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Tuesday, December 20, 2011

Pregnancy loss and grief: keep it under wraps?

Every once in a while, the dark, sick nature of the human race hits me: lately, it's been in comments both about the Duggars announcing their latest pregnancy, and then in the sad news that they had lost their precious child. The talons come out, of course, and people basically find a nice way of saying, "They deserved it!" Barf. 
Judging from some of the comments I've read, I'd say hate is the only word to describe some of them. Thinly-veiled at times, yes; but still hate, all the same. Then when I read an article about how they openly shared very touching, heartfelt photos taken after their baby had died, I saw even more hate and disdain.


"Disturbing" and "grotesque" were some of the words used. But as someone bluntly put it, "It's not like they posted pics of a bloody mess." Some comments are so utterly inappropriate - and made in all seriousness, I think - that I don't dare post them. And yet, on the TMZ site where the photo ran, this (see left) was in another set of photos on the sidebar. What kind of world do we live in where the above photo is "disturbing" and the other one is a-okay? I do not get this.

I've had two people on Facebook tell me that acquaintances actually unfriended them and stopped reading blog posts when they chose to open up about their experiences. Seriously?! I felt chills when I read this and couldn't imagine responding so coldly and callously about something like that.

A few years ago I caught up with my friend Em on Facebook and was delighted to hear from her after so many years. I was equally bummed, and felt sad and guilty, that I had no idea what she had experienced, that I wasn't there for her. I couldn't imagine the pain and grief she went through, in addition to the problems she already manages to deal with in her day-to-day struggles with bipolar disorder. Em also told me that another "friend" told her the same thing two months after her own pregnancy loss - that she was a "dweller" and criticized her for being so open about it. So when that "friend" ended up miscarrying twins, Em thought it would be a good chance to help her be more open with her feelings and emotions. Wrong.

Years ago, before I ever had kids, I was friends with a coworker who ended up giving birth prematurely to a baby that had a severe heart defect. Open heart surgery ensued, and an overbearing mother-in-law who accused her of doing something to cause this didn't help. I was appalled that this woman could be so heartless at a time when her daughter-in-law needed support, love and encouragement the most. In a crazy twist of fate, my coworker's brother and his wife lost their baby when she was six months pregnant to a heart defect as well.

Her hospital decided they weren't sure how staff would handle the birth of this stillborn baby, so they sent her an hour away to another hospital. At the time, and still, really - I can't understand why they did that. It wasn't like she had aborted her child, or done anything wrong to cause this to happen. Once they delivered the child, photos were reluctantly taken, which would appear gruesome to some, but were all she had at the time. I wasn't a mother yet, had no real idea what she was dealing with, when I saw her going about her business one day while the photo of her daughter lay on the table, out in the open. I only caught a glimpse of it, but rather than say something or react, I figured that was her way of dealing with it and just said hello and moved on. What else can you say?

I knew someone else, who, when she gave birth in the 1970s, was not even able to hold or see - or even know the sex of - her baby that was stillborn at around six months. I thought how horrible that was, to not even know, and couldn't imagine what kind of grief process she was still grappling with, several decades later. Who are they to decide how this mother grieves her child?

Several readers shared that they had been unfriended, had people stop reading their blog, even send hate mail - because they had shared their experience and grief so publicly. It's like saying, "I don't want to hear what you have to say about your hurting and loss. Get over it," and giving a big cyber middle finger to someone who is in pain and wants to grieve differently than someone else does. When you want to talk about it, they shut you out, shut you off, and effectively tell you, "You know what? I don't care, I can't care, because it makes me too uncomfortable to deal with this." 


Although I've never personally miscarried, I know the words most women who have least like to hear is "It was for the best," or "it just wasn't meant to be." It may be that these people mean well and don't know what else to say, or it just comes out wrong. But at least they're saying something - instead of tuning you out and getting mad when you want to share your feelings. Saying those things could be a lot worse - like simply severing contact with someone who is reaching out. By being shut down like that, it's like you're  not allowed to grieve. Like somehow in our minds, it's not really a baby unless it's full term and comes into the world screaming, pink and "healthy."

Jaime miscarried her first child two years ago, and she still finds it difficult to talk about. She says that saying nothing at all is better than "It was for the best," which she thinks kind of trivializes it and makes it sound like "no big deal." She writes, "I totally agree that most people are trying to be supportive and just aren't sure how. My best friend sat with me (over the phone cause she is 1,000 miles away) and let me vent and cry and prayed with and for me without saying 'It will be alright' or anything. That was and is, in my opinion, the best thing you can do for a person."

It certainly turns that "At least you have a healthy baby!" argument on its ear, doesn't it? As if to say, Well, it's supposed to turn out that way, but if it doesn't we don't want to hear about it. People don't seem to be able to handle it if that baby isn't healthy - then what? Well, we can't talk about that. Maybe it's a deeply-seated idea that there must have been something the mom did wrong for it to happen; or that if the pregnancy wasn't far enough along, surely she has nothing to grieve, perhaps.

