Pit to distress (you’re so brave to birth in a hostpital!)

I just learned about “pit to distress,” the practice of intentionally dosing a laboring woman with so much pitocin (artificial oxytocin) that it puts her baby in distress.

I couldn’t blog about it better than this mom:
http://keyboardrevolutionary.blogspot.com/2009/07/just-when-id-thought-id-heard-it-all.html

So yes, I birth at home, and that’s in great part for the safety of the birth, my baby, and my body.

“How did you do it without drugs?”

My first birth was a beautiful homebirth without any of what I considered at the time to be interventions.  I labored in my bedroom with my husband, both of our mothers, our lovely midwife Marianne, and her birth assistant Michelle.

Years later, a friend of mine from college asked me how I did it.  “I couldn’t have done it without pain medication!”

It wasn’t rhetorical, she was waiting for my answer, and I didn’t know what to say!  I was at a loss.  I didn’t know how I did it.  I didn’t have a method or a system.  It was birth–it’s inevitable!

I know so much more about typical medicalized birth now, that I can imagine the reasons why she couldn’t do it.

I wish I could have the conversation again, my big chance to educate her.

Was she given anything to stimulate, or hurry labor?  Artificially induced contractions are reportedly much more agonizing that natural ones, with the added problem of trying to birth a baby that was not ready yet–an uphill battle that may take longer and “require” more interventions (natural labor begins when all maternal and fetal systems are ready, and that is a moment that doctors have been unable to understand or predict).

Did she have a pain killer that failed to complete mask the pain, or which wore off so that she felt the subsequent pain?  Such interventions interfere with the body’s system of combining oxytocin to cause contractions with endorphins to give the mother and baby a natural morphine-like pain relief.  They prevent the body from laboring as intended, and from providing the mother and baby with the means to withstand the strength of the labor.  Since the mother did not have the benefit of the gradual building up of contractions along with the endorphins, when pain relief does wear off, the sudden pain can be shocking and intolerable.

Was she in one position, lying flat on her back?  The only position known to be less conducive to childbirth is possibly hanging by one’s feet.  Lying on the back can deprive the baby of oxygen rich blood and cause fetal distress.  It can severely slow the progress of labor which is naturally helped by gravity when a mother is in an upright position, and by a frequent changing of positions to help the cervix and vaginal opening open up.  Lying on the back also closes the vaginal opening by about 30%, making it hard for a baby to squeeze through and is probably the leading cause of diagnoses of CPD (baby doesn’t fit through pelvis) and “failure to progress.”

Was she deprived of food and drink during labor?  Labor is probably the greatest test of human endurance and the super-human strength required is unlikely to be mustered without sufficient nutrition throughout what is often a marathon of a process!

Were there, did she, did they, so many things could have contributed to her needing pain relief.  What she experienced was likely not the natural course of labor, and the natural course of labor is something that is so rewarding and worthwhile, I wouldn’t want anyone to miss it.  I’m even sorry for my husband!

It’s worth noting that not least among interventions that might have intervened with the natural course of labor, are the interruption of labor that accompanies transport to the hospital, the discomfort of an unfamiliar location with a multitude of unfamiliar faces, the various moods of those various faces, the cool air and cold mein of the hospital setting, the time-limits afforded birthing women, and the schedule of the average birth that is expected to be conformed to.

In contrast, what encourages a body to relax and open up is privacy, confidence, comfort, freedom to move and change position instinctively, and all the time in the world because some births take minutes and some take days.

I am surprised anyone at all manages to birth naturally in a hospital.

VBAC born out of self-preservation . . .

In the book “Silent Knife” by Nancy Wainer Cohen and Lois J Estner, Nancy’s husband Paul, in giving his account of their birth stories, states that his wife’s “obsession with having a VBAC was born out of self-preservation.”

I think he has hit upon something very important here.  In my plans for a VBAC, I sometimes feel slightly ridiculous in my obsession, even in front of my husband who is 100% supportive of my VBAC and never wants either of us or our babies to see the inside of a hospital again.

My cesarean was very traumatic for him, as well as for me, though our experiences and thoughts and emotions must have been traveling different paths and I cannot say that I know “how he feels” in any inclusive way.

But despite his resolve that our babies not be born by cesarean, I do feel embarrassed by my outright militance on the subject, my constant talking about and reading about and planning about it.

Why can’t I just decide to have a VBAC, and settle back contentedly to wait for it?

I believe it is because we humans, men and women, are most healthy, vital, strong, and human when we are able to create our environments, to bethe cause of our own outcomes, not the victims.

Some women plan a cesarean and no doubt have a much cheerier time of it than I did.

As for me, I am fighting against what happened to me, and the threat of what might happen again.  I am passionate beyond reason, because passion is not reasonable.

I have come far enough that I am not afraid of the birth, I have absolute knowingness that I can birth this baby naturally, and I am convinced of the strength and sanctity of my uterus, it’s ability to heal and to rebulid strong muscle fibers.  I’m not scared or worried in the least.

But I am still militant.

