Balance

I was just reading Navelgazing Midwife’s blog entry on the infamous Dr. Amy’s blog regarding her blatant denial of birth trauma. She evidently does not believe it happens, or that the routine things done to women during birth do not effect women in a traumatic way unless there is a history of abuse in her past. Well, that’s a whole ‘nother subject. I’m too stunned by her assertations to reply at this point.

What really struck me was the list the Navergazer put down as hurtful or harmful for women – things said or done to them in labor. Not just by OB’s, Gyn’s, or nurses but also by midwives. It hit me like a ton of bricks. I’ve heard alot of those things said at homebirths. My question is, “When the woman will not cooperate or LISTEN to the beloved “informed consent” statements and will NOT take responsibility for her and her babies well-being, then what do we do? Step back with folded arms and let a baby be harmed?

I heard a story recounted by a fellow midwife of a woman who wanted to “do labor alone”. She wanted to be left alone to labor, had a plan, etc. When labor came however, it was a different story. For hours she fought her contractions. No progress. Then she began to hurt herself. She began biting herself amd hitting her head on the wall. For awhile the midwife watched, not wanting to interrupt or go against the mom’s pointed wishes. At last she cuold take no more of the high pitched screaming, head banging and biting. She intervened. She held the mom’s hands and caught her eyes with hers. She began to match her breathing, helping her cope. The mom said, “Thank you.” In the end, the baby was fine, the woman had only a couple of bite marks to show for her “independent labor” and no concussion.

It seems to me, that in the interest of fairness we need to realize that there will be women in our care as midwives that NEED intervention. I’m not talking about needles and sutures and episiotomies and continuous monitoring. I’m talking about emotional and psychological intervention. Because let’s face it. In our culture here in the midwest birthing is NOT seen as natural and women are NOT brought up to believe they are powerful, life-giving creatures. They are raised to believe they are victims, in need of salvation, by and large and it can take a lifetime of work to undo the belief system that leaves women helpless in the hands of their care providers.

The list of harmful things  Navelgazing Midwife  put out was SO eye-opening. Words are so powerful. They contain life and death. Thanks Navelgazer for putting that up (don’t know where you got it, maybe it’s original, if so… COOL!). Let’s think of healthy ways of saying things, if they need said, as we prepare and work towards a culture of powerful birthing mothers.

I’m in a mood today. :)

A good one (really… even despite the last post!)

I just replaced my outside water hydrant and am taking a sip of “pond water” (what my kids call my chlorophyll tainted water) and resting a bit before going out to plant my vegetables.

It’s 73 degrees and sunny outside.

My husband tilled the garden for me this morning while I worked. Readying it for a new fruitful season.

This is the children’s last day of school and I will have them all back to myself for the summer.

I’m pregnant again, and feeling the baby move everyday now. I am planning a homebirth. All of it a miracle. Truly. 15 years ago last month I was diagnosed with CPD after trying to birth my 8lb 12oz baby boy. They told me not to even consider a vaginal birth. Several of “them” did. :) I hired a doula 4 years later and had my first vaginal birth. Repeat 2 times. This will be my 4th VBAC. :) Guess I showed “them”.

It is fitting that I will be growing my garden while I’m growing this baby. It is a blessing… a fruitful time… the summer of my days.

I’m happy. Life is good.

Life is good.

Prejudice…

is sickening and distasteful to me, in whatever form it takes. Many make arguments that “their prejudice is founded” like, “Chinese are always good in math.” or “African American women have big butts.” or “Women are too emotional to be in politics.” and recently, “You don’t know what you’re talking about because you’ve never had a homebirth.” or “You’re going to be a medically minded midwife because that’s all you know. Medical births.”

Ok. So I’ve never given birth at home. And that experience is just that: and EXPERIENCE. I admit fully that I do not have that personal experience. Does that make me a “junior” in all things homebirth? I don’t think so. Admittedly I don’t have the personal experience of having birthed at home, yet. But I take offense at the notion that I cannot understand how to “trust birth” because I’ve never had to. Bull. Here’s my “trust birth” story.

