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Wednesday, October 23, 2013

Breastfeeding and jury duty

Only twelve states exempt breastfeeding women from jury
duty. 
I live in New York State and have been summoned for the dreaded jury duty twice. Both times, I panicked - not because I wanted to shirk my public duty, but because I was the sole care provider for a breastfed infant. I lived hours away from family, had some neighbors - but they either worked or had their own kids to care for. What was I going to do?

Thankfully I was exempted. Maybe they think I'm still breeding, because they haven't called me back (perhaps I'll jinx myself by saying this).

Unfortunately this Missouri mom wasn't so lucky - her state does not have a breastfeeding exemption, and the judge gave her two options when she showed up in court holding her seven-month-old son: put him in childcare or bring someone with you to watch him while you sit in court.

The judge apparently said she could take breaks to pump (and someone else said 'to feed' the baby but these are two entirely different things), but I don't see how this would help her if her child refuses to take a bottle. I'm also curious where she would be allowed to pump: a judge's posh quarters, or the nasty public bathroom down the hall? Hmm... sounds like a tempting offer.

Only twelve states exempt breastfeeding mothers from jury duty. This is pathetic. And while Trickle's state recognizes 'undue physical or extreme financial hardship' as a reason to excuse someone, I'm almost sensing here that the court thinks that because she's a stay at home mom with presumably no income to lose, that there's therefore nothing lost because she's not earning a paycheck from a "real job."

Judge Marco Roldan, who is presiding over the case, said in the past he's exempted potential jurors because of a death in the family (did they provide a death certificate? *eyeroll*) or teachers who were scheduled to give mid-term exams. Seriously? You're joking, right? 

Of course, like any other mothering/childbirth/pregnancy/breastfeeding topic, it comes with no shortage of public outcry, usually from people who understand little about the mechanics of the subject. So as a former breastfeeding mother who has spent ... let's see.... roughly 6 1/2 years of her life nursing a child of varying ages, I can say that it's definitely not easy, especially when there are ridiculous limitations like this creating even more roadblocks to a successful breastfeeding relationship.

When you realize how engrained infant formula has become for decades - since probably the 1940s and 50s - it's not a wonder that many people just don't get it or even understand what the norm is for a breastfed baby. And this being Breast Cancer Awareness Month and all, let's not forget that recent studies have shown that breastfeeding can reduce cancer rates - yet we put up more hurdles that discourage or inhibit a mother's ability to nurse her child.

Many moms, myself included, cannot pump. It's not a sign that something is wrong with you; it's totally normal to be able to successfully breastfeed a baby but be able to pump next to nothing, even with a good pump. It doesn't matter anyway if the child refuses the bottle; some mothers try countless nipples (and they do come in a myriad of shapes and sizes) with no luck.

As far as childcare, when you're a full-time stay at home mom, you probably feel there are few reasons to really need it. I still don't have a regular babysitter whom I trust not to text the entire time she's watching my kids, and mine are 9, 7 and 4. I live hours away from family members, and many of the moms I know are either working by now or have kids of their own to watch; I cannot imagine handing off my baby to them for several hours a day for the duration of a trial (which can either be short and sweet or drag on for weeks, if not months). If you're paying for childcare, usually you have to agree to it long-term, and it can be hard to find one that will agree to short-term care. And of course, daycare is extremely expensive to boot.

The judge's other option was to bring someone with her to court so she could nurse the baby on breaks.  I hope she has really, reeeally good friends, because I personally know no one who would've been willing or even able to do this for me. Again, I'm sure many, if not most, of Trickle's friends either have infants of their own to care for or, if they don't, are working. Even if she could find someone, are they going to hang out all day wandering the courthouse, waiting for the next feeding? Perhaps set up a Pack-n-Play on the front lawn? Would she have to endure more financial hardship by providing additional monies for gas and activities if the babysitter decides to drive all over town day after day keeping baby occupied?

It all seems ridiculous and overly complicated when it doesn't really need to be: just exempt the breastfeeding mother.

More reading:
Jury duty is sometimes a trial for nursing moms - Best for Babes 

Friday, October 4, 2013

Doing the unthinkable: questioning Breast Cancer "Awareness" Month

Right now, as I type this, a college friend is going through what we can only guess are the final throes of brain cancer. It has been a horrible downward spiral to watch, dragged out over the course of several years, that - like most cancers seem to - started out as a battle initially won and then proved to be much, much worse.

Why is that? Have you ever noticed that "survivors" often end up getting cancer a second time, this time much more aggressive than the first? I am so sick of "pink ribbons" I could scream: namely because it seems few people really understand the truth behind them, or the often subversive, misleading marketing behind it. But how dare you ask? How dare you question it?

It's a reality that many of us probably think about, dread, pray will never come knocking at our door. It seems every time you turn around, someone you know or a friend of a friend has it. And it also seems that while advancements have been made, the medical community knows just as little about it as they always have.

Years ago when I was writing for a newspaper, I interviewed a top cancer surgeon at a nationally esteemed cancer facility. He told me that around the turn of the century, there was little they could do for cancer patients, and death from it was often brutal. You were basically just left to die, he said.

I was thinking today of my friend and wondered, if in some ways, that's not still true. Treatment options might work - or at least appear to - and then wham, a recurrence hits you like a ten ton truck several years later. This seems especially true with breast cancer, everyone's favorite 'pet project.'

And I just realized - it's October! Hey, Breast Cancer "awareness" month. Yeah, you're aware of it. But do you really know anything about it? What your risk factors are? How much money is poured into research that is inconclusive, misguided or redundant? The financial toll is one thing; the human toll is unspeakable.

Take a moment to consider:

• A company can merely slap a pink ribbon on a product that makes you think they're "doing something" for cancer research, when in fact they may not be donating anything at all
Products that contain known carcinogens (like personal care products) are often touting that cancer awareness ribbon

The documentary "Pink Ribbons" alludes to the fact that many studies are irrelevant and seemingly poorly organized. In one such study, a commenter responds that while an effort was made to do studies on breast cancer among black women, all the subjects were white. (Seriously?!) How is that making the best use of the millions of dollars funneled into "research" every year? If that's the best they can do, should we be more inclined to just hope for the best and take our chances?

Sometimes the treatment sounds scarier than the disease itself, and yet even if you're questioning traditional medicine at this point you're almost too scared not to seek it, even if it won't be successful. The last I knew, our friend has been reluctant to admit this might be the end, and I'm not sure who is worse - her tenacious (but completely understandable) struggle for survival or the doctors who keep pumping her full of this that and the other, doing surgery after surgery, instead of just addressing the truth head on. The same thing happened with another friend of ours who succumbed to brain cancer nearly 18 months ago. Literally days before he died, there was a medication switch, as if in some last-ditch effort to save him from one of the deadliest brain cancers there is. Why? To practice on him like some kind of guinea pig?

We've been so hopelessly exposed to chemicals in food, pesticides, plastics and who knows what else that of course, there's no surefire paper trail of where it comes from so all we can say for now is "Who knows?" and move on. It doesn't explain why some people get sick and some don't. I personally think the effects are cumulative, no doubt starting with our parents, grandparents, maybe even great-grandparents. Slowly, generationally, we are a nation of sick people - with everything from ADD to cancer, obesity, hypothyroidism, diabetes and a host of other things that seem to crop up in larger and larger numbers. When a company can produce products that cause cancer and then fund cancer research, it should make you seriously question where priorities lie, both in ourselves and in the industry that fuels this paradox. And why won't they tell you when they've got too many fingers in one pie, or conflicted interests that show you your health is really not their top priority?

Our age of quick fixes and 'feel as little pain as possible' living has far removed us from the idea that, really, there are no guarantees in life.

More reading:
Flawed research appalls cancer patient
Medical research studies: Are too many using flawed designs?
Conflicts of interest often under-reported in clinical trials
Clinical trials flawed by biased reporting

Friday, August 30, 2013

"Overachieving" moms, unite!

Lately I've loved being in the kitchen,
doing a ton of baking, canning and
cooking. Except I'm not wearing a bra.
Don't hate. 
I'm sure we've all seen those blog posts about how 'overachieving' moms try too hard, make the rest of us look bad, give us a false expectation of reality, etc. I wish I could find the original article I read - full of positive affirmations that we're all doing a good job, we're all good moms, blah blah blah.

