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Tuesday, April 27, 2010

Waterbirth Turned Car Birth

Yet again, another baby has dared to be born without the aid of hospital staff. Or even without a hospital. This couple from Australia were hoping for a waterbirth (yay!) at the hospital and ended up delivering in the back seat of the car on the side of the highway, aided by a phone operator.

Next OB's will tell us: "Unless you want to give birth to a dead baby in the backseat of your car, you'd better remain chained to a hospital bed for the remainder of your pregnancy. You know, just in case!"

According to the article, the baby decided to 'force his way into the world' by coming sooner than the mom, who was already in active labor, expected him to. Funny, but that phrase sounds more like how you'd describe a typical hospital birth. Compared to some of the stories I've heard about things done to pregnant women in hospitals, the back of my Honda minivan sounds a lot more inviting.

Congrats to this couple! Maybe they'll just forgo the hospital altogether next time, since things went so well this time around.

Saturday, April 24, 2010

Do-It-Yourself Pregnancy

*Disclaimer: I am not suggesting anyone be reckless, especially when it comes to their health or the health of their unborn baby. However, it is your body, and your baby, and you can - and should - essentially be able to do with it what you want. (Although try arguing that in a court of law...)

Anyway, I don't know what got me thinking about this lately, but while I was pregnant with my last I often would sit and daydream while waiting in the OB's office. What if I didn't seek prenatal "care"? Granted, I'm not exactly a good low-risk candidate, at least by my doctor's standards. After waiting upwards of an hour for one freaking five-minute visit where he just blows me off and his nurses do most of the work, I'd think, Why the hell can't I do that?!

Play along with me here for a moment. No one (usually) is there when you conceive. And you can walk into any drug store - even The Dollar Tree, if you're patient enough - and get a run-of-the-mill pregnancy test as cheap as ... well, a dollar. The ones your doctor's office uses really aren't any different (in fact, they probably got a better deal by ordering in bulk). So bam ... you're pregnant! You found out that information all by yourself, without any help!

Playing Devil's advocate, let's assume you have a healthy, normal pregnancy. No problems, no indications for a c-section. You've found out you're pregnant; the next step is to start taking your $4.99 a bottle prenatal vitamins from Walmart (or Target, if you prefer). While you're there, you can pick up a pretty good quality automatic blood pressure cuff for about $80 and you're set to take your blood pressure each month (heck, every day, if you want!) from here to eternity. Doing it yourself means you can get comfy in any position of your choosing, in the comfort of your own home, not having to worry about a nurse breathing down your neck asking you stupid questions like "Did you have a bad day?" when your readings are a little on the high side. (Whenever mine were, no doctor of mine ever offered me to lie down on my left side and rest for a few moments, which can sometimes help lower your BP.)

If you're like almost every woman in America, you have a bathroom scale. You'll be able to tell, just like anyone who can read numbers, if you're gaining weight and how fast you've gained. A good one will probably run you $30 or so, so chuck one in the cart while you're at Walmart. You can even get a fancy one that tells you body mass index and all that crap. Even your doctor's scale can't tell you that!

When it comes time to do the sugar test for gestational diabetes, you can go back to Walmart and pick up a home glucose monitoring system with test strips, if you choose. Diabetics do this all the time, and you can argue that really, if your pregnancy is uncomplicated, you'd only have to do it once if you were seeing a doctor. For probably less than $20, a box of urine glucose strips can detect protein in your urine, the same as it does at the doctor's office. (Tests you can take yourself, "in the privacy of your own home," touts the advertisement...)

Some argue that home glucose monitoring kits aren't as accurate, but in the case of the diabetic patient, they seem to work just fine for millions of people on a daily basis. They do have to follow certain manufacturing and accuracy standards and really, some would argue that perhaps the doctor's test isn't that much better. (Many women are often asked to repeat the one-hour test with a three-hour followup, often when the results are 'borderline' or even negative; one woman I know told me her doctor routinely ordered the three-hour test immediately, regardless.) While many doctors order the traditional nauseating 'flat orange soda' drink before a lab test, many OBs tell the patient to eat a candy bar or drink a glass of orange juice beforehand. Candy bar - less than a buck. Orange juice - around $3. Glucose tolerance screening test - $75-$85 (or more, probably depending on where you are). Think of the savings!

By now you're probably far enough along that you could, if you wanted to, have an ultrasound. Whether it's for fun, to check the gender, or look for fetal anomalies, you can have them done at "special" ultrasound places for a few hundred bucks. Normally I wouldn't recommend doing this because it's not a professional medical technician, and if they do see something wrong, they are not equipped to tell you so. But if you want to know that it's a boy, there you go. Maybe a quick check of baby's positioning just to make sure, even though Bub could still turn at the last minute. (But this is a normal, uncomplicated pregnancy, remember.)

If you're patient, you can just refuse the ultrasound and wait until the baby's born. After all, many reason that there are really very few things that can be done prenatally as far as birth defects are concerned, and many people just like to be prepared ahead of time. Assuming that you're having a normal, healthy pregnancy, this probably wouldn't even be a concern for the majority of the population. And you don't have to worry about hearing pressure from a care provider about what you'd plan on "doing" should something appear to be wrong with your baby. Added bonus!

The rest of the time is spent waiting. You can cruise through Babies 'R Us and while you're picking up the last-minute essentials, splurge on a fetal doppler monitor. Granted, some question the accuracy of these devices too, so remember it's just in fun. After about five months, you can even use a stethoscope to possibly hear the heartbeat, so maybe look for one at a garage sale in your spare time.

Now comes the hard part: labor and delivery. If you're smart, you'll stay home as long as possible until you feel that labor is imminent. If you're really brave, you'll have a do-it-yourself labor too, which many people have done. (My neighbors, a couple who are probably in their 50s, were planning an assisted homebirth in the 1970s and waited patiently for their doctor to arrive. When she didn't, dad had to step in, catching a healthy baby boy who lived to re-tell the tale.) Lots of people have unplanned unassisted births, spontaneously delivering while on the toilet, on the bathroom floor, in the car, on airplanes, and other random locations and do okay at it. (Notice how you'll never hear people tell you how dangerous unassisted birth is it were by accident: why not suggest confining a pregnant woman to a hospital bed once she hits 36 weeks, just in case?)

