden by a care provider with a medical degree, or a mom who has had more children than we have. We allow our empowerment to be taken away by believing that the hospital is the safest place for ANY birth, and hand over our autonomy as soon as we check in.
I feel helpless so often, because it's constantly pointed out that I have no medical degree. It's true, I don't. But I have devoted the past 4 years to study pregnancy, childbirth, and ALL that goes along with it. Four years to this alone. Every aspect that comes with each. I have attended women in birth who had previously been duped into believing that their body didn't work, and watched as they labored beautifully, and then reached down to welcome their baby into their own hands. The incredible moment where they learned that their body worked just as it was designed to do. When they didn't have any separation from their baby. No nurse taking baby off to the nursery for "observation". No separation, but immediate bonding. Immediate smell, touch, love. Breastfeeding as soon as baby is ready, not when a nurse says it's okay.
I have the honor of attending women in birth, and watching as they unfold in childbirth, and regain their power.
Here is a video of women who were told that their body failed them...and went on to discover that it was their care provider, rather than their body, that failed them.
~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~
Bishop Score and Risk of Cesarean Delivery after Induction of Labor in Nulliparous Women
http://www.ncbi.nlm.nih.gov/pubmed/15802392
Risks of Epidural Anesthesia
http://www.healing-arts.org/mehl-madrona/mmepidural.htm
http://www.breastfeeding.com/helpme/epidural_anesthesia.html
http://www.transitiontoparenthood.com/ttp/foreducators/ceinfo/Side%20Effects%202.htm
Risks of Vacuum - Assisted Deliveries:
http://www.fda.gov/cdrh/fetal598.html
http://childbirth---labour-delivery.suite101.com/article.cfm/the_truth_about_vacuum_deliveries
http://jama.ama-assn.org/cgi/content/full/289/1/46
http://content.nejm.org/cgi/content/extract/341/23/1758
I'll say it again. Roughly 1/2 - 2/3 of ALL cesareans done right now are unnecessary.
Does that not bother anyone? Ah, but I get the myriad stories of "My body wouldn't dilate", "My baby was too big", "My pelvis was too small", "I have already had a cesarean, and my OB ( SURGEON! ) wouldn't 'do' a VBAC".
I did a recent poll on a mommy-site, to see what reason women were given for their "emergency" c-section. 85% of them said that it was an induction ended in either FTP ( Failure to Progress ), or CPD ( CephaloPelvic Disproportion...pelvis too small, baby too big ). And they believed their diagnosis, because why would their doctor lie to them? They tried *everything*, and their baby just could not come out naturally.
Why is it that women are so ready to believe that their body failed them, rather than the SURGEON that they hired, screwed them over? Maybe not intentionally, no. I'm not saying that all Obstetricians are evil, and I'm also not saying that ONLY Obstetricians are the cause for unnecessary cesareans. Midwives can be just as bad, if not more damaging, IMO. But, let's face it. Women are hiring trained surgeons, but begging to avoid surgery. Why?
Let's go over a VERY common scenario:
First time mom, hires an OB because that's "just what's done". Plans a hospital birth. Really wants a natural birth, or as natural as she can "handle". Excitedly prints up her birth plan, that includes "No cesarean unless absolutely necessary", and has her doctor sign it, who is happy to do so, and says to patient "I ONLY do cesareans when necessary!". Patient gets to her due date. Doctor begins to check her cervix, that is yet "not doing anything". Cervix is high, thick, and closed. Doctor begins planting seeds about induction being necessary if patient is still pregnant by 41 weeks, because her body may need a jump start. And, baby might be a bit bigger since the baby has not dropped.
Mom may not necessarily want to be induced, but trusts that her doctor knows more about childbirth than she does, because she's never given birth before, and he's seen thousands of deliveries.
Does this sound familiar yet?
Patient gets to 41 weeks, cervix is still high, thick, and closed. Baby has not dropped. Doctor fails to inform patient of her Bishop's Score ( chart that can predict the likely success of an induction ), and says to head over to the hospital for an induction the next morning. Doctor also fails to tell patient that the labor hormones are more potent at night ( which is why women usually begin laboring at night ), because it's more convenient to schedule an induction during business hours.
