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Thursday, July 30, 2015

Improving birth by breaking the silence

The topic of childbirth is one that women - often those who don't even know each other - often freely engage in. We find ourselves sharing the most intimate details with strangers on what is often the happiest day of our lives. And for some, one of the most traumatic.

But it seems like if your outcome is anything less than happy, women suddenly don't want to hear about it. And when you question the actions of your doctor, or express anything less than total and complete gratitutde to your doctor, then you're attacked, criticized, made to feel like you're selfish for wanting something more or think you're smarter than the physician.

And yet, sometimes these stories still make it out, have a voice, are heard above the din. When "Kelly," the mom who had an episiotomy and was cut at least a dozen times by her physician, told her story, many women did come out of the woodwork. They shared their equally horrifying experiences, told her she wasn't alone, said the same thing had happened to them. It was terrifying and yet vindicating at the same time, knowing that finally these women are confident enough to talk about what happened to them. And with the number of them growing as more and more comments were added and the article continued to be shared, it was clear there were more of than them than not. And it was abundantly clear, even to those who are not involved in birth advocacy, that there is a shocking pattern of abuse in obstetrical care.

If you ask your mother, grandmother or great-grandmother what her birth story is, she may or may not be able to tell you. She may not remember any of it, drugged into oblivion with medication she may have felt at the time she neither wanted nor needed. While things have improved somewhat since then, it's not all that much, considering you still hear these horror stories. Women were given few choices then and to some extent, still aren't, with sometimes well-meaning and sometimes downright cruel care providers making choices for them on their behalf. These pictures continue to give us evidence of that.

I have seriously told women who were not
comfortable laboring at home to either labor in
the parking lot or the lobby but not necessarily
check in. That way you're close to the hospital,
but still on your "own time." How pathetic is it that
women even have to resort to doing this?
I can totally understand where she's coming from.
Photo used with permission from
Isn't that the truth. Remember Nurse Jenna's
post lightyears ago about "why you need
Pitocin in labor?" This was basically her
justification of it - they need to free up
beds. It's all your fault that you're not
laboring at home longer, even though
we care providers make you feel like it's
the most dangerous thing in the world to
do so. (To read the article, click here.)
Photo used with permission from
Coercion can often be another hallmark of abusive practices. And as some find out, they agree to the procedure only after much pressure and bullying, only to read in their chart later something entirely different.

The "maternal request" cesarean is often the result of
mom agreeing to a c-section after finally giving in to
bullying, scare tactics, and tremendous pressure to do so
from her physician.
Photos used with permission from
I am not at all surprised that this is a female physician. I
had similar experiences with one in my OB's practice and
found many of them to be far more condescending and
rude than the male doctors.
Photo used with permission from
When people say "Just trust your doctor" I think
of situations like this one and it makes
me want to throw up.
Photo used with permission from
I urge you to go through Improving Birth's FaceBook gallery. Maybe there is a situation that speaks to you or you have one to share - please do so. Maybe you personally have never experienced this and were completely unaware that such a thing existed. It is time for women to stop being shamed into silence and forced to accept something that is "normal" when it really isn't.

More information:
Improving Birth - Advocates for Evidence-Based Maternity Care 

Submissions will be accepted again soon - to submit your entry, click here

Monday, July 20, 2015

How to survive a family vacation out west

A few months ago, I started planning a vacation out west. A real extravaganza, we'd be gone for about three weeks and would plan on tent camping most of the time. Yeah. As the date approached and more and more people started asking us about our travel plans, I began to wonder: Am I *@&%^^@ crazy??

The view from our hotel
The magical date came and we set out from my parents' house in Ohio. I had a great deal on a hotel in downtown St. Louis through Travelocity or some such website, and was pleasantly surprised at how posh and super fancy it was for country folks like us. LOL What I didn't realize: it had no free breakfast and no pool. But never mind, the amazing view of the Gateway Arch from our room! more than made up for it (as did the totally awesome bathroom) and the kids didn't mind. Because I didn't want to spend the money on dinner, I made sandwiches in our room and ate fresh fruit that I had packed. Whew.