Option B would be to labor at home and call the fire squad. No doubt they have basic medical training when it comes to delivering babies, and they even get a fancy badge if they've done so, too. They also have quick access to medical equipment, just in case, but remember - this is a normal spontaneous delivery.

Option C would be to rush to the hospital when birth was imminent, ready to push. No time to argue over the over-administration of Pitocin, pushing flat on your back, or threatening to cut an episiotomy - just push that baby out! I'm sure this'll make you popular with caregivers, so beware.

If you should choose option A or B, you'll eat your own food, wear your own clothes, and sleep in your own bed. No free formula feeding bag, no blood pressure checks every hour on the hour when you're told to "rest." No Pitocin to induce contractions of the uterus; you've got boobs that can do that automatically, and for free!

Sure, I'm being facetious. But we've all heard stories of women who didn't know they were pregnant quite far into a pregnancy, sometimes even up until delivery, and manage, somehow, to have healthy babies. How does that happen?! They didn't see a doctor! Now that basically everyone is labeled high-risk (even though they really aren't), how can we possibly be trusted to care for our own bodies? If diabetics can do it, and people with other illnesses, (and pregnancy isn't even an illness) then why can't we?

I know we can't see into our crystal ball, but really, what percentage of pregnancies and deliveries are basically complication-free, spontaneous vaginal deliveries with *really* no need for intervention? Probably more than your doctor would like to admit.

Friday, April 23, 2010

Insurance coverage dropped for breast cancer patients

This headline screamed at me yesterday morning over my cup of coffee: "WellPoint routinely targets breast cancer patients." It's all over the internet now and raises a few questions about the treatment of patients - specifically women.

Interestingly enough, the original version of the story I read yesterday included this one brief nugget of information: That to insurers, breast cancer patients, as well as pregnant women, were an "anathema." Even as proficient as I am with the English language, I had to look that one up. It means "a person or thing, detested or loathed."

When I went back to reread the article through Reuters, I couldn't find the word "pregnancy" anywhere. Puzzled, I read the comments on the Reuters reader forum and realized, after someone noticed it, that the article had been severely edited, including the negative comments made about pregnant patients. Someone must have said something inflammatory and made the corporate lawyers mad, which prompted further editing of the article. However brief the mention was, though, at least it got some notice. (Ironically the comment was made by the city attorney of Los Angeles, not someone from the insurance carrier itself.) And while I think he is on the right track, the threat of disability is not the real reason here.

"But there are two things that really scare them and they are breast cancer and pregnancy. Breast cancer can really be a costly thing for them. Pregnancy is right up there too. Their worst-case scenario is that a child will be born with some disability and they will have to pay for that child's treatment over the course of a lifetime."

It's not news that insurance companies have been dropping pregnant women from their care for the last few years, especially in the case of a repeat c-section or the choice of doing a VBAC. For the group who don't want to do a repeat cesarean, often insurance carriers would refuse to pay for a VBAC, undoubtedly because their "panel of doctors" deemed it too dangerous. For the group who don't want to do a VBAC, the insurance carrier refused to pay for what they considered an 'elective' cesarean when a VBAC could be cheaper.

The take-home message in this particular case is that your insurance carrier is saying, "Don't get pregnant. We'll be glad to pay for your birth control pills, though." Because that baby has to come out, either way. So what is a woman to do, when her options are limited not only by her doctor, but by her insurance carrier?

In both cases of pregnancy and breast cancer, basically WellPoint uses a computer algorithm to single out particular patients. Certain conditions, apparently, "trigger investigations" with the company, even though the computer appears to be doing all the work. Apparently WellPoint is concerned about fraud, but really, when it comes to cancers, the United States has a high rate of survival for many cancers because of their rather aggressive treatment. If they're interested in investigating fraud, especially when it comes to pregnancy, perhaps they need to look into the overuse of the expensive induction agent Pitocin, which can cost hundreds of dollars per dose. Multiply that by the number of WellPoint's patients alone who are induced, whether for medical necessity or not, and I bet the figures add up very, very quickly. Or perhaps look into the number of unncesareans that are performed on their patients daily.

The difference between these types of patients is obvious: breast cancer is an illness that needs to be treated. Pregnancy is not. But either way, women are forced into neat little boxes, absolutes that are black and white. We know that the more interventions in pregnancy and labor that are performed can sometimes put the mother and baby at elevated risk, and are often extremely costly to the insurance provider. Instead of instantly dropping both groups of patients from their care, why aren't they taking initiatives to find evidence-based ways of saving money? In the case of labor and delivery, all the information is already out there, but few doctors put it into practice on a wide scale.

One thing I'm curious about: how do their treat male patients? No word on that yet. Especially those rare men who get breast cancer, because it does happen. Are they immediately dropped from their insurance carrier? Either way, it looks like women lose out again on this one.

Tuesday, April 20, 2010

Keeping our daughters young

I don't know about you, but when it comes to kids clothes, I am totally anal. I do not like Disney characters splashed across the front (or across the butt), and things must be tidy and respectable looking. LOL (My kids will love me in ten years, I'm sure) My mom has learned that buying clothes for them is a tough undertaking, and now just issues me a gift card so that I can do the dirty deed myself.

I've been doing some shoe shopping for myself lately, and have quickly scanned the kids' aisles, too. Perhaps I've just never noticed, but there are a ridiculous amount of high heeled shoes for little girls! out there. When I went to buy my daughter tennis shoes last year, I swear, I went to like eight stores looking for a conservative pair of Keds that didn't look like crazy tricked out hooker shoes for toddlers. I'm not into flashes and blinking lights (besides, once those lights don't light up anymore, it's a major disappointment that just can't be overcome).

I have serious foot issues so I can't really wear heels without torturous results. I know that in adult women, they can gradually shorten the achilles tendon, and since mine were basically born that way as it is, I don't need to make the problem worse. Not only that, but like any other child, my kids like to run around - and they can't do it in those things, for sure.