Patient is excited, and nervous, and doesn't do any research, because she believes that she will go in, have baby, and leave hospital happy. She arrives at the hospital between 6 and 7 am, signs paperwork, is monitored, blood drawn, and cervadil is usually administered. For doctors who don't care about the risk of DEATH, cytotec might be administered instead. Patient must lie in bed for roughly an hour, and then is *allowed* to walk the halls if she wishes. But, needs to sport her IV pole and sexy hospital gown as well. Patient is checked a few hours later, and the cervadil has softened the cervix a bit, but hasn't done much dilation wise, so she is informed that the Pitocin is being ordered, and will be started shortly. With the pitocin comes constant monitoring, because of the risk of overstimulation to the uterus, though she isn't told this risk.
Sometimes, the doctor will also suggest breaking the bag of waters, to get things moving more. Patient is not told the risk of causing, or cementing, a malposition along with this procedure, nor of the risk of distress to baby by causing head to hit pelvis unnaturally. ( Meaning before it would have broken on its own ) So now, patient is in bed ( or in a chair if she's *allowed* to be out of bed ), dealing with the unnatural contractions that pitocin brings, and will shortly ask for the epidural that she didn't really want to resort to, just a few weeks ago.
She is given her epidural, and left to lie/sit in bed, while not being able to feel much from the hips down. She is likely not told of the risks ( both short and long term ) of the epidural anesthesia, to both her and baby. However, she signs a blanket consent form, without reading, and happily gets a very long needle inserted into her dural space. She is checked a few more times, and is told that she is making progress, but slowly. So, the doctor is ordering that the unit of pitocin is turned up a bit. Sometimes they will then insert an internal monitor for both contractions, and for the baby's heartrate. The one for baby is a monitor that *screws into the baby's scalp*. Patient is not told of the risk of infection to baby in doing so.
When she is checked again and found at the same dilation as the last two checks, the Obstetrician comes in and talks to her about CephaloPelvic Disproportion, or CPD. He explains to her that her pelvis is not large enough to allow the baby to drop, nevermind be born through it. He tells her how good of a job she has done in labor, and that she gave it her absolute best. He explains that if they continue, there is a risk of injury to the baby, since her pelvis is too small to allow him/her to pass through. He tells the patient and her partner, that he can do a cesarean section, and they can see their baby within 30 minutes. He has a team waiting in the OR.
Or, alternate outcome....patient is finally found to be 10cm, preparations for the birth begin. The bed is broken down, the stirrups are pulled out, and the doctor dons the facemask, surgical gown, gloves, and turns on a very bright light. Mom is told when to push, where and how to push, and for how long. The baby's descent is seen, but baby continues to go back up after mom pushes. After a few of these, the doctor explains that he is going to help mom out, by using a set of forceps, or a vacuum extractor. The "aid" is placed, and doctor pulls on baby, to try and assist in the delivery. After a few tries, the doctor tells the patient that her pelvis is not large enough to allow the baby to pass, and that is why the baby never descended, and that is why the baby was not able to be born, despite the aid of forceps or vacuum. Patient is rushed off to an "emergency" cesarean.
I'm sure anyone reading this has heard a story ( or several! ) that runs along these exact lines. Is it that there are now so MANY women who cannot deliver their own baby, or have screwed up bodies that fail them in the one thing that they were LITERALLY designed for? Or is it that Doctors and Midwives are failing women in not informing them of the risks of the things that they walk into willingly, and equally, the fault of the women for not doing research for the most important thing they will ever do?
It makes me so incredibly sad, and so incredibly angry that women would rather believe that their body is broken, rather than understand that they weren't given a fair shot, and that their choices ( in care provider, place of birth, interventions ) failed them instead. I will agree though that it is MUCH harder to take responsibility. I didn't want to believe that I could have avoided my cesarean, or that I could have avoided my son being in the NICU. That was one of the hardest things that I have ever done. To realize that my choices led to what happened to my body and my son, was heartbreaking.
