If there is one thing that I would choose to educate women on nation-wide, just one topic that I could choose to cover for all women to hear, it would be the due date fallacies. So many unnecessary inductions are because of due date fears, misconceptions, and downright false information. So many unnecessary cesareans are due to "failed" ( see Failed Induction Means That Your Body Works! ) inductions. Not because there was something wrong with the woman's body, as MOST are told, but because her body and her baby simply were NOT ready.
There are so many false beliefs about due dates. One is that it is the magical number around which the baby is supposed to be born. I recently did an informal poll on CafeMom and so far ( I will post final results when they are in ), the VAST MAJORITY of women who have responded, have said that it's not normal to go past 40/41 weeks, and that they would absolutely induce so that they didn't risk baby dying or getting too big! Our society has done a great job of ignoring actual statistics and just following what their doctor tells them, or what their friends tell them. Why research when you can just ask? A commercial for Johnson and Johnson baby wash today started out with: "Your Doctor's guidance, your Mother's advice, your own intuition...." What does that tell us? Where do our securities lie when it comes to our children? According to most people in our society, doctors first.
And yet, the medical community and having a medical mindset in birth is what has gotten us into our 31.8% cesarean rate. Trusting your doctor first, instead of doing individualized research ( did your mom have a history of postdates? Did your grandma? Aunt? What might be normal for YOU and YOUR baby? ) is what is leading women to be cut open by the millions. And the worst part is - instead of it being viewed as a horror that needs to stop - it's seen as normalcy.
NORMAL gestation is anywhere from 38-42 weeks, and if you want to get technical, to 42 *completed* weeks. What now seems like long ago, women were given "due months". I like this idea! Let's take the "magical" number out of things, and let women know that they have a 4 week period of time in which their baby could be born. Maybe then we'd have less inductions. Maybe then we'd have less cesareans, and less women being told that there was something wrong with her body ( PELVIS too small KILLS me, "FAILURE" to progress, BABY too big...notice a theme? ). Depending on which statistics you look at, one study showed the stillbirth rate to be higher at 38 weeks than at 42 weeks. So then, should we induce at 37 weeks to avoid that higher curve at 38 weeks? Of course not! That would be just silly, right? ...
The MAIN thing with pregnant women is their due date. They get bombarded with highly personal questions starting as soon as 36 weeks. "When are you going to have your baby?" ( Did you GIVE me a crystal ball? ) "Are you dilated?" ( Are YOU dilated? What about YOUR bowel movements - have any soft ones lately? ) "When will your doctor induce you?" ( When did yours give you a lobotomy? ) "You look HUGE!" ( So do you, but it's rude for ME to say so! ) "Are you having twins?" ( Are YOU going to recover from my fiery wrath from being asked that for the one millionth time? )
Women are hardly ever reassured. Rarely is a woman told "Baby will come in perfect timing! Don't worry.", or "Your baby is just the right size! YOU made him/her after all." Women are rarely told that they DON'T need to be induced, and rarely are they NOT asked if their doctor has shoved a hand up their vagina to check the status of their cervix. People don't understand that they are continuing the common fears surrounding due dates and labor. They are doing NOTHING to help, but only cause worry, doubt, and possibly fear. "WILL I ever go into labor on my own? Maybe there IS something wrong with me?"
I recently watched Pregnant In America. I LOVED all of the wonderful information that they were providing. Studies, statistics ( the list of risks for inductions and epidurals would make your toes curl! ), alternatives. But then, just as I was ready to advertise this movie to every woman I know....the producer's wife ( who had been filmed as she planned a home birth for their first child ) decides to have her midwife strip her membranes at a mere 3 days past her due date. WHAT?!?! Didn't I JUST watch nearly 2 hours of "A woman's body does better in labor when left unhindered." "A woman's body knows just what to do on its own." "Intervention is a slippery slope." - GAH!
There seems to be this idea, even within some midwifery/home birth circles that birth is normal...unless you get to/past 40 weeks. But yet, according to medical literature ( you know, the stuff put out and IGNORED by OBs? ) we know that normal gestation is all the way until 42 completed weeks. WHY are women doing this to themselves, and why are care providers doing this to women?
