Archive for May, 2009

Quick Link: Nursing Birth

I had big plans for posting this week, but an international trip, a pre-term labor scare, and high drama at work have foiled them.  So for now, I’m just going to leave you with a recommendation for one of my new favorite websites, Nursing Birth (http://nursingbirth.wordpress.com/).  It’s written by a labor and delivery nurse here in the Northeast, with the goal of educating and advocating for safer birth.  It is an inside view of hospital birth in the U.S. and is simultaneously inspiring and horrifying to read.  The running “Injustice in Maternity Care” (a.k.a. Don’t Let This Happen to You) series is particularly enlightening and should be required reading for all pregnant women planning to give birth in a hospital.

30 May 2009 at 10:27 pm 1 comment

Share your birth story with us!

Hello all,

MFOM believes that one way to help women learn about midwifery and to show support for our midwives working here in Massachusetts is to share with each other our stories about birthing with a midwife (or midwives!) in attendance. One way we are doing that is through posting of birth stories of women who have given birth with midwives here in Massachusetts on our website: http://www.mfom.org . We have had the good fortune of having some truly beautiful stories to post and encourage everyone to take a look!

We also are looking for more birth stories! If you would be interested in sharing your birth story (or stories!) with us, please contact blog@mfom.org with “birth story” somewhere in the subject and our birth story editor will get back to you to talk about getting your story up on our website!

Thank you and we look forward to hearing all about your births!

Bridget Colvin
MFOM blog administrator

http://www.mfom.org

https://mfomnews.wordpress.com

29 May 2009 at 12:06 pm Leave a comment

Still the same

I was interested, as I helped my daughter set up her home for a homebirth, that her instructions from her midwife and the items she had to order, etc., were almost identical to mine when I was preparing to birth her at home 26 years ago! It felt soooo good!

28 May 2009 at 6:36 pm Leave a comment

How to talk to pregnant friends (part 1 of an occasional series)

This post is more a plea for advice than a how-to per se. I am having a lot of trouble figuring out how to talk to some of my pregnant friends. 

I know they don’t have to all use my midwife or have homebirths or even go all natural, like I did. They’re separate individuals, and what’s right for them, individually, may be different than what was right for me.

That’s not really my issue. My problem is that I have no idea how to respond when one of my pregnant friends says something like the following:

  • “My 30-week ultrasound shows that the baby’s already over 6 pounds–it’s going to be HUGE! I don’t know how I’m going to squeeze out this giant baby!”
  • “I know I’m never going to go into labor on my own–my doctor says my body just won’t do it.”
  • “My OB says my baby’s breech, so he’s just going to schedule a c-section for 39 weeks so I don’t risk going into labor first.”

What do you all think? How do you respond to statements like the above without sounding like a judgmental know-it-all? So far I’ve mostly kept silent, but as more of my friends start having babies, this is clearly an issue that will recur.

–Christina

27 May 2009 at 3:50 pm 2 comments

An Old Book for New Homebirth Women

As a homebirth grandmother, I recently reminisced on some of the reasons I chose to have babies at home. Of course the reasons were myriad. But one very significant book popped to mind. Way, way back in the late ’70′s I was introduced to Ashley Montagu’s “Touching.” An anthropologist, he presents an extremely deep look into both animal and human gestations, births, and perinatal periods. Well, my ancient copy of the book was in pieces, so last year I ordered a new one. Just one little peek into the book: “The biological unity, the symbiotic relationship, maintained by mother and conceptus throughout pregnancy does not cease at birth; indeed, it is naturally designed to become even more intensively functional and mutually involving after birth than during gestation in the uterus…” Do hospitals know this? Even if they did, how could they facilitate it? If they could, would they? I think we all know the answers to these questions. “Touching” is a magnificent book and wonderful reading for any mother preparing for birthing her baby. And another reason for saying “thank you!!!” to our brave midwivesd!!!

26 May 2009 at 9:42 am 1 comment

Quick link: NYTimes on maternal deaths in Tanzania

This article in The New York Times is the first of three in a series called “Death in Birth: Preventable Losses.” There are some heartbreaking pictures that accompany the article, and of course the goals mentioned in the article–to lower the maternal death rate in Africa, where many women “die during pregnancy and in childbirth, largely from problems that can be treated or prevented”–are essential, important goals for the UN, WHO, etc. 

But the article is very dismissive of midwifery, and seems to suggest that the answer to this problem is simply to improve the implementation of the medical model of childbirth, rather than to use a midwifery model. For example, this is what the article has to say about traditional birth attendants:

In rural areas, many women use traditional birth attendants instead of going to the hospital. The attendants usually have no formal training in medicine or midwifery. Many doctors blame them for high rates of maternal death and complications, saying they let labor go on for too long, cannot treat complications and fail to recognize emergencies that demand hospital care. But many women are loyal to them. For one thing, the price is right. Around Berega, they charge about $2 per birth. A normal birth at the hospital costs about $6, an emergency Caesarean $15.