I don't wish heartbreak on every woman out there who had an obviously unnecessary cesarean, but I do wish that women would become educated. I would rather heartbreak, than elective repeat cesareans. I would rather heartbreak than the belief that a woman's body just didn't work for them, and failed them in becoming a mother.
So above, what went wrong, and why?
* First time moms with a low Bishop Score, is up to 80% more likely to have a cesarean section due to the body not being ready for birth.
* Pitocin is known for causing distress in a baby, as it causes unnaturally strong contractions. If a baby wasn't ready to be born to begin with, the baby was not ready for *any* labor, nevermind unnaturally strong labor.
* Artificially Rupture Of Membranes ( AROM ) is known to sometimes cause a malposition in baby ( if baby is not low in pelvis ), or cement a bad position such as posterior, asynclitic, transverse. It can also cause distress, as the baby's head could have gone from outside the pelvis, to rammed *onto* the pelvis, with no cushion.
* Drugs or Epidural anesthesia are known for slowing or stalling labor progression. The medication also passes through the placenta, and into the baby's blood stream. This can lead to breathing depression, lethargy, problems nursing, and lower apgar scores in baby. Epidural anesthesia can also lead to a spike or drop in blood pressure for mom, fever ( which will be treated as possible infection ), headache ( that can last for weeks ), infection at the injection site ( that can lead to Staph ), nerve damage to the back, and in extreme cases...paralysis.
Epidurals also inhibit the pushing phase. Not only is mom unable to get up into varying positions to facilitate a larger pelvic opening ( lithotomy position causes the pelvis to be up to 20% smaller than in other positions for birth ), has a high risk of instrumental delivery, and perineal injury. Controversially, epidurals increase the risk for cesarean delivery because of these factors. When a woman has an epidural, she cannot efficiently feel when/where/how to push. She loses the ability to push effectively, therefore leading to the risk of higher rates of instrumental delivery.
* Vacuum delivery comes with a list of its own risks to baby. The most common is a hematoma, or a pocket of blood underneath fibrous covering of the skull bone. This can result in a "lump" the size of the vacuum cap. Also common are "superficial" markings to the scalp, or splits in the skin. Less commonly, these can be open to infection. Less common risks include neonatal jaundice, intracranial hemorrhage, and retinal hemorrhage.
But the most damaging risks, in my opinion, are the risks that come with a woman believing that she did everything she could, and that her body just didn't work right. Women anymore have so little belief in their body's ability, and don't look at the risks that come with each of the interventions that are allowed into a normal labor.
My desperate goal is to get women to make more careful choices in care provider, place of birth ( What is your doctor's cesarean rate? What is the hospital's cesarean rate? What is your doctor's track record with NATURAL - not just vaginal - births? What is your doctor's instrumental delivery rate? What's your doctor's episiotomy rate? ) Women need to make truly INFORMED decisions. Not just take the word of their care provider ( whether this be OB, Hospital Midwife, Birth Center Midwife, Home Birth Midwife ), friends, family members, and online pregnancy sites. Women need to understand the possible consequences of their decisions.
So many women believe that inductions are harmless, and therefore don't research the MANY possible risks. Many women believe that epidurals are harmless, and therefore don't research. Many women sign up for repeat cesarean sections, believing that it's safer than a VBAC ( Vaginal Birth After Cesarean ), without actually doing the research.
Women, we're smarter than this. And yet, we allow our instincts to be overridden by a care provider with a medical degree, or a mom who has had more children than we have. We allow our empowerment to be taken away by believing that the hospital is the safest place for ANY birth, and hand over our autonomy as soon as we check in.
I feel helpless so often, because it's constantly pointed out that I have no medical degree. It's true, I don't. But I have devoted the past 4 years to study pregnancy, childbirth, and ALL that goes along with it. Four years to this alone. Every aspect that comes with each. I have attended women in birth who had previously been duped into believing that their body didn't work, and watched as they labored beautifully, and then reached down to welcome their baby into their own hands. The incredible moment where they learned that their body worked just as it was designed to do. When they didn't have any separation from their baby. No nurse taking baby off to the nursery for "observation". No separation, but immediate bonding. Immediate smell, touch, love. Breastfeeding as soon as baby is ready, not when a nurse says it's okay.
