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Wednesday, March 30, 2011

If it quacks like a duck

The idea of quack medicine has been on my mind lately, particularly after hearing about how thousands of people were scrambling to buy up iodine pills on the US West Coast in the wake of Japan's nuclear disaster. In hopes of counteracting any possible radiation from being absorbed by the thyroid gland, dozens of pharmacies have been selling out of the pills, and there already is a shortage of them anyway.

I started thinking back on a time period in US history where x-rays and radioactive products - sold over the counter and with little, if any, warning label - were all the rage. People would regularly go to shoe stores to have their feet x-rayed, supposedly in an effort to get a "proper fit," and some people recounted tales of how, while waiting for mother to finish her shopping, they would leisurely sit and x-ray their feet over and over again while waiting.

In the 20s and 30s, use of radioactive products containing radium, an element discovered by Marie Curie (that would ultimately cause her untimely death due to overexposure) was extremely popular. People would use radioactive toothpaste - "for that healthy glow!" - the thought is just horrifying. The Radium Girls - who worked in a factory painting the dials on watches and instruments, would soften the tips of their brushes by putting them in their mouths - sometimes painting the stuff on their nails and teeth for some glow-in-the-dark fun.

Of course, the big-wigs at the company knew of the dangers of it; they just conveniently forgot to tell those who were working the closest to the material. Funny how that slips your mind ... (To read more about the "Radium Girls" and the horrific consequences of their work, click here.)

As if the toothpaste wasn't enough, radium face cream was also on the market, complete with a very authoritative looking label and a brief mention of "Dr. Curie," whoever he was. No doubt there was no such person, but hey - it sounded good. How could you go wrong?

Even the ad portrays a creepily-lit woman, with some fantastical wonder cream that you're supposed to put on your face and neck - the very area that absorbs radiation - the thyroid. I cringed. How could anyone possibly think this was a good idea? Truth be told, even scientists who worked with these materials knew little of how dangerous they would eventually be - the notebooks of Marie Curie herself, who had worked extensively with radioactive elements, are still highly radioactive to this day.

The authenticity of these products, and the deadly hazards they posed to unsuspecting customers, is why the FDA came into existence: initially, at least, to protect the consumer. (Some would argue about that part today.)

Most of us today would probably say, "How could people possibly fall for that stuff?" I think it's easy, because they still do. I'm sure the FDA has little power to stop people from marketing all kinds of whacked out concoctions and other things, under the guise of being "natural" and healthy.

My mom is retired, but spends probably hundreds per year on various herbal supplements and other items. While herbs in and of themselves do have some merit, depending on what they are and how they're used, sometimes while reading the labels of her bottles I silently freak out a little bit inside. Bovine thyroid extract? I quickly panic and immediately think "Mad Cow Disease!" Of course, so much of what we use, apparently, comes from cow - so if there was a potentially life-threatening risk, we'd probably (I hope) see it in our population by now. A quick internet search reveals a million sites that are either on the fence or in opposition or favor of it - meaning, you may not be able to get any real, solid information.

Hello - scorched
eardrums, anyone?
Another one that used to really get me was ear candling. My mom did that, too, and excitedly brought home a disgusting bag of flaky-looking "wax." I was immediately skeptical, and while I'm no physics expert, can't even begin to think that would be remotely possible, or necessary. Something about creating "negative pressure" - which essentially means, a vacuum - is achieved while holding a lit candle in a person's ear, as the wax drips onto a plate underneath. Apparently people have been seriously burned (gasp!) while doing this, and I can't think of anything that could create more immeasurable pain than having hot wax dripped in your ear canal. Lovely.

Not much of the remains of ear candling even look like ear wax. As a mom who single-handedly wages a war on boogers and ear wax removal with each of my children, I can tell you (from my experience) that ear wax is usually dark and sticky. And that it will eventually, if left alone, work itself out of the canal. Itself. (Did you hear that part?) Not only that, but if you created a vacuum that strong, you'd probably be in such pain from having pressure applied to the ear canal that you'd likely pass out.

Ear wax is good - we know that. Your body produces it for a reason. Some people, like my kids, produce a lot of it, but in order to produce that much it would probably equal the amount two or three dozen people produce: there is no way that much ear wax comes from one person. If it did, it would be so impacted that it would probably be lodged somewhere inside your brain, and the ear drum would be completely covered. But that's just a guess.

And lastly, one practice in alternative medicine that leaves me skeptical is muscle testing. I had no idea what it was (and still am not totally sure, but my BS Detector goes off whenever I hear about it) until a speaker came to our church to talk to us about it.

Yeah, that probably sounds weird. But his story was even weirder.

His wife was suffering from a dairy allergy or some other similarly uncomfortable issues, and they were urged to go to a "specialist" for muscle testing. At first skeptical, they decided to give it a try. Apparently, it worked.

Muscle testing, from what I can understand, is somehow supposed to tell you what substances your body cannot tolerate, for example, or generally evaluate health by applying force to a particular muscle or group of muscles. The idea is that the patient must resist the force that the practitioner is applying, and the differences in muscle response indicate a "weakness" or "imbalance" in the body.

I agree that your body can "talk" to you - by sending you directly to the bathroom if you've had something with dairy in it that you can't tolerate. If you're allergic to something, you will likely know it by breaking out into hives, throwing up, stomach upset or any number of responses. How is, say, holding down someone's arm going to indicate that she's allergic to milk?

The speaker at our church talked about how his wife made miraculous improvement after having this testing done. She could eat at restaurants again, free of embarrassment! She felt great, physically, at least for awhile. Then something changed.

This normally happy couple began to argue. They slammed doors, he said, fighting on their way to church. Something was happening, and they didn't know what - but whatever it was, it wasn't good.

Somewhere along the line they perceived that muscle testing, and seeking out alternative medicine to cure ailments and what not, was negatively altering their relationship with each other, and, the speaker said, with God.

While that sounds like crapola to a lot of people, I've known plenty of people who didn't believe in God or hold any religious beliefs whatsoever to be very aware of an evil presence. Something doesn't feel right, a voice is telling you not to do something because you think something bad might happen, an omen, whatever you want to call it: just a feeling, or a presence. For as much as people like to discount such feelings in their lives, I knew what this guy was talking about - because I felt much the same way about some of the stuff my mom has been into for years.

Her first foray into alternative medicine left me feeling strange - a negative, heavy presence sort of hung over my head every time she gushed about this that and the other. Having her palm read, seeing a "healer," whatever it was - it left me angry and confused every time. Finally I just rejected it outright and said, if this is what she wants to do, fine - but I don't want any part of it. I couldn't even explain it, but it just felt wrong, and shook me deeply to my core. Was I perhaps, even as a teenager, tuning into something more sinister? Was my mom being used by some negative energy, as she likes to call it, presenting itself as good?

Who knows. Definitely something to consider.

I think it's good to accept that medical technology has given us some wonderful advancements in improving our health. Decades ago my sole treatment for my ulcerative colitis probably would have been steroids, and I'm so thankful there are a host of medications I could take, if needed, that would help me. But I don't think it's safe or wise to become a "Pill Nation" like we have, where we think a pill should be used to treat everything. That mind-body connection is important in our understanding that something in our body doesn't feel right, but it can also be very swayed by the power of suggestion. A good dose of skepticism, in either direction, probably wouldn't hurt.