I checked out Zappos.com and saw these little beauties, most of which top out at a 1- 3/4" heel. The black sandals at the top actually have a 2- 1/2" heel. Can we say broken ankle? Of all the reasons to head to the ER this summer, I don't want this to be one of them.

Those brown pumps with the bow - how cute! I may order a pair for myself (some styles do come in women's sizes, but a girl's size 5 is like a women's 7 1/2 or something). But check out the ones on the bottom - that little heel is low, but so spikey I can just see an awkward 11-year-old wobbling her way through church/Bat Mitvah/whatever in those. (Wait, do 11-year-olds go through an 'awkward' phase anymore? It doesn't seem like it. *sigh*)

Apparently I'm not the only one who is freaked out about this. Doctors are issuing "warnings about the dangers of kids wearing high heels ," and you can see Suri Cruise wearing a crazy pair of peep toes that make her look like an elfin 12-year-old. One six-year-old mentioned in the article has worn them "until the jewels fell off," says her mother, who adds that "it's not my preference, but I've stopped fighting it."

Umm...hello...who's the parent here? If it's not your preference, then why did you buy them for her? Secondly, if you don't like them, they might just have to 'disappear,' and little Helena might have to get over it. She is six, for goodness sake.

As far as wardrobe choices, I see more four-year-olds in Hannah Montana than I can shake a stick at. Just the other day we were at a play date where a little girl the same age as my daughter pulled out her Hannah Montana electric guitar. I thought, Wow, my kids have no idea who that is, thank God. And after I saw pictures of how she 'performed' at the Teen Choice Awards last year, hopefully they never will, either.

In this photo (taken from the Huffington Post ) you can practically read the expressions of the girls in the background. Girl 1: "OMFG! Woot!" Girl 2: "Miley, you are a goddess! I worship you and your 3 1/2 inch heeled boots!" Girl 3: "Whoa, I can't believe she just did that! My mom is, like, going to kill me!" Girl 4: "Wow. She is so awesome. I'm going to ask my dad to install a pole in our basement, like, tomorrow!"

Ack.

It seems like when it comes to fashion, the industry is trying to sex up our daughters and make them grow up way sooner than they should be. Teens in the media don't often help - consider how long it took Britney Spears to shed her "good girl" image and head straight for Madonna's closet. And conversely, look what the fashion industry seems to be doing to women: convincing them that, even though you're pushing 40, you can still look like you're 20. (Even when I was 20, I didn't look that good.) It's great if you've got a nice body, but you need to treat it with respect - that doesn't mean showing up to Disney with four young, impressionable daughters in tow wearing a pair of skin-tight low rise jeans and a tube top that exposes your muffin top and size 38DDD breasts. What kind of image does that project to young girls?

I'm "old" LOL and a mom, and am not necessarily ready for the Alfred Dunner line. Neither am I going to bare all in a pair of Daisy Dukes and parade around showing all that extra flesh I've earned as a mom of three. (Dear God, the image is burning my retinas) Sometimes I think we need to be realistic about our body image - which doesn't necessarily mean negative - just be honest with ourselves that no, we can't squeeze into those pants no matter how much they stretch. And even if you somehow manage it, bending over is another task. If that's the case and you need an oxygen tank to breathe, you might want to reconsider.

Speaking of Madonna (who is 52! Hello, 1984 is over, honey! I think - and so do lots of other people - that it's time to hang up the fishnets and bustier) - all it took was one photo of daughter Lourdes' eyebrows circulating on the internet before the 12-year-old had them, and apparently her upper lip, done. I guess if you're a celebrity's kid the pressure is also on you to be beautiful and 'grown up' before your time. No wonder so many celebs shield their kids from the paparazzi. There is just as much an expectation for their kids to look as perfect as the parents do.

As a mom of two boys as well, I don't see the same pressure on them to look the part. In some ways, they do, what with the little three-piece suits and ties that look so cute as a button. But in girls, it's so much different. It's like the world has tapped into that feminine persona that defines us as women (or at least thinks that defines us), and has decided that girls need to look like that, too; that girls can't just be girls, but, rather, smaller versions of grown women.

I almost wish we were back in the 1950s, where women and men looked clean-cut and "dressed up" every day as part of their regular wardrobe. No, I don't think women should have been barred entry to a place simply because they were wearing pants; but it's sad that when you see someone dressed up you think, "Oh, they must be going somewhere!" At what point did we decide that a bra (or underwear) was optional? That it was okay to look like you just rolled out of bed when you're actually going for a job interview?

It's such a struggle as parents when we're up against these themes and images, constantly bombarded from all sides, and it continually undermines our authority as parents, in my opinion. In the meantime, I'm glad I know how to sew, because from now on it's pleats and Peter Pan collars, baby!

Thursday, April 15, 2010

Cleaning "house" and other cool stuff

I've been meaning to get around to doing this: accepting my very first blog award from one of my "readers"! (Readers ... wow. ... makes me feel so important, saying that.) When I first started this blog, I wondered if I would have even a reader.

I have officially received the ...wait for it ... Honest Scrap Award! Woot! (Better than Honest 'Crap' Award.) And if Heather hadn't told me in her post what I was supposed to do when I received it, I would have no freaking clue! I'm so new to this stuff.

Heather, a "reader" at http://qtberryhead.blogspot.com/ has her own cool blog, "Tact is For People Who Aren't Witty Enough to be Sarcastic." I can see why Heather follows my blog, I think, not just because she's a fellow "Birth Nerd," but because she sounds as sarcastic as I am. I also think she's the bees knees because she was probably one of the first to regularly visit and leave comments, which made me feel so loved! So read! So ... on the map! Thank you, Heather, for making me feel like I knew what I was doing!

As a result, I'm supposed to reveal seven things about myself that I haven't already blabbed about on my blog. That sounds pretty difficult, since I tend to be long-winded and talk incessantly. Some of which I wondered, if I really revealed to you, would make my readers instantly unsubscribe and run. I've decided to take my chances.

*sigh* Let's see. Seven things? That's a lot.