Well, of course. Why does it matter if someone is addicted to Pinterest and loves to craft and make exquisite Christmas cookies and you don't? Since when is this a sign that you're a "bad mom?"

As I canned what seemed like my 500th jar of applesauce this morning, I thought about that article - and how it's often perceived that anyone who so much as turns on an oven is thought of as a "overachiever." I sometimes wonder what people think when I post pictures of all the canned goods, birthday cakes and Barbie clothes I like to make. I wonder what the other moms think when our kids line up at Halloween, and my child is wearing a hand-made costume that took weeks to make while the kid next to her is wearing something they bought on clearance the day before yesterday.

I am not going to let that stop me, though, because you know what - it's my passion! It's what I love doing. And if those other moms don't, so what. I'm sure they have passions and interests that I don't have; things they know how to do that I wouldn't have a clue about. Why are we turning this into another mommy war? Why are you letting someone else make you feel inadequate? And why is this even perceived as an inadequacy in the first place?

One of my favorite DIY bloggers is Ana White - a wife and mother who knew nothing about power tools and building stuff and then decided to learn. Now she is building her mother a freaking house! Can you imagine? I bet she's doing it all to make the rest of us look really bad ....

I can't wait to make this and show the entire world
how awesome I am. *sarcasm*
Photo credit: lynneslovables.com
So far this summer I've canned, tried a buttload of new recipes, and picked fruit with my kids (cue the happy music and images reminiscent of a J Crew catalog), have plans to make more Barbie clothes for a craft show and am constructing a replica of a toy fashion shop and modeling runway to showcase my stuff. Because I'm nuts. And because I freaking love it and think it's fun. Not to make you feel like a bad person, so get over yourself already. (said in the most polite way possible)

I like to write, do family genealogy, bake and cook, photography, make beaded jewelry, make Barbie furniture, antiquing and yard saling and probably a bunch of other crap I can't even remember. While I'm not very good at decorating cakes, I still enjoy doing it. And when I've posted pictures before (of the ones that actually looked presentable), I've heard comments like, "You're such a good mom." Why?! Because I baked a freaking birthday cake?! Our culture has become so used to just opening a box and dumping it out and voila, you have a meal. And while I certainly make my share of Stove Top stuffing, it makes those of us who actually like to slave over a hot stove doing this stuff feel like freaks, like we're only doing it to show people up.

Before modern packaging, people canned and preserved food because that's all that was available. Things like store-bought sugar were a luxury. Handmade clothes were the standard because nearly everyone knew how to sew, and mass-produced clothing was a sign of status and wealth.

Pardon me while I post my pictures on FaceBook - because I want to share in a way that was shared with me, and sparked an awesome idea. That is why I sometimes wish I could live in Pinterest. So many great ideas, and who cares if you don't do them all? Who is ever going to know but you?

It can be so gratifying to take something from raw material to finished product (finish a project? What??) - whether it be sewing, hunting, carpentry, cooking or whatever. Instead it's almost like they're saying, "How dare you know how to do all that stuff, then have the audacity to share your ideas! Shame on you!"

I think our ancestors - you know, the ones who lived on farms and knew how to build and do things for themselves because there was no other way - would be laughing at us because many of these skills are a lost art. Gone are the days of little girls sitting quietly, cross-stitching a sampler (I wonder if that's a discipline skill in and of itself). I am amazed when I read the book Farmer Boy by Laura Ingalls Wilder: an account of her future husband Almanzo's family, an entire chapter is devoted to what the kids do all on their own while the parents are away for a few days. They use up all the sugar to bake goodies and make their own ice cream, and when a problem arises that could get them in some serious hot water, older sister comes to the rescue by meticulously patching up the wallpaper and scrubbing the entire room. Wow. A kid knows how to do that, all on her own?

An awesome photo collage wall that
I've been wanting to do for at least
five years now. I *will* do this. Someday.
I'm fortunate to have the time to dabble in a variety of things because I'm a stay-at-home mom, but I think I'd be doing this even if I had a "real" job. Sometimes, it comes down to priorities and making time for your hobbies - which can be a great stress-reliever! And sometimes I wonder if women, more so than men, create these inner and outer battles with themselves and each other - dwelling on what other people do and gauging their own abilities based on their perception of someone else. My husband is crazy busy with work but makes time to go hunting - because it's therapeutic, it's a passion, and a craft, so to speak. Are other men jealous of my husband because he hunts and can field dress a deer? I doubt it. So if someone is putting smiley faces on their kids' sandwiches and enjoys it, so be it. If you feel like a "bad mom" simply because of this, please don't. Sometimes I think the only one making you feel inadequate is you.

And if you'll excuse me, it's time to put my handmade-from-scratch calzone (no premade dough here!) in the oven. (My kids are eating cereal instead.)

If you're interested in seeing my (inadequate) craft blog, click here. Not updated very often, but I try. LOL



Friday, July 26, 2013

"Dr." Amy to speak at September ACOG conference

I just heard it through the grapevine that the formidable "Dr. Amy" of homebirth hater fame is on the docket to speak at an ACOG conference in September. And not surprisingly, one of her topics is "Everything an obstetrician needs to know about homebirth."


Of course, I don't know personally, but I'm going to take a wild guess that she's never attended a homebirth before. Yet she is probably considered the "expert" source on them, most likely because she squawks the loudest. Never mind what actually comes out of her mouth.

Here are her "credentials," according to the ACOG PDF handout:

Um, no, not exactly. Although I realize that the title "Dr." is often a courtesy after a physician has left practice or retired, this is incredibly misleading. My father-in-law is a retired physician that most people address as "doctor," but he certainly doesn't go around representing himself as a licensed, practicing physician. I would hope those in attendance actually know better when listening to her blather on for an hour about how much she hates homebirth and the women who choose them.

A Google search of her name produced the obvious results referring to her blog and "advocacy." She shows up on a number of websites like Healthgrades, listing a physical address to what would seem an office, but no reviews from actual patients. And when you search her name on the Massachusetts Board of Registration in Medicine database, you come up with this:


She spends countless hours trolling the internetz for every story ever published about homebirth and basically makes all natural birth advocates everywhere out to be liars. Yet she continues to represent herself as a licensed physician who is still practicing medicine. Hypocrisy much?

Since ACOG is trying to set guidelines that offer women the best care while treating them with dignity and respect, I'm not really sure how she fits into their lineup.

According to ACOG's website, they acknowledge that
"Most women have normal conception, fetal growth, labor and birth and require minimal-to-no intervention in the process. Women and their families have different views about childbearing based on their knowledge, experiences, belief systems, culture, and social and family backgrounds." (Really? They really believe that?! Who knew.)
It goes on to explain their idea of what "patient-centered care" means:
""Patient-centered" means that health care providers, and the system they practice within, accept that the values, culture, choices, and preferences of a woman and her family are relevant within the context of promoting optimal health outcomes." 
They also acknowledge that part of that patient-centered care includes having not only a skilled attendant (which can come in other forms besides an OBGYN), but also "supportive resources."

Based on their description, I don't think Dr. Amy fits into their scheme of things at all. Either that, or they're just very out of touch with the way a majority of births are carried out these days. Phrases like "support" and "education" are all relative, when you consider that many patients often get all their information from their physician and trust no one else in the process.

On the surface, healthcare initiatives and much of the jargon ACOG churns out sound great - but when you actually ask women about their experiences, it seems that there is a major disconnect. ACOG itself argues that they feel the hospital is the safest setting for giving birth, but admits that it "respects the right of a woman to make a medically informed decision about delivery." It's clear that Dr. Amy does not. I am really curious to hear how this one is going to play out.

From The SOb's website: What a caring, compassionate and professional
way to promote your "advocacy." Would you want someone this vulgar and
derisive in charge of your care? 
More reading:
The C in ACOG Stands for Castrated 

Saturday, July 20, 2013

Your baby, the (normal) "problem sleeper"

There's so much parenting advice out there, some of it really good, and some of it pretty awful. Sometimes it's hard to know what to do, especially if you're a first-time parent, and many times people can make you feel really guilty and pretty horrible for listening to your gut instinct when it comes to raising children.