More reading:
Cosmetics and Skin - A Glowing Complexion
The Radium Girls, Radium Jaw
Eben Byers - died after drinking radium water on a regular basis, for "health benefits"
FDA Takes a Stand Against Ear Candling

Monday, March 28, 2011

Everything I know about parenting I learned from Erma Bombeck

As I sent my oldest child to school before remembering to wipe the snot off his face, I was again reminded how my parenting style is sort of a cross between tough love meets take no prisoners. The baby has been sick, my oldest has been sick, and my daughter - well, who really knows what's up with her. I look at my children and say to them, "Does your mother ever groom you?" Sigh... I could blame it on the time change, which to my body is like the bad crack trip that never was. But sadly, I think that's the way I am in general - after losing my mind to my children almost seven years ago.

"When my kids become wild and
unruly, I use a nice, safe playpen.
When they're finished, I
climb out."
I first started reading Erma Bombeck when I was a teenager, when parenting was the furthest thing from my mind. I have no idea why, but something about her appealed to me - her sense of humor, her no-nonsense, off-the-cuff way of dealing with situations that meant you either had to sink or swim. Some days, obviously, are spent just treading water, so we're somewhere in the middle. I try to explain this parenting philosophy to my husband, who doesn't quite agree with me. Yet.

I have met few moms like Erma. In today's crazy world where people tend to take themselves too seriously, I think that's a shame. I knew one guy whose mother would tell her carload of kids, "If you don't stop crying, I'll give you something to cry about by ripping your arm off and beating you over the head with the bloody stump." Now, that's what I'm talking about! If you said that in public today, CPS would be over at your house within ten minutes, for sure.

I think if Erma were alive, she'd agree with me on certain quirks about family life: like, when you only have one bathroom in the house, count on everyone in the family needing to pee or poop, all at the same time. Conversely, when I get done changing a big stinker of a diaper, I look across the hall to see my daughter sitting on the toilet. What is up with that? I've learned my exclusively breastfed newborn will never fill his pants as loudly as he does during a quiet moment in church. And I can always count on my daughter to announce to her preschool that "Dad has yellow teeth!"

In typical third-child-syndrome fashion, somehow the baby gets put to bed with mashed potatoes on his face and in his hair, forming a sort of stiff resistance when I lovingly try to stroke his hair as I nurse him to sleep. At least I remembered to wash his hands. I remember the days when I would religiously bathe my oldest every two days, doing the math on how many baths per week that was. When the second came along, I probably relaxed a bit. Now it's, "Yeah, you don't stink too badly. Just put your pajamas on already!" We've discovered my daughter's hair is much easier to brush if you take the ponytail/braids out before bed, instead of in the morning when she looks like Medusa. (And there's a lot less screaming in pain, too.)

Erma would probably say, "Never turn your back on your children." Especially when you think they're playing quietly upstairs, when really they're climbing in and out of the bedroom window and walking on the porch roof. Yeah, that. (Another CPS moment)

I wouldn't say my house is a total disaster, just lived in. Yes, there are three baskets of clean laundry to put away that have been sitting there for .... um .... never mind. But at least it's clean. My philosophy on most items of clothing is, "It'll wash!" which is easier than trying to keep a distracted kid from wiping his fingers on his pants. My youngest might be crawling around under the dining room table, looking for old food to pick up and eat. Some days it's all I can do to say a prayer to protect my children from themselves and pray that God picks up where I left off. Most importantly, as Erma has taught us for decades, it's important to maintain a sense of humor - because sometimes, it's the only thing that will get you through the day.

I bet if Erma were alive today, she'd definitely have a blog. And a FaceBook fan page.

Saturday, March 26, 2011

Is brain-damaged mom "still" a mom?

I was reading the news online last night when I came across this article about Abbie Dorn, a woman who experienced catastrophic brain damage during a cesarean section to deliver her triplets. As a result of medical error, she lost oxygen for at least 20 minutes. While the details of the birth have not been disclosed, as a result she is in her parents' care - and the triplets are with their father across the country, after he divorced his wife in the year following their birth.

As others have already said, this case is very reminiscent of Terri Schaivo's, with the exception of having children, of course. Terri was a young woman who also suffered brain damage, and her parents were fighting to care for her, even in her near-vegetative state. Her estranged husband (who by that time had moved on with his life and had a fiancee and children), strangely, had rights to terminate her care and did so, causing her to essentially starve to death after a 13-day struggle. In Abbie's case, at least her parents are caring for her, and I'm not sure why that wasn't the case with Terri.

Abbie's husband feels that their children would be better off not seeing their mother, perhaps alarmed by her compromised state. He is also arguing for child support monies to come from her huge malpractice suit that is currently funding her care. He has reportedly kept them from their grandparents and allegedly hidden pictures of their mother from the children, saying that he doesn't want them to feel guilty about their mother's circumstances because it was their birth that caused it.

According to the article, the grandparents wanted their son-in-law to bring the children to see them regularly, as any grandparent would. Apparently until the four-year-old children saw their mother at the end of last year, he had not done so until that point.

I can't think of anything more sad and pathetic than the father's behavior in this situation. Admittedly there is no chance of his wife recovering the way she was before, which means it totally changes the nature of their relationship. To some people, that's okay, and they will continue to support their spouse regardless. To others, a divorce or annulment is also understandable as they are young and have an entire lifetime ahead of them, perhaps remarrying and having more children. Either way, though, it doesn't change that these grandparents have grandchildren whom they've barely seen, or held, until they turned four.

A friend of mine married quite young, and before he turned 30, he became a widower. His young daughter was barely a preschooler when her mother died, and yet she regularly sees her maternal grandparents in the summer. As awkward as it might be, considering her father has remarried and had another child, he still believes that his daughter needs to have a valuable relationship with her grandparents, as most people would. It seems that only when there's already bad blood existing between the grandparents and parents do the grandparents' rights get terminated or curtailed severely, which makes me wonder about the relationship Abbie's husband had before this even began.

Considering that often when there is a custody problem - say, if the parent is unfit to raise their child - they often place the child with its grandparents. And yet, grandparents have little if any rights in any state when it comes to their grandchildren, even though they are often willing and able, and are an interested, blood-related connection to the child. In this case, Abbie's parents realize that she will never be able to raise her children, but that still doesn't mean she - or they - shouldn't deserve to see them.

Aside from the rights of the grandparents, this issue raises questions for me - namely, the idea of personhood and the rights of the disabled - not to mention the triplets' right to see and know their own mother. The question "what would she would have wanted?" comes up, both in Abbie's case and in Terri Schiavo's. Terri was very young when her brain injury happened, and it's easy to say that a 20-year-old would not want to live with what others perceive as a "low quality of life," which is a relative term, at best. But when it comes right down to it, perhaps Terri would have wanted to live, and be in the care of her parents, surrounded by compassion and people who loved her. I'm sure Abbie would never say, "I don't ever want to see my children," if she could predict such a terrible outcome. Considering Abbie's current state and the orders of the judge (who originally sided with the dad), it's like they're saying Abbie is not really a person with any rights, just because she's severely brain-damaged. She gave birth to these children - how can you even begin to question, "Is she a mom?"

Ironically, when the triplets were allowed to finally see their grandparents last year, lawyers for both sides agreed that the visit went well. So then what's the problem?

Some have wondered just how "religious" the father is that he can deprive the children of their mother, by hiding her picture and refusing to talk about her to them. I'm sure it's painful and uncomfortable, but I don't see how his actions - or the court's - can possibly help this case.

In seeking money for child support from her estate, he's essentially saying, "Grandparents, I'm going to sever all ties and keep your grandchildren from you, but I want your settlement money to help raise them." Had he maintained more of a relationship with them, perhaps he would have been rightfully entitled to some of that money, including probably had childcare support from them. Talk about burning your bridges.

A new trial is set for May 13.

More here:
Judge to Decide if Paralyzed Mother Abbie Dorn Deserves Visitation Rights - Huffington Post
Stand Up for Abbie Dorn - A FaceBook-based advocacy group
Terri Schiavo - Wikipedia article

Wednesday, March 23, 2011

Peggy Vincent: Baby Catcher

After many stops and starts, I was finally able to finish this wonderful book. Baby Catcher (once I got started) was a quick read, and Vincent is a talented writer.