As far as meals on the road, I had planned on making as much "real food" as possible so we could avoid eating out and fast food all the time. In theory, this was great - especially as my stepdad had bought us a cast iron skillet (lid sold separately), we had a cranky campstove and lots of still frozen food in the cooler. Frozen water bottles will help keep things cold, they said. Uh huh. Until it thaws, the cookstove doesn't light (out of white gas, I see!) and the temps are so intense absolutely no one has any appetite. That didn't quite work out as planned.

Here's what I found:
Freezing food ahead is a good idea, at least in theory. Sometimes it doesn't always work out and stuff will go bad despite your best efforts. Super hot temps, kids getting in and out of the cooler, not enough ice, etc. The frozen water bottles worked for a little while but are not as practical as ice, since once they thaw, there is virtually no place to refreeze them. We missed at least one meal because of not enough fuel in the stove. (I advise bringing extra fuel so you don't get taken for a ride when you run out and the only option is some remote gas station that charges double the price.) Aside from that, realize that if you're not staying in the same spot more than one night or for the duration of your visit, lugging out the gear and food, plus setting up the tent, cot, sleeping bags and whatever else you have can be a giant pain in the butt and you just might say screw it. One other thing: when it's 86% humidity, no breeze is blowing and the temperature is in the 80s despite it being almost nine p.m., no one may even feel like eating anyway.

You may find yourself searching out Walmarts and grocery stores a lot to avoid the hassle of trying to keep food cold for longer periods of time. All I wanted was cinnamon rolls for breakfast, but I think three cans of them exploded on us in the process. (The one that didn't accidentally got dropped on the ground during cooking - totally not my fault.) Premade pizza crust with toppings worked well in the cast iron skillet, once we knew not to turn the flame up too high on the stove, and cooking stuff over a campfire works to slowly heat things up but otherwise takes forever. Making your own doughs may sound like fun, but again, if you're setting up and taking down camp each day and getting on the road, you're probably not going to feel like whipping up homemade pizza dough.

I also found it difficult to heat food in a cast iron skillet without a lid. If you need one while on the road, they sell them reasonably at Cabela's and probably any other outfitter store. It was easier to keep the bugs out of our food and keep stuff warm. While they sell the skillets at Walmart, they do not sell the lids there. You can also use glass lids or foil, too, though.

As far as staying in campgrounds, few required reservations. That doesn't mean that you shouldn't call ahead, either, though. I made almost no reservations while camping because I wasn't necessarily sure where we'd be. We chose to camp at KOA's most of the time, and for the most part they're large enough that they have plenty of room. However:

This may not include areas that are close to national parks, like Yellowstone. We stayed at the KOA in West Yellowstone, which is actually in Montana, and it was crowded. Very crowded. At first it was kind of a turnoff, but the people milling around and doing fun activities (which will cost extra) was almost like a little community. There are bears around, but usually outside the perimeter of the campground because, again, it's so crowded. We were able to call ahead a few hours and reserve a spot, and by the time we got there I think they were full (I did see some empty tent sites but I'm wondering if they were reserved). Cabins are fun, but I'm guessing that close to Yellowstone they were probably reserved months in advance. And even tent camping in that area will cost you: it was probably more than $60 a night just to set up our tent, which is the most we paid to tent camp the entire time. But you are close to the park and there is tons for the kids to do, plus a very cool gift shop (which had some items in it that I didn't see in the park's gift shop).

Camping in Yellowstone itself may sound like fun to some, but I chose not to simply because my kids are a mess when they eat and I didn't want to deal with meeting a bear face to face. Bears, as well as other predators, can be a problem if you don't take precautions. Because I wasn't sure what we'd end up doing, I did research camping in bear populated areas, and there are usually guidelines posted in the campgrounds within the parks on how to properly store food and anything scented - this means soaps, detergents, perfumes, anything. It may sound like I'm being paranoid - after all, we saw not one bear on our trip - but when you've never camped in those situations before and have three little kids in tow, it's always a good idea to be prepared. And never, ever, bring food into your tent. Depending on where you are, even pop-up campers won't keep you safe if there is substantial bear activity going on (but chances are if it's that bad you won't be allowed to camp there anyway.)