The funny thing is that my cesarean is not one that I feel tricked or mislead into.  Unlike most mothers who get surprise cesareans, I am not bitter towards the doctors, but grateful for their attempt to save my baby’s life.  My baby was in danger, unrelated to birth or labor (which were not naturally imminent).  Ours was a rare situation, and one that, for us, did warrant medical intervention.

So if I don’t feel cheated, why am I so militant?  Maybe it’s because they told me I could never birth vaginally again.

Then again, maybe a challenge is just what I need.

Millions of Peaches

Peaches for me!  On two separate days now I’ve had to tell our four year old friend Serena that no, she could not have a peach because I am pregnant and need ALL the peaches.

I’ve been eating three a day!

They are so good!

So much for teaching sharing!

Looking for the perfect diaper bag

I thought since I don’t need much for this baby, maybe I can get a few really choice things via registry.  I’ve always been a cheap-black-backpack-instead-of-a-diaper-bag-because-I-already-have-one-in-the-back-of-the-closet kind of girl.

But it wasn’t ideal.  I’d like to have had more pockets.  I’d like it to have different kinds of closures.  I’d have liked it to be prettier.

So now I’m looking for my ideal diaper bag.  I can ask for it and see what happens, and there’s always the backpack to resort to.

Criteria:

I actually like a backpack style–very comfy.  Not sure if messenger bag would work as well for me, but it might.  I don’t like a one shoulder bag.

As mentioned, I’d like several little pockets for little things so I don’t have to rummage.

I’d like the pockets to close somehow so things don’t fall out.

I’d like the top of the bag to close so I can toss it upside down in the car.

I’d love to find one that some hippie chick made (whether it was intended to be a diaper bag or not) with colorful corduroy patches or hand embroidery in meaningful designs . . .

Not sure this exists.  Here’s what I’ve found so far:

Chasing the hippie angle, the best I could find were these, not made to be diaper bags and lacking some of the features I think I really want: http://www.textilefetish.com/largebags.htm

Hmm, I kind of like this, but it isn’t beautiful–maybe I could do my own patches or embroidery on an otherwise functional bag.  This one can be messenger or one shoulder, so I could see what works . . .
http://www.toysrus.com/product/index.jsp?productId=2839066

And now for something completely different: http://www.petuniapicklebottom.com/collections/scout/journeypack/heatheredolivegreen/ I think that’s pretty cool.  But what the hell does this mean: Dimensions : 14”L x 16” W x 14”H x 5.5”D  I can’t figure out where they get all those dimensions.  It’s a bag from the fourth dimension!

This almost appeals to me, but to much antimicrobial, memory foam, and waterproof teflon coating.  Probably convenient but I’m all about some less processed materials (cotton?) and I think bacteria are good for kids . . .
http://www.milkface.com/detail.aspx?ID=48099

This one might be perfect: http://www.milkface.com/detail.aspx?ID=47996

This seems to be the same one in a different fabric and I really like the color: http://www.embellishedmom.com/kecci-shang-blue.html

One of those last two might really be the answer–not exactly what I pictured, but pretty darn close and I like what I see!

VBAC birth stories

This one isn’t so much a birth story as it is the story of how this woman found how to have a perfect birth after two cesareans and I think it is so helpful and beautiful for any woman who feels she needs the healing of a natural birth:

http://birthlove.cyclzone.com/pages/csec_vbac/success/kiley.html

I love this great unassisted homebirth story:

http://birthlove.cyclzone.com/pages/stories/micklyn.html

This is the birth story of a woman’s homebirth after 3 cesareans.  She found an amazing midwife and did everything she wanted to do:

http://birthlove.cyclzone.com/pages/csec_vbac/susanne_tristan.html

Okay, here’s just the whole page full of birth stories (VBACs).  I haven’t read them all yet, but it’s  a great collection:

http://birthlove.cyclzone.com/pages/csec_vbac/vbac_stories.html#ucvbac

I’m not hungry anymore . . .

I’ve been ravenous, and mostly for meat.  But the past week that has faded and my usual pre-pregnancy appetite is back.

My calculations put me at 12 weeks pregnant on Thursday, so maybe that was a first trimester thing.

Of course, I’m very unsure of the date of conception . . .

risks of uterine rupture–a new perspective

How likely is it that your VBAC uterus will rupture?

-by Eileen and Pat Sullivan

The chances of uterine rupture during labor is 1:333 for one lower transverse scar. Now let’s put the risk in perspective with this list of other risks (based on a 0.3% rupture rate):

Your risk of dying in a car accident, over the course of your lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5 times greater than the risk of uterine rupture.

You’re about twice as likely to have your car stolen (that’s an annual risk) than to experience a uterine rupture.

Your odds of being murdered are 1 in 140 over the course of your lifetime. That’s 2 times more likely than the risk of rupture.

The annual risk of having a heart attack is 1 in 160, 2 times more likely than rupture.

Your risk of dying from heart disease is roughly 1 in 6, or 55 times greater than your risk of rupture.