A couple chapters stood out for me the most, namely the first one, about a young black woman named Zelda, laboring with her third or fourth baby. She wanted to do it her way, but doctors and nurses - namely the nursing supervisor, Mrs. Purdue - were adamant that she labor in silence, on the bed. Doctors insisted on injecting her with pain meds even though she was coping well on her own, and one physician, as the baby was being born, finally gassed her - probably as a matter of course, because that's just how it's done, right? It was depressing - and launched Vincent onto her crusade as a midwife.

Fast forward a couple chapters, to where Vincent is assisting in the labor of none other than Mrs. Purdue herself. The wife of a university professor and herself an obstetrics instructor, she was laboring her way, with only Vincent's help. She didn't want drugs, she just wanted Vincent - to rock with her, sway, lean forehead to forehead in a motion of support. She coped with the pain, her way, vocalizing and doing whatever she had to do. Doctors - who were also colleagues - tried to intervene with pain medication, which she refused, and they finally acknowledged, "She's doing this her way."

My mind - and Vincent's - went back to Zelda, who as a young, unmarried, poverty-stricken black woman, was also doing it her way, but there was a clear difference. Vincent noticed the white, affluent, insurance-carrying wife of a professor had the rights to refuse meds and do whatever she liked, on her terms, but Zelda did not. The disparity in maternity care probably exists today, although few women want the natural birth that Mrs. Purdue sought, as Vincent notes. Her eventual return to hospital nursing reveals the differences in care between a home birth midwife and one who works in a labor and delivery unit: more time is allotted with patients at home, and Vincent notes that she often knew the personal lives of her patients; their relatives, children, lifestyles, and on and on. In the hospital, Vincent sadly acknowledges that she saw these women once and it's done, on to another patient.

One story that struck me, though, was the one about a home-birthed baby with clubfoot. Vincent, in her shock, tried to hide the baby's feet, but the mother knew better and immediately suspected something was wrong.

As a mother of a child born with clubfoot, I can relate on some level. As someone who was also born with severely clubbed feet, I wondered if this was how they treated my mom when I was born.

When I was born, my dad immediately came to her and said, "What's wrong with her feet?" My mom had no idea what he was talking about, which meant they had come to my dad and told him first before even telling my mom, perhaps in a measure to shield her from grief. It was my dad's worst nightmare confirmed: he had passed the "defective" clubfoot gene onto his child, and he felt terribly guilty about it. I was in casts for almost a year before having surgery.

Although ultrasound was not obviously a perfect science when Vincent delivered this baby, we knew ahead of time that my son had a clubfoot. While it was a big deal to us, we knew it wasn't life-threatening and were hoping for the best. Vincent may have been correct in her assumption that the baby's feet were really that bad. Who knows. I remember watching A Baby Story (gag) and was shocked out of my chair to see a baby girl with what looked like mildly clubbed feet, and an overzealous orthopedist who was scheduling her surgery at three months old. "No!" I practically screamed at the TV. I thought of the elderly Dr. Ponseti, who in his 90s, was still practicing orthopedics and employing his Ponseti Method on countless children, likely sparing them surgery that often causes pain and arthritis as the patient ages. I look at my own feet and wonder what could have been sometimes, but it's hard to say.

One thing I noticed in the book was the dad's comment about the foot not responding to gentle, or firm, massage. Perhaps the baby's feet were really that bad, and perhaps a gentler technique could have been employed; it's hard to tell. One thing I do think, though, is no parent is going to want to perform that kind of correction, however necessary, on his own child's feet. An objective, third-party orthopedist would likely have much better luck, simply because he's detached - it's not his kid. They suspected at first that it was positional, but in my experience those cases are rarely treated with surgery and can be manipulated rather easily.
Dr. Ponseti working his magic on a young patient.
(Photo: University of Iowa)
I thought back to our course of treatment on my son. He was casted while still in the hospital, and my mom watched as the doctor manipulated his foot into place. The baby cried, as any baby would that's having its' feet touched. My mom said the orthopedist wasn't necessarily being rough, but certainly wasn't gentle, either. I'm glad I wasn't there to see it. In my drug-induced state, I don't even remember seeing my son without a cast, and wished they'd just been upfront with me about it rather than trying to hide it from me.

When we were pregnant with our daughter, we saw on the ultrasound what appeared to be two very clubbed feet. While we were anxious, because we knew the family history, and the fact that while it's more common in boys, it usually affects girls even worse. We knew what we had to do: our son had been casted right away and then moved into corrective shoes at 8 weeks old, which is when correction should be complete, ideally. By five months, I knew his foot still wasn't in the right position, so we sought a second opinion and had a minor surgical procedure performed so his foot could be flat on the ground. I figured that while weekly orthopedist appointments were a huge pain in the butt, it wouldn't be too terrible since we'd been through it before.

My son was fitted with boots and bar
much like these. He wore them 23 hours
a day until he was about two years old,
and then only at nighttime after that
for about a year. 
Since our doctor had practiced the Ponseti Method on our son, it required regular manipulation of the foot and serial casting to hold the correction, which would be an alternative to surgery. The technique, which Dr. Ponseti had developed in the early 1940s, was often performed on pediatric patients by the doctor himself. The dude was ancient, respected and well-loved across the nation by parents and kids alike, who had been spared multiple, disfiguring surgeries because of this low-tech technique.

When we told my father-in-law, a retired orthopedist, about the baby's feet, he was skeptical. "I would just schedule the surgery," he scoffed. "I wouldn't even bother with that Ponseti stuff."

Boy, was I pissed. There was no way, I told him, that I would subject my daughter to a surgery that might not even be necessary. (Turns out it wasn't at all, because her feet were beautifully perfect when she arrived into the world.)

His reluctance to accept non-surgical technique reminds me of the medically-minded birthing community: why do what Mother Nature can in her own sweet time, with a much gentler approach, when we can get it over with more quickly? In their minds, science is better, faster, more efficient. Because it's available, we should use it, and use it often - whether it's needed or not. Because it's there.

While this isn't a pregnancy and childbirth book, I would almost consider it suggested reading simply for the perspective: births that are crazy, unpredictable, beautiful, and normal. Those kinds of tales never get old.

Sunday, March 20, 2011

Natural Childbirth Videos: A safe place to share!

A few weeks back several people, including myself, shared a link to a French natural childbirth video, provided by the Navelgazing Midwife's FaceBook fan page. It got quite a bit of attention, and of course, FaceBook pulled it. (I'm sure the still photo of a woman completely naked with legs spread, birthing her child with an expression of glee, didn't help.) I searched my page and couldn't find it, and even did a Google search, with no luck.

Now the video - with a different still shot for the link - has resurfaced on Birth Without Fear's FaceBook fan page. Before someone decides to pull it again, here is a link so you can watch this tremendous process unfold for yourself - on land, under water, with support from partners - without worrying about it suddenly 'disappearing.'

Maybe not for the faint of heart, but overall I think most of you will enjoy watching some incredible births take place.

(I tried to directly import the video into Blogger, but of course it wouldn't let me, so you'll need to click on the link and view it in that application. Sorry.)

If you have others to share, please e-mail me or write me on FaceBook.

Monday, March 14, 2011

Your (Fearful) Pregnancy, Week by Week

Consider yourself warned.
If you want to witness fear-based obstetrics at its finest, check out this book.

Seriously, one reader commented that it was the "most fear-based book I've ever's the only book I've ever put into the trash in my whole life."

