Wednesday, November 21, 2007

Bodily preparations

With Willem's birth, I experienced many hours of back labor. It could have been from the stressful, contentious environment at the hospital (because it wasn't until that started that the back labor started), or and more likely, is that he was positioned strangely where his body was pressing against my spine in a way causing discomfort and pressure.

After he was born, I started taking my family to the chiropractor where Dr. Vevoda informed me that sciolisis can lead to back labor. I was first diagnosed with scoliosis when I was 13 years old. The curvature was never to a great enough degree where something medical could be done (aka braces or spinal fusion surgery). Dr. Vevoda told me of another method of straightening the spine which is sustained traction over time. I decided to go ahead with the treatment with the hopes that correcting the curve as much as possible would make back labor less likely for my next pregnancy.

I started the 36 appointment or 4 month treatment looking like this:

The measurement of the curve at the start of treatment was 27 mm away from "straight." After treatments, the apex of the curve was brought closer to where it should be, by 9 mm. Here is the after picture:

Look closely at the red lines to see the difference.

I had really good result with that round of treatment and I have the option of going back for another round to get more results. We'll see which comes first...a straighter spine or another baby.

Tuesday, November 20, 2007

What they don't tell you about CSections

In a recent Mothering Magazine article, the writer shares the following risks of C Section, which often are undisclosed to women when being told they need one.

1. A woman is five to seven times more likely to die from a cesarean delivery than from a vaginal delivery.

2. A woman having a repeat C-section is twice as likely to die during delivery.

3. Twice as many women require rehospitalization after a C-section than after a vaginal birth.

4. Having a C-section means higher rates of infertility, ectopic pregnancy, and potentially severe placental problems in future pregnancies.

5. Babies born after an elective cesarean delivery (i.e., when labor has not yet begun) are four times more likely to develop persistent pulmonary hypertension, a potentially life-threatening condition.

6. Between one and two babies of every hundred delivered by C-section will be accidentally cut during the surgery.

7. The US is tied for second-to-last place with Hungary, Malta, Poland, and Slovakia for neonatal mortality in the industrialized world.

8. Babies born via C-section are at high risk for not receiving the benefits of breastfeeding.

9. The risk of death to a newborn delivered by C-section to a low-risk woman is 1.77 deaths to 1,000 live births. The risk of death to a newborn delivered vaginally to a low-risk woman is only 0.62 per 1,000 live births.

See full article here.

Another finding that greatly disturbed me since it affected me personally is that women are more likely to experience ectopic pregnancies or spontaneous abortions in subsequent pregnancies after a C Section. Women who previously had a C-section are more likely to have a stillborn child in subsequent pregnancies.

That finidng cuts me to the quick because I was born a C-Section baby (not medically necessary, breech presentation) and my mother's next pregnancy, my little brother, ended in a stillbirth. I don't feel guilt, persay, for being a C-section baby. Its not my fault that the US maternity care system in 1984 (and now) doesn't know how to birth breech babies, and it wasn't my fault that my mother wasn't more informed. But I feel hurt and in some way that my birth was tarnished and my only sibling lost because of something that involved me. Learning that finding brought the grief of knowing that I had a little brother and lost him back into my mind and more painful now that I know what having a child is all about.

I grieve for my mother all over again that she had to deal with the recovery from major abdominal surgery while adjusting to life with a newborn and then two years later face depression and grief when her second child died before being born.

I feel empathy for those women who regret the C-sections they've had or who had one and didn't want it, because those women shoulder the guilt, anger and sometimes trauma of that experience which is then compounded when their next birth and pregnancy does not yield a healthy baby.

They don't tell you that these things can happen (and more frequently do) when offering the consent form and schedulign for a C-section. Imagine what the C-section rate would be in this country if they did.