I honestly wonder sometimes if our culture's in-your-face attitude about abortion is another reason people are often reluctant to talk about pregnancy loss - it puts a face to that ultrasound of a baby that is, often times, fully formed even though they are nowhere near ready to be born. It presents a confusing, dual reality for some, I think, that it definitely is more than a "ball of cells," or the suspension of disbelief that this is, was, a living little person. The idea that for some, if you don't come home with a baby in your hands that somehow, it never happened, isn't worth dwelling on because it is a life prematurely halted and therefore somehow not worthy of celebrating.

While the Duggars are in the spotlight, I think we can all learn from their experiences and trials, and I hope these wonderful photos will be a vehicle for women to open up, should they choose to, about their pregnancy loss. Many women who had suffered losses also attended the funeral - no doubt as a show of support, but perhaps also in a way to acknowledge and memorialize their own lost babies.

The Duggars' choice to memorialize their child this way is nothing new - not more than a century ago that's what people did: took pictures of dead relatives (even propped up in a casket) to remember them and celebrate their lives. What people find most grotesque about these pictures is that it puts into perspective the potential for a human life, even one so small, that I think most people would just rather not think about and pretend doesn't exist, doesn't happen.

I think there are many, many silently grieving mothers who would beg to differ.

More reading:
Duggar pictures of dead baby at memorial raise ridiculous reactions 
Becoming Sarah blog - a mother writes about her home, family and healing from loss

Friday, December 16, 2011

Bi-polar and pregnant: One woman's story, part 3

As a birth advocate, I am a moderate - I don't feel that birth is a 'one size fits all' experience; neither do I think that every epidural, every cesarean, every induction is a horrible very bad thing. We can whine and complain and write about how maternal-choice inductions and cesareans are a bad thing that put mothers and babies at risk, but in reality, sometimes they're the best option at the time - for a variety of reasons.