I have the honor of attending women in birth, and watching as they unfold in childbirth, and regain their power.
Here is a video of women who were told that their body failed them...and went on to discover that it was their care provider, rather than their body, that failed them.
~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~*~
Bishop Score and Risk of Cesarean Delivery after Induction of Labor in Nulliparous Women
http://www.ncbi.nlm.nih.gov/pubmed/15802392
Risks of Epidural Anesthesia
http://www.healing-arts.org/mehl-madrona/mmepidural.htm
http://www.breastfeeding.com/helpme/epidural_anesthesia.html
http://www.transitiontoparenthood.com/ttp/foreducators/ceinfo/Side%20Effects%202.htm
Risks of Vacuum - Assisted Deliveries:
http://www.fda.gov/cdrh/fetal598.html
http://childbirth---labour-delivery.suite101.com/article.cfm/the_truth_about_vacuum_deliveries
http://jama.ama-assn.org/cgi/content/full/289/1/46
http://content.nejm.org/cgi/content/extract/341/23/1758
Friday, February 20, 2009
Powerbirth! Start pushing at 5cm!
So recently I became aware of a "Revolutionary" new birthing technique, called "Powerbirth". I watched a video of this technique, by the founder, Lydi Ronka Owen, as well as checked out her website.
While watching the video, I was horrified. Women are excitedly following this technique, under the false premise that it's what they SHOULD be doing, that it will be faster, and that there is no risk.
In the video, and on the website ( www.powerbirth.com ), Lydi states:
Lydi not only says in a blanket statement that EVERY woman feels the urge to push at 5cm, but that if she DOESN'T do this, then the mom will likely end up in a cesarean section.
This information goes against everything that we ( midwives ) know about the physiology of birth. Those of us who also don't ever tell a woman when it's okay to push ( because we're not in their body ), know for a fact that a woman feeling the complete urge to push at 5cm just doesn't happen. It's very, very rare.
What also bothers me, is that this "technique" is marketed as an EMPOWERING technique for birth, and yet...there is a midwife's hand in mom's vagina quite often. HOW is that empowering? During the video, one can literally see the midwive's hand and arm TREMBLING from the force of manual dilation. Yes, you read that right...manual dilation. Not holding back a lip because mom wanted that done instead of waiting it out...manually causing the cervix to be more open than it is naturally. And quite unnecessarily.
The most dangerous thing about this, is that women are being led to believe that this is SAFE. They are not told of the risks of cervical swelling, cervical tearing, hemorrhage, exhaustion from pushing before the body is 100% ready ( oh wait, according to the powerbirth technique, that's at 5-6cm. ), uterine and/or cervical prolapse.
Nevermind their power being taken away from them by having multiple vaginal checks, being brainwashed to begin pushing at 5-6cm ( how is this ANY different than the hospital staff saying "Okay! You're 10, you can begin pushing now...". Gee thanks for telling me what MY body is ready to do ) and being led to believe that this will lead to much faster births.
An acquaintance had a birth under this technique, and she ended up pushing for hours and hours on end, with the midwife's hand inside of her vagina the whole time, MANUALLY pushing the cervix back. I want to cry when I hear this.
Obstetricians aren't the only ones who are harming women, or putting them in very dangerous situations. Do these midwives believe that they're doing anything intentionally harming? No. But neither do most Obstetricians who believe in Cesarean Sections as whole for safety.
Just because a home birth midwife is a home birth midwife, it doesn't make her safe. Women...know who you're hiring, and thoroughly research what they're selling. There shouldn't be any "technique" for giving birth...women have been giving birth for centuries, without needing a label, a technique, or another woman's hand inside of their vagina, to do her body's job for her.
While watching the video, I was horrified. Women are excitedly following this technique, under the false premise that it's what they SHOULD be doing, that it will be faster, and that there is no risk.