As far as camping in Yellowstone, don't expect to just show up unnounced and get a good spot. I've been told that these places fill up sometimes a year in advance, so if you want to camp there, plan well ahead. You might get lucky, but I wouldn't take chances with it as it could put a real damper on your trip if that's what you were hoping to do. (This link has more detailed info on making reservations at the major parks, and suggests less than a year window, but it's still several months ahead of your actual visit.)

The only bear we saw was in the
campground giftshop 
As far as Yellowstone itself, it's wildly impressive but extremely overcrowded in some areas. This is one of the downsides. People everywhere, including in all the parking lots leading to the sites along with the way. There are bathrooms strategically placed throughout the park, but when we went through there were sometimes lines fifteen people deep for a unisex bathroom. Some sites we had to avoid altogether because there simply was no place to park, which was disappointing. The gift shop was pretty crowded but has fairly reasonable prices, and the attendant told me that crowd was nothing compared to what they normally get.

Which means that if you're looking for wildlife, you may not see any until you get to the less populated areas of the park. We saw a few bison along the road when we first entered, but the herds are usually further away from the more populated areas. If you see bison close up, don't be a dumbass: stay in the car. Zoom in with your camera or just look from a distance, because these huge, seemingly docile creatures will charge humans that are getting into their territory. There is a rather disturbingly impressive video in the visitors center that illustrates this point nicely.

Other dangers I added to my mental list included cliffs, dehydration, poisonous and dangerous insects and animals, and boiling hot springs. Don't overresearch it - trust me - just know that while it is possible to be paranoid to the point of not enjoying yourself, these are very real dangers that have claimed the lives of both young and old indscriminately. That's all I'm going to say about that. Keep a close eye on your kids, insist on holding little ones' hands, and try to enjoy yourself. The vast majority of people injured or killed in the park(s) do so because they either weren't paying attention or were being stupid. Some have said they saw children hovering dangerously near the edge of the Grand Canyon, shoving and horseplaying on the boardwalks of Yellowstone - park rangers will spare no feelings in yelling at you if you choose to wander outside designated boundaries.

LOL What?? 
As was the case with The Grand Canyon, Painted Desert and Badlands, you cannot just whiz through these parks - if you're pressed for time, you may want to choose which sites in particular you're interested in or skip them altogether. If you decide to go through, an America the Beautiful Parks Pass ($80) is a pretty cool option. They can be purchased at probably any National Park (although check the list online to be sure) and can get you in either for free or discounted admission to all national parks for up to one year.

Definitely bring a paper map. And maybe a laptop. If you don't have cell service (which is pretty common once you head into parts of Utah, Arizona, Yellowstone and Montana) that GPS isn't going to do much good. A road atlas is a must. And if you're taking six gagillion photos, you may need to dump them onto a computer or the Cloud if you run out of room on your phone. It also helped me to have an actual computer to continue to pay bills, etc. and have more of a physical connection on the trip than with just my phone. WiFi, even in hotels and campgrounds, may totally suck, so be prepared. Our hotel in northern Arizona frequently crapped out on me and kicked me off the network.

You will likely have overage charges on your smartphone, unless you already have a mega huge data package. Because of my particular plan, the Verizon rep told me it would actually be better for me to pay the overages than switch. You can also go into Cellular (under settings) and turn off the apps and stuff that hog the most data in order to avoid overages, which just means you won't be able to use things FaceBook or Pinterest while on the road.

If you're traveling out west, get gas frequently. Even if you feel like you don't need it, it's probably still a good idea, especially as you head into more remote parts that either have gas for twice the price or none at all. Thorough car maintenance before leaving is also a good idea, because once we were cruising down Utah highways we realized, hey, it's been about twenty minutes since I've seen another car.