1. I am a registered Republican. (figured if I was going to piss off readers, might as well get it out of the way right off the bat)
2. I have never smoked anything, or been drunk, ever. (told ya I was boring - which might explain the Republican thing)
3. I have an unnatural fear of horseshoe crabs.
4. If I had the money to blow, I would buy a trumpet. (har har - no pun intended!)
5. I do not recycle and probably never will (at least not in the conventional sense, anyway).
6. I taught myself how to type when I was ten. (See? Aren't I exciting?)
7. I have four blogs total (although one is for close friends and family only).

And now for the last part of Heather's challenge: I must nominate other bloggers.

1. First and foremost - like she needs it - is At Your Cervix , probably one of the best blogs I've read that talks about birth (and other things) from a nurse's perspective. And if I were delivering a baby, I'd want her to be my nurse. Not only that, but there has been more traffic directed from her site than I can possibly imagine, and I can't thank her enough. Since you're all coming from there anyway ... you can probably find your way back. LOL

2. Next up: The Unnecesarean . Jill and company have basically coined the phrase, and unfortunately, so many of us can relate. Here are our stories, our heartaches, our triumphs. Through this site, millions of women are reached and can now probably put a finger on the 'missing link' that was their cesarean birth experience, as well as connect with other women who have, too.

3. A new blog (to me) that I found not that long ago: Whoz Your Doula . Just looking at her picture makes me think, 'If I were pregnant, I would love to have this lady attending my birth!' In my experience, having a doula was awesome, and I recommend it to everyone who is pregnant. Plus, you can follow Whoz Your Doula Birth Services on FaceBook.

As far as cleaning "house" goes, I have been meaning to change that stupid header for the longest time. Enter my pseudo graphic design skills. I do volunteer my self-taught (I use that word lightly) talents for my son's school, and my current project is a fun poster for the upcoming seventh grade production of Charlotte's Web. Ooohh. But at least it's one of my favorite stories.

In addition to the new and improved header (that's only half-done), I am considering changing the background to black and going to a three-column format. I have this idea in my head that I could design banners and such for the entire third column, free to pass on and easy to see right when you log on. Sort of like a public service announcement. LOL I'm such a nerd. I did "design" the "Once a cesarean is not always a cesarean" button on the left, in case anyone's wondering, and still need to add attribution for the poor chap whose photo I used. I have some other fun ideas I'd like to pass along, as soon as I get time...

Tuesday, April 13, 2010

FaceBook, privacy and parenting

Technology and FaceBook can be wonderful things, but sometimes sharing is so not appropriate. I have reconnected with great people. But one friend, who told me in his recent FB post about the website www.spokeo.com , made me realize that both that wonderful technology and FaceBook - or any social networking site - can be downright scary.

The other day I got a frantic call from my dad, who received an obvious spam message from FaceBook - and among the people listed as her "friends," my name popped up. I am still puzzled how the connection was made (I'm sure it was no coincidence). The revelation of the spokeo.com website made me even more puzzled. Basically it aggregates public information from many sources and lumps it all together for all to see in one convenient package. Some of it is right - like my freaking full name when I enter my email address (that's only supposed to be visible by friends on FaceBook, not the entire world) - and some of it is comical: like the value of my dad's house being $1 million and then some. (One look at my dad's humble abode and you'd know that was far from the truth.)

I realized that much of the information was stuff we normally give out - names and addresses for marketing surveys, free giveaways, social networking sites profiles that aren't made private, and even comments we've left on public forums, etc. If I put in my email address and password, it can tell me the recent net activity of several people on my contacts list: Amazon.com wish list additions, music lists on public sites, and other oddities. Again, probably because their profiles are public, and they use their real names.

This is one thing I've always been paranoid about. Especially with regards to my kids. Although I'm not sure it matters in the end, all of my FaceBook photos and profile information is private to friends only. And all those photos I've been tagged in aren't much help to future employers, because I thankfully led such a boring life in college LOL.

One scary thing I noticed is how many people leave their information - photos, phone number, all of it - open to the public on FaceBook. Unless you're running a business and want to be noticed, I can't see why anyone would want the world to have free access to your drunken photos from last year's New Year's Party or your child's second birthday. One guy from college on my friends list is apparently going through a particularly nasty child custody battle and yet had all his information completely public. I suggested, as did several others on his list, to make his info and photos private, and untag himself from those party photos from over a decade ago, because while we know it's harmless, a judge might not. And a lawyer with high stakes will use anything possible to prove you are a bad father, which could mean your chances of custody have just gone into the crapper.

He ended up changing the somewhat racy (although probably harmless) profile photo of himself shortly after the suggestion was made. I was kind of surprised that someone actually had to tell him to do it, as if the idea had never occurred to him before. It somewhat shocks me that otherwise good, loving parents have little reservation about putting their child's face, detailed pictures of family and home, on the web for everyone to gawk at. That is why, on my other blog dedicated to my kids and family life, I have it password-protected. It might be a pain in the butt to some, but too bad!

Some suggestions I can offer, just off the top of my head:
  • Make your profile information and photos private. I found this hard to do on FaceBook, but once I found all the tools, it made sense. I sometimes wonder if, when they change or update settings and features, if those original privacy settings go out the window. And sometimes I feel like they actually make it harder to hide those private details. This should include the groups you belong to (if you want, anyway) because it can give away details about you as well. One thing I would like to see is for FB to allow me to make fan pages private, too. I don't necessarily want the outside world knowing that I am an alumni of such and such university, fan of Residents of X-Ville or the "My kids go to Blah Blah Elementary School" page, etc.
  • Have numerous emails for different purposes. I must have like a dozen emails for various things, like junkmail, my blog, my personal use, work and other things. If I want to sign up for free offers, mailing lists and coupons, I use the junkmail account. I also don't give my full name when setting up the account. One other thing: as an experiment, open a new email account and see just how long it takes for spammers to show up, even though you haven't given your address to anyone.
  • If you use Yahoo! email or another email program that ties in with social networking and instant messaging, check your privacy settings - it could be revealing your name and information to third parties without your knowledge. I checked on one of my Yahoo! accounts, and it was set to do this as a default setting, which really irritated me. If all those companies who say they're concerned about your information really were, they wouldn't make it readily available to everyone right off the bat without your express permission. Look for buried privacy settings, too. If you're not completely familiar with all these settings, it can get extremely confusing to make sure you're not revealing everything to the outside world.
  • Don't mention anything on your wall that you wouldn't want your mother/father/pastor, etc. reading. While this sounds obvious, sometimes I get strange postings from friends in my feed about going through divorce and the discovery of cheating, people using foul language, and all kinds of weird stuff. Most of the time it's harmless, but again, if your profile is marked 'public,' everyone and his brother is going to know you just found out your spouse has been running around on you behind your back.
  • And related to the previous point, it might be wise to not let your kids have a FB profile. While this is really up to your discretion, I have a real problem knowing my underaged nephews can read the comments of some of those posters I just mentioned. Say I make a comment about 'wood' and some smart ass decides to take it and run with it. Guess what? 12-year-old so and so can read that. Yeah, sure, they're going to see it sooner or later (or probably have already), but even if that's the case, I do not want to be an accessory to it. But then again, I have a thing about kids being on the internet in the first place, so that might just be me.
When we see sites like spokeo lumping all that information we willingly already give out over the internet, it makes you realize how long (and permanent!) our 'paper' trail really is. 