In the video, and on the website ( www.powerbirth.com ), Lydi states:
When a woman reaches 5-6 cm's dilation, she
feels like pushing. This is because the
fetus/baby has completed flexion of his/her
head. The occiput is now the presenting part,
the smallest diameter of the skull that has to
pass through the bony pelvis.
EVERY woman feels like bearing down at this
stage of labor, but is generally told that if she
pushes, she will hurt herself or her baby.
WRONG!!! If she pushes, she will be helping her
baby to make the 1/8 rotation from the Ischial
Spine to the Os Pubis, which will enable her
baby/fetus to pivot and enter the birth canal.
If she doesn't help her unborn to make this
rotation, she will be given an epidural to help
her with the pain she will endure because she
refused to listen to her body, and her baby's
suggestion of- "Give me a little help here, MOM,"
and, ultimately - the CESAREAN!
Lydi not only says in a blanket statement that EVERY woman feels the urge to push at 5cm, but that if she DOESN'T do this, then the mom will likely end up in a cesarean section.
This information goes against everything that we ( midwives ) know about the physiology of birth. Those of us who also don't ever tell a woman when it's okay to push ( because we're not in their body ), know for a fact that a woman feeling the complete urge to push at 5cm just doesn't happen. It's very, very rare.
What also bothers me, is that this "technique" is marketed as an EMPOWERING technique for birth, and yet...there is a midwife's hand in mom's vagina quite often. HOW is that empowering? During the video, one can literally see the midwive's hand and arm TREMBLING from the force of manual dilation. Yes, you read that right...manual dilation. Not holding back a lip because mom wanted that done instead of waiting it out...manually causing the cervix to be more open than it is naturally. And quite unnecessarily.
The most dangerous thing about this, is that women are being led to believe that this is SAFE. They are not told of the risks of cervical swelling, cervical tearing, hemorrhage, exhaustion from pushing before the body is 100% ready ( oh wait, according to the powerbirth technique, that's at 5-6cm. ), uterine and/or cervical prolapse.
Nevermind their power being taken away from them by having multiple vaginal checks, being brainwashed to begin pushing at 5-6cm ( how is this ANY different than the hospital staff saying "Okay! You're 10, you can begin pushing now...". Gee thanks for telling me what MY body is ready to do ) and being led to believe that this will lead to much faster births.
An acquaintance had a birth under this technique, and she ended up pushing for hours and hours on end, with the midwife's hand inside of her vagina the whole time, MANUALLY pushing the cervix back. I want to cry when I hear this.
Obstetricians aren't the only ones who are harming women, or putting them in very dangerous situations. Do these midwives believe that they're doing anything intentionally harming? No. But neither do most Obstetricians who believe in Cesarean Sections as whole for safety.
Just because a home birth midwife is a home birth midwife, it doesn't make her safe. Women...know who you're hiring, and thoroughly research what they're selling. There shouldn't be any "technique" for giving birth...women have been giving birth for centuries, without needing a label, a technique, or another woman's hand inside of their vagina, to do her body's job for her.
Lactation Consultants
I am newly aware of how lousy many Hospital Lactation Consultants are. A friend of mine had a cesarean 2 weeks ago, and baby ended up in the NICU. He also has a breathing condition, where if he gets too excited, he can't breathe well. He is having some trouble with staying calm with breastfeeding, until the milk is letdown.
Apparently the two hospital LCs she dealt with, didn't even give her the most basic of suggestions, such as giving him say half of a bottle of breastmilk, and *then* latching him on when the edge of hunger is gone. Or, stimulating letdown with the first show of interest in nursing from baby, and then latching him on with milk already flowing. Or, using a SNS until he gets the hang of it.
I'm disappointed, and left wondering how many women are receiving less than adequate support, information, or encouragement in breastfeeding...particularly if there are any even slight issues.
How can this be remedied?
Since most women still choose to birth in the hospital, and I'm now seeing that many hospital LCs are not adequately trained, or very knowledgeable ( or perhaps just complacent? )...what are women to do if they themselves don't know where to start? Is this why a good number of women who start out with intentions of breastfeeding, quit? Not enough adequate support?