If there's one thing I learned after having three kids, is that they're all different. As much as the mechanics of babies are the same (yeah, they eat, poop, sleep, repeat) they're not: their personalities begin to emerge early on, and as they grow and learn, you have to tailor your parenting to fit their needs and differences. But I came to the conclusion based on the advice of others, and in observing others and what's considered social norms, that sometimes we think it's the other way around.

Getting your baby on a sleep schedule, whatever that is, is probably a perfect example. People will ask you if your child is a "good baby," which must mean "Are they sleeping through the night yet?" when they're 3-4 months old. I remember with my oldest, as a newborn he would be awake at all hours before I finally thought, What am I doing?! This child should be in bed.  But lucky me - I was spoiled by what I'll call the "Perfect Sleeper."

He slept through the night probably around four months, which I'd say is great (when compared to my other two). If he cried or fussed at night, it usually meant one thing: he'd filled his pants and needed a diaper change.

I can't imagine if I had taken this advice - from the cringeworthy What to Expect website - you know, the book everyone loves to hate. It reads like something out of a Dr. Spock time warp:
"Your baby's bad sleep habits are being rewarded. If your child cries at night to be fed and you feed him, or if he cries because he wants to be held, and you pick him up, then he learns a tricky lesson: Cry and I'll get what I want. But by six months, rest assured he needs neither a nighttime snack nor a cuddle; he's just getting away with that because he can..." (emphasis mine) Healthy full-term babies are capable of fasting for up to 12 hours at night by six months of age..."
Unless, of course, your child is like mine and has just taken a giant dump when he's "supposed" to be sleeping. I mean, really. Every child is different! This is basically assuming that there surely must be something wrong either with your crappy parenting or your child - who can sleep for long stretches but simply doesn't want to. Stop cuddling your child at 2 a.m.! He doesn't need it!

What?!

I don't think there's a parent on Earth who would say, "I really regret spending more time with my kids." Love them, hold them, feed them, rock them - they're only little once.

All kinds of things can mess with their sleep schedule: illness, hunger, emotional needs, or meeting milestones (that always kept my kids up - they were practicing their new skills!). If your child is going through a growth spurt, heck yeah they're going to want to eat in the middle of the night. It may not happen to every kid, but it doesn't mean there's something wrong with yours if it does - it's totally normal!

Fast forward to children #2 and #3 - who probably slept through the night at around 18 months. I very briefly tried the "cry it out" method with my middle, who was having none of it, and just wanted the breast, for crying out loud. It was so much easier to just give it to her, spend the five minutes to nurse, and then both of us would go back to bed. End of story. Is she waking up every three hours to eat now that she's six? No. My youngest was probably the same way, I can't even remember. But somewhere in there I realized something crucial: if I don't change my perspective, especially on nighttime feedings, this is going to get old. Quickly. And I can't afford for that to happen because we've got a lonnnng way to go.

I noticed, especially with my youngest, all he wanted was five more minutes. Just a little longer on mommy's lap, at the breast, and he was okay. The more I tried to rush things because I had something else to do, the more he just wanted that time with me. It was like a way of forcing me to slow down, relax, and listen to him and his needs, instead of demanding that he conform to my schedule.

I'm not going to say it was a bucket of laughs the entire time, but once I started seeing it as less of a nuisance and more of an opportunity to just love my children, it totally changed how I felt about dragging my butt out of bed in the middle of the night to deal with that "problem sleeper." My youngest, who is 4, still occasionally gets up to come to me in the middle of the night, even if it's just to cuddle and fall asleep in my arms, and will gladly go back to his own bed to kick, thrash and roll around as much as he damn well pleases.

And by the way, all of them were breastfed exclusively for six months (my daughter a little longer), and were nursed long-term. All treated much the same in terms of feeding and bedtime routine, all with different results. I know some parents struggle for long periods either getting their children to go to bed, to stay in bed, to sleep alone, etc. - they're all different. No one method is going to work with each and every one of them, and sometimes it will take great feats to get them to just lie. still. for. five. minutes. It will seem, as it did for me for many many many nights up with one baby or another, to be an eternity, and before you know it - poof, it's gone. That's what you should expect.

For much better advice, click here. :)

Friday, July 19, 2013

Mom kicked out of pool for breastfeeding


A mom in Great Britain has staged a nurse-in because she was asked to leave the pool area while nursing recently. The lifeguard asked her to stop because it violated the 'no food and drink' rule. But the thing is, she was physically in the pool when she was asked to stop.

Normally I'm all for breastfeeding your baby wherever, whenever the baby needs to be fed. But I must admit, I find the idea of breastfeeding while in the pool kind of gross - but it has nothing to do with modesty, covering up, exposing the breast or any of that. 

Despite being treated with chemicals,
swimming pools are still pretty
disgusting when it comes to germs and
bacteria. Studies have shown that kids
and adults alike are known to treat it as
a public bathroom.
Photo: analab01/Stock.xchng
I think one person actually unfriended me on FaceBook over posting this article, perhaps misunderstanding my concern and interpreting it that I don't support public breastfeeding. Actually, it's quite the opposite. But I can understand how the pool would be concerned with her nursing there, and they actually stated that she was free to nurse anywhere around the pool area, just not in the water. 

Some mentioned the risks of milk leaking (probably unlikely) and the baby throwing up. In my case, this would've been a reality with my second, who regularly threw up copious amounts and then proceeded to want to nurse all over again. I probably would not have wanted to nurse in the pool, but had I decided to, most likely we would have contaminated the entire area. The cost to treat a pool that's been contaminated is likely quite high because it's a very involved process, involves closing portions of the pool and results in a loss of revenue because no one can swim. 

Despite all the chemicals used, pools apparently are still pretty disgusting. The woman was sitting in the jetted whirlpool area (I'm assuming the baby pool) where probably nearly all of the four-and-under set forego interrupting their play and just simply urinate wherever they are. If you've ever used those "swim diapers," they're pretty much worthless at containing anything. And it's estimated that even 1 in 5 adults pee in the pool. Disgusting!

Not to mention the grossness that's floating: residue from personal care products and sun lotions, body oils, dead skin cells. Yuck. It almost makes you never want to go swimming again, breastfeeding or not. 

It's been estimated that many people don't shower before entering the pool (who knew?) and therefore all kinds of interesting things like e. coli hang out in the filters and everywhere else. Bacterias that can ear infections and skin rashes were found in a majority of public pools, and "pools used primarily by children tested positive 73 percent of the time." Apparently public municipal pools are the worst offenders. 

It's not like your breasts are sterile, but perhaps reducing one more point of contact while nursing is wise, rather than staging a protest to fight for your right to breastfeed in what is quite literally a public bathroom. 

Tuesday, July 9, 2013

Review: VBAC Facts Class with Jennifer Kamel

Image: VBACFacts.com
This weekend I had the pleasure of attending Jen Kamel's VBAC class "The Truth About VBAC: History, Politics and Stats" in Buffalo, NY. She is amazing - traveling the lecture circuit to present loads of information to both laypeople and birth workers alike.

I've already had a VBAC and I'm "just" a birth advocate, but I highly recommend the class if you can either attend in person or check out the webinar version. Why spend money on a class when I'm not even a birth professional? For philosophical reasons, this was as inspiring as it was educational.

What an opportunity it was to network with local doulas, midwives, advocates and birth professionals! I met new friends, heard and shared stories and exchanged information that not only could I use but pass on to others as well. The presentation was heavy on graphs and charts (Jen's favorite LOL) which is a good thing - putting it all into perspective is important. Without that perspective and information, women are potentially making a life-changing decision with less data and fewer facts, perpetuating the idea that "VBAC is dangerous!" and that it's selfish, foolish or risky to even consider it.

Some important take-away messages that I left that night with:
• Studies are important, as long as you're looking at the big picture. For instance, rupture rates are key, sure; but if the study you're reading doesn't tell you the number of women who had labor induced or augmented, then it's not going to give you all the facts. That is very important information to have - because it can increase the overall risk of rupture. Without it, it can definitely skew your impression of whether it's safe or not. Is your doctor quoting these same studies, that might present data the way he wants it to? Perhaps.