Wow. Was it really that bad? I wondered at first. I checked it out from the library and decided to find out for myself.

The first thing that really struck me was the little callout box on the cover: "The Only Best-Selling Guide Written by a Doctor - Millions of Copies Sold!" I was immediately skeptical. To the unsuspecting pregnant woman, that's supposed to mean, "Everything written in this book is true, because it was written by a doctor."

There was also a nifty quote featured from Dr. Elizabeth Warren (should I know who that is??):
"The primary book I recommend...I know I can trust it. It's organized, up to date,  and provides women with terrific information."
Surely you're joking.

As far as being up-to-date, that's only as good as the copyright date, so there's not much I can say about that. I had a good chuckle when she said it was "organized" - in that case, I think either Dr. Curtis (the author) or his editors were smoking something, because that's one thing I noticed about this book: it seemed very willy-nilly and strange in that respect. In one paragraph we're talking about testing and procedures to baby's presentation to bug spray and its bad side effects. Then we jump from TB and lupus (even Mad Cow disease! As if you didn't have enough to worry about while pregnant!) to "How much does having a baby cost?" I thought my head was going to fall off.

I don't want to sound crazy or all conspiracy theorist, but I think this book is full of lies. (Lies! They're all lies, I tell you!) Or at the very least, it's lying by omission.

Why do I think that?

Lie #1: When it comes to the biggies, like VBACs and cesareans, Dr. Curtis (who's first name is Glade, which makes me automatically think of a stinky bathroom and a can of air freshener) spends little time discussing the risks of repeat cesareans. He also spends blessed little time emphasizing how those risks can essentially be mitigated by having a VBAC. Not surprisingly, he prefaces elective cesarean as "patient choice," but most of us realize that the mother agreeing to a cesarean simply because her doctor made it sound like she was going to spontaneously explode without one doesn't exactly equal "choice." At the end of the day, we know that many women have little, if any, choice in the matter at all.

Dr. Curtis makes a glaring discrepancy by not really mentioning how repeat cesareans can impact future pregnancies, which is probably why conditions like placenta accreta are on the rise. Curiously he mentions a product called ON-Q, a system of medication delivery that administers pain medicine to just the incision, rather than the entire body. While it sounds interesting, I wonder how many hospitals use it -and the words "Ask your doctor about it at one of your prenatal visits" makes me think of a drug commercial (shameless product plug here!). Is he basically saying, "Just in case you have to have a cesarean - and many women do! - you should be preparing yourself for it. You know ... just in case."

One thing I can't stand is the assumption that just because you want a natural birth/VBAC/something other than the "norm," it "might" fail. It's like tearing you down before you even begin. Conversely, I also don't really like the idea of saying "I will have a vaginal birth!" because really, you don't know that either. It's important to have confidence in yourself, yes; but we can't be too presumptive, either.

Lie #2: He sets you up for more pessimism and failure later: "but you might need another c-section anyway" (with regards to a diagnosis of CPD). You might as well add, "So you should just skip your stupid, lofty plans for VBAC and just have another section." Again, we hear "Not all hospitals permit VBAC nor are they equipped for it." If they're not equipped to handle a VBAC, then why are they delivering babies at all?

Lie #3: You can't eat anything more than ice chips in labor. I think even the recent studies were published by the time this edition came out (2008), yet they're still promoting starving a laboring woman. If your hospital insists on nothing by mouth, know that they're basing their findings on a very outdated study done in the 1940s that suggest women who have food and drink in their stomachs *might* aspirate it should they need anesthetic. I'm hoping, as I'm sure you are, too, that methods of anesthesia administration have improved dramatically since that time, and that your risk of aspirating is even lower than it probably already was then. Should you experience a long labor, light food and fluids (notice I didn't say turkey dinner with dressing and four gallons of pop) is going to give you essential energy to stay strong throughout. Dr. Curtis doesn't mention any studies (or anything else, for that matter) other than hospitals won't let you eat and drink (and really, some do, by the way) except that "it's for your own safety." (So don't worry your pretty little head over it, okay?)

Lie #4: "Avoid anxiety-inducing TV programs." Unless he's talking about Law & Order, I'm assuming he means all those insipid "reality birth" shows that are cropping up. I can't argue with him there, except for a different reason: I haven't seen one episode of "A Baby Story" that's even remotely realistic. Ditto on "One Born Every Minute" and all the others. So yeah, you'd be best to stay away, but not for the reasons he's thinking, I'm sure.

He also suggests "be careful of what you read on the Internet." You know, because those crazy bloggers that talk about natural childbirth all day (and give this book bad reviews) might give you some empowering information that might convince you that you can have a different experience than what Dr. Curtis thinks you should have. Seriously? I will admit, there's a lot of crap out there on the 'net about birth - both natural and medicated - that should be taken with a grain of salt. But there's also a lot of good information out there, and anyone who wants the trust and respect of their readers will provide reputable links that encourage you to read up on your own. Most blogs I read will have a blog roll of other birthy links for more info, and they come from some very well-respected, trusted midwives (and other sources). You're going to have a lot of pro- and anti- information thrown at you, but I really hate how he almost makes it sound like all the crapola and nonsense comes from pro-natural birth sources. 'Cause we all know there's some real shi!t-slinging going on from the other side too, don't we? (cough)

As far as natural birth philosophies, he does mention the big ones: Bradley, Lamaze, and hypnobirthing, to name a few. But it's almost like there's an invisible asterisk beside the paragraph that seems to say, "You can try these, but don't expect them to work." Some of them, according to Dr. Air Freshener, are best taken "before you get pregnant." Why? I'm completely puzzled over that one. So you'll be sure and forget everything you've learned by the time you give birth?

Lie #5: Diet is everything! Ok, it doesn't really say that, (actually, I think it says "Be vigilant about the foods you consume") but I swear - almost every time I flipped through this book my eyes fell on something about weight. Food. BMI. Desserts. Most of us realize that we shouldn't necessarily eat like there's no tomorrow when we're pregnant. But there's a hazy theory surrounding that: I'm not saying it's a good idea to eat with reckless abandon, but you need to enjoy yourself while pregnant, too. He actually says something like, 'At parties, you should avoid the dessert table if you think you're going to overeat.' You know, hide behind that big potted palm tree in the corner, you pregnant woman, because you don't deserve to have even one ounce of cake/cookies/or anything. If you sneak one hot dog or forget to microwave the cold cuts, it will go on your permanent record! (There's even a handy chart towards the back, so you can neurotically keep track of every ounce gained.)

We are not robots. Obviously cravings will overtake many of us while pregnant, and weight gain is just one of those things. Some women eat a reasonable amount of food and watch their diets and still gain a lot of weight. Others do not. Because if you're just harping on diet because of the "big baby" scare, well don't even go there, Dr. Curtis.

I'll admit - when I gave birth to my youngest, I was heavier than I'd ever been. And he was my largest baby, at 8 pounds 7 ounces. Woo. That's huge. Right? While you probably shouldn't be eating yourself into a food coma at every meal, neither should you feel like Dr. Curtis and the Pregnancy Food Police are going to come knocking on your door - with Heidi Murkoff bringing up the rear.

Lie #6: Vaginal exams are necessary. He goes on and on about how important they are to "assess" the pregnancy towards the end, such as baby's station and positioning, etc. etc. I will admit, during VE's two of my doctors were able to tell that my babies were not in the vertex position. (even with external palpitation, one doctor was also wrong) Aside from that, though, unless you're 35 weeks and in preterm labor, most people argue that they don't really tell your doctor anything. They sort of make him (and you) feel like he's doing something, and he is, all right: if you're not progressing, it gives him more of a reason to badger you into scheduling an induction because you're one day shy of your due date with no cervical changes whatsoever. You're already thinking about lupus and Mad Cow disease, who needs that on top of everything else??