I'm going to start having La Leche League information on hand, and I may just add "Breastfeeding Help" to my business card.
Why are women left without good support so often anymore? Whether it be regarding natural childbirth, breastfeeding, attachment parenting, non-vaxxing, or non-circing. Why aren't people helping more?
Apparently the two hospital LCs she dealt with, didn't even give her the most basic of suggestions, such as giving him say half of a bottle of breastmilk, and *then* latching him on when the edge of hunger is gone. Or, stimulating letdown with the first show of interest in nursing from baby, and then latching him on with milk already flowing. Or, using a SNS until he gets the hang of it.
I'm disappointed, and left wondering how many women are receiving less than adequate support, information, or encouragement in breastfeeding...particularly if there are any even slight issues.
How can this be remedied?
Since most women still choose to birth in the hospital, and I'm now seeing that many hospital LCs are not adequately trained, or very knowledgeable ( or perhaps just complacent? )...what are women to do if they themselves don't know where to start? Is this why a good number of women who start out with intentions of breastfeeding, quit? Not enough adequate support?
I'm going to start having La Leche League information on hand, and I may just add "Breastfeeding Help" to my business card.
Why are women left without good support so often anymore? Whether it be regarding natural childbirth, breastfeeding, attachment parenting, non-vaxxing, or non-circing. Why aren't people helping more?
Wednesday, February 18, 2009
Pregnant In America
I had a great time this past weekend. I was finally able to get out to Southern Utah, to visit a very dear friend of mine. I was supposed to go this past October, and then had to cancel. It was a wonderful weekend, and a total adventure. ;)
While there, we sat and watched the new documentary, Pregnant In America ( I'll put the trailer at the end of this post )
Over all, it was a great film. It was a bit more in depth than The Business of Being Born, covering more topics, and even traveling to other countries to see how babies are born there. It covered the topic of Cyotec, and the unwillingness of the FDA to offer more help to stop the use of Cytotec in labor, which has caused multiple maternal and fetal deaths. It covered a small bit on breech births, and how Obstetricians are not being trained in this art anymore. It covered VBAC bans, insurance problems, and Obstetricians pushing for more cesarean sections.
Steve ( the producer and husband of the wife being followed in pregnancy ) randomly interviewed both men and women on the streets of California and New York, to see where there beliefs were in childbirth. Many of the men said, hands down, that the hospital was certainly the safest place to be, but couldn't pinpoint why. Women said that they couldn't have done labor without an epidural, even though a few admitted that the epidural was likely to have caused some of the problems that either they faced, or friends had faced. It was all very interesting, and yet I found myself saddened, and even outraged at the utter lack of education by women in childbirth. The utter lack of power that they had, by statements like "I don't have any choice". I hear this all the time, but this struck more with me in this film for some reason.
It stated, and kept reiterating, that pregnancy, labor, and childbirth are natural processes. What was said a few times was "Mother Nature knows best". I was SO happy to hear this being said over and over...hoping that any viewers would have this sink in.
To my utter frustration, anger, sadness, and confusion....the producers wife had her membranes stripped by her midwife at a mere 3 days past her due date.
Wait, what? Didn't we just spend over an hour speaking about leaving labor and birth alone? Allowing it to continue naturally? Speaking of "Guess Date" instead of "DUE Date", and saying that pregnancy was normal two weeks before AND two weeks AFTER said guess date?
They researched everything else mentioned in the film, and yet failed to speak of the risks of stripping membranes. Or did they not research that? Granted, the risks are small. But it's highly confusing seeing this, when they spoke over and over again about NATURAL labor being best, sans intervention. Did they NOT understand that stripping membranes is not only an intervention, but a form of induction?
Risks, albeit small, of membrane stripping are:
Risk of infection
Risk of weakening Amniotic Sac, leading to PROM
Risk of PROM
Risk of beginning false labor that will exhaust mom, only to stop when she's now emotionally ready to have baby
Risk of causing a longer labor, because the body wasn't in labor on it's own before this induction technique
And sadly, her labor was pretty long, and she sounded to be in more pain than what is typical for most home births that I see.