• Ultimately it all comes down to the level of risk that you are willing to accept. One is perceived as inherently safer, or more dangerous, than the other. Why is this? Because one is performed much more frequently than the other, to the point where risks and disadvantages are glossed over and minimized. I've always thought that it's just a shuffling game: you're trading one set of risks for another. You put off the more immediate risks of a VBAC and trade them for the more long-term, cumulative risks of repeat cesarean. If you're not looking at the long-term picture, you may not have all the best information at the time.

Why does a rare but well-publicized uterine rupture (which is not always catastrophic) send up more warning flags than surgical complications after four cesareans? Why are we more afraid of the risk of rupture - which may not even be realized - than we are about cesarean complications, that are becoming increasingly more common as more women have more cesareans?

Jen's presentation may be just the thing to give a VBAC mom the edge when it comes to studies and statistics - and it's downright sad that you even have to walk into a doctor's office defensively posturing yourself with a ream of studies to back up your birth plan. Don't expect your doctor to know all the facts and figures - or to even come close. Jen's information is nothing that you can't already find on your own, it's just painstakingly put together from the same medical journals and articles your doctor has access to - conveniently all in one place. The benefit to you is that the legwork has already been done - which is a big plus when it comes to the virtual sea of data that can be very overwhelming. Kudos to Jen for her hard work and determination!

For a list of upcoming classes and webinars, visit www.vbacfacts.com.

Saturday, May 11, 2013

Why do women choose "risky" births?

Whenever a tragic birth outcome makes the headlines, especially if it's perceived as "risky," I know women ask themselves, "How can a woman do this? What on earth was she thinking?" It's hard not to, but much of the time, I can totally understand why.

The death of any baby is tragic, and I guess hindsight is 20/20 when you pronounce the death "unavoidable." In the case of this Australian woman, who was attempting a VBAC at home after two cesareans, she was summarily lambasted for not following the advice of her doctor and "internet advisers" were blamed for giving her false information on what she should do. One woman said, "I blame the 'variation of normal' crowd." (The woman's baby was breech.)

Contrast that to this story, of an American woman who died of complications following her sixth cesarean section. No is blaming her for her risky decision to have so many cesareans, as I'm sure she took her doctor's advice - and I highly doubt he/she was pleading with this mother to "please have a VBAC! It's safer!"

What's the difference, really?

Why is accepting one death - that could have also been avoidable - okay, but not the other? Imagine if the Australian woman had decided on that third cesarean, perhaps going on to have more children and more cesareans, and ending up like the woman who died? Are we saying that's just an acceptable risk that you take and "so what?"

I see it as merely shifting the risk. The more you discourage VBAC in women who've only had one prior cesarean, especially in those who desire larger families, the more you end up hearing stories like this. It seems like our medical community, and society at large, is perfectly willing to believe in dangerous paradoxes - namely, that VBAC is dangerous and cesarean section is "perfectly safe." Many commenters were disgusted that she went against the advice of her doctor and attempted a VBAC, which was unfortunate; but for many women who do take that advice, you better believe their doctor can churn out just as much misinformation as that sandal-wearing hippie natural birth advocate you so despise. How is being the opposite side of the same coin any better?

Add the fact that very few hospitals receive an official "Mother-Baby Friendly" designation (not that that matters, I guess) or can seem to be supportive without treating mom like brainless chattel and it should be easy to see why women choose an alternative birth. How many times have you heard that it's damned-near impossible to have a normal, let alone natural (gasp!) birth in a hospital setting? I'm not saying it can't be done, just that it's usually difficult and you have to really work the system (which has quite a learning curve, let me tell you).

For those who frequently bitch about how reckless or crazy women are after disastrous home births, what are they doing to make hospital births more hospitable? Oh wait - they're usually the ones that tell you to just "let go of your anger and get over the 'birth experience' - just deal with it." I'm guessing they've never once cracked open a book that details some of the absolutely barbaric birth practices that "modern" obstetrics have put women through* over the generations, and for what? To be treated like a human guinea pig? Or the formidable, unmentionable "physicians" who like to demonize all women for even thinking about a home birth, much less having one - are they making stunning strides and initiatives to support women in a comfortable, accommodating hospital atmosphere? Or just complaining about it and publishing the names and addresses of those women who've lost children in home births?

I'm not sure how I managed it, but I had a VBAC in 2006 and sort of fell into an OB's practice that would actually "let me" do it. I don't think I had any clue how difficult it is for some women to have one. If I hear someone say "just find a supportive OB and hospital with lots of experiences in VBAC" one more time I'm going to scream. Because it's definitely not that easy.

From the ICAN website.
If you look at this list, many are rural hospitals or in smaller towns. And many are hospitals in large cities. I'd like to know how you are just going to up and "find a supportive hospital" when they don't seem to exist. If you live in the boonies, your options for supportive hospitals and OBs or midwives is probably pretty limited, and I'm willing to bet the cesarean and induction rates at those hospitals that serve rural women are through the roof. ACOG Guidelines be damned; they aren't offering up an attorney, birth doula or physician to see you through your VBAC - which means the "guidelines" they issue do little to help the patient if a doctor can just pick and choose which guidelines to follow.

(*And for the record, I'm not intimating for one second that before modern obstetrics, women didn't suffer or go through torturous experiences in order to birth children, sometimes with disastrous results. But I think our glorification of modern medicine might be, at times, misguided and perhaps glosses over  its sordid history and past failings.)

More reading:
The "C" in ACOG stands for "castrated"
Tori Spelling and cesarean complications: why we need to hear about it


Friday, May 10, 2013

Newsflash: Pitocin could harm your baby

For some of us, the idea that Pitocin is not exactly a walk in the park is nothing new. So when this official proclamation came from ACOG, a lot of people were like, "Well, duh." 

Apparently this is "the first study of its kind to present data on the adverse effects of Pitocin use on newborns." Considering how deeply entrenched its use has been since its inception as the drug we know today, I find that incredibly shocking.

Unfortunately it seems like either those who swear up and down that it's the Devil's poison end up getting it, or those who are warned "don't induce!" often find out the hard way that in many cases, yes, it does suck as badly as everyone said it would. (Although obviously this is not the case for everyone.)

Back when my niece was expecting her first child, she said she was not planning on inducing but asked for advice about it. I tried to offer my opinion without sounding preachy, and a many of her friends said that in their experience, it was terrible and to avoid it if she could. I don't know what happened, but the next thing I knew, she was getting induced, had a hellish labor, and now apparently doesn't want any more children. *sigh*

What I've noticed is when people are asking about Pit, there are usually tons of people who relay their experiences - some okay, some great, some perfectly horrific and the stuff of nightmares. I'm not one to try and scare women by propagating horror stories, and whenever I speak of this stuff I try to be as balanced as possible. But I can't help but notice that usually, all the dissenters are ignored, their advice chucked to the curb and the mom is induced, sometimes with not so happy results. Sadly, it seems like those who filter out what they don't want to hear seem to have the worst time of it.

Either that, or one of two things happen: a dozen people say, "Well, I had it in labor and did just fine," as if they refuse to believe there is actually a problem. Or, they list the numerous reasons why they needed it in a defensive tone, which is kind of sad. Again, for some women, it's what they need and can really benefit them. But for everyone? I don't believe it.

I think some women get defensive because their hackles immediately go up and they miss the part where, again, it says that for some women, it can be a life-saving, very important drug to have on hand. I also wonder if they are in denial that their doctor could ever give them something that might be unsafe, completely trusting them with their own wellbeing as well as their unborn baby. I'm not necessarily saying that they aren't acting in your best interests, but rather questioning why this needs to be standard fare in so many hospitals today. One source suggested that approximately 81% of women receive Pitocin either to augment or induce labor. 81 percent?!

And because it's become so commonplace, it's perceived as unequivocally safe, a perfectly normal and acceptable routine of labor. If you question it, I highly doubt your doctor or nurse is going to calmly say, "Oh, you don't want it? Okay, that's fine." Administration protocols seem to vary by hospital and doctor, and while some appear to follow perfectly reasonable guidelines (especially the idea that if this isn't working, let's send mom home), others are outrageous - as expressed by nurses who work with these people, not just "natural birth hippie chicks."