Kids and Coping Skills

My son did not want to go to school today, which is completely uncharacteristic of him. We talk about his day after he comes home, and nothing came up last night. Until this morning at breakfast. The whining prevailed, the sluggish demeanor that says "I am stalling so I won't have to go!" and I asked what was up. He finally told all over a bowl of Rice Krispies.

"At recess.....(long pause, mumbling)...some kids were tying to hit me with a basketball."

"Who?"

"Some seventh graders."

"Was it an accident? Did they do it on purpose? What did they do?"

"They... (mumble mumble).... I turned around and they tried to hit me on the head. Twice."

"How do you know it was an accident if you weren't looking?"

Big pause.

After he stalled some more, I informed him of his options: Tell them to stop, and/or tell a teacher if it wasn't an accident. I added, bluntly, that we were not paying thousands of dollars a year to send him to a private school if he didn't want to go.

Blink.

I hate to be too "tough love" but sometimes I think it teaches my son better coping skills. Some candy coating is necessary; I mean, he is only 6. But, in my opinion, too much does not teach them how to deal with situations that come up on a daily basis.

Once we got to the bus stop, I explained to the mom (one of the parents I mentioned in the spanking post) what was going on. She said her son (we'll call him S) gets upset when the class has a substitute. He also freaks out when mom forgets to pack milk money, because it means he has to go up and ask an adult for help and get milk.

I'm thinking, "Wow. My kids are totally not like that." Yeah, like I blathered on about in my last post, every kid is different. Timid is something my children have never been. I wondered how S's mom helped him resolve his inner conflict? About getting up the nerve to ask for a milk because he forgot his money? How is he learning how to cope with his intense fear of social situations?

Then S's mom went on to say that R's mom (the other mom I mentioned in my spanking post) was having trouble with her daughter, too. Apparently difficult social situations at school that revolve around lunchtime and outdoor recess once a week are making things hard for R to deal with. So R's mom was diligently picking her up once a week - sanctioned by the school, of course - as an alternative.

I was kind of horrified inside. I already know the difficulty R's mother has in saying no, and just encouraging her daughter to face her problem. I said this to S's mom: "Well, we try to teach our kids to face their problems, rather than running away from them," which wasn't really in response to either of S's or R's moms' situations, but rather my own. I wasn't trying to say she was wrong, but absentmindedly just telling her what we did in those situations. I told my son that morning that chances are, those kids were playing and it was an accident, and it might never happen again. I did not want him to be afraid to go to school because of one isolated incident. And if it happened again, he definitely needed to say something.

It all reminds me of the 'helicopter mom' trend or the current problem among some parents who want their kids to be winners, even when they aren't. The "everyone's a winner!" philosophy has caused some to question how these parents are teaching their kids to deal with not being first, with competition and how to cope with loss.

It reminded me how one of my husband's students last year, a senior, would be whisked away from campus by his mother (waiting in the driveway of his dorm in the family minivan) every single day for some activity or other. It bothered me because her enabling was essentially robbing him of being an independent young man, who should be experiencing the full range of activities that defined him as a boarding school student. Not only that, but she never wanted the school to be too hard on her son and demand too much of him (which, thankfully, my husband and the administration just smiled and nodded to). Not only that, but his parents were paying over $30,000 a year for what - to pick him up and entertain him for a few hours? Plus gas for a 45-minute (one way) trip? What the heck?

My husband contends that, if sometimes our kids are unhappy, we must be doing our jobs. We are not striving to be our kids' friends, or extract them from every difficult social situation and come to their rescue all the time. I figure, sometimes we don't have a choice but to make our children do something they don't want to, and they need to learn, through us, how to cope with that. How to deal with not always feeling comfortable or getting their way on everything. Part of establishing my son's independence and growing up came with riding the bus by himself in the mornings and afternoons (he switches buses in the morning, which really worried me - but he did great!). I fear that constantly changing or bending the rules teaches them little of these skills, if only to perhaps enable them to grow accustomed to being catered to. Sometimes you do have to pick your battles, but some things are just non-negotiable.

I often think if we gave our kids half a chance to deal with things on their own, instead of metaphorically cutting and chewing their food for them to buffer them from disappointment, grief and loss, they would do just fine.

Monday, April 12, 2010

Defiance: Part 2

As a follow-up to my first post on this subject, last night I checked emails and found updates on the discussion over VBACs that I had been having at the BabyCenter birth forums. I really shouldn't read this stuff before bed, because it gets me so riled up. (As I lay there trying to get to sleep, I kept telling myself, 'Just think about shoes....just think about shoes...." LOL)

Remember Dr. So and So? You know, the one I said sounded pretty fair and stuff? Yeah. Well, I change my mind. He's a jerk, just like all the rest. He posted on the message board that he 'welcomed healthy debate,' but I think he avoids it - runs from it - just like everyone else. And in the end, he won another mom over to a repeat c-section, even after all the facts and differing opinions had been offered.