Monday, November 19, 2007

The Midwife Search

After my experience with CNMs (Certified Nurse Midwives) in a hospital setting, I feel very strongly that I cannot plan another birth in a hospital. That leaves me with two other settings: a dedicated birth center or at home. The attendants at births in those settings are midwives, whether LMs or CNMs. They are also much more likely to support the Midwifery Model of Care. That's the standard of care I thought I would be getting from the UW Midwives program, but I was mistaken and suffered because of my own ignorance.

This time around, I am interviewing potential midwives BEFORE I get pregnant so I don't feel any pressure to pick one because I have a time bomb in my uterus with a deadline. I started doing internet searches in my area. Living in Seattle(home of the pioneering Seattle Midwivery School), there are lots of midwives around.

Most out of hospital midwives will provide a free consultation appointment where a woman can interview with questions and get a feeling for a particular midwife's philosophy and style. I learned its important to be able to trust a midwife at the vulnerable time during labor and birth where a woman needs loving support and is easily open to suggestion.

Here is a sample of the questions I asked:

How do you employ the Midwifery Model of Care in your practice?

How do you empower women?

What positions do you suggest for birthing?

How do you support a laboring woman?

If a transfer is needed, what do you do? Where to?

What complications necessitate a transport?

Describe the prenatal care.

I interviewed four midwives initially and got enough information where I felt I could compare and choose of those four which I felt most comfortable. Tentatively, I have chosen one who also provides Naturopathic care to families and children. However, the search does continue while I continue to think through my wants while weighing what I feel is safest for me and my next baby.

Monday, November 12, 2007

The Mama Milk

Willem has always loved what I call the mama milk. He's a snob about his milk like Peter and I are snobs about chocolate. Willem has typically refused formula so he's always gotten breastmilk except on one or two occasions, and even then he'll only take it if mixed with breastmilk. Recently, he's starting doing some really cute things to tell me how much he likes the mama milk.

The newest thing is "talking" to my nipple when I'm breastfeeding him. He will be nursing, stop, look at my nipple until he goes almost crosseyed and then babble. It usually sounds something like "Wab, wab, blab, blab, blab." Then he'll look up and smile at me. It melts my heart.

Another cute, breastfeeding related thing (hey, good food is a powerful motivator!) is that he has learned to recognize some words. Milk being one of them. He loves his mama milk. When he's hungry, he will usually start grunting at me and pulling on my clothes. Pretty much general excitement ensues. I then ask him if he wants milk and I show him the sign for milk. (Its opening your hand and then closing it in a fist repeatedly--imagine that, its like milking a cow!) When I asks him that, the excitement level usually increases until he's at the breast and content.

So basically this blog is my expression that I love breastfeeding my baby. I was so proud of myself that he was so healthy and strong just off my breastmilk before he started solid food. Just because he eats lots of different foods now doesn't mean that he doesn't still need the mama milk. Breastfeeding has taught me to be amazed at the woman's body. Between producing a perfect and powerful food for babies and incubating and then birthing babies, a woman's body is amazing and wonderful!

We have made it almost 10 months in our breastfeeding relationship and I know it'll keep on going for awhile to come. I have no plans of weaning him before 2 years old, if he weans himself, I'll be sad but okay with it because it will be his decision.

Wednesday, November 7, 2007

Attachment Parenting: A Weight Loss Method?

I have officially lost 55 pounds since being pregnant with Willem. The last time I weighed what I weigh now was when I was 12. I didn't know that I could weigh what I do. One time my grandpa told me that my grandma liked to diet and stay thin, but he often felt like she was too thin. He said that he liked her most when she weighed 146 pounds. I made it a goal to never get below that because I always thought that my grandma looked great and if grandpa said that was the weight she looked best at, I believed him. Well, now I'm below that. I could lose a few more pounds and still be healthy, but I'm not pushing it and I don't want to lose more than another 10. Of course, there are differences between me and my grandma. She was about an inch taller than me, so she would need more weight to porportionally match her frame.