From a popular internet forum for nurses. Click to enlarge. 
Some things to consider:
• Sometimes inductions and Pitocin use are completely necessary and the best thing for both mom and baby. If at all possible, perhaps suggest a gentle induction that can get things started in a minimally invasive way. Remember that in first-time moms, inductions can increase the risks of cesarean, although sometimes this is unavoidable. (Pre-eclampsia is a good example.)

• Sometimes it is not necessarily the best course of action but is given anyway. Know that you have rights. Some women do say that while they refused it during their labors, they had it given to them anyway; perhaps hiring a doula or having a birth advocate present with you may help. Some reasons for its use are dubious at best, and can cause more harm than benefit. (For an example, click here.)

• Get all the facts prior to an induction and ask lots of questions. If your doctor starts talking about an induction early on as a matter of course, this could raise some major red flags.

• Throughout its history, it has affected different women differently. This can depend on a number of factors, including how aggressively it's administered. While it can have many benefits, it is not without risk to both mother and baby.

More reading:
Pitocin side effects
Five ways Pitocin is different than oxytocin

Friday, April 5, 2013

Does public education earn an F?

It's not much of a secret that American public schools are in the proverbial toilet. That's not to say that all districts are bad or fail their kids, but let's not kid ourselves: it seems that somewhere in the equation, we have screwed up. Badly.

My apologies to those who like this guy (I've never heard of him - does that make me uneducated?), but after seeing this meme on FaceBook I just kind of shook my head.


Hmm...did he really say this? Something didn't sound quite right here. His disclaimer: "Even though I don't personally have a kid in school" made me wonder if he was even old enough to have kids. Apparently he does, but I don't know if they're old enough to be in school yet. Even if they are, do you think with his wealth and fame he's going to put them in public school? And even if he is, again - with that wealth and fame he can pretty much move right in to one of the best, wealthiest districts in his area, I'm sure.

Because I didn't know who this person was, I looked him up. He was educated in a boarding/country day school and then moved on to the rural but prestigious Kenyon College, a private liberal arts college in Ohio (that is not that far from where I spent my formative years). I have lived as a faculty spouse in the boarding school culture for over a decade, and am quite familiar with its demographics: mostly made up of either parents who are scraping everything together to help their kids where the public school failed them, or parents who could literally write a check for the $50,000 tuition without batting an eyelash.

Either way, because we're a school that specializes in teaching kids with learning "differences," they're here because their former public school failed them. They're here because their public school either could not, or would not, give them what they needed to succeed.

As a product of the public school system myself, I caught on quickly to their schemes: tracking and grouping "smarter" students and sending them to the brighter, more engaged and dynamic teachers, while the rest of us were going in the other direction. I quickly noticed how the TAG (talented and gifted) program primarily consisted of the smartest kids in my class. I was there when, as we stood in the hallway looking at the class roster for the coming year, a fellow student who's mother was a substitute teacher was horrified to learn that she'd been placed in the teacher's room that ended up making my life a living hell for much of fourth grade. (It wasn't long before her mother protested and changed her to the other teacher's class, and I wondered to myself, What's wrong with this teacher? What does her mother know that mine doesn't? Why doesn't my mom move me, too? 

As it turned out, that fourth grade teacher would chastise me for my problems in math, calling me to the board to be embarrassed in front of the entire class time and time again. Meanwhile, in my head I was silently criticizing her for her professed inability to say the word 'aluminum.' Years later my mom told me told that classmates of mine asked her, "Why is the teacher so mean to Carrie?" Therein began my absolute hatred for math.

Fast forward a couple grades - after we stopped being separated by "smart kids, dumb kids" - and I was distinctly told by at least one of my teachers, "Oh, I've heard about your struggles in math." I thought to myself, Yes, and what are you going to do about it? I was again horrified and embarrassed. My high school algebra teacher separated me from the class, making the rest wait in silence as he went over negative numbers and integers with me. At one point during that year, I left the room in tears.

It was only when my chemistry teacher took the time to teach me a different way, to help me outside of class and away from the stares of my peers, that I really got it - and actually started to enjoy math. Somehow I can function just fine in my world, despite not having taken higher-level math - a reality that became crystal clear to me as I took one standardized test after another to assess what I knew and what I should know. The math questions always stumped me and I basically just started guessing. It occurred to me: This is an assessment of what the state thinks I should know. But what if I don't? How can I answer questions on a test when I've never even seen this material before?

I think of the learning-disabled kids who went to my school - stuck in the resource room, which translated into "party time!" They were kids with behavioral problems and bad grades, and it's hard to tell which came first. It's obvious when reading their status updates on FaceBook that they still clearly struggle with reading and writing skills, and I feel badly for them. They were just shuffled around, probably never made to think they could succeed. What if they had untapped potential and could've been helped in a different way? Even though this was during the 80s and 90s, don't think it still doesn't happen in schools today, despite all the legislation, funding and government intervention that tries to tell us differently.

I took "advanced placement" English in high school, which was nothing more than a year-long session of glorified spelling tests. We read one book the entire time. I got mad about it, admittedly disrespectfully arguing with the teacher in front of the entire class about how when I got to college, my English professor was going to laugh in my face. I asked the school's librarian about it, and she knew full well the problem, puzzled because that teacher's house was "full of books."

We are fortunate to have the opportunity to send our children to a private parochial school that has the cheapest tuition I've ever seen. But we're hoping to move closer to family, which makes me wonder if we're not crazy for giving up such a good deal (too bad it's only K-8). When I compared private education costs elsewhere, I was literally blown away. One school charges $6,000 a year for full-day kindergarten alone. How can we possibly afford to educate three kids there? Couple that with housing costs, and just in order to find a house reasonably within our budget, we're looking at sketchy, poorly-rated districts, if not some of the worst in the area. What do really poor, low-income people do? Just give up?

I think back to my conversation with a private school administrator currently facing low enrollment (because no one wants to shell out the big bucks for private schools) and a number of questionable students who are there on the voucher program. While it ideally should give bright students trapped in a crappy district the power to seek out better schools, in reality, she said that those A's they got in public school now translate into D's once in the private setting. That particular district was riddled with corruption scandals that included a heavy-handed principal that used his influence to hire friends who were incompetent and lied about their credentials during interviews. They tore down the completely ramshackle building and built a fancy new one, which now has empty classrooms that they cannot fill. The local police department also has an office within the building,  if that tells you anything.

Why should we be happy to shell out hard-earned tax dollars to a district that is underperforming? That has had state funds put on hold because they aren't churning out students that meet their expectations? Districts that are obsessed with raising those all-important test scores, at any cost? If all they care about is the scores, they're not caring whether or not the kids really know the information - all it does is teach you how to be a good test-taker. If you're not, then it's a poor reflection of what you really know, and how you can apply that knowledge.

I also think of the public school teachers I know who post multiple updates about how they hate their jobs, are getting out of teaching, because the students don't care, don't do any work, the administration gives them a pass and doesn't punish them, the parents are uninvolved and couldn't be bothered. It's endless. One person I actually had to unfriend because that's all she did, in every post. Is this the new "social order?"

One thing I've noticed that is rampant in the educational subculture is the use of big words, stock phrases and jargon that basically says absolutely nothing. We can speak this way all day long, to convince people we care, that we "get it," to make ourselves look puffed up and educated. When really, it's quite the contrary. Book smarts and fancy language are impressive, but can only go so far. I saw a great interview with old-school economist Thomas Sowell, who was public-schooled in Harlem, dropped out of high school and went on to become a veritable genius in his field, graduating magna cum laude from Harvard. He said that people are always coming up to him and bemoaning his experience in the inner-city public schools, but he doesn't know what they're talking about - he said he received a good education, and those in the neighborhood around him did, too. What happened? He now thinks there are none of those channels out of poverty and the very system in place to help is actually keeping these students from succeeding.

I don't like to use the phrase 'stupid people,' perhaps just "under smart." Not as smart as they could be, maybe because they're expecting and allowing the public school to fully educate their children? Trusting them to do a good job and pick up where the parent left off? What if the parent never started to begin with? I'm sure it's a combination of things - parents that don't care or can't care, students who don't care or fall between the cracks, teachers who don't have the time and mental fortitude to work on every single kid who comes from a household where education doesn't mean squat. And the more people who don't become their "child's first teacher," who don't give a rip, the more the district - and the state - decides to step in for "the social order" and the common good and start making decisions on the child's behalf. That includes in cases where the parents most definitely educate their kids and have a high stake in their learning. What gives the district and the state the right to undermine and override the parents' authority in their child's life, especially in the presence of very aware, intelligent and involved parents? If you have a district that's primarily made up of parents who don't care, are they doing more harm than good in acting on the child's behalf, just further making them victims of the system?