What angered me about this, was wondering if they understood / understand what message this may send to women. "Pregnancy and labor is natural, and should be left alone....unless you get past your due date.", despite the admittance that pregnancy is normal two weeks before AND two weeks AFTER a given "Guess Date". She was 3 *days* past, and allowed intervention.
Is this "Homebirth Lite", or "Mainstream Homebirth"?
It was said at the end of the film that she is pregnant again, and that they will be using the same midwife. I only hope that this time they will follow their own words of wisdom, and let this baby come when he/she is absolutely ready, and not add any interventions or "natural" ( don't get me started on this! ) induction techniques.
While there, we sat and watched the new documentary, Pregnant In America ( I'll put the trailer at the end of this post )
Over all, it was a great film. It was a bit more in depth than The Business of Being Born, covering more topics, and even traveling to other countries to see how babies are born there. It covered the topic of Cyotec, and the unwillingness of the FDA to offer more help to stop the use of Cytotec in labor, which has caused multiple maternal and fetal deaths. It covered a small bit on breech births, and how Obstetricians are not being trained in this art anymore. It covered VBAC bans, insurance problems, and Obstetricians pushing for more cesarean sections.
Steve ( the producer and husband of the wife being followed in pregnancy ) randomly interviewed both men and women on the streets of California and New York, to see where there beliefs were in childbirth. Many of the men said, hands down, that the hospital was certainly the safest place to be, but couldn't pinpoint why. Women said that they couldn't have done labor without an epidural, even though a few admitted that the epidural was likely to have caused some of the problems that either they faced, or friends had faced. It was all very interesting, and yet I found myself saddened, and even outraged at the utter lack of education by women in childbirth. The utter lack of power that they had, by statements like "I don't have any choice". I hear this all the time, but this struck more with me in this film for some reason.
It stated, and kept reiterating, that pregnancy, labor, and childbirth are natural processes. What was said a few times was "Mother Nature knows best". I was SO happy to hear this being said over and over...hoping that any viewers would have this sink in.
To my utter frustration, anger, sadness, and confusion....the producers wife had her membranes stripped by her midwife at a mere 3 days past her due date.
Wait, what? Didn't we just spend over an hour speaking about leaving labor and birth alone? Allowing it to continue naturally? Speaking of "Guess Date" instead of "DUE Date", and saying that pregnancy was normal two weeks before AND two weeks AFTER said guess date?
They researched everything else mentioned in the film, and yet failed to speak of the risks of stripping membranes. Or did they not research that? Granted, the risks are small. But it's highly confusing seeing this, when they spoke over and over again about NATURAL labor being best, sans intervention. Did they NOT understand that stripping membranes is not only an intervention, but a form of induction?
Risks, albeit small, of membrane stripping are:
Risk of infection
Risk of weakening Amniotic Sac, leading to PROM
Risk of PROM
Risk of beginning false labor that will exhaust mom, only to stop when she's now emotionally ready to have baby
Risk of causing a longer labor, because the body wasn't in labor on it's own before this induction technique
And sadly, her labor was pretty long, and she sounded to be in more pain than what is typical for most home births that I see.
What angered me about this, was wondering if they understood / understand what message this may send to women. "Pregnancy and labor is natural, and should be left alone....unless you get past your due date.", despite the admittance that pregnancy is normal two weeks before AND two weeks AFTER a given "Guess Date". She was 3 *days* past, and allowed intervention.
Is this "Homebirth Lite", or "Mainstream Homebirth"?
It was said at the end of the film that she is pregnant again, and that they will be using the same midwife. I only hope that this time they will follow their own words of wisdom, and let this baby come when he/she is absolutely ready, and not add any interventions or "natural" ( don't get me started on this! ) induction techniques.
Wednesday, February 4, 2009
How dilated are you?