In talking to Em about her birth experiences, I realized that sometimes, there are those unseen reasons that no mother likes to talk about - things that really, are no one's business even though they are not visible on the outside. And your choice may tick some people off - especially those who don't know the full truth - but that's just too bad. In short, she and her experiences have taught me a lot about my birth advocacy and how I can use it to help other women.
After losing our daughter, I had my breakdown, I had my meds back, and I was armed with research. I found that my meds were a C class drug. No definitive danger to my baby and they would help me tremendously with the turmoil ahead. My psych told me flat out -NO. I had pages of research, he said NO again. He told me I had to drop this, as it was making me upset to talk about it. No, asshole you flat out patronizing me is what was aggravating me. I left. I called my insurance asking for a new psych referral. I was referred to the head doctor of the hospital’s loony bin. He couldn’t take me on but referred me to another psych that did specialize in women during their reproductive years. Hallelujah.  She agreed with all my research, was pleased to have an informed patient and we decided on a direction for treatment of my bipolar disorder. Team member #2 was on board. My talk therapist has been with me since before my pregnancy with our second child. 
I asked my M/F doc for a referral to a new OB. My previous one left me less than impressed, we shall say. They didn’t see me till I was being discharged after our loss and then patronized me about psych drugs during my follow up. I was seriously given the speech about post-partum depression and to call when I needed drugs. They knew I was bipolar and had a doctor to cover that area of my health. Plus after they basically called me crazy for saying something was off, I couldn’t trust them. My M/F gave me the name of my new OB. We met and I liked her immediately. She knew my history and was willing to take on a mentally ill woman with a single-minded need to have a child. Team member #3 was on board.  
Shortly after we conceived again. I had this driving urge to be pregnant again and wasn’t in the mood to wait. I did wait long enough to have the autopsy confirm it was an infection, as we wanted to make sure what risks we faced in the future. I could tell you details, but really they don’t help. I felt by having a team in place I could get on with conception. So we did. From the moment I peed on the stick I knew everything was going to be ok, I knew it in my heart and soul. My pregnancy was less than ideal - I gained so much weight (55+ lbs total), I slept, and I ate like a teenager. I was moody and had emotional outbursts but refused extra meds. The less I took the safer my baby was. I was in Hell but as long as the baby was ok I could cope.
I again consented to the Nuchal fold test (I wanted to see my baby), but not the AFP. My OB agreed and didn’t push. After all I had the history of a false positive. I then had my 20-week ultrasound, which confirmed a very healthy baby boy was nestled in my womb. The tech was so cool and gave us a free 3-D scan. He slept just like his sister. I fell in love. My M/F doc came in and confirmed the healthy happy news. He had some residents and let them get a feel for the U/S on my belly - hey, it was more face time with Almond. He then tried the instruction of placing an amniotic needle and promptly got punched. He knew why and then explained that I was that patient, the 1 in 500. I can’t win the lottery but I got that one.
At my 34 wk appointment I looked at my OB and asked for a C-Section. After my previous two experiences it couldn’t be worse. I was huge and swollen and flat out miserable. She calmly looked at me and promised my next birth will go much easier and all will be ok. It is a testament to her diligence with me that I trusted her and let it go. The magic 37 weeks hit and I am 90% effaced, 3 cm dilated. We are feeling that by week 38 I will be holding my son. Week 38 hits and I am 95% effaced and 4 cm. No baby. 38 wks 4 days I headed into L&D - our son had been asleep for hours with no movement. I panicked and headed to the hospital. I get to L&D and it started - the breakdown. They were originally going to place me in the room we were informed of our daughter’s passing - nope that wasn’t happening. So into another room I go, get hooked up and bam - heartbeat blasting through to everyone but me. I began begging and crying to be induced, I was so scared my son would die in my womb. I was hearing his strong beautiful heartbeat and was crying. 
It was at this point in the conversation that I asked Em, given her need for medication as her due date approached, if she was suicidal. She responded, "Yes." Unfortunately, this is one "medical reason" that many women don't wear on their sleeves, or in their swollen ankles and discomfort: one that is often met with disapproving glances and harsh comments from people who have no idea what's going on on the inside. I felt badly and thought to myself, Have I ever questioned someone's decision like this? Have I ever rushed to judgment like this before? Probably.
My OB was called and stood by her guns; she wouldn’t budge - no induction till 39 weeks. Then the Bitch Nurse, as I can call her nothing else, said to me that I should thank God my child died in my womb where I could offer her the most comfort. She continued to go on and on, saying I needed to come to peace with her death, accept God into my life, and basically listen to her. She’d been in my shoes and knew better. No, she didn’t know better. Until you are in the exact place (which let’s face it, doesn’t happen) you can’t tell someone that you know better. I began crumbling fast. 
I continued to try all the tips to go into labor - membrane sweeps, spicy foods, labor cookies, sex, walking, you name it I tried it. My son was not moving; he was comfortable and stubborn. I (headed) to my psych who noticed I was in a bad place and started Prozac to help bring me out. The problem is that Prozac isn’t that safe for pregnant women. She asked how much longer I would be pregnant, to which I replied he would be born within 10 days, even if I needed an induction.  
Christmas passed and so did the next week. I checked into the hospital to have my induction. They were crowded with women wanting babies before the end of the year; I wasn’t there because of that but, because I desperately needed strong psychiatric drugs that might harm my child.
Em said that once the Pitocin started and the epi was placed, she progressed quickly. She requested to sit upright - which she said surprised them - and within a few minutes her son was born.
We could see the crown of our son’s head. I decided to take a look. They brought down the mirror so I could push and watch my son enter the world. (By the) third contraction and each push brought him closer to my arms. After the third contraction and the ninth push, he was born. I couldn’t make out his face for all the tears in my eyes. I pushed for all of 10 minutes. He was immediately placed on my chest to warm and nurse. He was perfect and he was here. 
My third time at the rodeo and I finally got it right. His birth cleansed me. Healed me. Made me whole again. Every moment I look at my son he heals me. His mere existence is amazing to me, as is my daughter’s. Yet when I think back on his birth is it with great joy and happiness, not the fear and apprehension I had at my daughter’s birth. I could go through the experience of birthing my son a million times over and it wouldn’t be enough for how amazing it was. My medically controlled birth, with the most interventions - and it was the best one. Not because of the medical interventions but due to the OB and her ability to do what was right for me and our son. 
To see him born was a singular moment for me. Is this birth for everyone? No. Was it right for us, given the circumstances? Yes. I cannot put into words how amazing I felt after my son was born. I stood up after his birth and felt as I did at 14 weeks post partum with his sister. Everything about our son’s birth was joyous and healing. 
So now you’re asking what was the point of my posts?  I don’t know. Maybe it’s to shed light onto how the same woman can have vastly different experiences. Maybe it’s to tell women that even if one birth scars you, the next one could heal you. And maybe it’s just to share. Maybe it’s so that there is a positive out of all of the dark. I know most birth advocates don’t get behind inductions, but mine was needed. Not because I was physically miserable - which I was, but for the fact my mental health was slipping fast and I needed stronger drugs. I wasn’t going to risk his exposure to my meds any longer than he had to be. I feel it’s important to say this - I was perfectly poised for an induction. My cervix was ripe, I was 39 weeks 6 days, and I was on medication that could prove harmful to my child if fully exposed. I had heard enough about possible complications and c-sections during the induction prep. Mine wasn’t one of these. I have an amazing OB who listened to me in the beginning and followed through with what we decided on in the face of my bipolar rage. I learned through all this that open honest communication with your health care provider is a must. If you fear a reaction from your doctor- you need a new doctor. There is no place for silence and fear in your relationship to your health care provider. 
Thanks for reading and sharing my experience. - Em.  
If you or someone you know is pregnant and experiencing symptoms bipolar disorder, depression or other mental health problems, there is support and help available.

Managing Pregnancy and Bipolar Disorder - NAMI
My Bipolar Pregnancy blog
SafeFetus.com - drug database for pregnant or nursing mothers
Infant Risk center - website of pharmacologist Dr. Tom Hale at Texas Tech University Health Sciences Center

Read part one and two here.

Bi-polar and pregnant: One woman's story, part 2

After a somewhat difficult birth and recovery with her first child, my friend Em continues her journey with her second pregnancy: which would prove more difficult than she ever imagined.