I think so.

More reading:
California 12-year-olds to get HPV vaccine without parental consent
Teen gets abortion with help from her high school


Thursday, April 4, 2013

Woman sues clinic for failed abortion

Photo credit: andreyutzu/stock.xchng
I wasn't really sure I wanted to write about this - it's always a touchy subject, and I don't think we have enough time to go into detail on my feelings about abortion. But hey, what the heck.

I first read about this woman - a mom of a preschooler who attempted to have an abortion, which was unsuccessful - and ended happily (she's happy about it, just for the record) with the birth of a healthy, live infant. Thankfully, they posted a link (that most people either missed or didn't bother to read) that is a little more detailed than theirs.

The woman has a double uterus with two cervices (that's plural for cervix) - otherwise known as uterus didelphys. Apparently it's rather rare and goes undiagnosed unless the woman has problems, such as miscarriages and preterm births. From what I understand, uterine defects - especially this one - can cause repeated miscarriages, pre-term births and intrauterine growth restriction, depending on the severity of the defect. I myself have a bicornuate uterus, which is a heart-shaped variation that at the very least is why two of my children were not able to turn into the vertex position before birth.

According to the article, during the woman's first pregnancy the embryo implanted in the right uterus, producing a healthy, preterm infant delivered by cesarean. Unfortunately, the second pregnancy implanted in the left portion, and doctors felt that it could jeopardize the life of the mother if she remained pregnant.

I don't necessarily fault her for following the advice of her doctor. Nothing in this article made her sound cruel, heartless, or any of the other vile comments that some people made. She followed the advice of her physician, something many pregnant women do every day. Is the doctor always right? Depending on who you ask, that might be subject to debate.

I've read some literature from at least one OB who said that oftentimes women are given a grave diagnosis and decide to abort based on that opinion alone. Some, he reported, sought him for a second opinion and were surprised that it might not be as terribly serious as they once thought (and some definitely seek second and even third opinions only to be told the same devastating news). Really, though, when you think about it: childbirth advocates and many others often realize that many obstetricians are taught that pregnancy is an illness, a pathology. What else can you expect?

If indeed her doctor's advice was premature, or he was unnecessarily trying to scare her, this again can point the finger at doctors who are quick to suggest abortion for anomalies that are not as life-threatening as once thought. If anything, his suggestion that her uterus would be "too weak" may have been misguided or bad advice, but it all depends on the degree of deformity. If her doctor's advice really wasn't that sound, then he failed her. How many times have you heard someone say, "Just trust your doctor!" How about when he's telling you "You're stupid for attempting a VBAC, it's so dangerous,""I can't believe you're planning a home birth - are you trying to kill your baby?"

How can we fault her for just taking her doctor's advice, something every pregnant woman is encouraged to do?

So to get to the details: this woman sought an abortion from a clinic and they supposedly announced her free and clear after the procedure, only for her to find out she was still pregnant. I'm sorry, but I don't see how they can even begin to deny her claim: if you go in for an abortion and something is allegedly done to you, if you remain pregnant it's clear that they didn't do their job, correct? How can they deny no wrongdoing or negligence?

This woman then spent the rest of her pregnancy wondering what would happen: would her baby be born prematurely? Would her water break at 18 weeks and the baby die anyway, compounded by the failed efforts of the abortion clinic? I can't imagine her fear - then wondering, once the baby was born, if there would be lasting complications. And lastly, wondering, if they didn't perform an abortion, what the hell *did* they do to me?! 

The point remains: they were negligent. They screwed up. Whatever the case, they said they were doing something - for a fee - and they didn't do it. What if something terrible had happened? If she had had an ectopic pregnancy and they handled it this way, there's probably little doubt that she'd be dead by now. If they didn't get sued or at least called out by her, who else are they going to mess up with?

Monday, April 1, 2013

Birth as a "Marathon"

Photo credit: An Empowered Birth FaceBook fan page. 
I love this photo. Interestingly enough, I wrote my blog post before placing it and realized pretty much everything I said echoed the sentiments in this photo.

If you were a marathon runner, would you try to run the Boston Marathon after only training for a week? A day? Probably not.

Preparing for birth can be like running a marathon - although to some women, "preparing" means different things to different people. It seems that few realize the mental and physical preparation that should go into preparing for birth.

When I look back on what I knew (or, rather, didn't know) before having my children, it honestly kind of scares me. I distinctly remember my first due date approaching, the baby was breech, and I was excited to meet my child. The doctor told me that if I showed up in labor (a very real concern of mine) they "wouldn't let me go too long" before sectioning me. That was about the sum total of his counsel when it came to the risks and benefits of surgical birth. I scurried (or waddled, probably) to my car in the parking lot, anxious about the impending arrival of my new bundle of joy.

I'm fairly certain that had I really known the risks of cesarean birth, I would have rightly been scared out of my wits. I'm also sure that the reason I wasn't worried about that aspect at all was because my doctor didn't mention jack crap about it. Any of it!

This is one inherent problem in obstetrics today, it seems: a sometimes complete lack of adequate, informed consent. How can we prepare ourselves for that birth marathon when we don't know what to prepare for? There has to be more to it than breathing through some contractions, grimacing through the pain while they place an epidural, and pushing out a baby. I have heard so many women, on the eve of their inductions, say in a panicked voice, "I'm being induced tomorrow and I have no idea what to expect!" Really??

When I think back on my experiences and how they've played out over three pregnancies, there is one central idea that pops out at me: essentially, you have to start planning future pregnancies before the first one is even finished.

It sounds ridiculous, and can be virtually impossible for many women, but that's about what it all boils down to.

Before your first pregnancy is even over, ideally you should ask yourself:

• What are the risks and benefits of cesarean? How will it effect any future pregnancies and births? (This is key!) Depending on how good or bad that experience turns out, it can not only influence how you give birth to future children, but can negatively impact your ideas on how future births may play out (which may or may not even be realized) - and some may decide to scrap their plans for a larger family and opt never to become pregnant again! 
• What is my doctor's cesarean rate? More importantly, what is his/her induction rate? (Studies have shown that in first-time mothers, induction can dramatically increase the risk of cesarean section.)
• How can I avoid an induction or cesarean?
• How can I prepare myself for one if one or both become necessary? And how does my doctor define "necessary?"

Another thing that stands out to me throughout my experiences and in hearing others talk about theirs, is the idea that everything our doctors do to us and for us while pregnant and laboring is always for our benefit, and therefore always necessary. This is where you cross into a gray area, I think: some inductions and cesareans are unavoidable and quite necessary, while others are sketchy. It can be quite a conundrum.

• What if I need to be induced for having a 'big baby?' What *is* a "big" baby? I think you'll find a wide range of answers.
• What if my fluid level is low? How can I increase fluid levels? Is it really always cause for alarm?
• If I need to have a cesarean, can I request one that is more "mother-friendly?" This may entail delayed cord clamping, immediate skin-to-skin contact and immediate breastfeeding. If your doctor refuses to do this, ask why - challenge the answers if they seem hesitant or cannot give you any compelling reasons why you couldn't do this (barring an emergency or "crash" section, obviously).

Another unfortunate problem is the "bait and switch," where doctors appear to be supportive of your concerns and ideas but then mysteriously change their minds at the end of your pregnancy. This especially happens with VBACs, where a care giver seems to support the mother's wishes and then poof! Two weeks before your due date they're pressuring you to schedule a cesarean. It sounds paranoid and terrible, but all I can say is, be prepared. If your doctor is threatening you this way, know your rights, know the risks and stand up for yourself the best way you can. Hire a doula, if possible.