Lie #7: Homebirth is dangerous. Dr. Curtis, bless his heart, devoted probably what amounts to an index card-sized space to tell you one thing: That home births are incredibly dangerous. (Actually, he prefaced it in the form of a question: "Are home births safe?" His answer: "NO!"in bold letters, just like that.)

I'm of the belief, like many people, that they are not safe for some. And perfectly safe for others. If you have access to good, quality care and are well-informed about the subject* then perhaps yes, home birth is safe for you. But for him to assert his opinion, essentially, as fact - well, that's just wrong. This book is more supposed to inform women about pregnancy and answer some of their questions, not start a firestorm of debate on whether you personally think it's safe, Doctor. Because there are many physicians who disagree with you on that one.

(*As for as being well-informed, I suppose that goes back to all that natural birth crap you read on the internet, right? Honestly, this is one of those murky areas that even the best natural birth/home birth advocates take issue with. This is your right as a childbirthing woman, and only you can discern whether you've gleaned enough - or the right - information in order to make that decision for yourself and your baby.)

Dr. Curtis goes on about how ACOG says this that and the other as far as the safety of homebirths, which is a dicey subject in and of itself. However, ACOG also says that it's safe for some women to have VBACs after two cesareans, but I don't see him jumping on that bandwagon. Know, ladies, that sometimes doctors like to pull out the ol' "ACOG says this!" about some things, yet completely ignore what they say about other stuff.

His pitiful, anemic take on home birth is probably the biggest stick-your-finger-in-someone's face judgmental BS ever, probably because it's written by a doctor who happens to think he's your boss, and that his opinion is the be-all-end-all on the subject. Let me tell you: whatever your stance, you deserve better than this!

At least he does suggest a birthing center, but you'd be hard-pressed to find one, depending on where you live. I live near an international border, 20 minutes from a major city, and there are no birthing centers where I live. That, in and of itself, severely limits your choices, and if you're also like me and live in a semi-rural area, you know that your choices are even more scarce. This is what Dr. Air Freshener, and many others like him, don't get.

This book is billed as "authoritative." Honestly, I'd call it more authoritarian than anything else.

Friday, March 11, 2011

Little birth on the Prairie

Although I can't be certain, I wonder if there's a
baby under there somewhere?
Most of you know that I am a total Little House on the Prairie freak. A few years ago, I went on an eBay crusade to buy all the books in hardcover, because I find it a valuable collection to have and want my kids to have something nice to hold on to. I still have a hard copy of The Long Winter that my dad gave me, complete with a "Herself the Elf" bookplate in the front, my name in 9-year-old scrawl. That and because it was something my dad gave me, I wouldn't trade that book for anything. If your teacher, like mine, read Farmer Boy to you in third grade, you probably remember drooling over the descriptions of food in Almanzo's childhood. And so a love affair began.

(Interestingly enough, Laura's grandparents were married somewhere up over the hill from my house, and Laura's grandmother was born in that area [even though some dolt who wrote a Wikipedia article on them says she was born somewhere else. Dude, you're wrong.])

Anyway, I digress.

When I read the last book in the series, The First Four Years, (after reading them in chronological order, of course), I came to an interesting, if not inevitable, scene where Laura gives birth to Rose, their first child. I don't know how it was portrayed in the TV series (haven't got there yet, I'm only in the middle of season four LOL). Now, most Little House fans speculate over the authorship of the books, as it's commonly believed that Rose helped Laura write the series in her old age. I would say that might be true of the books that cover Laura's childhood, which by the time they were written were a distant memory to an aging Laura. Childhood memories are one thing; childbirth, when you're a grown woman, is quite another. When reading Years, I could tell the tone was different than the other books, and found out later that this book, in its rough manuscript, was published after Laura's death when they found the notes among her things. This probably explains the straight-foward birth scene: no elaborating, definitely no dreamy, 'strong pioneer woman' characterizations that one might expect. Yes, she did have pain relief, if you're wondering, and yes, her birth was at home - attended by her mother, another woman, and a doctor. Not a midwife.

Most people often wonder what birth was like back then, and I thought it was an interesting glimpse. It's not like she wrote every detail down and talked about the placenta and contractions and all of that; there was a level of modesty, I suppose, to talking about birth (or anything female-y) in those days.

Before she talks about the birth, she mentions the weather - it was December 5, and a rare nice day. She mentions sled rides and climbing hills and all that stuff, but on this day, Laura is "quiet," which worried her husband. She wanted to sit by the fire and rest - and soon it's time to call the doctor. Labor is approaching. No hill climbs for Laura! LOL

Manly (Alamanzo) goes to fetch the doctor, telling Laura, "Keep as quiet as you can until we come." Why? Laura's no dummy - after he leaves she "walked the floor" until he came back.

In all of my children's births, I paced. It was comforting, a pace that was steady and predictable and helped me to cope.

When Manly returns with her mother, Ma scolds Laura for being up and around. I think Laura was just going on instinct - after all, there was no Ina May's Guide to Childbirth back then, and even that book shows women in Laura's day coping with labor pains. Ma says, "I'll get you to bed right away."

Laura responds, "I'll have a long time to stay in bed. I am going to stay up now as long as I can." Smart girl. Perhaps her instincts were telling her to keep upright and keep moving, two things that can help speed labor.

However, the book goes on: "Soon she made no objections and only vaguely knew when Manly drove away again to fetch a friend of Ma's from town." Was she inwardly focusing? Coping with the pain? Or was it becoming too much for her? One thing's for sure: it probably didn't help her once she got in bed and couldn't move around.

Once the "friend," Mrs. Power, shows up, she assesses the situation. Laura is young, she says, and that's an advantage. But Mrs. Power decided it was time to call the doctor - one only wonders how many children she's had. We know that Ma had five - four girls and one boy who died after birth - so you'd think these women would not be all about the pain. Did they tell tales of horrific births like women do today? Were they already, at this point, victims of labor myths and abnormal childbirth?

When Laura could again see and know what went on around her, Ma and Mrs. Power were standing one on each side of her bed. And was that Manly at the foot? No! Manly had gone for the doctor. Then were there two Mas and two Mrs. Powers? They seemed to be all around her.
 She was being borne away on a wave of pain. A gust of cold, fresh air brought her back and she saw a tall man drop his snowy overcoat by the door and come toward her in the lamplight.
She vaguely felt a cloth touch her face and smelled a keen odor. Then she drifted away into a blessed darkness where there was no pain. 
And no awareness or memory of your first child being born.

A rather insolent-looking Rose
The first thing that struck me after reading this passage was how women can give birth while unconscious. At some point, the body will push that baby out whether you like it or not, but with the incredibly inane idea of directed pushing, few women get to that point, it seems. Because I'm sure some people are wondering how a woman can give birth while not even awake, one can probably presume she had a forceps birth, no doubt what Laura was anticipating when she said "I'll have a long time to stay in bed." My own mother-in-law gave birth this way in the early 70s, in a high forceps birth (which is considered dangerous nowadays), and said she couldn't sit without pain or discomfort for probably a month.

The cost of the attending physician and birth was $100, which was a precious sum to the Ingalls in those days. No mention of a midwife, which is sort of unfortunate. And hospitals? Too far away, too expensive, and probably only a place you went if you were on your deathbed.

