Saturday, January 12, 2008

Well good

I hope I can intimidate somebody like the tribe of OBs that is deluded by current maternity care practices.

Take this test!

Your color is black. The color of night. Serene and mysterious, black conjures up images of elegant evening gowns, dashing tuxedos, and gleaming limousines. Traditionally a symbol of success, black also represents power and an uncompromising demand for perfection. Not surprisingly, you tend to set challenging goals for yourself and do whatever it takes to achieve them — your strength of character is second to none. This unfaltering determination, along with your natural elegance, impresses people. But keep in mind that your personality might be intimidating to some. Try to temper your demanding side with a little softness — trust us, it won't kill you. Overall, though, black is the color of professionalism and achievement, which means it's clearly the color for you.

Wednesday, January 9, 2008

I found trouble

I recently read the book "Expecting Trouble" by Dr. Thomas Strong, Jr., an OB who calls out the American system of providing intensive prenatal care to pregnant women. He calls attention to the number of prenatal visits typically done in other developed countries, with better infant and mother outcomes in the US. The main point of the book is that prenatal care has been proven to do nothing to improve outcomes for women or reduce the incidence of prematurity and other complications of pregnancy.

So why do we, as pregnant women go upwards of 14 prental visits when we are expecting perfectly healthy babies and are experiencing perfectly healthy pregnancies?

For many women, prental visits 5 -10 minutes with the OB or doctor. More time is spent in the waiting room and with the nursing assistant, just for the doctor to pop in, brush the expecting mother off and reschedule for next month.

Anyone else recall those experiences as a waste of time?

What Dr. Strong didn't mention in his book is the possible connection between increased number of prenatal visits and increased rates of "complications." The title of the book addresses it, though. Is the maternity care system in the US "expecting trouble" in intensively monitorring and looking for problems in populations of low risk, healthy women? Is the system overestimating the seriousness of complications or minor derivations from normal in higher risk women?

How can women respond when learning that the prenatal care expected of them is excessive? Do they avoid prenatal care all together, as an unnecessary production? Or become choosy about which appointments to attend and consciously refrain from the whole schedule?

Imagine being the woman who only sparadically shows up to the "schedule" prenatals. What would the practice's social worker have to say about that?

Some women do their own prenatal care. I'd include the link to the Unhindered Living website on the topic, but alas, it has been moved with no redirecting address.For more broad spectrum of childbirth topics covered on the site: look here.
Maybe the links will get working again soon.

Dr Strong raises some interesting questions. The answers he provides are obviously unwelcome to the general obstretrical community. Move prenatal care into the domain of nurse midwives (he refuses to recognize the possibility of Licensed Midwives or Certified Professional Midwives)and then reduce the number of prental visits to a schedule more like European models. He also advocates using prenatal visits as educational opportunities to inform and prepare women for birth. He even hints at counseling women for social risk factors like income level, marital status, abusive relationships, etc.

All that's not going to be covered in 5-10 minutes, now is it?

My experiences of PTSD after childbirth

Some of my friends may have noticed that I have not been myself in the last few weeks. There are a lot of reasons for this, some of which I understand and I'm sure some I don't. Since Willem was born, I have been plagued with memories from his birth. I have experienced flashbacks where memories loop over and over again and I cannot stop them. I experience flashes of anger as I recall the way I was treated by the hospital staff. I can recount the ways in which I felt violated, belittled, and ignored. These feelings are strongest when I'm trying to fall asleep at night so I have spent many times (such as this one) awake, struggling to fall asleep but I can't because I cannot get these thoughts out of my head.

For many months, I couldn't talk about my experiences or even birth in general without a flood of memory. My husband and I would spend hours whenever the topic came up (which was frequently) going over the time when I was laboring to give birth to our son. A couple of times, my sleepless nights resulted in my husband being awoken by my crying and then together we would talk through the whole experience again.

I was sad and hurt because of the treatment I received but afraid that other women everyday since then, maybe even as I'm writing this, are experiencing the same type of degradation and disrespect. I don't want that to happen to another woman and so I know that some action is needed to prevent it.