Warning: Em wanted to share her story, and both she and I felt that it might present triggers to those who have suffered through traumatic births or a pregnancy loss.
When my daughter turned two, the baby bug bit hard. So off the meds I went and started the baby making. I knew my Psych’s position and figured it worked so well the last time, we could do it again. I was wrong, so very wrong.... 
For some strange reason, I felt I was never going to hold this child; I was in constant fear of the other shoe dropping. I chose a new OB, one referred to me by many moms in my mommy group. I proceeded to have one complication after another with my bipolar this time. I was severely symptomatic. I was borderline bonkers for lack of a better term.  I screamed, I cried, I raged. I was unable to gain any weight, I was constantly sick with a cold or flu. We did the AFP (which I did with my daughter) and Nuchal fold test - this was new to me and I was super excited to get to see my baby so early. We were going about our business, trying to be positive in the midst of my hurdles. My spouse and I focused on the miracle in the womb. I could handle anything as long as my child was safe.
Then I got the dreaded phone call - my AFP results were positive for Down’s. Or I should say that my chances were 1:45. I lost it, not that I had it to begin with. The shoe had dropped. I was heavily guided and suggested to have an Amnio. I agreed feeling it would be important to have a team ready to care for my baby when he or she was born. I can tell you today I was strong-armed by that genetics counselor that day. I was told the risks were minimal; I was told 1:500 experience a complication. I thought, ‘oh that one won’t be me, it will be ok. They know better than me’. 
We went into a holding pattern after that. I was trying desperately to remain calm and centered; after all I had a 2 year old....Our first appointment was with a genetics counselor, went over our decision, and signed the consent waiver. I was told we could back out after the U/S if everything was good and we felt that was enough. Then we get to the ultrasound. This is always one of my favorite things - I get to see my baby. They did an in-depth level 2 test, checked all vital organs and systems, perfection. We were told to expect a baby girl. I was excited about having two girls - sisters. Yet I was dreading the teen years already, who wouldn’t with two girls? The doctor confirmed we wanted to do the amnio, and we nodded. So began the prep work. He joked about my navel ring and how the pain from the amnio would be less than the piercing. One stick and I had a contraction so we had to do a second sac puncture - I was in pain by that point. The test ran smoothly after that. Went home and rested, napped, checked Facebook - you know, the usual time wasters. I had zero pain, was relaxed and thought we’d get great news on our perfect daughter.
By midnight I had fever and chills, shakes and tremors. I managed to fall asleep thinking I was just cold. I felt as if I was freezing. I woke up alone in the morning feeling off. I couldn’t place it but I felt wrong. I called my OB and begged to be seen, so they squeezed me in. They had the hardest time finding a heartbeat, but swore they heard her moving so all was well. Checked my injection site and stated there was no infection. I had the flu and to go home and drink water, sleep....By 3 in the afternoon I started having pains. I waited, but called in about 4:15 when I realized they were rhythmic and regular - 12 minutes apart. They said I wasn’t resting enough. I got pissed and called the clinic where they did the amnio. Got my maternal fetal (referred to as the M/F doc) doc on the line and he was highly concerned. He told me 600 mg ibuprofen and sleep. So I slept. When I woke 45 minutes later, pains were worse. Then the blood. A tiny amount but I lost it. Called the M/F doc on his personal cell, which he freely gave to me, and he sent me into L&D....got settled, in the gown and the residents start(ed) listening for a heartbeat - with headphones. The second resident arrive(d) to do more of the same. Then they bring in the U/S machine. 
This is that moment, the moment when your life shatters. He looked at me and said, “I am sorry but there is no heartbeat.”  I went into shock and asked what that meant. We all know what that meant but I had to ask. We had lost our daughter.
At this point in editing Em's post, I stopped. I had never experienced these things before, and wasn't sure if the graphic nature of her post would help others or hurt more. I am so in awe of her openness to share this experience - after all, just this last week marked the anniversary of her daughter's death. What should I print? How should I say it? I felt like, even with Em's permission, that I was pushing the edge of an invisible envelope somehow.
I wanted to leave my body. I didn’t want the memories ahead of me, I didn’t want the pain I was feeling  inside my womb and in my heart. I was 75% effaced and 2 cm. Contractions were 6 minutes apart. I was told there were 2 options. Option 1) was to deliver my baby. Option 2) a D&E - this is one step up from a D&C and would require full anesthesia. 
I desperately wanted option 2, I wanted the pain gone. Then we asked the most important question of all - why? To get that answer I would have to deliver my daughter vaginally. 
Em wrote, in detail, the images from her birth: an unmedicated delivery of a baby that was 18 weeks. Perfect. In every way. She felt the urge to push before the epidural was administered, and, as Em put it, "There she was." It was at this point the physician realized - her baby had died from an infection via the amnio. His response: "Shit."
He knew immediately the why. She had died from an infection, introduced via the amniotic needle. I have no memories past this point, I blacked out. I know they put pain meds in the epi so the M/F doc could retrieve the placenta. Yet I have no memory till I woke an hour and a half later.  
That night is the single worst of my life. I woke off and on, crying, screaming. Finally about 6 am I got the courage to hold my little Angel. Tiny and perfect, she was wrapped in the smallest blanket I have ever seen, in a tiny bonnet and dress. Oh how I cried. I kissed her and begged forgiveness for not protecting her....This was my natural childbirth. This experience taught me many things. I learned I am stronger than I ever knew I could be. I learned that questioning everything was the only way to make an informed choice and if I didn’t like the answer to keep digging until I found one I could be at peace with. I also learned my body, my choice, and my decision.
Continued here.
Read part one here.