Laura did have a second baby, a son, who was, according to the book, born before the doctor got there. For many women, future labors are faster than the first one, and I'm sure Laura wasn't as scared now that she knew what to expect. She doesn't say much about the birth, and doesn't even mention the child by name at all. Perhaps it's a reflection on her feelings at the time it was written; maybe women knew not to grow too attached to their babies because of the high newborn mortality rate in those days. I found this passage strange, if not telling, of Laura's almost indifference towards her new baby:
Laura was proud of her new baby, but strangely she wanted Rose more than anything.
It almost sounds like Laura was going through some postpartum depression to begin with, obviously not helped by the fact that shortly thereafter the child dies. Apparently, even though he was almost a month old when he died, he was never given a name. day three weeks later when the baby was taken with spasms, and he died so quickly that the doctor was too late.
To Laura, the days that followed were mercifully blurred. Her feelings were numbed and she only wanted to rest - to rest and not to think.
I do wonder if there were some bonding issues between mother and son - Laura and Rose were very close and she was very protective of her, which you could expect her to be - but almost to a startling degree. I've also read that Laura was bossy and somewhat difficult to get along with in later years, and that she and Rose were often at odds with each other. (Rose later said she herself had what is now considered bipolar disorder.)

Interestingly enough, Laura's mother lost a son a little over a year after he was born. The TV series talks about this in the episodes "The Lord is my Shepherd" but the book series doesn't mention it all. Not much is known about the baby's health, but some speculate that he was suffering from a hereditary metabolic disease and failure to thrive, which is discussed in the show - the baby is not satisfied with breastmilk and chugs down cow's milk from a bottle, much to the family's wonderment (I don't find this story line much of a coincidence, considering the still somewhat negative attitudes about breastfeeding then). He fails to put on weight and dies within a year.

One of the sources I checked states that the baby died from diarrhea, which could come from any number of illnesses that were quite common in those days (one of the book details the family's bout with malaria).
"Laura herself said in her writings that he was 'taken with convulsions,' and a few days later he 'straightened out his little body and died.'"
Laura's lovely little writing desk
Although we can't really tell, I often wonder why the Ingalls sisters (minus Mary, who never married) never had children. In those days, all the children were born at home, and perhaps the girls were frightened by it?

Rose herself had a son - which most conclude was either stillborn or died shortly after - resulting in what sounds like a hysterectomy. She was a free spirit much like her father, and traveled the world as a reporter and writer.

I'm curious what either Laura or Rose (who was once considered one of the highest-paid female writers in the country) would be like today: mommy bloggers? Moms who vent about their trials and losses, sharing and enduring with hundreds, if not thousands of readers? Would we be reading "Little Blog on the Prairie" now instead?

I think I am going to go read. :)

Wednesday, March 9, 2011

Ina May's Guide to Childbirth (the *real* girlfriend's guide)

* Now, obviously I am a natural/normal birth advocate, so it's obvious that I'd be more likely to pan some books over others. I'll admit my bias and yet try not to get caught up in too much "woo." Just putting that out there. :)

In light of my last post on pregnancy/birth books, I decided this is the book a true girlfriend would give you if she really loved you. I first discovered this book when I was on the verge of delivering my second child. I was attempting a VBAC, and don't even remember where or how I heard about it - but once I started reading it I was immediately interested. Ina May Gaskin, much like The Navelgazing Midwife, Barbara Herrera, sounds like the kind of midwife you could trust to be open, loving, and more importantly - honest. Infallible and perfect; no - no midwife is. But someone you could trust to completely care for you to the best of her ability, yet call it as she sees it.

Before I even get into the book, take a look at Ina May's website - which has some impressive stats of the births she's attended while at The Farm, her "birth center" in Tennessee. Apparently she is well-esteemed within her local birthing community, even by obstetricians - which for a midwife is saying a lot. (I know there are lots of good doctor-midwife relationships in the medical world, but all things considered, most OB's will look at midwives disparagingly - even excluding them from their practices or at hospitals altogether.)

Ina May's stats - and her book - tell me that she must be doing something right, and has faith in the laboring woman! Among low-risk women over a thirty-year period, her rate of cesareans was ridiculously low. What hospital can say that? Obviously this is a picture that illustrates one thing: normal birth can work. It's clear that Ina May's insights into birth provide a glimpse that few other pregnancy and birth books outside the NCB circle provide - especially one that's not based on fear of birth.

Ina May's Guide has some amazing, empowering birth stories, which are always a fascinating read. Many of the mothers, I feel, give accounts that seem to show how inwardly focused they are, concentrating on their births and the process that is happening within them. It's often said that when a woman gets into the "zone" of labor that she should not be bothered, and yet some books seem to categorize this phase of labor as negative and a sign of the laboring mother losing control. Much like people who have witnessed animal births know that animal mothers don't like to be touched, moved or approached in any way, I think of it in kind of the same way with some laboring women: they need to be left alone, unless they request something else, to just go inside themselves and focus on getting the baby out, a process that ideally shouldn't be met with cries of "Push! Push!" and idle talk and chatter from attendants.

Interestingly enough, in probably every story, the women mention vaginal exams from the midwives. Not excessive ones, but one or two during the course of labor to determine progress. But obviously nothing about it suggests repeat checks every hour on the hour, and no harshness or disrespect that sometimes accompany a hospital birth. Many of the women mention the loving, caring atmosphere from the birth attendants, and being in strong, capable hands of people they knew they could trust implicitly.

Some of Ina May's ideas greatly impressed me when I first read this book, namely how much our fear (or lack thereof) can sometimes dictate our actions in childbirth. I thought back to my first birth, and how I knew I was going to have a cesarean anyway, but was scared something would happen before then (my baby was breech). I was breathing uncontrollably and my husband was busying himself at the monitor by telling me "that was a big one!" when the contractions showed up, which didn't help in the slightest. I was letting the pain and fear take over.

Ina May recounts the story of a woman laboring in a hospital under the care of a resident, who is horrified when her baby presents face-first:
"...[the resident] was not good at hiding his horrified expression when her baby's head parted the lips of her vulva. It seems that the baby was coming face-first, and it was the first time the resident had seen this (usually the top of the baby's head comes first). He imagined that he was seeing some horrible defect. His facial expression terrified the mother, who instantly felt her baby retract inside her body with such force that one of her ribs cracked."
I don't doubt it. When most of us are trained to see doctors as bastions of calm and collectiveness, it can be unsettling to see through their body language that something might be wrong (even when it isn't).

Ina May's Sphincter Law is a popular theme in the book, explaining how some women can literally clam up when a rough care provider is examining them. Not only are the frequent hospital examinations excessive, but are often done in a less-than-gentle way, especially if mom is already uncomfortable with the idea of a strange doctor delivering her.

She mentions this in relation to directed pushing, when the mother is literally ordered to start bearing down simply because she is dilated. If there is one thing I wish I could change about my VBAC delivery, this would be it: I would push when I was ready to, not when they are.
"Those who have never felt what it is like to give birth while being shouted at can better understand how this can interfere when they try to imagine what it might be like to poop while a stranger stationed a few feet away yells at them how to do it."
Kind of puts that whole thing in perspective: no, pushing out a baby is not like having a bowel movement. You know what's going to happen when you try to go and don't have the urge, right? Why should this be any different?

Ina May also mentions something very important: that a rough exam performed by someone with a less-than-pleasant demeanor (say, an OB who is ready to go home for dinner or is impatient to catch his flight) can actually cause reverse dilation of the cervix. Ina May recounts the story of a patient who was transferred to the hospital because of a bladder infection that was keeping her cervix from dilating past seven centimeters. Upon a rough examination by "an obstetrician who was rather sullen and unfriendly in his manner," he noted that the patient was only four centimeters. Ina May noted that after that encounter, the mother's labor "never reestablished itself after this obstetrician's rude internal examination, so this mother's baby was born by cesarean."