If I could erase one incredibly WIDESPREAD belief - it would be that a due date is a magical number. A date to count down to, and worry when it passes. A date that will *surely* bring us baby, because isn't that what it's supposed to do?
Will we ever get back to the belief and knowledge that our bodies know just what to do without inducing, augmenting labor?
Tuesday, April 28, 2009
Wednesday, April 22, 2009
From Home Birth to Interventions?
My heart drops into a big ball into my stomach when I hear of women allowing unnecessary intervention in pregnancy - but especially more so when I hear that they allow it from a home birth midwife. Women seem to want to trust birth, and want a safe and healthy birth for their baby, but then allow some of the most arbitrary and unnecessary intervention, not realizing that it can completely shape and transform the rest of their pregnancy.
What are the top two interventions I see with homebirthers?
Routine Vaginal Exams
Why is this done, especially by home birth midwives, starting as early as 36 weeks? Does it make the baby come sooner? Does the body not know what to do unless a midwife has a hand inside of her client's vagina and cervix? Do these midwives explain the risk of infection, accidental ( or purposeful, sadly ) membrane strip or artificial rupture of membranes, disappointment when mom "hasn't made any progress", false hope of a labor soon to come? If the midwife is not explaining these risks, then her clients are NOT giving informed consent. It blows me away when women allow this. It saddens me. It makes me wonder just what their midwife is telling them, or why a mom requests this.
"Natural" Induction
Ladies, there is NO such thing as a natural induction. Either you are trying to force labor to begin before it is happening naturally, or you are not. There's really no in between. Having a healthy sex life in the end of pregnancy is wonderful! But if the goal is to get it done as many times as possible in hopes of causing the cervix to ripen...you may be sorely disappointed. A ripening cervix does NOT guarantee a close labor day. It simply means that it is ripening. There is a lot more to the hormonal dance of labor preparation than a ripening cervix. Doing spicy foods may do nothing more than irritate your uterus, cause you to have diarrhea and heartburn. Pineapple needs to be *fresh* pineapple. You have no idea how many women try the out of the can stuff. LOL And even then, it does *nothing* unless your body is ready anyway....so why not wait until labor starts naturally? Nipple stimulation does indeed release oxytocin in the body, but so does some good love from your spouse. A nice massage, a cuddle and nice long kiss. This releases oxytocin as well. Why aren't more couples cuddling, instead of playing with nipples? Evening Primrose Oil *can* help to soften the cervix, but nothing more.
The problem with trying to do things to induce labor, is that it often will not work. When it doesn't work, you've wasted precious last days/weeks of your pregnancy that you could have been simply enjoying with your partner, instead of stressing out over trying to get labor to begin. Or even if not stressing, *thinking* about getting labor going. Your body knows what to do, and knows exactly the right time to do it in. I won't even go into castor oil induction, as I believe this is highly irresponsible and a waste of time unless it's a true last ditch effort. Inducing labor, no matter what label you want to put on it, is putting yourself before the safety and health of your baby...unless of course it is a TRUE medically warranted induction ( example - pre eclampsia, PIH, etc ).
Women, if you've chosen a home birth, you are in a low-risk pregnancy. If you are in a low-risk, normal pregnancy...why are you allowing intervention? It drove me crazy when I watched Pregnant In America, and saw them advocate for normalcy in pregnancy, believing in birth and trusting the body...and then the producer's wife having her midwife strip her membranes at a mere few days after 40 weeks. I was BAFFLED! How can you claim to be a NATURAL pregnancy and labor advocate, if you allow unnecessary induction techniques? There was no problem. She was simply a few days past 40 weeks. Not even to the high end of the normal gestation period, but smack dab in the middle! It was her first baby, and statistically first time moms will go about 8 days past their EDD, IF ALLOWED TO. :sigh:
In our society, we rush through so many things. We want to rush to get to the end of pregnancy, we want to rush to get into labor, we want to rush to birth the baby. We want to rush to see the baby sit up, eat solid food, crawl, talk, walk...