While there certainly may be traditional birth attendants (read a much more thoughtful approach to them here) who are less skilled than others, the mere presence of “formal training” (as opposed to apprenticeship) should not rule them out as birth attendants. I also cannot believe that price is the only reason women choose traditional birth attendants; this article does not consider the pull of culture and tradition, which can be enormously strong.

Furthermore, the article seems to highlight examples of less-effective practice even when implemented by “formally trained” birth attendants–essentially, physicians’ assistants and nurses. In one case, a baby is described as being delivered by a c-section formed by “a quick vertical cut,” rather than the safer horizontal incision. In another case–described in the article in the typical sensationalist “home births can go bad!” manner that is so common today in the media–a woman hemmorrhaged to death after birth. Why?

A case in the Tanzanian city of Moshi late last year reveals how suddenly a seemingly normal labor can turn into an emergency in which every second counts. . . . 

An autopsy found that Mrs. Khalidi bled to death because the nurse who delivered her baby failed to perform one basic task, essential to prevent deadly bleeding: removing the placenta after she gave birth.

Normally, pulling on the umbilical cord will extract the placenta. But the autopsy revealed that the cord broke off. The nurse apparently did not know how to reach into the womb to remove the placenta.

There is nothing here about normal, mother-directed delivery of the placenta, or about how midwives in the US today do not recommend “pulling on the umbilical cord” precisely because it can break off, leaving part or all of the placenta still inside. 

Clearly, the article highlights a terrible tragedy in Africa today, but I’m not convinced that the answer is more “formally trained” nurses–such as the one described above–and more cramped, unsanitary hospitals.

–Christina

23 May 2009 at 12:28 pm 4 comments

a bend in the path

I am a 34 year old SAHM of 4 living in the Pioneer Valley for just under 6 years. Together, my husband and I have a life overflowing with abundance. That said, our budget is an interesting patchwork that we often struggle to balance. I am a thrifty/frugal/mend it till it falls apart sort of earthy

gal. With each birth I have transformed my entire being. Without the support of midwives I don’t know where or who I would be.
Tomorrow my youngest child will turn two. TWO! I began my mothering journey at the tender age of 21, practically a baby myself. I was so young when I had my first child that I wasn’t completely formed yet as an adult. As such, I didn’t have a clear vision of what kind of mother I wanted to be. I was alone living on the west coast, no friends, no family, and no role models.  Five months along, armed with only one book (“What to Expect…”) gifted to me by my OBGYN, I jumped in with both feet and eyes half open. Oh dear. I was so ill prepared for birth. Though I wanted this baby, I felt victimized by the changes happening to my body. I was scheduled for section because I was a week overdue. I was given no alternative options and certainly my reading material didn’t empower my inner voice. I was embarrassed and ashamed at the birth. They broke my water and immediately began the PIT drip even though I was already experiencing contractions upon arrival. After 45 excruciating minutes and a nurse’s patronizing advice:
“It’s supposed to hurt.
Relax.
Nothing is wrong.
The doctor will not see you this soon.”

I begged for someone to check me. The doctor casually walked in my room and without warning checked my progress, then proclaimed:
“It’s breech.
We’re doing a section.
NOW!”

There were 8 more people in the room immediately. Instruments were coming out of the walls, gurneys flying, medical terms wielding across the room to each other. To everyone in fact, but me. They spread my legs and clumsily poked about until the rubbery cord inserted itself into my urethra.
“Doctor, she’s catheterizing. Let’s go!”

Off I went.

The years passed. The first year was blissful—thank god for mommies who make milk! I moved back to the east coast and found a supportive group of friends and even some mother’s I could count on for advice. I did not realize the full extent of the trauma, the damage to my self esteem, to my feelings of inadequacy, to how deeply I buried my voice. I learned that I did not have dominion over my own body. No one helped me to cope with the rapid changes to my body (during the pregnancy) , to embrace the transformation of becoming a mother. I became a parent who mistrusted her instincts and hated her body.
I became pregnant again when my first child was 2 ½. Though I regarded the gift of motherhood with great honor, there was a sadness inside that I could not shake. Luckily I found an old copy of Spiritual Midwifery and a new course was set.

I will finish my story this week! Please feel free to add your own stories of birth in the comments.  I welcome questions as well!

Yours in abundance,
Lisa

19 May 2009 at 1:26 pm Leave a comment

Time Magazine discusses Homebirth

I found this online today. I’m not sure if it appears in the print version as well. Unfortunately, the article only mentions nurse-midwives, and it is a major oversight to omit the rigorous training of professional midwives who are licensed in 26 of our 50 states.

It has some sentences that seem promising enough at first glance: “Modern medicine can eliminate a lot of the risk (of childbirth)but in doing so, it can also turn what could be a joyous experience for the mother into the equivalent of an all-day appendectomy.” But while the sentence acknowledges that many women are losing the joy of birth, the sentence doesn’t acknowledge that modern medicine may actually create – not eliminate — risk in childbirth with unnecessary routine interventions and restrictive protocols. Also, deservedly categorized as “high-risk” are the premature births, but how many of those premature births could have been avoided had they not been caused by inductions before 42 weeks gestation, under the seductive guise that a scheduled birth is less stressful than a spontaneous one? Medically, a baby is full term at 37 weeks, but what if that baby wouldn’t have been born until 41 if left on his own? That is 4 weeks his lungs would have had to mature in the safety of the uterus.