Granted, if you've done your homework about VBAC, and it's still not a choice or risk you choose to accept, that's great. I can totally respect that, as I am sort of in the same boat: if I have another baby, I'm not sure I want to try another VBAC after two sections. And I know that plenty of women have done it before. But for me, at least, I think it would depend heavily on my care provider: if I found someone pro-VBAC who would take me on as a patient and support me physically and emotionally, my mindset would no doubt be completely different. As would this mom's, if, say, Dr. Stuart Fischbein were the contributing doctor and not Dr. So and So.

But if your 'research' consists of Dr. So and So's one-sided drivel, the horror stories of gum-chewing girlfriends and the 'pregnancy bible' (GAG) What to Expect When You're Expecting, then you are ignorant.

There. I've said it. That I think some women truly are ignorant. And arrogant, in assuming that crunchy birth advocates are wrong or crazy; and especially so in assuming that nothing could ever happen to me, because I trust my doctor. Why listen to the opposing side? I know all the facts; I asked my doctor! What could possibly go wrong?

I'm sure I come off as arrogant to some in my fervor over birth. But I think the difference is this: I'm not trying to suggest that I know more than any doctor, that's for sure. They do know a lot, but it's a matter of what they're willing to share with others. That is where Birth Nerds like me are different. We want to share with you both sides, instead of the biased garbage you'll hear from your physician. He only wants you to hear what he wants you to hear. We are all told, by our friends, family and doctors, how different we are as women, how different our pregnancies are, as we waddle through those nine-plus months. Then, when we get to labor and delivery - BAM - suddenly we're all the same! And yet, when a doctor gets a patient who isn't, he treats them the same as the 100 other 'ignorant' women who walked in the door that morning. Dear Doctor, please stop treating me the same as those women who want to be induced, just want that baby out of there, looking at you with stars in their eyes as they worship you like you're God. I worship one God, and let me tell you, you're not Him.

I posted a huge diatribe in response to Ms. Board Owner at how insulted I was that she assumed that I knew less because I was just a patient, or that I was trying to assert that I knew more than a doctor. And this is the response I got from Dr. So and So:

Here is an interesting plan by an Ob doc from the state of Washington
Do a VBAC if a patient or her insurance agree to pay the true cost of attempted VBAC.

Catastrophic rupture during VBAC occurs ~1 in 200

Average liability pay out of $750K not counting the cost of litigating the law suits, average > $3750 per attempted VBAC

Average labor ~ 11 hours and would cost an additional $8250 to cover the cost of dropping all other Ob/Gyn care & being immediately available to perform emergency C/S. This could be more or less depending on the actual duration of labor & cost @ $750/hour.

If C/S was required, that would be an additional charge.
Healthy debate, my ass.

I haven't responded, and don't know if I will, but considered saying this: "Save your money and hire a midwife and have the birth you deserve."

Saturday, April 10, 2010

The S Word: Spanking

I have been a "fan" of the "Circle of Moms" page on FaceBook for a few months now. I don't check it frequently unless something interesting comes up on my home page, and yesterday the issue of 'alternatives to smacking' came up.

This one got my attention like a slap across the face (pun intended). Smacking? To me, that is not really the same as spanking. I've explained to my son the difference, to me, between hitting and spanking: one you do as a result of a fight or to be mean, the other you get when you have misbehaved. He seemed to understand this with no problem. I will say it right up front: I spank my kids. Not every day, and not for every little thing. But when it's warranted, they get spanked.

One mom on the chat that followed boldly told everyone she thought that spanking was a result of lazy parenting. That sort of stuck in my craw for the next 24 hours as I thought about her words. To automatically assume everyone who spanks is lazy is downright ridiculous. Nor can we say that people who don't spank aren't disciplining their children. They're just choosing to do so in a different way. I mean, that would be like someone saying of a formula-feeding mom, "Oh, you're just a lazy parent because you don't breastfeed." Can you imagine the scene after that one? (Probably, because I'm sure we've all been in the midst of that debate before.)

Whenever the subject comes up, I make the point that all kids are different - some do not need to be spanked, some do. It depends on the child, on the parent, and on the situation itself. There's only so much talking, reasoning and cajoling you can do with a defiant, headstrong 3-year-old who thinks she owns the world and is taking names. (Perhaps some of the people who are the most against spanking are the ones who never had a kid like this.)

I can use a couple of examples just from the people I'm close friends with. Granted, you can't really compare - because, again, every kid is different and so are we, vastly, as parents. There's the couple whose kids would routinely be rude to other adults, talk back to their parents and even openly hit them in front of others. I was horrified, as were my children, looking on with perplexed expressions on their faces.

Then there's the couple who don't spank and don't really need to, because their children would never dream of doing something so forward as causing an ounce of trouble of out fear. Irrational fear. Of everything. Although it is with a slight smile that I now know the youngest, another Fellow Princess Who Sometimes Think the World Revolves Around Her, is a bit of a screaming handful in public places. I am always interested to see how mom handles such incidents, but never do because they retreat to the depths of their house before anyone can so much as glimpse an altercation.

And there's the couple who placate their young daughters with toys, candy, whatever it takes to avoid a meltdown. I have rarely heard mom raise her voice to them, and she doesn't have to, because there is usually some gooey treat or new toy waiting on the horizon. I asked her one time what she would do when they turn 16 and want a car/pony/large sums of cash, and she said she didn't know, but knew she had created a monster. At least she is willing to admit it.

But, I realize, I can't really compare these children to my own. They are all different: unique personalities, situations, and age ranges. I think the dynamics of birth order and gender have a lot to do with it, too. So when someone says parents who spank are 'lazy parents,' it really cheeses me off, because my kids aren't the same as your kids. And I'm not the same parent as you. And probably few of our situations and family dynamics are the same. Since those things are all different, why shouldn't our approach to discipline?

For us, I know the spanking formula sometimes works and sometimes doesn't. I think it's an evolving thing, dependent upon their age and the situation. I am hoping we can move past it, because really, it's not like I enjoy it. But again, when you've reached the end of that invisible rope and nothing else is working, a spank might be just the thing.