If you’re a smoker, your risk of dying from lung cancer is 1 and a half times more likely than a VBAC mom rupturing during her labor.

You’re about 17 times more likely to contract an STD this year than you are to have a uterine rupture; more likely to contract gonorrhea than to rupture, as well.

You’re 13 times more likely to get food poisoning than to rupture.

You’re more likely to have twins than a uterine rupture. Odds of twins: 1 in 90. That’s about 3 1/2 times the likelihood of rupture.

If you ride horseback, you’re 3 times more likely to die in a riding accident than you are to experience a uterine rupture.

If you ride a bike on the street, you are 4 times more likely to die in an accident (annual risk) than you are to suffer a rupture.

Having a serious fire in your home during the next year is twice as likely as experiencing a rupture.

You’re ten times as likely to win at roulette as you are to have a uterine rupture.

If you flip a coin, you’ll be more likely to get heads (or tails) 8 times in a row than to rupture.

The risk of cord prolapse is 1 in 37 (2.7%), or nearly ten times more likely than that of rupture.

And a final irony (heads up, those of you who want a doc to give his/her opinion on your likelihood of rupture next pregnancy!)… You’re 6 times more likely to have a doctor who is an imposter than you are to suffer a rupture. Two percent of docs are phonies (1 in 50), according to several sources I found.

So instead of worrying about rupture, why not take a few minutes to check up on your doctor’s credentials? It’d be a more profitable use of your time, and a substantially more likely cause for alarm.

Birth is Safe

I’m pregnant, not sick.  And birth is a celebration, an emergence, NOT and emergency.

It’s ironic that I have come to feel so safe and secure about my pregnancy, labor and birth now, just when the medical profession has come to consider me “high risk.”

I would half expect my interest in unassisted childbirth and insistence on the safety of birth to be a response to lack of options, or a rebellion against the unsavory medical situation I was faced with in my last birth.

It is neither.  Studying childbirth has brought me to a place where I am so much more comfortable with childbirth than I have ever been.  The fact of my scarred uterus is not reassuring, but it is not frightening either.  It is almost irrelevant in it’s microscopic danger.

And, of course, confidence in the safety of birth makes my safe birth so much more likely than if I was uncertain or scared.

What’s that?  Before hospitals women died in childbirth?

News for you–women still do.  Twice as often in cesarean births than in vaginal ones.

It’s true that the chances of a mother dying in childbirth are infintesimal in devloped countries.  For a long time they died because of unsanitary doctors, but now that physicians have figured out the hand-washing thing, that’s not so much a concern (although hospitals are still a dangerous place to birth due to the germs that hospitals host, by nature).

What’s made birth so much safer is nutrition and sensible prenatal care–by which I don’t mean being weighed, measured, and tested so much as excercising, resting, and otherwise following the needs of our bodies.  We can afford to take a few months off from working in the fields.  And we can afford to eat all the food we need, with as much variety as will sustain us healthily.

And most of us have given up wearing corsets to conceal our pregnancies–a terribly unsafe and damaging practice!  My torso is not deformed from a decade of corsets rearranging my organs and changing the shape of my abdomen.

I won’t forget that the availability of emergency medical care makes the difference between life and death in the rare case of a birthing emergency, for which I am thankful.

But the risks of birth are not greater than the risks of life, of driving, boating, flying, walking barefoot, chewing and swallowing, lovemaking, crossing the street . . .

This lifetime I have been closest to death during my cesarean section. My second closest scrape with death was probably when I was run over by a car when I was seven.   Neither occasion saw me in real danger of dying.

And my homebirth was one of the farthest things from death I’ve ever experienced.

Someone asked me whether it wasn’t possible to notify the hospital when I went into labor so they would be ready for my transfer in case something went wrong.  I gently explained that it would be unnecessary and inappropriate, and later I told my husband it would be like notifying the hospital that an elderly person was going to be taking a shower–so please stay on alert in case of an accident.

Why ultrasounds

Why we don’t get ultrasounds:

1. Ultrasound technology has not been proven to be safe for developing babies.
2. Ultrasounds have been shown to affect cell development both by reducing the rate of cell division and increasing the rate of cell death.
3. Studies show that outcomes of pregnancies with ultrasounds are no better than those without.

From http://www.sarahjbuckley.com/articles/ultrasound-scans.htm:

“The casual observer might be forgiven for wondering why the medical profession is now involved in the wholesale examination of pregnant patients with machines emanating vastly different powers of energy which is not proven to be harmless to obtain information which is not proven to be of any clinical value by operators who are not certified as competent to perform the operations.”  –UK radiologist H.D.Meire

Why we are going to get an ultrasound this time:

To ensure that the placenta has not attached to scar tissue from my previous cesarean section.

I could add to the above “why we don’t” list:

4.  Medical testing can quietly undermine a pregnant woman’s own trust and communication with her body and her baby.

In this case, I do want the knowledge of placenta position to increase my trust in my birth, and give me a better base from which to take control and responsibility for my own birth.

We are planning the ultrasound for late in the pregnancy, when it has the smallest chance of doing harm.