I layed in a hospital bed with my first child, who was posterior, for 31 hours after my water broke. The last 8 were Pitocin augmented. Hard contractions. No support. My husband went for a haircut, brought Hardee’s for his breakfast back to my room while I starved, and watched television. I had no pain relief. I wouldn’t take it. I pushed for 4 hours. Almost 5 until they wheeled me into the operating room for an “emergency cesarean” for CPD. No one told me until weeks later that he had been brow presenting. The forceps wouldn’t budge him, the vaccum extractor didn’t budge him. I couldn’t budge him. ( I know this was all the fault of my OB and the attending nurses for a meriad of reasons. That’s not the point of the story.)

I BELIEVED I could birth my baby. I TRUSTED my body to do what it needed to. All the way to the OR I believed we were making a mistake. Too tired to fight anymore I gave up and gave in. But I “trusted birth” while hindered, drugged, scared, manipulated and assaulted and betrayed by my former husband and caregivers. I TRUSTED BIRTH in the most trying of circumstances.

Again when my youngest had sticky shoulders and (again on my back because the OB refused to catch if I didn’t lay down). She was prepping the OR while I did the McRoberts maneuver on myself and popped him out.

For those mamas who have had the priviledge of never birthing in a hospital or at least it was a one-time experience of which they have happily erased many of the memories, I find it appalling that my thoughts, desires and opinions as a student midwife would be called into question simply because I have not had that same priviledge. Some of the comments haven’t been blatant about it, but in a patronizing, pat on the head sortof way I have heard the message, “You just don’t understand.”

I TRUST BIRTH. You can’t say you really do until you’ve had to. I’ve had to. I do. I will.

Chinese woman breastfeeds orphans

 

 

 

I think we’ve all heard about the horrific earthquake that rocked China on May 12th. Many children and babies were left homeless. This street policewoman decided to help how she could, when she could by breastfeeding some of the infants. She is nursing 8 infants and toddlers in an orphanage that does not have powdered milk. Having just given birth herself, she is considered a hero by many.

I must agree.

Trust Birth or … ?

I guess I’m still reeling from a personal attack I faced last week regarding attendance at a birth. I can’t go into the details of it all but sufficient to say, my suggestions regarding concern over her rising blood pressure, swelling and general fatigue were met with scorn. Afterall… don’t I trust birth?

So the talk of me being “medically minded” might be true. I don’t know. All I know is that it is irresponsible to attend a birth without basic life-saving skills and equipment and the knowledge to implement it.

I will carry a suctioning device. In case I need it.

I would like to carry Pitocin or methergine and oxygen in the RARE, rare rare event that it is truly needed.

I will help my moms take care of themselves during pregnancy, watching their diet carefully together, tweaking as requested/needed for her and her babies optimal health.

I will keep my neonatal resuscitation certification up to date on a yearly basis.

I will continue my education as long as I am practicing, careful not to fall into the trap of “It’s worked for all these years, why change now?” and think I already know it all.

I do not consider myself a “med-wife” at all, though from the above list some would. I look at it like this:

I firmly believe in the innate knowledge and power that accompanies birth. And that nearly all births have the BEST outcomes when the mom is left alone. Totally.

Now here’s the but…

But! If I were to attend a birth where the baby needed resuscitation and I couldn’t do it? Or is he or she truly needed suctioning (thick mec/etc.) and I didn’t carry a suction device? Or if the mother hemorrhaged and none of my herbal or manual tactics were working? Or if the Mom’s diet was BAD and with this knowledge I did NOTHING TO HELP HER CORRECT IT?

Those rare instances, where life is hanging in the balance, are enough for me to be prepared. You know… like the Boy Scouts? :) Be prepared, with the firm belief and intention that those tools will rarely (and hopefully never) need to be employed. I believe anything less is irresponsible and careless. “Trust” has nothing to do with it. 