Something else I've noticed in talking with pregnant women and in the general population at large is that if it didn't happen to them, then it probably doesn't happen. *eyeroll* Birth trauma is an especially touchy subject for many to discuss, because so many people have come to accept these practices without question, not knowing any other way. One set of health care practitioners will be bold enough to assume that just because no doctor they've ever worked with does inductions without just cause, surely they all operate like that - while another group can vouch that many are truly "cut happy" and have a reputation for rushing through things. This tends to silence women who stand up to the bullying tactics of some care providers, marginalizing their experiences and making others think they're "conspiracy theorists" because they dare to care or push for something better for pregnant women.

If I could do it all over again, ideally I would've been more prepared with that first baby - asking more questions, demanding answers, and informing myself more. My suggestions to you are:

• First ask yourself what kind of birth you want. If you want an epidural and all that jazz, fine, have one! But be adequately informed of their benefits as well as potential risks and side effects. You have to have more of a knowledge of them than "they're safe, get one!" because that is garbage. If you're on the fence, research your options and know that there's more out there than just that. Keep an open mind about those options and how you can cope without them, including water birth, massage, walking, standing in the shower, etc. But certainly don't feel like a failure because you "caved" and asked for the epidural.

• Take a good childbirth class. This can be subject to personal opinion, honestly. To me, a "good" childbirth class entails informing you adequately about a number of options while not making you feel demonized for choosing an alternative. For instance, if you know you want a natural birth but your teacher is making you feel like an idiot for choosing one (especially issuing the ubiquitious phrase "You won't get a medal for doing it without drugs!") then perhaps that class isn't "good." Likewise, no childbirth educator should make you feel like crap because you want an epidural, nor should they gloss over the risks of them or make them sound like the Devil's poison, either.

• Read. There is a lot of material out there, (some really good and some really, really bad) and good material will back itself up with sources. However, I suggest getting your information from a lot of sources, not just one (that includes your doctor). Again, it all depends on what you want in a birth, but some sites will sway in one particular direction or another. An even mix is key: anyone that makes you feel bad for going off your diet occasionally or like everything in pregnancy is to be feared and avoided might be over-the-top. And likewise, someone that acts like there is only one way of doing things, ever! might not be an unbiased, objective source of information, either.

• Avoid people who cannot or will not give you encouragement. This is especially important if you are attempting something that most people consider unusual, risky or not "mainstream" (eyeroll) like home birth, VBAC or really, a completely unmedicated childbirth. More people than not are going to gasp, their mouths dragging the ground, and look at you like you have spontaneously grown four heads. While some people are just uninformed but well-meaning, it's probably best to steer clear of people who can't support you in your efforts and do nothing but tear you down (that includes care providers, too!).

• Realize that when it comes to labor pain, it's all subjective. If you haven't gone through it before, it's normal to be scared about it - but you never know how you are going to handle it. When people relate their horror stories to you, you have to realize that that's their interpretation of it, not necessarily how it's going to work out for you. There are so many ways you can manage and cope with it without having to immediately ask for drugs - although there should be no shame in that, either. Just realize one thing: that some hospitals make it intentionally difficult to use these coping strategies effectively, such as "not allowing" you to get into a different laboring/pushing position, insisting on continuous fetal monitoring (that can confine you to bed), among other things. Ask about a tub. Ask to move around. Don't be afraid to just ask and focus on your labor, not pleasing the staff or trying to be "nice" just for them.

• In the end, realize that sometimes the things you desire least may be unavoidable. Being emotionally prepared for this, while not dwelling too much on the negatives and "what ifs," as well as being involved in the process and made to feel like you are an active participant, rather than just a helpless bystander, can help tremendously when it comes to accepting those outcomes. When it comes to being empowered and informed, it may not prevent every intervention, but it sure can't hurt.

Thursday, February 21, 2013

Childbirth education is important!

Someone shared this meme on FaceBook and I totally loved it, because it was so true: (click here for full text)

It's been said that women spend more time researching and shopping for major appliances than they do their birth options. And when it comes to your wedding day, you go to great lengths to make sure everything turns out just so - even though it sometimes doesn't - spending countless hours in preparation.

I once heard someone say how when a wedding doesn't turn out as planned, when a detail doesn't work out the way you wanted or it pours down rain during your beautiful outdoor ceremony, people are sad for you. They express regret and sympathy for you that "your big day" might have somehow been marred. Yet, when your plans for childbirth are totally derailed or you feel that you were denied something during the process, they basically tell you to "deal with it!" or "Get over it, you don't get a medal!" "That's just the way it is, so what?"

They wouldn't tell you that if your bridesmaid ditched you a week before the wedding, or if the cake was the wrong flavor.

With a good childbirth class, it can not only help you prepare for that big day, but fully realize just what your body is capable of - as well as help you realize that sometimes, the routine practices in maternity care are not always evidenced-based, or the "best" thing for everyone.

Would you want a cake decorator to say, "You must have a chocolate cake. That is the only flavor that's any good, and even though you're allergic to chocolate and don't like the taste of it, I'm making you a chocolate wedding cake!"? Probably not. Just like flavors of a wedding cake, there are options in childbirth; you just have to know what they are.

There are all kinds of childbirth classes. Fortunately I had a great one with a nurse midwife who herself had had normal births and a VBAC. She discussed a wide range of options, the realities of choosing them, advantages and disadvantages. What she did not do was paint a picture that said, "You are a bad person for choosing to have an epidural!" Nor did she act like they were terrific and every woman should have them and no woman can ever make it without one.

I chose the long, six-week whatever class, because there was a lot to learn! Some choose the condensed, intense version that is over and done with in a few hours. Personally, when you consider that it seems like many women don't fully understand the process of childbirth and what it entails, it sounds like the long version might actually be a better option. It's hard to work that out with busy schedules and work, etc. but this is your body - and your baby - we're talking about here.

Would you buy a brand new car or go on a cruise without spending time and effort researching it? Hopefully not.

When it comes to birthing options, especially VBAC, it seems that not many women know they do have options. Studies have shown that women often choose the mode of delivery that's preferred by their doctors - which likely means a lot of physicians are influencing their patients to choose a repeat cesarean. Unfortunately, many are limited because of the hospital they plan to deliver at, where VBAC is either banned or there is a de facto ban (meaning, the hospital "lets you" attempt one but no doctor will agree to attend you. Especially with regards to cesarean section and induction, childbirth education can mean all the difference. What are the risk factors? What does the procedure entail? Sometimes you cannot always count on your doctor to tell you this information up front. And I can't even begin to tell you how many people I've heard say, I'm being induced tomorrow and I have no idea what to expect! Does their doctor not tell them anything? Do they do any of their own research?

I once sat in on a childbirth education class and was extremely disappointed to find people talking and chattering amongst themselves when the instructor mentioned risk factors for cesarean section. Ladies, don't ever think "This will never happen to me." Sometimes it happens for very necessary reasons that are beyond our control; sometimes it could have been avoided. I think prevention is key - and sometimes the very things we consent to in labor can often be risk factors in cesarean delivery. It's hard to focus on future births and how they might be impacted by decisions and choices you make today, but that's pretty much how it often works. How can you truly give informed consent when you aren't fully informed?

I don't ever want to blame a mother for not being "educated enough" about the process. Sometimes you have all the facts and it's still not enough to prevent something from happening. But being educated about the process and feeling capable of making informed choices and educated decisions can often help tremendously when it comes to accepting with the outcome.

Did you take a childbirth class? Did it help you or not?

Monday, February 11, 2013

Mom nurses triplets!

I love this picture: a Florida mom (who birthed them naturally!) is nursing two of her three babies, while the third one presumably sits patiently in line, waiting his turn... LOL

Photo: *The Milk* Sunshine Coast Lactation Consultant
FaceBook fan page

I want to post this here to make a mental note of it, because I just like this picture so much. Breastfeeding is hard enough with just one sometimes, between pressures with work and family, well-meaning but crappy advice, and just everything else. To nurse multiples?? I can't imagine, but if I had them I know I would do it, come sleep or no sleep (but that's just me). So it's great to see a positive image of someone managing to do it.

Of course, somewhere along the way FaceBook had a hissy fit and reprimanded some fan page admins at Peaceful Parenting for sharing it. Even though they supposedly support breastfeeding mothers, "as long as the baby is actively nursing." A screenshot of FaceBook's TOS on breastfeeding is as follows:


Those babies sure look like they're actively nursing to me. So before it gets yanked by the powers-that-be, I'm sharing it here.