I began considering becoming a midwife so I could ensure that I never was as insensitive to a laboring woman's needs as the midwives who were responsible for my prenatal care, labor and delivery. I realized that they weren't responsible for my care and my ability to give birth. They were supposedly assisting me in my responsibility as a woman, and a new mother. I wanted to be sure that I was also a help and a support, not an authoritarian, imposing figure of punishment and manipulation. I quickly realized that I am not prepared or willing for a complete career and educational change as going into the medical field from child development. But I realized that the role of a doula or labor assistant would be a complimentary type of family and parenting education to the type of educator that I am already trained to be. I started looking into the educational requirements that a doula needs to be certified and found that a strong understand of the physiological process of birthing as well as the ability to comfort and support a laboring woman in the way she feels she needs to be comforted is necessary. So I started researching and learning about the process of birth, how it is best accomplished without medical interventions and "aggressive management."

In this period of learning and thinking of changing direction in my education, I began to be more verbal about my experience which I realized could be considered traumatic since I was still dealing with negative emotional effects from it. I joined some online groups for women who dealt with traumatic birth experiences and found that I was not alone. I knew I was not depressed because I only became angry or hurt when recalling those events, and did not feel down at any other time. In my research and learning, I discovered that it is not uncommon for women who endured difficult birth experiences to display symptoms of Post Traumatic Stress Disorder. I read some the definitions and descriptions and found that I do display many of those symptoms. Since realizing that, it seems that a Pandora's Box of recollection and feeling has been opened. The thoughts and memories that once plagued me intermittently now wouldn't go away. They were always there, on the periphery of every thought and action of my day. I had a diagnosis, a reason, an explanation for why I was broken and dysfunctional.

I was able to give birth to my beautiful almost 7 pound baby without drugs and in a hostile environment where I had people telling me that I couldn't give birth without drugs, that I would need to be induced, that they—"the experts", the doctors, midwives and nurses—could take over and make my body do what it couldn't do on its own. But I believed that my body was capable of giving birth safely, naturally, without the "help" of interventions that could potentially harm me or my baby. And because I was able to be strong, to stand my ground and endure, I was treated that there was something wrong with me. That if I didn't receive their "help," my baby would be hurt, or killed or that I could die. And then I come away from that experience knowing that I can allow a baby to grow within my body and then pass through my body as he/she enters the world, feeling vindicated. I learned that it can be done, that it's not scary, or unbearable. But I was still scarred. By people who instead of helping me though a time of tremendous effort and concentration did everything in their power to make it harder for me, by insisting I remain in positions that are empirically shown to be ineffective and more difficult for a laboring woman, by pushing drugs and interventions that are shown to increase the occurrences of complications and needed interventions, when I could do it on my own. I needed people who would offer me confidence, strength, encouragement and measures to help me be more comfortable to make the process easier. Instead they made the whole experience harder and as I come to find out—traumatic.

And then there are other issues. Why am I having such a hard time putting this experience behind me when other women have experienced much worse? Giving birth to a child is always an emotional event and every woman I know has been able to put it behind her. No one that I know of has ever "suffered" long lasting emotional effects like I have. So what's wrong with me? This sense of inadequacy is probably why its taken so long for me to start talking about this with other women, especially other women who have given birth and are mothers.

Another thing that has kept me from talking about this experience (outside of the people who were there) is that it's been too painful for me to do so. I still have a hard time talking about it without breaking down, yelling, crying and having the bitter resurgence of anger rise up within me. I've even tried to refrain from talking about it with my husband and my friend who acted as my doula because I don't want to annoy or alienate them. I don't want to expose people whom I love and care for to a flood of negative emotion, anger and drama. I'm also especially cautious to share my feelings with friends who have not yet had children or encountered the mentality of doctors and hospital staff when it comes to pregnancy and birth. I don't want to scare them.