But the article does a good job highlighting some of the more-often discussed indications of why homebirth is a safe option, referring to the Oregon study and the British Medical Journal  findings. It also makes a fair statement about why OB’s may be “soured” on the entire concept of homebirth, as they only see the births that become complicated. OB’s are never brought in on the homebirths that are progressing as normal, unmedicated, physiological labor should — which is most of them! But combine that with our country’s zeal for litigation, where there is zero tolerance for a less-than-perfect baby, it doesn’t seem so unreasonable for an OB to be unsupportive of homebirth.

What I find most heartening, though, is that this article has appeared in Time — hardly the publication of Radicals. Homebirth is slowly, slowly making its way into more and more women’s menu of birthing options. Homebirth is also facing grave opposition, but I remain ever hopeful.

–maria  (this is cross-posted on my own blog)

16 May 2009 at 9:56 pm 1 comment

Quick link: LA Times on childbirth and c-sections

Just a quick link to a story (technically from the Sunday, May 17th edition) in the LA Times (Business Section) that poses the question “Childbirth: Can the US Improve?” The article highlights a few different initiatives that hospitals are trying in order to lower their c-section rates.

–Christina

16 May 2009 at 7:20 am Leave a comment

Ben’s story: The best breastfeeding advice, from the least likely source

Welcome, Carnival of Breastfeeding readers! The May 2009 Carnival of Breastfeeding is about personal breastfeeding stories–read mine, then click through to read those of the other contributors!

This is the story of the best breastfeeding advice I ever got. It wasn’t from my midwife, though she was invaluable in helping us get started latching, and it wasn’t from the lactation consultants who talked to me on the phone and made a home visit when my baby was four days old. No, the best piece of breastfeeding advice I ever got was from my husband’s childhood best friend—let’s call him Ben—and it wasn’t even directed at me at all, but rather at my husband.

Ben and my husband have been best friends since they were eleven years old. As adults, in addition to being the best men in each other’s weddings (Ben was late to ours), they’ve played and worked together. When he’s with Ben, my normally reliable husband does things like drive to Mexico for five days without telling anyone. Ben and I have arrived at a truce by this point, but at various times over the sixteen years I’ve known my husband, it has been open war between Ben and me.

Ben and his wife had twin girls thirteen months before my husband and I had our baby. This drastic initiation into fatherhood may or may not have changed him—I’m not sure—but it did lead to one particular interesting moment. Ben was visiting us (you know, leaving his wife and eight-month-old daughters alone for a couple days 300 miles away—what was that about change?) when I was pregnant, and sitting around the dining room table late at night, he nodded at my abdomen.

“Are you going to breastfeed?” he asked.

I told him I was. I prepared myself for a battle of some sort, though I didn’t know what was coming.

He ignored me and turned to my husband. (“Typical!” I thought, in a huff.)

“Bobby, all I have to say to you, is never, ever, make any suggestions about breastfeeding. Just say nothing. Never engage the subject. Whatever she wants to do about it is absolutely right.”

At the time, four months pregnant, I wasn’t sure what to make of this statement.

When my baby was born, though, he had trouble latching at first, so with the guidance of our midwife and lactation consultant I started both pumping throughout the night to build up my supply and nursing using a silicone nipple shield (awkward and messy, and almost impossible for me to maneuver in public places, which was discouraging to say the least). I never supplemented with formula—I personally was adamant that I did not want to—and my husband silently supported me through it all. I have to figure that he did, after all, take his friend’s advice to heart: he would put his hand on my back, hug me when I cried in frustration, tell me vaguely that I was “doing a great job,” and run to get a clean saucer for me to put the nipple shield down, but he never made any suggestions that I stop or use formula.

Two weeks after birth, however, my baby spontaneously weaned himself from the nipple shield, and my husband must have breathed a sigh of relief as breastfeeding got immeasurably easier for us.

Now, though, almost nine months later, we’re reaching another critical test of Ben’s advice. All of a sudden people are asking when I’m going to wean my baby, as though the same behavior which was admirable a few months ago is now about to cross a line and verge on the inappropriate. Watching our long-legged son crawl up to me, grunt at my breast, and then sprawl to nurse, my husband did say, once last week, that he wondered when I was going to stop breastfeeding. “When Marcus wants to!” I snapped. “But what if. . .” my husband began. “Honey,” I said, “remember that thing Ben said about supporting me in whatever my decisions are about nursing?” My husband was quiet, and just put an arm around Marcus and me as the baby kept chugging along.

For now, at least, Ben’s advice is getting us through.

–Christina

Don’t miss these posts from other bloggers:

13 May 2009 at 1:52 pm 8 comments

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