Bi-polar and pregnant: One woman's story, part 1

It's amazing how different each pregnancy - and each birth - a woman has can be completely different from each other. No more is that more apparent than with my friend Em, who has had three pregnancies and two live births. "My path is like many others, yet vastly different from most," she writes. "These posts are not a defense of my choices. They are my choices made with the most knowledge I had at the time. I can wish for different outcomes, but each experience shaped me in a way I needed to be shaped. Nothing is without pain and my path to today is no exception."

Warning: Em wanted to share her story, and both she and I felt that it might present triggers to those who have suffered through traumatic births or a pregnancy loss.
I have been very lucky - I have given birth to all three of my children vaginally. I have had two spontaneous labors and one induction. I have had three vastly different birth experiences.  My first was scary and painful, this one I call the bad. The second was the ugly, more on that later. The third was cathartic and cleansing and amazing. I ended my child bearing days on a high note. In fact I could relive my son’s birth a million times over. 
Let’s start with the major hurdle ahead of us - I am bipolar. This is important to know as it plays a massive part in the pregnancies ahead. I was 30 when diagnosed and felt reborn to have a name to the weird things in my head. I have a team when I get pregnant - my OB, my psychiatrist, and a talk therapist. Bipolar plays a role in everything I do, whether it is by conscious thought or my sub-conscious. My case is quite severe. I could write endlessly about how messed up I am but alas this blog is about birth, not mental health. So on with the show.
"The Bad"
We decided the time to start a family was right so I consulted my psych and was told no drugs. OK. I was scared and knew how sick I became off the meds, but I wanted a baby so no drugs. I am beyond lucky when it comes to conceiving my children, simple temping got me pregnant. We conceived our daughter easily and I started reading books.  I wanted to know what was ahead, both pregnancy and delivery wise. I dutifully read my books, feeling they made me knowledgeable. Never once did any one refer me to Ina May Gaskin. I promptly tossed “What to Expect” (LOL!) and focused instead on the Mayo Clinic book and the Week by Week book. Given my health history I had been taught to count and trust my doctors. They were the one with the medical degree not me, right?
I had a fairly easy, uneventful pregnancy.... I met all the doc’s in the practice so I wouldn’t have a stranger between my legs. I hired a Doula to get me through labor without pain meds, I had my birth plan. I was armed with knowledge. I have neck issues and was required to have an epi placed during labor or in early labor since I can’t get a breathing tube down without me being awake to swallow it, so I asked for the unheard of saline block. Sounds like I was heading for an amazing birth experience right? Yeah no. 
Em's first was a typical vaginal birth - 38-week membrane sweep that turned into what sounds - or reads - like a baby vs. doctor tug of war, in a way.
I am not one to follow all the rules and neither is my daughter. She got tired of all the poking and prodding and started labor. That was 2:50 p.m. By 3:30 I am writhing and screaming in pain, my daughter does nothing half-way - I was contracting every two minutes for 80 seconds. The nurse immediately says time for Nubain. Pain did not go away; I just stopped caring about it. From there the glorious epi was placed, with drugs. I had lost all my will and had zero support to go all natural. My husband panics when I am in labor.  He will stand there or stay in the room watching but he can’t get out of his own head to help me. I continued to progress steadily without the pit. Or if there was pit I was uninformed.  
.... I was told to start pushing, because being a 10 means you’re ready, right?  So I pushed, and pushed, and pushed some more. I pushed for an hour before I felt the urge to push. So like a good obedient patient I listened and kept pushing till I felt pain, burning tearing pain.  It felt like there was a Ring of Fire, as a friend of mine calls it. I was told to hold it and stop pushing when the pain was at its worst; I politely said “F*** that” and pushed my daughter into the world. They whisked her away to clean, weigh and Apgar her. The OB proceeded to start the stitching process which took approximately 25 minutes.  I have no clue how many stitches were placed but if she averaged a stitch a minute - 25 stitches sounds close enough. They we’re all internal, only three external. I looked - it hurt and I wanted to know why. They wouldn’t let me hold my daughter until I was done being stitched. They offered a bottle and I said no. My breasts were ready for her. I immediately placed her on my breast, and there she got her first meal. She was perfect and beautiful. She was then whisked away to the nursery for her exam. 
All was great until they stood me up to use the bathroom for the first time, and I can tell you I have never felt pain like that. I literally thought my uterus was going to hit the floor, I couldn’t move. Well, obviously that didn’t happen, but the pain was beyond my imagination. I sat on a plastic doughnut for three weeks till I popped that poor balloon. At my six-week post partum check I was cleared and “healthy." I was cleared to begin relations with my spouse and like a moron tried. I ended up in tears it hurt so badly. I still was in loads of pain and proceeded to find a new OB, whose nurse diagnosed a RAGING bacterial infection that took four rounds of antibiotics and seven weeks to heal. I swore a C-section couldn’t have been worse at that point - 14 weeks healing time total.
From what I have heard this is the typical experience. Yeah well, it isn’t a positive one, it sucked. I mean seeing and holding my daughter was amazing. The healing from this was awful and left me scarred for the days ahead. To say my post partum period was one of pain is an understatement. I thought there is no way I am doing this again. That thought lasted two years.
Continued here.