I’m not God. I have no desire to believe I am equal with Him. There are times a birth ends with death. I accept and acknowledge that God is the Father of all living and is in control of what happens at a birth. I realize and accept also, that all the tools in the medicine cabinet cannot save a life destined for heaven. I’ve seen that.

But I ask myself this question: “If a baby or mother died because I didn’t have these tools at my disposal, could I sleep well that night? Would I be consoled just knowing I “trusted birth” even though the evidence shows that life might have been saved had I been prepared?” I hope this question and the answer to it resonates deeply with many. Because frankly, what I am being accused of by being careful and watchful signals to me that the insistence to “Trust Birth” has gone a bit overboard.

I expect quite a bit of “flaming” over this post. I do. That’s ok. There’s room for disagreement (I think). This is my opinion and this is, afterall, just a blog. :)

Judgements

A recent story in a British newspaper left me feeling bewildered at this tragic loss and wondering what I can learn from it. A 20-something mother died 6 hours after giving birth to her baby at home.

I am not one to ignore or **hide** the less-than-optimal outcomes that occasionally occur at homebirths as some of our opposition would assert. Rather, I wish to dissect it (as much as possible form the information given in the article which is, I’m sure, far from all of it) and learn the lessons that are there for the taking.

The mom suffered a massive hemmorhage after an inverted uterus began bleeding profusely. It seems that a huge factor in this woman’s death revolves around lack of communication between the hospital and the attending midwife at the time of transport.

One of the gynecologists on staff said, “The staff were expecting a retained placenta. If they had been told it was a complete inversion of the uterus then she would almost certainly have gone straight to theatre and I would have been ready for her.”

One thing that seems to be missing from this article is the answer to this question, which of course, could only be answered by the attending midwife: “How/why did the inversion occur?” As a training midwife, this question is of utmost importance to me. All of the study I’ve come across says they are almost always caused by interference of some sort. Not always, but generally.

I am skeptical of it being anything but an induced inversion because she was not (apparently) forthright in telling the ER staff of the woman’s condition. Did she pull on the cord or placenta? Perhaps the woman was hemorrhaging and the midwife attempted manual removal in order to stop the bleeding? 

Or was there no communication because she is an independent midwife and was greeted with hostility when she arrived with her client at the ER with paramedics?

And rather than blame the midwife, we should probably wonder why paramedics weren’t trained to cannulate? When they, perceivably, attend more massive bleed situations than a midwife would? Her assumption was the same as mine might have been as she was quoted as saying, “Knowing the ambulance was only a few minutes away I thought it was better to leave it for the proper paramedics who have expertise in this on a daily basis.”  While cannulating (inserting an iv and fluids) may not have saved this woman’s life, it could have bought more time for the hospital staff to figure out what was going on and act accordingly.

There is quite a bit of talk about this on certain people’s blogs, saying this is exactly why DEM’s shouldn’t be practicing and why homebirths are “inherently dangerous”. Again, I would say, a DEM is such a broad term that I prefer not to use it. I prefer to use the term “midwife” and then find out on an individual midwife’s training is. Some CNM’s (from personal experience) have no business catching babies. They simply took the extra training for the pay raise. I had one tell me this straight out. She was an OB RN and had caught enough she thought she “ought to be getting paid for it”. “I wouldn’t say it’s my passion, but it’s a good gig.” CNM’s can also get their certification online. I mention this since it seems to be a point of contention and an excuse for the “CPM’s training isn’t good enough” crowd. All DEM’s are not created equal, just as all OB’s are not. Gasp – horror!!!!! Did I just endorse OB’s? No, I said I won’t cast judgement on them all for the actions of some.

This is all, of course, an overstepping of my bounds in regards to making a judgement on this midwife and this homebirth. There is no way for me to calculate, based on one newspaper article, what went wrong, who is to blame, etc. Nor is there enough in one article to use it as fodder for a position that says “ban on all homebirths”. It is a sadly uneducated and narrow-minded person who would do so.