And really what matters most is that I am healthy and not how much I weigh. And to be honest, I am at the healthiest point of my life so far. I am regularly exercising and eating well. If you ask family and friends, I eat ALOT, but I try to have it be a healthful diet of lots of veggies and whole grains.

To be honest, I can contribute my weight loss to my parenting style. I breastfeed Willem so my body is producing the calories he needs and its using my excess fat stores to do it. I also wear him when we take walks so I'm get weight resistance training while getting a cardio workout. Its like I'm wearing 20 pounds of ankle and wrists weights on my torso. I also make a goal to walk to the majority of places that I go and in Seattle its easy to do that with the scarcity of free parking. If I can walk somewhere, I'll do it. If its too far to walk, I can take a bus and that requires walking too as I get to bus stops and my destination. Another thing is bed sharing. Willem sleeps in our bed with us (we've got the crib set up as a sidecar) and he nurses throughout the night. I barely need to wake up and he's helping my body burn through even more calories. And its been working for me. Obviously. I'm now 25 pounds below my prepregnancy weight.

So really, who knew that attachment parenting could be a way to lose weight?

An Applicable Quote

"People are always blaming their circumstances for what they are. I don't believe in circumstances. The people who get on in this world are the people who get up and look for the circumstances they want, and, if they can't find them, make them."
~G.B. Shaw, Mrs. Warren's Profession, 1893

Women across the United States are doing this. They are not going to be victim to the circumstances of hospital and interventionist birth, but they will make the circumstances they want: where they can birth peacefully, safely and lovingly without a whole political machine crashing on around them.

Ina May Gaskin is an excellent example of a woman who is making those circumstances. She taught herself the art of midwifery because it had all but died out in the United States by the 1970's. And the women who travel across country to give birth attended by her are making their circumstances that they want not just for the sake of getting what they want but because its empirically shown that its better for women and babies.

Individuals are working to change the circumstances of their maternity care, myself included. Organizations are helping support these efforts. More and more women (and men) are becoming midwives, the optimal caregivers for the majority of pregnant women. The licensing and governing boards of certifying organizations are facilitating that process. Birthing centers are becoming more accessible to more women. National and international governing bodies are reinforcing these efforts.

I hope to be a part of the bands of organizations, individual professionals and the scores of mothers looking for something better. And I am trying to find my path in making those circumstances come to pass.

Willem's Birth Story

Thursday night, sex is what did it. Within a couple of hours the contractions started (around 1:30am). I tried to sleep but gave up at 5:30 when I woke Peter up and told him what was going on. We waited until my appt at 11:00 to give me more time to progress. At the appt, I was at 3 cm. That's when they told me I could go up to L&D and then a few minutes later found out they were full so they were sending me home. At that point, I just wanted to be in one place where I could get comfortable. I definitely had the urge to hole up so I could relax and just focus. I wasn't comfortable at home because it is such a small space that I felt trapped, my bed wasn't comfortable, the bath is too small, etc. I think if they had let me get comfortable at the hospital, things would have progressed a whole lot faster. But I got stressed out and I think that really slowed me down.

At 4:00pm Friday I went back to the hospital. My contractions were closer together and stronger but I was only at 3 1/2 cm. I was comfortable, relaxed and happy to finally settle in somewhere. I was looking forward to the bath and just focusing on the Hypnobirthing techniques. I got about 3 hours of that and then the evil midwife Cindy started harassing me about "moving things along." I was given a few options, none of which appealed to me. I might have considered having my water broken but I felt like I needed to progress more on my own. I was given an hour to "wait and see." After the hour was up, they came back and told me that my only options included drugs. That just pissed me off.

I was told that I could 1) get my water broken and started on a pitocin drip. 2) be given sleep medications and go home. 3) be put on a morphine drip and stay in the hospital. What did I want? To be left alone and stay in the hospital so I could focus on the Hypnobirthing techniques. When I made that clear, the chief resident came in and flat out told me that all my options had been taken away and that I needed to go home. No "come back when your water breaks" nothing. I was PISSED. To add insult to injury, the medical charts from that day said that I was told to leave but left before any direction or follow-up could be given. Hello!? They didn't offer it.