Wednesday, December 14, 2011

Merry Christmas to You! Blog giveaway

Sooooo.... who wants an Amazon Kindle? :)

Here's what it looks like, from Amazon's website.
Not sure if it's a 3G because I'm a big dummy about
those things. 
Here's the story: my mom gave me this thing for my birthday last month. Originally my grandma (who is a ripe 86 years old and wouldn't know which end was up on this thing, I'm sure) won it in a contest, and since neither of them could use it, she gave it to me. Well, I don't think I can either!

I know how much people love them. I personally would rather have the real thing in my hand, able to write notes in the margins, etc. and stuff. Plus, I already spend wayyyyy too much time on the computer, which is not helped by having a brand new laptop for Christmas. (Thank you, Mr. DH) And considering all our books have been packed in storage until we get a fancy dancy new built-in bookshelf built (ahem) I haven't really read much, much less picked up a book, in a while.

So, I decided to give it away! Whoopee!

Disclaimer: Here is a link to Amazon's page to see the product. It's just like this one, only the box has been opened. (so consider it a re-gift, of sorts) It's never been used, never plugged in, nothing downloaded to it or any of that. I opened the box, took one look at it and thought, WTH am I going to do with this?! So there. The rest is up to you.

All you have to do to enter is comment: say hello, tell me how supremely awesome I am, how much you love childbirth education or birth advocacy - whatever. Just keep in (reasonably) clean and in the Christmas spirit.

The contest will run from now (the date of this post, obviously) until 8 p.m. Friday, at which point comments will be closed. Make sure to turn on the message feature on your Google/Blogger profile  so I can contact you if you win. If I can't find a way to contact you without giving the entire world your full name, then you just might be screwed out of a chance to win, which wouldn't be cool. So make sure I can get a hold of you. I've had people win in contests before only to turn off their message feature on Facebook, which totally stinks.

(Because Facebook is totally anal about contests, I'm doing it strictly through the blog. If they come after me for posting the link to the blog, well, who knows what'll happen. We'll cross that bridge when we come to it.)

I will pay shipping (sorry, contiguous US people only), shipping confirmation to track the package, and insurance (up to $139 value! Woot!) just in case something disastrous happens, like it falls off the back of Santa's sleigh. I'll have my five-year-old pick the winner (she doesn't know how to read yet, so we're safe!).

Good luck!

PS. Email me if you have any questions, or if I'm forgetting something, which sometimes happens. Merry Christmas!

PSS. Do not forget to allow me to contact you through your Google/Blogger profile, or leave your email address in the comments. Thanks!

Sunday, December 11, 2011

Doctors perform cesarean - on woman who wasn't even pregnant

This article made the rounds again on Facebook and reminded me that I still wanted to write a blog post about it. It's been a year, and Jill over at The Unnecesarean did one then too, but it obviously bears repeating: and a resounding "WTF?!"

How does a woman who only looks - but isn't really - pregnant just 'walk in' to a labor and delivery ward and attempt to have a baby without:
1) complete medical records from her pregnancy care provider
2) a vaginal exam to check for dilatation of the cervix
3) fetal heart tone monitoring after a two-day induction?
4) and once you check the cervix and don't detect a fetal head, no ultrasound to determine baby's position or
5) if there really even is a baby there to begin with??

What?!


Even people who've never given birth before can likely guess that there is something seriously messed up here. (Actually, for those who want a completely natural hospital birth, to be left alone for two days to labor might be a dream come true...)

She apparently showed up in their hospital "asking for a c-section" and they made the pregnancy diagnosis. Later, however, the resident was found to "not have enough experience to make the pregnancy diagnosis and doctors should have conducted their own exam." No kidding.

Most of us could and do easily make a "pregnancy diagnosis" - it's called buying a $6 pregnancy test and peeing on a stick. And if that doesn't do the trick, I bet any one of us could easily pick up that ultrasound transducer, slather our stomachs in gel and somehow figure out how to get a rudimentary image to pop up on the screen. So what happened here?

Of course, the group of residents and physicians in question received no other disciplinary action other than a stern warning and a "letter of concern" (said with booming authoritative announcer voice) and that was about it. Which says a lot about the state of obstetrics and maternity care in this country these days.