In the meantime, I've unsubscribed myself from Circle of Moms and will now search for the "Moms Who Feel Spanking is Sometimes Necessary" group instead.

Monday, April 5, 2010

Study: Breastfeeding saves lives, money

A study recently published in the journal Pediatrics  has found - shocker - that breastfeeding saves lives and could save, theoretically, billions of dollars each year, according to a cost analysis.

They call the results "startling," but those of us who have had to buy formula, or are thankful we don't have to, are not surprised. One can alone of that stuff is not cheap. I think the philosophy of most of the nursing moms I know is, if you have 'em, use 'em. Nursing isn't always easy, but once you get the hang of it, it's cheap! Totally free! And so much more convenient than going to the store and buying caseload after caseload of formula.

I don't think, though, that that's going to change the mindset of the formula companies or hospitals/medical staff who practically shove the stuff down your throat when you have a baby. I've heard of so many women who are proverbially beaten over the head with the "Free Formula bag" they feel like it's a do-or-die situation. Or nurses who will feed bottles to the newborn even though the mother expressly said not to (or those who say "Formula is just as good as breastmilk." Hopefully they are rare!) With my third, they were concerned about his 'blood sugar,' but never told me his levels (or anything else), except "His sugars were borderline, so we gave him formula. That's what we do - we don't even ask."

One nurses' assistant while I was in the hospital said, "I don't believe that stuff about babies getting confused between the breast or bottle," and I thought, Well. I'll be sure and call you at 2 a.m. when my son decides he'd rather have formula than me." Try telling that to moms for whom it's been a serious problem and I'm sure they'll tell you otherwise.

Anyway, I digress.

I find the timing of this study interesting, to say the least. National healthcare legislation has just been passed, and I'm sure the government is all about saving money. I know WIC encourages breastfeeding, because it's healthy, of course, but yes - it saves them money - but I wonder how many mothers in the program are nursing. I'm not sure if WIC already does, but I would love to see some initiatives by this group to get more moms to nurse because of those very obvious benefits. That much saved on formula could mean that money goes to another family (or families) in the program who also need it.

Think about it - in the WIC program, I wonder how much money the government is paying for formula alone. It's just an observation - I'm not judging anyone for being on WIC - just wondering out loud how much it probably costs. I bet that's startling.

Sunday, April 4, 2010

A Journey to Homebirth: Part 2

The Story of My Second Birth

When I went for my 6 week post-partum check-up after the birth of my son, I learned that my midwife had been fired by the doctor that she worked for because of “business reasons.”  This is code for she was taking too many of his patients and he was having to pay her too much money (per her contract, she got a bonus for each delivery she did.)

About 15 months later, when I found out that I was pregnant again, I knew that I wanted to have a  home birth.  While my hospital birth experience wasn't bad (I actually enjoyed the actual experience, aside from a few incidences with Nurse Crusty, who the next morning was very kind and patient with us), I didn't want to have my next baby in the hospital.  After all, I wasn't sick.  I had began to view birth as a natural process, not a medical one.

We had the support from the ones that mattered most, our families.  We had found a wonderful, caring midwife.  She had worked in L&D for many years, before becoming a home birth midwife, so I was confident in her ability.  I knew that if there was any indication that there may be a problem, we would be off to the hospital.  After all, that's why they are there, right? 

We did not have the support of all of our friends, though.  One couple, in particular (she is a L&D nurse in a local hospital known for its interventions and high C-section rates) was out-outspokenly opposed to our decision.  She would often tell me stories of how many babies they saved that day from certain death.  I would ask how many of those babies were in distress because of their own medical interventions and “messing” with the natural process of labor.  I never received a reply to that.  They even told us that they would send us on a vacation to Hawaii if we would agree to have our baby at a hospital.

One Wednesday morning in late June, I woke up feeling different.  I couldn't tell you what was different exactly, but I felt like the baby had moved, not dropped, just moved, and I just felt different.

Later in the evening, I took our son for a walk in the stroller.  I felt like I could walk forever.  I was restless, but so was the weather.  Thunderstorms had already rolled through and more rain was on the way.  He and I walked around the little block and continued to just walk up and down the driveway and then played on the front porch.

That night, when I nursed my son as he fell asleep, I could tell that the contractions that I had during nursing felt different than the ones that I had been having during nursing, but they didn't feel like labor contractions.  I hurried up the nursing session and spent some time in front of the TV with my husband.  (Yes, I nursed all through my pregnancy and went on to tandem nurse my baby and my toddler for about nine months.  Pretty radical for a mom who was only planning on nursing her first babe for six months... But that's another story.)

At 11:00 PM, I was having a lot of pressure way down low and it was very uncomfortable to sit.  Being on my knees and leaning on the couch felt really comfortable.  I told my husband that I was pretty sure he wouldn't be going to work on Thursday.  I didn't feel like I was in labor, but I felt different.  I told him that I was going to bed because I was sure that it would be a long night.

Since about the middle of my pregnancy, my Braxton-Hicks contractions would be triggered when my bladder was full.  I spent from about 11:15 until 11:45 PM on the toilet.  I was more comfortable there and could empty my bladder easily.  What I thought was Braxton-Hicks contractions was actually my true labor.  By 11:45 PM, I couldn't tell the difference between one contraction and another.  I wasn't sure if they were coming right after another or if they were double-peaking.  My midwives had told me that I could probably expect a couple nights of labor starting and then stalling a few hours later.  I was expecting this to happen.   I decided to lay down in bed.  It was storming outside and I heard the tornado sirens go off.  I woke up my husband and he checked the radar on TV and the worst of the storms seemed to be to the east of us, near where my midwife lived.

My contractions, and the storm, continued through the early hours of the morning.  I finally agreed to let my husband call my midwife and my parents around 1:30 AM.  He wanted to call sooner, but I wanted to wait to make sure this was the real thing.  My husband was trained and knew the emotional and physical sign posts of labor.  He should have just ignored me and called! 