And when you get to the point of understanding how quickly it all goes by, it's too late to take it back.
Choose wisely, for some decisions are irreversible.
What are the top two interventions I see with homebirthers?
Routine Vaginal Exams
Why is this done, especially by home birth midwives, starting as early as 36 weeks? Does it make the baby come sooner? Does the body not know what to do unless a midwife has a hand inside of her client's vagina and cervix? Do these midwives explain the risk of infection, accidental ( or purposeful, sadly ) membrane strip or artificial rupture of membranes, disappointment when mom "hasn't made any progress", false hope of a labor soon to come? If the midwife is not explaining these risks, then her clients are NOT giving informed consent. It blows me away when women allow this. It saddens me. It makes me wonder just what their midwife is telling them, or why a mom requests this.
"Natural" Induction
Ladies, there is NO such thing as a natural induction. Either you are trying to force labor to begin before it is happening naturally, or you are not. There's really no in between. Having a healthy sex life in the end of pregnancy is wonderful! But if the goal is to get it done as many times as possible in hopes of causing the cervix to ripen...you may be sorely disappointed. A ripening cervix does NOT guarantee a close labor day. It simply means that it is ripening. There is a lot more to the hormonal dance of labor preparation than a ripening cervix. Doing spicy foods may do nothing more than irritate your uterus, cause you to have diarrhea and heartburn. Pineapple needs to be *fresh* pineapple. You have no idea how many women try the out of the can stuff. LOL And even then, it does *nothing* unless your body is ready anyway....so why not wait until labor starts naturally? Nipple stimulation does indeed release oxytocin in the body, but so does some good love from your spouse. A nice massage, a cuddle and nice long kiss. This releases oxytocin as well. Why aren't more couples cuddling, instead of playing with nipples? Evening Primrose Oil *can* help to soften the cervix, but nothing more.
The problem with trying to do things to induce labor, is that it often will not work. When it doesn't work, you've wasted precious last days/weeks of your pregnancy that you could have been simply enjoying with your partner, instead of stressing out over trying to get labor to begin. Or even if not stressing, *thinking* about getting labor going. Your body knows what to do, and knows exactly the right time to do it in. I won't even go into castor oil induction, as I believe this is highly irresponsible and a waste of time unless it's a true last ditch effort. Inducing labor, no matter what label you want to put on it, is putting yourself before the safety and health of your baby...unless of course it is a TRUE medically warranted induction ( example - pre eclampsia, PIH, etc ).
Women, if you've chosen a home birth, you are in a low-risk pregnancy. If you are in a low-risk, normal pregnancy...why are you allowing intervention? It drove me crazy when I watched Pregnant In America, and saw them advocate for normalcy in pregnancy, believing in birth and trusting the body...and then the producer's wife having her midwife strip her membranes at a mere few days after 40 weeks. I was BAFFLED! How can you claim to be a NATURAL pregnancy and labor advocate, if you allow unnecessary induction techniques? There was no problem. She was simply a few days past 40 weeks. Not even to the high end of the normal gestation period, but smack dab in the middle! It was her first baby, and statistically first time moms will go about 8 days past their EDD, IF ALLOWED TO. :sigh:
In our society, we rush through so many things. We want to rush to get to the end of pregnancy, we want to rush to get into labor, we want to rush to birth the baby. We want to rush to see the baby sit up, eat solid food, crawl, talk, walk...
And when you get to the point of understanding how quickly it all goes by, it's too late to take it back.
Choose wisely, for some decisions are irreversible.
Cesarean Awareness
There are people who might look at this title, and think "What is there to be aware of?". So often now people view cesareans as just another way to have a baby. Rarely are the true risks of a cesarean told to expecting couples, and those are usually the immediate risks that are mentioned ( most often in passing ), nevermind the long-term risks that a cesarean can create.