There is a very informative section on pushing positions, as well as illustrations that depict women of various cultures in different positions while birthing. Not surprisingly, few, if any, of the other books I've read so far mention anything about changes in position to either aid in the baby's descent or birth the child. In fact, as far as alternatives to the typical lithotomy position, I don't think they mention it at all. (With one exception: What to Expect does mention changes in positioning, but doesn't really elaborate much on them, that I remember.)

Pushing in the lithotomy position, or flat on your back, has been in fashion for probably a few centuries, at least in Western cultures. While most people think it's necessary, really the only reason it's used is for the convenience of the physician. "By the end of the nineteenth century," Ina May notes, "birth chairs were rarely used any longer." She adds that squatting in labor, which actually helps to open the pelvic outlet, was something considered "low-class."

She includes a passage from physician George Engelmann, written in 1882:
"At every pain she made violent efforts, and would bring her chest forward. I had determined to use the forceps, but just then, in one of the violent pains, she raised herself up in bed and assumed a squatting position, when the most magic effect was produced. It seemed to aid in completing the delivery in the most remarkable manner..."
It sounds like this lady was prompted by sheer instinct. As Ina May says about a patient who flipped to the all-fours position while laboring, "women often make this choice spontaneously." If they're allowed to.

Even Engelmann realized this, in his now-obsolete book Labor Among primitive Peoples. He, too, realized the importance of positioning during a mother's labor:
"If we wish to obtain an idea of the natural position we must look to the woman who is governed by instinct, not by prudery." 
(He does go on to mention women of "savage races," who we can assume are too uneducated or "tribal" to be worried about how their hair looks or if they look "lady-like." While it sounds blatantly discriminatory, I've often thought poorer, less educated laboring women I've read about in birth cultures were luckier than they realized: they were left alone to labor, and often chose medication less often because of physician distrust. Because of their lack of social standing and inadherence to societal customs of the day, they probably had easier labors than their elite counterparts.)

If you're interested in normal birth - not even completely "natural" birth, which can be defined in many, many ways - you need to read this book. Not only to see that yes, it is possible, but that there is definitely something different out there that's worth exploring. So much of the innately beautiful physiological aspects of birth are ignored, covered up with medication and interventions, when they don't even need to be.

Saturday, March 5, 2011

The Demise of the Disco Kitchen, Part 1

Yes, those are macaroni noodles on the floor. 
I've decided that lately some of the topics I've been blogging about have just been downright depressing. That, and really - I do talk about things other than birth. I've also decided that sometimes it would be a lot easier if I could turn off Professional Writer Mode in my brain once in a while, and not write everything in 'advertorial' voice. Kinda like peeling off those pantyhose at the end of the day and putting on sweats, finally. Ahh!

I told myself I would write about anything that affected me as a wife, mother, as a woman. I think ultimately most women want a nice kitchen, at least I know I do. An ongoing thorn in my side, the Disco Kitchen, as I call it, the culinary hub of my home, is about to get a bit of a facelift.

Notice I say a bit. Not a big one, I guess. But yesterday I was informed that that damned linoleum floor is going to be ripped out.

The heavens are singing! I can feel the vibrations!

After my husband had to swallow his pride and give in to the idea that they weren't going to rip it out and start fresh (which is what the maintenance guy in charge said he would do if it were his home, thanks for letting us know), but rather just cover it up, we've decided okay, fine - just get rid of it. We don't care how you do it. We're so sick of looking at linoleum that predates us that we're happy to get it over with already.

The house we live in was built as the Presbyterian manse, to house the pastor, in 1906. My husband's employer purchased the house in the late 80s from the church, and housed faculty in it. Not surprisingly, it is predictably Presbyterian throughout - with the exception of lovely hardwood floors throughout. Or at least, what would be hardwood - had it not been covered up with circa 1950s-style linoleum. I was hopeful that perhaps no, the maintenance department was wrong in telling me that there was no way the floors could be restored, that no, you wouldn't really need a hydrogen bomb to ply the stuff off.

Once I realized there was no hope, I stewed over it as I sat in church - the same church that used to own "our" house - and stared at the backs of blue-haired ladies wondering, Which one of you was it? Which one chose that crap to cover perfectly good hardwood floors?! I wanted to know. Now.

To further pour salt in my wounds, a woman from church came over and said smugly, "Yeah, I remember that floor." I figure I was must have been about six when that decision was made.

My precious wooden floors - which really aren't that precious - are probably the nicest feature of the house anymore, even though I can see through to the basement in several spots. There are holes drilled (which I've seen in another old house as well) which are no doubt to run TV cable through - my kids love to stuff things, like cereal, down the holes until there's a big pile of Kix on the basement floor. As probably only the third family to live here, we had to wait several weeks before the last guy - who rented a dumpster, he had so much crap to throw out - gathered his belongings and left for Greener Pastures. When I went inside for a quick peek, I was horrified: plaster coming off the walls, dingy paint, and that stupid disco flooring. The kitchen looked like a cave. Not that I minded their eclectic taste in furnishings and old movie posters, but honestly, a good cleaning wouldn't hurt. And it doesn't say a whole lot when the maintenance department was never allowed in. For 20 years.

Like most women, probably, I daydream about the wonderful renovations I want my kitchen to undergo. Knock a wall out here, add on there. A sun room, a play room. A kitchen that's functional. Nothing too fancy, just functional. Because right now, the state of my kitchen would be enough to make Paula Deen's butter turn rancid.

Last night I battled while making 8 pounds - 60+ servings "for a couple hundred!" people - of pasta. Elbow macaroni were everywhere, on the floor, a serving ended up in the sink. As I chopped celery by hand, a giant Tupperware container fell off the top of the coffeepot into the middle of my cutting board. I flung it on the floor. This never happens to Giada DeLaurentiis. I pictured Ina Garten's sleek, pristine kitchen island. I want one of those. It doesn't have to be stainless, or granite - just something other than an old table whose leaves are so warped that everything you put on it slides off onto the floor. (At least dirt doesn't show.)

So, Disco Kitchen, your days are numbered.

Friday, March 4, 2011

First membrane sweeps without permission, now cesareans

I know I'm supposed to be working on this dreaded pregnancy book series, but something else got my attention: the other day someone posted a link to the VBAC support forum on BabyCenter, where a mom had been denied a VBAC and had a "horrible experience":

Before the monitor was even plugged in, we were told that we were going to be moved to the OR "just in case" while being monitored more closely.  The midwife had called an OB to consult & we expected to meet him in the OR. 
On the way to the OR, my husband was sent to a dressing area to change into scrubs & I was sent straight into the OR.  My husband & I were seperated. 
As soon as I reached the OR, the staff began prepping me for surgery.  I stated that I did NOT want a c-section.  I demanded to see my husband and stated that IF I was to receive a c-section my DH & I would make that decision together.  I was told that my husband was on his way.  I was also told that my baby needed more oxygen & I was told to breathe deeply in a new mask because it had a better seal on my face (the oxygen I was breathing before was thru a smaller mask).  The new mask wasn't oxygen, I was gassed against my will.  I am unaware of what was done to me from the time I was gassed up until I awoke in recovery.  I am assuming that I only had a c-section.  Any further details have not been shared with me.  
That's not even the entire story. For more, go here.

Honestly, horrible isn't even the word for it. This sounds like something out of the Twilight Zone. This is Bait and Switch to the nth degree: this is coercion, assault and battery, and malpractice.

To preface the story, mother was told (after switching physicians) that she was a good candidate for VBAC, even waterbirth. Upon arriving at the hospital in labor, she was 4 cm, and progressed to 6 cm with SROM. Some decels were noted, and a monitor was placed. Then all hell broke loose.

Not surprisingly, readers were shocked into an almost stunned silence. I could feel my blood boil as I read her story, and was even more surprised that her entire post wasn't punctuated with expletives or at the very least, a million question marks and exclamation points.