A couple of weeks ago, I was finally able to express to the hospital where Willem was born that their staff may have been responsible for the maltreatment of me as a patient. In telling my story to the nurse manager, I was very proud of myself that I was able to remain calm. Upon hearing my description of the events, she promised me that she would call a review board with all the midwives and supervisory OBs to review my case as it sounded to her like there was some breech of hospital policy and violations of my rights as a patient. I have been waiting to hear about the results of that meeting (it will be in the form of a letter that will tell me nothing, but I still want to know that it happened). In the last two weeks, my emotional distress has reached a new height causing me to act in ways that I wouldn't typically act.

I have become very vocal about distrust for doctors, especially OBs, midwives and nurses and the medical interventions they routinely offer to laboring women, as well as my disappointment in the number of women who trust their doctors without understanding the potential risks of those interventions. I had learned some about the side effects of interventions in childbirth and knew that I didn't want to expose myself or my baby to them. I also looked at childbirth in a spiritual way—women were created by a Divine Creator who made women's bodies to be capable of giving birth without medical interventions and put medical technology on the earth to help treat women and babies in case something went wrong. I believe in the power of women to carry, nourish and birth their babies and I was sad to hear of so many of my sisters who were so scared of the pain of childbirth and instead opted for an "easier" way. Even though that easier way often leads to complications that make the whole process more difficult and potentially damaging to mothers and babies. Some women I talked to experienced stalled labor, C-sections, seizures, long term pain and difficulties, had babies born who were not breathing or had to spend weeks in the NICU because of the "care" they received. I am worried about my friends and the countless other women who are not informed of the potential side effects of standard ..:namespace prefix = st1 ns = "urn:schemas-microsoft-com:office:smarttags" />OB care during childbirth. Since I had a difficult experience without any of that, I just don't want anyone to experience anything similar or worse to my experience.

I feel that I was spared from a set of problems that I would rather do without. Because of the curvature of my spine (scoliosis) I am pretty confident that an epidural would not have been able to be placed properly in my spine so the likelihood of nerve damage and the resulting complications were high for me. I consulted with my chiropractor on this and was validated in my concern. Her professional recommendation was that it was a good thing that I didn't get the epidural.

Who knows is this explanation is helpful in explaining my actions of the last few weeks. I am seeking help to deal with the PTSD. I start meeting with a psychologist on Wednesday and hopefully, I'll be able to let go of the anger and hurt and I feel. I want to be able turn that bad experience into something good and channel my energies into making birthing more comfortable and safer for other women. I also know that I can turn to my Savior to find comfort and peace, where he can help me let go of my grief because he has suffered it for me. Unfortunately, it's not as simple as it is to say it. There is a process that I need to work though and I am making progress and starting to be able to move forward.

Many of my current decisions are being based on that experience to make things better. The main reason why I am seeing a chiropractor is to reduce the curve of my spine so my next labor will not have as much back labor. My current focus in my scripture study is to understand more about the resources God intends to use for our health and well-being, part of that the use of drugs in childbirth. As I also talked about, I'm studying a new area for my education as I am working to become a doula. I'm also starting research on PTSD that occurs after a traumatic birth experience and how it can be prevented in the future. One of the big answers to that question is by having supportive, sensitive birth attendants (doulas in particular), which is a big reason why I'm heading in that direction.

I hope I have not offended anyone with my actions of the last few weeks. I am trying to make sense of a difficult period of my life and that is why I've written this explanation—to explain to my friends why I've said and done some of the things that I have. I hope you can understand.

Saturday, January 5, 2008

Myspace is at it again

Breastfeeding in public is legal in all 50 states, and therefore exempt from public indecency and nudity laws.

Why then does Myspace think that images of breastfeeding is pornographic? And why are they censoring photos of mothers nursing their infants and toddlers?

What about images of birthing? Especially in light of the multitude of content on Myspace depicting nudity and videos depicting the act of sex?

My baby was born early 2007 and the first roundof Breastfeeding censorship by Myspace was big news at that time. I'm surprised that they are back at it again. An online petition was circulated. Currently there are over 10,000 signatures. And according to Birth Without Boundaries, the ACLU is now on board.

So here I am, recirculating the petition and getting it going around again. Myspace needs to listen to mothers that giving babies the best nurtrition available in the world and the educational videos and images of birth are not indecent.