POOP on the ACOG!

The American College of Obstetrics and Gynecology just released a new statement regarding home birth. It basically full of contradictions, lies, half-truths and propaganda regarding a topic they are opposed to on the sole reason is that home birth provides competition to a service that currently serves 98-99% of American women. That's pretty dang close to a monopoly, and of course, they want to protect it and their paychecks.

In order to not restate completely, I will refer my readers to a blog from the House of Harris that eloquently and comprehensively covers the contractions within ACOG's statement.

Rixa from the True Face of Birth also shows how ACOG is changing its own party line, without making offical statements that they are changing it. Like changing its verbage about freestanding birth centers. They used to be opposed, but without coming out and saying that they now consider ABCs (alternative birth centers) safe alternatives, they are lumping it into a statement reinforcing previous claims that they do not support home birth. They're so transparent (sarcasm intended).

And to conclude I will share an analogy. (Please remember that analogies are not perfect but can be used to figuratively illustrate a point).

The ACOG states that "while childbirth is a normal physiologic process that most women experience without problems, monitoring...is essential because complications can arise with little or no warning."

Let's compare this logic to the act of eliminating, emptying the bowel, or what I like to call pooping.

Pooping is a normal physiologic process where solid waste is eliminated from the body that is commonly occuring, most of the time without complications. Except for those unfortunate who experience hemmoriods. Sometimes, pooping is really hard and prolonged which is a complication known as constipation. Maybe we should start calling it "failure to progress" or "defecation dystocia." Death can also occur when a unsafe rise in blood pressure caused by defecation can cause an anueryism or blood clot to burst. Fecal incontinence or a fecal fistula are also complications that can arise from defecation.

With that list of complications that arise from a "normal physiologic process" why isn't our every bowel movement carefully monitorred in case these complications arise?

From now on, I would like a medical attendant to carefully monitor me during every bowel movement as to not put my "health and life at unnecessary risk."

Next Time

I have been carefulling reading and reflecting on Willem's birth story recently and have found some things that I want to change for next time. Those things are the times when things went off course, or I made a decision that I regret now.

First thing:

I'm not going ANYWHERE!

The furthest I may go from my home with be a nice walk on the nature trail or to the shopping center behind my complex. No getting in the car, going to an appointment, going to the hosptial, just to be sent home and go back again.

Next:

Forget the numbers!

I won't worry about dilation, or timing contractions to "prove" to anyone that my labor is for real. As I learned with a newborn, the clock will not be my guide. I will go with the flow of the labor process, trusting my body to do what it knows how to do. I will not impede the progress by stressing out about the numbers like I did last time.

And:

I'm not paying someone to be paranoid for me!

Last time (and I'm still shocked by this fact), I paid an organization to treat me like dirt. I paid them to inflict a trauma on me that led to PTSD and for them to interfere with a process that my body was made to do without "assistance." Their paranoia, time clock, and need to clear the room did not assist me in any way. Also, since I do trust my body to complete the process of birth, I am not going to pay someone to come into my home to worry about "what might go wrong." My husband and I can do enough of that for ourselves. And we can also educate ourselves to learn what to do if that "what if" happens.

This next time, we are relying on our own knowledge and ability to educate ourselves and to have trust in creation. And "if" that something happens, we'll know what to do and where to go to get the assistance needed.


I will also:

Relax!

With Willem's birth, I was so excited to start the marathon that would bring him into my arms that I forgot to rest and conserve strength and energy. I know for next time to take things slowly, as they come, and to sleep when I can. The whole time I was actively doing: focusing, willing my body and baby to hurry up. I know now that is counterproductive and can lead to exhaustion and frustration. Each of the above items will also aid in this goal.

Above all, I will:

TRUST

I am disappointed in myself that I normally approach every life process with faith, prayer, seeking the Spirit of God and when in labor with Willem, I didn't. With Willem's birth, I think I took for granted that the Lord would be my help and I didn't turn to him during the time I was working to bring his spirit child into the world. Next time, I will seek the comfort, guidance and inspiration of the Spirit by seeking a priesthood blessing from my husband who has given me countless blessings in the time we have been married. The birth of a child is a sacred event that I will welcome the great Creator to attend this time and through trust in His process, I be confident in the ability I have been given to become a mother.

Home Birth Safer Than Hospital Birth?

This new study hesitates to say that home birth is actually safer than hospital birth (for low risk pregnancies, which most pregnancies are). But the findings can be interpretted that giving birth at home is safer than giving birth in a hospital.

It depends how one wants to define "safety." Is safety the outcome that mom and baby come out alive? Or is safety the outcome that mom and baby are alive and unharmed?

Is a mother unharmed when she leaves the hospital with sutures from an episiotomy, or a healing C-section incision? Is she unharmed when she experiences spinal headaches for weeks, months or even years after giving birth? Is a baby unharmed when he has injured neck muscles from being pulled out by forceps, or when he has a scab from the internal fetal monitor gouged into his scalp or an accidental nick from a surgeon's scalpel?

For moms birthing babies at home, these injuries aren't even possible because there has been no epidural or internal monitorring or abdominal surgery. She's 32% less likely to have an episiotomy showing that midwives are not as cut happy as the hospital birth attendants.

As for mortality rates, the study showed that the rates were very similar between home births and hospital births (1.7% or 14 in 5,418 babies). It important to note that the percentage of fetal or neonatal deaths was comparable to deaths of babies in the hospital, showing that location of birth doesn't make a difference in those cases.

An interesting note was the researchers explanation of the mortality rate in the study. They said, "Although the crude mortality for low risk babies weighing over 2500 g intended at home was 2.4 per 1000 and intended in hospital was 1.9 per 1000, when standard methods were employed to adjust for differences in risk profiles of the two groups (indirect standardisation and logistic regression), both methods showed slightly lower risk for intended home births."

To explain the technical mumbo jumbo, they were comparing results of other studies investigating infant mortality rates in home births and hospital births. They had to use some statistical analysis to fairly compare the studies and in their comparisons, they found slightly lower risk for intended home births. Suggesting that home birth is actually safer for babies too, than hospital birth.

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.