The next few hours at home were some of the worst of my life. All the reasons why I wasn't comfortable before were so much worse. The contractions were stronger and closer together and most of them were in my back at that point. I hadn't slept in 24 hours, I was stressed and scared and panicky after the conflict with the hospital staff. Laying down was miserable because I was having back contractions, my bed was too soft to be on my knees and that was making the back contractions worse, flat was bad, on my side was bad. The birthing ball was okay but my legs were so tired that I couldn't keep myself up. I called my friend who was acting as a doula (she had been there at the hospital with us) and she came back. Without her, I don't know what I would have done. I was scared and Peter was scared. She helped us figure out some things to do. I still can't believe the hospital sent me home then without any support. When I called to ask for some help, the only thing I was told was I could come in and they could augment my labor (i.e. breaking the water and pitocin) and received no sympathy. It was either I go in and let them take over or I stay at home. This was about 2 am. By then I had been in labor for 24 hours and I felt like I had been kicked out on the street with no one other than my friend to turn to. It was a hellish experience and I hope I'm not scarred for life. I was so stressed out by then I started vomiting. I seriously started considering giving birth at home but felt like the conditions I was in was second world at best. For goodness sakes, Peter and Shawnette were having to heat water on the stove to put it into my bath, the only place where I was semi-comfortable.

All through this time, I was able to use the Hynobirthing techniques which was basically breathe through each contraction and visualization labor progressing, my cervix opening and the baby moving down. Those mental cues weren't as powerful as I think they should have been because of all the stuff I described in the paragraph above. The breathing kept me sane and Shawnette and Peter helped me focus on that.

By 7 am Saturday, my contractions were much stronger and closer together. I was completely distrusting of the hospital but couldn't keep going like I had been so I basically resigned myself to letting them take over. I went into the hospital at 8 am and found out that I was 5 cm dilated and fully effaced. That was disappointing and I would have been very discouraged if it weren't for the midwife and nurse (the good Cindy) who were on the shift. They were excited to help me and wanted to make sure that I was able to get comfortable. Everything was 1, 000 times better with those two looking out for me. They let me progress for another few hours and then suggested that they could break my water so I could get to the next phase of labor. After contracting furiously for 35 hours, I was open to that, especially since there was no mention of pitocin.

They broke my water at 11:30 Saturday morning. Things really started picking up from there and by 2:00 pm I was fully dilated. I was exhausted but was much more relaxed than I had been in the previous day. I was still breathing through contractions pretty well.

I should probably mention that Willem was doing fine through all of this. His heartrate was strong and stable. I was surprised to find out that he was sleeping through some of my strongest contractions.

At 2:00, I felt like I wanted to start pushing. I expressed that to the nurse and midwife who insisted that I move from my comfortable spot in the tub to the bed. The nurse cajoled and insisted on having me lay down and be monitorred. I was bothered and annoyed and told her repeatedly to take the monitors off. They were making me uncomfortable and I couldn't move into a position that I felt I needed to be in.

In the Hypnobirthing method, pushing is not encouraged and a technique called "breathing the baby down" is used. But because of my exhaustion and the stress of fighting off the nurse and recalling the stress of the day before, I just couldn't figure out how to do it, so I did the only thing I knew I could do- push, in the position they wanted me to be in, on my back, with my legs being held by Peter and the nurse. After 45 minutes of pushing, he was out. I had always heard that after the head is out, that it takes another push or two to get the rest of the body out. Nope, not with this kid. He went flying out in that last push, his head and everything else flying at a surprisingly high velocity. Sad for Peter, he missed taking a picture of the baby's first breath because he was moving so fast. Pushing intimidated me and my intensity in that situation intimidated me. I didn't feel like myself and I still can't describe what it was like. The best I can come up with is primal. The scream that tore through my body was not one of pain, but of sheer effort and the fear that I was actually expelling a child from me and with a vague sense of familiarity like the scream accompanying an intense orgasm.