As one commenter - who happens to be a homebirth midwife - said:
And all they get is a "letter of concern"??? As a homebirth midwife, I would get my license yanked for far less. Just goes to show the double standard.
Preach it, sister!

It is a double standard. And the comments - as well as the almost lackadaisical approach the medical staff takes - is troubling to maternity patients who are otherwise said to be "demanding," "seeking attention," blah blah blah - as if it's all their fault. If this woman had a rare medical condition (a false pregnancy, or "hysterical pregnancy," as the article says) that fools her body into thinking she's pregnant when she's really not - who can blame her? Hell, sometimes I get weird flutters and sensations (that are no doubt gas bubbles) that would convince me, if I didn't know any better, that I was pregnant. The idea of calling it a "hysterical pregnancy" immediately conjures up women who are desperate, mentally ill and out of control, running around in circles around the unit with their arms waving madly, "I just need to have a cesarean! Agggghhhh!"

And not only does this take a turn that suggests this woman is clearly at fault and to blame, but if she is mentally ill, there is that stigma as well: and therefore reason to issue a complete lack of sympathy for her. As if to say, Oh, first she thinks she's pregnant - now she's crazy! *snort* Crazy hormonal women! 


Per Wikipedia:
"Research shows that 18% of women with pseudocyesis were at one time diagnosed as pregnant by medical professionals. 
The hallmark sign of pseudocyesis that is common to all cases is that the affected patient is convinced that she is pregnant. Abdominal distension is the most common physical symptom of pseudocyesis (60–90%). The abdomen expands in the same manner as it does during pregnancy, so that the affected woman looks pregnant. These symptoms often resolve under general anesthesia and the woman's abdomen returns to its normal size.
The second most common physical sign of pseudocyesis is menstrual irregularity (50–90%). Women are also reported to experience the sensation of fetal movements known as quickening, even though there is no fetus present (50–75%). Other common signs and symptoms include gastrointestinal symptoms, breast changes or secretions, labor pains, uterine enlargement, and softening of the cervix. One percent of women eventually experience false labor."

Apparently some women even have a positive pregnancy test. 

This article mainly focuses on the psychological aspects of it - women who have tried unsuccessfully for years to become pregnant; those who have suffered pregnancy loss; etc. The actual medical problems, like pituitary problems, are kind of glossed over - probably because when it comes to certain hormone-related illnesses, they are clueless. Chalk one up for the crazy lady again! 


It's amazing the number of comments passing this off as no big deal, blaming the woman for attention or just kind of blow it off and hope no one notices.
Dena Konkel, assistant director of public affairs for the medical board, said the case was "unique." "The board was mostly concerned about the management of patient care," she said. "It may have fallen below the standard of care." 
"Some would argue that this is not disciplinary in nature -- it doesn't limit their ability to practice medicine," said Konkel. But, "it creates a public record, something that can be looked up and read about what happened."
Yeah, that public record that future patients can look at that basically points in all directions to these clowns. And the sad part is that people will still trust them, still keep going to them, as if nothing happened. They'll likely read this story and think, "That woman was mentally ill - it's not really the doctor's fault." "Unique" isn't exactly the word I'd use to describe this situation; I think completely effed up is way more suitable. Using a word casually like that to categorize this event is completely ignoring the fact that yes, it "may" have fallen below the standard of care - by completely ignoring or bypassing all protocols in place to protect both the mother and the baby. Are they really that hands-off that they did no vaginal exams on this patient? I doubt it.

I wonder if perhaps this person just came in, perhaps in pain, and the resident took one look at her and didn't know what to do with her. I've had only one resident in my pregnancy care, while in the hospital, and I could read him like a book: he was young, uncomfortable, and wanted to parrot exactly what he was told to say and do from his superiors. When I presented him with my opinion, firm and respectfully, he backed down immediately, like he had the spine of a jelly fish. I wondered if he'd ever encountered an informed patient before that just didn't take his word for it?

The article indicated that the resident who dealt with the patient was trained in ultrasound. So why the heck didn't they do one? To at least check for the position of the baby's head, since it didn't sound like they had any prior medical records for her? No explanation was offered. Of course.

Something to consider, however, is that in some parts of the state - including those counties surrounding the area where this "birth" took place - there are as many as 5.5 percent of women seeking little if any prenatal care at all. This could explain why there were no medical records (we can assume) or why the seemingly blasé attitude towards the lack of records. Unfortunately this may not be all that uncommon in hospitals where certain factors (like lack of education, poverty and lack of health insurance) mean a woman has not sought proper care in pregnancy.

While this case happened in late 2008, it took the state medical board a year to investigate, and the public first heard about it two years after it happened. One physician still works in the facility, but doesn't deliver babies anymore; another has since left the hospital. It makes you wonder just what went on behind the scenes: was there more than a slap on the wrist? Why didn't the patient sue? Did her mental status have something to do with it? Her economic situation? Why haven't we heard anything from her - or at the very least, seen her on an episode of Jerry Springer? Her neighbors, her friends - surely someone would have seen that she looked visibly pregnant and now, has no baby to show for it. I hope it wasn't a case of her just being too embarrassed to say anything, perhaps for fear of even more stigma should it come to light as a psychological condition that makes her look "crazy." And consider the tone of these doctors - who don't want to come right out and take the blame - it almost makes it sound like they're blaming her and her "mental condition" for all of it.