I am involved in a new organization called BirthAction. The site is still in progress, but we very much hope for it to be a hub for pregnant women to come and receive well-rounded information on everything pregnancy. Kind of like What To Expect When You're Expecting, just with accurate information. ;) We'd like it to be a place where women can come and find information about routine pregnancy screenings ( like ultrasound, afp testing, gestational diabetes testing, Rh sensitization, gbs, etc ) and make informed decisions about their prenatal care. It also offers tips on how to avoid a primary cesarean, tips on how to optimize the chance of a successful VBAC, information on home birthing, unassisted birthing, water birth...and everything in between.
In our goal to create awareness about the risks of cesarean sections, I designed the poster that I am putting on this page. Women need to think long and hard before agreeing to a cesarean for reasons that are not life threatening, and to elective ( or coerced ) repeat cesareans.
I am five years out from my one and only cesarean, and I have what will probably be life-long side effects. For the first time in my menstrual history, I have irregular periods, endometriosis, and PCOS. This did not occur until *after* my cesarean. I have had hormonal problems, weight gain, and much pain as a result. It breaks my heart when I hear of women resigning to a cesarean for a "large" baby, for a breech baby, or for twins. It breaks my heart and makes me want to throttle doctors when I hear of elective inductions, inductions for "large baby", inductions because mom hits 40/41/42 weeks. It makes my stomach drop when I hear women count down to their due dates, because they obviously are unaware that a due date is simply an estimation, NOT a guaranteed date of arrival. It makes me cringe when women call themselves "overdue" when they are a few days past 40 weeks. They do not know that they are not a bit "overdue" until after 42 weeks. Technically, according to medical literature, not even until after 43 weeks. It's 42 *completed* weeks.
So many cesareans can be avoided. If women would come back to the knowledge that their bodies are strong. That they are capable. That pregnancy is not a condition or disease or pathology. That they do not need drugs to begin, or to get through their labor. That their baby is healthier when they allow labor to begin, and to occur naturally. I wish that women would stop believing that there is something wrong with their body, or that they are not strong enough to endure labor without the blasted epidural.
Women need to wake up and realize what is being done to their babies.
I am involved in a new organization called BirthAction. The site is still in progress, but we very much hope for it to be a hub for pregnant women to come and receive well-rounded information on everything pregnancy. Kind of like What To Expect When You're Expecting, just with accurate information. ;) We'd like it to be a place where women can come and find information about routine pregnancy screenings ( like ultrasound, afp testing, gestational diabetes testing, Rh sensitization, gbs, etc ) and make informed decisions about their prenatal care. It also offers tips on how to avoid a primary cesarean, tips on how to optimize the chance of a successful VBAC, information on home birthing, unassisted birthing, water birth...and everything in between.
In our goal to create awareness about the risks of cesarean sections, I designed the poster that I am putting on this page. Women need to think long and hard before agreeing to a cesarean for reasons that are not life threatening, and to elective ( or coerced ) repeat cesareans.
I am five years out from my one and only cesarean, and I have what will probably be life-long side effects. For the first time in my menstrual history, I have irregular periods, endometriosis, and PCOS. This did not occur until *after* my cesarean. I have had hormonal problems, weight gain, and much pain as a result. It breaks my heart when I hear of women resigning to a cesarean for a "large" baby, for a breech baby, or for twins. It breaks my heart and makes me want to throttle doctors when I hear of elective inductions, inductions for "large baby", inductions because mom hits 40/41/42 weeks. It makes my stomach drop when I hear women count down to their due dates, because they obviously are unaware that a due date is simply an estimation, NOT a guaranteed date of arrival. It makes me cringe when women call themselves "overdue" when they are a few days past 40 weeks. They do not know that they are not a bit "overdue" until after 42 weeks. Technically, according to medical literature, not even until after 43 weeks. It's 42 *completed* weeks.
So many cesareans can be avoided. If women would come back to the knowledge that their bodies are strong. That they are capable. That pregnancy is not a condition or disease or pathology. That they do not need drugs to begin, or to get through their labor. That their baby is healthier when they allow labor to begin, and to occur naturally. I wish that women would stop believing that there is something wrong with their body, or that they are not strong enough to endure labor without the blasted epidural.
Women need to wake up and realize what is being done to their babies.
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