Cure Gum Disease = Cure Pre-Eclampsia

I read an interesting article a couple of days ago and it’s been bothering me ever since. In essence, this study is showing a link between a protein marker for inflammation and gum disease with pre-eclampsia. Ok. So ok. I can deal with that. Nutritionally speaking, if one is eating a diet low in protein and quality amino acids/vitamins/minerals/etc. then gum disease is likely to be present along with pre-eclampic symptoms. Ok. So far so good. But the last line just cracks me up. Then it ticks me off. Are they for real?

“What remains to be seen,” concluded Ruma, “is whether treatment of maternal periodontal disease can reduce the rate of preeclampsia.”  ~ Gum Disease, inflammation risky for pregnant women

Alrighty then. So we’re going to see if “treating gum disease” will prevent 30% of pre-eclampisa cases? Good grief. I mean, this group is actually WONDERING this!

Do any of the people who do these expensive studies on toxemia ever consider that MAYBE the midwifery community might be right in saying that dear Dr. Brewer was onto something when he claimed to cure and prevent 100% of eclampsia with dietary measures??? And that hey, I don’t know, but maybe gum disease is also a symptom of DIET issues and just happens to occur simultaneously with pre-eclamptic symptoms???

UGH. I’d think, after all of these years of turning up NOTHING, they’d be willing to dive into Dr. Brewers research and actually try to help women. But that’s the rub isn’t it? Helping women doesn’t seem to be the main focus of the medical community at large. Making them “feel” better… maybe, by delivery thier babies via surgical wounds. Yep. That “fixes” the problem doesn’t it? All better. Makes the joke “Take 2 aspirin and call me in the morning” seem pretty fitting.

Lest I end this sour post on a sour note, here is some further reading on nutrition in pregnancy.

Modern Baby Books Full of Bad Advice

Brewer Diet FAQ’s

Toxemia Case Studies

Of course Brewer’s Diet could use a little “tweaking” but overall it jsut makes too much common sense to ignore completely. yes, it’s pretty calorie dense, and yes there are alot of fats in it. But for me, reading the research, case studies, and first-hand accounts (and the latter carry alot of weight for me)  makes it too good to just off-handedly set aside. I’ve seen first-hand, an increase in protein ALONE fix pre-eclamptic symtpoms. Within a week’s time blood pressure readings went down to normal that had been steadily climbing in this mon with a high-carb / low-protein diet (otherwise healthy eating habits). So – read the stuff, decide for yourself. But I believe it’s worth investigating.

 

Activism, Shmacktivism

I wonder sometimes if I am really doing ANYTHING of value these days. I have an open door at the local hospital concerning VBAC’s, as in, they won’t let me have one and by them refusing I could create a HUGE media frenzy and demand appointments with hospital administration. And probably get them. I might. At the very least, I’d like a local paper to do an interview or something regarding the fact that I have no choice in birthing my baby unless I can afford to drive to Kansas City or Columbia. I might write a letter to the editor at least. No doubt, small town, it won’t be published but I’m mulling it over.

The down side to being so public about things is that 1) they will have contat information should they get really peeved and send DFS out to visit after they discover I’ve had a homebirth. There’s nothing they can LEGALLY do, but it would be a headache nonetheless. 2) they would, no doubt, remember me if I ever am practicing in this area and have a transport. So I’m trying to weight out those factors plus the stress of fighting a battle like this while pregnant. Not sure I want to, but I hate passing up the opportunity too for other women who could be helped by it.

It seems to me, that if one woman would start the ball rolling and then when the inevitable happens (ie: “We’re sorry ma’am but this is policy. We will take your suggestions to the board.” ) a group of women could storm the waiting rooms or parking lot with signs we might get something done. But then I have been told I am tenaciously optimistic. And that wasn’t a compliment. LOL Who knows what would really happen. Maybe I’m the only woman in the area bothered by this at all.

I think I was born in the wrong decade. :-/