Her one support system, her husband, had systematically been separated from her - because he was, as the hospital staff knew, the last line of defense in helping his laboring wife get her much-desired VBAC. What if she had died? How were they going to explain that one?

The woman is asking for her medical records, but honestly, I don't know that it looks very promising. As The Navelgazing Midwife noted, charts are not always an accurate representation of what really happened, although you'd think it would be hard to hide this one: a glaring abdominal scar - which opened and got infected - should give them away immediately. No consent papers, no discharge papers that indicated instructions on how to clean a surgical wound, no nothing.

I can't wait to see how this one turns out, and I hope to God this woman takes her case to the nearest TV station, and then to a lawyer. People who think this "never happens!" need to pull their heads out of their collective butts and realize that yes, it does - even here in the United States - even though it sounds like an experiment only someone like Dr. Mengele could perform on someone.

My heart and soul go out to her.

Update: Another article has been brought to my attention - this one dealing with the removal of the child after the mother refused a cesarean. In the comments section, a mother gives a chilling, horrific story much like the one here - and later, someone confirms that she committed suicide. Curious, I just googled her name and came across an obituary for someone with the same name, of childbearing age, who left behind two children - one of whom was a nine-month-old infant. 

We cannot ignore or underestimate what these experiences have on a woman's psyche. Nor can we hide behind the happy, chirpy shroud of "At least you have a healthy baby!" 

More reading:
Birth Sense: Five Reasons Your Doctor/Hospital/Midwife May Not Want You To See Your Medical Records

Thursday, March 3, 2011

The Girlfriend's (misguided) Guide to Pregnancy

"Or everything your
doctor won't tell you."
(Oh, if only that
were true.)
I vaguely remember when I first heard about this book - that and Jenny McCarthy's Belly Laughs were pretty popular, and I figured it would be a nice alternative to those books that depicted pregnancy as all flowers and sunshine.

What I wasn't prepared for was the tone (of either book) to be the verbal equivalent of a cheese grater. I read a few passages of Jenny's book and thought, Ok, this is going a little too far in the opposite direction. (She obviously has never been known for her grace or demure behavior.) While not necessarily that bad, Vicki's book struck an uneasy chord with me on much the same level. 

This book is probably one of the biggest reasons I would hesitate to rely on  something written from the author's perspective. (Unless she's like Robin Elise Weiss, who is on like her eighth child: that alone gives her a bit more leeway in that department.) Iovine rubbed me the wrong way on several topics, namely:

• Home birth. Her perspective on it is somewhat sad, and reflects the notion that only doctors are capable of handling a birth. Not only that, but it sounds like she did little - if any - research on it, and relates the story of her friend Kathy, who transferred from a home birth to the hospital.
"....[Kathy's] midwife did everything from make her herb teas to walk with her in the hills ... to bring on regular contractions. The nurturing and reassurance were extraordinary... Unfortunately, Kathy found labor longer, more painful, and more frightening than she had anticipated..."
I'm not exactly sure how to interpret this passage. What is she saying? Have a plan? Be prepared for it to fail? The way she describes it, the midwife must not have been that reassuring.

Iovine says she "gleaned three lessons" from her friend's experience: you can never get to the hospital too early, (oh yes, Vicki, you certainly can!), save the "homebirths, midwives and underwater deliveries for the second, third and fourth babies" (because you have no idea what to expect or how to manage labor when it's your first child), and "never elect to have a child where you have no access to medication, or God forbid, real doctors."

(I think here is where Vicki just figuratively smacked the collective group of home- and waterbirthing women across the face with her book. Ouch.)

I don't really get the mention of water birth - which can be done in the "safety" of a hospital with "real doctors! Gasp!"

She says that "childbirth is as messy as a pig slaughter," and wonders who would want to 'sacrifice' their beautiful sheets and other linens for such a thing. She recommends giving birth in a four-star hotel, where the maids can clean up afterwards. Seriously?! 

So much for a real, meaningful or educational dialogue on home birth. No wonder it gets so much flak!

• Regarding pain management and epidurals:
"You will tell yourself from now till labor begins that you intend to try delivering without an epidural, but I can't think of a Girlfriend who didn't take it when it was offered."
What the heck kind of thing is that to say?

So don't even bother, because no one else does, and you're weird if you think you can actually try to get through this without it. Just go ahead and try, because I bet you can't! Honey, I think you need different friends.

(One Amazon reviewer noticed this too, and said Vicki was "downright hostile" towards moms who don't have epidurals and "chastises women who are disappointed to end up with c-sections." While she emphasizes the 'natural' changes in your body such as weight gain, the reviewer notes, she "has no use for the natural process when it comes to birth," and "thinks everyone should induce labor at a convenient moment.")

As far as childbirth in general, she concludes that:
"A delivery that results in a healthy mother and baby is a gift from God, no matter how that delivery was achieved. Period. Childbirth is not like a visit to a spa: It is not designed for your personal enjoyment and fulfillment. It is not an opportunity to demonstrate your abilities or fitness....I think this feeling of being "gypped" by a birth experience that doesn't match our expectations is one more example of that yuppie self-centeredness that is none of our least attractive characteristics." 
This passage .... this part made me mad. Right after I thought my eyeballs were going to pop out of my head, I then felt like barfing. So, all you ladies who feel victimized, used, abused, betrayed or otherwise treated like crap by an OB, you better just get over it. Because all that matters is your baby was born healthy, okay? Your feelings don't really mean much, in the broad scope of things, now do they? (sarcasm off)

It's this kind of behavior that makes women feel like their thoughts, feelings and emotions surrounding childbirth are completely invalidated, and that is so not fair. Who are you to say another person has no right to feel the way she does?

As far as the whole "personal enjoyment and fulfillment," I bet there are loads of women - both of whom had epidurals and those who didn't - who would definitely beg to differ. For many of us, it definitely is about fulfillment - of your role as a mother, as the giver of life.

And as more women are realizing, sometimes those interventions that are supposed to help us have a "healthy baby" do more harm than good, and we would oftentimes be better off without.

Ironically, a few pages back she talks about her primary cesarean with a baby conceived through IVF, and how let down she was by the experience of not having a vaginal birth. So much so that she had her next three children by VBAC, because she says that she "felt so robbed of something my soul had yearned for." (At least one Amazon reviewer said Vicki frequently contradicts herself, and I guess this is one of those moments.) She goes to on to mention two of her friends and their husbands, who, at the time, were planning on all natural births. (emphasis mine)
Both of them labored for more than twenty hours. They were in the kind of pain that only fear and no end in sight can create....I call these husbands Golden Retrievers because they continue to act sweet, loyal, and dumb even when all evidence is making it abundantly clear that everyone in their little family had been unimaginative in how big and long and scary the pain of childbirth can be. 
Finally, it was the insistence of their doctors that got the laboring moms and their clueless husbands to surrender and release their stressed babies via the zipper. 
The babies were "scandalously healthy and robust," she adds. So maybe that means they weren't so stressed after all? I feel badly for her friends, who I bet aren't anymore after that one.

So basically it's okay for Vicki to feel "robbed of an experience," but no one else should be because she says so. "Period."

I don't know if I can go any further, honestly.

Ladies, you have every right to feel "robbed" of an experience if that's what happened to you. Taking into account that not every birth can always turn out the way we'd like, that "experience" can be very important in deciding the outcome. As the person giving birth to this child, it can be about you and your wishes too, without compromising the "healthy baby" part. It's important to realize that some of what is done and isn't done in labor - that can either add to or take away from the "experience" of birth - is key in the healthy baby equation. Don't let Vicky Iovine or anyone else tell you to just get over it and move on; a true girlfriend would never say that.