A certain percentage of false pregnancies are due to mental conditions; but not all can be attributed to that. Some believe that a truly false pregnancy (as opposed to a simulated pregnancy, where the woman fakes it) originates from the pituitary and hormonal imbalances. This is, after all, where breast milk production generates as well, and why some women who were not even pregnant can breastfeed a child. In fact, I remember distinctly a client at the mental health facility where I worked who was lactating - and had never been pregnant. She was concerned, because she knew she wasn't pregnant - didn't want to be pregnant - hadn't even had sex recently. I'm sure the already-existing mental health problems she was already experiencing only added to the "it's all in your head!" ideology.

False pregnancies are apparently fairly common in animals - who knew? But they don't do it to seek attention or as the result of a mental condition. According to Wikipedia, "symptoms of pseudocyesis are similar to the symptoms of true pregnancy and are often hard to distinguish from it." We can give the doctors a pass for not knowing, but not the patient? Especially when a simple ultrasound could have avoided two days worth of expensive induction procedures and a completely unnecessary scar on this woman's uterus. 


More reading:
Doctors perform c-section on non-pregnant woman
False pregnancy

Tuesday, December 6, 2011

A (surprise!) breech birth story

A few months ago, I posted a breech birth link on FaceBook for my non-birthy friends and was very surprised at the answers: many of them were born breech, knew someone who was, and one even had twin siblings both delivered breech. Many made jokes about their choice of presentation coming into the world, but by and large, they all considered it a totally normal, if not slightly old-school way to be born, and something to be proud of. Some seemed completely surprised that nowadays, cesarean section is usually the general rule of thumb (at least in the United States).

So when I saw that one of my readers had a breech vaginal birth, I got excited! Having two breech-presenting babies myself, I wanted to hear how it went and have been dying to post her story. Farrah has her own blog here, but has graciously offered to let me borrow her story so you'll see it here, too!
One of the topics I have hoped to touch on in my blog is natural childbirth. Most people are amazed at the birth story of my youngest child who is now 14 months old.

People thought that Joe and I were crazy when we conceived our third child when our daughter was just a few months old. Maybe we were. I don't know, but I do know it felt right (and still does). From the beginning, we had tossed around the idea of a home birth, but I went back and forth about it my entire pregnancy. 

Fast forward to my 39th and most miserable week of pregnancy. I went to visit my midwife, to find out that my baby was breech. Of course, the medical standard is that breech equals an automatic c-section. I wasn't just going to give in and accept that. I told her that I was still a few days away from my due date and I felt that I could give him a chance to turn. She offered some suggestions such as inversion. I decided to visit a chiropractor who specialized in the Webster Technique, which is known to help breech babies flip. I also used techniques from Spinning Babies.

After some belly mapping and a medical opinion, we were convinced that the baby was now head down. I decided against any sort of medical induction and decided that I would go into labor on my own at home. My labor started at approximately 8pm and my water broke by the early morning. Now I was induced twice in the past (once for true medical reasons and the other was an elective induction), so maybe that is the reason I'm used to my babies coming out within 15 minutes of my water breaking. That didn't happen this time. I can't say that I was intending on staying home through the whole thing, but I froze up in the midst of active labor from lovely vomiting and pain that I just couldn't communicate that it was time to go to the hospital. 

I remember wanting to push and there was vernix and meconium coming out. It dawned on me that the baby had flipped BACK to breech. And I thought what a stubborn child this would be (and he is). We called the paramedics and I needed to push in the ambulance, but they kept wanting me to hold him in. To this day, I still find that ridiculous. It did cause problems because he needed to come out and needed oxygen after he was born. 

My breech baby was 8lb 15oz and was 21.5 inches long. It was just about as painful as a pitocin induced birth (I've never had a epidural). But it is an experience that made me stronger. I do hope to see more childbirth professionals educate themselves on the "hands off" breech technique and realize that breech babies CAN be born vaginally. I don't know if the United States is starting to change (I doubt it), but I know that in Canada, they have said that mothers should be allowed to try to birth a breech baby vaginally instead of automatically doing a c-section.
Farrah did say the birth was pretty painful; she could feel contractions going all the way down her legs and was "seeing stars." I am in awe of her intuition to head to the hospital when she felt the pushing phase was taking too long, and realized that yes, her baby was breech! She said that on the way to the hospital, medical staff was alerted to her baby's position and quickly "read up" on how to deliver a breechling. She said, though, that "within 20 minutes of arriving at the hospital, I was pushing him out." Wow!

Despite needing oxygen shortly after his birth, she says that her little boy nursed like a champ and was very healthy. "He's an amazing, content, breastfed, and intact baby boy. I love him very much and his birth was a very healing experience for me."

More reading:
Keep Your Hands Off The Breech, by Mary Cronk, MBE
No more automatic c-section for breech births, says OB/GYN Society