I will start this post by saying that I have been working very hard to tone down my, well, tone. Especially on here. I attended a women's retreat with a very dear friend of mine, and God did awesome things in me...and in turn, my family. It's been a long time, and He still gathered me back into His arms. God is such a gracious God.
Anyway...some of what I'm saying may sound a bit graphic...but think of it in terms of anatomy, purely.
It occured to me today, after reading a post from a woman in one of my birthy groups, just how intimate the question, "How dilated and effaced are you?" really is.
Think about it. The person is asking you if another person has had you spread open your legs, and insert a hand into your vagina, and felt your cervix. They're asking how open your cervcal Os is, and if it's thinned any.
And we don't see any problem with this initially, because we're groomed to believe that it's just what happens during pregnancy and labor...not what it is. A violation. I truly wonder what the reaction would be if we countered that question with, "How hard and long was your husband's penis at the time that you two conceived your baby?". Is that really any more personal than the question asked above?
The penis is not checked at the time of conception to make sure that it is hard enough for insertion, or that it is long enough and the sperm will make it to the cervical Os, correct? Why do we need to know, to feel with an outsider's hand, what the cervix is doing to make sure that a birth can happen?
Yes, I know, I know. If any midwives are reading this, I'm sure I know what the reaction is. YES...sometimes a cervical exam can be a VERY useful tool IN LABOR. There is zero excuse, IMO, for checking a woman's cervix before labor. And in labor? It really would have to be an exceptional reason. Checking because the labor has been going on for a few hours? Not a good reason. Checking because you want to see if mom's made any progress from the last time you checked? Not a good reason. Yes, I personally have had moms want to know what their cervix is doing, but those have only been the moms who have brought massive fears into the birth ( both being VBAC women ). I didn't want to check. Checking the cervix doesn't change what the body is doing. It doesn't change when the baby will be born.
And before anyone gets their panties in a bunch...this is not a blanket statement that ANY and ALL vaginal exams during labor are evil...just that they're overdone. I don't care if you're an OB, a hospital nurse, a hospital midwife, or a home birth midwife. I have seen home birth midwives be even more invasive than some OBs. We need to figure out WHY this is being done to women...and why women are accepting it without question.
Anyway...some of what I'm saying may sound a bit graphic...but think of it in terms of anatomy, purely.
It occured to me today, after reading a post from a woman in one of my birthy groups, just how intimate the question, "How dilated and effaced are you?" really is.
Think about it. The person is asking you if another person has had you spread open your legs, and insert a hand into your vagina, and felt your cervix. They're asking how open your cervcal Os is, and if it's thinned any.
And we don't see any problem with this initially, because we're groomed to believe that it's just what happens during pregnancy and labor...not what it is. A violation. I truly wonder what the reaction would be if we countered that question with, "How hard and long was your husband's penis at the time that you two conceived your baby?". Is that really any more personal than the question asked above?
The penis is not checked at the time of conception to make sure that it is hard enough for insertion, or that it is long enough and the sperm will make it to the cervical Os, correct? Why do we need to know, to feel with an outsider's hand, what the cervix is doing to make sure that a birth can happen?
Yes, I know, I know. If any midwives are reading this, I'm sure I know what the reaction is. YES...sometimes a cervical exam can be a VERY useful tool IN LABOR. There is zero excuse, IMO, for checking a woman's cervix before labor. And in labor? It really would have to be an exceptional reason. Checking because the labor has been going on for a few hours? Not a good reason. Checking because you want to see if mom's made any progress from the last time you checked? Not a good reason. Yes, I personally have had moms want to know what their cervix is doing, but those have only been the moms who have brought massive fears into the birth ( both being VBAC women ). I didn't want to check. Checking the cervix doesn't change what the body is doing. It doesn't change when the baby will be born.
And before anyone gets their panties in a bunch...this is not a blanket statement that ANY and ALL vaginal exams during labor are evil...just that they're overdone. I don't care if you're an OB, a hospital nurse, a hospital midwife, or a home birth midwife. I have seen home birth midwives be even more invasive than some OBs. We need to figure out WHY this is being done to women...and why women are accepting it without question.
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