Shortly after my husband called my midwife, I was back in the bathroom.  I felt my stomach gurgle and thought “I am hungry!”  I know that hunger is an early labor sign.  I felt so discouraged because my labor was so intense.  I felt like that if this is just the beginning, how am I going to make it through the “hard part?”  About 2 seconds later, I yelled to my husband, “I'm going to throw up!  I'm going to throw up!”  I remember that one of the nurses at our son's birth called this the “seven centimeter pukes.”  I was relieved to think that maybe I was actually seven centimeters.

The apprentice midwife that was training with my midwife arrived around 2:30 AM.  It is normally a 20 minute drive, but with the weather it took her about 45 minutes.  She asked how I was doing and I told her that I had already puked.  She checked me and found that I was already about nine and a half centimeters and had a bulgy bag of waters.  She called the head midwife right away.

I was having horrible back labor that wouldn't go away.  All I had learned said that back labor moves down your back as the baby moves lower in your pelvis.  My back labor never moved; it stayed high in the middle of my back.  It would fade a little as the contraction changed and the tightness would increase across my abdomen.  I labored the whole time that I was in bed on my right side.  I tried to move to my hands and knees, but couldn't force myself to move.  The contractions were so intense that I had a hard time relaxing through them.  I had my husband talk me through them several times and also guide my breathing to slow it down.  He  and the apprentice midwife took turns guiding my relaxation and putting counter pressure on my back.  They told me that they could feel the baby move through my back as they applied the counter pressure.  I could feel the baby move in my uterus and could feel its feet pushing back against the contractions.  It was marvelous!  This baby was working so hard to be born!  The apprentice midwife would check the baby periodically with the Doppler and every time the heartbeat was strong and reassuring.  Later in my labor it was noticeably slower; she told me that the heartbeat slows normally as the baby moves lower in the birth canal and all sounded great.  It was nice to be informed about the progress of my labor and to know the natural processes that occur.  The storm outside was powerful and seemed to echo the power of my contractions.  The lights flickered several times and I know at some point my husband went to get the Coleman lantern and an extra flashlight in case the power went out.

My head midwife arrived  just before 3:30 AM.  The storm was still raging outside and my contractions weren't letting up, either.  She later said that it was the worst drive she had ever had to any birth.  After she checked me, my midwife kept telling me to listen to my body, so I knew that I was complete and could push whenever I felt the urge.  Finally, I had what seemed like a one or two second break between contractions (the first complete break that I had) and I knew that my pushing contractions were beginning.  Like my first birth, I didn't get the overwhelming urge to push, but I knew that my body was telling me it was time.  It was a relief to push and be an active participant in my labor, rather than to strive to remain relaxed.  My husband didn't know that I was pushing; he was still trying to coach me through contractions when he told me not to hold my breath.  My midwife told him that I was pushing.  I started pushing at 3:55 AM.  At 4:03 AM, my water broke.  It was strange sensation; a relief in a way.  As I was pushing the baby out, my contraction stopped as it was half-way out.  It was almost confusing having the baby's body half in and half out.  I know I said “Get it out!!”  The baby was born at 4:05 AM.  As the baby was being born into this world, I heard my midwife say, “Hi, Baby! Jesus loves you.”  What glorious first words for my child to hear!  My husband saw part of the cord and her genitals were swollen from the hormones and cried out “It's a boy!”  The midwives had to look again because they were sure that they had seen girl parts.  She is indeed a girl!  All of our “girl feelings” were correct.

My daughter was quiet and calm after birth.  And, as soon as she was born, the thunderstorms stopped.  It was as if God had provided the storms as a cover noise for my son to sleep through my labor.  Her APGAR scores were 9 and 10.  I was amazed at how great I felt as soon as she was born.  The contractions were over and I felt normal.

My baby weighed eight pounds and eight ounces and was 20.5 inches long.  I had no tears.

I called my mom after my daughter was born; my parents were still making the long drive to our house.  My mom could tell that all was quiet and that I was calm and relaxed.  She said “You aren't in labor any more, are you?”  I am pretty sure she thought my labor had stalled out.  I told her that if she
hurried (they were actually only about two minutes from our house) that she could still cut the cord.

It took a while for the placenta to detach and be born.  My baby's cord was short and I wasn't able to nurse her until after it was cut.  (I am not sure why I didn't let them cut the cord.  I know nursing her would have helped me deliver the placenta.  I am not sure where my mind was when I kept insisting to wait until I delivered the placenta to cut the cord.)

After delivering the placenta, and the cutting of the cord, my daughter and I got into a warm bath filled with soothing herbs.  It was a wonderful time to bond and gaze into each other's eyes and get to know each other.  It was amazing birthing her at home.  It seemed so natural.

My labor was just over four and a half hours.  It was so different than my eighteen and half hour labor with my son.  My second labor started right away in active labor, where as my first labor started slowly and gently.  I told my husband several times during my second pregnancy that I thought I was going to have a very different labor.  I think God was preparing me for it. 

After our herb bath, and baby getting measured and weighed, my husband took our new baby girl, all swaddled in a blanket, into our son's room later that morning when he woke up.  Our son saw the baby in his daddy's arms, pointed, and said, “What's that?  A sister?”  God must have been preparing him, too, because we did not know the gender of our baby until she was born, and our son didn't even know I had been in labor.

For me, having a home birth was a beautiful, peaceful experience.  It seemed natural and comfortable.  It was so nice to cuddle in my own bed with my new baby and then later as a whole family.  I hardly have words to describe it.  But, as much as I loved having my baby at home, home birth is not for everyone.  You have to be willing to accept full responsibility for your birth experience.

Many people wonder about newborn and post-partum care when you have a home birth.  The midwives stay for several hours after your birth to check your bleeding, the monitor the baby and to make sure that nursing gets off to a good start.  They also do a 24 hour check, as well as coming back three days and two weeks after your birth to check you and baby.

And, as much as I endorse natural, medicine-free, intervention-free births, I know that the ONLY thing that is important is having a healthy baby and a healthy mom.  To me, this also includes the mother's mental health... her being an active participant in her labor and delivery and her and her husband being allowed to make the choices necessary.  The medical field serves a very important role in the birth of our children; they DO save countless lives every day.

When I have another baby, will I have it a home?  Absolutely.  If something indicated that I should have a hospital birth, would I hesitate to go? Absolutely not.