Of course, when there is no baby in the picture, those fully exposed breasts are just fine.

Friday, February 8, 2013

Maternity leave rates around the world

It may come as a shock to some, and not to others, that the US is one - if not the only - nation that does not offer mandatory paid maternity leave to new mothers.


It makes the US sound pretty darned bad to be stacked up against third-world nations who seemingly offer better for their women. Maybe, maybe not. Even working a dead-end job you hate is arguably better than no prospects at all. Some of the countries on this list made me wonder: What is it like giving birth in, say, the Democratic Republic of the Congo? What's it like living and working there?

My husband visited there last year and he could probably tell you better than I: if you are lucky to have a job, you will get, according to statistics, 14 weeks of partially paid maternity leave. Among the Congolese, however, about one in 13 women dies during childbirth, ranking them 17th in the world for maternal deaths. My husband was awestruck by the dichotomy of living conditions there: in the villages, at least one man took in many children (almost a dozen) who were either his own or orphaned, doling out food to the family and himself often not eating for days at a time. On the flight in from Brussels, only the wealthiest of Congolese could even begin to afford a plane ticket, and you would be sitting amongst only the upper crust of businessmen and women, not average citizens. In the city of Kinshasa, he noted the absolute dismal filth, and the children who would crush rocks and pebbles into sand to sell for a little extra money. He even got a tour of the local hospital (where Hillary Clinton once visited), which has a large wall around it to keep out the 'dregs.'

Yes, the same country that requires a woman's employer to grant her maternity leave and a part of her wages is also the same government that employs soldiers who help themselves to your possessions and house, because the military is grossly underpaid and pissed off that they can't feed their own families. They are also the same government that sanctions rape of their women, sometimes upwards of 100 victims at a time. In many aspects of life there, much of the female Congolese population are treated like shit. So who cares if they get paid maternity leave? (It's a wonder, really...)

One would wonder, then, especially among these poorest nations, what percentage of those women really get maternity leave? Likely precious few.

More reading:
Congo-Kinshasa: Where giving birth is deadly
In US, maternity leave benefits are still dismal
Women for Women International

Tuesday, February 5, 2013

OB complains about patient on FaceBook

This happy little post has made the rounds today over at Jezebel.com - an obstetrician is openly venting her frustrations (well, now her wall is private) over a patient who has shown up late repeatedly for her prenatal appointments, and is now three hours late for her induction. The physician snarkily asks, May I show up late to her labor? (Gee, I think it's been done before...)

Apparently, she tells her friend, the only reason she's been putting up with it is because the woman has a prior history of stillbirth.

Hmm... On one hand, showing up late is not such a good thing. On the other, perhaps this mama doesn't want an induction. Doesn't like you as her doctor, but is afraid to tell you. Who knows what her issues are. All I know is, it seems like doctors have the market cornered on making people wait, often without any explanation, and you're just supposed to sit there and deal with it? What, like my time isn't important, too?

Someone said they had seen other posts on the good doctor's wall, including comments trivializing circumcision and complaining about having to return to the hospital later on in the day to do one. For some reason, her wall was public - duh! - and I hope her patient didn't happen upon it. How heartbreaking.

It kind of irritated me how both her friends and the commenters on Jezebel blamed the mother and acted as if the physician's time was way more important. "If it's elective, cancel the induction!" one friend trumpeted. I kind of agree. She might be better off if you do.


More reading:
Being censored: By your OB? 

Sunday, February 3, 2013

Facelift!

Time for a new look here. Bear with me, because Blogger likes to make things ridiculously difficult when uploading templates, etc. and changing things around. It took me like ten whole minutes just to find out how to make a new post. It seems like every template that initially looks good ends up looking like crap once I make it go live, so it might take a while before anything is legible! And being as extremely anal as I am, this could get ugly. I am also having major computer issues so I'm wondering if that's part of the problem.

Blogger, you stink. But you're free, so I'll take what I can get. Hopefully the whole thing won't crash and blow up while I'm not looking.

Wednesday, January 23, 2013

Reproductive rights don't end with abortion

Everyone's talking about the 40th anniversary of Roe v Wade, especially celebrities. They are lending their voices and faces to the movement in hopes to get better access to reproductive health services for women everywhere.

That's all fine and good, but I think part of that puzzle is missing. What no one wants to talk about, it seems, are what happens if you want choices in childbirth. Aren't those reproductive rights, too?

Many pro-choice advocates like to say that Republicans "don't care" what happens if you decide to not have abortion. Maybe, but from the looks of it, they don't care, either - if you want a VBAC, home birth, natural hospital birth, unassisted birth, etc. where are they?

Many celebrity faces of the pro-choice movement include Meryl Streep, Ani DiFranco, Demi Moore, Cybill Shepherd and many others. Meryl Streep had at least one home birth, but I don't hear her ever mention it, much less do a commercial for it. Both Ani and Demi also had home births. Cybill Shepherd searched tirelessly for a doctor who would "let her" give birth vaginally to her twins. Why are none of these women on the street corner with other birth advocates holding signs that say "Stop banning VBACs!" or "Fight for normal birth!"? Demi Moore starred in the movie "If These Walls Could Talk" - perhaps she could play Laura Pemberton, the Florida woman who was taken from her home during a homebirth after cesarean and forced by the court to undergo a repeat cesarean?? I won't hold my breath.

While there are many childbirth advocates, one of the few celebrities standing on that side of the fence is Ricki Lake. A face and name you are likely to remember, with enough leverage to get her advocacy out there, she is equally praised and hated, it seems. While one side praises women for standing up for their rights to not carry a baby if they don't want to, others are demonizing those women who stand up for their rights to birth that baby in the manner of their choosing. Why are so many in the pro-choice movement silent on this?

I just read an article from the feminist site Jezebel that in a nutshell says, "Home birth is dangerous. Natural birth advocates are stupid," and unbelievably lists one of her sources as "Hurt by Homebirth," a website run by Dr. Amy Tuteur (who, I think we can all summarily agree, is someone who hates all women that exercise their childbirthing rights more than anyone I've ever known).

Why aren't they saying, "I personally wouldn't have a home birth, but applaud Ricki Lake for standing up for birthing women?" Instead of basically saying "I only support the reproductive freedoms of some women, not all." They similarly malign Michelle Duggar, mom of 19 kids.

We readily support advocates who sail into international waters to provide abortions to women in need, but where is the support for victims of forced abortions in China? I am not saying that providing abortions to women in countries where they are strictly illegal and maternal deaths are high is not a necessary service. But why are you only focusing on one aspect of reproductive care? What are you doing to improve birth outcomes and make childbirth safer for those women?

Where are Meryl Streep, Kyra Sedgwick and others when...
• a woman's doctor won't "let her" go beyond 40 weeks?
• a woman's doctor dispatches the police when she wants a natural birth and refuses the induction appointment?
• every hospital you turn to has banned VBAC?
• you want to have a home birth but your midwife could be arrested for attending it?
• you are bullied endlessly about scheduling an induction or cesarean when you don't want one?
• you want a doula but your doctor or hospital "won't allow" it?
• you are removed from your home during a home birth in progress, only to have a judge sign a court order and demand you have a cesarean? (see the Laura Pemberton link above)
• your doctor, nurses and anesthesiologist repeatedly badger you about accepting an epidural even though you don't want one?
• hospital workers dispatch CPS when you refuse a cesarean, or because you birthed a breech baby at home?
• hospital staff treats you badly during a homebirth transfer?
• your local hospital has a VBAC ban in place and says they will get a court order to force you into surgery even if you show up in labor?
Excerpt from the ICAN VBAC database (currently under construction
and now only open to paying members) 
Please note: The state of New York, or any other state, for that matter, does not have a ban on VBACs. Individual hospitals may have outright bans, or "de facto bans," which means they would allow it but no physician will support you in your efforts

I'm not saying I necessarily agree or disagree with abortion; what I'm saying is that vocal pro-choice advocates should not draw the line at abortion. They should not turn their heads or walk away from those who advocate for choices in childbirth, call them "crazies" or degrade their efforts. If you are pro-choice, I merely ask you to consider directing your energy and focus into supporting the reproductive rights of all women, not just some of them.