So after 38 hours of labor, Willem was born at 2:45 pm Saturday afternoon. At birth, he weighed 6 lbs. 13/4 oz. and was 20 1/2 inches long. The only medical assistance I got was having my water broken, something looking back on I regret. How I know that AROM rarely does not speed labor along in statistical tests and wouldn't have have affected my labor in any substantial way.

I did tear a little bit in a couple of different places but I was assured repeatedly that its not that bad and only required one or two stitches in each place. At the time I asked if it was neccessary for the stitches because I would have preferred any small tears to heal on their own. The midwife responded that they probably weren't neccessary but she was going to do them anyway. Before I had a chance to refuse, she had started. I laid back, again, exhausted and tired of fighting and let the whirlwind of activity take place as my baby was taken from my arms and kept away from me while a needle was being pulled through my flesh over and over.

I stayed in the postpartum ward at the hospital on Saturday night but got really tired of the constant monitoring and interruption. The bed was too short for me to get comfortable and I was really looking forward to going home. I'm so glad that home was appealing to me because after Friday night... I was worried that I never want to go back there. Now its the hospital that I never want to go back to.

I feel like I was treated unfairly and unprofessionally by the hospital staff on Friday and am so glad (and the hospital should be too) that I got better care on Saturday, when even then my rights were violated when treatment was forced on me when I was clearly voicing or even before I could voice my refusal.

Since then I've learned that the care I received was standard procedure at that hospital and at most hospitals in the United States. I have experienced months of Post Traumatic stress from that ordeal where I feel like control of my body was taken away from me and my freedom restricted. One reaction I had to that experience was wanting to have another baby as soon as possible to do it better next time, like a do-over. And the next time will be out of hospital with either a hands off midwife, midwife on call for an emergency or completely unattended by midwife or doctor.

Crash Course in Birth TRUTH

In the last two weeks I have read, no, devoured the following books:
  • Gentle Birth, Gentle Mothering by Sarah J. Buckley
  • Ina May's Guide to Childbirth by Ina May Gaskin
  • A Thinking Woman's Guide to a Better Birth by Henci Goer
  • Pushed: The Painful Truth About Childbirth and Modern Maternity Care by Jenninfer Block

Upon finishing these works, I am MAD about the current system of maternity care, how women are systematically lied to by trade organizations, denied their rights based on doctors trying to protect themselves from liability, and how women are being forced into unnatural, unneccessary, cruelly painful procedures that actually increase the risks of birthing than make it safer for healthy pregnant women.

The fact that the information is out there and so readily available for women to know that undisturbed, physiological birth is best so women going into laboring knowing what they want and what they have chosen is best for them and their babies, just to encounter a system who denies them what is scientifically proven to be BEST based on professionals who are trying to earn money at the expense of women.

I AM PISSED. More so now than when I was that women who knew what I wanted, who had done my homework, learned what the research says is best practice and did what was in my means to ensure that outcomes. And what did I encounter? Derision, condesencion, hostility, conflict, manipulation, bullying, and lies. When what I needed was caring, support and respect of a glorious natural process in a vulnerable time. What was the outcome? A nasty case of Post Traumatic Stress Disorder.

Since learning more, I have realized that I am not alone in my experiences. Most women may have encountered what I did and not have realized it or maybe did not react as strongly as I have. But that fact is that the treatment I received in the STANDARD of care. When did abuse become standard? Jennifer Block gives in "Pushed" a very enlightening history that answers that question.

Its been through this process that I have started this blog, as an effort to lend my voice to the advocates supporting the normal process of birthing and respecting women for their innate capabilities to do so. So here I am: another woman and mother who desperately wants to change the current climate of maternity care to be more hospitable to mothers, babies and families.