Definitely check the forecast before you leave. For several weeks, I would check the weather for the various parts of the country we planned on visiting. Not that the weather will be that way when you get there, but it helped me to prepare as far as packing. We brought a heavier jacket, fleece, pants and long sleeves for the nights in Yellowstone, which can get into the 40s even during the summer. Obviously not everyone did this, because we saw a lot of people bundled up in Yellowstone sweatsuits, which the park must make a killing on from people who aren't prepared for their wild weather.

If you're using ideas from Pinterest (or anywhere on the internet, really) test them first. What works for one person may not for another, and depending on where you are, it may not be the best idea. Those wax cotton pad firestarters may be awesome, but I used scented candle wax - which was all I could find - and if I were camping in Yellowstone, I definitely would not have used them. We lugged them, with the recycled egg cartons - halfway across the country and when we finally did use them, the wood wouldn't burn. There may be burn restrictions in place out west, in which case you may not be able to have a campfire anyway.

These solar powered mason jar lights sounded like a great idea - dual purpose not only for lighting up the tent at night, but keeping matches dry. Unless you're white water rafting and bringing all your gear along or leaving it out during a thunderstorm, I think we'd be hard pressed to find a reason for our matches to get wet. Not only that, but my solar lights were way too small for the diameter of the mason jar and I just stuck my matches in a ziplock bag for the same effect. Solar technology in general, I've found, pretty much sucks in the long term (as in after a few days of regular use), as I read review after review of expensive solar-powered lanterns from perfectly reputable companies either not working straight out of the package, not holding a charge, or fizzling out after a few uses. I did use some solar stakes I found for a $1 at Walmart to light the tent at night, but I think one totally stopped working and the other decided to stay lit when we didn't need it, which meant it went out before the night was over. What did work for us was inexpensive glow stick lanyards, which come with a string to hang from the ceiling of the tent (ours has a hook there for a lantern) and are two for $1. Some campsites aren't actually dark enough to really need them, though. And of course bring batteries and lots of flashlights. 

I also suggest not only going through all your gear before you leave, but if you're buying a new tent, get a good one. I read tons of reviews and finally settled on one that ended up being out of our budget, but was worth it. One reviewer rated it favorably in high winds and rainy conditions, which is exactly what we faced while out west - those storms can come up fast. When you're struggling with the rain fly at 1 a.m. (hello, Tucumcari, NM) you want something that will withstand the blast, and some tents definitely fare better than others. If you plan on doing any serious camping in the future, spending money on good gear is definitely worth it.

TripAdvisor was a very helpful website along the way (they even have an app). From campsites to parks and hotels, they offered the most comprehensive reviews I could find, which was an awesome tool to help guide us in unfamiliar territory. Blog posts from others who've done it also helped me a lot (which is why I'm writing this post). The GasBuddy app wasn't as helpful as I thought, and I ended up deleting it in order to save space on my phone. The white noise app wasn't too bad and offers lots of different choices for background noise, but some campsites and cabins have electricity if you're really desperate and need a white noise machine or fan to get you to sleep.

I have pretty much nothing bad to say about KOA campgrounds. They are awesomely family-friendly and usually have all kinds of fun things for kids to do. There are lots of others out there, but KOAs are usually pretty easy to come by, you'll meet nice people and they are generally reasonably priced. They also have pretty cool cabins that are about the price of a hotel room or less that have electricity (some even have bathrooms and TV). We decided to check one out while in South Dakota and I'm glad we did, since we got a whopper of a thunderstorm that night.

You will probably drive each other nuts. Face it - if you're in the car a lot, this is bound to happen. I put a big bag of activities together, from car bingo (which they hardly played with) to journals, books, coloring pads, and homemade word searches (click here). Of course, DVDs are probably essential and I changed out the music on my iPhone to liven things up (which actually helped keep me awake while driving through the night to get home, who knew). For those moments, it might be helpful to say a prayer, take a deep breath, pull over at a rest stop (several have playgrounds, woot!) and take a breather before getting back on the road. Have a plan, but don't overplan, and be prepared for things to not always work out - but by all means, take everything in, learn a ton about our country,
and have fun!